Canadian Geriatrics Journal最新文献

{"title":"Breaking the Inverse Care Law for Fall Prevention Programs: a Collaborative and Community-led Approach.","authors":"Nicholas C Chan, Joe Pedulla, Alicia Remark, Sue Bartleman, Ana Macpherson, Howard Abrams, Melissa Chang","doi":"10.5770/cgj.28.799","DOIUrl":"10.5770/cgj.28.799","url":null,"abstract":"","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"103-104"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory Test Use and Values in the Last Year of Life-a Matched Cohort Design.","authors":"Rhiannon L Roberts, Haris Imsirovic, Robert Talarico, Wenshan Li, André Carrington, Kruti Patel, Douglas Manuel, Peter Tanuseputro, Steven Hawken, Colleen Webber","doi":"10.5770/cgj.28.808","DOIUrl":"10.5770/cgj.28.808","url":null,"abstract":"<p><strong>Background: </strong>As individuals approach death, they experience declines in their cognitive, physical, motor, sensory, physiologic, and psychosocial functions. In this exploratory study we examined individuals' physiologic changes in the last year of life by examining laboratory tests commonly used in clinical practice.</p><p><strong>Methods: </strong>Using health administrative datasets, we conducted an observational matched cohort study to assess laboratory test use and values over a decedent's last 12 months and a matched observation window for non-decedents. Laboratory tests included tests for electrolytes: potassium and sodium; complete blood count: hemoglobin and leukocytes; diabetes: hemoglobin A1c; and kidney or liver function: albumin-serum, alanine aminotransferase, and creatinine.</p><p><strong>Results: </strong>We identified 376,463 decedents, 367,474 (97.6%) of whom were matched to non-decedents (similar age and sex). For each test, the proportion of non-decedents who received the test was stable over the 12-month observation period. A higher proportion of decedents had a laboratory test than non-decedents for all but the diabetes test. As decedents neared death, there was a gradual increase in test use until their final month of life, when test use dramatically increased. Across all laboratory tests, test values remained similar for non-decedents over the 12-month observation period. However, for decedents, there were differences in the magnitude and direction of the test values over the 12 months.</p><p><strong>Conclusion: </strong>Our findings indicate distinct changes in decedents' laboratory test use and values over their last 12 months. Future work should explore whether laboratory tests could predict survival or improve the performance of mortality prediction models.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"73-86"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Canadian Coalition for Seniors' Mental Health Canadian Clinical Practice Guidelines for Assessing and Managing Behavioural and Psychological Symptoms of Dementia (BPSD).","authors":"Stacey Hatch, Dallas P Seitz, Marie-Andrée Bruneau, Vivian Ewa, Sid Feldman, Yael Goldberg, Zahra Goodarzi, Nathan Herrmann, Debbie Hewitt Colborne, Alexandre Henri-Bhargava, Zahinoor Ismail, Julia Kirkham, Sanjeev Kumar, Krista L Lanctôt, Wade Thompson, Jennifer Porter, Jennifer A Watt","doi":"10.5770/cgj.28.820","DOIUrl":"10.5770/cgj.28.820","url":null,"abstract":"<p><p>In Canada, approximately 730,000 people are currently living with dementia. Over 75% will experience behavioural and psychological symptoms of dementia (BPSD). There is a lack of consensus on best practices for the assessment and management of BPSD. In 2024, the Canadian Coalition for Seniors Mental Health (CCSMH) developed a Clinical Practice Guideline (CPG) for assessing and managing BPSD, specifically for agitation, depression, anxiety, psychosis, and sexual expressions of potential risk, and deprescribing antipsychotics and psychotropic medications. Development of the BPSD CPG followed the Guideline International Network (GIN)-McMaster Guideline Development checklist. The guideline is intended for people living with dementia, caregivers of people living with dementia, and health-care providers in community, outpatient, inpatient, long-term care, and other residential care settings. Recommendations were informed by a Canada-wide prioritization exercise to identify CPG topics and preferred terms for describing BPSD. A systematic review of existing dementia CPGs, an overview of systematic reviews on assessing and managing BPSD, and systematic reviews of tools for measuring psychosis, anxiety, and depressive symptoms in people living with dementia was undertaken, along with a rapid review of studies of pharmacologic and nonpharmacologic interventions for reducing sexual expressions of potential risk in people living with dementia. Guideline panel members voted on recommendation strength and quality of evidence, per the Grading of Recommendations, Assessment, Development, and Evaluations approach. This CPG resulted in 11 good practice statements and 63 guideline recommendations that will inform BPSD best practices in a Canadian health-care context.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"91-102"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Cognition Remotely: Expanding the Reach of Cognitive Testing for Older Adults at Risk for Dementia in a Randomized Controlled Trial.","authors":"Aidan Steeves, Karla Faig, Chris McGibbon, Andrew Sexton, Pamela Jarrett","doi":"10.5770/cgj.28.790","DOIUrl":"10.5770/cgj.28.790","url":null,"abstract":"<p><p>Little is known about whether cognitive assessments can be completed remotely by older adults at risk for dementia, and there is no consensus on which tool is best. The SYNchronising Exercises, Remedies in GaIt and Cognition at Home (SYNERGIC@Home) study evaluated the feasibility of a home-based, double-blind, randomized-controlled trial to improve gait and cognition in individuals at risk for dementia. This paper reports a secondary analytic outcome of the cognitive tests used. The three aims were: 1) to examine whether the Montreal Cognitive Assessment (MoCA 8.1 Audiovisual), Cognitive-Functional Composite2 (CFC2), and Telephone Cognitive Screen (T-CogS) could be administered remotely; 2) to compare each tool; 3) to evaluate changes in cognition following the intervention. Sixty participants were randomized to one of four physical/cognitive exercise intervention arms, with 52 participants completing the intervention. Cognitive tests were done in the homes of participants via Zoom for Healthcare™. All 52 participants completed the assessments. The interquartile range (IQR) for the MoCA was 4, the CFC2 was 8, and the T-CogS was 1. At baseline, 11.5% scored perfectly on the MoCA, 0% scored perfectly on the CFC2, and 62% scored perfectly on the T-CogS. Scores on the MoCA (<i>p</i>=.076), CFC2 (<i>p</i>=.053), and T-CogS (<i>p</i>=.281) were not statistically significantly different from baseline to post-intervention. This study demonstrates that these cognitive tests can be administered remotely, with the MoCA and the CFC2 being the most sensitive to variability in scores.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"87-90"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Local Consultation Patterns of Inpatient Geriatric Medicine Teams: a Cross-Sectional Study.","authors":"Krista M Reich, Jennifer Watt, Bing Li, Jason Jiang, Zahra Goodarzi","doi":"10.5770/cgj.28.768","DOIUrl":"10.5770/cgj.28.768","url":null,"abstract":"<p><strong>Background: </strong>Geriatric consultation for Comprehensive Geriatric Assessment (CGA) improves outcomes of older adults living with frailty who are hospitalized, but consultation patterns and utilization of inpatient geriatric consultation teams by other hospital-based services are poorly understood.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using linked health administrative data to describe characteristics of older adults (≥ 65 years) who received a CGA while hospitalized between January 1, and December 31, 2019. We identified hospital-based services requesting CGA and the frequency and reasons for referral. We used multivariable logistic regression to estimate the association between patient-level characteristics and receiving a CGA.</p><p><strong>Results: </strong>A total of 29,090 older adults were admitted to hospital; 38.7% were classified as frail and 5.4% (1,563 patients) received at least one CGA. The top three reasons for requesting a CGA were to assess the need for care on an inpatient geriatric rehabilitation unit (43%), and for assessment and management of delirium (27%) and dementia (24%). Referrals were most frequently received from Hospitalists (48%). Frailty was associated with increased odds of receiving a CGA (adjusted odds ratio [aOR] 12.02; 95% confidence interval [CI] 9.67-14.82). A diagnosis of cancer was associated with lower odds of receiving a CGA (aOR 0.75; 95% CI 0.60-0.93).</p><p><strong>Conclusions: </strong>Inpatient geriatric consultation teams support 5.4% of hospitalized older adults. With the rapidly growing aging population, future efforts are needed to explore the optimal delivery of inpatient geriatric services to support its sustainable provision.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"28 1","pages":"41-52"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Priorities of Older Adults in Managing Urinary Incontinence: a Patient-Oriented Research Approach.","authors":"Marina Kirillovich, Saima Rajabali, Adrian Wagg","doi":"10.5770/cgj.27.758","DOIUrl":"https://doi.org/10.5770/cgj.27.758","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary incontinence (UI), the complaint of involuntary leakage of urine, has a substantial impact on the quality of life of older adults. Most UI research is driven by researchers and lacks the patient perspective. The goal of this qualitative study was to gain the perspective of older adults in formulating a research agenda tailored to address their questions and improve their experience with managing UI.</p><p><strong>Methods: </strong>Implementing a community-based participatory research framework, an advisory group of eight older adults with UI were recruited to be on the research team. An initial focus group was conducted to learn about their research needs. Nominal Group Technique was used to reach saturation of themes and data was analyzed thematically. Employing a Delphi consensus method, a national online questionnaire containing 20 priorities for future UI research and education was developed in collaboration with the advisory group.</p><p><strong>Results: </strong>59 older adults with UI rated each priority on a Likert scale. Priorities which advanced to the second round were re-rated, with an 85% response rate. 11 priorities of ≥80% agreement were retained. The highest rated priorities included relationship between physical activity and UI; support for those with UI; causes of UI and its management; sleep and UI; and public restroom accessibility.</p><p><strong>Conclusions: </strong>Findings from this study will help researchers and health-care professionals understand and address the needs of older adults with UI. Efforts should be made to translate research findings in this area and disseminate them in a medium accessible to older adults.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 4","pages":"473-484"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Perioperative Medication and Prolonged Postoperative Hospital Stay in Older Adults with Spinal Surgery: a Retrospective Cohort Study.","authors":"Jianghua Shen, Suying Yan, Jagadish K Chhetri, Yanqi Chu, Peng Wang, Shuai Feng, Tianlong Wang, Chaodong Wang, Guoguang Zhao","doi":"10.5770/cgj.27.748","DOIUrl":"https://doi.org/10.5770/cgj.27.748","url":null,"abstract":"<p><strong>Background: </strong>Older people are prone to multiple chronic diseases and, as a result, require multiple medications. At present, there is no study to verify whether the use of high-risk perioperative medications (HRPOMs) will adversely affect postoperative outcomes in the relatively old patient. In this study, we aimed to analyze the risks of HRPOMs for prolonged length of hospital stay (LOS) in advanced-aged (≥ 75 years) patients undergoing spinal surgery.</p><p><strong>Methods: </strong>Medical records of advanced-aged patients who underwent spinal surgeries were retrospectively reviewed. Patients were divided into those who had prolonged LOS (≥ eight days) versus those who did not (< eight days). The demographics, medical comorbidities, and perioperative medications were analyzed. Univariate and multivariate regression were used to determine perioperative risk factors for prolonged LOS.</p><p><strong>Results: </strong>A total of 268 patients were included with a median age of 79 years (interquartile range [IQR]=76, 82) and 127 (47.4%) patients had a prolonged LOS. In multivariate logistic analysis, higher body mass index (odds ratio [OR] = 1.116; 95% CI, 1.031-1.209), operation time (OR) = 1.009; 95% CI, 1.005-1.012), and number of postoperative HRPOMs (OR= 1.910; 95% CI, 1.464-2.492) were identified as independent predictors for prolonged LOS. The use of metformin was associated with lower likelihood of prolonged LOS in diabetic patients (OR = 0.365; 95% CI, 0.157-0.846).</p><p><strong>Conclusion: </strong>Our results indicate that the higher number of postoperative HRPOMs, rather than a specific HRPOMs type, is a risk factor for prolonged LOS. The continued preoperative use of metformin in patients with diabetes has a positive impact on the postoperative outcomes.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 4","pages":"500-518"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Disability in a Cohort Study of Older Men-The Manitoba Follow-Up Study.","authors":"Philip D St John, Scott Nowicki, Robert B Tate","doi":"10.5770/cgj.27.771","DOIUrl":"https://doi.org/10.5770/cgj.27.771","url":null,"abstract":"<p><strong>Background: </strong>There is a large literature on the prevalence of disability in older men, but less data on the incidence of new disability.</p><p><strong>Objectives: </strong>1. To determine the incidence of moderate-to-severe disability in a prospective cohort study of aging men; and 2. To determine predisposing risk factors for new moderate to severe disability.</p><p><strong>Design & setting: </strong>The Manitoba Follow-up Study is a closed cohort study. In 1948, the initial sample was 3,983 men who qualified for air crew training in the Royal Canadian Air Force. In 2004, there were 796 men who were still alive and responded to the annual questionnaire with no missing data, and who did not have disability. The mean age at that time was 84.</p><p><strong>Methods: </strong>We calculated the incidence of new moderate-to-severe disability from 2004 to 2017, calculated the time to disability, and constructed survival analysis models to determine factors which predicted disability.</p><p><strong>Results: </strong>The incidence of disability increased with the aging of the cohort and ranged from 4% to 12% per year. In unadjusted models, poor self-rated health (SRH), low life satisfaction, a low score on the Physical Component Score (PCS) of the Short Form-36, and the number of chronic conditions were all associated with new disability. In adjusted models, SRH, the PCS, and the number of chronic conditions were associated with new disability.</p><p><strong>Conclusions: </strong>Global measures of well-being, as well as multimorbidity, predict new disability.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 4","pages":"462-472"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Patients' Eating Habits with Planetary Health-Pilot Study to Decrease Food Waste with Vegetarian Lunches using a Quality Improvement Approach.","authors":"Eileen M Wong, Stephanie Maclean","doi":"10.5770/cgj.27.764","DOIUrl":"https://doi.org/10.5770/cgj.27.764","url":null,"abstract":"<p><strong>Background: </strong>Patient health is greatly impacted by increased likelihood of malnutrition if food is not consumed. Food waste also contributes to greenhouse gas emissions and may be possibly reduced by offering vegetarian food options. Therefore, a Plan-Do-Study-Act intervention of \"Vegetarian Week\" was conducted in an urban geriatric rehabilitation unit.</p><p><strong>Method: </strong>Food waste was measured using the Visual Estimation Method, and the proportion of waste before and after the intervention was compared using a two-tailed <i>z</i>-test. Surveys assessed patients' attitudes towards vegetarian meals.</p><p><strong>Results: </strong>Study population was of 54 (2022) and 65 (2023) patients with the majority being male (62.5%), average age 74.5 years, average length of stay 33 days. Comparing pre- and post-intervention periods, overall food wastage increased at: breakfast (22% to 32%), lunch (22% to 32%), and dinner (20% to 25%) with <i>p</i> values <.001. Considering lunch entrées only, wastage increased from 17% to 38%, with vegetarian entrees wasted (46%) more than non-vegetarian ones (34%). Vegetarian patients wasted (37%) as much as non-vegetarians (39%). Survey response rate pre-PDSA was 45%, with most patients (76%) reporting eating an omnivorous diet, a prior awareness of personal and planetary health benefits of vegetarian diets (59%), and previously trying vegetarian dishes (62%). Post-PDSA survey response rate was lower (22%) with 57% not willing to try vegetarian dishes again.</p><p><strong>Conclusion: </strong>Through evaluation of the patient food experience with Visual Estimation Method and surveys, the very complex issue of food satisfaction was explored in older adults. Although food waste was not decreased during this \"Vegetarian Week\" pilot, improving patient and planetary health requires ongoing efforts.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 4","pages":"430-437"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian Clinical Guidelines on Social Isolation and Loneliness in Older Adults.","authors":"David K Conn, Tanya Billard, Suzanne Dupuis-Blanchard, Amy K Freedman, Peter M Hoang, Mélanie Levasseur, Nancy E Newall, Mary Pat Sullivan, Andrew V Wister","doi":"10.5770/cgj.27.772","DOIUrl":"https://doi.org/10.5770/cgj.27.772","url":null,"abstract":"<p><strong>Background: </strong>Preventing and addressing social isolation and loneliness among older adults is important because of the known associations with negative health outcomes. The Canadian Coalition for Seniors' Mental Health (CCSMH) took on the task of creating clinical guidelines.</p><p><strong>Method: </strong>A multidisciplinary working group was established. The process was guided by an initial rapid scoping review of the literature focused on older adults. An adapted GRADE approach was utilized.</p><p><strong>Results: </strong>CCSMH has produced first-ever clinical guidelines on social isolation and loneliness in older adults. Prevention, including recognition of risk factors and educational approaches focused on clinicians and students, is recommended. Targeted screening with validated tools is recommended. A comprehensive assessment is optimal to treat any underlying conditions and to identify contributing factors that may be responsive to psychosocial interventions. An individualized approach to interventions with shared decision-making is recommended. A variety of possible interventions include social prescribing, social activity, physical activity, psychological therapies, animal-assisted therapies and ownership, leisure skill development and activities, and the use of technology.</p><p><strong>Conclusion: </strong>The problem of social isolation and loneliness is a \"geriatric\" giant that needs to be recognized and addressed. Because of its complexity, it will require the collective attention of many individuals and organizations working together at multiple levels of society, to raise awareness and find solutions. We recommend that health-care and social service providers use these guidelines as a comprehensive tool to identify, assess, and implement strategies to reduce the negative impact of social isolation and loneliness.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 4","pages":"531-538"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}