Journal of Addiction Medicine最新文献

{"title":"Olanzapine/Samidorphan (Lybalvi) and Buprenorphine: Considerations for a Contradictory Combination: A Case Report.","authors":"Alyssa Thomas, Joseph Mott, Karen Antwiler","doi":"10.1097/ADM.0000000000001542","DOIUrl":"10.1097/ADM.0000000000001542","url":null,"abstract":"<p><strong>Introduction: </strong>Samidorphan is an opioid receptor antagonist and naltrexone analogue that has been harnessed in unique ways. Samidorphan has been paired with olanzapine in the new oral agent Lybalvi, approved by the FDA in 2021 for the treatment of schizophrenia and bipolar I disorder. The addition of samidorphan to olanzapine has the intention of reducing olanzapine's metabolic side effects (ie, weight gain), however, samidorphan's antagonism of the mu opioid receptor can lead to complications in patients with opioid use disorder on agonist therapy. These complications include not just precipitated withdrawal, as explored in prior case studies, but also the risk of reduced opioid tolerance and overdose in the event of olanzapine/samidorphan (Lybalvi) discontinuation and concurrent opioid use.</p><p><strong>Case report: </strong>A 42-year-old female with a history of opioid use disorder, posttraumatic stress disorder (PTSD), and bipolar disorder presented to an opioid treatment program for buprenorphine/naloxone (BUP/NX) continuation. On presentation, she was being treated with a combination of olanzapine/samidorphan (Lybalvi) for bipolar disorder and 18 mg/d of transmucosal BUP/NX for opioid use disorder. Due to concern for interaction between buprenorphine and samidorphan, she was gradually tapered to a lower dose of buprenorphine to allow for discontinuation of olanzapine/samidorphan then titrated to an effective buprenorphine dose for long-term treatment.</p><p><strong>Discussion: </strong>This case report outlines the safety concerns of utilizing an opioid antagonist (samidorphan) in conjunction with an opioid partial agonist (buprenorphine) and demonstrates the process for safe transition to an alternative regimen.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASAM/AAAP Clinical Practice Guideline (CPG) for Stimulant Use Disorder (StUD) Management: Commentary on Research Priorities.","authors":"Javier Ballester, Dawn Lindsay, Kevin Simon, Lara Weinstein, Stephanie Weiss, Ray Denny, Daniel Ciccarone","doi":"10.1097/ADM.0000000000001494","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001494","url":null,"abstract":"<p><p>This commentary highlights significant research gaps identified during the creation of the ASAM/AAAP Clinical Practice Guideline (CPG) on the Management of Stimulant Use Disorder (StUD). These included further research into the implementation of contingency management for StUD, pharmacotherapy options for StUD, evaluation and treatment of stimulant-induced psychosis, harm reduction techniques, and better defining a stimulant overdose. Further research concerning other populations impacted by stimulant use, including adolescents, pregnant and incarcerated individuals, and minoritized populations, is also urgently needed.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Stigma in Addiction Research: Insights From the HEALing Communities Study Coalition Meetings.","authors":"Nabila El-Bassel, James L David, Eric Aragundi, Scott T Walters, Elwin Wu, Louisa Gilbert, Redonna Chandler, Tim Hunt, Victoria Frye, Aimee N C Campbell, Dawn A Goddard-Erich, Marc Chen, Parixit Davé, Shoshana N Benjamin, David Lounsbury, Nasim Sabounchi, Maneesha Aggarwal, Dan Feaster, Terry Huang, Tian Zheng","doi":"10.1097/ADM.0000000000001534","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001534","url":null,"abstract":"<p><strong>Objectives: </strong>This paper describes how artificial intelligence (AI) was used to analyze meeting minutes from community coalitions participating in the HEALing Communities Study. We examined how often coalitions discussed stigma when selecting evidence-based practices (EBPs), variations in stigma-related discussions across coalitions, how these discussions addressed race, ethnicity, and racial inequity, and whether the frequency of stigma discussions was associated with the proportion of minoritized populations in each community.</p><p><strong>Methods: </strong>We used Natural Language Processing, Machine Learning, and Large Language Models, employing ChatGPT Enterprise to code data, ensuring data security and privacy compliance with the General Data Protection Regulation and HIPAA.</p><p><strong>Results: </strong>Community coalitions varied in the extent to which they discussed stigma during meetings focused on EBPs to reduce overdose deaths. Stigma was mentioned more frequently in the context of medication for opioid use disorder compared with other EBPs. As the percentage of racial/ethnic minority populations increased in a county, so did the strength of the association between discussions of EBPs and stigma. Counties with a greater proportion of racial/ethnic minority populations were more likely to integrate discussions of EBPs with stigma-related issues. Specifically, discussions about stigma were ~57% more likely to occur when racial or ethnic disparities were mentioned, compared with when they were not (odds ratio=1.57; 95% CI: 1.22, 2.03).</p><p><strong>Conclusions: </strong>The paper highlights the potential for integrating AI-human collaboration into community-engaged research, particularly in leveraging qualitative data such as meeting minutes. It shows how AI can be used in real-time to enhance community-based research.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Opioid Use Disorder Among Peripartum Individuals During Hospitalization.","authors":"Shelby A Powers, Noel Ivey, Dana Clifton, Rebecca Lumsden","doi":"10.1097/ADM.0000000000001523","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001523","url":null,"abstract":"<p><strong>Objectives: </strong>Peripartum opioid use disorder (OUD) is a significant public health concern. Although hospital admission for labor and delivery is common, little is known about hospitalized peripartum individuals with OUD or their inpatient management. The purpose of this study was to characterize hospitalized peripartum individuals with OUD who were seen by an OUD consult service and to examine their inpatient OUD treatment.</p><p><strong>Methods: </strong>This was a retrospective cohort study of peripartum individuals who received an OUD consult from May 2020 to April 2022. All individuals were pregnant or up to 3 months postpartum at admission. Substance use and psychosocial history were collected, along with timing and acceptance of medication for opioid use disorder (MOUD) and details of discharge transitions.</p><p><strong>Results: </strong>Of the 23 peripartum individuals with OUD who received a consult during admission, 61% were white, 30% were black, and all were non-Hispanic. Most individuals (78%) had Medicaid. Only 30% were using MOUD at hospital admission. Two-thirds (63%) of those not using MOUD were started on treatment during hospitalization, most commonly with buprenorphine-naloxone. At discharge, most (74%) individuals were connected to outpatient OUD treatment. Of the total, 35% self-directed their discharge, and there was a higher proportion of self-directed discharges among those who did not receive inpatient MOUD compared with those who did (P < 0.01).</p><p><strong>Conclusions: </strong>Hospitalization during the peripartum period is an important opportunity for initiation of MOUD and linkage to longitudinal, community OUD services. Further understanding of factors contributing to high rates of self-directed discharge in the peripartum period is needed.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of Physician Champion Efforts to Expand Buprenorphine Treatment in Primary Care and Explore a Quality Implementation Measure of Success: Buprenorphine as a Percentage of All Opioids Prescribed.","authors":"Thaddeus R Salmon, Anna-Maria South, Michelle R Lofwall","doi":"10.1097/ADM.0000000000001535","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001535","url":null,"abstract":"<p><strong>Objective: </strong>This study describes the impact of a single physician champion's implementation efforts to increase buprenorphine treatment for opioid use disorder (OUD) in primary care and a \"proof-of-concept\" new quality electronic health record outcome indicative of success.</p><p><strong>Methods: </strong>Five primary care clinics at one academic medical center participated in this retrospective program evaluation conducted from October 2021 to December 2023. A physician champion led all implementation strategies for buprenorphine prescribing, including \"en bloc\" group engagement and training of physicians at clinic A; a limited set of implementation resources was later shared with clinic B. Clinics C-E served as controls. Electronic health record outcome measures from each clinic included (1) percent of clinicians prescribing buprenorphine, (2) number of buprenorphine prescriptions, (3) number of full opioid agonist prescriptions, and (4) percentage buprenorphine (PB) prescriptions defined as the number of buprenorphine prescriptions divided by the sum of the total number of buprenorphine and full mu-opioid agonist prescriptions.</p><p><strong>Results: </strong>During the 2-year period at clinic A, all clinicians prescribed buprenorphine; there was a decrease in full agonist prescribing, and PB increased from 0% to 30.8%. PB increased also at Clinic B. Buprenorphine prescribing did not increase, full agonist prescribing was stable, and PB remained <10% at control clinics.</p><p><strong>Conclusions: </strong>These results show that a single physician can help other clinicians initiate and sustain buprenorphine prescribing. The PB metric, which includes full agonist prescribing along with buprenorphine, may be a particularly important quality metric for tracking implementation progress and quality improvement.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance-related Risk Factors for Leaving Against Medical Advice after Opioid Overdose: A Cross-sectional Study Using Electronic Health Records.","authors":"Bailey W Osweiler, William D Hutson, Phillip L Marotta","doi":"10.1097/ADM.0000000000001521","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001521","url":null,"abstract":"<p><strong>Objectives: </strong>The United States is in an overdose crisis, with many Americans seeking emergency medical services for drug overdose. Patients who leave against medical advice (AMA) have higher risk of subsequent health complications and hospital readmission. This cross-sectional study uses electronic health records (EHRs) to identify insurance-related risk factors for leaving AMA among patients hospitalized for opioid overdose.</p><p><strong>Methods: </strong>Documented opioid overdose hospitalizations between June 2019 and November 2021 were identified using ICD-10 codes from EHR at a large Midwest academic hospital. Multivariate logistic regression was used to identify risk factors associated with leaving AMA. Opioid overdose hospitalizations were aggregated by patient, and bivariate analyses (χ2​​​​​, ANOVA) and logistic regression were used to test for associations between demographics and repeat hospitalization.</p><p><strong>Results: </strong>Among 3608 hospitalizations, 2985 unique patients were admitted. Compared with Medicare, patients with all other specified insurance types were more likely to leave AMA: self-pay 294% more (aOR = 3.94; 95% CI = 1.83-10.34), Medicaid 299% more (aOR = 3.99; 95% CI = 1.78-10.72), and commercial 402% more (aOR = 5.02; 95% CI = 1.88-14.94). Risk factors for repeat hospitalization included black race (aOR = 1.61, 95% CI = 1.26,2.07), and young age (aOR = 0.99, 95% CI = 0.98, 0.99), while female sex was associated with decreased odds (aOR = 0.73, 95% CI = 0.57, 0.92).</p><p><strong>Conclusions: </strong>Insurance may be associated with AMA discharge after opioid overdose. Tailored interventions addressing patients' financial concerns after hospitalization may increase access to care and reduce inequities.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis Use Behaviors and Desired Interventions Among Postpartum Individuals With Frequent Cannabis Use in Early Pregnancy: A Qualitative Study.","authors":"Shannon N Ogden, Tara R Foti, Monique B Does, Andrea Altschuler, Esti Iturralde, Stacy A Sterling, Deborah Ansley, Carley Castellanos, Kelly C Young-Wolff","doi":"10.1097/ADM.0000000000001514","DOIUrl":"10.1097/ADM.0000000000001514","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use among perinatal individuals has dramatically increased. Thus, it is crucial to understand postpartum individuals' experiences with cannabis use, particularly during breastfeeding, and desired postpartum interventions to improve the care and well-being of parents and their children. We aimed to understand motivations for postpartum cannabis use and desired interventions for new parents who frequently used cannabis in early pregnancy.</p><p><strong>Methods: </strong>We conducted semistructured interviews from April to May 2022 with postpartum patients who were first-time parents and endorsed daily or weekly cannabis use during early pregnancy on a universally administered, self-reported screener at prenatal care entry in a large integrated health care system in Northern California. We analyzed the professionally transcribed interviews using thematic analysis.</p><p><strong>Results: </strong>Our sample included 17 interviews with Black (n=4), Hispanic (n=4), and White (n=9) postpartum patients. Most participants (n=15) reported at least some postpartum cannabis use, two thirds of whom (n=10) reported use during breastfeeding. We identified 4 themes concerning postpartum cannabis use behaviors: (1) cannabis use to cope with mental health and physical pain postpartum, (2) minimal knowledge of cannabis risks with which to make decisions about postpartum use, (3) responsible cannabis use and concern about child's health and safety, and (4) desire for nonjudgmental postpartum supportive services to manage new parenthood.</p><p><strong>Conclusions: </strong>Findings highlight the need for supportive services for new parents and education on cannabis use while breastfeeding. Health care settings should equip their perinatal care teams with information on how to discuss the current evidence and potential harms and provide appropriate counseling regarding postpartum cannabis use.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of Mothers With Substance Use Disorder on Naloxone Education: \"I'm Ready to Have Those Conversations About Who I Was, Because That's Not Who I Am\".","authors":"Jessica B Calihan, Gina Liu, Katie Raftery, Latisha Goullaud, Jenna LaFleur, Galya Walt, Barbara H Chaiyachati, Sarah M Bagley, Jessica R Gray, Davida M Schiff","doi":"10.1097/ADM.0000000000001531","DOIUrl":"10.1097/ADM.0000000000001531","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately 3 million U.S. children live with a parent with an illicit or prescription substance use disorder (SUD) and may be at risk of witnessing an overdose. Parents with SUD offer valuable perspectives on how to facilitate conversations around overdose response. Our aim was to assess attitudes of parents with SUD towards discussing naloxone with their children.</p><p><strong>Methods: </strong>Parents with SUD were recruited from SUD treatment programs, social media, and a research website to participate in semistructured virtual focus groups facilitated by peers with lived experience of SUD while parenting. The interview guide was informed by study teams' clinical experiences. We used an inductive thematic analysis approach; transcripts were double-coded.</p><p><strong>Results: </strong>Fifteen parents identifying as mothers participated in 4 focus groups. Four themes were identified. First, most mothers had not discussed naloxone use with their children, yet felt it was important to prepare them to respond to potential overdoses. Second, mothers highlighted that normalizing naloxone education through comparisons to other emergency responses may reduce stigma and expand learning opportunities. Third, mothers noted that overdose response involves physical, cognitive, and emotional processing skills that are acquired at different stages of child development. Fourth, mothers shared that naloxone discussions often require disclosing their own substance use, which was identified as a challenging conversation that mothers were variably ready to navigate.</p><p><strong>Conclusions: </strong>Mothers with SUD believed their children would benefit from naloxone education. Supporting parents navigating their own SUD disclosure and identifying developmentally appropriate tools are important steps in devising education strategies.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Now It's Up to Me to Take Advantage of the Shot\": Patient Perspectives on Hospital Initiation of Long-acting Injectable Buprenorphine.","authors":"Clarissa O'Conor, Aria Armstrong, Mistead Sai, Shai Farhi, Emma Klug, Ruchi Fitzgerald, Siri Shastry","doi":"10.1097/ADM.0000000000001529","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001529","url":null,"abstract":"<p><strong>Objectives: </strong>The inpatient addiction medicine consult team at West Suburban Medical Center started administering long-acting injectable buprenorphine (LAIB) to hospitalized patients in response to low rates of patients continuing treatment with sublingual buprenorphine after discharge. The aims of this study are to understand patients' motivations to receive LAIB during hospitalization and their experiences with the medication after discharge.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with patients who received LAIB while hospitalized between August 2022 and April 2023. Inductive analysis was used to identify themes and develop the codebook. Two researchers independently coded each interview and refined the codebook with oversight from 2 senior members of the research team. After the coding team reviewed each interview together to arrive at a joint consensus, a third coder found concordance in a random sample of interviews. Finally, the entire research team met to discuss key themes.</p><p><strong>Results: </strong>Eighteen participants were interviewed between March and May 2023. The following key themes emerged: (1) limited knowledge and access to LAIB before hospitalization, (2) the role of peer support specialists in deciding to start LAIB while hospitalized, (3) fears around an increasingly unpredictable drug supply and personal experience with overdose as motivations to receive LAIB, (4) benefits of LAIB in multiple areas of participants' lives, and (5) negative aspects of LAIB.</p><p><strong>Conclusions: </strong>Our participants' overall positive experiences with hospital-administered LAIB should inform policymakers and payors to support the expansion of this model and the exploration of additional strategies to lower barriers to LAIB access.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Decision Analysis to Assess the Safety of Providing Medication for Addiction Treatment to Professionals With Substance Use Disorder.","authors":"Matthew Robert Dernbach, Lisa J Merlo, Robert L DuPont, Patrick R Krill, Quay Snyder, Anthony P Tvaryanas","doi":"10.1097/ADM.0000000000001530","DOIUrl":"10.1097/ADM.0000000000001530","url":null,"abstract":"<p><p>Care models for professionals with substance use disorder (SUD), such as those for physicians, attorneys, military personnel and commercial pilots, currently do not have a standard method to determine whether to allow medication for addiction treatment (MAT) in profession-specific treatment plans. The decision to endorse the use of MAT involves a tradeoff between maximizing SUD relapse prevention and minimizing MAT-related adverse effects that might impact safety. We propose a decision analysis process to facilitate an objective and evidence-based use of MAT in these circumstances. Already implemented in high-reliability sectors such as aviation, decision tree analysis of quantifiable hazards and mitigating variables can be used to calculate an evidence-based risk for the number of bad outcomes with one alternative versus another. Greater data transparency from and increased resource availability to professional care models are necessary to conduct and disseminate these analyses.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}