Geriatric Nursing最新文献

{"title":"COVID-19 hospitalization place of live discharge outcomes for long-term care facility residents with dementia: Mediation by comorbidities index scores and moderation by health insurance status.","authors":"Cheng Yin, Elias Mpofu, Kaye Brock, Stan Ingman","doi":"10.1016/j.gerinurse.2025.04.029","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2025.04.029","url":null,"abstract":"<p><strong>Background and aim: </strong>COVID-19 hospitalization place of discharge outcomes for Long Term Care Facility (LTCF) residents with dementia are less well known for preventing excess mortality in this vulnerable population.</p><p><strong>Method: </strong>This cross-sectional study utilized the Texas Inpatient Public Use Data File (PUDF) data on LTCF residents with dementia (n = 1,413) and without dementia (n = 1,674) to examine variations in their hospitalization outcomes of live place of discharge, comorbidity scores, and health insurance status.</p><p><strong>Results: </strong>Dementia diagnosis increased risks of hospice care (OR = 1.44, 95 %CI = 1.16-1.80), while decreasing the likelihood of discharge to recovery hospitals by almost 30 % (OR = 0.70, 95 %CI = 0.52-0.94). Higher Elixhauser Comorbidity Index Score (ECIS) significantly mediated the relationship between dementia and hospice care discharge (indirect effect = 0.07, p < 0.01, R² = 0.09). Health insurance significantly moderated the relationship between dementia and hospice discharge, with for a lower probability of discharge to hospice care with health maintenance organization insurance (β = -0.51, p < 0.05, R² = 0.09).</p><p><strong>Conclusion and implication: </strong>Covid-19 discharge plans for patients with dementia should prioritize recovery hospitals rather than hospice care for minimizing health care disparities compared to other residents. Given the increased risk of hospice discharge among dementia patients, healthcare providers should integrate comorbidity burden assessments into discharge planning. Conceivably, dementia patients with higher ECIS may face systemic barriers to recovery-focused care if carers paid less regard to the role of comorbidities in hospitalization outcomes.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":" ","pages":"103356"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User evaluations of a Dementia case management information system: A cross-sectional study.","authors":"Yu-Chen Hu, Yi-Ping Chao, Hsiu-Li Huang, Wen-Chuin Hsu, Yea-Ing L Shyu, Yen-Ting Liao, Huei-Ling Huang","doi":"10.1016/j.gerinurse.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2025.04.027","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the acceptability of a recently developed electronic Dementia Case Management Information System (DCMIS) following hands-on use by dementia case managers.</p><p><strong>Methods: </strong>Dementia case managers from 28 community-based dementia care centers who had previously provided feedback about needs and wants of an electronic case management system were invited to participate (N =30). Following a training session, participants used the DCMIS to assess patients in two scenarios typical for case managers at our centers. Participants then evaluated their experience with a researcher-developed 25-item Technology Acceptance Model questionnaire (scored from 1 to 5). Multiple linear regression analysis examined significant associations between technology acceptance and variables of demographics and external factors (system quality and information, and job relevance) to identify predictors of acceptance of the DCMIS.</p><p><strong>Results: </strong>Acceptance and perceived usefulness of the DCMIS were high; mean scores were 4.05 (SD,0.62) and 4.15 (SD, 0.67), respectively. Job relevance was a significant predictor of perceived usefulness (β = 0.721, P <.001). System quality and information quality were significant predictors of perceived ease of use (β = 0.355, P =.03 and β = 0.395, P =.02, respectively); job relevance was also a predictor for behavioral intention to use (β = 0.487, P =.03).</p><p><strong>Conclusions: </strong>The quantitative assessments of the DCMIS by the dementia case managers demonstrated most found the system to be useful. Factors that were predictors of acceptance suggest that the ability to easily access quality information and improved the ability of dementia case managers to perform their jobs contributed their willingness to view the DCMIS as a tool that could enhance workflow.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":" ","pages":"103354"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between home-visit nursing use and the occurrence of unfavorable health outcomes among community-dwelling older adults: A prospective cohort study","authors":"Sameh Eltaybani ,&nbsp;Saori Anezaki ,&nbsp;Chie Fukui ,&nbsp;Ayumi Igarashi ,&nbsp;Mariko Sakka ,&nbsp;Maiko Noguchi-Watanabe ,&nbsp;Asa Inagaki-Asano ,&nbsp;Taro Kojima ,&nbsp;Noriko Yamamoto-Mitani","doi":"10.1016/j.gerinurse.2025.04.010","DOIUrl":"10.1016/j.gerinurse.2025.04.010","url":null,"abstract":"<div><div>This prospective cohort study examined the association between home-visit nursing use and the occurrence of unfavorable health outcomes (UHOs) among community-dwelling older adults (≥75 years) across Japan. An online survey collected data about older people’s characteristics (household composition, diagnosis, etc.) and the occurrence of 21 UHOs (e.g., hospitalization, respiratory infection, sleeping disorders, lack of serenity) twice a year apart. The analysis included 835 older adults (58.2% were female, and 39.4% had dementia). Controlling for participants’ characteristics and the occurrence of UHOs at the baseline, regression analyses revealed that home-visit nursing use was associated with statistically significant lower occurrence rates of lack of social interaction, social isolation, neglecting the client’s desired care, urinary tract infection, and poor family well-being, as well as lower incidence rate of the total number of UHOs. The results demonstrate the favorable contribution of home-visit nursing in minimizing the occurrence of UHOs among older people.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 661-669"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of virtual reality on pain and anxiety in older adults: A scoping review","authors":"Camille Corbel PhD candidate ,&nbsp;Flora Le Cerf MD ,&nbsp;Jean Breaud PR ,&nbsp;Xavier Corveleyn AP","doi":"10.1016/j.gerinurse.2025.04.031","DOIUrl":"10.1016/j.gerinurse.2025.04.031","url":null,"abstract":"<div><h3>Background</h3><div>Interventions using Virtual Reality (VR) improve physical and mental health in different populations. Despite the prevalence of anxiety and pain and their impact on the quality of life of older adults, only a few studies have examined the effects of VR-delivered interventions on these conditions.</div></div><div><h3>Objective</h3><div>This paper reports findings on the feasibility and efficacy of interventions delivered through VR to reduce pain and/or anxiety among older patients.</div></div><div><h3>Method</h3><div>A systematic literature search was conducted focused on 8 databases, using the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines.</div></div><div><h3>Results</h3><div>Seventeen studies met the inclusion criteria. VR intervention appears to be a suitable and effective method for reducing anxiety in older adults. Results regarding pain are promising, although some studies report non-significant effects.</div></div><div><h3>Conclusions</h3><div>Despite methodological limitations, the studies revealed the acceptability and feasibility of VR interventions for reducing pain and anxiety. The development of personalized VR interventions, considering factors like familiarity and comfort, holds promise for further investigation.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 619-629"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation and validation of the Chinese version of the Revised Identification of Seniors At Risk tool in the emergency department","authors":"Lanxin Ouyang,&nbsp;Di Liu,&nbsp;Wei Jiang,&nbsp;Yangyujing Li,&nbsp;Yin Lin,&nbsp;Peiwen Zhang,&nbsp;Lei Wang,&nbsp;Mengmeng Wu","doi":"10.1016/j.gerinurse.2025.04.011","DOIUrl":"10.1016/j.gerinurse.2025.04.011","url":null,"abstract":"<div><h3>Objective</h3><div>To adapt and validate the Simplified Chinese version of the Revised Identification of Seniors At Risk (ISAR-R) tool for identifying older patients at risk of adverse outcomes post-discharge in emergency departments.</div></div><div><h3>Methods</h3><div>Brislin's bidirectional translation was used for accuracy. This prospective cohort study involved 1324 patients aged 65+ in three EDs of a tertiary hospital in central China. ISAR-R was administered before discharge, and 30-day outcomes were assessed via follow-up.</div></div><div><h3>Results</h3><div>The tool showed good content validity (CVI=0.92). Among 1324 patients, 37.5 % were at high risk (ISAR-<em>R</em> ≥ 2). Logistic regression indicated that older age, wheelchair/ambulance arrival, and severe triage levels significantly increased high-risk classification. The primary endpoint occurred in 54.6 % of patients at 30 days. The ISAR-R score's AUC was 0.663.</div></div><div><h3>Conclusions</h3><div>The Simplified Chinese ISAR-R tool effectively identified older patients at risk of adverse outcomes in EDs, with appropriate cut-off values for different settings.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 604-610"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective memory complaints and cognitive performance among older adults living in low-income senior housing communities: The moderating role of race","authors":"Sarah Holmes PhD, MSW ,&nbsp;Barbara Resnick PhD, CRNP ,&nbsp;N. Jennifer Klinedinst PhD, MPH, RN ,&nbsp;Nicole Brandt PharmD, MBA ,&nbsp;Merve Gurlu MS ,&nbsp;Anne Hagan MSN, BSN, RN ,&nbsp;Sylvia Joledo Nursing Student","doi":"10.1016/j.gerinurse.2025.04.022","DOIUrl":"10.1016/j.gerinurse.2025.04.022","url":null,"abstract":"<div><div>The purpose of this study was to examine the relationship between subjective memory complaints and objective cognitive performance and test whether this relationship was moderated by race, after controlling for age, gender, and education. This was a descriptive, cross-sectional study including 151 older adults living in low-income senior housing. Results from the logistic regression models showed that compared to those without subjective memory complaints, older adults with subjective memory complaints had 2 times greater odds of having impaired cognition, after controlling for age, gender, and education (OR: 2.27, 95% CI: 1.08-4.78, p=.03). Race moderated the relationship between subjective memory complaints and the odds of having impaired cognition (p=.002). Findings suggest that subjective memory complaints are associated with objective cognitive performance and this relationship differed significantly for Black and White older adults. Further research is needed to understand reasons for these racial differences and to develop clinical interventions for supporting the cognitive health of older adults living in senior housing.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 574-580"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need for community-based medical-nursing combined services among urban empty nesters in China and its influencing factors: a cross-sectional study","authors":"Qianru Liu ,&nbsp;Tianyu Zhang ,&nbsp;Jiao Yuan ,&nbsp;Xiaoxiao Mei ,&nbsp;Cheng Wan ,&nbsp;Yangzheng Liu ,&nbsp;Guang Cai ,&nbsp;Zhuoya Zhang ,&nbsp;Li Geng","doi":"10.1016/j.gerinurse.2025.04.033","DOIUrl":"10.1016/j.gerinurse.2025.04.033","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the need and influencing factors for community-based medical-nursing combined services among urban empty nesters in China based on ecological system theory.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in Wuhan and Nanyang city. 289 empty nesters participated in the survey. This study employed a self - administered questionnaire, which had been tested for reliability and validity, to conduct the survey. Descriptive analysis, univariate analysis, and multiple stepwise linear regression were used for data analysis.</div></div><div><h3>Results</h3><div>Chinese empty-nest elderly had the highest need for health management and safety services. Age, monthly income, number of chronic diseases, marital status, walking time to the community health service center, frequency of choosing community health service center for primary medical treatment, differences in the health insurance type, and the understanding of medical-nursing combined model policies, could predict urban empty nesters’ needs.</div></div><div><h3>Conclusion</h3><div>The findings of this study assist elderly care service providers in closely matching the needs of empty-nest elderly when delivering medical-nursing combined services. In community elderly care, special attention should be given to specific types of elders, like the very old, the chronically ill, and those with mobility impairments. A comprehensive assessment of the needs of empty-nested elders for community-based home healthcare services should be carried out. Moreover, a community social and recreational platform should be established to facilitate interactions among the empty-nest elders.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 581-589"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early identification and delirium recognition in acute care: A quality improvement initiative","authors":"Shavinderpal K. Sanga MSN, RN, ACCNS-AG, GERO-BC ,&nbsp;Lianna Z. Ansryan DNP, MSN, RN, AGCNS-BC, GERO-BC, FCNS","doi":"10.1016/j.gerinurse.2025.04.013","DOIUrl":"10.1016/j.gerinurse.2025.04.013","url":null,"abstract":"<div><div>Recognition of delirium continues to be a challenge in acute care despite the use of validated and reliable tools. This evidence-based quality improvement project aimed to increase delirium recognition by increasing daily screening using the Confusion Assessment Method (CAM) tool. Methods to increase usage and accuracy of the assessment included targeted education by specially trained geriatric nurse champions (GNCs). During rounds, GNCs performed bedside assessment, provided real-time feedback, and focused on non-pharmacological interventions on medical-surgical and telemetry units. All patients 65 years of age and older were included. Daily screening of CAM assessment increased by 7.6 % over three months, including an increase in CAM positive results from 7.1 % to 8.5 %—additional favorable outcomes observed with an increase in delirium diagnosis. This project increased knowledge retention and reinforcement of non-pharmacological interventions through peer coaching and focused rounds. Continued training efforts and education are needed to increase identification of patients experiencing delirium.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 630-634"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of different types of exercise based-interventions in sarcopenia: A systematic review and meta-analysis","authors":"José Luis Ceballos Sánchez ,&nbsp;Daniel Gallardo-Gómez ,&nbsp;Rosa M. Alfonso-Rosa ,&nbsp;Borja del Pozo Cruz ,&nbsp;Javier Ramos-Munell ,&nbsp;Jesús del Pozo-Cruz","doi":"10.1016/j.gerinurse.2025.04.019","DOIUrl":"10.1016/j.gerinurse.2025.04.019","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is one of the most prevalent and disabling health conditions in older adults associated with muscle mass loss and a reduced ability to perform daily-living activities. Although evidence supports the use of exercise interventions to reduce the impact of sarcopenia, the most effective type of physical exercise remains unknown. The objectives of this review were (1) to determine the effectiveness of physical exercise at overall and type-specific levels on the physical performance and muscular strength of older adults with sarcopenia, and (2) to detect potential effect modifiers such as age and sex.</div></div><div><h3>Methods</h3><div>Three databases (i.e., PubMed, Web of Science, and Scopus) were used to conduct the searches. We included randomised controlled trials where exercise-based interventions were applied to participants aged 65 and over diagnosed with sarcopenia using the EWGSOP2 or AWGSOP2 criteria. Bayesian meta-analyses were performed to pool the evidence using standardised mean changes from baseline [SCFB] for physical performance and mean changes from baseline for muscle strength as effect measures. The risk of bias was assessed using the revised Cochrane risk-of-bias tool.</div></div><div><h3>Results</h3><div>Evidence from 28 studies (2582 participants) showed that physical exercise was effective to improve the physical performance (SCFB = 0.21; 95 % CrI 0.08 to 0.33) and muscular strength (Kg grip strength gain = 2.50; 95 % CrI 0.32 to 4.63) of older adults with sarcopenia. Resistance-based interventions presented a meaningful treatment effect on physical performance (SCFB = 0.23; 95 % CrI 0.10 to 0.36). Age and sex modified the effects of physical exercise on both outcomes.</div></div><div><h3>Conclusions</h3><div>This meta-analysis supported the use of physical exercise to improve the physical performance and muscular strength of people with sarcopenia. Resistance-based interventions were the most effective type of activities in both outcomes. Physical exercise effects may vary between males and females older adults. These findings should inform policymakers and healthcare providers in developing more targeted and efficient physical exercise programs (resistance based interventions) to enhance functional independence and reduce the risk of falls in older adults with sarcopenia.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 635-642"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between stigma and negative emotions among patients with Parkinson’s disease: The mediating role of health literacy and family function","authors":"Aoxue Zhu MSN ,&nbsp;Huiling Xie MD ,&nbsp;Juan Wei BD ,&nbsp;Mei Wang BD ,&nbsp;Tianrong Huang MD ,&nbsp;Huina Mao MD","doi":"10.1016/j.gerinurse.2025.04.004","DOIUrl":"10.1016/j.gerinurse.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease is a neurodegenerative disorder causing physical and psychological challenges. Stigma exacerbates negative emotions, resulting in anxiety and depression, as well as undermining self-perception and social participation. Health literacy aids in disease management, and family function plays a crucial supportive role. However, the interplay between these variables remains underexplored.</div></div><div><h3>Objective</h3><div>To examine the chain mediating effects of health literacy and family function between stigma and negative emotions in patients with Parkinson’s disease.</div></div><div><h3>Methods</h3><div>This study adopted a cross-sectional design, recruiting eligible patients from a tertiary hospital in Guangzhou, China. A total of 245 participants completed questionnaires on stigma, health literacy, family function and negative emotions. Statistical analyses were performed using Spearman’s correlation and mediation effect analysis.</div></div><div><h3>Results</h3><div>Negative emotions were positively correlated with stigma (<em>β</em> = 0.584) and inversely associated with health literacy (<em>β</em> = −0.258) and family function (<em>β</em> = −0.144). Mediation effect analysis showed that the mediating effects of health literacy, family function, and their combined effects on the relationship between stigma and negative emotions were 0.033, 0.020, and 0.008, respectively, accounting for 8.89%, 5.39%, and 2.16% of the total effect.</div></div><div><h3>Conclusions</h3><div>Stigma in patients with Parkinson’s disease not only directly affects negative emotions but also indirectly influences them through health literacy and family function.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"63 ","pages":"Pages 567-573"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}