Archives of Gerontology and Geriatrics Plus最新文献

{"title":"Lung ultrasound (LUS) as a predictor of delirium in elderly patients with COVID-19 during hospitalization: A geriatric vulnerability-stress model","authors":"Thomas Fraccalini MD ,&nbsp;Isa Rita Bergoglio MD, PhD ,&nbsp;Gianfranco Fonte MD, PhD ,&nbsp;Andrea Trogolo MD ,&nbsp;Alessandro Maraschi MD ,&nbsp;Thomas Roberts ,&nbsp;Beatrice Tarozzo PsyD ,&nbsp;Beatriz Vitorino MS ,&nbsp;Julia Michelin Vecchini MS ,&nbsp;Santoro Mariangela MD ,&nbsp;Monica Traversa MD, PhD ,&nbsp;Teresa Crea MD ,&nbsp;Luciano Cardinale MD, PhD ,&nbsp;Giuseppe Maina MD ,&nbsp;Valerio Ricci MD, PhD ,&nbsp;Elisa Binello CNO ,&nbsp;Reald Turja NU ,&nbsp;Federico Mallamaci NU ,&nbsp;Giovanni Volpicelli MD","doi":"10.1016/j.aggp.2025.100186","DOIUrl":"10.1016/j.aggp.2025.100186","url":null,"abstract":"<div><h3>Introduction</h3><div>Delirium, an acute confusional state, is common in elderly hospitalized COVID-19 patients and is linked to poor outcomes. Despite this, underdiagnosis persists due to symptom overlap with dementia. This study investigates whether lung ultrasound (LUS) and cognitive screening can predict delirium risk in elderly COVID-19 patients.</div></div><div><h3>Methods</h3><div>A prospective study at San Luigi Hospital enrolled 64 COVID-19 patients (mean age 82.6). Pulmonary involvement was assessed using the LUS Extension Score (LUSext), while cognition was evaluated via MMSE and 4AT tests. Clinical data, including comorbidities and inflammatory markers, were analyzed. ROC curves and multivariate regression identified delirium predictors.</div></div><div><h3>Results</h3><div>Delirium occurred in 61.4 % (35/57). Univariate analysis linked delirium to pre-existing dementia (<em>p</em> = 0.03), higher LUS scores (<em>p</em> = 0.004), and lower MMSE scores (<em>p</em> = 0.0002). A LUS score &gt;3 (sensitivity 74 %, specificity 82 %) best predicted delirium. Multivariate analysis confirmed LUS &gt;3 (OR=4.22, <em>p</em> = 0.023) and lower MMSE (OR=0.87, <em>p</em> = 0.007) as independent risk factors.</div></div><div><h3>Discussion</h3><div>LUS and cognitive impairment are strong predictors of delirium in elderly COVID-19 patients. The LUSext score provides an objective, rapid bedside measure of lung pathology severity, with a score &gt;3 indicating significantly elevated delirium risk. The link between low MMSE and delirium underscores cognitive vulnerability.</div></div><div><h3>Conclusion</h3><div>While delirium is multifactorial, integrating LUS into routine assessment may improve early detection and management in resource-limited settings, effectively identifying high-risk patients using an accessible bedside investigation. A LUS score &gt;3 and low MMSE should prompt preventive measures. Further studies should validate these findings and explore pathophysiology.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557611","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":"Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?","authors":"Henry Sutanto","doi":"10.1016/j.aggp.2025.100185","DOIUrl":"10.1016/j.aggp.2025.100185","url":null,"abstract":"<div><div>Polypharmacy among geriatric patients poses significant clinical and economic challenges, including increased risks of adverse drug reactions, cognitive decline, and hospitalizations. While raising physician awareness is necessary, it is insufficient on its own. This narrative review highlights the importance of comprehensive, evidence-based interventions to optimize medication management. Tools such as the Beers Criteria, STOPP/START guidelines, Anticholinergic Cognitive Burden (ACB) scale, and Drug Burden Index (DBI) are essential for identifying potentially inappropriate medications and reducing medication-related harm. The review underscores the need for structured medication reviews, deprescribing protocols, and individualized care planning. Furthermore, clinical decision support tools (CDSS) enhance prescribing safety by identifying drug-drug interactions and recommending safer alternatives. Systemic reforms—like policy incentives for deprescribing, medication reconciliation programs, and telemedicine-enabled interventions—support continuity of care and improve adherence. Interdisciplinary collaboration, involving pharmacists, nurses, and geriatricians, is critical for effective polypharmacy management. In low- and middle-income countries (LMICs), tailored solutions such as task-shifting, simplified prescribing protocols, and culturally sensitive education are emphasized. Overall, the article advocates for a comprehensive approach that combines clinical tools, systemic strategies, and collaborative care to ensure safer, more effective pharmacotherapy for older adults.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518001","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":"Gender differences in disability among older persons in India: Evidence from the longitudinal ageing study in India (LASI)","authors":"Kinkar Mandal PhD (Assistant Professor) ,&nbsp;Lekha Subaiya PhD (Professor)","doi":"10.1016/j.aggp.2025.100183","DOIUrl":"10.1016/j.aggp.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>Older women experience higher rates of disability compared to men. This gender disparity is linked to varying risk factors. The objective of this study is to investigate gender differences in disability among older adults in India</div></div><div><h3>Methods</h3><div>For this study, we used Longitudinal Ageing Study of India, Wave 1 (2017–2018) data, a nationally representative dataset of older persons age 60 years and above. Both descriptive and inferential statistics are used to analysis the data.</div></div><div><h3>Results</h3><div>Our findings indicate that older women report higher rates of vision, hearing, difficulty in chewing solid food, and physical disabilities, contributing to the observed gender differences in disability. Among these, vision impairment is the most prevalent. Notably, women with fewer years of schooling and those living in households in the lower wealth quintiles exhibit the highest levels of disability. Additionally, older individuals who are of advanced age, widowed, living in urban areas or alone, currently employed, or who experienced poor childhood health are more likely to report disabilities.</div></div><div><h3>Conclusion</h3><div>The higher prevalence of disability among women is the result of a combination of demographic and socioeconomic factors. These findings serve as a wake-up call for researchers and policymakers to prioritize gender-sensitive interventions aimed at preventing disability among older adults.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive-impairment-free life expectancy (CIFLE) among older adults in India: A gender and residence based study","authors":"Madhurima Sharma,&nbsp;Abdul Fathah,&nbsp;Indrajit Goswami","doi":"10.1016/j.aggp.2025.100182","DOIUrl":"10.1016/j.aggp.2025.100182","url":null,"abstract":"<div><h3>Background</h3><div>While cognitive impairment (CI) and dementia are among the most severe morbid conditions in later life, life expectancies free from CI have been much less investigated than measures of physical functioning. This study aimed to determine the health expectancies in middle aged and older adults in India, considering cognitive status as a health indicator.</div></div><div><h3>Methods</h3><div>We estimated Cognitive Impairment-free life expectancy (CIFLE) in India for people aged 45 and older using data from Longitudinal Ageing Study in India (LASI), 2017-18. Mortality data has been derived from the Sample Registration System (SRS), 2016-20. Sullivan’s method is used to estimate the average number of years a person can expect to live with and without cognitive impairment.</div></div><div><h3>Results</h3><div>The prevalence of CI among Indian adults 45 and above is 10.28 %, increasing from 4.34 % (45–49) to 47 % (85+). Higher rates in females (13.65 % vs 6.42 % in males) and rural areas (12.39 % vs 6.38 % urban). The results indicate that after attaining age 60, males are expected to live 15 more years as cognitive impairment-free, which is only 12 years for females; though life expectancy for females is higher than that of males. Older adults in rural areas are expected to have fewer cognitive impairment-free years than in urban areas.</div></div><div><h3>Conclusion</h3><div>Longer life does not extend cognitive health. CI reduces quality of life and increases care needs, aligning with global trends. The disparities in CI-free life expectancy between genders and rural-urban areas highlight the need for targeted interventions and policies to address cognitive health inequalities in India.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513574","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":"Factors associated with frailty progression in community-dwelling older adults: A cross-sectional observational study","authors":"Yuko Sawada ,&nbsp;Akihiro Kakuda ,&nbsp;Emiko Tanaka ,&nbsp;Etsuko Tomisaki ,&nbsp;Taeko Watanabe ,&nbsp;Munenori Matsumoto ,&nbsp;Rika Okumura ,&nbsp;Hiroshi Kinoshita ,&nbsp;Tokie Anme","doi":"10.1016/j.aggp.2025.100179","DOIUrl":"10.1016/j.aggp.2025.100179","url":null,"abstract":"<div><div>This cross-sectional observational study aimed to identify factors associated with frailty status in community-dwelling older adults. A total of 188 older adults (mean age: 75.9 ± 6.7 years) attending municipal exercise facilities between 2019 and 2022 were included. Data were collected on participants' basic characteristics, physical fitness, and scores from the Kihon Checklist (KCL). Frailty status was classified into robust (KCL score ≤3), pre-frail (4–7), and frail (≥8) groups based on established criteria. Group differences were analyzed using the Kruskal–Wallis test with Bonferroni correction for multiple comparisons. Significant differences among the robust, pre-frail, and frail groups were observed in most physical fitness and frailty-related items, particularly grip strength, walking ability, and lifestyle-related functions, except for cognition and depression. These findings indicate that specific domains of physical function are significantly associated with frailty status. Interventions targeting a broad range of physical fitness factors are essential to mitigate frailty in older adults.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472058","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":"Frailty and delirium: A fatal combination in older adults","authors":"Jay Acharya ,&nbsp;Radcliffe Lisk ,&nbsp;Rashid Mahmood ,&nbsp;Amir Manzoor ,&nbsp;Francesca Young ,&nbsp;Mitveer Gill ,&nbsp;Keefai Yeong ,&nbsp;Kevin Kelly ,&nbsp;Jonathan Robin ,&nbsp;David Fluck ,&nbsp;Christopher Henry Fry ,&nbsp;Thang Sieu Han","doi":"10.1016/j.aggp.2025.100180","DOIUrl":"10.1016/j.aggp.2025.100180","url":null,"abstract":"<div><h3>Background</h3><div>Frailty and delirium commonly coexist in acutely ill older adults, but they are variably measured. The Clinical Frailty Scale (CFS) and the 4AT scores are advocated as standardised tools to assess these conditions. We have developed risk categories based on these scales to predict mortality.</div></div><div><h3>Methods</h3><div>Two-graph ROC curve analysis derived thresholds at 5.5 for CFS and 1 for 4AT for predicting mortality, from which three composite <em>Risk-Categories</em> were created: “<em>Low-Risk</em>” represents low scores for both CFS (1–6) and 4AT (0); <em>Intermediate-Risk”</em> represents either high CFS (7–9) or high 4AT (1–12) scores; and <em>High-Risk</em>” represents both high CFS and 4AT scales. These <em>Risk-Categories</em> were used to predict in-hospital or 30-day mortality using logistic regression, and up to 27 months since admission using Cox regression; adjusted for age, sex, Charlson comorbidity index, anticholinergic burden and polypharmacy.</div></div><div><h3>Results</h3><div>There were 1192 patients (57.1 % women) of mean age 86.1 yr (SD=7.1) consecutively admitted to a hospital. Compared to those in the “<em>Low-Risk</em>” category (reference), in-hospital mortality odds-ratios (ORs; 95 %CI) were greater for those in the “<em>Intermediate-Risk”</em> category: OR=1.74 (1.11–2.72), and “<em>High-Risk</em>” category: OR=2.72 (1.47–5.02). Corresponding values for within 30-day mortality were: OR=1.75 (1.18–2.60) and OR=3.03 (1.76–5.21). Risk of death within 27 months of admission was increased in the “<em>High-Risk</em>” category: hazard ratio=1.46 (1.14–1.87). The association of CFS and mortality was partially mediated by 4AT.</div></div><div><h3>Conclusion</h3><div>Mortality in hospital was approximately doubled in “<em>Intermediate-Risk</em>” and tripled in “<em>High-Risk</em>” patients, which persisted after discharge. These risk categories are a useful tool for identifying high-risk patients.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intergenerational programmes on older adults for active ageing. A systematic review","authors":"Victoria Sánchez-Cazalla ,&nbsp;Tamara Gutiérrez-Domingo","doi":"10.1016/j.aggp.2025.100176","DOIUrl":"10.1016/j.aggp.2025.100176","url":null,"abstract":"<div><h3>Introduction</h3><div>Ageing is a process that covers the entire life cycle of a human being and that, around old age, is usually accompanied by negative stereotypes, social isolation and a feeling of loneliness, resulting in a rupture between diverse generations. Intergenerational programs have been used to address this concern to pursue active ageing.</div></div><div><h3>Objetive</h3><div>Analyze the impact of intergenerational programs on the ageing process to achieve cohesive societies for all ages and thus promote the active ageing model.</div></div><div><h3>Material and methods</h3><div>A systematic review has been prepared, the search of which was carried out in the Pubmed, Web of Science, Scopus, PsycINFO, and Cochrane Libary databases, that included studies published between 2014 and 2025. A total of 3.144 articles were identified, of which 290 underwent selection according to title and abstract, leaving 72 that were evaluated for eligibility, according to the inclusion criteria.</div></div><div><h3>Results</h3><div>A total of 8 articles were valid for inclusion. The methodological quality of the studies was low to moderate, although most research reported improvements in participants' well-being after participation in an intergenerational program.</div></div><div><h3>Conclusions</h3><div>Intergenerational programs provided biopsychosocial benefits to generations of different ages, which helped enhance the pursuit of active ageing in order to establish strong connections in the community.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687408","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":"Addressing conflicts in later life through intergenerational mediation: A scoping review","authors":"Arezo Feroz,&nbsp;Amanda Oliveri,&nbsp;Marley Goldenberg,&nbsp;Gagan Takhar,&nbsp;Michelle Hur,&nbsp;Jamie-Leigh LeTourneau","doi":"10.1016/j.aggp.2025.100178","DOIUrl":"10.1016/j.aggp.2025.100178","url":null,"abstract":"<div><div>Intergenerational mediation has significant implications for the well-being and quality of life of older adults and their families. Literature has emerged relating to the complexities of mediation practices and their effectiveness in addressing diverse issues older adults face. This scoping review aims to synthesize existing research on intergenerational mediation and explore, assess, and map key concepts related to mediating conflicts within later-life families. Databases, including PsychINFO, EMBASE, MEDLINE and CINAHL; Sociological Abstracts and International Bibliography of Social Sciences, were searched (as of Febraury 6th, 2024) and 930 titles and abstracts were identified. Of these, 44 met the inclusion criteria.</div><div>In this paper, the aim is to synthesize existing research on intergenerational mediation, mapping key concepts and identifying the gaps in literature across various articles and studies. Scoping review allows for a broader inclusion of different types of studies, without needing to assess methodological quality as a systemic review would, this makes systematic review less appropriate, especially if the studies are still emerging.</div><div>Seven themes emerged in the review of the literature: (a) mediation practice and guidelines; (b) sources of family conflict; (c) prevention of elder abuse and neglect; (d) family dynamics; (e) ethics; (f) mediation and law; and (g) implications for social work practice. The scoping review identified research gaps, including limited articles on intergenerational mediation across different cultures, religions, and geographic contexts. Due to the lack of consistent definitions of elder abuse in many countries, research is limited, highlighting the need for future research. The literature lacks sufficient exploration of the intersection of mediating conflicts and the older adults' aging process. Findings from this scoping review can inform best practices for intergenerational mediation and older adults’ aging.</div><div>Mediation provides a confidential space for collaborative discussions, aiding to prevent elder abuse and empower older adults. This review underscores the multifaceted role of mediation in social work, highlighting its potential to enhance care for older adults and their families.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314649","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":"Corrigendum to “Delirium in the emergency department: Incidence and risk factors in a Ligurian hospital” [Archives of Gerontology and Geriatrics Plus Volume 2, Issue 2, June 2025, 100165]","authors":"Thomas Fraccalini ,&nbsp;Andrea Trogolo ,&nbsp;Monica Traversa ,&nbsp;Beatrice Tarozzo ,&nbsp;Luciano Cardinale ,&nbsp;Giuseppe Maina ,&nbsp;Salvatore Di Gioia ,&nbsp;Davide Minniti ,&nbsp;Ivana Finiguerra ,&nbsp;Roberta Vacchelli ,&nbsp;Martina Battaglia ,&nbsp;Angelica Ruggeri ,&nbsp;Valerio Ricci ,&nbsp;Alessandro Maraschi ,&nbsp;Thomas Roberts ,&nbsp;Giovanni Volpicelli ,&nbsp;Luca Tagliafico","doi":"10.1016/j.aggp.2025.100173","DOIUrl":"10.1016/j.aggp.2025.100173","url":null,"abstract":"","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866279","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":"Reflections of those who have lived: Phenomenological perspectives from adults at end-of-life from an Eriksonian lens","authors":"Brittany Stahnke ,&nbsp;Roxxi Davis ,&nbsp;Morgan Cooley ,&nbsp;Porsha Farmer","doi":"10.1016/j.aggp.2025.100175","DOIUrl":"10.1016/j.aggp.2025.100175","url":null,"abstract":"<div><div>There is little research focused on the knowledge that those in the last stage of their lives can offer. The last phase of life brings with it unique wisdom and life advice that can be used to guide all people in their journeys. The purpose of this study was to provide scholarship detailing advice and learnings of those in this unique and final life stage. Nine participants were interviewed in the year 2021, and transcripts were analyzed in an interpretative phenomenological manner. Main themes of life suffering and values presented with sub-themes including illness, loss, family, faith, and purpose. The importance of choice in the lives we live, as well as hard work supports the abilities to succeed in valued areas. Family was stated to be the most important part of these lives; however, with or without family, one also benefits from a sense of accomplishment and pride in themselves.</div></div>","PeriodicalId":100119,"journal":{"name":"Archives of Gerontology and Geriatrics Plus","volume":"2 3","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271631","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}