Dementia (London, England)最新文献

{"title":"Ethical issues associated with assistive technologies for persons living with dementia and their caregivers - An overview of reviews.","authors":"Anthony Scerri, Frederik Schou Juul, Rosa Silva, Rodrigo Serrat, Adrienne Grech, Gabija Jarašiūnaitė Fedosejeva, Montserrat Celdrán, Elzbieta Trypka, Christian Borg Xuereb, Nilufer Korkmaz-Yaylagul, Melina Evripidou, Isabel Machado Alexandre, Sigurd Lauridsen","doi":"10.1177/14713012251341374","DOIUrl":"https://doi.org/10.1177/14713012251341374","url":null,"abstract":"<p><p>Assistive technologies hold significant potential to enhance the quality of life for persons with dementia and their caregivers by addressing key concerns related to safety, independence, and social inclusion. Although ethical issues surrounding the design and use of assistive technologies have been explored in various studies, no comprehensive overview of reviews has been conducted to synthesize the existing evidence on these issues. This study aims to categorize the ethical issues associated with assistive technologies for persons with dementia and their caregivers using established ethical principles, while also examining factors shaping the ethical debate on their design and implementation. The study was conducted across nine databases and included reviews published in the past 20 years that substantially addressed ethical considerations. Data synthesis followed the framework synthesis approach developed by Carroll et al. (2011). Out of 509 identified records, 15 reviews focusing significantly on ethical issues were included in the analysis. Findings revealed key ethical issues, including maintaining autonomy, respecting privacy, and addressing equity and accessibility. While assistive technologies demonstrate potential in enhancing safety and independence, concerns about surveillance, depersonalization, and stigmatization persist. The ethical debate is shaped by contextual, philosophical, temporal, and geographical factors, including varying stakeholder priorities, the fluctuating nature of dementia symptoms, diverse approaches to dementia care and ethics, cultural differences, and the implications of future technological advancements. This review underscores the complexity of ethical issues related to assistive technologies for dementia care and how these identified factors inform the ethical design and their use for persons with dementia and their caregivers.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251341374"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082405","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":"Impact of memory clinics on carers of people living with dementia: An integrative review.","authors":"Asha Beattie, Amy Montgomery, Elizabeth Halcomb","doi":"10.1177/14713012251337497","DOIUrl":"https://doi.org/10.1177/14713012251337497","url":null,"abstract":"<p><p>People living with dementia and their carers require ongoing support in the community. Memory clinics can provide a range of supports including education, respite and symptom management. While these clinics improve consumer outcomes, their impact on the carers of people living with dementia is unclear. This review sought to identify and critically synthesise the literature on the effectiveness of memory clinics in supporting carers. An integrative review process was used to identify papers from CINAHL and Medline databases. Of the eight included papers, two were qualitative and six were quantitative studies. Three themes were identified, namely; psychological heath, carer burden and satisfaction with memory clinics. Four studies found decreases in caregiver burden, distress, and psychological symptoms such as anxiety and worry. Satisfaction with the clinic model was discussed as a source of support by carers, highlighting the memory clinics. The variable outcomes seen in this review require further research to elucidate the impacts of memory clinics on carers along the dementia trajectory.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251337497"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082410","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":"Agitation in individuals with Alzheimer's disease: An assessment of behaviors using the cohen-mansfield agitation inventory in community-dwellers and impact on caregiver experience.","authors":"George Grossberg, Cynthia Willey, Christy Houle, Jeff Schein, Rebecca Bungay, Martin Cloutier, Marjolaine Gauthier-Loiselle, Deborah Chan, Annie Guerin, Zahinoor Ismail, Jyoti Aggarwal","doi":"10.1177/14713012251340463","DOIUrl":"https://doi.org/10.1177/14713012251340463","url":null,"abstract":"<p><p>BackgroundAgitation is a common neuropsychiatric symptom of Alzheimer's disease; however, limited information exists on how measurable changes in agitated behaviors relate to overall caregiver experience. We sought to describe agitated behaviors measured by the Cohen-Mansfield Agitation Inventory (CMAI) score among individuals with Alzheimer's disease living in US community-based settings and experience of their caregivers.MethodsAn online survey was conducted (08/26/2021-09/24/2021) among adult caregivers who lived with and provided unpaid care for an individual with Alzheimer's disease. The 3-part survey involved (1) informed consent and screening; (2) CMAI assessment (total and sub-scores for four agitation factors); (3) characteristics and outcomes of caregivers and individuals with Alzheimer's disease. Descriptive statistics are reported. Association between the CMAI total score and caregiver burden (measured using the Zarit Burden Interview), mental health (measured using the Patient Health Questionnaire 4-item), and work/activity impairment (measured using the Work Productivity and Activity Impairment: Caregiver scale) was estimated using regression models.ResultsA total of 250 caregivers (mean age: 44.5 years; 55.2% male; 86.4% White) completed the survey. Based on the CMAI, 99.6% of individuals with Alzheimer's disease (mean age: 68.6 years; 55.2% male; 83.2% White) experienced ≥1 agitated behavior in the past 2 weeks. Caregivers reported providing an average of 39.1 hours of care per week for individuals with Alzheimer's disease (additional non-paid and paid care provided by other caregivers was 58.8% and 38.4%, respectively); 60.8% of caregivers had a high caregiving burden, 35.2% experienced moderate-to-severe distress, and 68.2/64.0% had impairment in work/daily activities. Agitation among individuals with Alzheimer's disease was associated with significantly poorer caregiver outcomes.ConclusionsIndividuals with Alzheimer's disease frequently experience several different agitated behaviors. Effective management of agitated behaviors is important and has the potential to improve the overall caregiver experience.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251340463"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022330","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":"Navigating the diagnosis and treatment of primary progressive aphasia: Lived experience of a rural patient.","authors":"Abigail Avendaño Villaseñor, Ladan Ghazi Saidi","doi":"10.1177/14713012251342630","DOIUrl":"https://doi.org/10.1177/14713012251342630","url":null,"abstract":"<p><p>Frontotemporal dementias (FTD) are a group of early-onset neurodegenerative disorders that primarily affect the frontal and temporal lobes, leading to changes in behavior, motor abilities, communication, and executive functions. Primary progressive aphasias (PPA), the language variant of FTD, specifically impair speech and language abilities. The heterogeneous presentation of FTD, particularly PPA, complicates differential diagnosis and treatment selection for healthcare professionals. These challenges are further exacerbated for patients in rural areas due to limited access to specialized healthcare services. This cross-sectional, descriptive case study examines a 76-year-old male patient diagnosed with agrammatic primary progressive aphasia (nfvPPA) living in a rural area in the U.S. We conducted a semi-structured interview with his caregiver to explore the lived experience of being diagnosed and treated for PPA in a rural setting and to identify challenges encountered during the diagnostic and therapeutic processes. Several critical barriers were identified, including poor interprofessional communication, inadequate practitioner-patient and caregiver communication, limited access to educational resources, inconsistent intervention and follow-ups, and restricted healthcare services. To improve the patient and caregiver experience, we propose a collaborative management model centered around speech-language pathologists with expertise in FTD/PPA. This model aims to facilitate smoother navigation of the healthcare system and improve patient outcomes. Effective care management requires clear and continuous communication among providers, patients, caregivers, and other professionals. Additionally, educating and supporting FTD/PPA patients and their families is essential. Research gaps in rural areas regarding diagnosis and treatment outcomes further hinder care, underscoring the need for targeted studies to enhance clinical practices and improve the quality of life for both patients and caregivers.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251342630"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065435","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":"Frequency of care mediates the effect of older adults' cognitive performance on the perceived strain of their informal caregivers in a middle-income country.","authors":"Lucas Nogueira de Carvalho Pelegrini, Tamara Backhouse, Aline Cristina Martins Gratão, Marcia Regina Cominetti","doi":"10.1177/14713012251342631","DOIUrl":"https://doi.org/10.1177/14713012251342631","url":null,"abstract":"<p><p><b>Background and Objectives:</b> As low and middle-income countries face a rapid increase in their older adult populations, the demand for informal caregiving is expected to rise. Understanding caregiving dynamics in these settings is crucial for developing effective support systems.<b>Aims:</b> To investigate whether the frequency and duration of care provided to older adults mediate the relationship between cognitive performance and caregiver strain.<b>Methods:</b> A cross-sectional study that evaluated informal caregivers of cognitively unimpaired (<i>n</i> = 78) older adults and people living with Alzheimer's dementia (<i>n</i> = 39). We controlled for variables including age, current medications, functional status, cognitive decline, and cognitive functioning. We analyzed whether caregiving frequency and duration mediated the effect of older adults' cognitive performance on caregiver strain.<b>Results:</b> Frequency of care, rather than its duration, significantly mediates the association between older adults' cognitive performance and caregiver strain. Specifically, more days of care are associated with increased caregiver strain, compared to the total number of caregiving hours.<b>Conclusion:</b> Addressing the frequency of caregiving days rather than just the duration in hours offers a more effective approach to reducing caregiver strain. Policies should aim to reduce the number of caregiving days, potentially through expanded respite care programs and full days off for caregivers.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251342631"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029762","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":"Development of a communication curriculum for family care partners of persons living with dementia.","authors":"Suzanne S Sullivan, Elaine Wittenberg, Lori-Jeanne West, Amarjot S Gill, Caitlin Tomko, Catherine Mann","doi":"10.1177/14713012251342029","DOIUrl":"https://doi.org/10.1177/14713012251342029","url":null,"abstract":"<p><p>The healthcare system often fails family care partners of persons living with dementia as their involvement in care requires long-term planning in collaboration with healthcare providers. Unmet needs that may improve family participation in partnering in care include communication, education, and information. The objective of this study was to identify learning objectives to inform development of a communication curriculum for family care partners of persons living with dementia. This three-round Delphi study conducted from June to November 2023 adheres to Conducting and Reporting Delphi Studies (CREDES) guidelines in palliative care. Expert participants were recruited based on their experience as a healthcare professional, academic researcher, policy expert, or family care partner. Participants completed three rounds of surveys to: (a) rank the importance and relevance of learning objectives, (b) rank-order learning objectives from least to most important, and (c) priority-rank learning objectives for each stage of dementia. Participants also provided qualitative feedback for each learning objective. Nine priority learning objectives were identified, with learning objectives for communication knowledge emphasized across all stages of dementia. Unique learning objectives were found for mild stage dementia (sharing positive and negative feelings) and severe stage dementia (defining communication topics for the healthcare team). This study provides a foundation for developing a targeted communication curriculum for family care partners to enhance their skills and confidence when communicating with healthcare providers. Implementing the identified learning objectives in educational programs can improve family care partners' ability to communicate effectively with healthcare professionals, leading to better health outcomes and improved care partner experiences. Variation in learning objectives across stages of dementia suggest targeted intervention approaches.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251342029"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063329","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":"Power, class, and gender in dementia care: Stories of carer precariousness from culturally and linguistically diverse female family carers in Australia.","authors":"Teddy Nagaddya, Ruth Brookman, Olivia Maurice, Celia B Harris","doi":"10.1177/14713012251342059","DOIUrl":"https://doi.org/10.1177/14713012251342059","url":null,"abstract":"<p><p>Dementia care provision is a global challenge. However, dynamics to provide care to a family member living with dementia in their home are far more complex. Evidence suggests that dementia care among culturally and linguistically diverse (CALD) communities is largely offered by family members within communities. But at a family level, care happens at the intersection of unequal gender relations, complex cultural constructions of dementia, and longstanding family values and traditions. While these dynamics show the intersection of power, class, and gender, these aspects have not gained widespread currency in dementia policy plans. Yet they shape the identities and social positioning of carers and consequently carer precariousness. This article reveals that the role of caring for family members living with dementia is embedded in complex power structures that stigmatise the identities of carers and those cared for, reproduces gendered social hierarchies, exacerbate economic uncertainties, and diminish the merits of filial piety - a valued cultural practice. By centering the voices of female carers from a CALD background, the authors highlight the need for policymakers to devote particular attention to how the intersection of the diverse cultural environments with dementia care at a family level induce carer insecurities and vulnerabilities - precariousness. This calls for an emancipatory dementia policy agenda that values the lived experiences of female carers' cumulative disadvantage over the course of providing care.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251342059"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028392","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 stimulation in non-memory led dementias: A scoping review.","authors":"Chiara Lousley, Joshua Stott, Caroline Fearn, Céline El Baou, Suman Kurana, Emilie V Brotherhood, Aimee Spector","doi":"10.1177/14713012251342018","DOIUrl":"https://doi.org/10.1177/14713012251342018","url":null,"abstract":"<p><p>ObjectivesCognitive stimulation is a non-pharmacological approach to support cognitive and social functioning in people with dementia. This review aimed to evaluate the evidence for the feasibility of cognitive stimulation in people with non-memory led dementias, and whether adaptations may accommodate individuals' primary symptoms.MethodsWe conducted a scoping review, searching five databases (PsycINFO, MedLINE, EMBASE, Web of Science and Cinhal Plus) for cognitive stimulation studies in people with non-memory led dementias specifically.ResultsEight studies met the inclusion criteria, focusing on Parkinson's related dementia (<i>N</i> = 7), and posterior cortical atrophy (<i>N</i> = 1). The studies included, five quantitative and three mixed-methods designs. Six studies reported on the effects of cognitive stimulation interventions on domains such as cognition and mood. The findings on cognitive stimulation for non-memory led dementias were generally mixed and were limited by studies with small sample sizes.ConclusionsThis review indicated the limited research on cognitive stimulation interventions for non-memory led dementias, with adaptations primarily focussed on just Parkinson's related dementia. Future research could expand on existing adaptations for Parkinson's related dementia by gathering additional insights from individuals with other non-memory led dementias, for example, posterior cortical atrophy, frontotemporal dementia and primary progressive aphasia, along with input from their caregivers and dementia care professionals. This approach may help adapt cognitive stimulation interventions to meet the unique cognitive needs associated with diverse dementia profiles.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251342018"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014215","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":"Co-designing a mealtime intervention integrating Spaced Retrieval and montessori-based activities for people with dementia living in nursing homes.","authors":"Zhoumei Yan, Victoria Traynor, Elizabeth Halcomb, Ibrahim Alananzeh, Joel Zugai, Peta Drury","doi":"10.1177/14713012251340112","DOIUrl":"https://doi.org/10.1177/14713012251340112","url":null,"abstract":"<p><p>IntroductionEating difficulties significantly impact the nutrition, health, and well-being of people with dementia worldwide. Training strategies, such as Spaced Retrieval and Montessori-based activities, have the potential to enhance the self-eating ability of people with dementia but have not been widely tested. This paper reports the co-design and preliminary testing of the SPREMON (Spaced Retrieval and Montessori-based activities) intervention to enhance mealtime independence and experiences for people with dementia living in nursing homes.MethodsInformed by experience-based co-design methodology, this study used a three-phase approach to intervention development. Three initial sessions were conducted with aged care professionals to develop and refine the intervention. Four pilot sessions were conducted with people with dementia to assess the feasibility and suitability of intervention elements. A final consultation session explored the data and identified barriers and facilitators to successful implementation. While field notes were kept in early sessions, the final session was audio-recorded and transcribed for analysis. Thematic analysis was undertaken with all qualitative data, while observational data are reported using descriptive statistics.FindingsSix aged-care professionals, 3 researchers, and 9 people with dementia participated in the intervention development. The intervention approach was positively appraised for its potential to enhance self-feeding abilities in people with dementia while saving staff time. Participants suggested improvements to the Spaced Retrieval approach by incorporating visual and verbal cues to make it less confrontational. However, challenges regarding the lack of detail and guidance for implementing Montessori-based activities made them difficult to apply without clarification. Additional barriers included staff shortages, engagement difficulties, and scheduling conflicts. Pilot activities highlighted practical considerations for intervention implementation and patient engagement.Discussion and ImplicationsThis study demonstrates that the SPREMON intervention holds significant potential to enhance the self-eating ability of people with dementia living in nursing homes. However, the paper also highlights potential challenges in the implementation.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251340112"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057632","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":"Creative support: Enhancing well-being in mild and moderate cognitive impairment through museum interventions.","authors":"Sergey Zakharov, Adi Lifshitz-Ben-Basat, Sharon Barak, Sharon Levi, Ile Kermel Schiffman, Yael Maizels, Shmuel Springer, Riki Tesler","doi":"10.1177/14713012251340468","DOIUrl":"https://doi.org/10.1177/14713012251340468","url":null,"abstract":"<p><p>BackgroundThe global incidence of dementia is increasing, establishing it as a significant cause of disability and diminished quality of life. The World Health Organization underscores the necessity of enhancing the well-being of individuals with dementia and their caregivers. Research has indicated that art-based interventions can improve cognitive functions and overall quality of life. This pilot study aimed to evaluate the impact of a museum-based intervention program on the well-being (quality of life, depression, and mood) of individuals with mild-to-moderate cognitive impairment (MCI-moderate), which may indicate early to moderate stages of dementia that was not formally diagnosed.MethodsWe recruited 29 participants with MCI-moderate (median MoCA score: 22). The intervention group consisted of 16 individuals (11 females, 5 males; mean age 83.5 years) who attended sessions at an art museum in Israel every once a week from March to April 2023. Thirteen age-matched individuals formed the control group, which did not participate in the museum program. Measures of well-being were assessed before and after the intervention, along with collecting participants' feedback. Well-being changes within and between-groups were analyzed using mixed model analysis of variance. Effect sizes were also calculated.ResultsThe intervention group showed significant improvements in quality of life with large effect sizes in all domains, and a significant reduction in depression symptoms; the control group experienced non-significant changes. Additionally, mood significantly improved following museum activities. Most participants positively reviewed the program, with a significant majority reporting enhanced mood (81.2%) and a strong intention to recommend it (93.7%); 62.5% expressed a desire for future participation.ConclusionsOur findings suggest that art interventions, such as museum programs, can significantly boost well-being in people with MCI-moderate, suggesting further exploration of the specific elements of such programs and their long-lasting effects.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012251340468"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042980","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}