Journal of Addiction Medicine最新文献

{"title":"Medications for Opioid Use Disorder After Entering Residential Treatment: Evidence From Louisiana Medicaid.","authors":"Wenshu Li, Matthew Eisenberg, Minna Song, Alene Kennedy-Hendricks, Brendan Saloner","doi":"10.1097/ADM.0000000000001373","DOIUrl":"10.1097/ADM.0000000000001373","url":null,"abstract":"<p><strong>Objective: </strong>Policies have attempted to increase the use of medication for opioid use disorder (MOUD) during an admission to a residential treatment program, but little is known about the association of residential admission with subsequent MOUD use.</p><p><strong>Methods: </strong>In a cohort study of Louisiana Medicaid beneficiaries age 18-64 with diagnosed opioid use disorder (OUD), weekly MOUD use and overdose for 20 weeks before and after an admission to residential treatment was analyzed using comparative interrupted time series regression. Participants with residential treatment admission between January 1, 2018, and December 31, 2020 (N = 12,222) were compared against a demographically similar group of people with OUD without residential treatment during the study period.</p><p><strong>Results: </strong>The samples with residential treatment were largely male (61.9%), White (47.2%), and aged 30 to 39 years (41.4%). At baseline, people admitted to residential treatment were much less likely to use MOUD than the comparison group (4.2% lower, CI: 3.8%, 4.5%, P < 0.01). After admission, use of any MOUD initially increased by 3.1% ( P < 0.01) relative to the comparison group, which reverted to the counterfactual trend by 20 weeks. Post-admission MOUD use differed widely by medication. Overdose incidence was highest in the weeks right before admission, but otherwise, it did not change during the study period.</p><p><strong>Conclusions: </strong>Admission to residential treatment for OUD was associated with a temporary increase in MOUD use. Policy initiatives should focus on both boosting use of MOUD during residential treatment and sustaining access to MOUD in outpatient care in the weeks following discharge.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"47-52"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987995","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":"An Intervention to Improve Evidence-based Nicotine Prescribing by Primary Care Physicians.","authors":"Alaina Martinez, Payam Sazegar","doi":"10.1097/ADM.0000000000001355","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001355","url":null,"abstract":"<p><strong>Objectives: </strong>Nearly 70% of people who use tobacco want to quit. Combination nicotine replacement therapy (cNRT), a long-acting controller plus short-acting reliever, is the most effective way to prescribe nicotine but is infrequently prescribed by primary care physicians (PCPs). We tested the feasibility and effectiveness of a brief, educational intervention to increase cNRT prescribing by PCPs in a large integrated health system.</p><p><strong>Methods: </strong>We conducted a pre-post study from 2022-2023 at a large integrated health system in California where specific NRT products are covered with a prescription. PCPs were offered a 30-minute virtual training about cNRT during a required monthly meeting (n = 267; 202 attended). The training was interactive, included simple \"asks\" and a 6-week follow-up communication. Chi-square analysis was used to test for changes in cNRT prescribing behaviors in the 6 months before and after training.</p><p><strong>Results: </strong>Among physicians who completed a posttraining questionnaire (180/202), 93% reported increased confidence, 91% reported favorable attitudes, and 88% reported intention to prescribe cNRT. According to data obtained from the integrated pharmacy database, the total number of patients who received a cNRT prescription increased from the 6-month pre- to 6-month postintervention from 135 (9%) to 380 (23%), P < 0.001. The total number of physicians who prescribed cNRT increased pre- to posttraining from 78 (23%) to 124 (37%), P < 0.001.</p><p><strong>Conclusion: </strong>cNRT is an underutilized form of tobacco cessation therapy by PCPs. This may reflect a gap in prescriber knowledge. A brief, virtual training delivered to PCPs was associated with increased cNRT prescribing.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":"19 1","pages":"102-104"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122720","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":"Two Clinical Insights on Methamphetamine Withdrawal at a Safety-net Hospital.","authors":"Dale Terasaki, Ryan Loh, Scott Simpson","doi":"10.1097/ADM.0000000000001365","DOIUrl":"10.1097/ADM.0000000000001365","url":null,"abstract":"","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"118"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125776","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":"Association Between Variables and Transitions Among No Opioid Use, Opioid Use, and Subsequent Dropout Among Participants on Methadone Treatment: A Retrospective Study Utilizing a Multistate Model.","authors":"Boyu Li, Chijie Wang, Xijia Tang, Zouxiang Chen, Zhiyao Li, Wensu Zhou, Wen Chen, Li Ling","doi":"10.1097/ADM.0000000000001370","DOIUrl":"10.1097/ADM.0000000000001370","url":null,"abstract":"<p><strong>Background: </strong>Although previous studies have reported the variables that influence opioid use or dropout among participants receiving methadone treatment, limited attention has been given to the variables related to transitions among no opioid use, opioid use, and dropout.</p><p><strong>Methods: </strong>This retrospective study utilized data collected from June 2010 to June 2022 at 11 methadone treatment clinics in Guangdong Province, China. Two transient states (no opioid use and opioid use) and 1 absorbing state (dropout) were defined based on monthly urine morphine test results and daily methadone intake records. We used a multistate model to explore the variables associated with transitions among no opioid use, opioid use, and dropout among participants.</p><p><strong>Results: </strong>Among 3136 participants, with an average treatment duration of 497 days, 1646 (52.49%) underwent at least 1 period of opioid use, resulting in 3283 transitions from no opioid use to opioid use. The transitions between no opioid use and opioid use were significantly associated with variables such as age, gender, employment status, marital status, living situation, travel time to the clinic, human immunodeficiency virus and hepatitis C virus infection statuses, average methadone dosage, and attendance rates. The variables influencing participants' dropout varied depending on their opioid use behaviors. Additionally, the probability of a specified opioid use state remaining unchanged or transitioning to a different state at a defined time point would change over time.</p><p><strong>Conclusions: </strong>The opioid use behaviors of participants are dynamic. Methadone providers should offer targeted interventions based on participants' opioid use behaviors to effectively decrease rates of opioid use and improve retention.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"26-34"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465899","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":"Naloxone Stigma Among People Who Use Drugs: Characteristics and Associations With Stigma Toward Medication for Opioid Use Disorder.","authors":"Devin E Banks, Xiao Li, Brandon Park, Rachel P Winograd, Patricia Cavazos-Rehg","doi":"10.1097/ADM.0000000000001377","DOIUrl":"10.1097/ADM.0000000000001377","url":null,"abstract":"<p><strong>Objectives: </strong>Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD.</p><p><strong>Methods: </strong>We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale.</p><p><strong>Results: </strong>One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is \"enabling.\" Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models.</p><p><strong>Conclusions: </strong>This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"68-74"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132726","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":"Disparities in Buprenorphine Administration for Opioid Use Disorder in the Emergency Department.","authors":"Samantha N Koerber, David Huynh, Sydney Farrington, Kylie Springer, Jacob Manteuffel","doi":"10.1097/ADM.0000000000001392","DOIUrl":"10.1097/ADM.0000000000001392","url":null,"abstract":"<p><strong>Study objective: </strong>Although buprenorphine is an effective treatment for opioid use disorder (OUD), this treatment is often not universally provided in the emergency department (ED). We aimed to determine whether patient characteristics, particularly race and ethnicity, were associated with buprenorphine administration.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study of adult patients who had a positive screening result for opioid misuse in the ED at a single urban hospital. Univariate and multivariable logistic regressions were used to assess the association of patient characteristics (race, ethnicity, age, sex, insurance type, and Area Deprivation Index) with buprenorphine administration.</p><p><strong>Results: </strong>Of 1082 patients who screened positive for opioid misuse, 133 (12%) were treated with buprenorphine and 949 (88%) were not. Despite representing over half the patient sample, Black patients (n = 682) were less likely than White patients (n = 310) to be treated with buprenorphine (multivariable: OR, 0.56; 95% CI, 0.35-0.88; P = 0.023). Age, sex, insurance type, ethnicity, and Area Deprivation Index were not associated with buprenorphine administration.</p><p><strong>Conclusions: </strong>Patient race was associated with buprenorphine administration, even after controlling for multiple other social determinants of health. These data suggest racial disparities in care that should be investigated through further research to optimize equitable administration of buprenorphine.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"89-94"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604581","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":"Association of Opioid Use Disorder-Related Service Trajectories during Pregnancy and Postpartum Health Service Use: A Group-Based Multitrajectory Modeling Study.","authors":"Yuan Fang, Alvin D Jeffery, Stephen W Patrick, Jessica Young, Edwin Raffi, Gabrielle M Harder, Sarah Osmundson, Julia C Phillippi, Ashley A Leech","doi":"10.1097/ADM.0000000000001434","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001434","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to examine the relationship between opioid use disorder (OUD)-related service trajectories during pregnancy and postpartum emergency department (ED) and hospitalizations.</p><p><strong>Methods: </strong>We used the Merative MarketScan Commercial Claims and Encounters Database (2013-2021) to identify a cohort of pregnant individuals with OUD. We used group-based multitrajectory modeling to identify opioid-related treatment and service trajectories during pregnancy and examined their association with postpartum ED and hospital utilization.</p><p><strong>Results: </strong>Seven opioid-related treatment and service trajectories were identified in our cohort of 2,531 pregnant individuals with OUD. Compared to individuals initiating medications for OUD (MOUD) halfway through pregnancy but maintaining high adherence without ancillary services, those receiving only services throughout pregnancy had a higher risk of postpartum ED visits (HRED = 1.34). This latter group also faced significantly higher risks of postpartum hospitalizations, compared to adherent MOUD use (proportion of days covered ≥80%) alone, both throughout or in the latter half of pregnancy (HRHOS = 1.93; HRHOS = 1.60), and patients without MOUD or services (HRHOS = 1.43). Individuals initiating MOUD late in pregnancy with poor adherence and infrequent service use faced significantly higher risks of postdelivery hospitalization compared to consistent MOUD users throughout pregnancy (HRHOS = 2.33), or in the latter half, with or without services (HRHOS = 2.02; HRHOS = 1.93), and those not receiving MOUD or services (HRHOS = 1.73).</p><p><strong>Conclusions: </strong>Adherent MOUD use either throughout pregnancy or the latter half of pregnancy, irrespective of other service use, was associated with better postpartum outcomes defined by fewer ED visits and hospitalizations.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949199","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":"Direct Induction of Buprenorphine Extended-Release: A Case Report.","authors":"Pouya Azar, James S H Wong, Jessica Machado, Mohammadali Nikoo, Victor W Li, Martha J Ignaszewski, Nickie Mathew, Reinhard M Krausz, Andrew A Herring, Rodney Mullen, Julio S G Montaner, Anil R Maharaj","doi":"10.1097/ADM.0000000000001425","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001425","url":null,"abstract":"<p><strong>Abstract: </strong>Buprenorphine has superior safety in opioid use disorder compared with alternatives due to its action as a partial opioid agonist, which limits its ability to cause respiratory depression. There is a risk of precipitated opioid withdrawal after buprenorphine exposure in someone using full opioid agonists. Buprenorphine induction strategies that avoid precipitated withdrawal remain a crucial component for starting buprenorphine in individuals actively using opioids. These strategies start with low doses of buprenorphine increasing over time, which may avoid precipitated withdrawal at the cost of an extended initiation period, potentially discouraging patients and increasing healthcare costs.A 55-year-old male with severe opioid use disorder and unregulated fentanyl use presented after an overdose, was admitted due to a cerebral venous sinus thrombosis and anemia (hemoglobin of 4.4 g/dL), and was given 300 mg of buprenorphine injection depot subcutaneously without any prior buprenorphine stabilization. Prior to injection, he was taking 30 mg of methadone and 96 mg of oral hydromorphone equivalents daily. Over the 6 hours after injection, he received another 272 mg oral hydromorphone equivalents and experienced a maximum Clinical Opiate Withdrawal Scale score of 7. Over the next 18 hours, he received no additional hydromorphone, and his Clinical Opiate Withdrawal Scale was a maximum of 1.This case illustrates a buprenorphine induction method without precipitated withdrawal by relying on the elution of buprenorphine from the subcutaneous depot alongside full agonist opioids that are given as needed. If these results are readily replicable, this approach may have significant implications for the accessibility and acceptability of buprenorphine for patients and providers.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949203","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":"Use of Practices to Reduce of Sudden Unexpected Infant Death among Caregivers of Opioid Exposed Newborns.","authors":"Margaret G Parker, Fiona Rice, Chanel Peguero, Ariana Evans, Davida M Schiff, Bryanne Colvin, Hayley Friedman, Katherine Harer, Stephen M Kerr, Michael J Corwin, Timothy C Heeren, Eve R Colson, Elisha M Wachman","doi":"10.1097/ADM.0000000000001442","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001442","url":null,"abstract":"<p><strong>Objectives: </strong>Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs.</p><p><strong>Methods: </strong>We surveyed 50 English-speaking mothers and other primary caregivers of OENs 1-6 months old between 02/2022 and 10/2023. We examined prenatal and postnatal cigarette smoking exposure, breastfeeding initiation and duration, and sleep position (side, back, or stomach), sleep location (bed-sharing, room-sharing not bed-sharing, or separate room), and soft bedding or objects in the infant sleep space.</p><p><strong>Results: </strong>Thirty-six (72%) of 50 respondents were birth mothers and 14/50 (28%) were other caregivers. Sixty-one percent of infants were exposed to cigarette smoking prenatally (mothers only) and 34% postnatally (41% mothers vs 14% other caregivers). Sixty percent of infants received breast milk ≤4 weeks. Among respondents, 32% placed infants in nonsupine sleep position (36% mothers vs 21% other caregivers), 38% shared a bed with their infant for sleep (47% mothers vs 14% other caregivers), and 30% used soft bedding in the infant sleep space (33% among mothers vs 21% among other caregivers).</p><p><strong>Conclusions: </strong>Infant care practices associated with SUID were highly prevalent in our pilot sample of OENs and differed among mothers versus other caregivers. Further investigation and tailored approaches to this population are needed.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949210","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":"Self-Harm as a Contributor to the Opioid Epidemic: Data From the Toxicology Investigators Consortium Registry.","authors":"Stephanie T Weiss, Xiaobai Li, Kim Aldy, Paul M Wax, Jeffrey Brent","doi":"10.1097/ADM.0000000000001433","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001433","url":null,"abstract":"<p><strong>Objectives: </strong>Although considerable focus has been placed on understanding the causes of opioid drug overdoses, the intentions for such overdoses are not well characterized. We investigated the motivations behind nonfatal opioid exposures resulting in serious adverse health outcomes.</p><p><strong>Methods: </strong>We analyzed prospectively collected data on nonfatal opioid overdoses in the multicenter Toxicology Investigators Consortium (ToxIC) Core Registry between 2014 and 2021. Included patients were age ≥11 years with serious toxicity after use of pharmaceutical and/or nonpharmaceutical opioids for whom the reasons for opioid exposure were determined. Pharmaceutical opioids were defined as United States Food and Drug Administration-approved medications. All other opioids were classified as nonpharmaceuticals.</p><p><strong>Results: </strong>The 5250 cases meeting the criteria were 56.6% male with a median age of 36 years (IQR, 26-50). There were 2960 (56.4%) opioid misuse cases and 1456 (27.7%) self-harm attempts. Within the self-harm group, 1242 (85.3%) were suicidal, and 1187 (95.6%) of these used pharmaceutical opioids in their suicide attempt. Only 94 (4.2%) patients using nonpharmaceutical opioids did so in a suicide attempt. Pharmaceutical opioid suicide attempts as a percent of all registry cases peaked between 2015 and 2017 and fell dramatically thereafter (P = 0.005). For comparison, benzodiazepine overdoses similarly decreased (P = 0.003), whereas non-opioid analgesic or antidepressant overdoses increased.</p><p><strong>Conclusions: </strong>A majority of serious opioid overdoses were sequelae of opioid misuse, but over a quarter were intentional self-harm attempts, primarily involving pharmaceutical opioids. Decreased prescribing of opioids and benzodiazepines after 2016-2017 may have resulted in decreased pharmaceutical opioid and benzodiazepine misuse and self-harm attempts. Similar trends were not seen for nonpharmaceutical opioids.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846735","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}