Psychiatric research and clinical practice最新文献

{"title":"Ongoing Challenges to Integrating Care in Settings That Serve Patients With Serious Mental Illness and Substance Use Disorder.","authors":"Jennifer D Hall, Maria N Danna, Deborah J Cohen, K John McConnell","doi":"10.1176/appi.prcp.20250020","DOIUrl":"10.1176/appi.prcp.20250020","url":null,"abstract":"<p><strong>Background: </strong>People with serious mental illness (SMI) and substance use disorders (SUD) experience difficulties accessing high-quality medical care, despite their elevated risk for chronic health conditions. One proposed solution is the integration of medical and behavioral health services. This study identifies the barriers behavioral health agencies (BHAs) face when attempting to incorporate physical health services for their patients, following a legislative change requiring managed care organizations (MCOs) to oversee all Medicaid-covered medical, mental health, and SUD services.</p><p><strong>Methods: </strong>We conducted semi-structured interviews (<i>n</i> = 34) with MCO and BHA leaders to identify the barriers to integrating care following this policy change.</p><p><strong>Results: </strong>BHAs highlighted the absence of established integrated care models for serving patients with SMI or SUD. Integrating services incurred additional costs, and motivated BHA leaders sought out grants to fund their efforts. MCOs described the limitations to offering alternative payments to BHAs, and BHAs reported that reimbursement rates were insufficient to hire primary care clinicians due to their relatively small size. BHAs expressed a need for reimbursement rates and methodologies better aligned with their patients' needs.</p><p><strong>Relevance to clinical practice: </strong>Supporting integrated care within settings that serve patients with SMI and SUD is essential for addressing this population's higher rates of chronic illness and inequities in healthcare access and treatment.</p><p><strong>Conclusion: </strong>Current obstacles suggest that only the most mission-driven BHAs are likely to attempt integration. Engaging states and payers to overcome these barriers is a critical step toward implementing and sustaining integrated care in behavioral health settings.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791626","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":"Assessment, Intervention, Monitoring, Step-Up/Step-Down (AIMS) in Action: 5 Years Review of Transforming Transitions in Crisis Care.","authors":"Jacqui Chiu, Idalia Rodriguez, Nikki Geffen, Marianne Wyder, Muthur Anand, Sharon Locke, Abigail Lane, Kieran Kinsella, Manaan Kar Ray","doi":"10.1176/appi.prcp.20250091","DOIUrl":"10.1176/appi.prcp.20250091","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Emergency departments (EDs) are the primary entry point for individuals in acute mental health crisis in Australia. However, EDs are ill-suited to meet the complex needs of this population, often resulting in suboptimal outcomes. This study evaluates the impact of a novel model designed to improve crisis care coordination by integrating a transition coordinator (TC) role and the AIMS (Assessment, Intervention, Monitoring, Step-up/Step-down) framework across community mental health services, ED, and inpatient settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected from an Australian metropolitan public mental health service over 5 years (2020-2024). Routinely gathered TC records documented proactive identification of mental health deterioration and subsequent care pathways. Additional data from 2022 onward tracked all ED presentations by individuals receiving case management. Descriptive statistics were used to examine changes in service use and care coordination outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over the study period, 4382 individuals were proactively flagged to the TC, with 72.6% supported in the community and 1230 admitted via direct or coordinated pathways. Coordinated admissions rose substantially, while unplanned ED presentations declined by 21.4% from 2022 to 2024. Among flagged individuals, uncoordinated admissions dropped by 66.1%. Early detection and enhanced communication across services were key contributors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The introduction of the TC role and AIMS framework significantly improved proactive identification, reduced unplanned ED presentations, and fostered timely, coordinated crisis responses. These changes illustrate the importance of building capacity, capability, and culture to shift from reactive to proactive care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Relevance to clinical practice: &lt;/strong&gt;This study demonstrates the role of structured coordination in improving outcomes for individuals experiencing mental health crises. The TC functions as a dedicated clinical bridge between community and hospital settings, facilitating earlier identification of mental health deterioration and streamlined crisis responses. Importantly, this role supports case managers in navigating logistical and systemic barriers, ensuring people received timely, appropriate care while minimizing unnecessary ED presentations. From a clinical practice perspective, the findings advocate for investment in roles and frameworks that prioritize continuity of care, shared decision-making, and person-centered pathways. The implementation of the AIMS framework offers a common clinical language across services, enhancing communication and reducing fragmentation during transitions. Clinicians are empowered to move away from a crisis-driven mindset and instead adopt a proactive stance, treating admission not as a failure but as a legitimate and therapeutic component of care when appropriately timed. The reduction i","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791556","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":"Correction to \"Quality of Life and Functioning Impairments Across Psychiatric Disorders in Adults Presenting for Outpatient Psychiatric Evaluation and Treatment\".","authors":"","doi":"10.1176/rcp2.70030","DOIUrl":"https://doi.org/10.1176/rcp2.70030","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1176/appi.prcp.20230064.].</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"286"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783852","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":"Quantifying the Societal Impacts of Schizophrenia: A Survey of Caregivers.","authors":"Holly Krasa, Kelly Birch, Frances Eskew, Theresa Frangiosa, Andrew Palsgrove, Melissa C Maravic","doi":"10.1176/appi.prcp.20240135","DOIUrl":"10.1176/appi.prcp.20240135","url":null,"abstract":"<p><strong>Objective: </strong>To characterize humanistic and financial burden associated with caregiving for people with schizophrenia in the United States.</p><p><strong>Methods: </strong>Unpaid caregivers (<i>n</i> = 200) of adults with schizophrenia or schizoaffective disorder completed an online survey. Caregiver impacts were determined by quantifying out-of-pocket (OOP) costs for care recipient everyday needs and significant life events (SLEs), humanistic burden assessed by the Burden Assessment Scale, and career, educational, and personal impacts that result from caregiving.</p><p><strong>Results: </strong>Caregivers were 42.3 ± 13.4 years old, with 54.0% of identifying as male, 65.5% as white, 24.5% as Black or African American, and 11.0% as Hispanic or Latino/a. Caregivers reported providing 36.1 ± 33 h of care per week. Per caregiver report, care recipients had experienced two SLEs in the past year, most frequently including psychiatric hospitalization (64.5%), education and employment support (32.0%), and substance use treatment (28.0%).Caregivers reported paying OOP to support SLEs (average annual costs ranged from $1068 to $2395 across categories). Caregivers also reported additional monthly OOP costs of $1809 for everyday needs. The highest monthly costs included mental health treatment ($767), property damage ($728), housing ($670), and medication ($664). Individuals with schizophrenia residing in the caregiver's home and at least one SLE in the past year were associated with significantly higher monthly OOP spending (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The demands of caregiving for individuals with schizophrenia require additional emotional and financial resources. Clinicians should offer resources to mitigate impacts of caregiver burden as an important approach to support patient recovery.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"244-253"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783922","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":"Five-Year Implementation of Zero Suicide: Lessons Learnt From an Academic Health System.","authors":"Seethalakshmi Ramanathan, Lianne De La Cruz, Michiko Ueda, Jay Carruthers","doi":"10.1176/appi.prcp.20250078","DOIUrl":"10.1176/appi.prcp.20250078","url":null,"abstract":"<p><strong>Objective: </strong>The rising rates of suicide in the United States have motivated several interventions, including among health systems. A leading quality improvement approach for health systems is the Zero Suicide (ZS) model. Despite its well-recognized nature, implementation of ZS initiatives across health systems remains underutilized and understudied. We evaluated a 5 year-long real-world implementation of the ZS initiative in a behavioral health inpatient setting to understand strategies and challenges.</p><p><strong>Methods: </strong>Electronic medical record (EMR) data were used over a period of 5 years between January 2020, and June 2024, to study implementation of 3 clinician-delivered domains of the zero-suicide model, identify, engage, and transition. For each domain, we evaluated implementation rates and then stratified by demographic characteristics. We also estimated a logit model with individual-level data to examine whether implementation rates varied by demographic characteristic.</p><p><strong>Results: </strong>During the implementation period, 8810 individuals were hospitalized and included 5703 unique individuals. For each domain, attrition was noted. Racial and gender disparities were observed in all domains. While 100% of individuals were screened and stratified for risk level, approximately 80% of individuals identified as high risk received safety planning, and 53.3% accepted the proposed transition intervention. Refusal reasons ranged from having enough resources to feeling overwhelmed.</p><p><strong>Conclusion: </strong>Our study provides useful insights for behavioral health settings planning to implement the ZS initiative and discusses strategies including EMR integration.</p><p><strong>Relevance to clinical practice: </strong>For clinical systems incorporating ZS as a quality improvement implementation, this study provides suggestions about potential challenges, particularly related to sociodemographic disparities.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"254-260"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783924","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":"Prevalence and Implementation of Psychiatric Advance Directives Among Veterans With Serious Mental Illness.","authors":"Lauren McBride, Nathaneal Putris, Will Hagans, Ardrina Hoxey, David Oakes, Vanessa Girard, Andrea Avila, Emily Treichler","doi":"10.1176/appi.prcp.20250024","DOIUrl":"10.1176/appi.prcp.20250024","url":null,"abstract":"<p><strong>Objective: </strong>Psychiatric advance directives (PADs) are evidence-based tools to increase patient autonomy and reduce coercive practices in inpatient psychiatric settings. No prior research has investigated PAD prevalence or implementation within the Veterans Health Administration (VHA), the largest integrated healthcare provider in the US. Our aims were to (1) determine the prevalence and (2) assess the implementation of PADs among Veterans with serious mental illness (SMI) receiving care at the VHA.</p><p><strong>Methods: </strong>We reviewed electronic health records for Veterans in the Southwestern US enrolled in VHA SMI specialty treatment programs. The study had two phases. During phase one, we collected data on the presence of PADs within Veterans' medical records, along with mental health preferences specified in each PAD. In phase two, we examined evidence of PAD implementation via record review during subsequent psychiatric hospitalizations.</p><p><strong>Results: </strong>Among 5021 Veterans, 160 had a PAD (3.2%). Zero medical record notes from inpatient hospitalizations contained any explicit evidence of PAD implementation. Medical record notes from inpatient hospitalizations falsely stated that Veterans did not have a PAD in 89% of cases, and care aligned with Veterans' preferences 49% of the time.</p><p><strong>Conclusions: </strong>Few Veterans with SMI have PADs, and for those who do, their preferences are not consistently implemented during psychiatric crises. Addressing VHA-specific PAD implementation barriers is warranted to improve VHA inpatient psychiatric care.</p><p><strong>Relevance to clinical practice: </strong>Despite their potential to increase patient autonomy and reduce coercive crisis interventions in inpatient psychiatric settings, low uptake of PADs within the VHA suggests an important gap in recovery-oriented care delivery.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"277-285"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783931","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":"Post-Stroke Acute Psychosis With Homicidal Ideation.","authors":"Adam Dalkilic, Cristian Cirjan","doi":"10.1176/appi.prcp.20250102","DOIUrl":"10.1176/appi.prcp.20250102","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 3","pages":"213-214"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042535","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":"Prevalence of Anxiety and Depression Among Children and Adolescents in Low- and Middle-Income Countries-A Systematic Review.","authors":"Karishma Ramdhonee-Dowlot, Kieran Balloo, Evren Morgül, Cecilia A Essau","doi":"10.1176/appi.prcp.20250026","DOIUrl":"10.1176/appi.prcp.20250026","url":null,"abstract":"<p><strong>Background: </strong>This study reviews literature examining the prevalence of emotional problems (i.e., anxiety and depressive symptoms) among child and adolescent populations living in low- and middle-income countries (LMICs).</p><p><strong>Method: </strong>Following recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, PsycINFO (EBSCO), and MEDLINE (PubMed) databases were searched for articles published from January 1, 2000 to April 30, 2024. Quantitative studies reporting epidemiological/prevalence data were included in the review.</p><p><strong>Results: </strong>Fifty-one studies (<i>N</i> = 208,842) across 23 LMICs were included in a qualitative synthesis. Measures used in studies on LMIC samples were comparable to those used in high-income countries (HICs). The prevalence of emotional problems among children and adolescents in LMICs appears to be higher than in HICs. The synthesis showed an estimated prevalence ranging from 1% to 58% for depression, 1% to 30% for anxiety, and 1% to 41% for overall emotional problems (i.e., both anxiety and depression). The review indicates that types of anxiety problems with the highest prevalence estimates related to symptoms of generalized anxiety (18.2%), separation anxiety (14.0%), posttraumatic stress (32.0%), specific phobia (20.9%), and social phobia/social anxiety (20.2%).</p><p><strong>Conclusions: </strong>There are a number of potential risk factors for child and adolescent populations living in LMICs, which could explain the elevated prevalence: an increased vulnerability related to being left-behind by one or both migrant parents, orphaned status due to high rates of mortality from poor health conditions, experiences of war conflict and violence, childhood maltreatment, and poverty. These findings highlight the urgent need for scalable, culturally sensitive mental health screening, prevention, and intervention programs tailored to LMIC contexts. They also have important implications for global child and adolescent mental health policy, funding priorities, and capacity-building efforts.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"218-243"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783843","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":"Psychiatric Advance Directives: An Analysis of Current Usage at a Large County Hospital.","authors":"Vivek Mathesh, Kayla Murphy, Mashal Ali, Natalie Provenzale, Christopher Clark, Joan Reisch, Abhisek Khandai, Moises Narvaez, Mustafa M Husain","doi":"10.1176/appi.prcp.20250025","DOIUrl":"10.1176/appi.prcp.20250025","url":null,"abstract":"<p><strong>Background/purpose: </strong>Approximately one third of adults in the United States complete a Medical Advance Directive in their lifetime. However, few complete a Psychiatric Advance Directive (PAD), despite the high prevalence of psychiatric illness. PADs help those with mental illness specify their care preferences during periods of acute psychiatric illness. Given the minimal research regarding PAD usage, the use of PADs in clinical practice remains poorly understood. This study aims to use electronic health record (EHR) data to investigate and describe PAD usage in a large, county health system.</p><p><strong>Methods: </strong>EHR data for all patients 18 years and older with a 2022 inpatient or observation discharge were retrieved. A sample of these patients who had scanned Advance Directive documents were reviewed to assess for the presence of a PAD.</p><p><strong>Results: </strong>A total of 41,421 patients were included in this EHR analysis. No PAD documents were found in this population.</p><p><strong>Conclusion: </strong>Although the PAD template was published on the hospital website, we found no evidence of completed PADs at our facility. Further work is needed to educate providers on the importance of PADs and promote appropriate and inclusive PAD usage at the health system level.</p><p><strong>Relevance to clinical practice: </strong>This research identifies a significant gap in PAD utilization and emphasizes the potential for increased PAD use in clinical care. It highlights current obstacles to PAD implementation while offering actionable next steps for how PADs can fit into the larger flow of patient care.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"269-276"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783919","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":"Reliability and Validity of the Full-Length Greek-Cypriot Version of the Children's Depression Inventory 2.","authors":"George Alexandrou, Maria Karanikola, Andreas Chatzittofis, Sokratis Sokratous","doi":"10.1176/appi.prcp.20250033","DOIUrl":"10.1176/appi.prcp.20250033","url":null,"abstract":"<p><strong>Objective: </strong>Childhood depression has become a serious concern in recent years. Therefore, it is important for healthcare professionals to have a reliable instrument for measuring depressive symptoms adapted to their culture and language. The Children's Depression Inventory 2 (CDI-2) is a tool that has been widely used in many countries. The present study aimed to investigate the internal consistency reliability and construct validity of the full-length 28-item Greek-Cypriot version of the CDI-2: Self Report (CDI-2:SR) among schoolchildren in Cyprus.</p><p><strong>Methods: </strong>A methodological instrument validation design was performed between 2020 and 2023 on a nationwide random sample of schoolchildren in Cyprus recruited from public elementary schools. A total of 420 Cypriot children aged 11-13 years were included in the study. Internal consistency was determined, and factor analysis was performed to examine the psychometric properties of the CDI-2:SR.</p><p><strong>Results: </strong>The internal consistency of the CDI-2:SR was adequate. In addition, factor analysis indicated a two-factor solution, with the first factor reflecting social-emotional problems and the second factor representing cognitive-behavioral problems.</p><p><strong>Conclusions: </strong>The Greek Cypriot version of the instrument appeared to be satisfactory in terms of reliability and validity for screening depressive symptoms in children.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"7 4","pages":"261-268"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783837","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}