{"title":"The theory of preloading: A cognitive-behavioural motivational model.","authors":"Jacob G Sorbello, Grant J Devilly","doi":"10.1186/s12954-024-01122-7","DOIUrl":"10.1186/s12954-024-01122-7","url":null,"abstract":"<p><p>Preloading of alcohol and/or drugs before an event has been examined in the research literature for the past two decades. Despite the considerable interest and scrutiny on the behaviour, there are limited, if any, attempts to conceptualise a theoretical understanding of why people preload before an event. Here we propose a Theory of Preloading (TOP)-a general cognitive-behavioural motivational model for alcohol and drug preloading. This conceptualisation reviewed and borrowed relevant cognitive, motivational and behavioural constructs from previous models-i.e., the Motivational Model of Alcohol Use, (Cox & Klinger, 2011), PRIME theory (West, 2007); SORCK analysis (Kanfer & Sanslow, 1965)-applied to the target behaviour of preloading with alcohol and/or drugs. The TOP proposed that a central construct of affective management-guided by distal and cognitive factors-contributes to decisional factors for preloading. Consequential reinforcers and punishers create a reinforcement loop that feeds back into distal and immediate environmental factors for preloading, increasing the likelihood of future occurrences of preloading behaviours. Our proposed theoretical formulation concludes with practical and clinical implications, along with future directions for testing the model.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"226"},"PeriodicalIF":4.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phyo Aung, Margaret Hellard, Paul Dietze, Bek Petrovic, Peter Higgs, Mark Stoové
{"title":"Practical solutions to resolve social barriers to hepatitis C treatment initiation among people who inject drugs: a qualitative study.","authors":"Phyo Aung, Margaret Hellard, Paul Dietze, Bek Petrovic, Peter Higgs, Mark Stoové","doi":"10.1186/s12954-024-01136-1","DOIUrl":"10.1186/s12954-024-01136-1","url":null,"abstract":"<p><strong>Background: </strong>We aimed to identify motivators for people who inject drugs to pursue treatment for hepatitis C virus (HCV) infection and uncover opportunities that could make treatment more appealing.</p><p><strong>Methods: </strong>Between November 2023 and January 2024, we conducted semi-structured interviews with 15 HCV RNA-positive individuals with a history of injecting drug use and self-reported as either untreated or treated but delayed treatment for more than 6 months. Thematic and framework data analysis was employed and interpreted using the Capability, Opportunity and Motivation (COM-B) framework of behaviour change.</p><p><strong>Results: </strong>The findings suggest that a combination of stability through secure housing, mental readiness and overcoming drug dependence supported by OAT (Capability), accessible and convenient healthcare like mobile outreach services coupled with financial incentives (Opportunity), and supportive relationships (Motivation) could serve to help people who inject drugs take up HCV treatment.</p><p><strong>Conclusion: </strong>Alcohol and other drug and primary care services for people who use drugs should adopt person-centred approaches and recognise the gradual nature of behavioural change to foster empathy and supportive relationships to promote engagement in HCV care. Additionally, integrating HCV treatment with mobile outreach services and providing practical assistance, such as housing and financial incentives, are critical to ensuring that individuals remain engaged in HCV care.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"221"},"PeriodicalIF":4.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Precious Anyanwu, Olajumoke A Olateju, Vaishnavi Tata, Tyler Varisco, Lauren R Gilbert, Motolani E Ogunsanya, E James Essien, Michael L Johnson, J Douglas Thornton
Matthew Murphy, Nyx Gomes, Kimberly Kane, Josiah D Rich, Lloyd Goldsamt, Jasjit S Ahluwalia, Kate M Guthrie, Susan E Ramsey, Sara Vargas
{"title":"Developing an ethical framework for the recruitment of people who inject drugs experiencing incarceration in HIV prevention research: a qualitative study.","authors":"Matthew Murphy, Nyx Gomes, Kimberly Kane, Josiah D Rich, Lloyd Goldsamt, Jasjit S Ahluwalia, Kate M Guthrie, Susan E Ramsey, Sara Vargas","doi":"10.1186/s12954-024-01138-z","DOIUrl":"10.1186/s12954-024-01138-z","url":null,"abstract":"<p><strong>Background: </strong>HIV disproportionately impacts people who experience incarceration. Incarceration represents an opportunity to engage in HIV prevention care for individuals who often experience a number of barriers accessing health services in the community. The development of evidence-based practices promoting pre-exposure prophylaxis for HIV prevention (PrEP) is crucial for ending the HIV epidemic within this highly marginalized population. However, PrEP research within carceral facilities has been limited and is hampered in part by the lack of ethical guidance on conducting HIV prevention research in this unique setting where incarcerated individuals are categorized as a vulnerable population requiring specific protections. This lack of knowledge is particularly striking when considering the lack of input from incarcerated individuals themselves on the responsible conduct of research, which is critical to understanding ways to ensure participant autonomy while avoiding coercive practices in research activities.</p><p><strong>Methods: </strong>In order to gain a better understanding of ethical approaches to the conduct of HIV prevention research among incarcerated individuals, we conducted qualitative interviews with 21 incarcerated men who reported injecting drugs and met clinical criteria for PrEP use. The interview topics included HIV knowledge, PrEP knowledge, stigma, and perceptions related to ethical research practices.</p><p><strong>Results: </strong>Themes identified included how forced abstinence during incarceration can negatively affect research participation, the importance of participant comfort as it relates to ensuring autonomy in decision making, a desire for person centred approaches in research activities, study staff characteristics impacting participant experience, and perceptions of carceral staff as members of research teams.</p><p><strong>Conclusions: </strong>The results of this study indicate that conducting research focused on improving PrEP use in a carceral environment has support among those experiencing incarceration. However, researchers should place the participant experience at the center of research protocol development.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"223"},"PeriodicalIF":4.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gyde Steffen, Amrei Krings, Sarah Guttmann, Nadine Lübke, Kristin Meyer-Schlinkmann, Carsten Tiemann, Jörg Timm, Andreas Walker, Ruth Zimmermann
{"title":"Progress and challenges in the elimination of hepatitis C among people who inject drugs in Germany: results of a pilot study for a national monitoring system, 10 years after the first data collection.","authors":"Gyde Steffen, Amrei Krings, Sarah Guttmann, Nadine Lübke, Kristin Meyer-Schlinkmann, Carsten Tiemann, Jörg Timm, Andreas Walker, Ruth Zimmermann","doi":"10.1186/s12954-024-01119-2","DOIUrl":"10.1186/s12954-024-01119-2","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) are at high risk of blood-borne infections, and injection drug use contributes significantly to hepatitis C virus (HCV) transmission. The WHO has therefore set targets of reducing HCV incidence and prevalence among PWID and increasing treatment coverage to eliminate HCV by 2030. The DRUCK study (2011-2014) found high HCV prevalence and low treatment coverage among PWID in Germany. To assess progress in the elimination of HCV among PWID, we conducted a cross-sectional study in two German federal states that piloted a future monitoring.</p><p><strong>Methods: </strong>PWID aged 16 + who injected drugs (previous 12 months) were recruited in low-threshold drug services and opioid agonist treatment (OAT) practices in Berlin and Bavaria between June 2021 and April 2022. Participants completed a questionnaire on sociodemographics, behaviours and access to care, and were tested for hepatitis B virus (HBV) and HCV, and HIV. Data was analysed regarding HCV prevalence, history of treatment, and risk and prevention behaviours. Results were compared with the DRUCK study.</p><p><strong>Results: </strong>A total of 588 PWID, with a median age of 39 (range: 17-66) years and 68% (399/587) male, were included in the analysis. Of the participants, 61% (353/574) reported receiving OAT and 14% (66/469) recent use of shared needles/syringes during the last 30 days. History of imprisonment was reported by 77% (444/577) and history of homelessness by 75% (428/569) of participants. Among anti-HCV positive participants, viraemic HCV infections decreased by 44% from 66% (904/1361) in 2011-2014 to 37% (160/432) in 2021-2022, while those with cleared HCV infection and treatment history increased from 20% (266/1361) to 34% (148/432).</p><p><strong>Conclusions: </strong>Despite a decrease since 2011-2014, viraemic HCV prevalence among PWID in Germany remains high, and treatment coverage is still insufficient. To achieve the WHO targets, universal health coverage and targeted integrated testing and treatment for PWID are needed. PWID receiving OAT and people in prison should be offered testing and treatment at any contact with the medical system. A nationwide monitoring system will help assess successes and remaining gaps, and track progress towards elimination of HCV among PWID in Germany.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"222"},"PeriodicalIF":4.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Harm reduction and its monitoring in Europe, from EMCDDA to EUDA.","authors":"Alexis Goosdeel","doi":"10.1186/s12954-024-01130-7","DOIUrl":"10.1186/s12954-024-01130-7","url":null,"abstract":"<p><strong>Background: </strong>Harm Reduction, conceptualized by Russell Newcombe in the late 1980s, has revolutionized how drug use, individuals who use drugs, and drug policies are understood globally. Emerging from the HIV/AIDS crisis, Harm Reduction sought to address the dire rates of drug-related infections and the overwhelming burden on healthcare providers. Early initiatives, such as Opioid Substitution Treatment (OST) and needle exchange programs, were met with resistance but gradually established new standards of care, transforming attitudes toward people who use drugs and prioritizing human-centered, rather than solely medical, approaches.</p><p><strong>Main body: </strong>This paper explores the evolution and expansion of Harm Reduction from an HIV/AIDS prevention strategy to a broader framework adopted across Europe. Although ideological barriers initially slowed adoption, Harm Reduction principles have gained acceptance, notably through EU policies promoting drug-related harm reduction and the United Nations' 2024 resolution. Through initiatives such as OST, needle exchange programs, drug consumption rooms, and drug-checking services, the European Union has demonstrated progressive success in reducing drug-related deaths and infectious diseases. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has supported this evolution by providing extensive data, scientific evidence, and policy recommendations that guide national approaches. More recently, advancements in hepatitis C treatment have created opportunities for improved health outcomes among individuals who use drugs, fostering their role as active partners in healthcare processes.</p><p><strong>Conclusion: </strong>Today's increasingly complex drug landscape, characterized by high substance availability, poly-drug use, and drug-related violence, necessitates a redefined approach to Harm Reduction. With the transformation of the EMCDDA into the European Union Drug Agency (EUDA), the agency's mandate now includes a proactive focus on anticipating, alerting, responding to, and learning from emerging drug-related challenges. Strengthening collaboration with civil society will be crucial in evolving Harm Reduction to meet future needs, ensuring that EU drug policies remain inclusive, adaptive, and aligned with the diverse realities faced by individuals who use drugs.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"219"},"PeriodicalIF":4.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryann Mason, Bruce Johnson, Christorpher Schaffner, Sean Johnston, Ursula Alexander, Oyindamola Ajala, Nia Andrews, Sarah B Welch
{"title":"Door-to-door overdose harm reduction: an Illinois case study.","authors":"Maryann Mason, Bruce Johnson, Christorpher Schaffner, Sean Johnston, Ursula Alexander, Oyindamola Ajala, Nia Andrews, Sarah B Welch","doi":"10.1186/s12954-024-01134-3","DOIUrl":"10.1186/s12954-024-01134-3","url":null,"abstract":"<p><strong>Background: </strong>Harm reduction for people who use drugs (PWUD) is an established evidence-based practice that encompasses a wide variety of services, delivery formats, and settings and has been named a priority in US drug policy. Harm reduction is focused on planning with communities and meeting PWUD where they are and encompasses a wide variety of interventions. We describe and report the feasibility, acceptability, and process implementation outcomes for an innovative pilot drug overdose harm reduction intervention, Block-by-Block (BXB), focused on training for and distribution of naloxone and test strips in areas identified as high risk for fatal overdoses.</p><p><strong>Case presentation: </strong>Beginning operations in 2022, BXB operates in five pilot sites in four Illinois counties. Through partnerships with local organizations, BXB delivers harm reduction services in a private setting (home) or in a setting not specifically focused on serving PWUD (businesses, libraries, faith-based organizations, etc.) to reach PWUD and their friends, family and neighbors living in areas disproportionately affected by opioid overdose death. The intervention theory is based on acknowledgement that harm reduction services that require PWUD to visit a mobile unit, van or community organization, may not reach those in need or their friends, neighbors, and family for a variety of reasons including stigma associated with drug use, lack of awareness about these services, or where to locate them. Services delivered include education and training in the use of naloxone and fentanyl, xylazine and benzodiazepine test strips. Leave behind materials include naloxone, test strips and handouts with information on the intervention and local resources.</p><p><strong>Conclusions: </strong>Results to date indicate that this intervention is feasible -over half (55%) of the doors approached were answered. Acceptability of the intervention as delivered is high --people at 75% of doors that were answered were interested in and received training and/or supplies. BXB is flexible in that it has been quickly adapted to changes in community conditions, the drug supply, and shifting high risk areas as they developed. This is a promising intervention that leverages available data and resources and is readily implementable in communities with support from a central program administrator and access to geo-coded data.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"218"},"PeriodicalIF":4.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tanja Schwarz, Deniz Akartuna, Martin Busch, R Michael Krausz, Alfred Uhl
{"title":"Challenges for the implementation of injectable opioid agonist treatment: a scoping review.","authors":"Tanja Schwarz, Deniz Akartuna, Martin Busch, R Michael Krausz, Alfred Uhl","doi":"10.1186/s12954-024-01102-x","DOIUrl":"10.1186/s12954-024-01102-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Injectable opioid agonist treatment (iOAT) is a valuable, patient-centred, evidence based intervention. However, limited information exists on contextual factors that may support or hinder iOAT implementation and sustainability. This study aims to examine existing research on iOAT using diacetylmorphine and hydromorphone, focusing on identifying the key barriers and facilitators to its successful implementation.</p><p><strong>Methods: </strong>A systematic search was conducted in the MEDLINE and PsycInfo databases (via Ovid) from inception to February 2024, supplemented by a comprehensive grey literature search. No restrictions were applied regarding publication type, year, or geographic location. Articles were independently screened by two reviewers. Eligible articles described the feasibility, implementation, and/or evaluation of iOAT in one or more countries, presenting perspectives on receiving, administering, or governing iOAT.</p><p><strong>Results: </strong>Forty-four publications were selected for inclusion. Barriers identified through thematic analysis included public acceptance concerns such as medication diversion, increased crime, and the Honey-Pot effect. Legal and ethical challenges identified involved enacting changes in law to make certain substances available as a medically controlled options for treatment, and addressing patient consent issues. Negative media coverage and public controversies were found to undermine acceptance, and high start-up costs especially for security, facility access, and economic feasibility were seen as additional obstacles. Regulatory barriers and stringent protocols were the most frequently cited limiting factors by patients and providers. Facilitators included the integration of trial prescriptions into comprehensive drug policy strategies and publishing data for evidence-based debates, together with ethics committees ensuring compliance with ethical standards. Developing information strategies and addressing opponents' claims improved public perception. Cost-effectiveness evidence was found to support long-term implementation, while flexible treatment protocols, inclusive spaces, and affirming therapeutic relationships were seen as important facilitators to enhance patient engagement and treatment effectiveness.</p><p><strong>Conclusions: </strong>Successful implementation of iOAT requires balancing political and social acceptability with scientific integrity, alongside strategic communication and public outreach. Further research is needed to enhance the transferability of findings across diverse socio-political contexts and address key influencing factors associated with iOAT programs.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"217"},"PeriodicalIF":4.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin D Scher, Benjamin W Chrisinger, David K Humphreys, Gillian W Shorter
{"title":"Exploring drug consumption rooms as 'inclusion health interventions': policy implications for Europe.","authors":"Benjamin D Scher, Benjamin W Chrisinger, David K Humphreys, Gillian W Shorter","doi":"10.1186/s12954-024-01099-3","DOIUrl":"10.1186/s12954-024-01099-3","url":null,"abstract":"<p><p>People who use drugs are among the most socially excluded groups in Europe. Qualitative research on Drug Consumption Rooms (DCRs) has reported various benefits to clients, including increased feelings of well-being, safety and connection, however, few studies have explored in-depth client narratives of belonging and social inclusion. In this article, we explore this literature and describe the ways in which DCRs foster social inclusion and feelings of belonging amongst their clients. With a view towards the future of DCR implementation in Europe, this argument positions DCRs as effective 'inclusion health interventions'. The shift in analysis from DCRs as a purely harm reduction or overdose prevention and response intervention to one of 'inclusion health' could work towards a wider recognition of their effectiveness in addressing broader health and social inequities. At a policy level, this shift could result in increased political support for DCRs as recognized interventions, which through their design, effectively promote social inclusion.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"216"},"PeriodicalIF":4.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"People who use drugs and the right to health.","authors":"Alison Ritter, Liz Barrett","doi":"10.1186/s12954-024-01132-5","DOIUrl":"10.1186/s12954-024-01132-5","url":null,"abstract":"<p><p>Support for a human rights framework for drug policy has been growing for some years. This year, the UNODC published a chapter in the World Drug Report focussed on the right to health. In this paper, we draw attention to the conceptualisation of the right to health for people who use drugs. While one essential element is access to appropriate, high quality, and affordable healthcare, this needs to occur hand-in-hand with two other central components of the right to health - the right to conditions that promote health (the social, economic, legal, commercial, and cultural determinants of health) and the right to meaningful participation in healthcare decisions and in health policy. We consider these three components of a right to health against the current international drug control regime. More specifically we point to how the three drug conventions (1966 as amended 1972, 1971 and 1988) make explicit mention of the right to health. In this way, we argue that duties to respect, protect and provide the right to health for people who use drugs accrue through being a signatory to the drug conventions. Given that there does not appear to be international appetite to abandon the current treaties, and notwithstanding the strong impression that they reinforce a criminalisation approach to people who use drugs, the work herein may afford another avenue for effective advocacy about the right to health.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"215"},"PeriodicalIF":4.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}