Pub Date : 2025-03-01Epub Date: 2024-12-24DOI: 10.1097/JNC.0000000000000517
Evelyn Iriarte, Allison R Webel, Paul F Cook, Ashley Turner, Grace L Ditzenberger, Kristine M Erlandson, Catherine Jankowski
Abstract: Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial ( n = 30) and PLWH who declined enrollment in the same exercise trial ( n = 4). The theory of planned behavior (TPB) guided a directed content analysis of the interviews. Data analysis identified four themes: (a) intention or motivation (perceived benefits, maintaining the exercise behavior over time), (b) attitudes (goals and preferences), (c) perceived behavioral control (barriers, facilitators, and self-efficacy), and (d) subjective norms (pressure from health care providers and social networks). Findings from our study contribute to informing the development of future exercise interventions or trials and to planning care to encourage a physically active lifestyle.
{"title":"What Motivates Older Sedentary People Living With HIV in the United States to Participate in an Exercise Trial? A Qualitative Study.","authors":"Evelyn Iriarte, Allison R Webel, Paul F Cook, Ashley Turner, Grace L Ditzenberger, Kristine M Erlandson, Catherine Jankowski","doi":"10.1097/JNC.0000000000000517","DOIUrl":"10.1097/JNC.0000000000000517","url":null,"abstract":"<p><strong>Abstract: </strong>Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial ( n = 30) and PLWH who declined enrollment in the same exercise trial ( n = 4). The theory of planned behavior (TPB) guided a directed content analysis of the interviews. Data analysis identified four themes: (a) intention or motivation (perceived benefits, maintaining the exercise behavior over time), (b) attitudes (goals and preferences), (c) perceived behavioral control (barriers, facilitators, and self-efficacy), and (d) subjective norms (pressure from health care providers and social networks). Findings from our study contribute to informing the development of future exercise interventions or trials and to planning care to encourage a physically active lifestyle.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"143-155"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-05DOI: 10.1097/JNC.0000000000000527
Christine Horvat Davey
{"title":"The Intersection of HIV and Aging.","authors":"Christine Horvat Davey","doi":"10.1097/JNC.0000000000000527","DOIUrl":"10.1097/JNC.0000000000000527","url":null,"abstract":"","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"96-97"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Chronic diseases such as osteoporosis and low bone mineral density (BMD) are significant public health concerns for people living with HIV (PLWH), especially with the increased life expectancy because of antiretroviral therapy (ART). This study evaluated the prevalence and associated factors of low BMD among 94 PLWH in Kerman, Iran, from September 2021 to February 2022. Using dual-energy X-ray absorptiometry, BMD was measured, with low BMD defined by specific T-scores and Z-scores. Predictors were assessed through interviews, medical records, and blood tests. Bivariable and multivariable logistic regression models identified associations between low BMD and various factors. The study found a 51.1% prevalence of low BMD, with significant associations with hypogonadism (adjusted odds ratio [aOR]: 3.19), longer ART duration (aOR per month: 1.02), and lower body mass index (aOR per unit: 0.83). The findings highlight the need for regular screening and timely intervention for low BMD among PLWH, particularly with prolonged ART use.
{"title":"Low Bone Mineral Density and Associated Factors Among People Living With HIV in Kerman, Iran: A Cross-Sectional Study in 2021-2022.","authors":"Hamidreza Rashidi, Soheil Mehmandoost, Noushin Fahimfar, Hamid Reza Aghaei Meybodi, Seyed Mohammad Hosseinian, Noushin Shirzad, Fatemeh Hajivalizade, Mahnaz Sanjari, Mohammad Reza Shakibi, Tarlan Hasan Aghaei, Farzaneh Yazdi Yahaabadi, Pouriya Salajegheh, Gita Shafiee, Farideh Razi, Ebrahim Ranjbar, Willi McFarland, Afshin Ostovar, Hamid Sharifi","doi":"10.1097/JNC.0000000000000521","DOIUrl":"10.1097/JNC.0000000000000521","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic diseases such as osteoporosis and low bone mineral density (BMD) are significant public health concerns for people living with HIV (PLWH), especially with the increased life expectancy because of antiretroviral therapy (ART). This study evaluated the prevalence and associated factors of low BMD among 94 PLWH in Kerman, Iran, from September 2021 to February 2022. Using dual-energy X-ray absorptiometry, BMD was measured, with low BMD defined by specific T-scores and Z-scores. Predictors were assessed through interviews, medical records, and blood tests. Bivariable and multivariable logistic regression models identified associations between low BMD and various factors. The study found a 51.1% prevalence of low BMD, with significant associations with hypogonadism (adjusted odds ratio [aOR]: 3.19), longer ART duration (aOR per month: 1.02), and lower body mass index (aOR per unit: 0.83). The findings highlight the need for regular screening and timely intervention for low BMD among PLWH, particularly with prolonged ART use.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"98-107"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-24DOI: 10.1097/JNC.0000000000000505
Jennifer C Price, Kyoko Hirose, Naga Chalasani, Holly Crandall, Sonya Heath, Rohit Loomba, Susanna Naggie, Richard K Sterling, Mark Sulkowski, Laura Wilson, Jordan E Lake
Abstract: Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in people with HIV (PWH) and increases the risk of hepatic fibrosis and hepatocellular carcinoma. We sent an online survey to providers of the American Academy of HIV Medicine. Of respondents ( n = 214, 8% response rate), 65% reported screening for NAFLD in PWH, with 28% routinely screening all patients. Most respondents refer patients to hepatology if workup suggests another coexisting liver disease or cirrhosis, with the primary goals of referral being additional diagnostic testing (60%) or specific treatments (75%). The most common barriers to screening were feeling unsure of what tests to order (28%) and how to conclusively diagnose NAFLD (29%). Most respondents were interested in society guidelines (73%) and NAFLD education for patients (57%) and providers (55%). Our findings support the development of NAFLD clinical practice guidelines for HIV providers and the inclusion of PWH in clinical trials of novel agents.
{"title":"Primary Care Screening for Nonalcoholic Fatty Liver Disease Among People With HIV in the United States: A Real-World Provider Survey.","authors":"Jennifer C Price, Kyoko Hirose, Naga Chalasani, Holly Crandall, Sonya Heath, Rohit Loomba, Susanna Naggie, Richard K Sterling, Mark Sulkowski, Laura Wilson, Jordan E Lake","doi":"10.1097/JNC.0000000000000505","DOIUrl":"10.1097/JNC.0000000000000505","url":null,"abstract":"<p><strong>Abstract: </strong>Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in people with HIV (PWH) and increases the risk of hepatic fibrosis and hepatocellular carcinoma. We sent an online survey to providers of the American Academy of HIV Medicine. Of respondents ( n = 214, 8% response rate), 65% reported screening for NAFLD in PWH, with 28% routinely screening all patients. Most respondents refer patients to hepatology if workup suggests another coexisting liver disease or cirrhosis, with the primary goals of referral being additional diagnostic testing (60%) or specific treatments (75%). The most common barriers to screening were feeling unsure of what tests to order (28%) and how to conclusively diagnose NAFLD (29%). Most respondents were interested in society guidelines (73%) and NAFLD education for patients (57%) and providers (55%). Our findings support the development of NAFLD clinical practice guidelines for HIV providers and the inclusion of PWH in clinical trials of novel agents.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"177-182"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-06DOI: 10.1097/JNC.0000000000000528
{"title":"Call for Papers: Ethical, Social, and Political Issues in HIV Prevention, Care, and Treatment.","authors":"","doi":"10.1097/JNC.0000000000000528","DOIUrl":"10.1097/JNC.0000000000000528","url":null,"abstract":"","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"95"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-03DOI: 10.1097/JNC.0000000000000519
Levin Chetty, Saul Cobbing, Verusia Chetty
Abstract: Well-established, regular exercise interventions for older people living with HIV (OPLWH) are beneficial. However, the fundamental principles of exercise prescription for this population have not been sufficiently explored. An expert panel of health care professionals engaged in a modified Delphi technique to explore their perceptions of, and gain their consensus on, an exercise prescription framework for OPLWH in a resource-poor South African setting. A high level of agreement among participants was determined using a priori threshold of 80% agreement and an interquartile range of ≤ 1. Expert consensus was reached on a structured, multifaceted exercise prescription and also fundamental principles, such as multidisciplinary engagement and team collaboration, pre-exercise health screening, and exercise supervision. These were viewed as necessary components of a framework to improve the integration of exercise rehabilitation in the treatment, care, and support for OPLWH.
{"title":"Expert Consensus on an Exercise Prescription Framework for Older People Living With HIV in a South African Setting-A Delphi Study.","authors":"Levin Chetty, Saul Cobbing, Verusia Chetty","doi":"10.1097/JNC.0000000000000519","DOIUrl":"10.1097/JNC.0000000000000519","url":null,"abstract":"<p><strong>Abstract: </strong>Well-established, regular exercise interventions for older people living with HIV (OPLWH) are beneficial. However, the fundamental principles of exercise prescription for this population have not been sufficiently explored. An expert panel of health care professionals engaged in a modified Delphi technique to explore their perceptions of, and gain their consensus on, an exercise prescription framework for OPLWH in a resource-poor South African setting. A high level of agreement among participants was determined using a priori threshold of 80% agreement and an interquartile range of ≤ 1. Expert consensus was reached on a structured, multifaceted exercise prescription and also fundamental principles, such as multidisciplinary engagement and team collaboration, pre-exercise health screening, and exercise supervision. These were viewed as necessary components of a framework to improve the integration of exercise rehabilitation in the treatment, care, and support for OPLWH.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"156-166"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-21DOI: 10.1097/JNC.0000000000000522
Rebecca Conway, Michael Evangeli, Angelina Namiba, Rachael Jones
Abstract: Effective antiretroviral treatment means that people with HIV are living for longer. This includes Black African women, who represent a large proportion of people aging with HIV in the United Kingdom. Despite this, the impact of living and aging with HIV on the well-being of Black African women aging with HIV has not been investigated. Interpretative phenomenological analysis of interviews with eight Black African women ages 50 years and older living with HIV developed six superordinate themes. Findings demonstrated how experiences of HIV-related stigma negatively affected social, occupational, and psychological well-being. Perspectives on living and aging with HIV into the future included experiences of acceptance, uncertainty, anxiety, and hope. Recommendations are made, including developing clinical practice to consider needs relating to social and psychological well-being, as well as physical well-being, for women aging with HIV.
{"title":"\" I Look in the Mirror and Say ' You Know What, There Is Hope for You '\"-An Interpretative Qualitative Study of Current and Future Well-Being in Black African Women Older Than 50 Years With HIV in the United Kingdom.","authors":"Rebecca Conway, Michael Evangeli, Angelina Namiba, Rachael Jones","doi":"10.1097/JNC.0000000000000522","DOIUrl":"10.1097/JNC.0000000000000522","url":null,"abstract":"<p><strong>Abstract: </strong>Effective antiretroviral treatment means that people with HIV are living for longer. This includes Black African women, who represent a large proportion of people aging with HIV in the United Kingdom. Despite this, the impact of living and aging with HIV on the well-being of Black African women aging with HIV has not been investigated. Interpretative phenomenological analysis of interviews with eight Black African women ages 50 years and older living with HIV developed six superordinate themes. Findings demonstrated how experiences of HIV-related stigma negatively affected social, occupational, and psychological well-being. Perspectives on living and aging with HIV into the future included experiences of acceptance, uncertainty, anxiety, and hope. Recommendations are made, including developing clinical practice to consider needs relating to social and psychological well-being, as well as physical well-being, for women aging with HIV.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"118-129"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-08-29DOI: 10.1097/JNC.0000000000000497
Samuel Akyirem, Guangyu Tong, Gloria Aidoo-Frimpong, Diana Namumbejja Abwoye, Daniel Jacobson López, Leo Wilton, LaRon E Nelson
Abstract: The aims of this study were to determine if HIV symptoms among sexual minority men formed clusters and to examine the sociodemographic and clinical characteristics that are associated with these clusters. We analyzed cross-sectional data from Ghanaian sexual minority men ( N = 225) living with HIV. We used both principal component analysis and multivariable linear regression. Our findings indicate that sadness (64.0%) and headache (62.7%) were the most prevalent symptoms among our sample. Seven symptom clusters were identified: neurological symptoms, psychological symptoms, gastrointestinal symptoms, dermatological symptoms, self-concept/self-esteem, weight/diet-related symptoms, and sleep quality and potential disturbances. Late HIV diagnosis was significantly associated with higher distress scores for all symptom clusters except for the self-concept/self-esteem and gastrointestinal symptoms clusters. The findings emphasize the importance of early HIV symptom identification.
{"title":"HIV Symptom Clusters Among Sexual Minority Men in Ghana, West Africa: A Cross-sectional Study.","authors":"Samuel Akyirem, Guangyu Tong, Gloria Aidoo-Frimpong, Diana Namumbejja Abwoye, Daniel Jacobson López, Leo Wilton, LaRon E Nelson","doi":"10.1097/JNC.0000000000000497","DOIUrl":"10.1097/JNC.0000000000000497","url":null,"abstract":"<p><strong>Abstract: </strong>The aims of this study were to determine if HIV symptoms among sexual minority men formed clusters and to examine the sociodemographic and clinical characteristics that are associated with these clusters. We analyzed cross-sectional data from Ghanaian sexual minority men ( N = 225) living with HIV. We used both principal component analysis and multivariable linear regression. Our findings indicate that sadness (64.0%) and headache (62.7%) were the most prevalent symptoms among our sample. Seven symptom clusters were identified: neurological symptoms, psychological symptoms, gastrointestinal symptoms, dermatological symptoms, self-concept/self-esteem, weight/diet-related symptoms, and sleep quality and potential disturbances. Late HIV diagnosis was significantly associated with higher distress scores for all symptom clusters except for the self-concept/self-esteem and gastrointestinal symptoms clusters. The findings emphasize the importance of early HIV symptom identification.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"108-117"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-24DOI: 10.1097/JNC.0000000000000514
Jennifer S Tinman, Nqobile Nzama, Jenifer Patterson, Lesley M Harris, Jelani C Kerr
Abstract: The intersections of HIV with aging, incarceration, and racial disparities have been well studied, but little is known about the lived incarceration experiences of older African American persons living with HIV. This phenomenological study examined the fear of HIV disclosure among older African Americans living in Kentucky who have experienced incarceration. Based on the interviews analyzed, five main themes were identified: experiences with fear, experiences pertaining to confidentiality, experiences with disclosure, experiences with stigma, and the desire to be accepted. These themes demonstrate HIV disclosure fear within incarceration settings and the desire for support and services. Findings suggest that there should be more efforts to increase HIV knowledge and awareness within incarceration settings. Participants shared that having a support network alleviates isolation. We recommend that correctional settings implement policies to protect confidentiality violations and facilitate groups to help foster a more supportive environment for individuals living with HIV.
{"title":"\"Don't Tell Nobody Nothing\": A Phenomenological Study on Fear of HIV Disclosure Among Older African Americans During Incarceration Living in Kentucky, USA.","authors":"Jennifer S Tinman, Nqobile Nzama, Jenifer Patterson, Lesley M Harris, Jelani C Kerr","doi":"10.1097/JNC.0000000000000514","DOIUrl":"10.1097/JNC.0000000000000514","url":null,"abstract":"<p><strong>Abstract: </strong>The intersections of HIV with aging, incarceration, and racial disparities have been well studied, but little is known about the lived incarceration experiences of older African American persons living with HIV. This phenomenological study examined the fear of HIV disclosure among older African Americans living in Kentucky who have experienced incarceration. Based on the interviews analyzed, five main themes were identified: experiences with fear, experiences pertaining to confidentiality, experiences with disclosure, experiences with stigma, and the desire to be accepted. These themes demonstrate HIV disclosure fear within incarceration settings and the desire for support and services. Findings suggest that there should be more efforts to increase HIV knowledge and awareness within incarceration settings. Participants shared that having a support network alleviates isolation. We recommend that correctional settings implement policies to protect confidentiality violations and facilitate groups to help foster a more supportive environment for individuals living with HIV.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"130-142"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-04DOI: 10.1097/JNC.0000000000000526
Allison R Webel
{"title":"Giants.","authors":"Allison R Webel","doi":"10.1097/JNC.0000000000000526","DOIUrl":"10.1097/JNC.0000000000000526","url":null,"abstract":"","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"93-94"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}