European Geriatric Medicine最新文献

{"title":"Feasibility within-subject RCT of neuromuscular electrical stimulation; an Intervention to Maintain and improve neuroMuscular function during period of Immobility (IMMI).","authors":"Helal B Alqurashi, Tahir Masud, Adam Lee Gordon, Mathew Piasecki, Dominic O'Connor, Katie Robinson, John R F Gladman","doi":"10.1007/s41999-024-01133-4","DOIUrl":"https://doi.org/10.1007/s41999-024-01133-4","url":null,"abstract":"<p><strong>Introduction: </strong>Neuromuscular electrical stimulation (NMES) is a potentially effective intervention to improve outcomes after a fragility fracture, but its feasibility in this group has not been established.</p><p><strong>Methods: </strong>A feasibility study was conducted in two phases: 1) in the hospital only, and 2) hospital, rehabilitation centres, and participants' homes. Patients with fragility fracture were randomised to receive NMES for 6 weeks/discharge either to the right or left leg, with the other leg serving as control. Patients who had no mobility issues had contraindications to NMES and were unable to give consent were excluded. NMES was applied to quadriceps and tibialis anterior muscles for 30 min, 3 days/week. Sessions were progressed to achieve 60 min, 5-7 days/week. Feasibility outcomes included participant characteristics, recruitment rate, tolerability, and number of NMES sessions. Clinical outcomes included muscle strength, and ADL at six months.</p><p><strong>Results: </strong>Overall, 1052 patients were identified, of whom 113 (11%) were eligible, and 29 (3%) were recruited (median Clinical Frailty Score 3, median Barthel ADL score 93/100). The recruitment rate was 0.45/week in phase 1 and 0.9/week in phase 2. Fifty-three percent achieved the target of 24 NMES sessions. However, 5/29 withdrew due to intolerance of NMES. Leg muscle strength improved in both treated and untreated legs, with marginally greater improvement observed in the tibialis anterior of treated legs.</p><p><strong>Conclusion: </strong>Although it would be feasible to evaluate the specific effect of NMES in fragility fracture patients in a multi-centre trial using home-based NMES, this would be possible only in a minority of mildly frail fragility fracture patients with little premorbid disability.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plantar cutaneous sensation is independently associated with postural balance and lower limb motor function in older adults: the Shizuoka study.","authors":"Michitaka Kato, Kazuya Kito, Satoko Nakano, Wataru Nakano, Yasunari Kurita, Yoshihiro Tanaka, Nagato Kuriyama, Kazuya Seto, Etsuko Ozaki, Yasuharu Tabara","doi":"10.1007/s41999-024-01141-4","DOIUrl":"https://doi.org/10.1007/s41999-024-01141-4","url":null,"abstract":"<p><strong>Purpose: </strong>A relationship between decreased plantar cutaneous sensation and impaired balance function has been reported in patients with peripheral neuropathy and diabetes. This cross-sectional study aimed to investigate the relationship between plantar sensation and postural balance, as well as the association between plantar sensation and sarcopenia-related motor function in community-dwelling older adults.</p><p><strong>Methods: </strong>The participants included 1659 community-dwelling older adults with a mean age of 74 ± 5 years, of which 43% were male patients. Plantar cutaneous sensation thresholds were assessed using an automatic plantar sensation testing device. Postural balance was measured using one-leg standing (OLS) time. Grip strength, five-time sit-to-stand (STS) time, and normal gait speed were measured as components of muscle strength and physical function related to sarcopenia. The skeletal muscle mass index (SMI) and leg phase angle were obtained using bioelectrical impedance analysis.</p><p><strong>Results: </strong>Age, sex, body mass index, and leg phase angle, but not SMI and grip strength, were independently associated with the plantar sensation threshold. Plantar sensation threshold was independently associated with the OLS time (P = 0.001) and STS time (P = 0.001) after adjusting for potential confounders. No significant association was found between plantar sensation threshold and normal gait speed (P = 0.741).</p><p><strong>Conclusion: </strong>Plantar sensation was independently associated with postural balance and lower limb function in community-dwelling older adults. The assessment of plantar sensation could be useful for identifying factors contributing to poor postural balance and lower limb motor function.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of determining gait independence using adductor pollicis muscle thickness and skeletal muscle mass index in community-dwelling older adults undergoing outpatient rehabilitation.","authors":"Taisei Ishimoto, Takehiro Fujimoto, Ken Hisamatsu, Nozomi Matsudaira, Hikaru Hayashi, Risako Hashimoto, Yoshio Toyota, Naoki Akazawa","doi":"10.1007/s41999-024-01145-0","DOIUrl":"https://doi.org/10.1007/s41999-024-01145-0","url":null,"abstract":"<p><strong>Objective: </strong>The accuracy of determining gait independence using adductor pollicis muscle thickness (APMT) and skeletal muscle mass index (SMI) in community-dwelling older adults undergoing outpatient rehabilitation remains unclear. The purpose of this study was to compare the accuracy of determining gait independence using APMT and SMI in community-dwelling older adults undergoing outpatient rehabilitation.</p><p><strong>Methods: </strong>This study included 98 older adults (mean age: 85.2 years). Participants received outpatient rehabilitation one to three times a week. The main outcomes were gait independence (functional independence measure gait score: 6 or 7), skeletal muscle mass index (SMI), and APMT. Receiver operating characteristic (ROC) curves of APMT and SMI for gait independence were created, and cut-off values were calculated using the Youden index. Additionally, the area under the curve (AUC) s of the APMT model and the SMI model were compared using the Delong test.</p><p><strong>Results: </strong>Among the 98 participants (male; 19, female; 79), 53 (54.1%) were in the gait independent group. The cut-off value of APMT calculated from the ROC curve was 13 mm; the sensitivity and specificity were 67.9% and 86.7%, respectively; and the AUC was 0.800. The cut-off value of SMI calculated from the ROC curve was 4.6 kg/m²; the sensitivity and specificity were 90.6% and 26.7%, respectively; and the AUC was 0.582. The AUC for the APMT model was significantly higher than the SMI model (P < 0.001).</p><p><strong>Conclusions: </strong>The results of this study show that the cut-off value of APMT for determining the gait independence was 13 mm. In addition, APMT had a higher accuracy of determining gait independence than SMI. This indicates that measuring APMT is more useful for predicting gait independence than SMI in community-dwelling older adults undergoing outpatient rehabilitation.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harmonious ageing: a narrative review of music therapy in the biomedical literature.","authors":"Shaz Raja, Ciara Barry, Rohit Upadhyay, Rana Alash, Méabh O'Raghallaigh, Róisín Hayes, Roman Romero-Ortuno","doi":"10.1007/s41999-024-01146-z","DOIUrl":"https://doi.org/10.1007/s41999-024-01146-z","url":null,"abstract":"<p><strong>Purpose: </strong>As the global population of older adults rises, the United Nations Decade of Healthy Ageing (2021-2030) advocates for disease prevention, management, and enhancing overall wellbeing in older adults. We reviewed the MEDLINE literature under the MeSH term \"music therapy\" (MT), for its role in promoting healthy ageing.</p><p><strong>Methods: </strong>A systematic search of the MEDLINE biomedical database (Ovid) was conducted using \"MT\" and \"Ageing\" as keywords, retrieving relevant full-text studies in English. Preference was given to more recent studies with higher levels of evidence. The studies were categorised according to the biopsychosocial framework into physical, cognitive and social domains, and further subcategorised based on their relevance to disease prevention and management.</p><p><strong>Results: </strong>The initial search identified 1147 articles, of which 75 met inclusion criteria. Studies encompassed both MT and music interventions delivered by non-music therapists. Overall, studies showed benefits in the promotion of physical health, including enhancing exercise capacity and improving fitness among older adults. Results were promising in managing conditions such as Parkinson's disease and frailty. In the area of brain health, studies showed cognitive benefits, particularly in attention and processing speed among older adults. Socially, there was evidence of enhanced quality of life, reduced anxiety and depression, and improved social engagement, including in people living with dementia, underscoring the role of music in fostering emotional connections and mitigating caregiver stress.</p><p><strong>Conclusion: </strong>MT and interventions can enhance biopsychosocial health outcomes in older adults. Research should prioritise isolating MT's specific effects, standardising definitions and methodologies, and exploring therapeutic mechanisms.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dysphagia and social isolation in community-dwelling older people.","authors":"Takuya Maeda, Naoto Kamide, Masataka Ando, Takeshi Murakami, Miki Sakamoto, Takuya Sawada, Yoshitaka Shiba","doi":"10.1007/s41999-024-01140-5","DOIUrl":"https://doi.org/10.1007/s41999-024-01140-5","url":null,"abstract":"<p><strong>Purpose: </strong>This cross-sectional study aimed to clarify the relationship between dysphagia and social isolation among community-dwelling older people.</p><p><strong>Methods: </strong>The study participants were 238 community-dwelling older people (168 women; mean age, 74.0 ± 5.2 years; independent in instrumental activities of daily living, 97%) who lived independently and didn't have a history of cerebrovascular disease. Swallowing function was assessed using the Eating Assessment Tool-10, with a score of ≥ 3 defined as dysphagia. Tongue pressure and oral diadochokinesis (ODK) were assessed as swallowing-related functions. Social isolation was assessed using the 6-item Lubben Social Network Scale. Physical function, cognitive function, and basic attributes were investigated as confounding factors. The relationship between social isolation and dysphagia was examined by logistic regression analysis with social isolation as the dependent variable and swallowing function as the independent variable, adjusted for confounding factors.</p><p><strong>Results: </strong>Twenty-one percent of the participants were classified as social isolation group. A significantly higher percentage of participants with dysphagia were in the social isolation group than in the nonsocial isolation group (odds ratio [OR]: 3.3, 95% confidence interval [CI] 1.4-7.9). No significant association was found between social isolation and either tongue pressure or ODK. Dysphagia was significantly associated with social isolation (OR: 2.8, 95% CI 1.1-6.9), even after adjusting for confounders (physical function, cognitive function, and basic attributes).</p><p><strong>Conclusion: </strong>Dysphagia may be an independent risk factor for social isolation in community-dwelling older people. These findings suggest that dysphagia should be assessed in community-dwelling older people at risk of social isolation.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should formalities be less formal? A comparative study of patient preferences on formalities and accommodation choices from 1999 to 2023.","authors":"Lucy Chapman, Simon Daly, Celia Fernandez, Marie Therese Cooney, Rachael M Doyle","doi":"10.1007/s41999-024-01138-z","DOIUrl":"https://doi.org/10.1007/s41999-024-01138-z","url":null,"abstract":"<p><strong>Purpose: </strong>To explore if patients' preferences regarding formalities and inpatient accommodation during their inpatient hospital experience have changed since 1999.</p><p><strong>Methods: </strong>A ten-item survey was administered to an inpatient sample in an urban teaching hospital and compared with results from a similar survey in 1999.</p><p><strong>Results: </strong>The majority (98.1%; n = 211) of patients in 2023 preferred to be addressed by their first name (73.8%; n = 152 in 1999; p < 0.001). Patient's preference for doctors using their full title fell (72.3% in 1999 versus 36.7% in 2023; p < 0.001). Inpatients in 2023 tended to have no preference regarding their doctor's gender (91.6% versus 80.1% in 1999; p = 0.001) and age (87.0% versus 40.8% in 1999; p < 0.001). Half (52.7%) of inpatients aged above 65 years preferred multi-occupancy wards when compared with those aged below 65 years (32.0%; p = 0.02).</p><p><strong>Conclusion: </strong>Inpatients prefer less formal interactions within the doctor-patient relationship. Multi-occupancy ward accommodation is favored among those above 65 years.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the circadian timing system in sarcopenia in old age: a scoping review.","authors":"Francesco Palmese, Ylenia Druda, Rossella Del Toro, Giorgio Bedogni, Marco Domenicali, Alessandro Silvani","doi":"10.1007/s41999-024-01129-0","DOIUrl":"https://doi.org/10.1007/s41999-024-01129-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia is a progressive and generalized skeletal muscle disorder, involving the accelerated loss of skeletal muscle mass and function, associated with an increased probability of adverse outcomes including falls. The circadian timing system may be involved in molecular pathways leading to sarcopenia in older adults. We aimed to provide an updated and systematic map of the available evidence on the role of the circadian timing system in sarcopenia, specifically related to the aging process.</p><p><strong>Methods: </strong>We developed a scoping review protocol following the PRISMA-ScR guidelines. Searches were conducted on PubMed, Scopus, Web of Science, RESULTS: We identified 373 papers from three online databases, screened 97 for full-text analysis. and selected 37 papers for inclusion. These papers included 17 primary research studies on human persons, focusing on cortisol and melatonin secretion, rest-activity rhythms, chrono-exercise, and chrono-dietary regimens, 9 primary research studies on animal models (mice, rats, fruit flies) focusing on direct expression measurement or mutations of core clock genes, and 11 narrative reviews.</p><p><strong>Conclusion: </strong>While several reports supported the role of the circadian timing system in sarcopenia, specifically related to the aging process, the available evidence is fragmented and limited. The field is thus open to preclinical and clinical research that addresses the wide knowledge gaps in the available evidence, taking advantage of what has already been published to optimize and refine experimental and clinical protocols.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Circulating irisin levels in patients with sarcopenia: a systematic review and meta-analysis\".","authors":"Tomoyuki Kawada","doi":"10.1007/s41999-024-01136-1","DOIUrl":"https://doi.org/10.1007/s41999-024-01136-1","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty, comorbidity, and multimorbidity and their relation with medications adherence in primary care older adults.","authors":"Francesco Lapi, Ettore Marconi, Pierangelo Lora Aprile, Alberto Magni, Davide Liborio Vetrano, Alessandro Rossi, Alberto Pilotto, Claudio Cricelli","doi":"10.1007/s41999-024-01098-4","DOIUrl":"https://doi.org/10.1007/s41999-024-01098-4","url":null,"abstract":"<p><strong>Purpose: </strong>To assess and compare, through a retrospective cohort study, the relationships between frailty, comorbidity, multimorbidity, and levels of adherence to lipid-lowering drugs (LLDs), antihypertensives and antidepressants.</p><p><strong>Methods: </strong>In a primary care database, we selected a cohort of patients aged 60 or older on December 31, 2022. The date of the first prescription of the aforementioned medications was the study index date. Patients with Variable Medication Possession Ratio (VMPR) > = 80% were classified as properly adherent. Frailty (i.e. Primary Care-Frailty Index), comorbidity (i.e. Charlson Index) and multimorbidity (i.e. disease counts) alternatively entered multivariate logistic regressions along with age and sex. Models' performances in prediction of medications adherence were compared in terms of information (AIC; BIC) and discrimination values (AUC).</p><p><strong>Results: </strong>Incident users of LLDs, antihypertensives or antidepressants were 4310 (mean age: 67.9 (SD: 6.9); 56.0% females), 5969 (mean age: 69.1 (SD: 7.6); 58.0% females), and 3834 (mean age: 68.7 (SD: 6.9); 66.5% females), respectively. Among users of LLDs (46% adherent) and antidepressants (22% adherent), those who were moderately or severely frail showed a significant 30-32% decrease in adherence. In contrast, users of antihypertensives (46% adherent) showed a 41% increase in adherence when multimorbid. As a whole, the three multivariate models were equally effective in informing on medication adherence, as per AIC and BIC. They also displayed similar discriminatory ability, with AUC scores ranging from 53 to 58%. Regarding the workload of GPs, the number of elderly patients classified as moderately/high frail was less than those with co-morbidities or multimorbidities. For instance, there were approximately 35 users of antihypertensive medications per GP for the moderately frail group, compared to 46 and 66 for the co-morbid and multi-morbid groups, respectively.</p><p><strong>Conclusions: </strong>These findings showed similar capacity for frailty, comorbidity, and multimorbidity in capturing medications adherence. Given the existence of a validated tool in primary care that aligns well with GPs' workload, frailty seems the most suitable measure for assessing the complexity of older adults in relation to their adherence to long-term medications.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core elements of the perioperative medicine for older people undergoing surgery (POPS) model of care.","authors":"Margot E Lodge, Jugdeep Dhesi, David J H Shipway, Philip Braude, Catherine Meilak, Judith Partridge, Nadine E Andrew, Velandai Srikanth, Darshini R Ayton, Chris Moran","doi":"10.1007/s41999-024-01122-7","DOIUrl":"https://doi.org/10.1007/s41999-024-01122-7","url":null,"abstract":"<p><strong>Purpose: </strong>Hospital surgical services that utilise the approach of the perioperative medicine for older people undergoing surgery (POPS) model of care improve outcomes for older people contemplating and undergoing surgery. Complex models of care like POPS may be difficult to implement without understanding the elements that comprise that model of care. Logic models can be used to aid implementation by visually depicting theoretical relationships between the elements of the model of care. Our objective was to understand the core elements of the POPS model of care at health services other than where it was first developed.</p><p><strong>Methods: </strong>A qualitative case study at three contextually different health services in England with POPS models of care of varying implementation maturity was undertaken. We conducted semi-structured interviews with clinicians and managers involved in POPS (n = 56). The interviews were analysed using inductive and deductive methods.</p><p><strong>Results: </strong>We developed a logic model with seven domains and themes that described the core elements of the POPS model of care compared and contrasted across the three health services. We found POPS could be adapted to 'fit' the local contexts of our study and still achieve its desired outcomes if it remained true to the principles of comprehensive geriatric assessment and optimisation and was delivered by staff with expert skills and attitudes.</p><p><strong>Conclusion: </strong>Our logic model provides potentially generalisable information about the core elements of the POPS service in three health services. This information can be used to aid the implementation of the POPS model of care in healthcare settings similar to our study. Further research may be required to test the logic model in other healthcare contexts.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}