Administration and Policy in Mental Health and Mental Health Services Research最新文献

{"title":"\"So Many Other Things Improve\" with Transdiagnostic Treatment for Sleep and Circadian Problems: Interviews with Community Providers on Treating Clients with Serious Mental Illness.","authors":"Laurel D Sarfan, Zia Bajwa, Marlen Diaz, Sondra Tiab, Krista Fisher, Emma R Agnew, Shayna A Howlett, Sophia Oliver, Catherine A Callaway, Allison G Harvey","doi":"10.1007/s10488-024-01410-1","DOIUrl":"https://doi.org/10.1007/s10488-024-01410-1","url":null,"abstract":"<p><p>Community mental health centers (CMHCs) offer invaluable, publicly-funded treatment for serious mental illness (SMI). Unfortunately, evidence-based psychological treatments are often not delivered at CMHCs, in part due to implementation barriers, such as limited time, high caseloads, and complex clinical presentations. Transdiagnostic treatments may help address these barriers, because they allow providers to treat symptoms across multiple disorders concurrently. However, little research has investigated CMHC providers' experiences of delivering transdiagnostic treatments \"on the ground,\" particularly for adults with SMI. Thus, the aim of the present study was to assess CMHC providers' perspectives on delivering a transdiagnostic treatment - the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) - to adults diagnosed with SMI. In the context of a larger parent trial, providers were randomized to deliver a standard version of TranS-C (Standard TranS-C) or a version adapted to the CMHC context (Adapted TranS-C). Twenty-five providers from the parent trial participated in a semi-structured interview (n = 10 Standard TranS-C; n = 15 from Adapted TranS-C). Responses were deductively and inductively coded to identify themes related to Proctor's taxonomy of implementation outcomes. Four novel \"transdiagnostic take homes\" were identified: (1) transdiagnostic targets, such as sleep, can be perceived as motivating and appropriate when treating SMI, (2) strategies to bolster client motivation/adherence and address a wider range of symptom severity may improve transdiagnostic treatments, (3) balancing feasibility with offering in-depth resources is an important challenge for transdiagnostic treatment development, and (4) adapting transdiagnostic treatments to the CMHC context may improve provider perceptions of implementation outcomes.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152963","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":"Treatment Personalization and Precision Mental Health Care: Where are we and where do we want to go?","authors":"Danilo Moggia,&nbsp;Wolfgang Lutz,&nbsp;Eva-Lotta Brakemeier,&nbsp;Leonard Bickman","doi":"10.1007/s10488-024-01407-w","DOIUrl":"10.1007/s10488-024-01407-w","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 5","pages":"611 - 616"},"PeriodicalIF":2.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming the Effectiveness and Equity of a Psychological Therapy Service: A Case Study in the English NHS Talking Therapies Program","authors":"Katy James,&nbsp;David Saxon,&nbsp;Michael Barkham","doi":"10.1007/s10488-024-01403-0","DOIUrl":"10.1007/s10488-024-01403-0","url":null,"abstract":"<div><p>To work with a psychological therapies service to implement a recovery plan, as required by a government body, aimed at improving patient outcomes (effectiveness) and decreasing practitioner variability (equity). A case-study utilizing components of a learning health system, including nationally mandated patient outcome data, comprising three 18-month phases: (1) retrospective baseline; (2) improving patient outcomes (management-led); and (3) reducing practitioner variability (clinician-led). Primary analyses focused on 35 practitioners (N_PR = 35) who were constant across the three phases and their patients in each phase (N_PA = 930, 1226, 1217, respectively). Reliable improvement rates determined patient outcomes and multilevel modeling yielded practitioner effects. To test generalizability, results were compared to the whole practitioner sample for each phase: (1) N_PR = 81, N_PA = 1982; (2) N_PR = 80, N_PA = 2227; (3) N_PR = 74, N_PA = 2267. Ethical approval was granted by the Health Research Authority. Patient outcomes improved in successive phases for both the core and whole practitioner samples with the largest impact occurring in the management-led intervention. Practitioner variability decreased in successive phases in both the core and whole practitioner samples except in the management-led intervention of the whole sample. Compared with the management-led intervention, the practitioner-led intervention yielded a decrease in practitioner effect exceeding 60% in the core sample and approaching 50% in the whole sample. The implementation of multiple components of a learning health system can lead to improvements in both the effectiveness and equity of a psychological therapy service.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 6","pages":"970 - 987"},"PeriodicalIF":2.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-024-01403-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Monitoring for Adults Living with a Serious Mental Illness on a Second-Generation Antipsychotic Agent: A Scoping Review.","authors":"Tien Ngoc Thi Bui, Ruby Tszwai Au, Jack Luke Janetzki, Sara S McMillan, Elizabeth Hotham, Vijayaprakash Suppiah","doi":"10.1007/s10488-024-01408-9","DOIUrl":"https://doi.org/10.1007/s10488-024-01408-9","url":null,"abstract":"<p><p>Premature mortality in people living with a severe mental illness (SMI) is often attributed to multiple factors including the use of medicines such as antipsychotics. Second-generation antipsychotics (SGAs) are known to cause metabolic syndrome which can increase the risk of cardiovascular disease. Practice guidelines have recommended regular physical health monitoring, particularly of metabolic parameters, however, metabolic monitoring for people living with SMI using antipsychotics remains suboptimal. Therefore, highlighting the need for ongoing research. This scoping review aimed to provide an overview of current metabolic monitoring practices. We anticipate that this information will assist clinicians and policymakers and inform future research. The following databases were searched: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), the Cochrane Database of Systemic Reviews (Wiley), APA PsycInfo (Ovid) and Scopus (Elsevier Science Publishers). The target group was adults (aged ≥ 18) diagnosed with SMI (including bipolar disorder, major depressive disorder and psychotic disorders) and taking SGAs. In total, 44 studies from 14 countries were retrieved. Our findings highlighted that most studies conducted in hospitals did not report on metabolic monitoring practices. Additionally, the roles and responsibilities of healthcare professionals in metabolic monitoring for SMI were infrequently described and parameters such as waist circumference and BMI were often poorly monitored. The scoping review highlights that no streamlined approach towards metabolic monitoring currently exists. There is a need to stipulate and define the roles and responsibilities of all health professionals involved in metabolic monitoring in SMI to optimise care for these individuals. Moreover, there is a need for ongoing research, particularly in the community setting, to promote increased accessibility to metabolic monitoring for SMI.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995086","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":"Barriers to Progress Feedback Adoption in Outpatient Geriatric Mental Healthcare: Exploring Age-Related Factors - A Qualitative Study","authors":"L. N. Frissen,&nbsp;P. D. Janse,&nbsp;R. V. Roskam,&nbsp;G. J. Hendriks","doi":"10.1007/s10488-024-01402-1","DOIUrl":"10.1007/s10488-024-01402-1","url":null,"abstract":"<div><p>Monitoring treatment progress through progress feedback is recognized for its efficacy and demonstrated value. However, its integration and utilization within treatments still need to be improved. Insufficient understanding exists regarding the factors within geriatric mental healthcare influencing the adoption of progress feedback. This study aimed to explore the determinants impacting the utilization of progress feedback within outpatient geriatric mental healthcare, specifically focusing on age-related perspectives and patient group characteristics. This qualitative investigation employed semi-structured interviews involving clinicians (<i>N</i> = 14) selected from four outpatient geriatric teams. The findings revealed both inhibiting and facilitating perspectives concerning progress feedback. Clinicians preferred user-friendly, specific, and tailored measures. Challenges included organizational support, integration in work processes, training, and the digital progress feedback system. Age-related perspectives such as older adults’ diverse issues, limited digital skills, and cognitive problems hindered implementation, particularly in the oldest generation of older patients. In outpatient geriatric mental healthcare, many factors and attitudes influencing progress feedback align with those observed in adult psychiatry literature. Moreover, this study highlights specific age-related factors that impede the adoption and implementation of progress feedback, shedding light on the specific barriers within this context.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 1","pages":"252 - 260"},"PeriodicalIF":2.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-024-01402-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symphony of Success: Leader-Practitioner Reciprocity during Evidence-Based Practice Implementation","authors":"Karina Myhren Egeland,&nbsp;Marisa Sklar,&nbsp;Gregory A. Aarons,&nbsp;Mark G. Ehrhart,&nbsp;Ane-Marthe Solheim Skar,&nbsp;Randi Hovden Borge","doi":"10.1007/s10488-024-01405-y","DOIUrl":"10.1007/s10488-024-01405-y","url":null,"abstract":"<div><p>This study aimed to explore the reciprocal relationships between implementation leadership and practitioner implementation citizenship behavior during the implementation of evidence-based practices (EBPs). Data were collected at two timepoints with a time lag of six months during a national implementation of evidence-based treatment for post-traumatic stress disorder in Norwegian mental health clinics. Data from 72 leaders and 346 practitioners were analyzed with a two-wave cross-lagged panel model, accounting for the nested structure and adjusting for demographic variables. Significant positive autoregressive effects for both implementation leadership and implementation citizenship behavior indicated some stability in ratings across time. Significant cross-lagged effects in both directions indicated that practitioners who experienced greater implementation leadership from their leaders demonstrated greater implementation citizenship behavior six months later, and vice versa. Findings hence supported both the social exchange hypothesis and the followership hypothesis, suggesting reciprocal associations between the constructs. The findings underscore the mutually influential relationship between leaders’ behavior and practitioners’ engagement in citizenship behavior during EBP implementation. The study emphasizes the importance of interventions focusing on leadership behaviors that encourage practitioner engagement and mutually beneficial behavior patterns, highlighting the reciprocal and vital roles that both leaders and practitioners play in successful EBP implementation.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 6","pages":"988 - 996"},"PeriodicalIF":2.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-024-01405-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging K-12 Student Mental Health Policy to Practice Gaps with a Multi-Component Framework","authors":"Lindsay Brindley,&nbsp;Paul Bauer,&nbsp;Alan J. Card,&nbsp;John Crocker,&nbsp;Nick Ialongo,&nbsp;Allen Tien","doi":"10.1007/s10488-024-01396-w","DOIUrl":"10.1007/s10488-024-01396-w","url":null,"abstract":"<div><p>K-12 schools are a major sector for efforts to prevent and treat student mental health problems. In the United States, these efforts have led to the emergence of the MultiTiered System of Supports (MTSS) universal prevention, early intervention, and treatment policy framework. With a major focus on behavioral and mental health, MTSS has been adopted by all fifty state education departments. However, multi-level complexities of addressing student mental health within and across organizational structures complicate MTSS and broader policy development, implementation, and evaluation; disconnects between policy writers and practitioners obstruct progress, limiting positive outcomes. To bridge these policy-to-practice gaps, a multi-component solution is needed. The authors propose integrating the following elements: the Massachusetts School Mental Health Consortium’s Five Guiding Principles for Building a Coordinated School Mental Health System, the comprehensive school improvement methodology Evolutionary Systems Improvement (ESI); and the ontological framework of BioPsychoSocioTechnical Systems Theory (BPST). Individual application of these components has already yielded systems-level improvements outperforming compliance-driven procedures. Used together, these components offer a multi-level solution for establishing conceptually-guided, measurement-based loops that transcend the restrictions of uninformed policy, supporting stakeholders as they work to systematically eliminate barriers and improve student mental health.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 6","pages":"1011 - 1019"},"PeriodicalIF":2.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-024-01396-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Bundled Outpatient Behavioral Health Services in VA-Direct Versus VA-Purchased Care","authors":"A. Taylor Kelley,&nbsp;Michael P. Torre,&nbsp;Todd H. Wagner,&nbsp;Amy K. Rosen,&nbsp;Michael Shwartz,&nbsp;Chao-Chin Lu,&nbsp;Todd K. Brown,&nbsp;Tianyu Zheng,&nbsp;Erin Beilstein-Wedel,&nbsp;Megan E. Vanneman","doi":"10.1007/s10488-024-01404-z","DOIUrl":"10.1007/s10488-024-01404-z","url":null,"abstract":"<div><p>The Veterans Health Administration (VA) increasingly purchases community-based care (CC) to improve healthcare access, including behavioral health. In 2018, VA introduced standardized episodes of care (SEOCs) to guide authorization and purchase of CC services for specific indications in a defined timeframe without bundling payment. In this retrospective cross-sectional study, we describe trends in VA and CC behavioral healthcare utilization using the VA Outpatient Psychiatry SEOC definition. Counts of Outpatient Psychiatry SEOC-allowable service and procedure codes during fiscal years 2016–2019 were organized according to four SEOC-defined service types (evaluation and management, laboratory services, psychiatry services, transitional care) and measured as percentages of all included codes. Trends comparing behavioral healthcare utilization between Veterans using any CC versus VA only were analyzed using a linear mixed effects model. We identified nearly 3 million Veterans who registered 60 million qualifying service and procedure codes, with overall utilization increasing 77.8% in CC versus 5.2% in VA. Veterans receiving any CC comprised 3.9% of the cohort and 4.7% of all utilization. When examining service type as a percent of all Outpatient Psychiatry SEOC-allowable care among Veterans using CC, psychiatry services increased 12.2%, while transitional care decreased 8.8%. In regression analysis, shifts in service type utilization reflected descriptive results but with attenuated effect sizes. In sum, Outpatient Psychiatry SEOC-allowable service utilization grew, and service type composition changed, significantly more in CC than in VA. The role of SEOCs and their incentives may be important when evaluating future behavioral healthcare quality and value in bundled services.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 6","pages":"998 - 1010"},"PeriodicalIF":2.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900594","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 Change as a Predictor of Treatment Outcome in Patients with a Personality Disorder","authors":"Pauline D. Janse,&nbsp;Sophie Vercauteren,&nbsp;Rianne Weggemans,&nbsp;Bea G. Tiemens","doi":"10.1007/s10488-024-01401-2","DOIUrl":"10.1007/s10488-024-01401-2","url":null,"abstract":"<div><p>A significant proportion of patients with a personality disorder do not benefit from treatment. Monitoring treatment progress can help adjust ineffective treatments. This study examined whether early changes in symptoms and personality dysfunction during the first phase of therapy could predict treatment outcomes. Data from 841 patients who received specialized treatment for personality disorders were analyzed. The study focused on whether changes in the Outcome Questionnaire-45.2 (OQ-45.2) symptom distress scale (SD), the General Assessment of Personality Disorder (GAPD), and Severity Indices of Personality Problems (SIPP) in the early phase of therapy predicted post-treatment personality dysfunction, as measured by the SIPP and GAPD. Early changes within a specific SIPP domain were the strongest predictors of post-treatment outcomes in that same domain. Early changes in symptoms significantly predicted outcomes in Self-Control, Relational Functioning, and Identity Integration, while the GAPD predicted outcomes in Self-Control and Social Attunement on the SIPP. For the GAPD, early changes on the GAPD itself, followed by early changes on the OQ-45 SD and the SIPP domain Social Attunement, were significant predictors. Thus, when it comes to personality dysfunction, early changes in a specific domain or measure are the best predictors of outcomes in that same domain. While the OQ-45 predicted some aspects of personality dysfunction, it should not replace disorder-specific measures. Additionally, the SIPP domains and the GAPD should not be used interchangeably to predict each other. In sum, considering these factors, monitoring early change can be useful in assessing progress in the treatment of patients with personality disorders.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 5","pages":"780 - 791"},"PeriodicalIF":2.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scale-up of Global Child and Youth Mental Health Services: A Scoping Review","authors":"Sarah Cusworth Walker,&nbsp;Lawrence Wissow,&nbsp;Noah R. Gubner,&nbsp;Sally Ngo,&nbsp;Peter Szatmari,&nbsp;Chiara Servili","doi":"10.1007/s10488-024-01400-3","DOIUrl":"10.1007/s10488-024-01400-3","url":null,"abstract":"<div><p>Numerous influential policy and scientific bodies are calling for more rapid advances in the scale-up of child and youth mental health services (CYMHS). A number of CYMHS innovations hold promise for advancing scale-up but little is known about how real-world efforts are progressing. We conducted a scoping review to identify promising approaches to CYMHS scale-up across the globe. Searches were completed in six databases (Academic Search Complete, CINAHL, MEDLINE, PsychInfo, PubMed, and Web of Science). Article selection and synthesis were conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. A second search focused on low-and-middle-income countries (LMIC) was conducted based on the Cochrane Library recommended search filters of the World Bank listed LMIC countries. Authors used a double coding strategy during the title/abstract and full-text review. Twenty-eight articles meeting the eligibility criteria were identified that described 22 initiatives (in 11 different countries). Our review found the majority of published scale-up studies in CYMHS were not informed by scale-up frameworks in design or reporting. The methods and outcomes used in the identified articles were highly variable and limited our ability to draw conclusions about comparative effectiveness although promising approaches emerged. Successes and failures identified in our review largely reflect consensus in the broader literature regarding the need for strategies to better navigate the complexities of system and policy implementation while ensuring CYMHS interventions fit local contexts.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"51 6","pages":"935 - 969"},"PeriodicalIF":2.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10488-024-01400-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}