Journal of opioid management最新文献

{"title":"\"Part of the policy\": A qualitative study of PCP attitudes toward urine drug testing for chronic opioid prescriptions.","authors":"Elizabeth Magnan, Melissa Gosdin, Alicia Agnoli","doi":"10.5055/jom.0966","DOIUrl":"10.5055/jom.0966","url":null,"abstract":"<p><strong>Objective: </strong>Guidelines for safer chronic opioid prescribing recommend regular urine drug testing (UDT); however, evidence on the best use of this testing is less clear, and wide variation exists in practice. Our objective in this qualitative study was to assess provider attitudes, barriers, and facilitators to ordering and interpreting UDT for patients prescribed chronic opioids.</p><p><strong>Design, setting, and subjects: </strong>Qualitative study among family and internal medicine physicians working at several clinics within a large community and academic health system.</p><p><strong>Methods: </strong>Semistructured interviews were analyzed with qualitative thematic analysis.</p><p><strong>Results: </strong>Themes were (1) perceived medical benefit outweighs concerns, (2) UDT requirement has a push-pull relationship with professional autonomy, (3) standardization of UDT as key to reduce bias, (4) systematic process eases confusion, and (5) desire for training for \"gray areas.\"</p><p><strong>Discussion: </strong>A key facilitator was also a key barrier: Guideline-required urine drug tests as the requirement both reduced conflict between primary care physicians (PCPs) and patients around ordering urine drug tests and reduced professional autonomy and shared decision-making. Education on ordering and interpreting urine drug tests was endorsed as important to facilitate use.</p><p><strong>Conclusions: </strong>PCPs generally view urine drug tests favorably but have mixed attitudes toward urine drug test mandates and desire comprehensive education on urine drug test management.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"135-139"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for substance use disorders in primary care settings: A systematic review.","authors":"Ishika Patel, Bianca Bryant, Joseph D Wolfe, Davis Bradford, Li Li","doi":"10.5055/jom.0977","DOIUrl":"10.5055/jom.0977","url":null,"abstract":"<p><strong>Background: </strong>Population-based screenings for substance use are highly recommended, but little is known about the screening status of substances in primary care settings (PCSs). This systematic review aims to understand what screening tools are used, the barriers that impact screenings, and the opportunities to improve screenings.</p><p><strong>Methods: </strong>Articles focusing on the utilization of screening tools for substance use disorders (SUDs) within PCSs were considered for inclusion. Searches on PubMed and Embase databases were conducted from April 25, 2022, to July 22, 2022, which yielded 487 results; only 32 articles meeting the inclusion and exclusion criteria were included.</p><p><strong>Results: </strong>Among all substances, alcohol was the most frequently screened substance at PCSs, with 20 studies included in this article. This was followed by opioids (n = 11), other illicit drugs (n = 8), cannabis (n = 6), and nicotine (n = 2). The Alcohol Use Disorders Identification Test was the most commonly used screening tool. Most studies utilized different screening tools to screen for the same substances. Identified barriers include no referral to treatment upon positive screenings, lack of training in providing interventions, and no recognition of the effectiveness of intervention services.</p><p><strong>Conclusion: </strong>Our search resulted in only 32 studies focusing on substance screening at PCSs, indicating that substance screening may not be conducted as recommended or formally. Integrating patient-centered SUD screening in PCSs is challenging but could be feasible via implementation strategies to address barriers. Future studies focusing on the feasibility, acceptability, and effectiveness of screening tools in PCSs may increase the screening rates for early identification and intervention for SUDs.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"219-235"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a multifaceted intervention on post-operative opioid use after orthopedic and spine surgery: Results of a before-after pilot study.","authors":"Jeffrey L Schnipper, Linda S Aglio, Laura Mendez-Pino, Kristen Warren, Sarah Corey, Eduardo Mendez-Pino, Patrick W Collins, Robert N Jamison, Michele L Matthews, Michelle Ko, Lauren Konieczynski, Martha B Carnie, Shimon Shaykevich, Julie Fiskio, Lina Matta, Joji Suzuki, E John Orav, Michael J Weaver, Richard D Urman","doi":"10.5055/jom.0970","DOIUrl":"10.5055/jom.0970","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical effectiveness of a pilot multifaceted intervention to prevent persistent opioid use among patients undergoing orthopedic and spine surgery.</p><p><strong>Design: </strong>Pre-post pilot study.</p><p><strong>Setting: </strong>Two hospitals (academic medical center and affiliated community hospital) in a single healthcare system. Preintervention period was July 1, 2021 to June 1, 2022; post-intervention period was June 2, 2022 to February 28, 2023.</p><p><strong>Patients: </strong>A total of 171 inpatient orthopedic and neurosurgical spine patients.</p><p><strong>Intervention: </strong>Multifaceted persistent Opioid use Prevention Program (MOPP), including standardized order sets, pharmacist-led discharge counseling, a virtual post-discharge visit, and a mobile app for tracking pain, function, and opioid use for up to 180 days after hospital discharge.</p><p><strong>Main outcome measures: </strong>Persistent opioid use within 180 days post-discharge.</p><p><strong>Results: </strong>Outcome assessors were blinded. Of 115 patients in the intervention group, 91 (79 percent) received at least one component of MOPP. Persistent opioid use was observed in 10.9 percent of usual care patients and 4.5 percent in intervention patients (weighted difference -6.4 percent, 95 percent confidence interval [CI] -21 percent, +8.2, p = 0.37). In subgroup analyses, the intervention demonstrated a significant reduction in persistent opioid use among nonopioid-naive patients (weighted difference -40 percent, 95 percent CI -76 percent, -4.2 percent), with evidence of effect modification by opioid-naive status (p value for interaction term 0.005).</p><p><strong>Conclusions: </strong>This pilot study demonstrated a nonsignificant overall effect on the primary outcome, with significant effects on nonopioid-naive patients. Further research with a larger trial is needed to validate these findings.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"195-211"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NOPAIN Act: Implications for opioid use reduction in orthopedic surgery.","authors":"Ahmed Nadeem-Tariq, Matt Michelberger, Christopher J Fang, Karen Nelson","doi":"10.5055/jom.0989","DOIUrl":"10.5055/jom.0989","url":null,"abstract":"<p><strong>Background: </strong>The opioid epidemic remains a critical public health issue, with orthopedic surgeons being among the highest prescribers of opioids for post-operative pain management.</p><p><strong>Objective: </strong>To elucidate the provisions of the Non-Opioid Prevent Addiction in the Nation (NOPAIN) Act and its implications for reducing opioid use in orthopedic surgery.</p><p><strong>Methods: </strong>A comprehensive review of the NOPAIN Act's legislative framework, historical opioid use in orthopedic practices, current nonopioid pain management strategies, and insights from relevant reports was conducted.</p><p><strong>Results: </strong>The NOPAIN Act, effective January 1, 2025, mandates Medicare reimbursement for Food and Drug Administration-approved nonopioid pain treatments at 106 percent of the average sales price (+6 percent) in hospital outpatient departments and ambulatory surgery centers. This legislation incentivizes the adoption of nonopioid alternatives, promoting multimodal analgesia and regional anesthesia techniques. The Act may improve patient outcomes, reduce opioid-related adverse events, and help offset institutional costs.</p><p><strong>Conclusion: </strong>Implementation of the NOPAIN Act may influence orthopedic surgeons in adopting evidence-based, nonopioid pain management protocols, enhancing patient outcomes and contributing to national efforts against the opioid crisis. The Act's financial incentives and structured reimbursement framework may contribute to the transition toward safer practices.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"141-150"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of naloxone distribution and training programs at 4-year public colleges in the United States.","authors":"Annabelle S Morgan, Jordan Perry, Christopher M Seitz","doi":"10.5055/jom.0963","DOIUrl":"10.5055/jom.0963","url":null,"abstract":"<p><strong>Objective: </strong>In response to opioid use among students in the United States (US), many colleges have made naloxone available on campus. However, the exact prevalence of such campus programs is unknown. As such, the objective of this study was to determine the prevalence and methods of naloxone distribution programs and training programs at 4-year public universities in the US.</p><p><strong>Design: </strong>A cross-sectional, simple random sample of 237 medium and large four-year public colleges in the US was included in the study.</p><p><strong>Main outcome measures: </strong>The presence and types of naloxone distribution programs and related training programs.</p><p><strong>Results: </strong>Of the 237 colleges included in the study, 67 (28 percent) had a naloxone distribution program on their campus. The most common locations for naloxone distribution were through a campus wellness center (39 percent), opioid rescue boxes (32 percent), and health services (18 percent). Of the colleges with a naloxone distribution program, only 28 (42 percent) included student training. Most (68 percent) training was implemented in person, compared to online.</p><p><strong>Conclusions: </strong>Given the nation's opioid epidemic, this study underscores the need for more naloxone distribution programs and educational training programs on college campuses to save the lives of those experiencing an opioid overdose.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"213-218"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients with heart failure with preserved ejection frac-tion on chronic opioids: A nationwide analysis.","authors":"Ahmed M Younes, Hesham Afify, Ibrahim Kamel, Ahmed K Mahmoud, Ahmed Maraey, Mahmoud Khalil","doi":"10.5055/jom.0957","DOIUrl":"10.5055/jom.0957","url":null,"abstract":"<p><strong>Background: </strong>Opioid misuse has become a widespread public health issue, affecting diverse patient populations, including those with heart failure. Given that heart failure with preserved ejection fraction (HFpEF) constitutes nearly half of all heart failure cases, understanding its management and the influence of various factors on patient outcomes is essential. This study seeks to evaluate the outcomes of chronic opioid therapy in patients with HFpEF.</p><p><strong>Methods: </strong>Utilizing the National Inpatient Sample (2016-2020), adult HFpEF patients were identified using the appropriate International Classification of Diseases, Tenth Revision codes, excluding those with end-stage renal disease. Outcomes were compared between chronic opioid users and nonusers. Multivariate logistic and linear regression analyses were conducted, controlling for various patient and hospital confounders. The primary outcome measured was all-cause in-hospital mortality, with secondary outcomes including acute kidney injury/hemodialysis (AKI/HD), cardiogenic shock, cardiac arrest, mechanical ventilation, length of stay, and total hospital charges.</p><p><strong>Results: </strong>Among 1,557,344 HFpEF patients, 21,655 (1.4 percent) were on chronic opioid therapy. No significant difference in inpatient mortality was found (adjusted odds ratio [aOR] 1.04, 95 percent confidence interval [CI]: 0.88-1.24, p = 0.58). A nonsignificant increase in cardiogenic shock (aOR 1.12, 95 percent CI: 0.85-1.48, p = 0.39) and cardiac arrest (aOR 1.06, 95 percent CI: 0.81-1.38, p = 0.65) was noted in chronic opioid users. However, chronic opioid use was associated with a higher risk of AKI/HD (aOR 1.15, 95 percent CI: 1.07-1.24, p < 0.001) and mechanical ventilation (aOR 1.27, 95 percent CI: 1.14-1.41, p < 0.001). Opioid use was also linked to longer hospital stays (adjusted mean difference [aMD] 1.15 days, 95 percent CI: 0.83-1.47, p < 0.001) and a nonsignificant increase in total charges (aMD USD 3,615, 95 percent CI: USD -1.014 to USD 8,245, p = 0.12).</p><p><strong>Conclusions: </strong>While chronic opioid use in hospitalized HFpEF patients did not significantly affect in-hospital mortality, it was associated with a higher risk of other adverse events and longer hospital stays.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"175-182"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers providers face to prescribe buprenorphine as MOUD that can inform critical supports after the removal of the DATA-waiver.","authors":"Nora M Marino, Adrienne Call, Dana Franceschini, James A Swartz","doi":"10.5055/jom.0932","DOIUrl":"10.5055/jom.0932","url":null,"abstract":"<p><strong>Objective: </strong>To assess barriers to providing buprenorphine as medication for opioid use disorder (MOUD) and identify differences among providers who prescribed buprenorphine more recently versus those who prescribed it less recently.</p><p><strong>Design: </strong>A 10-minute online survey was fielded between August and November 2021.</p><p><strong>Participants: </strong>All Illinois providers (N = 2,996) who had a DATA-waiver to prescribe buprenorphine as MOUD were invited to complete an online survey; 623 (21 percent) completed the survey.</p><p><strong>Main outcome measures: </strong>The survey measured provider-identified barriers to providing MOUD and collected suggestions to improve delivery. Barriers and suggestions for improvement were analyzed using weighted descriptive statistics. Weighted logistic regression analyses were conducted to determine differences between participants who prescribed buprenorphine more recently versus those who prescribed it less recently, as determined by prescriptions in the past year.</p><p><strong>Results: </strong>Among the 623 participants who completed the survey, 73.5 percent prescribed buprenorphine in the past year. Insufficient behavioral health treatment and insufficient training were frequently cited barriers. Compared to recent prescribers, participants who had not prescribed in the past year were six times more likely to report that their practice does not support MOUD providers (adjusted odds ratio: 6.20, p < .001). To improve prescribing capacity, participants requested training on prescribing to patients with comorbidities, assistance in identifying treatment options, and guidance on implementing MOUD in their practice.</p><p><strong>Conclusions: </strong>While the DATA-waiver was eliminated, barriers to prescribing buprenorphine remain. This study contributes to understanding those barriers and, importantly, offers suggestions to expand prescribing through trainings and access to resources. As more providers are eligible to prescribe buprenorphine, practices, educational institutions, and decisionmakers must equip them with the support needed to care for patients with an opioid use disorder.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"151-173"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative opioid consumption after single-shot versus continuous erector spinae plane block in cardiac surgery: An observational study.","authors":"Iván Fernando Quintero-Cifuentes, Alejandra Holguín-Noreña, Katheryne Chaparro-Mendoza, Sergio Alzate-Ricaurte, Natalia Plata-Ayala, Mabel Moreno, Jessica Largo Ocampo, Gustavo A Cruz-Suárez","doi":"10.5055/jom.0964","DOIUrl":"10.5055/jom.0964","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of single-dose anesthetic (SDA) erector spinae plane block (ESPB) versus continuous ESPB via thoracic catheters (CATs) in managing pain and reducing opioid use in cardiac surgery patients.</p><p><strong>Design: </strong>Prospective, observational, longitudinal study.</p><p><strong>Setting: </strong>A tertiary-level hospital.</p><p><strong>Patients: </strong>A total of 70 patients aged 18 and above undergoing cardiovascular surgery involving sternotomy were included (35 per group).</p><p><strong>Interventions: </strong>Patients received either a single-dose ESPB with bupivacaine or continuous ESPB via thoracic CATs with automatic intermittent boluses of bupivacaine for 72 hours.</p><p><strong>Main outcome measures: </strong>Opioid use (primary outcome) was measured in morphine milligram equivalents (MMEs), while pain intensity (secondary outcome) was assessed using the Numeric Rating Scale (NRS).</p><p><strong>Results: </strong>The CAT group demonstrated significantly lower cumulative opioid use at 72 hours (median 12.0 MME [interquartile range {IQR} 9.0-20.0]) compared to the SDA group (median 17.0 MME [IQR 12.0-37.0], p = 0.029). Pain intensity scores on NRS showed no significant differences between groups. Post-operative nausea was less frequent in the CAT group (17.1 percent vs 40.0 percent, p = 0.034). No major complications were observed in either group.</p><p><strong>Conclusions: </strong>Continuous ESPB via thoracic CATs provides superior opioid-sparing effects compared to single-dose ESPB in cardiac surgery patients while maintaining comparable pain relief and safety. This technique may enhance recovery protocols by reducing opioid-associated side effects. Further research is warranted to explore adjuvants and optimize ESPB protocols in cardiac surgery.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 2","pages":"183-193"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow opioid tapering compared to continued stable opioid therapy for chronic noncancer pain: A double-blinded randomized controlled trial.","authors":"Benjamin Lai, Brandon Hidaka, Mohammad Aziz, Tasha Schneider, Jennifer Rich, Rebecca Schmidt, Carolyn Flock, Daniel Witt, Melissa Manley, Terrence Witt","doi":"10.5055/jom.0969","DOIUrl":"10.5055/jom.0969","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether gradually discontinuing chronic opioid therapy (COT) affects quality of life (QOL), depression, and anxiety.</p><p><strong>Design: </strong>Double-blinded, randomized controlled trial.</p><p><strong>Setting: </strong>Ten primary care clinics in Wisconsin.</p><p><strong>Participants: </strong>Adults on stable doses of COT for chronic noncancer pain.</p><p><strong>Interventions: </strong>Participants were blinded and randomized to either a slow taper or to continue their COT. Participants were assessed at baseline, 3, 6, 9, and 12 months post-enrollment.</p><p><strong>Outcome measures: </strong>Primary outcomes were study completion and QOL, measured by the Medical Outcomes Study Questionnaire Short Form 36 Health Survey version 2. Secondary outcomes were depression and anxiety symptoms, measured using the Patient Health Questionnaire-9 Depression Scale and the Generalized Anxiety Disorder-7 Anxiety Scale, respectively.</p><p><strong>Results: </strong>Of the 1,140 patients invited to participate, 18 enrolled-all prescribed tramadol or hydrocodone at the time of enrollment (median morphine milligram equivalents per day [MMED] of 17.5 mg; range: 5-40 MMED). Both groups had similar QOL and depression symptoms. The tapering group reported increased anxiety (p = 0.04).</p><p><strong>Conclusion: </strong>Our findings suggest that opioids can be slowly tapered without affecting QOL or depression. Tapering led to a slight increase in anxiety. Larger-scale studies are needed to confirm our findings.</p><p><strong>Trial registration number: </strong>21-009836 (ClinicalTrials.gov, Home | ClinicalTrials.gov). The trial was registered on March 22, 2022, \"Slow Opioid Tapering Pilot Study of Patients Using Chronic Opioid Therapy.\"</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"11-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the future of opioids: A prognosis rooted in history.","authors":"Nathan Langley, Edric Engert, Steven Passik","doi":"10.5055/jom.0985","DOIUrl":"https://doi.org/10.5055/jom.0985","url":null,"abstract":"","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}