Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

{"title":"Beneficial effects of anticholinesterases: Reducing the anticholinergic load, the missing link of the story?","authors":"Hervé Javelot ,&nbsp;Amélie Rousseau","doi":"10.1016/j.encep.2025.01.010","DOIUrl":"10.1016/j.encep.2025.01.010","url":null,"abstract":"<div><div>Anticholinergic effects are often identified as adverse drug effects. They can manifest at the central level with cognitive disorders and peripherally with various symptoms such as dry mucous membranes, constipation, urinary retention, or even tachycardia. Several studies have also shown that a high anticholinergic burden may be associated with an increased risk of dementia, hospitalization and even mortality. On the other hand, anticholinesterase drugs, through their protective action on acetylcholine, improve cognitive functions but may cause adverse effects such as diarrhea, urinary incontinence, and bradycardia. Large retrospective cohort studies have also shown that anticholinesterase drugs are associated with a reduced risk of mortality. We thus hypothesize, based on these opposing effects, that the symptomatic improvements, both central and peripheral, observed with anticholinesterase drugs could be linked, at least in part, to the reduction of the anticholinergic burden. Further studies are needed to confirm this hypothesis. These studies should investigate the potential positive correlation between the beneficial effects observed with anticholinesterase drugs and the anticholinergic burden.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 332-334"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789304","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":"Sur les pas de Pinel, la psychiatrie francophone rayonne sur la Méditerranée","authors":"Charline El-Hachem ,&nbsp;Elina Dirani ,&nbsp;Rami Bou Khalil","doi":"10.1016/j.encep.2024.09.001","DOIUrl":"10.1016/j.encep.2024.09.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Page 341"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607053","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":"Redefining the relationship in digital care: A qualitative study of the Digital Therapeutic Alliance","authors":"Emilie Stern ,&nbsp;Zélia Breton ,&nbsp;Maïa Alexaline ,&nbsp;Pierre A. Geoffroy ,&nbsp;Catherine Bungener","doi":"10.1016/j.encep.2024.02.011","DOIUrl":"10.1016/j.encep.2024.02.011","url":null,"abstract":"<div><div>Digital therapeutic programs are emerging almost daily, offering the potential to reduce healthcare access inequalities by providing more flexible and accessible care options. However, as with traditional healthcare, the issue of patient engagement is fundamental, and the latest research have reported that fewer than 30% of users complete these programs in their entirety. Hence, many authors emphasize the importance of studying the role of therapeutic alliances specifically adapted to digital care. The therapeutic alliance encompasses the collaborative aspects of the relationship between the therapist and the patient. In this context there is a need to reconceptualize the alliance within the context of digital healthcare as it can enhance engagement, adherence, and the effectiveness of such treatments. The objective of this qualitative study was to identify the components of the digital therapeutic alliance. A thematic analysis has identified three major themes that appear to constitute the digital therapeutic alliance among 44 users of an online program: trust in the program, perception of interactions, and feeling of consideration. These results prompted a discussion of the challenges of digital healthcare, including the terminology to use. The term “digital therapeutic adherence” is proposed, thereby opening up a field for research and clarification of this important concept distinct from traditional alliance.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 227-232"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900170","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":"Evaluation of a medically coordinated care program in the management of autism","authors":"Elodie Schembri ,&nbsp;Elisabeth Jouve ,&nbsp;François Poinso ,&nbsp;Laure Encely ,&nbsp;Marine Viellard ,&nbsp;Arnaud Fernandez ,&nbsp;Jokthan Guivarch","doi":"10.1016/j.encep.2024.04.006","DOIUrl":"10.1016/j.encep.2024.04.006","url":null,"abstract":"<div><div>Autism spectrum disorders (ASD) are neurodevelopmental disorders of varying intensity and disability. The reference health strategy in France for the care of young children with autism is day care hospital (DCH). As the number of places in DCH is insufficient, medically coordinated care programs by the mental health consultation centers (MHCC) are being developed in response.</div></div><div><h3>Objectives</h3><div>Our objective is to evaluate the effectiveness of a medically coordinated care program in a MHCC versus the care in DCH of child psychiatry.</div></div><div><h3>Methods</h3><div>Non-inferiority retrospective study comparing the evolution after one year of care of 20 ASD children divided into two groups DCH and MHCC. In the DCH ASD group, the child is taken care of two half-days a week in a day hospital with individual educational care. In the MHCC ASD group, the child benefits from a medically coordinated care program. The medical care is reinforced by more frequent and longer consultations with guidance offered to parents. In both groups, the child receives speech therapy and psychomotor therapy in private practice at the same rate. Comparison is made using a composite criterion associating CARS-2 and VABS-II. Non-inferiority of the medically coordinated care program in autism in reference to DCH was tested on the difference between the changes (DCH group variation – MHCC group variation) with a non-inferiority threshold of 10% of the initial value of each score.</div></div><div><h3>Results</h3><div>We observed a reduction in autism severity at the CARS-2 and a moderate improvement in socio-adaptive behavior at the VABS-II in both groups. This trend was even more pronounced in the MHCC group than in the DCH group, but only the greater reduction in CARS-2 severity in the MHCC was statistically significant.</div></div><div><h3>Conclusions</h3><div>As it is necessary to integrate the two scales into the composite criterion, it is not possible to retain the non-inferiority of the MHCC with care program. However, both those children followed in DCH and those in the MHCC care program progress. This shows the relevance of the care offered at the MHCC for children suffering from ASD, in the context of a growing lack of space in DCH. The continuation of this research work through multicenter studies with larger numbers could demonstrate the non-inferiority of coordinated care programs in the MHCC versus DCH. It would also allow subgroups to be set up, taking into account the initial characteristics of the children in order to have more precise indications concerning the relevance of each treatment.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 274-279"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545434","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":"What about the relevance of PIP of psychotropics in older psychiatric inpatients?","authors":"Morgane Houix ,&nbsp;Ilia Humbert ,&nbsp;Fanny D’Acremont ,&nbsp;Anne Sauvaget ,&nbsp;Jean-François Huon ,&nbsp;Samuel Bulteau","doi":"10.1016/j.encep.2024.04.005","DOIUrl":"10.1016/j.encep.2024.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>In 2019, a regional survey of potentially inappropriate prescriptions (PIP) of psychotropic drugs in elderly psychiatric inpatients was carried out highlighting their inappropriate use in this population. The aim of this study was to assess the clinical relevance – defined as the provision of an appropriate and necessary treatment, chosen from other alternatives as being the most likely to produce the expected results for a given patient – of these prescriptions considered inappropriate according to current established criteria.</div></div><div><h3>Material and method</h3><div>Patients aged over 75, or 64 to 75 and polypathological with at least one PIP of psychotropic drugs or drugs with a high anticholinergic burden, identified by an audit grid established on the basis of STOPP/STARTv2 criteria and the Laroche list on the prescription at 48<!--> <!-->h of hospitalization, were included. The weighing of the inappropriateness nature of the prescription (resistance to treatment, period of crisis, comorbidities…) was established by a pharmacist-psychiatrist pair on the entire computerized record of the current episode. The clinical relevance of the PIP and the overall prescription was rated as 0 (irrelevant), 1 (partially relevant) or 2 (relevant).</div></div><div><h3>Results</h3><div>Thirty-four patients were included. One hundred and twenty-five PIP of psychotropic drugs were noted: 50.4% concerned benzodiazepines and non-benzodiazepines anxiolytics (BZD/Z), 25.6% neuroleptics (NL), 12% antidepressants (ATD) and 12% drugs with a high anticholinergic burden. On one hand, 49.2% of PIP of BZD/Z, 50% of PIP of NL and 20% of PIP of ATD were considered irrelevant. On the other hand, 49.2% of PIP of BZD/Z, 31.3% of PIP of NL and 13.3% of PIP of ATD were considered partially relevant. Furthermore, 1.6% of PIP of BZD/Z, 18.8% of PIP of NL and 66.7% of PIP of ATD were considered relevant. For PIPs of drugs with a high anticholinergic burden, 80% were deemed irrelevant, 13.3% partially relevant and 6.7% relevant. In all, of the 34 drug prescriptions studied, three (8.8%) were considered irrelevant, 11 (32.4%) partially relevant and 20 (58.8%) clinically relevant.</div></div><div><h3>Conclusion</h3><div>This study highlighted the clinical relevance of more than half the prescriptions considered inappropriate according to current PPI criteria in the elderly. It underlines the interest of a new PPI detection tool for elderly patients with psychiatric disorders.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 267-273"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565081","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":"Non-suicidal self-injury and anorexia nervosa: A systematic scoping review","authors":"Sixtine Sesboüé ,&nbsp;Salomé Grandclerc ,&nbsp;Marie-Rose Moro ,&nbsp;Nathalie Godart ,&nbsp;Corinne Blanchet","doi":"10.1016/j.encep.2024.11.017","DOIUrl":"10.1016/j.encep.2024.11.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Psychiatric comorbidities are frequent in anorexia nervosa, non-suicidal self-injury being one of the more frequent. The aim of this study was to review the literature exploring the links between these disorders and thus to improve our understanding of their causality, risks, and consequences.</div></div><div><h3>Method</h3><div>We used electronic searches in Pubmed, Cochrane, PsychInfo, and Web of Science to conduct a systematic scoping review of the publications dealing with the association between non-suicidal self-injury and anorexia nervosa published through November 2023.</div></div><div><h3>Results</h3><div>The study finally included thirty-three studies, mainly of female adolescents and young women, and most frequently from an epidemiological perspective. The results confirmed a frequent association between non-suicidal self-injury and anorexia nervosa, and a significantly higher prevalence of such self-injury in the anorexia subtype involving binge-eating/purging than in the purely restrictive subtype. This result appears to confirm an earlier finding that only the diagnosis of anorexia nervosa with binge-eating/purging behaviours predicts the occurrence of non-suicidal self-injury during eating disorder. In addition, results reported that the risks of psychiatric comorbidities and of suicide were higher and that the treatment of anorexia was longer and the weight gain slower in those patients.</div></div><div><h3>Conclusions</h3><div>This study confirmed the association between these two disorders which makes their management more complex. More rapid identification of non-suicidal self-injury in anorexia nervosa and a better understanding of its underlying psychopathological processes are needed to propose appropriate multidisciplinary care. More systematic studies on the associations between these disorders are essential.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 318-331"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426713","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":"Factors associated with sexual dysfunction in patients with bipolar disorder","authors":"Mona Lagha ,&nbsp;Wided Homri ,&nbsp;Naouel Dhaouadi ,&nbsp;Sarra Rouached","doi":"10.1016/j.encep.2024.03.008","DOIUrl":"10.1016/j.encep.2024.03.008","url":null,"abstract":"<div><h3>Objectives</h3><div>The aims of our study were to assess the sexual function in men with bipolar disorder type 1 in remission and to determine the various sociodemographic, clinical and therapeutic factors associated with sexual dysfunction.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study over an 18-month period (January 2020–June 2021) in which we included men followed up for bipolar disorder type 1 in the euthymic phase strictly defined by a score &lt;<!--> <span>8 on the Young Mania Rating Scale and a score ≤</span> <span>7 on the Hamilton Depression Rating Scale. Sexual function was assessed using the Arizona Sexual Experiences Scale (Asex) in its Arabic-validated version.</span></div></div><div><h3>Results</h3><div>Sixty patients were included in the study. The mean age was 42.5 (SD<!--> <!-->=<!--> <!-->11.1) years. Among the patients, 68% had sexual dysfunction according to the total score of the Asex scale. According to univariate analysis, several factors were significantly associated with sexual dysfunction in patients with bipolar disorder type 1: age (<em>P</em> <!-->=<!--> <!-->0.001), total number of hospitalizations for thymic relapse (<em>P</em> <!-->=<!--> <!-->0.015), total number of depressive episodes (<em>P</em> <!-->=<!--> <!-->0.006) and depressive dominant polarity (<em>P</em> <!-->=<!--> <!-->0.046). The factors identified as modifying sexuality according to the total score of the Asex scale by multivariate analysis were age at first antipsychotic prescription: <em>P</em> <!-->=<!--> <!-->0.01; ORa<!--> <!-->=<!--> <!-->1.109; 95% CI [1.021–1.206] and number of hospitalizations for thymic relapse: <em>P</em> <!-->=<!--> <!-->0.015; ORa<!--> <!-->=<!--> <!-->1.259; 95% CI [1.046–1.546].</div></div><div><h3>Conclusion</h3><div>Studies assessing factors associated with sexual dysfunction in patients with bipolar disorder type 1 in euthymia were mostly concerned with the effects of psychotropic drugs on sexual function, with factors inherent in bipolar illness itself not widely addressed in the literature. According to the results of our study, sexual dysfunction in patients with bipolar disorder in the euthymic phase is frequent and significantly associated with clinical factors inherent in the bipolar illness itself and its course.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 249-254"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187211","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":"Should the French approval of baclofen for alcohol dependence be extended to abstinence maintenance?","authors":"Benjamin Rolland ,&nbsp;Laurent Karila ,&nbsp;Nicolas Franchitto ,&nbsp;Camille Barrault ,&nbsp;Mickael Naassila ,&nbsp;French Alcohol Society","doi":"10.1016/j.encep.2024.05.001","DOIUrl":"10.1016/j.encep.2024.05.001","url":null,"abstract":"<div><div>Ever since 2018 France has been the only country to approve the gamma aminobutyric acid type B (GABA-B) receptor agonist baclofen for alcohol dependence. This authorization follows a ten-year period of intensive off-label use during which baclofen was used in doses of up to 300 and even 400<!--> <!-->mg per day to support the gradual reduction of alcohol consumption in patients suffering from alcohol dependence. However, in international clinical trials, baclofen has mainly been studied to support the maintenance of abstinence. The French use of baclofen was therefore somewhat atypical as it paved the way for drug-supported approaches to reducing alcohol consumption, even before nalmefene was marketed. In line with this specific use of baclofen, approval was granted only for alcohol reduction support. However, a recent Cochrane systematic review and meta-analysis by Agabio et al. found significant efficacy only for abstinence maintenance, while no significant effect was found on alcohol reduction outcomes and no dose-response relationship was identified in the analyses. The safety of baclofen was judged to be good. Based on these substantial new results, the Société française d’alcoologie (SFA) now considers that baclofen should also be approved for the maintenance of abstinence. The extension of approval should not lead to the removal of the initial indication or the possibility of using high doses, as some patients have found this therapeutic regimen particularly useful for them. France, which has been a open skies national laboratory on the use of baclofen in alcohol dependence for over ten years, should let this original therapeutic option available to patients. However, it should update the regulatory framework defining the main conditions of access to treatment for patients based on the latest and highest scientific evidence.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 335-337"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146779","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":"Representations and knowledge of residents about ADHD in children in two regions in France.","authors":"Thiébaut-Noël Willig, Louise Brun, Anne Piollet, Marie Dajon, Marie-Claire Thiollier, Rémy Assathiany, Pierre Fourneret, Stéphane Oustric, Michel Amouyal, Magali Masse, Anne Monge, Diane Purper Ouakil","doi":"10.1016/j.encep.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.02.002","url":null,"abstract":"<p><strong>Introduction: </strong>In France, knowledge and awareness of childhood ADHD remain insufficient. To guide the development of training programs for medical residents, we assessed the understanding of ADHD among residents in family practice, pediatrics, and psychiatry across two major French regions in 2021.</p><p><strong>Methods: </strong>A SurveyMonkey® survey was distributed to residents in two French regions, gathering information about their training experiences on child/adolescent ADHD, as well as their knowledge and perceptions of the disorder.</p><p><strong>Results: </strong>Among the 251 residents who completed the survey (response rate: 28.5%), 53.4% reported receiving no training on ADHD during their residency. Substantial differences were observed across specialties: 75% of psychiatry residents reported receiving training, compared to only 38% of family practice residents. Even brief training sessions (e.g., one hour) significantly improved knowledge and perceptions of ADHD, with greater effectiveness observed as the duration of training increased.</p><p><strong>Conclusions: </strong>Residency training on ADHD shows potential for improving access to care as post-training knowledge and perceptions align with those of trained practitioners actively managing ADHD in the same regions. Action plans are recommended to enhance training for family practice residents, with follow-up assessments planned using the same methodology.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175694","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":"[Towards an equipped psychiatry].","authors":"Louis Jehel, Mathieu Guidère","doi":"10.1016/j.encep.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.encep.2025.03.002","url":null,"abstract":"<p><p>The article by Moizard and Geoffroy highlights the importance of an integrated approach in psychiatry, emphasizing the need to move beyond the dichotomy between the somatic and the psychic. In their commentary, the authors advocated for precision psychiatry, which leverages the latest scientific and technological advancements. They underscored the necessity of equipping psychiatry with advanced technologies, particularly neuroimaging, artificial intelligence, and digital twins. These tools enable a more rigorous and personalized approach to mental healthcare grounded in specific biomarkers and precise modeling of psychiatric disorders.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144311","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}