Archives of gerontology and geriatrics最新文献

{"title":"Spillover effects of integrated care: Evidence from the impact of Home- and Community-Based Integrated Care for Older Adults (HCICOA) on spouses’ health and well-being in China","authors":"Yating Liu ,&nbsp;Chenlu Hong ,&nbsp;Guangwen Liu ,&nbsp;Yujie Huang ,&nbsp;Boyuan Guan ,&nbsp;Yanan Luo","doi":"10.1016/j.archger.2025.105907","DOIUrl":"10.1016/j.archger.2025.105907","url":null,"abstract":"<div><h3>Background</h3><div>Home- and Community-Based Integrated Care for Older Adults (HCICOA) has been rapidly implemented in China to address aging population needs. While its direct benefits for care recipients are well studied, its spillover effects on spouses remain underexplored. This study examines HCICOA’s impact on spouses' health and well-being.</div></div><div><h3>Methods</h3><div>Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, we employed a difference-in-differences (DID) approach to estimate HCICOA’s effects on spouses' happiness, life satisfaction, self-reported health, depressive symptoms, chronic diseases, and function status.</div></div><div><h3>Results</h3><div>HCICOA positively influenced spouses' happiness (β=0.322, <em>P</em> &lt; 0.01), especially among female spouses (β=0.369, <em>P</em> &lt; 0.05), rural residents (β=410, <em>P</em> &lt; 0.01), those with lower education (β=0.394, <em>P</em> &lt; 0.01) and those in western China. However, no significant effects were found on life satisfaction (β=0.084, <em>P</em> = 0.054), self-reported health (β=-0.025, <em>P</em> = 0.577), depressive symptoms (β=0.026, <em>P</em> = 929), chronic diseases (β=-0.046, <em>P</em> = 0.604), or function status (β=0.018, <em>P</em> = 0.860).</div></div><div><h3>Conclusions</h3><div>HCICOA has a positive spillover effect on spousal happiness, underscoring its broader social advantages. Policymakers should expand implementation of the HCICOA and adopt a family-centered approach in designing HCICOA program to further broaden its coverage and impact.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105907"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between social isolation and depression, and sex differences in older adults: A systematic review and meta-analysis","authors":"Yuyan Liu ,&nbsp;Yue Zhou ,&nbsp;Dan Sun ,&nbsp;Yuhang Wen ,&nbsp;Hui Zhao ,&nbsp;Yu Long ,&nbsp;Qiongge Yu ,&nbsp;Qiufeng Jia ,&nbsp;Yufeng Yu","doi":"10.1016/j.archger.2025.105915","DOIUrl":"10.1016/j.archger.2025.105915","url":null,"abstract":"<div><h3>Background</h3><div>Depression is the most common mental health problems worldwide. Although several studies have explored the relationship between social isolation and depression, the specific association and gender differences are still inconsistent.</div></div><div><h3>Objective</h3><div>To systematically evaluate the association between social isolation and depression, and sex differences in older adults.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Web of Science, Cochrane Library, Scopus, and PsycINFO databases from inception to January 21, 2025. Two researchers independently conducted literature screening, data extraction, and quality evaluation. Meta-analysis was performed using Stata 17.0.</div></div><div><h3>Results</h3><div>This meta-analysis included a total of 11 studies, involving 103,408 older people from 7 different countries, which showed a significantly increased risk of depression in older adults who experienced social isolation (OR 1.46, 95 % CI 1.21–1.77). Sex differences analysis revealed that females (OR 1.59, 95 % CI 1.08–2.33) were at greater risk of depression compared to males (OR 0.98, 95 % CI 0.75–1.27). Subgroup analyses showed that the risk of depression was significantly increased in older people with advanced age and low education levels, and was significantly increased in both developed and developing countries, especially Europe and Asia. Cross-sectional and cohort studies also showed strong associations.</div></div><div><h3>Conclusions</h3><div>Social isolation significantly increases the risk of depression among older adults, with consistent findings across age, education level, region, and level of economic development. Analysis of gender differences suggests that older women are particularly affected. Strengthening the identification of social isolation in older people is essential to prevent depression in older people and promote successful aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105915"},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213278","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":"Feedback mechanisms between physical frailty and cognitive declines in older community-dwelling adults: The Rancho Bernardo Study","authors":"Kai Zhang","doi":"10.1016/j.archger.2025.105870","DOIUrl":"10.1016/j.archger.2025.105870","url":null,"abstract":"<div><div>This study investigates bidirectional feedback mechanisms between physical frailty and cognitive decline in older adults using 12-year longitudinal data from the Rancho Bernardo Study. Frailty phenotypes were assessed through measures of body composition (appendicular lean mass, adjusted by BMI and height squared), weakness (handgrip strength), and physical functioning (Timed Up-and-Go test and 5-times chair stand test). Cognitive function was evaluated using the Mini-Mental State Examination (global cognitive function), Trail Making Test (executive function), Category Fluency Test (semantic memory), and Buschke–Fuld Selective Reminding Test (verbal episodic memory). We propose a mediation-based approach to model the temporal sequences within the complex system of frailty, and found significant reciprocal associations between physical and cognitive decline. For example, muscle strength fully mediated the association between prior body composition and subsequent cognitive functions, and vice versa. These findings advance the understanding of frailty as a dynamic, multifaceted syndrome by elucidating the direct and indirect pathways across its functional domains, highlighting muscle strength as a pivotal target for screening and interventions to mitigate frailty progression.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105870"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205536","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":"Muscle-fat interactions in aging–A call for mechanistic research to guide clinical practice","authors":"Liang-Kung Chen","doi":"10.1016/j.archger.2025.105913","DOIUrl":"10.1016/j.archger.2025.105913","url":null,"abstract":"","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105913"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201041","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":"Causal relationships between micronutrients and sarcopenia: a two-sample bidirectional Mendelian randomization study","authors":"Huilin Liu ,&nbsp;Jiahui Chen ,&nbsp;Shihao Ni ,&nbsp;Wenjie Long ,&nbsp;Xiaoming Dong ,&nbsp;Huili Liao ,&nbsp;Lu Lu ,&nbsp;Zhongqi Yang","doi":"10.1016/j.archger.2025.105917","DOIUrl":"10.1016/j.archger.2025.105917","url":null,"abstract":"<div><div>Sarcopenia, a geriatric syndrome in older adults, significantly impacts quality of life and elevates health risks. This study examines the causal relationships between specific micronutrients—magnesium, selenium, calcium, zinc, iron, phosphorus, and omega-3 fatty acids—and sarcopenia-related traits (SP-traits) using Mendelian randomization (MR) based on genome-wide association studies (GWAS). A bidirectional two-sample MR analysis was performed using data from fourteen GWAS, focusing on five SP-traits: low hand grip strength, moderate-to-vigorous physical activity (MVPA), ability to walk or cycle unaided for 10 min (AWCU10), usual walking pace, and adjusted appendicular lean mass (ALM). The analysis identified 14 single nucleotide polymorphisms (SNPs) linked to zinc levels and MVPA, and 12 SNPs associated with usual walking pace. Concerning ALM, 72 SNPs were associated with magnesium and 81 with omega-3 fatty acids. Significant associations were noted between zinc levels and MVPA (beta = 0.85, <em>P</em> = 0.026) and usual walking pace (beta = 0.53, <em>P</em> = 0.008). The reverse MR analysis revealed a positive correlation between ALM and magnesium (beta = 0.126, <em>P</em> = 0.0004) and a nominally significant negative correlation with omega-3 (beta = -0.083, <em>P</em> = 0.008). While some heterogeneity was noted, no pleiotropy was detected, reinforcing the robustness of the findings. This study highlights the importance of magnesium, zinc, and omega-3 fatty acids in muscle health and advocates for their inclusion in public health strategies to enhance the physical function and quality of life in older adults. Further research is needed to validate these findings across diverse populations.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105917"},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229835","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":"Combined association of social isolation and loneliness with frailty onset among independent older adults: A JAGES cohort study","authors":"Mamoru Sato ,&nbsp;Manami Hoshi-Harada ,&nbsp;Kenji Takeuchi ,&nbsp;Taro Kusama ,&nbsp;Takaaki Ikeda ,&nbsp;Sakura Kiuchi ,&nbsp;Masashige Saito ,&nbsp;Naoki Nakaya ,&nbsp;Ken Osaka","doi":"10.1016/j.archger.2025.105914","DOIUrl":"10.1016/j.archger.2025.105914","url":null,"abstract":"<div><h3>Objectives</h3><div>Social isolation and loneliness each have negatively affect various health outcomes. No studies have examined the combined association of social isolation and loneliness on frailty onset. This study aimed to investigate both the objective and subjective aspects of isolation by evaluating social isolation and loneliness and to determine their interaction effects on frailty onset.</div></div><div><h3>Methods</h3><div>This cohort study used data from the 2019 and 2022 Japan Gerontological Evaluation Study. The eligible participants were independent older adults aged ≥65 years without frailty in 2019. The outcome variable was frailty onset in 2022. The exposure variables were social isolation and loneliness in 2019. Risk ratios (RR) and 95 % confidence intervals (CI) were estimated using modified Poisson regression models, with potential confounders as covariates. Moreover, a multiplicative scale and relative excess risk due to interaction (RERI) was used to assess the interaction.</div></div><div><h3>Results</h3><div>The analysis included 8440 participants (mean age: 73.2 [standard deviation, 5.5] years). During the follow-up, 15.1 % of participants experienced frailty onset. After adjusting for all covariates, the “severe isolation” &amp; “severe loneliness” group had the highest risk of frailty onset (RR = 2.09 [95 % CI: 1.60–2.73]) compared to “no isolation” &amp; “no loneliness” group. However, there were no significant multiplicative and additive interaction between social isolation and loneliness on frailty onset (multiplicative scale: 0.75 [95 % CI: 0.50–1.11]; RERI:0.29 [95 % CI:1.02–0.44]).</div></div><div><h3>Discussion</h3><div>These findings highlight the importance of considering social factors such as interaction with others and loneliness, to prevent frailty.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105914"},"PeriodicalIF":3.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213324","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":"Heterogeneity in the association between internet use and dementia among older adults: A machine-learning analysis","authors":"Atsushi Nakagomi ,&nbsp;Katsunori Kondo ,&nbsp;Koichiro Shiba","doi":"10.1016/j.archger.2025.105912","DOIUrl":"10.1016/j.archger.2025.105912","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Internet use among older adults may reduce the risk of dementia, but it remains unknown how the effects vary across individuals. The aim of this study was to rigorously examine heterogeneity in the association between internet use and dementia among older adults with a machine learning approach.</div></div><div><h3>Methods</h3><div>This cohort study used data from the Japan Gerontological Evaluation Study involving functionally independent adults aged 65 or older (n = 5,451). The exposure, internet use a few times a month or more often, was assessed with the 2016 survey (baseline) and covariates (potential confounders and effect modifiers) were assessed with the 2013 survey (pre-baseline). Follow-up continued until 2022, identifying 5.5-year dementia onset (n = 549) using the public long-term care insurance system. Using the generalized random forest algorithm, we estimated how the association between internet use and dementia onset during a 5.5-year follow-up period varies by pre-baseline sociodemographic characteristics and health conditions.</div></div><div><h3>Results</h3><div>Internet use was on average associated with a lower risk of dementia (estimated population average effect = -0.033; 95 % CI: -0.051, -0.016). However, we found evidence of between-individual heterogeneity in this association, where internet use appeared more beneficial among individuals who reported middle income, higher education levels, and were socially and physically inactive at the pre-baseline wave.</div></div><div><h3>Conclusions</h3><div>Internet use may disproportionately benefit people based on socioeconomic status, suggesting equity concerns of universal implementation. Understanding such effect heterogeneity can inform more targeted public health interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105912"},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189984","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":"Financial performance of people with acquired cognitive impairments or affective disturbances – A prospective, European-wide study","authors":"Ting Jiang,&nbsp;Geraldina F. Gaastra,&nbsp;Janneke Koerts","doi":"10.1016/j.archger.2025.105911","DOIUrl":"10.1016/j.archger.2025.105911","url":null,"abstract":"<div><h3>Background</h3><div>Financial capability, encompassing both financial competence and financial performance, is essential for independent living. However, individuals with neurological and psychiatric disorders often demonstrate difficulties with financial capability. This study examined the influence of common neurological and psychiatric conditions, i.e., Alzheimer's disease (AD), Parkinson's disease (PD), stroke, and affective disturbances, on financial performance.</div></div><div><h3>Methods</h3><div>Prospective data from wave 8 (<em>n</em>= 53,695) and wave 9 (<em>n</em>= 69,477) of the Survey of Health, Retirement and Ageing in Europe were used, which included individuals aged 50+; part of Wave 8 and all of Wave 9 data were collected during the COVID-19 pandemic. Logistic regressions and group comparisons were conducted to analyze the influence of self-reported disease diagnosis on three aspects of (future) financial performance: difficulties in managing money, difficulties in making ends meet, and debt situation.</div></div><div><h3>Results</h3><div>Compared to controls, participants with one of the four conditions reported significantly more often having difficulties managing money. Within the AD group, over half of the participants reported these difficulties. The different diagnoses also predicted both current and future difficulties in managing money and making ends meet. However, only affective disorders were associated with and predicted a higher likelihood of having household debts.</div></div><div><h3>Discussion and Implications</h3><div>Compared to controls, individuals with PD, AD, stroke, or affective disorders are more prone to experiencing impairments with both current and future financial performance, potentially facing financial difficulties. These results emphasize the importance of recognizing financial difficulties in such individuals and offering financial assistance when needed.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105911"},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178463","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":"The influence of the built environment and perceived neighborhood on physical frailty and sarcopenia in older adults: A systematic review","authors":"Lucas dos Santos Ferreira ,&nbsp;Thais Evelin Marques da Silva ,&nbsp;Eliziane Batista dos Santos ,&nbsp;Felipe Fank ,&nbsp;João Araújo Barros Neto ,&nbsp;Enaiane Cristina Menezes","doi":"10.1016/j.archger.2025.105910","DOIUrl":"10.1016/j.archger.2025.105910","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the scientific evidence on the relationship between the built environment, perceived neighborhood, and physical frailty and sarcopenia in older adults.</div></div><div><h3>Methods</h3><div>The search used PUBMED, SCOPUS, EMBASE, Web of Science, Scielo databases, and Google Scholar as gray literature. Studies with non-institutionalized older adults aged 60 years or older that tested the relationship with the perceived neighborhood and built environment and with physical frailty or sarcopenia, as well as observational studies published in English, Portuguese, and Spanish, were included.</div></div><div><h3>Results</h3><div>18 studies were included in the qualitative synthesis (<em>n</em> = 102.789 older adults). Three studies evaluated the relationship between the built environment and perceived neighborhood and sarcopenia, and 15 studies with physical frailty. Regarding the study design, five studies were cohort, and 13 were cross-sectional. The results found that lack of access to public transportation, poor access to recreational facilities, absence of destination, hazard hills, and absence of traffic safety were risk factors for sarcopenia. Walkability, safety from crime, recreational facilities/walking and cycling facilities/exercise facilities and neighborhood aesthetics, were environmental characteristics that showed associations with physical frailty. After sensitivity analysis, walkability was shown to be inconclusive.</div></div><div><h3>Conclusion</h3><div>Evidence indicates that older adults who live in built environments with higher walkability, access to recreational facilities/walking and cycling facilities/exercise facilities and neighborhood aesthetics are less likely to develop physical frailty. Current evidence regarding sarcopenia remains limited and inconclusive.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"137 ","pages":"Article 105910"},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222705","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":"Beyond the “European health divide”: Functional limitation disparities among older adults in Central and Eastern Europe","authors":"Shane D. Burns ,&nbsp;Liili Abuladze ,&nbsp;Luule Sakkeus","doi":"10.1016/j.archger.2025.105908","DOIUrl":"10.1016/j.archger.2025.105908","url":null,"abstract":"<div><h3>Objectives</h3><div>Countries in Central and Eastern Europe (CEE) generally have worse health outcomes than the rest of Europe, commonly referred to as the “European health divide”. Regional specificities and historical pathways can shape health outcomes later in life, although variance of older adult functional limitation <em>within</em> CEE is understudied.</div></div><div><h3>Methods</h3><div>We used wave 9 (2021–2022) data (<em>n</em> = 18,903) from the Survey of Health, Ageing and Retirement in Europe (SHARE) with mixed effects regression models to analyze difficulty with mobility, near vision, hearing, and episodic memory among those ages 65+ in the Baltic States (Estonia; Latvia; Lithuania), Visegrád Group (Czechia; Hungary; Poland; Slovakia), Former Yugoslavia (Croatia; Slovenia), and the Black Sea (Bulgaria; Romania) while accounting for demographic, socioeconomic, health, and social tie indicators.</div></div><div><h3>Results</h3><div>Age-adjustments showed the highest difficulty rates of: mobility in Romania and Hungary, near vision in Latvia and Bulgaria, hearing in Estonia and Poland, and episodic memory in Poland and Croatia. Compared to the Baltic States, odds of reporting mobility difficulty were greater in the Black Sea but accounted for by socioeconomic factors. Fully adjusted odds of reporting near vision difficulty were lower in Visegrád Group and Former Yugoslavia. Fully adjusted odds of reporting hearing difficulty were lower in Visegrád Group, Former Yugoslavia, and the Black Sea. There were no regional differences in episodic memory.</div></div><div><h3>Discussion</h3><div>Functional limitation disparities, which were largely shaped by socioeconomic factors, varied throughout CEE. These findings highlight the heterogenous health and long-term care needs of older adults throughout CEE.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105908"},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185703","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}