Miguel Muñoz-Muñoz, Julian Alcazar, Luis M Alegre, Ignacio Ara, Francisco José García-García
{"title":"Toledo Study for Healthy Aging in Middle Age: Frailty and Early Vascular Decline at the Onset of the Pathogenic Chain of Disability.","authors":"Miguel Muñoz-Muñoz, Julian Alcazar, Luis M Alegre, Ignacio Ara, Francisco José García-García","doi":"10.1093/gerona/glae256","DOIUrl":"https://doi.org/10.1093/gerona/glae256","url":null,"abstract":"","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019365","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}
Ben Kirk, Chia-Ling Kuo, Peiran Liu, Meiruo Xiang, Jesse Zanker, Konstantinos Prokopidis, Marc Sim, Richard H Fortinsky, George A Kuchel, Gustavo Duque
{"title":"Diagnostic Power of Serum Creatinine/Cystatin C Ratio for Identifying Low MRI-Muscle Volume and Low Grip Strength: Data From 9 731 to 149 707 UK Biobank Older Adults.","authors":"Ben Kirk, Chia-Ling Kuo, Peiran Liu, Meiruo Xiang, Jesse Zanker, Konstantinos Prokopidis, Marc Sim, Richard H Fortinsky, George A Kuchel, Gustavo Duque","doi":"10.1093/gerona/glae274","DOIUrl":"10.1093/gerona/glae274","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers for sarcopenia are lacking. We examined the diagnostic power of serum creatinine to cystatin C ratio for identifying low magnetic resonance imaging-muscle volume and low grip strength in a large observational study of UK Biobank older adults.</p><p><strong>Methods: </strong>Serum creatinine and cystatin C were measured via immunoassays (Beckman Coulter AU5800 and Siemens Advia 1800, respectively) and grip strength by hydraulic hand dynamometer at baseline visit (2008-2010). magnetic resonance imaging-thigh fat-free muscle volume and DXA-derived appendicular lean mass were measured at imaging visit (2014-2018). Extreme outliers were removed, and covariates (demographic, lifestyle, and clinical factors, as well as time elapsed between baseline-imaging visit) were adjusted for in statistical models.</p><p><strong>Results: </strong>12 873 older adults (mean age: 63.5 ± 2.7 years, 44.2% women) were included for fat-free muscle volume and appendicular lean mass/body mass index; 149 707 older adults (mean age: 64.0 ± 2.9 years, 50.5% women) for grip strength. Despite significant associations (p < .05), in fully adjusted models, creatinine to cystatin C showed poor to acceptable diagnostic power for identifying low fat-free muscle volume when using cutpoints of 20th percentile (area under the curve: 0.577 men; 0.622 women) and T scores of -2 (area under the curve: 0.596 men; 0.659 women) and -2.5 (area under the curve: 0.609 men; 0.722 women). In fully adjusted model, creatinine to cystatin C showed poor diagnostic power (area under the curves: <0.70) for identifying low appendicular lean mass/body mass index or low grip strength, irrespective of the cutpoint used.</p><p><strong>Conclusions: </strong>Creatinine to cystatin C may not be a suitable biomarker for identifying low muscle volume or low strength in older adults. This finding, drawn from a large sample size and the use of advanced medical imaging, marks an important contribution to the sarcopenia field.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635625","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}
Man-Kit Lei, Steven R H Beach, Ronald L Simons, Michelle M Mielke
{"title":"Cumulative Socioeconomic Status Risk is Associated With Greater Increase in Serum Neurofilament Light Chain Levels Among Middle-Aged Black Adults.","authors":"Man-Kit Lei, Steven R H Beach, Ronald L Simons, Michelle M Mielke","doi":"10.1093/gerona/glae253","DOIUrl":"10.1093/gerona/glae253","url":null,"abstract":"<p><strong>Background: </strong>This study examined the longitudinal relationship between cumulative socioeconomic status (SES) risk and serum neurofilament light chain (NfL) levels to better understand the association between social factors and a biomarker of neurodegeneration.</p><p><strong>Methods: </strong>We used data from the Family and Community Health Study, collecting psychosocial and blood data at 2 waves (2008) and (2019) from 254 Black Americans (43 males and 211 females). Blood samples were analyzed at each wave for serum NfL concentrations. Regression analysis and mixed-effect modeling examined relationships between cumulative SES risk and serum NfL, controlling for covariates and assessing time effects.</p><p><strong>Results: </strong>Utilizing 11-year longitudinal data, serum NfL levels increased with age. Higher cumulative SES risk at baseline correlated with elevated serum NfL at the 11-year follow-up and predicted a greater increase in NfL levels. Clinically, NfL is a sensitive biomarker for axonal injury and neurodegeneration, commonly used to detect early and preclinical stages of conditions such as Alzheimer's disease, multiple sclerosis, and other neurodegenerative disorders.</p><p><strong>Conclusions: </strong>Our results suggest that exposure to cumulative SES risk among Black adults may contribute to elevated levels of NfL, indicating potential early neurodegeneration. Given the established role of NfL in detecting neurodegenerative processes, these findings underscore the importance of interventions that bolster social safety nets and social connectedness to enhance brain health and mitigate neurodegenerative risks.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549914","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}
Erwin Stolz, Anna Schultz, Emiel O Hoogendijk, Olga Theou, Kenneth Rockwood
{"title":"Short-term Frailty Index Fluctuations in Older Adults: Noise or Signal?","authors":"Erwin Stolz, Anna Schultz, Emiel O Hoogendijk, Olga Theou, Kenneth Rockwood","doi":"10.1093/gerona/glae262","DOIUrl":"10.1093/gerona/glae262","url":null,"abstract":"<p><strong>Background: </strong>Reversible short-term fluctuations in the frailty index (FI) are often thought of as representing only noise or error. Here, we assess (i) the size and source of short-term FI fluctuations, (ii) variation across sociodemographic characteristics, (iii) association with chronic diseases, (iv) correlation with age, frailty level, frailty change, and mortality, and (v) whether fluctuations reflect discrete health transitions.</p><p><strong>Methods: </strong>Nationwide, biweekly longitudinal data from 426 community-dwelling older adults (70+) were collected in the FRequent health Assessment In Later life (FRAIL70+) study using a measurement burst design (5 122 repeated observations, median of 13 repeated observations per person). We calculated the intraindividual standard deviation of the FI and used location-scale mixed regression models.</p><p><strong>Results: </strong>Mean intraindividual standard deviation was 0.04 (standard deviation = .03). Fluctuations were driven foremost by cognitive problems, somatic symptoms, and limitations in instrumental and mobility-related activities of daily living. Short-term fluctuations correlated with higher FI levels (r = 0.62), 1-year FI change (r = 0.26), and older age (+3% per year). Older adults who took to bed due to a health problem (+50%), those who had an overnight hospital stay (+50%), and those who died during follow-up (+44%) exhibited more FI fluctuations.</p><p><strong>Conclusions: </strong>Short-term FI fluctuations were neither small nor random. Instead, as older adults become frailer, their measured health also becomes more unstable; hence, short-term fluctuations in overall health status can be seen as a concomitant phenomenon of the aging process. Researchers and clinicians should be aware of the existence of reversible fluctuations in the FI over weeks and months and its consequences for frailty monitoring.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585317","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":"Accumulation of Advanced Oxidation Protein Products Promotes Age-Related Decline of Type H Vessels in Bone.","authors":"Kai Zhao, Guo-Zheng Zhu, Hong-Zhou Li, Jia-Wen Gao, Chen Tu, Di-Zheng Wu, Yu-Sheng Huang, Dong Han, Xing-Yu Chen, Long-Yan Wu, Zhao-Ming Zhong","doi":"10.1093/gerona/glae271","DOIUrl":"10.1093/gerona/glae271","url":null,"abstract":"<p><p>Type H vessels have been proven to couple angiogenesis and osteogenesis. The decline of type H vessels contributes to bone loss in the aging process. Aging is accompanied by the accumulation of advanced oxidation protein products (AOPPs). However, whether AOPP accumulation is involved in age-related decline of type H vessels is unclear. Here, we show that the increase of AOPP levels in plasma and bone was correlated with the decline of type H vessels and loss of bone mass in old mice. Exposure of microvascular endothelial cells to AOPPs significantly inhibited cell proliferation, migration, and tube formation; increased NADPH oxidase activity and excessive reactive oxygen species generation; upregulated the expression of vascular cell adhesion molecule-1 and intercellular cell adhesion molecule-1; and eventually impaired angiogenesis, which was alleviated by redox modulator N-acetylcysteine and NADPH oxidase inhibitor apocynin. Furthermore, reduced AOPP accumulation by NAC treatment was able to alleviate significantly the decline of type H vessels, bone mass loss, and deterioration of bone microstructure in old mice. Collectively, these findings suggest that AOPPs accumulation contributes to the decline of type H vessels in the aging process, and illuminate a novel potential mechanism underlying age-related bone loss.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592401","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}
Chixiang Chen, Terrence E Murphy, Jaime Lynn Speiser, Karen Bandeen-Roche, Heather Allore, Thomas G Travison, Michael Griswold, Michelle Shardell
{"title":"Gerontologic Biostatistics and Data Science: Aging Research in the Era of Big Data.","authors":"Chixiang Chen, Terrence E Murphy, Jaime Lynn Speiser, Karen Bandeen-Roche, Heather Allore, Thomas G Travison, Michael Griswold, Michelle Shardell","doi":"10.1093/gerona/glae269","DOIUrl":"10.1093/gerona/glae269","url":null,"abstract":"<p><p>Introduced in 2010, the subdiscipline of gerontologic biostatistics was conceptualized to address the specific challenges of analyzing data from clinical research studies involving older adults. Since then, the evolving technological landscape has led to a proliferation of advancements in biostatistics and other data sciences that have significantly influenced the practice of gerontologic research, including studies beyond the clinic. Data science is the field at the intersection of statistics and computer science, and although the term \"data science\" was not widely used in 2010, the field has quickly made palpable effects on gerontologic research. In this Review in Depth, we describe multiple advancements of biostatistics and data science that have been particularly impactful. Moreover, we propose the subdiscipline of \"gerontologic biostatistics and data science,\" which subsumes gerontologic biostatistics into a more encompassing practice. Prominent gerontologic biostatistics and data science advancements that we discuss herein include cutting-edge methods in experimental design and causal inference, adaptations of machine learning, the rigorous quantification of deep phenotypic measurement, and analysis of high-dimensional -omics data. We additionally describe the need for integration of information from multiple studies and propose strategies to foster reproducibility, replicability, and open science. Lastly, we provide information on software resources for gerontologic biostatistics and data science practitioners to apply these approaches to their own work and propose areas where further advancement is needed. The methodological topics reviewed here aim to enhance data-rich research on aging and foster the next generation of gerontologic researchers.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585250","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}
Randi Chen, Brian J Morris, Timothy A Donlon, Kazuma Nakagawa, Richard C Allsopp, Bradley J Willcox, Kamal H Masaki
{"title":"FOXO3 Longevity Genotype Mitigates Risk Posed by Hypertension on Incident Coronary Artery Disease in Middle-Aged Men: Kuakini Honolulu Heart Program.","authors":"Randi Chen, Brian J Morris, Timothy A Donlon, Kazuma Nakagawa, Richard C Allsopp, Bradley J Willcox, Kamal H Masaki","doi":"10.1093/gerona/glae254","DOIUrl":"10.1093/gerona/glae254","url":null,"abstract":"<p><strong>Background: </strong>This study tested whether the carriage of the longevity-associated G-allele of FOXO3 SNP rs2802292 (TG/GG) protects against incident coronary artery disease (CAD) in men with hypertension.</p><p><strong>Methods: </strong>Subjects were American men residing on Oahu having Japanese (n = 5415) or Okinawan (n = 897) ancestry and free of CAD at baseline (1965-1968) when aged 45-68 years.</p><p><strong>Results: </strong>During the follow-up, there were 1 629 incident CAD cases. Adjusting for age and cardiovascular disease risk factors, the main effect Cox model showed that in men of Japanese ancestry, hypertension was a strong predictor of CAD (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.44-1.80), p < .0001), but TG/GG genotype was not associated with CAD (HR 0.92; 95% CI = 0.82-1.02; p = .11). A full Cox model showed the interaction of TG/GG with hypertension was significant (β = -0.23, p = .038). Stratified by hypertension status, TG/GG genotype TG/GG had a protective effect against CAD in each group (HR 0.83; 95% CI 0.71-0.96; p = .021 in men of Japanese heritage, and HR 0.66; 95% CI 0.43-1.01; p = .054 in men of Okinawan heritage). No association with CAD was seen in normotensive men having either Japanese (HR 1.04; 95% CI 0.89-1.22; p = .61) or Okinawan (HR 0.95; 95% CI 0.66-1.38; p = .79) heritage.</p><p><strong>Conclusions: </strong>The present prospective study found that longevity-associated FOXO3 genotype did not independently affect the risk of CAD in all men. Rather, it was associated with protection against incident CAD in men with hypertension. Hypertensive middle-aged men with FOXO3TT genotype may merit particular attention in CAD prevention programs.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577355","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}
Yeunkyung Kim, Jihye Kim, Hyunjee Kim, Sungchul Park, Yue Li
{"title":"Trend in Respite Use by Race Among Caregivers for People Living With Dementia.","authors":"Yeunkyung Kim, Jihye Kim, Hyunjee Kim, Sungchul Park, Yue Li","doi":"10.1093/gerona/glae036","DOIUrl":"10.1093/gerona/glae036","url":null,"abstract":"<p><strong>Background: </strong>Respite care provides short-term relief for caregivers. Despite efforts to promote respite use among Black caregivers, little is known if disparities in respite use between Black and White dementia caregivers have decreased over time. We examined a trend nationally to see if more recent efforts may have helped reduce disparities in respite use.</p><p><strong>Methods: </strong>We used a repeated cross-sectional design, with the data from 2015, 2017, and 2021 of the National Health and Aging Trends Study and National Study of Caregiving. Our study sample included 764 (in 2015), 839 (in 2017), and 521 (in 2021) non-Hispanic White and Black caregivers who provided care to older adults living with dementia, representing weighted 5 157 569 (2015), 5 877 997 (2017), and 4 712 144 (2021) dementia caregivers nationally. We conducted logistic regression models to assess the differences in respite use between White and Black caregivers over time.</p><p><strong>Results: </strong>In 2015, Black dementia caregivers had a respite care use rate 11.6 percentage points (95% CI: -16.9 to -6.4) lower than that of White dementia caregivers. However, both in 2017 and 2021, the difference in the use of respite was not statistically significant, leading to a reduced or no gap in respite use between White and Black dementia caregivers. However, respite use remained low in both groups.</p><p><strong>Conclusions: </strong>Although the gap in respite use between Black and White dementia caregivers had been gradually narrowed over time, more efforts are needed to encourage more respite use among both groups through targeted efforts to address factors that hinder respite use.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":"S42-S49"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673975","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":"Projecting Long-Term Care Costs Among Older Adults With ADL Disabilities and Cognitive Impairment in China.","authors":"Haiyu Jin, Chenkai Wu","doi":"10.1093/gerona/glae140","DOIUrl":"10.1093/gerona/glae140","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence suggests that cognitive impairment is strongly associated with disability in activities of daily living (ADL disability) and long-term care (LTC) costs. However, studies forecasting future LTC costs often overlook these relationships. Consequently, this study aims to more accurately project future LTC costs in China over the next 20 years by considering the intertwined association between disability and cognitive impairment on future LTC costs.</p><p><strong>Methods: </strong>Data were from 10 959 adults ≥65 years from the 2005-2018 waves of the Chinese Longitudinal Healthy Longevity Surveys. We used the Markov model to project the population of China and track the transition of older adults in the next 20 years between 4 disability-cognition states. We employed a 2-part model to estimate LTC costs (direct and indirect LTC costs) per capita.</p><p><strong>Results: </strong>The proportion of disabled older adults with cognitive impairment was projected to increase from 1.4% in 2021 to 3.4% in 2040, while that of those without cognitive impairment was projected to decrease from 4.7% in 2021 to 4.5% in 2040. The direct and indirect LTC costs were projected to increase from 0.3% and 0.2% of gross domestic product (GDP) in 2021 to 1.4% and 0.7% in 2040 for disabled persons without cognitive impairment and from 0.1% and 0.1% of GDP in 2021 to 1.3% and 1.3% in 2040 for those with cognitive impairment, respectively.</p><p><strong>Conclusions: </strong>Policy-makers could include the assessment of cognition in the LTC needs assessment and allocate more compensation to LTC insurance participants with cognitive impairment.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":"S50-S58"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156047","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":"Closing the Data Gaps on Trends in Dementia and Related Care in Low- and Middle-Income Countries.","authors":"Lindsay C Kobayashi, Joshua R Ehrlich","doi":"10.1093/gerona/glae189","DOIUrl":"10.1093/gerona/glae189","url":null,"abstract":"","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":"79 Supplement_1","pages":"S5-S6"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607820","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}