International Journal of Clinical Pharmacy最新文献

{"title":"A case/non-case study of a national pharmacovigilance database to explore drug-induced acute kidney injury.","authors":"Catarina Luz Oliveira, Fernando Fernandez-Llimos, Filipa Alves da Costa, João Pedro Aguiar, Filipa Duarte-Ramos","doi":"10.1007/s11096-025-01940-0","DOIUrl":"https://doi.org/10.1007/s11096-025-01940-0","url":null,"abstract":"<p><strong>Background: </strong>Monitoring safety throughout a medicine's lifecycle is essential. Pharmacovigilance systems are rich sources contributing to this aim in a real world context.</p><p><strong>Aim: </strong>To identify and estimate disproportionality rates associated with the drugs that are most frequently reported to induce acute kidney injury (AKI).</p><p><strong>Method: </strong>A case/non-case study was conducted, using data extracted in 2022 from the Portuguese National Pharmacovigilance Database for the period between 01/01/2009 and 12/31/2020. Cases were identified using the 'Acute Renal Failure' standardized MedDRA query, all remaining reports were considered non-cases, and a random sample without replacement of 4 non-cases per case was extracted. Data were expressed as the reporting odds ratio (ROR) and the 95% confidence interval.</p><p><strong>Results: </strong>During this 11-year period, 352 AKI cases were identified, representing 0.7% of the 53,505 reports received. A total of 559 different drugs were considered 'suspect' in these AKI cases. Three therapeutic subgroups (ATC2) showed a significant ROR: antithrombotic agents (ROR 6.72; 95% CI 2.23-20.22), antivirals for systemic use (ROR 4.02; 95% CI 2.76-5.87), and antineoplastic drugs (ROR 2.14; 95% CI 1.48-3.11). Additionally, we identified individual drugs with significant RORs where no class effect was observed, namely mycophenolic acid, ciclosporin, tacrolimus, simvastatin, prednisolone, vancomycin, and deferasirox. In total, eleven drugs were identified as potentially associated with the occurrence of AKI.</p><p><strong>Conclusion: </strong>This study highlights the importance of clinical pharmacy activities in closely monitoring renal function of people with known risk factors or those prescribed medications known to increase the risk of AKI. Some of the medications identified require further investigation to validate their association with AKI.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142484","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":"Overcoming challenges: implementing and scaling clinical pharmacy education and practice in the Republic of Srpska/Bosnia and Herzegovina.","authors":"Tijana Kovacevic, Josephine Falade","doi":"10.1007/s11096-025-01939-7","DOIUrl":"https://doi.org/10.1007/s11096-025-01939-7","url":null,"abstract":"<p><p>Bosnia and Herzegovina, one of the six countries created from the breakup of Yugoslavia, is classified as a low resource setting despite its geographic position in Europe. It is one of the most severely affected by the Civil war and international sanctions resulting in damaged infrastructure and underdeveloped healthcare services. Clinical pharmacy, which aims to improve patient outcomes through optimized medication use, has been well established in high-income countries since the 1960s. However, in low-resource settings, its development is often delayed by inadequate education, lack of trained personnel, and limited institutional support. The main aims of this article are to present the development of clinical pharmacy services in a low-resource setting, using the example of the Republic of Srpska (an entity within Bosnia and Herzegovina), and to offer a replicable model for similar settings. This article highlights how clinical pharmacy can be gradually established through international training, structured mentorship, curriculum reform, political and institutional support. Starting in 2007 with the training of a pharmacist in the United Kingdom, the Republic of Srpska initiated a pilot clinical pharmacy service program that expanded to various hospital wards, introduced formal education programs, and integrated clinical pharmacy into daily clinical practice. Additionally, a fully reimbursed outpatient clinical pharmacy service was launched in 2023. This shows that with targeted investments and long-term strategy, countries with limited resources can establish clinical pharmacy practice. The Republic of Srpska's experience offers valuable lessons for accelerating clinical pharmacy development in other low-resource setting contexts.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142489","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":"Effects of children's criteria for identifying potentially inappropriate prescribing on prescription review by pharmacists: a before-after study.","authors":"Siyi He, Siyu Li, Haotian Fei, Sha Diao, Linan Zeng, Guo Cheng, Liang Huang, Ling-Li Zhang","doi":"10.1007/s11096-025-01928-w","DOIUrl":"https://doi.org/10.1007/s11096-025-01928-w","url":null,"abstract":"<p><strong>Background: </strong>We previously developed the children's potentially inappropriate prescribing (PIP) criteria to help detect and prevent inappropriate drug prescriptions in children.</p><p><strong>Aim: </strong>To evaluate the impact of implementing the children's PIP criteria on pharmacists' pediatric prescription review processes.</p><p><strong>Method: </strong>The prospectively before-after study was conducted in tertiary hospitals across China. In the control phase, pharmacists reviewed prescriptions based on their clinical experience without the involvement of children's PIP criteria. In the intervention phase, they implemented the children's PIP criteria to assist their review. Primary outcomes included the number of identified PIP before and after implementing the criteria and pharmacists' acceptance of the criteria. Secondary outcomes included inter-pharmacist consistency and the median time spent reviewing each case.</p><p><strong>Results: </strong>Twenty-one pharmacists reviewed 362 drug prescriptions of 24 patients in two phases. The number of identified PIP increased from 26 (7.2%) in the control phase to 90 (24.9%) in the intervention phase (P < 0.001). The Fleiss Kappa value of inter-pharmacist consistency was enhanced from 0.182 to 0.262 after implementing the PIP criteria. Of 362 prescriptions, 280 had consistent review results across both phases, while 82 showed a change. The children's PIP criteria helped reduce review time by 1-8 min per case, saving a total of 55 min (P < 0.001).</p><p><strong>Conclusion: </strong>The children's PIP criteria effectively assist pharmacists in identifying PIP during pediatric prescription review, improving inter-pharmacist consistency and reducing review time. These findings support broader adoption of the children's PIP criteria in clinical practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142487","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":"ESCP Spring Workshop: the prescribing pharmacist-a prescription for better patient care : 7-8 April 2025, Egmond aan Zee, The Netherlands.","authors":"","doi":"10.1007/s11096-025-01937-9","DOIUrl":"https://doi.org/10.1007/s11096-025-01937-9","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119667","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":"The impact of the bedside check of medication appropriateness (BED-CMA) at the hematology ward: a mixed-methods study.","authors":"Greet Van De Sijpe, Lien Cosemans, Jens Neefs, Hannah De Schutter, Tine Van Nieuwenhuyse, Mariëlle Beckers, Johan Maertens, Hélène Schoemans, Peter Vandenberghe, Minne Casteels, Veerle Foulon, Isabel Spriet","doi":"10.1007/s11096-025-01926-y","DOIUrl":"https://doi.org/10.1007/s11096-025-01926-y","url":null,"abstract":"<p><strong>Background: </strong>Hematology patients have complex medication regimens and rapidly changing organ function, rendering them susceptible to medication errors. Health information technology can facilitate the detection of inappropriate prescriptions and assist healthcare professionals in enhancing patient safety.</p><p><strong>Aim: </strong>To evaluate the impact of a pharmacist-oriented clinical decision support system, called Bedside Check of Medication Appropriateness (BED-CMA), on inappropriate prescribing at the hematology ward, and to qualitatively assess its impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Method: </strong>A mixed-methods study was conducted at the semi-critical 15-bed hematology ward of UZ Leuven between 2020 and 2023. A pre-post study was performed to evaluate the impact of BED-CMA on residual potentially inappropriate prescriptions (PIPs), defined as those that persisted for at least 24 h after their initial identification. A time trend analysis was performed to identify any potential pre-existing patterns. The BED-CMA intervention consisted of embedding 19 clinical rules into the hospital information system. The pre-intervention cohort received usual clinical pharmacy services. Post-intervention, clinical pharmacists used BED-CMA alerts in addition to standard practices. A focus group discussion with clinical pharmacists assessed the impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Results: </strong>Pre-intervention, 70% (48/69) of initial PIPs remained residual PIPs, which decreased to 20% (13/66) post-intervention (odds ratio 0.11 (95% confidence interval 0.05-0.22, P < .0.0001)). There was no evidence for a pre-existing time trend (P = .0.52). Pharmacists reported improved workflow efficiency through enhanced patient prioritization and prompt identification of PIPs.</p><p><strong>Conclusion: </strong>BED-CMA significantly reduced residual PIPs by streamlining clinical pharmacy practice at a hematology ward.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110548","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":"Triggers for identifying anticoagulation-associated adverse drug events in hospitalized patients: a systematic review and meta-analysis.","authors":"Uyen Thi Nguyen, Khanh N C Duong, Phuong Thi Lan Nguyen, Ha Ngan Tran, Hoa Mai Nguyen, Huyen Thi Thu Cao, Hoa Dinh Vu, Hoang Anh Nguyen","doi":"10.1007/s11096-025-01916-0","DOIUrl":"https://doi.org/10.1007/s11096-025-01916-0","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulation therapy presents a high risk of adverse drug events (ADEs) in hospitalized patients, highlighting the need for effective detection strategies in clinical practice.</p><p><strong>Aim: </strong>The review aimed to identify triggers for detecting anticoagulation-associated ADEs in hospitalized patients and describe the performance of these triggers.</p><p><strong>Method: </strong>PubMed, Cochrane, and Embase were queried until April 19, 2024. We included studies on trigger tools for detecting anticoagulation-related ADEs in hospitalized patients. The study quality was assessed using the Quality Assessment Trigger framework based on the QUADAS-2 tool for diagnostic accuracy. We performed random-effects meta-analyses to pool positive predictive values (PPV), with heterogeneity assessed via I² statistic and Cochran's Q test.</p><p><strong>Results: </strong>Twenty-three studies were included. Seventeen triggers were reported and categorized into three modules: abnormal laboratory values (11 triggers), medications or antidotes (three triggers), and care (three triggers). Elevated international normalized ratio (INR) was the most prevalent trigger (16 studies) with a PPV of 0.539 (95% Confidence Interval [CI] 0.310-0.768). Other triggers exhibited lower pooled PPVs than elevated INR, including vitamin K administration (15 studies, PPV 0.222, 95% CI 0.153-0.290), abrupt medication cessation (14 studies, PPV 0.418, 95% CI 0.169-0.667), and activated partial thromboplastin time > 100 s (11 studies, PPV 0.336, 95% CI 0.173-0.498). Importantly, in-hospital stroke (three studies) had the highest pooled PPV of 0.964 (95% CI 0.803-1.000).</p><p><strong>Conclusion: </strong>This review demonstrated the variability in PPVs of triggers for anticoagulation-associated ADEs, emphasizing the necessity for a specialized trigger tool for hospitalized patients on anticoagulants.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110551","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":"Peripheral neuropathy associated with immunomodulatory drugs: a pharmacovigilance analysis based on the FDA adverse event reporting system database.","authors":"Chunhong Liang, Xueyan Zhang, Lijuan Zhou, Weiquan Zhang, Leifeng Liang, Di Xiao, Pingzhi Peng","doi":"10.1007/s11096-025-01925-z","DOIUrl":"https://doi.org/10.1007/s11096-025-01925-z","url":null,"abstract":"<p><strong>Background: </strong>Peripheral neuropathy requires early detection and intervention.</p><p><strong>Aim: </strong>This study aimed to examine the association between immunomodulatory medications (IMiDs; thalidomide, lenalidomide, and pomalidomide) and peripheral neuropathy.</p><p><strong>Method: </strong>OpenVigil 2.1 was used to retrieve data associated with IMiDs and peripheral neuropathy from the FDA Adverse Event Reporting System (FAERS). Disproportionality analysis was performed using the reporting odds ratio (ROR) and information components (IC) with a 95% credibility interval. Peripheral neuropathy signals were further prioritized using a rating scale.</p><p><strong>Results: </strong>We found 645 cases of peripheral neuropathy in 19,622 adverse event reports for thalidomide, 4849 cases in 197,866 adverse event reports for lenalidomide, and 933 cases in 40,582 adverse event reports for pomalidomide. Based on the clinical priority assessment, peripheral neuropathy was identified as having moderate clinical priority for the three immunomodulatory drugs (priority score = 6). In plasma cell myelomas, more peripheral neuropathy was reported for thalidomide [4.24% vs. 2.51%; ROR = 1.72 (1.42, 2.08); IC = 0.23 (0.05, 0.41)] and lenalidomide [2.71% vs. 1.06%, ROR = 2.59 (2.29, 2.91); IC = 0.14 (0.08, 0.20)] than in non-plasma cell myelomas. Peripheral neuropathy signals were detected in age groups 51-74, 63-74, and 51-62 for lenalidomide, thalidomide, and pomalidomide, respectively. No disproportionate gender differences were detected.</p><p><strong>Conclusion: </strong>Our study indicated that the risk of peripheral neuropathy varied among patients with different indications and age subgroups for the same IMiD. Further investigation is required to verify these risk signals.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110513","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":"Authors response to comments on \"Association of polypharmacy with clinical outcomes and healthcare utilization in older adults with cardiometabolic diseases: a retrospective cohort study\".","authors":"Su Su, Xuelu Zhu, Shiqi Wu, Wenyao Ma, Suying Yan, Lan Zhang","doi":"10.1007/s11096-025-01918-y","DOIUrl":"https://doi.org/10.1007/s11096-025-01918-y","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964403","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":"Delirium in critically ill children: a retrospective pre- and post-cohort study on the introduction of delirium screening in a paediatric intensive care unit.","authors":"Diarmaid Semple, Fiona Boland, Cormac V Breatnach, Moninne M Howlett, Judith D Strawbridge, John C Hayden","doi":"10.1007/s11096-025-01887-2","DOIUrl":"https://doi.org/10.1007/s11096-025-01887-2","url":null,"abstract":"<p><strong>Background: </strong>Paediatric delirium is a neuropsychiatric disorder with disrupted cerebral functioning due to underlying disease and/or critical care treatment. It has been reported in up to one third of paediatric intensive care admissions, with hypoactive delirium most prevalent in children.</p><p><strong>Aim: </strong>The aim of this study was to assess whether the introduction of delirium screening was associated with a change in the pharmacotherapy exposure and clinical outcomes.</p><p><strong>Method: </strong>A retrospective pre and post cohort study of all admissions > 48 h who required mechanical ventilation between 11th March 2019 and 11th March 2021. Cohort 1 (11th March 2019-11th March 2020) prior to the introduction of delirium screening and cohort 2 (12th March 2020-12th March 2021) after delirium screening. Patients < 3 months old, who were never mechanically ventilated, admitted <48 h, continuously receiving neuromuscular blockade or deeply sedated were not included. A multivariate model was created to compare pharmacotherapy use before and after implementation of delirium screening.</p><p><strong>Results: </strong>Two thousand and thirty-four patient encounters were identified with 588 meeting the inclusion criteria (364 cohort 1 and 224 cohort 2). There was a reduction in usage of infusions of morphine (decrease in doses of 18% p < 0.05) and midazolam (50% reduction in patients receiving p < 0.05), after screening commenced. Chloral hydrate use was unchanged however cohort 2 received lower daily doses (p < 0.05). Clonidine infusion use increased for cohort 2 (16% v 28% p < 0.05), with lower daily doses (23 v 13 µg/kg/day p < 0.05). Positive clinical outcomes such as decreased duration of mechanical ventilation, length of stay and out of range sedation and withdrawal scores were also observed.</p><p><strong>Conclusion: </strong>Introduction of a paediatric delirium care bundle including screening tool and associated education was associated with decrease in exposure to modifiable pharmacotherapy risk factors for the development of paediatric delirium. These findings should be further evaluated in future interventional studies.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985829","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":"Real-world clinical outcomes of apalutamide versus abiraterone with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer.","authors":"Eduardo Pons-Fuster, Celia Maria Gonzalez-Ponce, Silverio Ros-Martinez, Juan José Fernández-Ávila, María Sacramento Díaz-Carrasco, Alberto Espuny-Miró","doi":"10.1007/s11096-025-01920-4","DOIUrl":"https://doi.org/10.1007/s11096-025-01920-4","url":null,"abstract":"<p><strong>Background: </strong>Metastatic hormone-sensitive prostate cancer (mHSPC) is an aggressive disease with a poor prognosis. Current treatment guidelines recommend combining androgen receptor axis-targeted therapies (ARATs) with androgen deprivation therapy (ADT) for mHSPC. While individual ARATs have shown success, few studies directly compare their effects.</p><p><strong>Aim: </strong>To compare the safety and clinical outcomes of abiraterone acetate (abiraterone) and apalutamide in chemotherapy-naïve mHSPC patients, focusing on prostate-specific antigen (PSA) kinetics, safety, and survival outcomes.</p><p><strong>Method: </strong>A retrospective, single-centre study included 107 chemotherapy-naïve mHSPC patients treated with abiraterone or apalutamide plus ADT. PSA levels were measured at baseline and during treatment. Primary outcomes were PSA progression-free survival (PSA-PFS) and overall survival (OS). Adverse events were recorded. Inverse probability treatment weighting adjusted baseline differences.</p><p><strong>Results: </strong>Median PSA-PFS significantly favoured apalutamide (log-rank p = 0.015). Achieving PSA ≤ 0.02 ng/mL was strongly associated with delayed progression (HR 0.07, 95% CI 0.02-0.28; p < 0.001). OS did not differ significantly between groups (p = 0.504). Apalutamide achieved lower median nadir PSA (0.02 ng/mL vs. 0.23 ng/mL, p < 0.001) and shorter mean time to nadir (4.5 vs. 7.2 months, p = 0.001), with more patients reaching ultralow PSA levels (≤ 0.02 ng/mL) during follow-up. Adverse events occurred more frequently with apalutamide (71.2% vs. 46.5%, p = 0.015), with fatigue and rash being the most common.</p><p><strong>Conclusion: </strong>Apalutamide demonstrated deeper and more sustained PSA reductions, translating into delayed disease progression compared to abiraterone. Both treatments were generally well tolerated, though adverse events were more prevalent with apalutamide.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009554","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}