Forensic Toxicology最新文献

{"title":"Inactivation of calcium Ion signaling in neuronal SK-N-SH cells with development of resistance to a designer drug α-pyrrolidinooctanophenone.","authors":"Yuji Sakai, Yoshifumi Morikawa, Toshihiro Matsumura, Shunsuke Jimbo, Koichi Suenami, Gento Yamashita, Atsushi Nagai, Tomomi Michiue, Akira Ikari, Toshiyuki Matsunaga","doi":"10.1007/s11419-025-00751-2","DOIUrl":"10.1007/s11419-025-00751-2","url":null,"abstract":"<p><strong>Purpose: </strong>The cellular mechanisms underlying tolerance development to psychostimulant-induced neurotoxicity remain poorly understood. This study investigated these mechanisms using pyrrolidinophenone derivatives (PPs), potent amphetamine-type stimulants with strong dopaminergic activity and high cytotoxicity, aiming to establish a neuronal tolerance model and to explore adaptive processes relevant to substance use disorder.</p><p><strong>Methods: </strong>Human SK-N-SH neuronal cells were chronically exposed to α-pyrrolidinooctanophenone (α-POP) to prepare the drug-resistant cell line, SH/POP. Transcriptomic profiling was performed to identify gene expression alterations associated with tolerance development.</p><p><strong>Results: </strong>Cell sensitivity assay showed that SH/POP cells can survive at lethal concentrations (> 40 μM) of α-POP. RNA sequence analysis of the resistant cells identified alterations in 1,298 differentially expressed genes and the gene ontology analysis surmised an upregulation of calcium-binding-related genes. The development of α-POP resistance reduced the basal Ca²⁺ concentration and suppressed the caspase-3 activation elicited by the drug. Additionally, the development down-regulated the phosphorylation of a transcription factor cAMP response element-binding protein (CREB) and expressions of CREB-target genes, Fos proto-oncogene AP-1 transcription factor subunit and neurotensin. Furthermore, constitutive activation of endoplasmic reticulum stress responses and selective enhancement of trypsin-like proteasome activity in SH/POP cells were detected.</p><p><strong>Conclusions: </strong>Resistance development of neuronal cells to PPs is ascribable to suppression of calcium-dependent apoptosis and CREB signaling, and constitutive activation of endoplasmic reticulum stress responses. The SH/POP cell line represents a novel in vitro model to study molecular adaptations to psychostimulant toxicity and provides insights into neuroadaptive mechanisms underlying substance use disorder.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"177-191"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755526","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}

{"title":"Hair testing for investigating intake and use history of hypnotics in the forensic field.","authors":"Noriaki Shima, Munehiro Katagi, Takako Sato","doi":"10.1007/s11419-025-00730-7","DOIUrl":"10.1007/s11419-025-00730-7","url":null,"abstract":"<p><strong>Purpose: </strong>Hair testing for drugs has been used extensively in the forensic field since the 1990s, primarily in cases involving abused drugs such as methamphetamine and cocaine. Since the 2010s, its scope has expanded to include the detection of single dose of hypnotics, aiding in the investigation of serious crimes. This review presents essential knowledge for hair testing and the currently recommended analytical procedures and forensic applications.</p><p><strong>Methods: </strong>A review of literature from the 1990s to the 2020s was conducted, focusing on analytical methods for detecting drugs in hair, drug concentrations in hair, and drug incorporation pathways.</p><p><strong>Results: </strong>The characteristics of hair as a biological specimen include a longer detection window than other matrices such as urine and blood, as ingested drugs remain stable in hair over time. Significant differences in drug concentrations in hair are observed among substances, with several hypnotics, such as triazolam, having extremely low concentrations. Drugs are incorporated into hair primarily through two main pathways (the hair bulb and the upper dermis zone), with the dominant pathway depending on the drug's properties. In addition, hair dyeing and subsequent exposure to aqueous environments (e.g., daily hair washing) can significantly influence drug concentrations and their distribution patterns (concentration and hair region). These factors must be carefully considered in hair testing.</p><p><strong>Conclusions: </strong>Hair testing is an effective means for proving drug intake and estimating use history, particularly in cases where there is a delay in reporting the incident. The interpretation of results must account for various factors, such as the chemical structures of drugs, incorporation pathways, and hair dyeing.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575162","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}

{"title":"Simultaneous quantitative determination of 2-fluoro-2-oxo-phenylcyclohexylethylamine, methylenedioxymethamphetamine and ketamine in postmortem blood using liquid chromatography-tandem mass spectrometry.","authors":"Meejung Park, Sungmin Moon, Nahyun Lee, Jihyun Kim","doi":"10.1007/s11419-025-00743-2","DOIUrl":"10.1007/s11419-025-00743-2","url":null,"abstract":"<p><strong>Purpose: </strong>The abuse of 2-fluoro-2-oxo-phenylcyclohexylethylamine (2F-2-oxo-PCE), a dissociative anesthetic structurally related to phencyclidine (PCP) and ketamine, has recently increased in South Korea. This study presented the first forensic toxicological detection of 2F-2-oxo-PCE in autopsy cases and described a validated method for the simultaneous quantification of 2F-2-oxo-PCE, methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), ketamine, and norketamine in postmortem blood.</p><p><strong>Method: </strong>2F-2-oxo-PCE and its metabolite, 2F-deschloronorketamine (2F-DCNK) were identified using gas chromatography-mass spectrometry (GC-MS). A liquid chromatography-tandem mass spectrometry (LC-MS/MS) with solid-phase extraction (SPE) was developed and validated for the simultaneous quantification of 2F-2-oxo-PCE, MDMA, MDA, ketamine and norketamine in blood.</p><p><strong>Results: </strong>The validation parameters including linearity, accuracy, precision, matrix effect, and recovery were satisfactory. In postmortem blood samples, 2F-2-oxo-PCE concentrations ranged from 664 to 7911 ng/mL. Concurrent detection with MDMA and ketamine suggested possible polydrug use contributing to fatal outcomes.</p><p><strong>Conclusions: </strong>The validated LC-MS/MS method is suitable for forensic applications and may enhance the toxicological profiling of emerging dissociative substances. The results can provide critical baseline data for interpreting 2F-2-oxo-PCE-related intoxications.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"248-256"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205984","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}

{"title":"Quantitative determination of suvorexant, lemborexant, and daridorexant in human plasma using a MonoTip C18 and gas chromatography-mass spectrometry.","authors":"Koichi Aoyama, Chika Hasegawa, Masaya Fujishiro, Maiko Kusano, Takeshi Kumazawa, Akihiro Nakauchi, Motofumi Miura, Mitsuru Honda, Takaaki Matsuyama, Kunihiko Kurosaki","doi":"10.1007/s11419-025-00745-0","DOIUrl":"10.1007/s11419-025-00745-0","url":null,"abstract":"<p><strong>Purpose: </strong>Orexin receptor antagonists (ORAs) are a novel class of medications used in the treatment of insomnia. With increasing restrictions on benzodiazepine prescriptions, a rise in ORA overdose is expected. To enable the prediction of clinical severity and formulation of appropriate treatment strategies, we developed a rapid analytical method for detecting ORAs in plasma samples using a Monolithic solid-phase extraction (SPE) and gas chromatography-mass spectrometry (GC-MS).</p><p><strong>Method: </strong>Extraction was performed using MonoTip C18. All steps from pretreatment to elution were conducted using centrifugation. Quantification was carried out using GC-MS with temperature-programmed analysis by positive ion electron ionization, using suvorexant-d₆ as the internal standard. The method was applied to plasma samples from actual ORA overdose cases to evaluate its practical applicability.</p><p><strong>Result: </strong>The calibration curves demonstrated excellent linearity over the range of 10-2,000 ng/mL, with correlation coefficients of at least 0.9999. Reproducibility showed a coefficient of variation (CV) between 0.6% and 6.9%, and recovery rates were over 83%. ORA concentrations in overdose patient samples were successfully quantified using this method.</p><p><strong>Conclusion: </strong>MonoTip C18 utilizes a reduced amount of solvent, thereby eliminating the need for evaporation-to-dryness steps. As a result, the entire procedure, encompassing SPE to GC-MS detection, can be completed within 40 min. This single protocol is applicable to all ORAs currently available in Japan and is suitable for both clinical and forensic toxicological applications.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"130-140"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755628","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}

{"title":"Synthetic Cannabinoid AB-FUBINACA Negatively Impacted the Male Fertility and Induced Testicular Toxicity.","authors":"Ayman Alzu'bi, Ejlal Abu-El-Rub, Fatimah A Almahasneh, Rawan Almazari, Amani Kasasbeh, Heba F Ai-Jariri, Amneh Alrabie, Raed M Al-Zoubi","doi":"10.1007/s11419-025-00739-y","DOIUrl":"10.1007/s11419-025-00739-y","url":null,"abstract":"<p><strong>Purpose: </strong>The recreational use of synthetic cannabinoids (SCs) by adolescents and adults has markedly increased in recent years. Previous studies demonstrated that exposure to SCs is associated with multiple adverse health effects. Nevertheless, little is known about the effects of these substances on male fertility. The current study aimed to investigate the toxicological effects of subacute exposure to synthetic cannabinoid AB-FUBINACA on male reproductive system in mice.</p><p><strong>Methods: </strong>Adult male Balb/c mice received daily intraperitoneal injections of various doses of AB-FUBINACA (0.75, 1.5, and 3 mg/kg for 3 weeks). Using biochemical and molecular methodologies, the impact of AB-FUBINACA on serum levels of reproductive hormones, sperm viability as well as various parameters in testicular tissue were evaluated.</p><p><strong>Results: </strong>Our findings demonstrated that AB-FUBINACA induces dose-dependent reduction in testosterone levels in the serum, but not in follicle-stimulating hormone or luteinizing hormone. AB-FUBINACA treatment also causes a significant dose related decrease in sperm viability. These findings were associated with higher level of oxidative stress (GP91 expression and malondialdehyde level) and elevated expression of key regulators of apoptosis (Bax and caspase-3) as well as reduced expression of mitochondrial respiratory chain complexes SDHB (II), UQCRC2 (III), and ATP5a (V) in the testicular tissue.</p><p><strong>Conclusion: </strong>From these findings, it can be concluded that exposure to AB-FUBINACA can interfere with the normal physiology and functioning of the male reproductive organs. Hence, gaining insight into the mechanisms by which SCs interfere with male fertility could guide future interventions and treatments.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"120-129"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285845","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}

{"title":"Forensic implications of ethyl glucuronide and ethyl sulfate pharmacokinetics in Japanese adults: the influence of dose, genetic polymorphisms, and habitual alcohol consumption.","authors":"Yuko Suefusa-Shimogori, Hirokazu Wakuda, Shinichi Nureki, Megumi Kai, Daisuke Sakamoto, Nao Mori, Tatsuji Fujisawa, Masaharu Narihara, Naoto Uemura","doi":"10.1007/s11419-025-00747-y","DOIUrl":"10.1007/s11419-025-00747-y","url":null,"abstract":"<p><strong>Purpose: </strong>Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are direct metabolites of ethanol (EtOH) and sensitive biomarkers of alcohol consumption. However, despite extensive studies in Western populations, data on Japanese individuals are limited. This study characterized the pharmacokinetics of EtG and EtS in Japanese adults and evaluated the influence of dose, genetic polymorphisms, and habitual alcohol use.</p><p><strong>Methods: </strong>Twenty-eight healthy Japanese adults received either 1.0 or 0.2 g/kg of pure EtOH (high or low dose). Whole blood and urine samples were collected for 24 h, and EtG and EtS were quantified using validated liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were analyzed. The urinary excretion and recovery of EtG and EtS were estimated. Associations between genetic polymorphisms in alcohol-metabolizing and conjugation-related enzymes and Alcohol Use Disorders Identification Test (AUDIT) scores were also evaluated.</p><p><strong>Results: </strong>EtG and EtS persisted longer than EtOH in both blood and urine. Both metabolites were excreted in the urine in a dose-dependent manner. Individuals carrying ALDH2*1/*2 showed a significantly higher urinary EtG formation rate than those carrying ALDH2*1/*1 (wild type). The AUDIT score showed a modest positive association with the urinary formation rate of EtS but not with EtG. The 24 h urine from high-dose participants exceeded international cutoffs, whereas that from low-dose participants was below the quantification limits.</p><p><strong>Conclusions: </strong>EtG and EtS showed sustained detectability, and their urinary excretion was dose-dependent, indicating their utility as biomarkers of recent alcohol intake. These findings support their potential forensic applications of EtG and EtS in Japan.</p><p><strong>Clinical trial registration: </strong>Japan Registry of Clinical Trials (jRCT), jRCT1070240083 (registered 2024-12-10).</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"152-166"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631390","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}

{"title":"An unusual way of acute Pyrazolam poisoning in consumer of commercially approved benzodiazepines.","authors":"Romain Magny, Arezki Khaled Boukerma, Amine Mihoubi, Laurence Labat, Pascal Houzé","doi":"10.1007/s11419-025-00750-3","DOIUrl":"10.1007/s11419-025-00750-3","url":null,"abstract":"","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"271-279"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699850","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}

{"title":"Identification of toxic plants from poisonous samples using massively parallel sequencing.","authors":"Hitomi S Kikkawa, Kouichiro Tsuge","doi":"10.1007/s11419-025-00748-x","DOIUrl":"10.1007/s11419-025-00748-x","url":null,"abstract":"<p><strong>Purpose: </strong>Some toxic plants have strong morphological similarities with edible wild plants. Therefore, poisoning often occurs due to accidental ingestion. It is important to identify poisonous plants in edible plant mixtures, even if the samples have been digested. In the present study, we developed a method for genus and species identification in mixed samples using massive parallel sequencing (MPS).</p><p><strong>Methods: </strong>Veratrum oxysepalum and Colchicum autumnale are the most common causative plants of such accidents and their morphological features are similar to those of the edible Hosta sieboldiana. In this study, we used V. oxysepalum and C. autumnale as the target poisonous plant species. We developed and optimized an MPS analysis method for trnL and rbcL regions that are commonly used in plant species identification. Initially, DNA from poisonous plants (V. oxysepalum and C. autumnale) and edible plants (H. sieboldiana) were mixed in various ratios and analyzed using MPS. Next, we prepared cooked materials and simulated gastric contents from V. oxysepalum, C. autumnale, and H. sieboldiana and analyzed them using MPS.</p><p><strong>Results: </strong>We detected both poisonous and edible plant DNA when mixed in equal amounts. Poisonous plants were also detected in cooked or simulated gastric acid content. These results suggest that our method can be used to identify the genera or species of plants present in cooked materials and simulated gastric contents.</p><p><strong>Conclusions: </strong>These results indicate that MPS techniques are useful for the forensic analysis of plant materials.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"231-240"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699845","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}

{"title":"Application of the transient matrix effect for determination of anabolic-androgenic steroids in biological samples by GC-MS/MS.","authors":"Michal P Dybowski, Krystian Siwek","doi":"10.1007/s11419-025-00731-6","DOIUrl":"10.1007/s11419-025-00731-6","url":null,"abstract":"<p><strong>Purpose: </strong>Anabolic-androgenic steroids (AAS) enhance athletic performance, giving athletes an unfair advantage and disrupting fair competition. Banned in sports and listed by World Anti-Doping Agency, they require precise detection. This study aimed to develop a method using the transient matrix effect to improve AAS identification in biological samples.</p><p><strong>Methods: </strong>Gas chromatography-tandem mass spectrometry (GC-MS/MS) method for determination of AAS samples was developed and validated. Biological samples were prepared using the QuEChERS technique.</p><p><strong>Results: </strong>The optimised and validated method enhances AAS signals using high-boiling protectants. It ensures good linearity, low detection limits, and reliable precision. Optimal QuEChERS extraction and multiple reaction monitoring transitions in GC-MS/MS were evaluated, confirming applicability with blood plasma samples. The addition of a protectant to the analysed sample results in several notable effects. High-boiling protectants, such as polyethylene glycol (PEG-400), tetradecanoic acid (C14-COOH), n-tetradecylalcohol (C14-OH), and n-tetradecylamine (C14-NH₂), significantly enhance AAS's signal in blood plasma. This enhancement, however, is accompanied by a transient matrix effect induced by the protectants. PEG-400 produced the most substantial signal increase, with the response for nandrolone rising by as much as 912%.</p><p><strong>Conclusions: </strong>The results demonstrate the potential offered by the utilisation of PEG-400 as a protectant to generate a transient matrix effect. The outcome of this process is an increased analytical signal from AAS in blood plasma, enabling their identification even at trace concentrations. The methodology developed and applied during the study can be used to reduce the detection limit of steroids and thus improve antidoping measures in sport.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"204-216"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495450","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}

{"title":"Innovative applications of nanotechnology in enhancing forensic science investigations.","authors":"Asmita Podder, Agnishwar Girigoswami, Koyeli Girigoswami","doi":"10.1007/s11419-025-00734-3","DOIUrl":"10.1007/s11419-025-00734-3","url":null,"abstract":"<p><strong>Purpose: </strong>Forensics, along with the implementation of techniques from nanosciences, has brought about a change in the domain of forensic science and criminal investigation. It has brought about a positive change in the criminal investigation framework by making investigation more efficient and to-the-point.</p><p><strong>Methods: </strong>This paper reviews the nanotechnology-based techniques that are introduced in forensic science to unravel the mysteries behind crimes as it highlights various kinds of nano-sized particles, nanodevices along with their applications that the forensic experts use to analyze the evidences collected from the crime scenes. Google scholar, PubMed, and Scopus search engines are used to select the related articles to write this review paper.</p><p><strong>Results: </strong>DNA analysis, fingerprint detection, drug detection, explosive analysis, blood stain analysis, time since death estimation, and analysis of counterfeit documents are some of the sectors in which nanotechnology has made notable contributions.</p><p><strong>Conclusion: </strong>As the paper unfolds, it makes sure that the readers get the taste of both the worlds, and that it helps them grasp the concept and idea behind the techniques used to make a change across the globe.</p>","PeriodicalId":12329,"journal":{"name":"Forensic Toxicology","volume":" ","pages":"19-36"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783906","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}