Innovations in Pharmacy最新文献

{"title":"Identification and Characterization of Workflow Models for Medication Therapy Management in Community Pharmacies.","authors":"Rachel A Stafford, Megan G Smith","doi":"10.24926/iip.v14i2.5387","DOIUrl":"10.24926/iip.v14i2.5387","url":null,"abstract":"<p><p>Community pharmacists providing medication therapy management (MTM) services report difficulty incorporating MTM services with dispensing and other pharmacy services. A variety of approaches exist due to a lack of an ideal standard for service integration. This study seeks to identify and characterize MTM workflow models in pharmacies of one geographic area of a large community pharmacy chain. Thirteen semi-structured interviews were conducted with pharmacists from thirteen different pharmacies. Interviews were audio-recorded, transcribed, and analyzed for common themes using an inductive qualitative approach. We did not find a high level of MTM task integration into the dispensing workflow in this setting. However, three main strategies used to delegate work of MTM activities were identified and defined: shared teamwork, delegated teamwork, and single delegation. Few MTM tasks were integrated into the dispensing workflow among interviewed pharmacies; most tasks were performed outside of workflow. The most common integration was performing patient interviews at pick up. There were no trends identified among high performing or low performing pharmacies. This work may provide a basis to define workflow models for further research to test implementation strategies within community pharmacies.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88925806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Menopausal Quality of Life Claims: Overlooking the Requirements of Normal Science and Fundamental Measurement in ICER'S Cost-Effectiveness Assessment of Fezolinetant for Moderate to Severe Vasomotor Symptoms.","authors":"Paul C Langley","doi":"10.24926/iip.v14i1.5118","DOIUrl":"10.24926/iip.v14i1.5118","url":null,"abstract":"<p><p>One of the signal failures in health technology assessment is the absence of consideration given, not only to the standards of normal science, but to those of fundamental measurement. A recent evidence report by the Institute for Clinical and Economic Review (ICER) is emblematic of this failure. Based on a simple linear regression model that translates aggregate scores from the ordinal Menopause-specific Quality of Life Questionnaire (MENQOL) to the ordinal EuroQol EQ-5D-5L, ICER has applied these scores to an assumption driven model simulation to produce preferences, QALYs and incremental cost-per-QALY claims for fezolinetant for moderate to severe symptoms associated with menopause. Unfortunately, the attempt to crosswalk multidimensional or multiattribute ordinal scores is mathematically impossible. The 'created' EQ-5D-5L preferences are, as a result, of no interest. The overall result is that the ICER modelled claims for cost-effectiveness fail the required standards for normal science and fundamental measurement. fundamental are impossible. This is unfortunate, although it might be possible to assess certain domains of the MENQOL for their approximation to an interval score with the application of the Rasch Rating Scale Model, this will not support quality of life claims. A preferred approach would be to consider an alternative latent trait for quality of life in menopause, applying Rasch Measurement Theory (RMT), to develop a polytomous instrument that has the required measurement properties. The purpose of this commentary is to point out, as a number of previous commentaries have done, that this framework for creating assumption driven simulated modelled claims has no role in decisions for product assessment, access to formulary and pricing. This commentary expands upon these previous commentaries in placing RMT is the context of a needed paradigm shift to support the evolution of objective knowledge. This is critical if we are to understand, from the individual's perspective, not only an accurate assessment of the burden of menopause but to see this as part of an on-going research program that has to rely on fundamental measurement.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90453602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Perceptions and Medication Disposal Habits in Rural Michigan.","authors":"Cassandra L Falk, Scott M Sexton","doi":"10.24926/iip.v14i2.5433","DOIUrl":"10.24926/iip.v14i2.5433","url":null,"abstract":"<p><p><b>Background:</b> Inadequate or inappropriate medication disposal is a public health concern that may lead to increased community risk of accidental poisonings, substance misuse, and environmental pollution. <b>Objective:</b> The study's primary objective was to assess medication disposal knowledge and practices of Michigan residents living in rural, underserved areas. Secondary objectives included determining baseline perceptions of at-home drug disposal kits and examining the impact of an educational video intervention on at-home drug disposal kit perceptions. <b>Methods:</b> To measure the objectives, an online 15-question survey was deployed to the general public via convenience sampling from local organizations working with drug disposal. The survey questions assessed medication disposal knowledge and practices in underserved, rural Michigan. Participant responses were assessed categorically and numerically. <b>Results:</b> Inclusion criteria were met by 97 survey participants. Results indicated that Michigan rural residents, regardless of various demographic factors, would benefit from increased drug disposal education. Specifically, at-home drug disposal kits and medication drop boxes have the highest need for additional education. Perceptions related to home disposal safety and ease of use improved significantly with an educational video intervention. <b>Conclusion:</b> All rural residents, regardless of demographics, would benefit from increased drug disposal education. A short, educational video can impact thoughts and attitudes related to at-home drug disposal kits. Similar interventions may be successful in other rural, underserved areas.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74540768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Dosing of Enoxaparin in Critically Ill Patients with Venous Thromboembolism.","authors":"Aliya Abdulla, Caitlin M Williams, Trisha N Branan, Susan E Smith","doi":"10.24926/iip.v14i1.5174","DOIUrl":"10.24926/iip.v14i1.5174","url":null,"abstract":"<p><p><b>Background:</b> Evidence suggests that goal anti-Xa levels are achieved in only 33% of critically ill patients receiving standard prophylactic enoxaparin dosing. There has been limited focus on the potential suboptimal anticoagulation effect on medical intensive care unit (MICU) patients receiving therapeutic enoxaparin dosing for venous thromboembolism (VTE). <b>Methods:</b> MICU patients receiving enoxaparin 1 mg/kg twice daily or 1.5 mg/kg daily for VTE treatment in a 350-bed community teaching hospital between 2013 and 2019 with at least one peak anti-Xa level measured were included. The primary outcome was the proportion who achieved therapeutic anti-Xa levels with standard dosing. Secondary outcomes included types of dose-adjustments required and the proportion requiring subsequent dose-adjustments. Descriptive statistics were presented for all outcomes. <b>Results:</b> Fifty-three patients were evaluated, including those receiving either twice-daily or once-daily standard therapeutic dosing. Optimal anti-Xa levels at first measurement were recorded after the initiation of enoxaparin in 26.4% (n=14) patients. Dose adjustments were required in 70.7% (n=29) of patients receiving twice-daily dosing and in 83.3% (n=10) receiving once-daily dosing (P=0.97) to appropriately increase or decrease the enoxaparin dose. By the third anti-Xa level measurement, 3 patients remained outside of the therapeutic range. <b>Conclusions:</b> Standard therapeutic enoxaparin dosing did not result in optimal anti-Xa levels for a majority of MICU patients regardless of dosing regimen used or patient specific factors. Future studies should identify patient factors associated with the requirement for higher or lower enoxaparin dosing.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74803259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Forums to Address Vaccine Hesitancy: A Useful Tool for Meeting the Needs of Diverse Communities.","authors":"Laura Palombi, Jazmin Belknap, Mary Jo Katras, Grant Anderson","doi":"10.24926/iip.v14i1.5432","DOIUrl":"10.24926/iip.v14i1.5432","url":null,"abstract":"<p><p>Community forums are a valuable tool in engaging rural communities to address critical public health issues. Recognizing low levels of COVID-19 vaccine uptake in rural Minnesota communities and the critical public health threat that resulted, pharmacy faculty and Extension professionals from the University of Minnesota partnered with a diverse group of rural stakeholders to plan a series of six community forums to provide life-saving, evidence-based education about the COVID-19 vaccine. Each forum allowed trusted local community leaders, public health workers and healthcare providers to share information about the impact of COVID-19 in their communities. Data about the COVID-19 vaccines was provided, and community members were allowed to ask questions and voice their concerns about the virus and the vaccines. Virtual community forums allowed rural stakeholders to reach a diverse and geographically remote population while maintaining COVID-19 distancing requirements. Offering a safe, virtual space and immediate access to reliable and trusted place-based education allowed individuals an opportunity to get their vaccine questions answered immediately. Community forums can be conducted in rural communities as a direct communication tool to address critical public health issues such as vaccine hesitancy, and empower community members to make informed decisions in fighting against the COVID-19 pandemic.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91224412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Patient Access to Primary Care Providers Using a Pharmacist-Physician Co-Visit Model.","authors":"Diana Palandri, Hanna Raber, Casey Tak, Elizabeth Bald, Katherine Hastings, Karen Gunning","doi":"10.24926/iip.v14i2.5106","DOIUrl":"10.24926/iip.v14i2.5106","url":null,"abstract":"<p><p><b>Background</b>: Implementation of a clinical pharmacist in the primary care setting can offset provider time spent managing chronic diseases using Collaborative Practice Agreements (CPAs). The pharmacist-physician co-visit model presents an opportunity for pharmacists to increase patient access to their primary care provider (PCP). Studies of the co-visit model show that co-visits increase clinic efficiency by allowing the PCP to see additional patients and achieve more health care goals compared with independent visits^1-4. <b>Objectives</b>: The aim of this study was to increase patient access to their PCP by utilizing a pharmacist-physician co-visit model at the Madsen Health Center Family Medicine (MHC FM) Clinic. The primary outcome was to identify the number of co-visits completed compared to the number of possible co-visits, and the number of appointment slots made available. The secondary outcomes were to track the time spent with patients and to obtain provider feedback via a survey. <b>Methods</b>: The co-visit model was implemented as a 4-month pilot study at the MHC FM Clinic. Complex care appointments lasting 40 minutes were selected based on inclusion and exclusion criteria. Potential co-visit appointments were identified one week prior then provider consent was obtained to change the appointment into two separate 20-minute visits. Schedules were reviewed to determine if the appointment slot opened by the co-visit was filled by another patient. Upon completion of the study, a survey was distributed to providers to collect feedback. <b>Results</b>: A total of five co-visits were completed out of a possible 19 (26%). All the appointments made available were filled by another patient. On average, the provider and pharmacist spent 15 and 14 minutes with the patient, respectively. <b>Conclusion</b>: Implementation of the physician-pharmacist co-visit model increased the availability of the PCP to see more patients without disrupting clinic workflow and provider schedules.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86346610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Rurality and Age on Colorectal Cancer Screening Among Michigan Residents.","authors":"Katherine Bromm, Antoinette B Coe, Sarah E Vordenberg","doi":"10.24926/iip.v14i1.5212","DOIUrl":"10.24926/iip.v14i1.5212","url":null,"abstract":"<p><p><b>Background:</b> Colorectal cancer (CRC) is a prevalent cause of cancer-related deaths in Michigan, but not all Michigan adults had appropriate CRC screening. <b>Objective:</b> To assess the relationship between rurality and age on CRC screenings to inform how pharmacists could focus their efforts to educate, facilitate, or offer CRC health screenings. <b>Methods:</b> This was a retrospective, cross-sectional study using 2018 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) survey data. Michigan participants aged ≥ 50 years were included. Outcomes included the utilization of stool-based tests, sigmoidoscopies, colonoscopies, and the most recent CRC screening. Demographic variables included age, sex, income, race/ethnicity, relationship status, education level, employment status, income, rurality, and health insurance. Representative sampling weights were used to adjust for the complex survey design. Descriptive statistics, chi-square, and multivariable logistic regression analyses were conducted. IBM SPSS version 28.0.1.0 was used and an a priori p-value of <0.05 was deemed significant. <b>Results:</b> A weighted total of 3,762,540 participants were included, of which 21.3% (n = 781,907) reported living in a rural area and approximately 70% (n = 2,616,646) were between the ages of 50-69 years old. Most participants reported being White, non-Hispanic (n = 3,104,117, 84.5%), having health insurance (n = 3,619,801, 96.4%), and having a colonoscopy (74.6%, n= 2,620,581). There was no difference based on rurality. Compared to those aged 50-59 years, adults 60-69 years (AOR = 1.97, 95% CI: 1.58,2.45), 70-79 years (AOR = 3.29, 95% CI: 2.40,4.51), and ≥ 80 years (AOR = 2.23, 95% CI: 1.54,3.24) had higher odds of receiving a colonoscopy. Lack of insurance was associated with lower odds of receiving a colonoscopy (AOR = 0.38, 95% CI: 0.23, 0.56). <b>Conclusion:</b> Most participants reported having a CRC screening but efforts to increase CRC screening in Michigan adults aged 50-59 are warranted.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79260874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Student Pharmacist-Led Program to Enhance Health Access in an Arab-American Community Head: Health Program in an Arab-American Community.","authors":"Sally A Arif, Irfana Lakada, Zahi Fawaz, Jenine Abuzir, E Paul O'Donnell","doi":"10.24926/iip.v14i2.5243","DOIUrl":"10.24926/iip.v14i2.5243","url":null,"abstract":"<p><p><b>Objectives:</b> Immigration of Arabs to the United States has increased in recent years due to political instability and need for improved access to healthcare. Cardiovascular disease, diabetes, and obesity disproportionally affect Arab Americans. Student pharmacists are well positioned to increase health awareness by providing health screening services and education classes to the Arab immigrant community. This report will describe the development of a student-run Arab American Health Awareness Program (AAHAP) that provides culturally-sensitive community screening services targeting common health disparities seen among Arab-Americans. <b>Design:</b> Data were collected on the number of patient cardiometabolic screenings, referrals for medical care, and health classes which were performed over the course of 2 years. The practice setting included community centers, faith-based centers, and grocery stores in the Chicago area participating in the AAHAP. <b>Results:</b> Over the course of two years, eight cardiometabolic screenings and four community health classes were provided to the Arab-American community. Over 100 student pharmacists provided screenings to 929 patients through AAHAP. Twenty percent (n=193) of all patients screened were referred for further medical care. A total of 77% patients were within goal for blood pressure, 82.3% for blood glucose, and 39.4% for BMI. Patients with a known history of hypertension (n=83) or diabetes (n=64) were more likely to have uncontrolled blood pressure (45% vs 11%, p<0.05) or blood glucose (39% vs 14%, p<0.05) compared to patients without a history of these chronic conditions. <b>Conclusion:</b> Student pharmacists can be drivers for health access through community health programs for ethnically minoritized populations. Development of a health awareness program focused on known health disparities in Arab Americans has provided student pharmacists with opportunities to deliver culturally-sensitive care and medical referral services to an underserved community.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75903131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Ambulatory Care Pharmacist-Led Management on Hemoglobin A1c Values among Patients with Uncontrolled Diabetes in a Primary Care Clinic vs Usual Care over Two Years.","authors":"Insaf Mohammad, Alyssa Poyer, Roukia Hamoud, Julie George","doi":"10.24926/iip.v14i1.5444","DOIUrl":"10.24926/iip.v14i1.5444","url":null,"abstract":"ABSTRACT Background: Literature has shown the positive impact of ambulatory care pharmacists on diabetes management, yet additional research on clinical outcomes compared to traditional care models is warranted. Objective: The objective of this study is to evaluate the impact of an ambulatory care pharmacist on glycemic control over two years compared to patients who received usual care. Methods: This retrospective cohort study matched patients with a baseline hemoglobin A1c (HgbA1c) ≥8% managed by the ambulatory care pharmacist to patients who received usual care. The primary outcome was the mean change in HgbA1c over two years. The secondary outcomes were to evaluate the difference in (1) the proportion of patients achieving HgbA1c <8%, (2) the proportion of patients achieving blood pressure <130/80 mmHg, (3) mean LDL, (4) the proportion of patients prescribed SGLT2 inhibitors, GLP-1RA, and sulfonylureas, and (5) severe hypoglycemia after two years. Results: Data for 180 patients was analyzed over two years. The mean HgbA1c was 10% at baseline vs 8.2% after two years (adjusted mean change -1.92) among pharmacist-managed patients, compared to 9.9% vs 9% respectively for usual care patients (adjusted mean change -0.98) (p=0.004). Among pharmacist-managed patients, 53.5% achieved HgbA1c <8% compared with 34.2% of usual care patients (p=0.014). There were no statistically significant differences in proportion of patients at goal blood pressure, mean LDL, or hypoglycemia between the two groups. After two years, 18.3% of pharmacist-managed and 5.8% of usual care patients were on an SGLT2 inhibitor (p=0.008), and 46.7% of pharmacist-managed and 9.2% of usual care patients were on a GLP-1RA (p<0.001). No difference was found in sulfonylurea utilization. Conclusion: Patients with HgbA1c >8% managed by an ambulatory care pharmacist had twice the HgbA1c reduction and significantly more utilization of GLP-1RA and SGLT2 inhibitors as compared to controls provided usual care.","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73869770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expunging Board of Pharmacy Disciplinary Actions.","authors":"Alex J Adams, Timothy P Frost","doi":"10.24926/iip.v14i1.5219","DOIUrl":"10.24926/iip.v14i1.5219","url":null,"abstract":"<p><p>Boards of pharmacy have the authority to discipline licensees whose actions fall short of practice standards. Disciplinary action may include license suspension, revocation, practice restrictions, fines and reprimands. Once discipline is levied against a board of pharmacy licensee, it is usually part of the licensee's permanent record. At least four states have created a pathway for individuals to seek expungement of previous disciplinary actions levied by a board of pharmacy. These states have variations on what violations may be expunged and when. Given the evolving approach to the regulation of pharmacists, more states may want to consider expungement pathways in the years ahead.</p>","PeriodicalId":13646,"journal":{"name":"Innovations in Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73635609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}