Journal of analytical toxicology最新文献

{"title":"The detection of phenibut in keratinized specimens: a validation and case study.","authors":"Amy Racines, Joseph T Jones, Ming Wang, Donna J Coy","doi":"10.1093/jat/bkag011","DOIUrl":"10.1093/jat/bkag011","url":null,"abstract":"<p><p>Phenibut (β-phenyl-γ-butyric acid) is a central nervous system depressant that acts on the GABAB and, to some extent, the GABAA receptors. Phenibut is not approved for human use in the USA or throughout most of Europe due to its numerous adverse effects, such as intoxication, tachycardia, agitation, and confusion. A method to detect phenibut in hair and nail specimens using solid phase extraction followed by liquid chromatography tandem mass spectrometry was validated. This method was used to analyze a pair of hair and fingernail specimens from a self-reported user of phenibut. The assay validation satisfied all the criteria of the ANSI/ASB. Standard Practices for Method Validation in Forensic Toxicology Standard 036. The measured concentration of phenibut in the hair and the fingernail of the self-reported phenibut user were greater than the upper limit of linearity (>4000 pg/mg). Phenibut continues to be a growing concern in the USA with limited information on public health outcomes due to the scarcity of testing and the interpretation of results. This study is the first report of an analytical method for the detection of phenibut in keratinized specimens, including positive detection in both hair and nail of a self-reported user. Keratinized specimens show promise as alternatives for phenibut detection to the more invasive testing matrices, including urine and blood.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201804","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":"Toxicological interpretation of N-ethylpentedrone and its metabolites in 12 fatal and non-fatal forensic cases.","authors":"Jeroen Roosendaal, Ingrid J Bosman, Pieter M I Van Driessche, Dingeman J Rijken, Janneke W Hulshof, Bas van de Velde, Theo Klein, Kristof E K Maudens","doi":"10.1093/jat/bkag010","DOIUrl":"10.1093/jat/bkag010","url":null,"abstract":"<p><p>N-Ethylpentedrone (NEP) is a synthetic cathinone that remained legally available in the Netherlands until its inclusion under the Opium Act as of 1 July 2025. Although NEP emerged in the mid-2000s, toxicological data, especially regarding its metabolism and concentration in real-world cases, are scarce. The aim of this study is to demonstrate analytical methods for the detection and quantification of NEP and its metabolites in antemortem and postmortem biological matrices and to provide reference values and guidance for interpretation. Cases where NEP was detected between May 2024 and September 2025 were selected. All cases have undergone Systematic Toxicological Analyses, which consists of a selection of screening procedures (HS-GC-FID and LC-QToF-MS) and a targeted semi-quantitative LC-MS/MS method. Additional quantitative LC-MS/MS analyses were performed if needed. NEP metabolites were investigated by LC-Q-Orbitrap-MS. NEP was detected in 12 cases (all male, age range 18-56 years). The median antemortem (n = 8) and postmortem (n = 5) NEP (femoral) blood concentrations were 0.062 mg/L (range <0.005-0.45 mg/L) and 0.63 mg/L (range 0.26-0.93 mg/L), respectively. In four cases, a NEP (multidrug) intoxication was concluded as a possible cause of death. One case indicated a half-life of around 2-3 hours, a blood/plasma ratio of around 1.1 and an up to 5-fold postmortem increase of NEP within 48 hours after death. Several phase-1 metabolites of NEP were detected, but only NEP itself was identified in all investigated blood, plasma, urine, and vitreous humor samples. NEP recently resurfaced in the Netherlands, with four potentially fatal cases. For the analysis and interpretation of NEP blood concentrations, degradation of NEP in blood stored at room temperature, (survival) time since intake and a potential significant postmortem increase should be taken into account. NEP itself remains the target compound of choice, with dihydro-NEP and N-desethyl-NEP serving as complementary analytes depending on case circumstances.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149823","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":"Antidepressant metabolite concentrations and metabolite-to-parent drug ratios in postmortem femoral blood.","authors":"Pirkko Kriikku, Ilkka Ojanperä","doi":"10.1093/jat/bkag012","DOIUrl":"10.1093/jat/bkag012","url":null,"abstract":"<p><p>Antidepressants are commonly used psychiatric medications, many of them associated with significant toxicity in overdose. While established reference values are used in therapeutic monitoring of these drugs, there are less abundant reference data available in postmortem (PM) toxicology, especially concerning antidepressant metabolites. In this study, all such PM cases in 2016-2023 were retrieved from the Finnish national PM toxicology database in which an antidepressant drug and its metabolite were quantified concurrently in femoral venous blood, representing all causes of death (N = 3472). The results comprise the median concentrations of 11 antidepressants and their main metabolites, the parent drug plus metabolite sum concentrations, and the respective metabolite-to-parent drug ratio (MPR) values. The study revealed that the concentrations of antidepressants and their metabolites in PM blood generally increase in the following order according to the group studied: other cause of death than poisoning < implicated in fatal poisoning < principal finding in fatal antidepressant poisoning < single finding in fatal antidepressant poisoning. MPR was found to be a useful addition to concentration values in distinguishing acute poisoning death from other causes of death, showing lower MPR values in poisoning, and the results obtained in this study compared favorably with data previously published in the literature. The parent drug plus metabolite sum concentration did not provide significant additional information to parent drug only in PM diagnostics of poisoning.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201799","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":"Aldehyde dehydrogenase 2 and sex influence blood acetaldehyde levels in mice, but not ethanol levels.","authors":"Mostofa Jamal, Sella Takei, Takanori Miki, Ikuko Tsukamoto, Hiroshi Kinoshita, Takehiko Murase","doi":"10.1093/jat/bkag002","DOIUrl":"10.1093/jat/bkag002","url":null,"abstract":"<p><p>This study measured the concentrations of blood ethanol (EtOH) and acetaldehyde (AcH) in mice to examine the roles of aldehyde dehydrogenase 2 (ALDH2) and sex following intragastric administration of EtOH. The experiment utilized males and females of two mouse strains: C57BL/6N (wild-type, WT) and Aldh2-knockout (Aldh2-KO) mice. Aldh2-KO mice lack the ALDH2 enzyme, leading to the accumulation of high levels of AcH in the blood. The mice were fasted for approximately six hours before EtOH administration. EtOH (1.0, 2.0, and 3.0 g/kg) was administered intragastrically, and blood samples were collected at 30, 60, 120, 180, 240, and 300 minutes post-EtOH administration through retro-orbital puncture. The samples were then analyzed using headspace gas chromatography. The results for both male and female WT mice showed that EtOH and AcH levels increased in a dose-dependent manner, peaked at 60 minutes post-ingestion, and then gradually decreased. While there were no significant differences in blood EtOH concentrations between males and females, the concentrations of AcH were significantly higher in female mice than in male mice, indicating potential sex-related differences in EtOH metabolism. In Aldh2-KO mice, the EtOH and AcH levels increased initially and peaked at 30-60 minutes post-ingestion, with no significant differences in EtOH or AcH concentrations between the sexes. While the concentrations of EtOH in both male and female Aldh2-KO mice gradually decreased, the concentration of AcH remained elevated until six hours post-ingestion due to the ALDH2 deficiency inhibiting AcH oxidation. Our findings emphasize the importance of considering the influences of sex and ALDH2 when researching the effects of alcohol, particularly in relation to the EtOH byproduct AcH.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911912","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":"False positive urine drug screens.","authors":"Alec Saitman, Robert L Fitzgerald, Kyle Lund, Raymond T Suhandynata, Marlen Menlyadiev","doi":"10.1093/jat/bkag007","DOIUrl":"10.1093/jat/bkag007","url":null,"abstract":"<p><p>Immunoassay-based urine drug screens are widely employed in clinical toxicology due to their speed, low cost, and ease of automation. However, these assays are inherently limited by antibody cross-reactivity, which can result in false-positive findings and incorrect interpretations with major implications for patient care, employment, and legal outcomes. This review updates prior literature by analyzing reported false-positive interferences published between 2013 and 2024 across commonly screened drug classes, including opioids, amphetamines, benzodiazepines, cannabinoids, barbiturates, phencyclidine (PCP), cocaine, ethanol, and ethyl glucuronide. A total of 61 studies met inclusion criteria from 569 unique publications retrieved via PubMed. Each report was categorized by level of evidence, ranging from single case reports to controlled spiking experiments. Despite advances in antibody specificity, immunoassay drug screens remain presumptive and require confirmation by orthogonal techniques such as gas or liquid chromatography coupled with mass spectrometry (GC-MS or LC-MS/MS). This review provides updated reference data on known interferents, emphasizes the need for laboratorian-clinician communication, and supports continued education on assay limitations. Reliable interpretation of presumptive immunoassay drug screen results remains essential to prevent inappropriate clinical care decisions.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118970","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":"GC-FID quantification of methanol, ethanol, 2-propanol, acetone, ethylene glycol, diethylene glycol, 1,2-propylene glycol and 1,3-propylene glycol in plasma.","authors":"Mohsin El Amrani, Arjan Zandbergen, Mike Groot, Tim Bognar, Erin H Smeijsters, Kim C M van der Elst","doi":"10.1093/jat/bkag013","DOIUrl":"10.1093/jat/bkag013","url":null,"abstract":"<p><p>Alcohol and glycol ingestion, including substances such as methanol, ethylene glycol, and isopropanol, constitute a serious medical emergency that requires prompt diagnosis and treatment of patients. Rapid and accurate quantification of these compounds in plasma is essential to guide clinical decision-making and prevent delays in treatment that could result in irreversible organ damage or death. Many healthcare facilities lack analytical methods capable of simultaneously quantifying both alcohols and glycols in a single run. This study describes the development and validation of a rapid gas chromatography-flame ionization detection (GC-FID) method for the simultaneous screening and quantification of methanol, ethanol, 2-propanol, acetone, ethylene glycol, diethylene glycol, 1,2-propylene glycol, and 1,3-propylene glycol in human plasma. Plasma samples were prepared using a protein precipitation technique with acetonitrile containing two internal standards: 2-butanol and 1,4-butanediol. Acetonitrile effectively precipitated plasma proteins. The supernatant was then subjected to GC-FID analysis for quantification of the target al.ohols and glycols. The total analytical run time was 5 minutes, enabling the quantification of eight analytes in a single injection. The method demonstrated excellent linearity, with correlation coefficients (R2) exceeding 0.9995 for all compounds. The linear dynamic range was 40-1280 mg/L for methanol, 2-propanol, acetone, ethylene glycol, diethylene glycol, 1,2-propylene glycol, and 1,3-propylene glycol, and 80-2560 mg/L for ethanol. Within-run and between-run precision and accuracy (CV and bias) for all analytes were within the predefined acceptance criteria of ±15%. No significant interference, carry-over, or matrix effects were observed, confirming the method's selectivity and robustness. The developed GC-FID method enables rapid, accurate, and simultaneous quantification of toxic alcohols and glycols in plasma within a 5-minute run time. The excellent linearity, precision, and selectivity of the method met al. analytical performance criteria, making it well-suited for routine clinical use. This method provides a valuable tool for timely diagnosis and management of suspected toxic alcohol and glycol ingestions in patients in emergency settings.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201873","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":"Correction to: The detection of cannabinoids in breath after ingestion of cannabis-infused edibles.","authors":"","doi":"10.1093/jat/bkag018","DOIUrl":"10.1093/jat/bkag018","url":null,"abstract":"","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":"50 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015454","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":"Illicit opioid adulterant trends in patients presenting with acute opioid overdose.","authors":"Michael Levine, Rachel Culbreth, Jeannie Buchanan, Evan Schwarz, Jennifer Love, Jeffrey Brent, Christopher W Meaden, Bryan Judge, Kim Aldy, Rob Hendrickson, Adrianne Hughes, Alex Krotulski, Barry Logan, Joshua Shulman, Joseph E Carpenter, Paul Wax, Alexandra M Maducci, Diane P Calello, Sharan Campleman, Alex F Manini","doi":"10.1093/jat/bkag006","DOIUrl":"10.1093/jat/bkag006","url":null,"abstract":"<p><p>Clandestine fentanyl manufacturing oftentimes introduces adulterants and contaminants. This article aims to evaluate trends in adulterants from a cohort of patients presenting to the emergency department (ED) with illicit opioid overdose across the United States. The Fentalog Study group is a multicenter toxicology study group which evaluated ED patients with suspected opioid overdose at 10 medical centers across the United States between 21 September 2020 through 5 February 2024. Comprehensive qualitative toxicology testing was performed on residual serum specimens. Study sites were divided into three geographic regions: West (California, Oregon, Colorado), Midwest (Missouri, Michigan), and East (New York, New Jersey, Pennsylvania, Georgia). Illicit opioids were defined as fentanyl and fentanyl analogs, heroin or its metabolites, and/or novel potent opioids such as nitazenes. 1295 patients with confirmed illicit opioid overdose were included. Males accounted for the majority (73.7%) of patients. The median age was 39 (IQR: 31-54) years. Adulterants were detected in 745 (57.5%) patients. Quinine was the most abundantly encountered adulterant (433; 33.4%). Antihistamines were the most frequently detected class of adulterants (19.6%). There were significant differences in adulterants detected across the three time periods, with notable decreases in adulterants from time-period 1 (79.5%) to time-period 3 (41.7%; P < .001). Adulterants were found in 84 (27.0%) of patients that presented to a hospital in the Western United States, compared with 181 (24.3%) in the Midwest, and 480 (64.4%) of patients in the East (P < .001). Patients with concurrent cocaine were more likely having an adulterant present than those without cocaine present (OR 1.23; 95% CI 1.15-1.31). In contrast, patients with illicit opioids and concurrent methamphetamine were less likely to have adulterants present (OR 0.89; 95% CI 0.84-0.95). Adulteration of illicit opioids was more likely in the Eastern United States and for those with concurrent cocaine and opioid exposures.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226668","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":"Psilocin glucuronide in whole blood: a stable and useful biomarker of psilocybin intake.","authors":"Marianne Skov-Skov Bergh, Inger Lise Bogen, Merete Vevelstad, Åse Marit Leere Øiestad","doi":"10.1093/jat/bkag015","DOIUrl":"10.1093/jat/bkag015","url":null,"abstract":"<p><p>Detecting psilocybin use is challenging because it rapidly converts to its psychoactive metabolite psilocin, and both compounds are unstable in blood. Bufotenin, a structural isomer of psilocin, may exhibit comparable instability in blood. For reliable detection, we developed and validated an LC-MS/MS method to simultaneously quantify psilocin, bufotenin, and their metabolites, psilocin glucuronide (PSG) and 5-hydroxyindole-3-acetic acid (5-HIAA), in human whole blood. We prepared blood samples by protein precipitation and lipid removal filtration. Analytes were separated using a biphenyl column. The method was validated according to AAFS guidelines with LOQs of 2.4 nM for psilocin, PSG, and bufotenin, and 30 nM for 5-HIAA. We assessed analyte stability in whole blood under conditions relevant to forensic sample handling. Psilocin degraded by 46%-66% at room temperature and 66%-76% at 4°C after one day, increasing to 88%-99% and 94%-100% after three days. At -20°C, degradation slowed, with up to 51% loss after one month and ≥91% after three months. In contrast, PSG remained stable for 14 days at both room temperature and 4°C, and for at least one year at -20°C, making it a reliable biomarker of psilocybin intake. Bufotenin showed moderate stability, while 5-HIAA was unsuitable as a biomarker due to its endogenous presence. Our method enables direct quantification of PSG, offering a straightforward and accurate alternative to indirect approaches. We demonstrated the method's applicability by analyzing 23 forensic blood samples that screened positive for psilocin or PSG, with PSG quantified in nearly all cases, even when psilocin was below LOQ. These findings confirm PSG as a specific and stable biomarker of psilocybin use, and its integration into routine forensic workflows could significantly improve detection reliability.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271153","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":"The rise of nitrous oxide in toxicological casework: no laughing matter.","authors":"Amanda L D'Orazio, Jolene J Bierly, Kari M Midthun","doi":"10.1093/jat/bkaf108","DOIUrl":"10.1093/jat/bkaf108","url":null,"abstract":"<p><p>Nitrous oxide (N2O), the colorless, odorless gas known as \"laughing gas,\" has gained recent attention for its misuse as a recreational drug. As an anesthetic, N2O produces sedation, euphoric, and possible hallucinogenic effects. Adverse effects may include disorientation, psychomotor retardation, hypoxia, and asphyxia. N2O misuse has grown due to its ease of availability, rapid onset of effects, and increased social media attention, leading to anticipated increases in forensic testing needs. Due to its short half-life and volatility, analytical detection can be challenging. From January 2022 through September 2025, over 1700 cases were analyzed for N2O using headspace-gas chromatography-mass spectrometry (HS-GC-MS) over a calibration range of 1.8-180 mcg/mL. Total test requests and percent positivity increased during this timeframe for both driving (DUID) and postmortem (PM)/clinical casework. Blood, brain, liver, lung, and urine yielded positive detections. Attempts at repeat testing indicate significant losses in analyte concentrations. Consideration of pre-analytical and analytical factors is critical for suspected inhalant casework. Overwhelmingly, both DUID and PM casework noted N2O canisters present at the scene. Common driver behaviors included disorientation, slow reaction times, struggling with speech, inability to follow directions, and difficulty maintaining balance. DUID blood draws should be collected as close as possible to the suspected incident. Further review of case histories and testing practices generated handling recommendations for suspected inhalant case samples: fill containers to limit headspace; glass containers and tight-fitted closures are preferred; avoid transferring volume to alternate containers; limit container ingresses; and avoid repeat testing within the same container. Multiple matrices/containers should be collected and preserved, whenever possible, with inhalant testing prioritized over other drugs and/or alcohol. Laboratories should also consider qualitative reporting and/or testing as a one-time analysis. By employing these best practices, an inhalant gas may be better collected and preserved, increasing the chances of detection.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794012","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}