Aging and health research最新文献

{"title":"The associations between multimorbidity, healthcare resource utilisation and costs in individuals with Alzheimer's disease dementia","authors":"Sophie Edwards ,&nbsp;Marc Evans ,&nbsp;Craig Ritchie ,&nbsp;Julie Hviid Hahn-Pedersen ,&nbsp;Mei Sum Chan ,&nbsp;Benjamin D Bray ,&nbsp;Alice Clark ,&nbsp;Christian Ahmad Wichmann ,&nbsp;Dominic Trepel","doi":"10.1016/j.ahr.2025.100234","DOIUrl":"10.1016/j.ahr.2025.100234","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity (having two or more comorbidities), is common among people with dementia and associated with lower survival and increased healthcare use. We aimed to identify comorbidity clusters in people living with Alzheimer’s disease (AD) dementia in the UK, describe comorbidity-cluster prevalence and patterns, and estimate associations of clusters with healthcare resource utilisation (HCRU) and costs.</div></div><div><h3>Methods</h3><div>This was a cohort study using Discover dataset (electronic health records from approximately 2.8 million North-West London residents). We identified individuals with AD dementia using diagnostic codes, and estimated HCRU and total healthcare costs (including primary and hospital-based care). Individuals were grouped based on comorbidity profile using k-medoids clustering. Multivariable modelling was used to estimate associations between comorbidity clusters and healthcare costs.</div></div><div><h3>Results</h3><div>Among 18,116 individuals with AD dementia, eight comorbidity clusters were identified. The three highest-cost clusters incurred mean costs per patient year(ppy) of £6355, £5560, and £5284 respectively. The highest-cost cluster had a high burden of comorbidities with the most prevalent: frailty (83.2 %), hypertension (81.8 %), type 2 diabetes mellitus (81.4 %), and chronic kidney disease (69.7 %). Costs in the three highest-cost clusters were 1.7 to 2.0 times higher than the lowest-cost cluster (mean cost £3160ppy), which featured the lowest overall comorbidity burden. The lowest median survival times were in the two highest-cost clusters. Cluster membership was strongly associated with costs even after adjusting for a wide range of demographic and clinical factors. Compared with the lowest-cost cluster the average marginal increases in costs for the clusters ranged between £1072 (95 %CI:£478-£1666) and £3531ppy (95 %CI: £2850-£4212).</div></div><div><h3>Conclusions</h3><div>HCRU and costs in individuals with AD dementia show notable differences, with a large proportion of costs attributable to a minority of individuals with multiple comorbidities (particularly cardiometabolic diseases and frailty). Health systems should ensure initiatives to improve timely diagnosis and treatment of people with AD taking account of the high multimorbidity prevalence in this population.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality-based robotic training for lower limb rehabilitation in stroke patients with Hemiplegia: A pilot study","authors":"Lijing Chen ,&nbsp;Huanzhi Zhu ,&nbsp;Jing Wang ,&nbsp;Rongrong Lu ,&nbsp;Jing Tian ,&nbsp;Bei Wu ,&nbsp;Jing Chu ,&nbsp;Juan Li","doi":"10.1016/j.ahr.2025.100233","DOIUrl":"10.1016/j.ahr.2025.100233","url":null,"abstract":"<div><h3>Background</h3><div>More than half of stroke survivors suffer from movement disorders after receiving routine rehabilitation treatment. Evidence suggests that virtual reality (VR)-based robotic training for lower limb rehabilitation is a promising approach for improving motor function recovery.</div></div><div><h3>Methods</h3><div>A pilot open-label randomized controlled trial was conducted to explore the feasibility and preliminary effects of VR-based robotic training for lower limb rehabilitation in stroke patients with hemiplegia. We enrolled 42 stroke patients with hemiplegia, 21 received VR-based robotic training for lower limb rehabilitation and conventional rehabilitation treatment as the intervention, and 21 only received conventional rehabilitation treatment as the control.</div></div><div><h3>Results</h3><div>Forty participants completed the trial. We found a statistically significant difference in lower limb motor function scores from baseline to week 4 between the intervention and control group (mean difference (MD): 6.5 vs 3.3, <em>p</em>&lt;0.001). At week 4, participants in the intervention group demonstrated significant enhancements in balancing function, walking ability, activities of daily living, and quality of life (<em>p</em>&lt;0.05). However, the intervention group did not show a significant improvement in global cognitive function compared to the control group (MD: 3.8 vs 3.7, <em>p</em> = 0.873). No adverse events were observed during the trial.</div></div><div><h3>Conclusion</h3><div>The VR-based robotic training for lower limb rehabilitation showed promise in improving motor function, activities of daily living, and quality of life in stroke patients with hemiplegia. These preliminary findings support the feasibility of this approach and highlight the need for large-scale studies to validate its effectiveness.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive outcomes following ischaemic stroke: a narrative review","authors":"Jananee Myooran ,&nbsp;Faiyaz Rahman ,&nbsp;Dennis Cordato ,&nbsp;Danielle Ní Chróinín","doi":"10.1016/j.ahr.2025.100232","DOIUrl":"10.1016/j.ahr.2025.100232","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a common sequela of ischaemic stroke, especially in older patients who are often predisposed to both delirium and dementia. Despite this, factors associated with cognitive impairment post-stroke are poorly evaluated in everyday clinical practice, including associated risk factors, the impact of reperfusion therapies on risk of post-stroke cognitive impairment, and effects on mortality and morbidity.</div></div><div><h3>Methods</h3><div>A literature review was conducted, using PubMed and EMBASE databases. 62 articles were included in the review.</div></div><div><h3>Results</h3><div>The review demonstrated several risk factors for cognitive impairment in patients with ischaemic stroke. Patient related factors include age, race, atrial fibrillation, diabetes and pre-stroke cognition. Stroke-related factors include extensive, multi-territorial infarcts. Only endovascular thrombectomy improved cognitive outcomes post stroke. Post stroke cognitive impairment is associated with greater risk of institutionalization, depression, delirium, stroke recurrence and mortality.</div></div><div><h3>Conclusion</h3><div>Moving forward, utilizing cognition as a primary outcome in trials, as well as exploring the impact of post-stroke cognition on patients is essential. Therefore, further research is required to delineate the relationship between ischaemic stroke and post-stroke cognitive impairment.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of chronic conditions to mortality: Differences by race and ethnicity","authors":"Miriam R. Elman ,&nbsp;Ana R. Quiñones ,&nbsp;Gail J. McAvay ,&nbsp;Brent Vander Wyk ,&nbsp;Corey L. Nagel ,&nbsp;Heather G. Allore","doi":"10.1016/j.ahr.2025.100231","DOIUrl":"10.1016/j.ahr.2025.100231","url":null,"abstract":"<div><h3>Background</h3><div>Racial and ethnic health disparities are persistent in the United States. The accumulation of chronic conditions and mortality are important contributors to these observed inequities.</div></div><div><h3>Methods</h3><div>We assessed the contribution of coexisting conditions to mortality among Hispanic, non-Hispanic White, and non-Hispanic Black older adults born in the United States. We used nationally-representative data from the Health and Retirement Study (HRS) from 1998–2020 (<em>n</em> = 10,430). Estimates for the absolute additive contributions of nine chronic conditions using a longitudinal extension of the average attributable fraction (LE-AAF) were derived from survey-weighted multivariable discrete survival models adjusted for sociodemographic and health characteristics.</div></div><div><h3>Results</h3><div>Death occurred in 42.2 % (95 % confidence interval [CI]=37.4, 47.0) of Hispanic, 42.7 % (95 % CI=41.7, 44.2) of White, and 46.4 % (95 % CI=42.7, 50.1) of Black respondents. The eight conditions increasing the risk of death contributed 73.9 % (95 % CI=50.7, 100.0) of mortality events among Hispanic respondents, 66.2 % (95 % CI=48.9, 81.5) among Black respondents, and 57.7 % (95 % CI=52.1, 62.5) among White respondents. Dementia had the strongest association with mortality with an adjusted odds ratio of 3.23 for Hispanic (95 % CI=1.90, 5.49), 3.14 for White (95 % CI=2.61, 3.78), and 2.11 for Black (95 % CI=1.63, 2.73) respondents. The development and progression of cancer malignancies contributed most to mortality for White adults. In contrast, hypertension, contributed most to mortality for Hispanic and Black adults.</div></div><div><h3>Conclusions</h3><div>Hispanic, Black, and White Americans differed in the prevalence and incidence of chronic conditions, as well as their association with mortality. Together, these conditions resulted in contributions to mortality that varied substantially.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential associations of the stages of pressure and stasis ulcers and social engagement among nursing home residents","authors":"Anyah Prasad ,&nbsp;Anthony P. Nunes ,&nbsp;Bill M. Jesdale ,&nbsp;Natalia N. Nielsen ,&nbsp;Catherine E. Dubé ,&nbsp;Deborah S. Mack ,&nbsp;Kate L. Lapane","doi":"10.1016/j.ahr.2025.100230","DOIUrl":"10.1016/j.ahr.2025.100230","url":null,"abstract":"<div><h3>Background</h3><div>Social engagement is an important determinant of health in older adults. Skin ulcers may adversely impact social engagement among nursing home residents. This study sought to quantify the differential associations between pressure and stasis ulcers and social engagement among long-stay US nursing home residents.</div></div><div><h3>Methods</h3><div>Cross-sectional, nationally representative data was obtained from the Minimum Data Set 2.0 on US nursing home residents aged ≥ 50 years with an annual assessment between Oct 1, 2009 and Sept 30, 2010. Adjusted prevalence ratios (aPR) of low social engagement among residents with the four stages of pressure and stasis ulcers and 95 % confidence intervals (CI) were estimated from multivariable Poisson models using a generalized estimating equation approach to account for residents nested within nursing homes.</div></div><div><h3>Results</h3><div>Among the 771,634 residents, 4.5 % had pressure ulcers, and 1.1 % had stasis ulcers. The presence of pressure ulcers, regardless of the stage, was associated with an increased risk of low social engagement (stage 1 aPR: 1.05 (95 % CI: 1.03–1.07); stage 4 aPR: 1.07 (95 % CI: 1.05–1.08)). Residents with stage 1 to 3 stasis ulcers were less likely than those without any skin ulcers to have low social engagement. In contrast, those with stage 4 stasis ulcers had an increased prevalence of low social engagement (aPR: 1.10 (95 % CI: 1.06–1.14)).</div></div><div><h3>Conclusion</h3><div>Social engagement should be monitored and addressed in residents with skin ulcers. Since pressure and stasis ulcers have different etiologies and treatment modalities, they should be considered separately in the empirical work on their association with social engagement.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of the Persian version of Alzheimer's disease-related quality of life (P-ADRQL) questionnaire among older Iranian adults","authors":"Masoud Gharib ,&nbsp;Jafar Hajghani ,&nbsp;Hamed Cheraghmakani ,&nbsp;Vahid Rashedi","doi":"10.1016/j.ahr.2025.100229","DOIUrl":"10.1016/j.ahr.2025.100229","url":null,"abstract":"<div><h3>Background</h3><div>Assessing quality of life (QOL) in individuals with Alzheimer's disease (AD) is particularly challenging due to the subjective nature of the concept and the cognitive deficits associated with the condition. This study aimed to translate the AD-Related QOL (ADRQL) questionnaire into Persian and rigorously evaluate its reliability and validity in this population.</div></div><div><h3>Methods</h3><div>This cross-sectional methodological study was conducted between March 2021 and August 2022, involving 220 patients diagnosed with AD according to DSM-IV criteria, along with their primary caregivers. The Persian version of the ADRQL (P-ADRQL) and the QOL in Late-Stage Dementia (QUALID) scales were used to collect data, allowing for a thorough assessment of QOL across multiple domains.</div></div><div><h3>Results</h3><div>The P-ADRQL demonstrated excellent psychometric properties, with an overall Cronbach's alpha of 0.92, indicating strong internal consistency. This suggests that the items reliably measure the construct of QOL in patients with AD. Additionally, test-retest analysis revealed consistent scores across all subscales, confirming the stability of caregiver assessments over time. Significant correlations between P-ADRQL and QUALID further supported the convergent validity of the instrument, affirming its ability to measure QOL in alignment with established dementia assessment tools.</div></div><div><h3>Conclusion</h3><div>The P-ADRQL is a robust and reliable instrument for evaluating QOL in older Iranian adults with AD. Its strong psychometric properties ensure accurate and consistent assessments, addressing a critical need within Iran's healthcare system.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth loss and physical function among older adults related to race and ethnicity in Hawai‘i: A cross-sectional study from 2014 to 2020","authors":"Wei Zhang ,&nbsp;Yan Yan Wu ,&nbsp;Fran C. Woodworth ,&nbsp;Deborah J. Mattheus","doi":"10.1016/j.ahr.2025.100228","DOIUrl":"10.1016/j.ahr.2025.100228","url":null,"abstract":"<div><h3>Background</h3><div>Oral health and functional limitations are major health concerns among aging populations in the U.S. and globally. Although the relationship between tooth loss and physical disabilities is well documented, less is known about the role of race and ethnicity in this association. This study examined the association between tooth loss and ADL (activities of daily living) limitations across various racial/ethnic groups in Hawai‘i.</div></div><div><h3>Methods</h3><div>We examined severe tooth loss and functional limitations in relation to sociodemographic factors, including race/ethnicity, using four waves of data from the Hawaiʻi Behavioral Risk Factor Surveillance System collected between 2014 and 2020. Weighted Poisson regression was used to estimate the unadjusted and adjusted prevalence ratio of severe tooth loss and functional limitations.</div></div><div><h3>Results</h3><div>There was a significant association between severe tooth loss and the prevalence of ADL limitations among older adults in Hawai‘i. Notably, this association varied by race/ethnicity: After adjusting for sociodemographic covariates, it was stronger among White, Native Hawaiian, and Japanese respondents compared to Filipinos.</div></div><div><h3>Conclusions</h3><div>These results suggest that the relationship between severe tooth loss and physical decline is differentiated by race/ethnicity, and that socioeconomic variables (including education and income) play a complicated role in the association. Awareness of the unique challenges and inequities faced by older racially/ethnically marginalized populations is critical for policymakers to develop strategies to achieve health equity, which must entail addressing these interrelated health problems and their structural determinants at every level.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725772","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":"Concurrent validity of quantitative upper extremity function tests in Parkinson's disease: 9HPT, MDS-UPDRS, and MAM-36","authors":"Narges Azari Jafari,&nbsp;Reza Daneshvar Kakhki,&nbsp;Mohammad Shahab Shafaei","doi":"10.1016/j.ahr.2025.100225","DOIUrl":"10.1016/j.ahr.2025.100225","url":null,"abstract":"","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725843","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":"Clinical profile of heart failure in geriatric patients in a tertiary cardiac hospital of Bangladesh","authors":"Mahbuba Yesmin ,&nbsp;Lutfun Nahar Nizhu ,&nbsp;Afroja Alam ,&nbsp;Abdullah Al Mamun","doi":"10.1016/j.ahr.2025.100227","DOIUrl":"10.1016/j.ahr.2025.100227","url":null,"abstract":"<div><div>This study included 100 geriatric patients admitted at National Institute of Cardiovascular Diseases (NICVD) in Bangladesh having clinical features of heart failure, possible other information (Framingham Criteria) and increase in natriuretic peptide or echocardiographic findings. It was a single center, cross sectional study. Regarding functional NYHA classification, 14 % presented with class I, 30 % with class II, 35 % presented with class III, 21 % presented with class IV heart failure.</div><div>Regarding left ventricular ejection fraction (LVEF), heart failure (HF) was classified into the following categories: (1) HF with reduced EF (HFrEF) - 19 %; (2) HF with improved EF (HFmpEF) - 13 %; (3) HF with mildly reduced EF (HFmrEF) - 22 % and (4) HF with preserved EF (HFpEF) - 46 % . 23 % of the study population had iron deficiency anemia and about one-third-patient had associated renal failure (AKI/CKD). This study revealed that a significant geriatric population has unrecognized heart failure (HFpEF).</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734594","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":"Unraveling the molecular mechanisms of vitamin deficiency in Alzheimer's disease pathophysiology","authors":"Vipul Sharma,&nbsp;Khadga Raj Aran","doi":"10.1016/j.ahr.2025.100226","DOIUrl":"10.1016/j.ahr.2025.100226","url":null,"abstract":"<div><div>Alzheimer's disease (AD) is the most prevalent progressive neurodegenerative disease often characterized by memory loss, cognitive decline, and behavioral changes. The actual pathophysiology of AD remains unclear, but several factors including genetic, environmental, and lifestyle contribute significantly to the pathogenesis of AD. Even after over two decades of combined efforts to create novel interventions that can retard the progress of the disease, researchers still only have a small number of alternate medicines with poor efficacy. There is a recent growth of interest in the role of nutrients in brain health as we learn more about what nutrients are and how they impact hormonal and neurological processes that can result in a variety of neurological and psychiatric conditions. Additionally, deficiency of vitamins also gained attention for their pivotal roles in cognitive health. Vitamins, a crucial dietary supplement, regulate various physiological functions and maintain neuronal health, energy metabolism, and antioxidant defence. Vitamin B, such as B1, B6, and B12, are chief constituents for the metabolism of homocysteine and the release of neurotransmitters, a decrease in vitamin E and D may result in increased oxidative damage, which further contributes to neuronal loss. Vitamin deficiencies may make AD degenerative processes more severe as increased amyloid-beta (Aβ) plaque development and tau protein phosphorylation, are two characteristics of AD. This review explores a comprehensive summary of the most widely used vitamins and discusses the findings of recent research on the relationship between these vital micronutrients and AD.</div></div>","PeriodicalId":72129,"journal":{"name":"Aging and health research","volume":"5 2","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734593","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}