Journal of Addiction Medicine最新文献

{"title":"Navigating Choices: Pregnancy Options Counseling Experiences in Individuals With Opioid Use Disorder.","authors":"Blythe Bynum, Katherine M Mahoney, Tachianna Griffiths, Arden McAllister, Courtney Schreiber, Sarita Sonalkar, Nia Bhadra-Heintz","doi":"10.1097/ADM.0000000000001476","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001476","url":null,"abstract":"<p><strong>Objectives: </strong>People with childbearing potential and opioid use disorder (OUD) have high rates of unintended pregnancies. Addiction medicine providers occupy an important role in diagnosing and counseling those who become pregnant; however, no guidelines exist to facilitate these conversations. We sought to explore participant experiences with pregnancy options counseling while in opioid use disorder treatment clinics.</p><p><strong>Methods: </strong>We conducted semistructured interviews with people who became pregnant while in OUD treatment, regardless of pregnancy outcome. The interview domains included (1) interactions with health care upon pregnancy discovery, (2) pregnancy options counseling provision, and (3) factors affecting pregnancy decision. A codebook was formulated through an iterative process using a P3 framework (practice, provider, patient). All interviews were double-coded and analyzed for content and themes.</p><p><strong>Results: </strong>Eighteen participants completed interviews between December 2022 and April 2023. Participants reported valuing nonjudgmental communication when providers disclose unexpected pregnancy results, as well as the need for unbiased and trustworthy information regarding the impact of OUD and OUD treatment on their options. They also identified the unique stigma and bias experienced by pregnant people with OUD.</p><p><strong>Conclusions: </strong>Although no guidelines exist to guide pregnancy options counseling in addiction medicine settings, efforts should be made to integrate all pregnancy options counseling-parenting, adoption, and abortion-and/or referrals into the care of pregnant patients at OUD treatment centers. Effective discussions should be conducted in a nonbiased and nonjudgmental fashion. Our findings can be used to develop patient-centered counseling aimed at improving pregnancy decision-making while in treatment for OUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573057","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":"A Call for Better Guidance and Treatments for Comorbid Postpartum Depression and Substance Use Disorders.","authors":"Jeffrey Pan, Kevin Y Xu, Evan Wood","doi":"10.1097/ADM.0000000000001475","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001475","url":null,"abstract":"<p><p>Postpartum depression is a serious, but treatable condition experienced after childbirth. While most cases do not involve excess substance use, alcohol and other substance use have been strongly associated with this condition. While serotonergic antidepressants have been a mainstay of pharmacologic therapy for postpartum depression, studies of antidepressant use in postpartum depression have largely excluded those with substance use disorder, and meta-analyses suggest antidepressants offer limited benefit in those with depression and co-occurring substance use disorder. There is also under-appreciated literature demonstrating the potential for a medication-mediated increase in substance use in some individuals taking serotonergic antidepressants. These facts and an examination of guideline recommendations on the treatment for postpartum depression highlight the need for new research and practice improvements for patients with comorbid substance use disorder and postpartum depression.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556908","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":"The Impact of Frequency of Cannabis Use on Hypertensive Disorders During Pregnancy.","authors":"Nichole Nidey, Erica Raff, Md Tareq Ferdous Khan, Shannon Lea Watkins, Jennifer M Jm McAllister, Laura Kair, Mishka Terplan, Andrea Greiner","doi":"10.1097/ADM.0000000000001454","DOIUrl":"10.1097/ADM.0000000000001454","url":null,"abstract":"<p><strong>Objectives: </strong>Cannabis is 1 of the most commonly used substances during pregnancy, and there is mixed evidence of its impact on maternal outcomes, such as hypertensive disorders. Prior research on cannabis use during pregnancy has not accounted for use frequency, which might explain mixed results across studies. The objective of this study was to examine how frequencies of use during pregnancy are associated with hypertensive disorders.</p><p><strong>Methods: </strong>This was a retrospective cohort study of the 2017-2018 Pregnancy Risk Assessment Monitoring System survey (n = 10,911/weighted n = 587,486). Frequency of cannabis use was categorized for analysis as follows: no use, minimal use (1 time per month or less), moderate use (2 times per month to 1 day per week), and frequent use (2-6 times per week to daily). Multivariable logistic regression models were used to examine how the frequency of cannabis use influenced the odds of experiencing hypertensive disorders during pregnancy.</p><p><strong>Results: </strong>Cannabis use, measured as a binary exposure variable (yes/no), was not associated with higher odds of hypertension during pregnancy (odds ratio, 0.86; 95% confidence interval, 0.54, 1.35). However, among those with any cannabis use, frequent use (vs minimal use) was associated with higher odds of hypertensive disorders (odds ratio, 3.44; confidence interval, 1.40, 8.43).</p><p><strong>Conclusions: </strong>Identifying cannabis use frequency during pregnancy can help identify maternal risk of hypertensive disorders.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542219","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":"The Confusing Terminology of \"Medical Cannabis\" and Cannabinoid Products.","authors":"Jennifer A Ross, William Riccardelli, Sharon Levy","doi":"10.1097/ADM.0000000000001471","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001471","url":null,"abstract":"<p><p>With the expansion of the \"medical cannabis\" or \"medical marijuana\" market, there is significant confusion surrounding cannabinoid terminology. This commentary provides definitions for cannabinoid terminology, examines US Food and Drug Administration (FDA)-approved and non-FDA-approved medications with cannabinoids as the main ingredient, and discusses how vague terminology may lead to a public misperception regarding the lack of evidence-based medical indications for cannabis.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542217","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":"Stigmatizing Language in Substance Use-related International Classification of Diseases Codes.","authors":"Neeraj Chhabra, Huiyi Hu, Rebecca T Feinstein, Niranjan S Karnik","doi":"10.1097/ADM.0000000000001462","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001462","url":null,"abstract":"<p><strong>Objectives: </strong>Healthcare-associated stigma is a critical barrier for treatment engagement for patients with substance use disorders. Although there are efforts to combat stigmatizing language in clinical documentation, little is known about the presence of substance use-related stigmatizing language in structured diagnosis codes ubiquitous in clinical medicine.</p><p><strong>Methods: </strong>We examined the presence of substance use-related stigmatizing terms contained within the International Classification of Diseases, 10th revision, clinical modification (ICD-10-CM) diagnosis code descriptions. Stigmatizing terms were compiled from guidelines authored by the National Institute on Drug Abuse, while ICD-10-CM codes were obtained from the United States Centers for Disease Control and Prevention.</p><p><strong>Results: </strong>We evaluated 74,259 ICD-10-CM code descriptions and identified 173 substance use-related codes with stigmatizing language. The stigmatizing terms detected were \"abuse\" (157 code descriptions), \"alcoholic\" (16), and \"drug abuser\" (2). The term \"abuse\" was used in relation to multiple substances including alcohol, opioids, cannabis, sedatives, hypnotics and anxiolytics, cocaine, stimulants, hallucinogens, inhalants, other psychoactive substances, tobacco, and other medicinal products.</p><p><strong>Conclusions: </strong>Stigmatizing language is used in multiple ICD-10-CM code descriptions. Subsequent iterations should bring ICD-10-CM code descriptions in line with current recommendations for destigmatized descriptors to avoid the perpetuation of stigma in healthcare.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542216","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":"A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period.","authors":"Steve N Caritis, Raman Venkataramanan","doi":"10.1097/ADM.0000000000001380","DOIUrl":"10.1097/ADM.0000000000001380","url":null,"abstract":"<p><strong>Background: </strong>The dosing regimen in the package insert for sublingual buprenorphine is similar for pregnant and nonpregnant people despite the physiologic changes seen during pregnancy.</p><p><strong>Aims: </strong>To compare plasma buprenorphine pharmacokinetics during and after pregnancy and relate buprenorphine concentration to the pharmacodynamic endpoints of pupil diameter, Clinical Opioid Withdrawal Scale (COWS), and craving scores.</p><p><strong>Study design: </strong>Prospective cohort of 22 pregnant people undergoing 33 pharmacologic studies (6-8 hours each) during pregnancy or postpartum. Participants were on a stable daily dose of 2-8 mg sublingual buprenorphine every 6 or 8 hours. The dosing frequency was selected by the participant. On study day, baseline measurements of plasma buprenorphine, pupil diameter, COWS, and craving scores were obtained, then the usual morning dose was taken, and measurements were repeated several times over 1 dosing interval.</p><p><strong>Findings: </strong>The dose-normalized area under the plasma buprenorphine concentration time curve was significantly ( P = 0.036) lower during pregnancy (155 ± 52 ng × min/mL) than postpartum (218 ± 113 ng × min/mL). Buprenorphine trough concentrations were similar at the start (1.1 ± 0.7 ng/mL) and end of a dosing cycle (1.2 ± 0.8 ng/mL) regardless of dosing frequency. Pupillary diameter, COWS, and craving scores returned to baseline as buprenorphine concentrations approached ~1 ng/mL.</p><p><strong>Conclusions: </strong>Pregnant people require a higher dose of buprenorphine to achieve concentrations comparable to nonpregnant people. There is a temporal relationship between the plasma buprenorphine concentration and the pharmacodynamic markers of pupillary diameter, COWS, and craving scores. An average plasma concentration of ~1 ng/mL was associated with the lowest level of COWS and craving scores.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"129-134"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xylazine Positivity in Opioid-positive Drug Screens on an Inpatient Labor Unit.","authors":"Cassandra Trammel, Vahid Azimi, Bridgit Crews, Stephen Roper, Nandini Raghuraman, Ebony B Carter, Antonina Frolova, Anthony O Odibo, Megan Lawlor, Jeannie C Kelly","doi":"10.1097/ADM.0000000000001396","DOIUrl":"10.1097/ADM.0000000000001396","url":null,"abstract":"<p><strong>Objective: </strong>Untreated opioid use disorder (OUD) is associated with significant morbidity in pregnancy. Recent reports have highlighted the rise of xylazine in the nonprescribed fentanyl supply. The frequency with which pregnant people with OUD are exposed to xylazine has not been characterized. We sought to describe the rate of xylazine detection in urine drug screens (UDS) from pregnant people admitted to a labor unit.</p><p><strong>Methods: </strong>We performed a cross sectional study of all UDS results from an inpatient obstetric unit at an urban tertiary care center from December 2022, when xylazine was added to the detection panel, through July 2023. We perform universal verbal drug screening, with subsequent urine drug screening only performed after a positive verbal screen and consent. The trend of opioid-positive urine drug screens also positive for xylazine from December to July was measured with the Cochran-Armitage test.</p><p><strong>Results: </strong>Of 5662 people admitted to Labor and Delivery during the study period, 138 UDS were sent for 123 unique individuals. Ninety-eight (71%) of UDS were positive for nonprescribed substances. Of positive UDS, 36 (37%) were positive for nonprescribed opioids, and of these, 17 (47.2%) were positive for xylazine among 14 pregnant people. The trend of UDS positive for opioids that were also positive for xylazine increased significantly over time ( P = 0.030), from 0% in December 2022 to 100% in July 2023.</p><p><strong>Conclusions: </strong>Over 8 months, xylazine positivity significantly increased in UDSs positive for nonprescribed opioids in an urban Midwestern hospital. These results underscore the critical need to study the impact of xylazine on obstetric outcomes.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"233-235"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603724","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":"Clinician and Practice Characteristics Associated With Support of Office-based Methadone: Findings From a National Survey.","authors":"Minhee L Sung, Anne C Black, Derek Blevins, Brandy F Henry, Kathryn Cates-Wessel, Michael A Dawes, Holly Hagle, Paul J Joudrey, Todd Molfenter, Frances R Levin, David A Fiellin, E Jennifer Edelman","doi":"10.1097/ADM.0000000000001388","DOIUrl":"10.1097/ADM.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>Alternative models for methadone delivery outside of federal and state-regulated opioid treatment programs may improve access. We determined factors associated with clinician support for continuing office-based methadone.</p><p><strong>Methods: </strong>We used data from the electronic Opioid Use Disorder Provider COVID-19 Survey conducted among X-waivered clinicians who were providing outpatient, longitudinal treatment of opioid use disorder (OUD) from July 2020 to August 2020. The outcome variable was selecting \"The opportunity for patients to receive office-based methadone\" when asked \"Which pandemic-related policy changes or new policy changes would you like to be continued or started after the pandemic?\" Using sequential multivariable logistic regression modeling, we estimated the association between clinician and practice characteristics and support for office-based methadone.</p><p><strong>Results: </strong>Of 1900 respondents, 728 met the inclusion criteria. Twenty-eight percent indicated support for office-based methadone. Clinician characteristics associated with support for office-based methadone were being Black or African American versus White (adjusted odds ratio [AOR] [95% confidence interval (CI)], 2.88 [1.19-6.98]), having provided medications for OUD (MOUD) for >15 years versus ≤15 years (AOR [95% CI], 1.66 [1.02-2.68]), treating 51 to 100 patients with MOUD monthly versus <25 patients (AOR [95% CI], 1.79 [1.04-3.09]), providing methadone (AOR [95% CI], 1.71 [1.03-2.85]) versus not providing MOUD previously, and working in an academic medical center versus other settings (AOR [95% CI], 1.88 [1.11-3.16]).</p><p><strong>Conclusions: </strong>A minority of surveyed X-waivered clinicians supported office-based methadone. Efforts to expand access to methadone via office-based settings should address implementation barriers.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"150-156"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.","authors":"Ayesha Azeem, Marci Lobel, Cassandra Heiselman, Heidi Preis","doi":"10.1097/ADM.0000000000001427","DOIUrl":"10.1097/ADM.0000000000001427","url":null,"abstract":"<p><strong>Introduction: </strong>There is an urgent need to improve the identification of psychosocial vulnerabilities in clinical practice (eg, stress, unstable living conditions) and examine their contribution to prenatal substance use, especially for legal substances such as alcohol, tobacco, and recently, cannabis.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 1842 patients who completed the PROMOTE screening instrument during their first prenatal visit to outpatient clinics of a New York State health system in 6/2019-11/2020. The PROMOTE includes 18 core items to assess psychosocial vulnerabilities including the NIDA Quick Screen assessing past year substance use. Outcomes were tobacco, cannabis, and alcohol use during pregnancy based on electronic medical record abstraction including clinical notes, self-report, or urine toxicology.</p><p><strong>Results: </strong>A total of 188 (10.2%) patients used at least 1 substance prenatally, including 132 (7.2%) tobacco, 50 (2.7%) cannabis, and 45 (2.4%) alcohol. Two of the NIDA Quick Screen items (past year tobacco use and past year illegal drug use) were associated in the bivariate analysis with greater use risk of all 3 substances. Additional risk factors uniquely associated with specific prenatal substance use variables include low education predicting tobacco use (adjusted odds ratio [AOR] = 2.74, 95% confidence interval [CI] = 1.43-5.23), being unpartnered predicting cannabis use (AOR = 3.37, 95% CI = 1.21-9.39), and major life events predicting alcohol use (AOR = 3.25, 95% CI = 1.439-7.38).</p><p><strong>Conclusions: </strong>Utilizing brief psychosocial self-screening instruments such as the PROMOTE can help identify and refer at-risk patients to appropriate care. Particular attention should be paid to life context including partner support, emotional health, stress, and past year substance use.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"216-222"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal Experiences With Xylazine and Behavior Change: A Qualitative Content Analysis of Reddit Posts.","authors":"Omeid Heidari, Olivia K Sugarman, Abigail K Winiker, Sabrina Gattine, Vivian Flanagan, Roham Razaghi, Brendan K Saloner","doi":"10.1097/ADM.0000000000001383","DOIUrl":"10.1097/ADM.0000000000001383","url":null,"abstract":"<p><strong>Objectives: </strong>Xylazine is a rapidly spreading adulterant in the United States' drug supply and is increasingly associated with overdoses and severe wounds, but there is a dearth of information about the clinical presentation or means of treatment for human xylazine exposure. The objective of this study was to explore personal attitudes about xylazine in the drug supply and experiences with xylazine-related use among people who reported using drugs and contributed content to social media site Reddit.</p><p><strong>Methods: </strong>To conduct a retrospective qualitative content analysis, the study team extracted all posts and comments from Reddit, which mentioned the terms \"xylazine\" or \"tranq.\" Content was extracted from 10 Reddit forums, or subreddits, specific to drug use, and included content created on or before the extraction date of January 2023. In total, 3284 posts were identified and 1803 were qualitatively coded using an inductive approach until meaning saturation was reached.</p><p><strong>Results: </strong>Three themes emerged across comments and posts: (1) personal experiences with xylazine, including a negative impact on overdose, withdrawal, and wounds; (2) behavior changes in response to xylazine in the drug supply, including devising and sharing new harm reduction and detection tips, and reducing or abstaining from drug use altogether; (3) a perceived lack of treatment options for xylazine withdrawal and information sharing to help others self-treat withdrawal symptoms, most often with clonidine.</p><p><strong>Conclusions: </strong>This study of people who reported using drugs with xylazine provides new insights into how xylazine is perceived, possible treatment modalities, and potential clinical research approaches.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"135-142"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346998","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}