Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Health System Organization and Logistics of Trauma Care Since the Russian Invasion of Ukraine: A Qualitative Assessment.","authors":"Lynn Lieberman Lawry, Miranda Janvrin, Jessica Korona-Bailey, Christian Betancourt, John Maddox, Kyle Patrick Apilado, Luke Juman, Vivitha Mani, Amandari Kanagaratnam, Zoe Amowitz, Tiffany E Hamm, Oleh Berezyuk, Tracey Pérez Koehlmoos","doi":"10.1177/00469580251333327","DOIUrl":"https://doi.org/10.1177/00469580251333327","url":null,"abstract":"<p><p>The February 2022 Russian invasion in Ukraine delayed healthcare reforms. The conflict has led to disruption of medical supply chains and a rapid need for integration between military and civilian entities. This study aims to assess the organization and logistics of the Ukrainian trauma system since the Russian invasion. Qualitative key informant interviews were conducted among Ukrainian military and civilian health care workers using a Ukraine Trauma System Assessment Tool from September 2023 to February 2024. Thematic content analysis was used to derive key themes related to medical logistics and organizational leadership from interviews. Thematic saturation was reached after 36 key informant interviews. Respondents described the roles of the Ministry of Health and Ministry of Defense, as well as the collaboration and integration between military and civilian trauma systems with medical logistics as a key area of focus. Respondents discussed on-going efforts to develop a centralized logistics system to better coordinate supplies and overcome current bureaucratic and communication challenges. The organizational structure and the logistics of the trauma care system in Ukraine are integral to the facilitation of healthcare delivery among both the civilian and military health systems. While rapid coordination has supported triage and increased the efficiency of resources, barriers are still recognized by healthcare personnel including disruptions in the medical supply chain, unpreparedness for large-scale combat operations, inadequate training, outdated equipment, and attacks on infrastructure.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251333327"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Cardiovascular Surgery Intensive Care Nurses in the Care of Patients With Postoperative Cognitive Dysfunction: A Qualitative Study.","authors":"Hatice Azizoğlu","doi":"10.1177/00469580251332061","DOIUrl":"https://doi.org/10.1177/00469580251332061","url":null,"abstract":"<p><p>Postoperative cognitive dysfunction (POCD) is the development of cognitive decline following anesthesia and surgery. The incidence of POCD is more pronounced in patients undergoing cardiac surgery than in patients undergoing non-cardiac surgery. This study aims to evaluate the experiences, knowledge status, and clinical practice interventions of nurses caring for patients diagnosed with POCD. Ten nurses working in the intensive care unit of cardiovascular surgery participated in this study, which used a phenomenological design, one of the qualitative research types. We collected the data face-to-face between January and March 2023 using the individual in-depth interview method. The data were analyzed by the researcher using thematic analysis. The study identified 13 main themes: cognitive, behavioral, emotional problems, occupational difficulties, increasing duration, age, premorbid period, psychological resilience, effective coping skills, interaction, restraint, external support systems, and cognitive structuring. After cardiovascular surgery, patients should be evaluated not only for cardiac but also for cognitive, emotional, and behavioral factors. In addition, the risk factors that cause POCD, the difficulties faced by nurses, and their coping skills are the effects that shape the patient care process of POCD.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251332061"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of 340B Program Drug Margins with Covered Entity Characteristics.","authors":"Robert J Nordyke, James Motyka, Julie A Patterson","doi":"10.1177/00469580251324051","DOIUrl":"10.1177/00469580251324051","url":null,"abstract":"<p><p>The 340B Drug Pricing Program aims to help facilities serving low-income and uninsured patients to stretch scarce resources by allowing covered entities to purchase outpatient drugs at federally mandated discounted rates while often receiving reimbursement for them at higher rates by commercial payers and Medicare. Despite increasing focus on the expansion and impact of the program, profit margins under 340B have not been fully explored. We aimed to examine drug-, facility-, and geographic-level factors that influence drug margins among 340B covered entities. We conducted a cross-sectional analysis of predictors of facility-level 340B margins for 5 drug classes in a multivariable regression model using 2021 data linked across multiple proprietary and public datasets. Regression results show that drug, facility characteristics, and geographic healthcare market-level characteristics influence drug margins under the 340B program. Adjusted 340B margins were higher in hospital outpatient departments than free-standing offices (ie, hospital-affiliated physician offices and independent, 340B eligible clinics) and among covered entities in more concentrated (ie, less competitive) markets. Covered entity market power, quantified by a facility-level measure of non-340B drug margins indicating pricing power, and area wealth were both associated with higher 340B drug margins. Margins on 340B drugs were higher among facilities in stronger bargaining positions and those serving wealthier areas. These findings add to the growing body of literature on expansions of the 340B program into more affluent communities, informing calls for reforms to ensure the 340B program serves low-income and uninsured patients.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251324051"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Effect of the COVID-19 Pandemic on Community Health Services: A Pre-post Analysis.","authors":"Prabhjot Kaur Juttla, Bernard Kimani, Moses Kamita, Teresia Kariuki, Naomi Wachira, Alfred Owino Odongo, Magoma Mwancha-Kwasa","doi":"10.1177/00469580251338681","DOIUrl":"10.1177/00469580251338681","url":null,"abstract":"<p><p>Following COVID-19 containment measures, healthcare service utilization was expected to decline, including in Kenya, across all healthcare tiers. We investigated the impact on community-level health indicators before and during the pandemic. This pre-post study examined community health utilization in 2019 (pre-pandemic) and 2020 (pandemic year) from March to December. Normality was assessed using the Shapiro-Wilk test, followed by Mann-Whitney <i>U</i> or Welch <i>t</i>-tests as appropriate. During the pandemic, facility deliveries (159.2 ± 39.0 vs 496.4 ± 288.2; +237.96%, <i>P</i> = .0232) and ANC referrals (191.0 ± 55.3 vs 630.1 ± 287.2; +229.89%, <i>P</i> = .0008) increased significantly. Child immunization referrals also rose (57.3 ± 11.7 vs 350.2 ± 259.3; +511.17%, <i>P</i> = .0060), while diarrhea treatments in children declined (59.2 ± 47.6 vs 9.2 ± 6.7; -84.46%, <i>P</i> = .0001). Diabetes referrals increased (108.7 ± 65.3 vs 319.5 ± 310.2; +211.15%, <i>P</i> = .035). Households with handwashing facilities saw a non-significant rise (78073.7 ± 16367.9 vs 118457.9 ± 90291.8; +51.73%, <i>P</i> = .3527). Community-level prevention and promotion programs persisted and were enhanced, due to increased fiscal and training support. Even amid crises, community health strategies can adapt and thrive with proper training and funding.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251338681"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endorsement of the Lisbon Outcome Statement and Launch of a National Programme for Age-Friendly Cities and Communities in Portugal.","authors":"Miguel Arriaga, Yon Yongjie, Thiago Herick de Sa, Ana Justo, Gisele Câmara, Andreia Costa","doi":"10.1177/00469580241298829","DOIUrl":"10.1177/00469580241298829","url":null,"abstract":"<p><p>Portugal is one of the European Union countries with the highest rates of people aged 65 or more. The old-age dependency index is the third highest in Europe. Longevity is a remarkable human achievement but without a comprehensive approach to fostering healthy ageing over the life-course, the burden on health and care systems and social services will increase. This issue is compounded as life expectancy rises, but many of these additional years are not lived in good health. Promoting healthy ageing is an essential political and moral strategy for the well-being both of individuals and societies. Concerning this, Portugal endorsed the Lisbon Outcome Statement drawn up based on the 2023 Regional Summit on Policy Innovation for Healthy Ageing and made its commitment for the creation of age-friendly environments. The National Programme for Age-Friendly Cities and Communities in Portugal is one of the first concrete steps to fulfill that endorsement.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580241298829"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Intelligent Delivery Systems and Automated Rail Logistics on the Efficiency and Safety of Clinical Item Transportation: A Observational Studies.","authors":"Yi Li, Ping He, Xue-Lian Peng, Min Peng","doi":"10.1177/00469580251314760","DOIUrl":"10.1177/00469580251314760","url":null,"abstract":"<p><p>This paper aims to establish an intelligent delivery system integrated with track logistics and explores its impact on the clinical transportation of goods. The study analyzed hospital delivery items before and after the implementation of an intelligent delivery system combined with automated track logistics in 2023. Delivery conditions prior to the system's activation served as the control group, while those post-implementation formed the observation group. This research assesses the effects on transportation efficiency, resource allocation, transport safety, and satisfaction among medical staff. The average delivery time of goods significantly decreased following the adoption of the intelligent delivery system combined with automated track logistics (<i>P</i> < .01). The total number of adverse delivery-related events was reduced from 25 to 4 (<i>P</i> < .01). Departmental medical staff reported substantial increases in scores for delivery efficiency, error incidence, and overall satisfaction with the delivery process (<i>P</i> < .01). The integration of the intelligent delivery system with automated track logistics significantly enhances the efficiency of clinical goods transportation, optimizes resource allocation, ensures the safe transport of items, and improves the patient experience and clinical staff satisfaction with delivery operations. Regular system maintenance and adjustments, supported by professional technical personnel, are essential to fully leverage the system's advantages.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314760"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System.","authors":"Connor M Warren, Laura Ellen Ashcraft, Amanda Peeples, Kirstin Manges Piazza, Octavia Goodman, Laura N Gitlin, Judith A Long, Robert E Burke, Rachel M Werner, Rebecca T Brown","doi":"10.1177/00469580251322364","DOIUrl":"10.1177/00469580251322364","url":null,"abstract":"<p><p>The Tailored Activity Program (TAP), an intervention for people living with dementia (PLWD) and their caregivers, has been shown to reduce behavioral symptoms for PLWD and caregiver burden. While TAP is proven as an evidence-based practice (EBP), it has yet to be implemented at scale. The Department of Veterans Affairs (VA) has prioritized the Age-Friendly Health System (AFHS) initiative, providing an opportunity to test implementation of TAP in a complex healthcare system. We conducted semi-structured pre-implementation interviews with leaders and clinicians at 6 VA Medical Centers (VAMCs) to engage key implementation partners and understand their unique implementation contexts. We utilized team-based rapid qualitative analysis to identify themes related to implementation determinants. We interviewed 65 unique informants in 58 interviews (5 VAMC leaders, 36 department leaders, and 17 frontline clinical staff). Informants identified 4 key factors critical to consider prior to implementing TAP: (1) alignment with organizational priorities; (2) perceived value and fit with existing clinical workflows; (3) competition with existing organizational and clinical priorities; and (4) considerations about the effect of caregiver burden on participation. We identified key factors to consider for successful implementation of a multicomponent intervention for PLWD and their caregivers within a complex healthcare system. As the AFHS initiative expands, there is a growing need for EBPs focused on the care of PLWD and their caregivers. These factors can guide clinicians, leaders, and implementation scientists in planning for implementation and sustainment of EBPs to bolster AFHS initiatives.Trial RegistrationRegistered 05 May 2021, at ISRCTN #60,657,985.Reporting GuidelinesThe COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to ensure proper standards for reporting qualitative studies (see attached).</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251322364"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4 Steps to 4Ms: A Navigation Guide for a Hospital-Based Composite Measure of 4Ms Care and the Implications for Outcomes Assessment.","authors":"Benjamin Rosner, Robert Thombley, Stephanie Rogers, Julia Adler Milstein","doi":"10.1177/00469580251323135","DOIUrl":"10.1177/00469580251323135","url":null,"abstract":"<p><p>The 4Ms Framework is the foundation of the Age-Friendly Health System (AFHS) movement. While the framework is based on standalone evidence for each M, there is limited evidence about the impact on outcomes when practiced as a set. A composite measure capturing adherence to the many care processes that comprise the 4Ms is a necessary but complex component of closing the evidence gap. We offer a navigation guide that addresses key considerations for developing a hospital-based composite measure of 4Ms care. The Institute for Healthcare Improvement operationalizes the 4Ms Framework as a minimum set of Assessment and Act On care processes. In developing a composite measure of inpatient 4Ms adherence, we offer a 4 step framework with associated discussion of considerations related to composite measure type (eg, continuous, dichotomous), and synchrony within and across the Ms containing these care processes. Using real-world electronic health record data capturing care process adherence in the 4Ms implementation at a large academic hospital, we illustrate the considerations, and report the implications for sample size and composite measure scoring. We also present our selected composite measure-a dichotomous measure delineating 4Ms care when all encounter-level processes (those needing to be done only once during the hospital encounter) are followed and all day- and shift-level processes are followed for at least 50% of hospital days. While there is no single, standard approach to create a 4Ms composite at this early stage of the AFHS movement, as organizations develop their measure(s), our guide and the considerations we suggest should serve to inform this process and support progress toward meaningful measurement.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251323135"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies for Implementing Palliative Care Services for Cancer Patients in Low- and Middle-Income Countries: A Systematic Review.","authors":"Neema Florence Vincent Mosha, Patrick Ngulube","doi":"10.1177/00469580251325429","DOIUrl":"10.1177/00469580251325429","url":null,"abstract":"<p><p>Palliative care (PC) services are essential for cancer patients, particularly in low- and middle-income countries (LMICs), where cancer-related deaths are disproportionately high. Despite their significance, access to effective PC remains limited in many LMIC settings. This systematic review aims to identify strategies for implementing PC services for cancer patients in these regions, focusing on the challenges faced. A comprehensive search was conducted for peer-reviewed articles published between January 2004 and July 2024, utilizing the databases Web of Science, Scopus, PubMed, and Google Scholar. The Critical Appraisal Skills Program (CASP) assessment tool was employed to evaluate the quality of the studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for transparency. Out of approximately 966 818 articles retrieved, only 17 studies met the defined inclusion criteria. The findings highlighted effective strategies for delivering PC services in LMICs, including patient navigator-led programs, telemedicine, and home health care services. The review highlighted several interventions for PC services, including massage, Cancer and Living Meaningfully (CALM), and light therapies. However, it also identified significant challenges, such as the educational levels of caregivers, patient acceptance of PC services, logistical issues, medication side effects, and a preference for traditional healing practices. This systematic review highlights the critical need for effective PC services for cancer patients in LMICs, where cancer-related mortality rates remain alarmingly high. By synthesizing data from various studies, this analysis offers a comprehensive framework for developing successful palliative care initiatives in these regions. It emphasizes the importance of training caregivers of cancer patients to enhance their confidence in delivering palliative care services and counseling patients about the benefits of these services. Utilizing this information can help practitioners and policymakers improve palliative care services, ultimately enhancing the quality of life for cancer patients in LMICs.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251325429"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-of-Life Health Costs Were Predicted Primarily by Prior Health Costs, and Secondarily by Temporal, Health and Demographic Factors.","authors":"Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Moshe Hoshen","doi":"10.1177/00469580251326315","DOIUrl":"10.1177/00469580251326315","url":null,"abstract":"<p><p>We examined regression models predicting health services standardized costs (HSSC) during the years preceding death using varied temporal parameters related to the dependent and independent variables. The regression models sought to elucidate how costs before the final year of life, temporal factors, and demographics are associated with costs in the final year. Anonymized data were derived from the records of Israel's largest health maintenance organization for 71,855 people aged 65+ in 2006, who died between 2008 and 2011. In the regression models, the Independent Variables of <i>age</i>, <i>sex</i>, and <i>comorbidity</i> (as measured by the Charlson Comorbidity Index) were significant predictors of the dependent variable of <i>HSSC during the final year of life</i>. However, the strongest predictor (independent variable) of the dependent variable, <i>HSSC in the final year of life</i> was the independent variable, <i>HSSC in the years preceding the final year of life</i>. Prediction was more accurate when the predicting period was closer to the predicted period. Accuracy declined as the predicted period approached death. The results provide insights into methodological considerations in the process of prediction of end-of-life expenditures, which may assist in setting methodological standards that may facilitate arriving at consistent findings in this field. While end-of-life is associated with aberrant increases in costs, that is, increases that deviate from prior predictions, significant predictions can still be made.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251326315"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}