Applied Nursing Research最新文献

{"title":"Factors enhancing critical care nurses' utilization frequency of behavioral pain assessment tools for critically ill adults unable to self-report","authors":"Yuan-Mei Liao ,&nbsp;Shu-Fen Niu ,&nbsp;Louise Rose ,&nbsp;Tzu-Ying Wu ,&nbsp;Yen-Kuang Lin ,&nbsp;Jui-Chen Tsai ,&nbsp;Zhi-Han Cai ,&nbsp;Ying-Shan Chen","doi":"10.1016/j.apnr.2025.151963","DOIUrl":"10.1016/j.apnr.2025.151963","url":null,"abstract":"<div><h3>Aim</h3><div>This study investigated the factors associated with nurses' often and routine utilization of behavioral pain assessment tools for critically ill adults unable to self-report.</div></div><div><h3>Background</h3><div>Few studies have explored the factors associated with critical care nurses' utilization frequency of behavioral pain assessment tools.</div></div><div><h3>Methods</h3><div>This cross-sectional study used a questionnaire to collect data from critical care nurses. Descriptive statistics and multivariate multinomial logistic regression analysis were used to present collected data and identify the associated factors.</div></div><div><h3>Results</h3><div>We received responses from 477 nurses. Respondents were classified into three utilization frequency groups–infrequent (≤50 %), often (51–75 %), or routine (&gt;75 %)–use of behavioral pain assessment tools. Factors associated with nurses' often or routine use of behavioral pain assessment tools included receipt of relevant training, perceptions that pain assessment tools and frequent pain assessment and documentation as being extremely important, and being employed at institutions where pain assessment tools were available. Working in surgical units was associated with often use of behavioral pain assessment tools, whereas routine discussion of pain assessment findings during nursing handovers was associated with routine use.</div></div><div><h3>Conclusions</h3><div>Routine discussion of pain assessment findings during nursing handovers influenced nurses' utilization frequency of behavioral pain assessment tools. The identified associated factors are modifiable and, therefore, amenable to healthcare quality improvement projects. Well-structured interventions and interprofessional educational programs, including discussion of pain assessment findings during nursing handovers, prioritization of pain healthcare quality, utilization of adequate tools to assess pain, and strategies for effective communication between healthcare providers, should be delivered regularly.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151963"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network analysis and within-unit correlation of nurse fatigue and recovery measures and their association with unit manager fatigue and recovery","authors":"Hyeonmi Cho ,&nbsp;Anne L. Thatcher ,&nbsp;Linsey M. Steege","doi":"10.1016/j.apnr.2025.151958","DOIUrl":"10.1016/j.apnr.2025.151958","url":null,"abstract":"<div><h3>Background</h3><div>Nurse fatigue and recovery can influence staff well-being and patient outcomes. Understanding the relationships among different types of fatigue and recovery and the extent to which these measures are shared among nurses within the same unit is crucial for guiding effective interventions. Examining the relationship between unit managers' fatigue and recovery levels and those of staff nurses is also important, given managers' impact on unit dynamics and support.</div></div><div><h3>Aim</h3><div>This study aimed (1) to explore connections among nurse fatigue (mental, physical, acute, chronic) and inter-shift recovery using a network-based approach; (2) to quantify the extent to which fatigue and recovery vary among nurses within the same unit; and (3) to investigate the relationship between unit managers' and staff nurses' fatigue and recovery levels.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive study was conducted from April 2021 to July 2022 in 24 units across three U.S. Midwest hospitals. Data were collected via surveys from 24 managers and 598 staff nurses. Network analysis was used to map and identify central connections among fatigue and recovery measures, intra-class correlations were calculated to assess within-unit variability, and linear mixed models were employed to examine manager–staff relationships.</div></div><div><h3>Results</h3><div>Physical fatigue emerged as a central element within the network of fatigue and recovery measures, strongly connecting to other measures. Intra-class correlation values indicated that acute and physical fatigue varied meaningfully between units, while mental fatigue showed minimal variation. Unit managers' acute and physical fatigue levels were significantly associated with those of staff nurses.</div></div><div><h3>Conclusions</h3><div>The findings suggested the importance of physical fatigue as a leverage point for targeted interventions and highlight the need for unit-specific strategies that address both individual and collective sources of fatigue. By integrating a network-based perspective and examining manager–staff relationships, this study offers practical insights to improve nurse well-being and strengthen effective leadership.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151958"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' perceptions of care practices for adults with cognitive impairment in hospital: a cross-sectional study","authors":"Erin Rachel Davis ,&nbsp;Christina Aggar ,&nbsp;Michelle Bissett","doi":"10.1016/j.apnr.2025.151953","DOIUrl":"10.1016/j.apnr.2025.151953","url":null,"abstract":"<div><h3>Aim</h3><div>To explore nurses' perceptions of care practices for adults with cognitive impairment.</div></div><div><h3>Design</h3><div>A cross-sectional survey using an amended psychometrically tested tool. This cross-sectional study followed the STROBE guidelines.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with nurses working on select surgical and medical hospital wards in 9 hospitals across a regional health district in NSW, Australia. Participants (<em>N</em> = 235) completed a survey which collected relevant demographic information and explored their perceptions of care practices for adults with cognitive impairment. A five-point Likert scale was utilised in the survey, with a higher score indicating higher usage of the care practice. For data analysis, descriptive statistics explored perceptions and correlation analysis examined associations between participant demographics and perceptions.</div></div><div><h3>Results</h3><div>Nurses react with care (median = 3.75) when adults with cognitive impairment display challenging behaviours and most often use their professional knowledge (median = 4.00) as an alternative to physical restraints. The results of this study suggest that nurses' experience and recent education focused on adults with cognitive impairment significantly influenced care practices.</div></div><div><h3>Conclusion</h3><div>Years of experience as a nurse and recent workplace education may positively influence the nursing practice of adults with cognitive impairment. This paper supports the development of mentorship programs led by experienced nurses and the provision of workplace education to improve nursing care practice for adults with cognitive impairment in hospital.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151953"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of enhanced stress resilience training for intensive-care unit nurses: a randomized waitlist control trial","authors":"Soo-Jeong Lee ,&nbsp;Brian Cunningham ,&nbsp;Mya Childers ,&nbsp;Maria Yefimova ,&nbsp;Haeun Kim ,&nbsp;Thomas Hoffmann ,&nbsp;Carter Lebares","doi":"10.1016/j.apnr.2025.151965","DOIUrl":"10.1016/j.apnr.2025.151965","url":null,"abstract":"<div><h3>Background</h3><div>Job stress and burnout are significant problems with negative impacts on psychological and occupational wellbeing of nurses.</div></div><div><h3>Purpose</h3><div>To examine the efficacy of 5-week Enhanced Stress Resilience Training (ESRT) among intensive-care unit (ICU) nurses.</div></div><div><h3>Method</h3><div>This randomized waitlist control trial included 48 ICU nurses in a university medical center in Northern California. The final sample for analysis included 40 nurses, including 18 nurses in the intervention group who completed all five ESRT sessions and provided post-intervention data.</div></div><div><h3>Findings</h3><div>ESRT showed significant intervention effects in improving burnout, in the domains of personal accomplishment at immediately post-ESRT and at 1-month follow-up; but the effect on emotional exhaustion was not significant. For secondary outcomes (mindfulness, resilience, stress, depression, work abilities, professional fulfillment), ESRT showed significant intervention effects at either or both time points.</div></div><div><h3>Discussion</h3><div>ESRT can be an effective intervention to improve the psychological and occupational wellbeing of ICU nurses.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151965"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scenario-based simulation training as a strategy to improve infection prevention and control adherence: A quasi-experimental study","authors":"Soon-Hee Lee ,&nbsp;In-Suk Yang","doi":"10.1016/j.apnr.2025.151966","DOIUrl":"10.1016/j.apnr.2025.151966","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated infections remain a critical global health concern, adversely affecting patient outcomes and increasing healthcare costs. Effective infection prevention and control measures are essential to mitigating healthcare-associated infections, yet traditional educational methods often fail to ensure their practical application.</div></div><div><h3>Objective</h3><div>This study evaluates the effectiveness of scenario-based simulation training in improving infection control knowledge, self-efficacy, and adherence to standard precautions among clinical nurses.</div></div><div><h3>Methods</h3><div>A quasi-experimental pre-test/post-test design with a nonequivalent control group was employed. Sixty-eight clinical nurses were randomly assigned to an experimental or control group. The intervention included four scenario-based simulation sessions on standard and transmission-based precautions. Outcomes were assessed at baseline and two months post-intervention using validated instruments. Data were analyzed using paired <em>t</em>-tests and independent t-tests.</div></div><div><h3>Results</h3><div>Nurses in the experimental group demonstrated significant improvements in infection control knowledge (<em>t</em> = 7.111, <em>p</em> &lt; .001, Cohen's d = 1.725, 95 % CI [1.086, 2.348]), self-efficacy (<em>t</em> = 2.194, <em>p</em> = .032, Cohen's d = 0.532, 95 % CI [0.036, 1.021]), and adherence to standard precautions (<em>t</em> = 4.191, <em>p</em> &lt; .001, Cohen's d = 1.017, 95 % CI [0.476, 1.545]) compared to the control group. These findings underscore the efficacy of simulation training in enhancing infection prevention and control competencies among clinical nurses.</div></div><div><h3>Conclusion</h3><div>Scenario-based simulation training is a valuable educational strategy for improving infection prevention and control practices among clinical nurses. Integrating this approach into infection prevention and control training programs can strengthen infection prevention efforts, enhance healthcare worker preparedness, and improve patient safety.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151966"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential elements and outcomes of psychological safety in the healthcare practice setting: A systematic review","authors":"Rose D. LaPlante MBA, MSN, RN, NEA-BC ,&nbsp;Patricia Reid Ponte DNSc, RN, FAAN ,&nbsp;Cherlie Magny-Normilus PhD, FNP-BC, FNYAM, FAAN","doi":"10.1016/j.apnr.2025.151946","DOIUrl":"10.1016/j.apnr.2025.151946","url":null,"abstract":"<div><h3>Background</h3><div>Psychological safety is considered an essential component of highly effective teamwork in organizations, including healthcare organizations. This systematic review examines essential elements and outcomes of psychological safety in healthcare practice teams to determine best practices for implementing psychological safety.</div></div><div><h3>Method</h3><div>A systematic literature review of published studies that described psychological safety as a variable in healthcare practice settings was conducted. Articles were included if they were published in English, peer reviewed, included nurses or physicians either individually or as part of a team, incorporated psychological safety, presented workforce or patient outcomes, and published in the past 10 years.</div></div><div><h3>Results</h3><div>Out of 220 articles, 30 met the inclusion criteria. This review identifies five essential elements and outcomes of psychological safety in healthcare.</div></div><div><h3>Conclusion</h3><div>This systematic review corroborates the importance of psychological safety to healthcare teams. Directing resources toward ensuring the implementation and enhancement of psychological safety in healthcare teams would improve the likelihood of reliable, safe, and high-quality healthcare delivery.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151946"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between perceived and actual diabetes knowledge among nurses in an outpatient setting","authors":"Shannon Knapp ,&nbsp;Melissa Matras ,&nbsp;Susan Cotey ,&nbsp;James Bena ,&nbsp;Sarah Kirschling ,&nbsp;Lee Anne Siegmund","doi":"10.1016/j.apnr.2025.151944","DOIUrl":"10.1016/j.apnr.2025.151944","url":null,"abstract":"<div><h3>Background</h3><div>Nurses' perceived basic diabetes knowledge may not align with actual knowledge of diabetes basics. Prior to this study, little was known about basic diabetes knowledge among outpatient nurses.</div></div><div><h3>Method</h3><div>Surveys were used to collect data to identify differences between perceived and actual knowledge among outpatient nurses and data were analyzed using Kruskal-Wallis and Spearman's correlation as appropriate.</div></div><div><h3>Results</h3><div>There were 492 participants. Perceived knowledge was associated with actual (<em>p</em> = 0.009); however, the effect size was small (<em>r</em> = 0.12), indicating an unlikely correlation. Actual knowledge scores were higher for those who obtained diabetes information from job experience, recent continuing education, and those who reported having diabetes. Item discrimination showed higher overall test scores with higher item scores (&gt;0.15).</div></div><div><h3>Conclusions</h3><div>Correlation between actual and perceived knowledge was negligible, indicating nurses may think they have high diabetes knowledge when they may not. Results reflect the need for ongoing diabetes continuing education for outpatient nurses, regardless of specialty.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151944"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bibliometric study of compassion fatigue, compassion satisfaction, secondary traumatic stress, and professional quality of life in nursing research","authors":"Neta Roitenberg","doi":"10.1016/j.apnr.2025.151956","DOIUrl":"10.1016/j.apnr.2025.151956","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this study was to conduct a bibliometric analysis of the thematic advances and trajectory of compassion fatigue, compassion satisfaction, secondary traumatic stress, and professional quality of life in the field of nursing.</div></div><div><h3>Design</h3><div>Bibliometric analytic methods.</div></div><div><h3>Methods</h3><div>The Bibliometrix Package in R software was used to analyze the data and create the graphic illustrations. The methods used included descriptive analysis, citation analysis, collaboration analysis, co-word analysis, and thematic map analysis.</div></div><div><h3>Data sources</h3><div>On April 5, 2025, bibliometric data was downloaded from the Web of Science Core Collection database.</div></div><div><h3>Findings</h3><div>The analysis showed that 3053 authors produced relevant publications between 2001 and 2024, resulting in 1408 author keywords. Over the past 24 years, there has been a generally rising trend in published papers, with an annual growth rate of 23.81 %. The fundamental themes forming the field's backbone were: “empathy,” “compassion fatigue,” “secondary,” “compassion,” and “qualitative.” The main hot research topics were: “mindfulness” and “death.”</div></div><div><h3>Conclusions</h3><div>The growing understanding of the significance of professional quality of life in nursing research is reflected in the bibliometric study, which shows a notable growth in research on the topic. The results show increased interest internationally, with varied collaboration patterns between nations.</div></div><div><h3>Reporting method</h3><div>Complying with accepted bibliometric reporting guidelines (specifically, the EQUATOR recommendations).</div></div><div><h3>No patient or public contribution</h3><div>This study was not designed, conducted, analyzed, interpreted, or prepared by patients; rather, it is based entirely on previously published material.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151956"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation and psychometric validation of the Indonesian questionnaire for evaluating nurses' adherence to pressure ulcer prevention guidelines","authors":"Defi Efendi ,&nbsp;Amil Tan ,&nbsp;Bejo Utomo ,&nbsp;Chiyar Edison ,&nbsp;Min-Huey Chung ,&nbsp;Muhammad Muslih ,&nbsp;Rini Wahyuni Mohamad ,&nbsp;Nyimas Sri Wahyuni ,&nbsp;Habibah Muchtar ,&nbsp;Aip Rukmana ,&nbsp;Wong Cho Lee ,&nbsp;Dessie Wanda","doi":"10.1016/j.apnr.2025.151962","DOIUrl":"10.1016/j.apnr.2025.151962","url":null,"abstract":"","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151962"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges navigating thymectomy with myasthenia gravis: A qualitative study of patient treatment experiences","authors":"Malene Missel ,&nbsp;Rene Horsleben Petersen ,&nbsp;Erik Lilja Secher ,&nbsp;Estephani Birkenfeldt Zeballos Medeiros ,&nbsp;Katrine Rude ,&nbsp;Joan Lilja Sunnleyg Højgaard ,&nbsp;Niels Erik Viby ,&nbsp;Simone Birnbaum ,&nbsp;Nanna Witting ,&nbsp;Linda Kahr Andersen","doi":"10.1016/j.apnr.2025.151961","DOIUrl":"10.1016/j.apnr.2025.151961","url":null,"abstract":"<div><h3>Aim</h3><div>This study explores myasthenia gravis patients' experiences with the thymectomy treatment pathway.</div></div><div><h3>Background</h3><div>Myasthenia gravis is a chronic autoimmune neuromuscular disorder causing skeletal muscle weakness. While thymectomy can alleviate symptoms, little is known about patients' subjective experiences.</div></div><div><h3>Methods</h3><div>An exploratory qualitative design was employed, utilizing interviews with 10 individuals with myasthenia gravis who have undergone thymectomy. Data analysis involves thematic analysis to identify common patterns and themes in patients' experiences.</div></div><div><h3>Results</h3><div>Derived from the collected interviews, challenges and experiences perceived by individuals with myasthenia gravis throughout the thymectomy treatment pathway was described. Patients narrated about feelings of being caught in a fragmented process contributing to their sense of uncertainty. Despite these challenges, positive experiences were also expressed, emphasizing the importance of individualized acknowledgment of patient needs. Despite a well-organized and streamlined treatment pathway in a highly specialized thymectomy center, patients felt that their body was split in two and highlighted the need for better integration between specialities, as well as greater understanding and support from surgical nursing staff. Furthermore, patients expressed uncertainties regarding postoperative care, underscoring the need for clearer guidance and support beyond the surgical hospital stay.</div></div><div><h3>Conclusions</h3><div>Addressing individual patient needs, enhancing interdisciplinary coordination, and strengthening surgical nursing support can improve the thymectomy experience. Post-surgical discharge follow-up plans are essential for providing comprehensive care and meeting the diverse needs of individuals with myasthenia gravis throughout their medical and surgical treatment journey.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"83 ","pages":"Article 151961"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}