Journal of the American Geriatrics Society最新文献

{"title":"Inspiring Undergraduate Student Training in Alzheimer's Research (USTAR): Training the Next Generation of Aging Scientists.","authors":"Robin Casten, Megan Kelley, Hakeem Lawal, Bernard L Lopez, Susan Parks, Erin Perchiniak, Barry Rovner","doi":"10.1111/jgs.19400","DOIUrl":"https://doi.org/10.1111/jgs.19400","url":null,"abstract":"<p><p>Inspiring Undergraduate Student Training in Alzheimer's Research (USTAR) aims to provide Underrepresented Minority (URM) undergraduate students with mentored didactic, clinical, and research experiences to stimulate interest in research related to Alzheimer's Disease and Related Dementias (ADRD). USTAR specifically focuses on social determinants of health (SDOH) as risk factors for ADRD minoritized populations. USTAR's scientific rationale is that URM undergraduates are less likely to enter the biomedical workforce. Addressing this disparity is important since minorities are disproportionally affected by ADRD, and URM scientists may deeply appreciate the sociocultural forces that create racial health disparities. USTAR unites faculty expertise from Thomas Jefferson University (TJU) and Delaware State University (DSU), a Historically Black College and University (HBCU). The faculty's work spans the full spectrum of ADRD research and care, including neuroscience, biology, gerontology, geriatrics, neurology, and geriatric psychiatry. The 20-month USTAR program will train two cohorts of 10 students. Across all USTAR activities, we emphasize the relationship between SDOH and cognition. USTAR's goals are to: (1) provide interdisciplinary ADRD-related research, educational, clinical, and community experiences; (2) enhance research skills via group research projects; (3) facilitate transition from undergraduate to graduate studies in science; and (4) evaluate USTAR's effectiveness. USTAR has the potential to increase diversity in the national workforce that conducts health disparities research pertaining to ADRD. This goal aligns with the National Institute on Aging's (NIA) mission to meet the nation's biomedical, behavioral, and clinical research needs and to ensure health equity for all Americans.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426888","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":"The Halo Effect: Perceptions of Information Privacy Among Healthcare Chatbot Users.","authors":"Jessica R Ellis, Natalia S Dellavalle, Mika K Hamer, Marlee Akerson, Matt Andazola, Annie A Moore, Eric G Campbell, Matthew DeCamp","doi":"10.1111/jgs.19393","DOIUrl":"https://doi.org/10.1111/jgs.19393","url":null,"abstract":"<p><strong>Background: </strong>Patient-facing chatbots can be used for administrative tasks, personalized care reminders, and overcoming transportation or geographic barriers in healthcare. Although some data suggest older adults see privacy as an ethical barrier to adopting digital technologies, little is known about privacy concerns regarding information shared with novel patient-facing chatbots. We sought to examine attitudes toward privacy based on age or other sociodemographic characteristics.</p><p><strong>Methods: </strong>We conducted a sequential mixed methods study among patient users of a large healthcare system chatbot. We purposively oversampled by race and ethnicity to survey 3089 patient chatbot users online using de novo and validated items. Next, we conducted semi-structured interviews with users (n = 46) purposively sampled based on diversity or select survey responses. We used multivariable logistic regression to analyze survey data and modified grounded theory to analyze interviews. We integrated data using simultaneous visualization and triangulation.</p><p><strong>Results: </strong>We received 617/3089 surveys (response rate, 20.0%). Overall, 370/597 (63.9%) expressed worry about the privacy of information shared with the chatbot. Logistic regression found that users ≥ 65 years were 26% points less likely to be worried about information privacy compared to those 18-34 years old (p < 0.001). We found less worry among Black, non-Hispanic users and among those with more than a four-year college degree. By integrating our survey and interview data, we observed that older adult users experienced a halo effect: they worried less because they saw the chatbot as associated with a trusted health system and experienced lower medical mistrust.</p><p><strong>Conclusion: </strong>Contrary to some prior research, adults aged 65 and older expressed less concern about chatbot privacy than younger adults because of their trust in health care. To maintain this trust and build it among all users, health systems using patient-facing chatbots need to take active steps to maintain and communicate patient privacy protections.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401013","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":"Trust in Physicians and End-of-Life Discussions and Preferences for Place of Care Among US Chinese Older Adults.","authors":"Hyosin Kim, Yanping Jiang, Paul R Duberstein, Fengyan Tang, Elizabeth A Luth","doi":"10.1111/jgs.19396","DOIUrl":"https://doi.org/10.1111/jgs.19396","url":null,"abstract":"<p><strong>Background: </strong>Patient trust in physicians is essential for effective end-of-life discussions. Little is known about how Chinese older adults' trust in physicians relates to their end-of-life care discussions and care setting preferences.</p><p><strong>Objective: </strong>To examine the association between medical trust among Chinese older adults and their views on end-of-life discussions and care setting preferences.</p><p><strong>Design: </strong>Secondary analysis of longitudinal cohort data from the Population Study of Chinese Elderly (PINE) using linear mixed-effects logistic and multinomial logistic regressions, adjusting for covariates. Predicted probabilities of outcome measures were reported.</p><p><strong>Participants: </strong>A total of 2192 Chinese older adult immigrants in greater Chicago participated in the PINE study from 2017 to 2020.</p><p><strong>Main measures: </strong>Outcome variables encompass four dimensions of end-of-life care planning: (1) beliefs about the importance of discussions with family; (2) discussions of end-of-life options with family; (3) preference for counseling with a healthcare provider as a resource; and (4) preferred place of care. The main independent variable was trust in physicians. Covariates included age, sex, education, income, years in the United States, living children, self-rated health, and medical conditions.</p><p><strong>Key results: </strong>Respondents with strong trust were less likely to consider end-of-life discussions with family important (AOR = 0.70, 95% CI: 0.55-0.88). Those with strong trust were more likely than those with weak trust to value counseling with a healthcare provider for end-of-life discussions with family (AOR = 5.86, 95% CI: 4.65-7.38). Moderate trust was associated with a preference for end-of-life care in a hospital (AOR = 1.63, 95% CI: 1.30-2.05) over home care, relative to weak trust.</p><p><strong>Conclusions: </strong>Older Chinese immigrants with strong trust tended to place less emphasis on end-of-life discussions with family and favored one-on-one counseling with a healthcare provider for end-of-life discussion. Patient education and family engagement in end-of-life discussions led by trusted healthcare providers may be promising approaches to ensure goal-concordant care for this population.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384547","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":"Team-Based Communication for Patient Health Priorities Within a Home-Based Program.","authors":"Hao T Pham, Josie R Tombrella, Brian R Riveland, Claire M Campbell, Aanand D Naik, Paul Di Capua","doi":"10.1111/jgs.19394","DOIUrl":"https://doi.org/10.1111/jgs.19394","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375070","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":"Diverticulitis in Older Adults: A Review of Etiology, Diagnosis, and Management.","authors":"Jessica K Hall, Mark A Supiano, Jessica N Cohan","doi":"10.1111/jgs.19388","DOIUrl":"10.1111/jgs.19388","url":null,"abstract":"<p><strong>Background: </strong>Diverticulitis accounts for over 300,000 hospitalizations annually in the United States and its incidence increases with age. Among older adults, diverticulitis is the fourth leading cause for emergency surgery. Older adults with multimorbidity and geriatric syndromes are often excluded from clinical studies, leaving a gap in the evidence needed to guide management. Here, we provide a clinically oriented review of the diagnosis and management of older adults with diverticulitis through the lens of age-friendly care.</p><p><strong>Methods and results: </strong>We reviewed the literature describing the epidemiology, diagnosis, management, and prevention of diverticulitis in older adults. Due to age-related physiologic changes, the presence of geriatric syndromes, and multimorbidity, older adults with diverticulitis often present with atypical symptoms, variable laboratory findings, and are at higher risk for complications than younger patients. Guidelines support a more aggressive approach to diagnosis in this population, with lower threshold for obtaining diagnostic imaging. Antibiotics remain a mainstay of treatment for uncomplicated disease, and surgical management should be focused on severity of disease and the balance between the likelihood of improving quality of life and risks and burden of treatment.</p><p><strong>Conclusions: </strong>Diverticulitis is a common disease that has a unique presentation among older individuals with limited evidence to guide management. Diagnosis and treatment should focus on what matters most to the patient, providing the most meaningful outcome possible within the context of multimorbidity, patient goals, symptom burden, and anticipated treatment outcomes.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375069","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":"Clinician Perspectives on Increased Gabapentinoid Prescribing in Nursing Homes.","authors":"Jonathan D Winter, J William Kerns, Danya M Qato, Katherine M Winter, Nicole Brandt, Linda Wastila, Christopher Winter, Yu-Hua Fu, Eposi Elonge, Alex H Krist, Sarah R Reves, Rebecca S Etz","doi":"10.1111/jgs.19381","DOIUrl":"https://doi.org/10.1111/jgs.19381","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191682","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":"Around the EQUATOR With Clin-STAR: AI-Based Randomized Controlled Trial Challenges and Opportunities in Aging Research.","authors":"Betsy Yang, Caroline Park, Steven Lin, Vijaytha Muralidharan, Deborah M Kado","doi":"10.1111/jgs.19362","DOIUrl":"https://doi.org/10.1111/jgs.19362","url":null,"abstract":"<p><p>The CONSORT 2010 statement is a guideline that provides an evidence-based checklist of minimum reporting standards for randomized trials. With the rapid growth of Artificial Intelligence (AI) based interventions in the past 10 years, the CONSORT-AI extension was created in 2020 to provide guidelines for AI-based randomized controlled trials (RCT). The Clin-STAR \"Around the EQUATOR\" series features existing reported standards while also highlighting the inherent complexities of research involving research of older participants. In this work, we propose that when designing AI-based RCTs involving older adults, researchers adopt a conceptual framework (CONSORT-AI-5Ms) designed around the 5Ms (Mind, Mobility, Medications, Matters most, and Multi-complexity) of Age-Friendly Healthcare Systems. Employing the 5Ms in this context, we provide a detailed rationale and include specific examples of challenges and potential solutions to maximize the impact and value of AI RCTs in an older adult population. By combining the original intent of CONSORT-AI with the 5Ms framework, CONSORT-AI-5Ms provides a patient-centered and equitable perspective to consider when designing AI-based RCTs to address the diverse needs and challenges associated with geriatric care.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191680","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":"Use and Discontinuation Rates of Long-Acting Injectable Antipsychotics Between Race/Ethnicity in Older Adults Using Medicaid Databases.","authors":"Christopher M Cassara, Jianing Xu, Daniel B Hall, Xianyan Chen, Henry N Young, Joshua Caballero","doi":"10.1111/jgs.19386","DOIUrl":"https://doi.org/10.1111/jgs.19386","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to assess the prescribing patterns of long acting injectable (LAI) antipsychotics in an older adult population. Secondary objectives were to determine if there were differences in treatment discontinuation rates between different LAI agents and race/ethnicity.</p><p><strong>Methods: </strong>Merative MarketScan Multi-State Medicaid Databases (2017-2021) were used to identify patients 65 years or older who were prescribed a LAI antipsychotic. Pharmacy claims for LAI antipsychotics were referenced via National Drug Code (NDC) by brand/generic name and dose. International Classification of Diseases, 10th edition (ICD-10) codes were used to identify older adults diagnosed with schizophrenia, schizotypal or schizoaffective disorders. Those with dementia or related disorders were censored. Conditional associations between race/ethnicity and generation of LAI antipsychotics were investigated using logistic regression controlling for age, sex, and health plan. Cox proportional hazard regression was used to compare the distribution of time until treatment discontinuation among older adults across LAI antipsychotics.</p><p><strong>Results: </strong>A total of 526 older adults (59% female) with an average age of 70.4 ± 5.5 years met inclusion for analysis. The most commonly used LAI antipsychotics included paliperidone palmitate-1 month formulation (~35%), haloperidol decanoate (~24%), and risperidone microspheres (~15%). Overall, approximately 32% received LAI first-generation antipsychotics and 68% received LAI second generation antipsychotics. Blacks (n = 204) received LAI first-generation antipsychotics more often than Whites (n = 283); (OR: 1.74, 95% [1.18, 2.56], p < 0.01). When controlling for age, sex, and race/ethnicity, LAI first-generation antipsychotics showed earlier discontinuation rates compared to LAI second-generation antipsychotics (HR: 2.12, 95% CI [1.45, 3.10], p < 0.001).</p><p><strong>Conclusions: </strong>LAI first-generation antipsychotics showed treatment discontinuation significantly earlier compared to LAI second-generation antipsychotics. Furthermore, Blacks were prescribed LAI first-generation antipsychotics at a higher rate than Whites, which may contribute to poorer health outcomes. Futures studies are needed to establish a causal relationship.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191684","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":"\"By the Time We Knew …\": Poetic Analysis of End-of-Life Caregiving Experiences for Rapidly Progressive and Slower-Duration Dementia Syndromes.","authors":"Krista L Harrison, Brianna E Morgan, Juliana Friend, Sarah B Garrett, David Looi, Madina Halim, Jennifer E James, Nicole D Boyd, Joni Gilissen, Michael D Geschwind, Christine S Ritchie, Alexander K Smith","doi":"10.1111/jgs.19382","DOIUrl":"10.1111/jgs.19382","url":null,"abstract":"<p><strong>Background: </strong>One in three older adults in the United States dies with or from dementia. Little is known about whether end-of-life caregiving experiences differ by dementia diagnosis.</p><p><strong>Methods: </strong>We conducted a secondary analysis of two qualitative studies. Participants included caregivers of decedents with \"rapid-type\" sporadic Creutzfeldt-Jakob Disease (sCJD, survival prognosis of < 1 year) or \"slow-type\" Alzheimer's disease and related dementias (survival prognosis of 5-20 years). We used reflexive thematic analysis and a novel method, poetic analysis, to compare end-of-life caregiving experiences.</p><p><strong>Results: </strong>\"Rapid-type\" caregivers (n = 12) had a median age of 59 (range 45-73) years; 6 were female, and 9 were spouses. \"Slow-type\" caregivers (n = 15) had a median age of 69 (45-82) years; 9 were female, and 11 were spouses. We identified three main areas of differential experience that were influenced by syndrome rarity and participation in research yet hinged on time. Time enables preparation: Due to the rarity of sCJD, \"rapid-type\" caregivers struggled to obtain accurate diagnoses, which prevented preparation for end-of-life care. Weeks or months before death, specialists simultaneously disclosed sCJD diagnoses and recommended hospice. In contrast, for \"slow-type\" dementia, preparation began years before death. Time complicates conflict: Most \"rapid-type\" caregivers described conflicts, rarely resolved before death, about code status, treatment, or care location decisions. Fewer \"slow-type\" caregivers experienced such conflicts, and these were typically resolved before death; instead, they experienced conflict between needs and what the care system provides. Postmortem experience contrasts with perimortem: For \"rapid-type\" dementia, short perimortem periods contrasted with elongated and often intense postmortem logistics and grief. For \"slow-type\" caregivers, preparation and perimortem grieving typically led to shorter duration and minimally intrusive postmortem logistics and grief.</p><p><strong>Conclusions: </strong>End-of-life care for dementia should attend to and support axes of differential experience based on diagnosis and rarity, time since symptom onset (affecting preparation and conflict resolution), and participation in research studies.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191667","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":"Associations of Accelerometer-Measured Physical Activity With Dementia, Anxiety, and Depression Among Older Adults.","authors":"Eric L Stulberg, Lin-Na Chou, Shweta Gore, Molly B Conroy, Jennifer J Majersik, Katherine J Hunzinger, Alexander LaPoint, Mandeep Kaur Sandhu, Andrea L C Schneider, Amit Kumar","doi":"10.1111/jgs.19383","DOIUrl":"https://doi.org/10.1111/jgs.19383","url":null,"abstract":"<p><strong>Background: </strong>Higher physical activity (PA) is associated with better neuropsychiatric health, but prior studies have been limited by cross-sectional designs, self-reported PA measures, and small numbers of older individuals. We examined associations between baseline and changes in accelerometer-measured moderate-vigorous PA (MVPA) with neuropsychiatric health among individuals aged ≥ 70 years in the National Health and Aging Trends Study.</p><p><strong>Methods: </strong>We used the average daily minutes of accelerometer-measured MVPA above a validated threshold of 2184 counts per minute as a continuous measure at baseline for the exposure variable. For longitudinal analyses, we categorized change in MVPA as follows: an increase of > 20 min/day over 1 year, a decrease of > 20 min/day over 1 year, and staying within 20 min/day over 1 year. Our outcomes were possible/probable dementia and anxiety or depression. Associations were estimated using confounder-adjusted logistic regressions.</p><p><strong>Results: </strong>In our survey-weighted analytic sample of 639 individuals aged ≥ 70 years, 56% were ≥ 75 years, and 53% were female. After adjusting for confounders, a 20-min/day higher baseline MVPA was significantly associated with lower odds of possible/probable dementia 1 year later (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.83-0.96) but not with depression and anxiety symptoms. Compared to no change in PA over 1 year, an increase in MVPA by > 20 min/day was associated with decreased odds of depression and anxiety symptoms (OR = 0.06, 95% CI = 0.03-0.14) but not with possible/probable dementia. Compared to no change in MVPA over 1 year, a decrease in MVPA by > 20 min/day was associated with higher odds of possible/probable dementia (OR = 3.82, 95% CI = 1.34-10.87) but not with depression and anxiety symptoms.</p><p><strong>Conclusions: </strong>Higher and increasing MVPA over time is associated with better neuropsychiatric health in individuals aged ≥ 70 years. Future studies should prioritize evaluating detailed PA trajectories to better understand how different doses, intensities, and modalities of PA impact neuropsychiatric decline in older adults.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191681","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}