Journal of Oncology Pharmacy Practice最新文献

{"title":"Ethanol intoxication in paediatric patients receiving intravenous etoposide as conditioning regimen for allogenic hematopoietic stem cell transplant.","authors":"Pauline Claraz, Marie de Tersant, Valentine Feyants, Julie Roupret-Serzec, Thomas Storme, Jean-Hugues Dalle","doi":"10.1177/10781552251330244","DOIUrl":"https://doi.org/10.1177/10781552251330244","url":null,"abstract":"<p><p>IntroductionTotal body irradiation associated with etoposide is widely used in conditioning regimens before hematologic stem cell transplantation (HSCT). The etoposide formulation exposes children to a high dose of ethanol, and data on its side effects are scarce. We investigated whether paediatric patients with acute lymphoid leukaemia and lymphoblastic lymphoma were experiencing hypersensitivity reactions or ethanol-related reactions after etoposide infusion before HSCT.MethodsThis study retrospectively analyzed all patients treated with a TBI 12 Gy-based-conditioning associated with etoposide 60 mg/kg before HSCT. Hypersensitivity reactions (tachycardia, hypotension, dyspnea, flushing and erythema) were opposed to ethanol-related symptoms (dizziness, impaired balance) in patients who presented clinical reactions during or after etoposide infusion. Ethanol-induced toxicity risk factors related to demographics and infusion data were analysed such as age, gender, etoposide and ethanol amount, etoposide or ethanol infusion rate.ResultsBetween January 2015 and December 2020, 62 patients received etoposide as conditioning regimen and 48 patients were included in the study. The median etoposide dose was 1960 mg (414-3600), and the median amount of ethanol in the preparation was 24.3 g (5.1-44.6). Twenty patients exhibited etoposide-related symptoms. Eighteen patients presented ethanol-related symptoms, and 2 patients had hypersensitivity reactions and were admitted to the Intensive Care Unit. The incidence of ethanol-related symptoms was significantly higher in patients ≥ 7.5 years old at the time of HSCT (<i>p</i> = 0.04). No other risk factors were found.ConclusionThese data must raise awareness among physicians and pharmacists about the high dose of ethanol to which children are exposed during conditioning, and their adverse effects.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251330244"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of a pharmacy introductory cancer care program: Impacts on employee knowledge, engagement and retention.","authors":"Liam King, Anastasia Peripetsakis, Alborz Soroush, Ella Raguz","doi":"10.1177/10781552251330158","DOIUrl":"https://doi.org/10.1177/10781552251330158","url":null,"abstract":"<p><p>IntroductionProvision of education and training is essential when transitioning staff into specialist practice areas within pharmacy. While many professional organisations provide high-quality cancer/oncology education programs, they are non-specific to the policies, workflows, and resources of service providers. Furthermore, effective training and education programs can be a tool to increase staff engagement and retention. Our organisation developed a pharmacy Introduction to Cancer Care (ICC) program to address these needs.MethodThe ICC program utilised online learning modules and a two-day face-to-face workshop. The program targeted pharmacists, intern pharmacists and pharmacy technicians new to cancer care and was facilitated by experienced pharmacists. Two evaluations were provided to participants, the first immediately post-program completion and the second, one-month post-program completion. The evaluations contained questions answered on a Likert Scale. Finally, staff retention rates were calculated at 6 months post-program.ResultsFour sessions of the program were conducted between April 2023 and April 2024, with 24 pharmacists, six intern pharmacists and five technicians completing the program. Of the participants 89% (n = 31) provided responses to the evaluation on program completion and 31% (n = 9) to the evaluation at one-month post-program completion. Retention rates at six months post-program were found to be 100% for pharmacists (n = 24), intern pharmacists (n = 6) and technicians (n = 5).ConclusionEvaluation responses were overwhelmingly positive, with all participants finding the program beneficial, increasing their interest in cancer care. Finally, all participants were still employed at the organisation six months post-program completion. Our program demonstrates ability of effective training and education programs to enhance staff learning and have positive impacts on engagement.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251330158"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of the prevalence of drug therapy problems and its associated factors among ovarian cancer patients at Kenyatta National Hospital.","authors":"Millicent Gesare Morefu, Amsalu Degu","doi":"10.1177/10781552251331479","DOIUrl":"https://doi.org/10.1177/10781552251331479","url":null,"abstract":"<p><p>IntroductionDespite several studies in various cancers reporting a high prevalence of drug therapy problems (DTPs), there is a notable scarcity of comprehensive data addressing DTPs among patients with an ovarian cancer diagnosis. This study aimed to assess DTPs among those patients at Kenyatta National Hospital.MethodsA retrospective cohort study was used to assess the prevalence of DTPs among all 100 eligible patients with an ovarian cancer diagnosis. This research used a data abstraction tool to gather ovarian patients' data on drug therapy problems. The statistical package for Social Science version 20.0 software was used for data entry and analysis. The findings were presented using frequency tables, percentages and figures.ResultsThe mean age of the study population was 51.2 ± 15.1 with a bigger population being above 50 years (57.0%). The prevalent histological type of ovarian cancer was epithelial ovarian cancer (79.0%) followed by sex cord-stromal ovarian cancer (13%) and germ cell ovarian cancer (8%) which was least prevalent. A total of 175 DTPs were identified with the most prevalent being adverse drug reactions (40.6%) and drug non-adherence (17.1%). The number of medications used and stage of ovarian cancer as statistically significant predictors of DTP.ConclusionThe prevalence of DTPs was high and the most prevalent DTP was adverse drug reactions. The number of medications used and the stage of ovarian cancer were statistically significant predictors of DTP. Hence, regular medication reviews and robust pharmacovigilance systems should be implemented to detect and manage DTPs effectively.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251331479"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of carboplatin doses according to several formulae in a cohort of patients treated for an ovarian cancer in real life.","authors":"Ali Hassan, Aurore Carrot, Reine Kimbidima, Olivier Colomban, Chloé Herledan, Olivier Glehen, Benoît You, Catherine Rioufol, Florence Ranchon","doi":"10.1177/10781552251332600","DOIUrl":"https://doi.org/10.1177/10781552251332600","url":null,"abstract":"<p><p>IntroductionCarboplatin doses are calculated using several formulae, with the most recent being the Calvert formula with Glomerular Filtration Rate estimated using the CKD Epi cystatin C (Calvert CKD-Epi Cys) equation. The aim of this study was to compare the carboplatin doses estimated by this formula with the most commonly used formulas.Materials and methodsThe carboplatin doses prescribed for 84 patients with ovarian cancer were calculated according to Chatelut, Calvert with Glomerular Filtration Rate estimated using Cockcroft and Gault (Calvert CG), CKD-Epi (Calvert CKD-Epi) equation, modified Thomas and Calvert CKD-Epi Cys formulas. First, these 4 formulas were compared with the Calvert CKD-Epi Cys formula using a Wilcoxon test for pairwise comparison, and by assessing mean predictive error (MPE), mean absolute percentage error (MAPE), and absolute percentage error over 20% (P20). A subgroup analysis was then performed to determine the clinical and biological parameters responsible for the observed differences.ResultsThomas modified formulas showed low bias (MPE = 1.5%) and good precision (MAPE = 4.5%). Chatelut and Calvert CG were less precise with P20 values of32.1% and 13.5% respectively. Differences were mostly due to body weight, age and plasma cystatin C levels. The Calvert CKD-Epi formula showed good precision (MAPE = 8.1%) and low bias (MPE = 2.4%) except when plasma cystatin C levels were equal or above normal range (MPE = 14.9%).ConclusionAs proposed by White-Koning et al., we have chosen Calvert CKD-Epi Cys formula as a reference for carboplatin dosage calculations in our hospital. However, the limited doses differences with the Calvert CKD-Epi formula make it another reliable option in clinical practice.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251332600"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of immune checkpoint inhibitor-associated adrenal insufficiency: A single-institution experience.","authors":"Brooke Jennings, Andrea Arenz, Susan M Frankki, Aiman Riaz","doi":"10.1177/10781552251332284","DOIUrl":"https://doi.org/10.1177/10781552251332284","url":null,"abstract":"<p><p>BackgroundImmune checkpoint inhibitor (ICI) therapy has revolutionized the treatment of various malignancies. Unfortunately, ICI therapy has been associated with multiple immune related adverse events (irAEs) resulting in organ damage. One rare, but potentially devastating side effect, is adrenal insufficiency.MethodsA retrospective analysis of all patients receiving anti-PD-1/PD-L1 or anti-CTLA-4 therapy at Gundersen Health System from 2011 to 2023 was conducted.ResultsPatients (n = 684) receiving anti-PD-1/anti-PD-L1/anti-CTLA-4 therapy at Gundersen Health System were included in our retrospective analysis. There were eleven (1.6%) patients that were diagnosed with an adrenal irAE after beginning immunotherapy. The median days from first treatment to diagnosis of irAE was 304 days. Most common symptoms at the time of onset included fatigue (82%) and syncope (36%). Five patients (45%) required treatment delay or cessation and eight (73%) patients were referred to endocrinology after original diagnosis.DiscussionDetection of adrenal insufficiency secondary to immunotherapy requires a degree of high suspicion. Given the potential significant morbidity and mortality associated with adrenalitis/adrenal insufficiency, prompt diagnosis is of the utmost importance. Liberal use of early morning/8 am cortisol screening should be implemented as a standard part of clinical work up in acute onset of fatigue, hypotension, fever, weakness, weight loss, dehydration, oral intolerance, gastrointestinal upset, hyponatremia, and hyperkalemia. Immunotherapy related adrenal insufficiency is a rare complication, with most cases being secondary adrenal insufficiency. Multidisciplinary care with oncology and endocrinology is an important aspect of comprehensive management.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251332284"},"PeriodicalIF":1.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contamination on inner walls of syringes used for compounding and administration of hazardous drugs.","authors":"Paul Sessink, Birgit Tans, David Devolder","doi":"10.1177/10781552251332884","DOIUrl":"https://doi.org/10.1177/10781552251332884","url":null,"abstract":"<p><p>PurposeThe aim of the study was to measure contamination on inner walls of syringes used for compounding hazardous drugs. As the syringes have an open connection to the environment, evaporation of the drugs could result in environmental contamination and potential exposure of healthcare workers.MethodsForty-three 50 mL BD Plastipak luer lock syringes were collected after single use in compounding hazardous drugs. The inner wall of the barrel was wiped for each syringe. Potential remaining contamination was also measured by liquid extraction to verify the effectiveness of the wiping procedure. Six hazardous drugs were tested. Liquid chromatography tandem mass spectrometry was used for the analysis of cyclophosphamide, doxorubicin, 5-fluorouracil, ifosfamide, and methotrexate. Platinum analysis of cisplatin was performed with voltammetry.ResultsContamination was found for all cyclophosphamide, doxorubicin, ifosfamide, and methotrexate syringes, for eight out of ten 5-fluorouracil syringes, and for none of the cisplatin syringes. Contamination as part of the dose transferred differs between the drugs showing the highest contamination for doxorubicin (median 21.90 ppm) followed by cyclophosphamide (median 1.24 ppm), and ifosfamide (median 0.60 ppm). The lowest contamination was measured for 5-fluorouracil (median 0.02 ppm) and methotrexate (median 0.006 ppm).ConclusionContamination was found on almost all syringes and differs between the drugs indicating some drugs stick more to the inner walls and plunger shafts than others. Contamination implies a potential exposure risk as hazardous drugs could evaporate from the open syringes, contaminate the working environment, and expose healthcare workers.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251332884"},"PeriodicalIF":1.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venotoclax associated hypothyroidism in a patient with acute myeloid leukemia.","authors":"Uğur Can İzlimek, Barış Karagün, Emel Gürkan","doi":"10.1177/10781552251331601","DOIUrl":"https://doi.org/10.1177/10781552251331601","url":null,"abstract":"<p><p>IntroductionVenetoclax is a selective inhibitor of BCL2. While its combination with hypomethylating agents (HMAs) is associated with manageable side effects, thyroid dysfunction has not been previously reported.Case ReportWe present the case of a 62-year-old female with relapsed/refractory AML who was treated with azacitidine and venetoclax. Within a month, she developed hypothyroidism with elevated TSH (42.86 µIU/mL) and low FT4 (0.34 ng/dL). Baseline thyroid function tests were normal.Management & OutcomeUltrasonography showed a diffusely enlarged thyroid gland, and thyroid autoantibodies were negative, ruling out autoimmune thyroiditis.Thyroid hormone replacement therapy was initiated, normalizing thyroid function, while venetoclax was continued due to its efficacy.DiscussionThis case highlights a rare, non-autoimmune thyroid dysfunction associated with venetoclax. The absence of autoantibodies suggests a mechanism unrelated to autoimmunity, emphasizing the need for thyroid monitoring during venetoclax therapy.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251331601"},"PeriodicalIF":1.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of scalp lotion containing alpha lipoic acid derivatives for chemotherapy-induced alopecia in patients with gastrointestinal cancer: A prospective cohort study.","authors":"Takahiro Hiratsuka, Yohei Kono, Chiho Tomimatsu, Tetsuji Ohyama, Takayuki Aiba, Yoshitake Ueda, Kae Matsuda, Akio Shiromizu, Masafumi Inomata","doi":"10.1177/10781552251330283","DOIUrl":"https://doi.org/10.1177/10781552251330283","url":null,"abstract":"<p><p>IntroductionChemotherapy-induced alopecia results in a poor quality of life, compromised immune system, and adverse effects on cancer prognosis. Its prevention is vital in patients with gastrointestinal cancer; however, there are no standard guidelines for prevention. The efficacy of a scalp alpha lipoic acid derivative-containing lotion (ALADL) remains unknown. Therefore, we evaluated the effects of ALADL on chemotherapy-induced alopecia in patients with gastrointestinal cancer.MethodsThis single-center prospective cohort study included 21 patients with gastric and colorectal cancer who received chemotherapy between May 2021 and December 2023. The patients were divided into two groups: those who used ALADL and those who did not. Gross alopecia score and head hair diameter were measured immediately before initiating chemotherapy and after one and three courses.ResultsNo significant differences existed in age, sex, cancer type, chemotherapy regimen, clinical stage of TNM classification, Eastern Cooperative Oncology Group performance status, comorbidity, or medication between the two groups. After three courses of chemotherapy, a significant difference was observed between the ALADL and the non-ALADL groups, with the ALADL group showing significantly larger hair diameters (whole, pigmented, white) (<i>p</i> = 0.022, 0.029, 0.020). Patients who underwent one and three courses of chemotherapy and used ALADL showed a significant increase in white and pigmented hair diameters compared with that noted in patients before chemotherapy (<i>p </i>< 0.05). In the group that did not use ALADL, there were significantly more patients with grade 1 or higher gross alopecia after three courses of chemotherapy compared with that before chemotherapy (<i>p </i>< 0.05).ConclusionsIn this study, an increase in hair diameter after chemotherapy was found in the ALADL-treated group including patients with gastric or colorectal cancer undergoing chemotherapy; no significant worsening of gross alopecia grade was confirmed. However, as this was an observational study, a randomized controlled trial is warranted to verify the effects of ALADL.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251330283"},"PeriodicalIF":1.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conception of a board game as a training tool on the best practices for chemotherapy drug preparation.","authors":"Nawres Makhlouf, Zribi Kaouther, Amani Cherif, Olfa Gloulou, Emna Zribi","doi":"10.1177/10781552251330270","DOIUrl":"https://doi.org/10.1177/10781552251330270","url":null,"abstract":"<p><p>ObjectivesThe aim of this study was to develop a gamified tool on best practices for chemotherapy drug preparation and validate it.MethodsThe conception process of the gamified instrument encompassed multiple integral steps to develop the tool and to assess its usability. To validate the tool, the game was tested by interns and residents at a Pharmacy Faculty over a single day, a pre-test and post-test assessments were conducted with participants before and after playing the game to evaluate the utility of the gamified tool. The exploitation of the results was carried out using a student's t-test statistical analysis. Then, participant satisfaction was evaluated through a questionnaire and results was analysed using Excel^®.ResultsThe gamified tool (ChemINJ) is a board game designed for two to four players. The game board have 59 squares of different colours, corresponding to a theme of the questions cards. The questions are divided into three themes: protection, preparation, and administration, with a total of 244 questions. The game was applied with the participation of 24 participants across six tournaments. Eighteen out of 24 expressed a high level of satisfaction regarding the knowledge achieved through ChemINJ, and 23 players expressed their desire to play ChemINJ again. The game is considered as a continuous training tool inspired by the game of the goose^® and Trivial Pursuit^®.ConclusionChemINJ offers a gamification approach to enhance knowledge in the field of manipulation of anticancer drugs. Therefore, it is suggested to integrate it into the curriculum for students.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251330270"},"PeriodicalIF":1.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of pembrolizumab in microsatellite instability high (MSI-H) and deficient mismatch repair (dMMR) non-colorectal patients with metastatic cancer.","authors":"Alexis Tandyk, Trevor Christ","doi":"10.1177/10781552251331958","DOIUrl":"https://doi.org/10.1177/10781552251331958","url":null,"abstract":"<p><p>Pembrolizumab was approved for the treatment of MSI-H/dMMR solid malignancies in a tumor agnostic approval in 2017. Treatment records for patients harboring MSI-H/dMMR status at our institution treated with pembrolizumab were reviewed for outcomes of duration of treatment, progression free survival, and overall survival. Adverse events and immunotherapy biomarkers of PDL-1 status and tumor mutation burden (TMB) were also assessed. Thirty patients were included: 13 with endometrial cancer, 5 non-colorectal gastrointestinal cancer, 2 ovarian or uterine cancer, 2 breast cancer, and 8 with other malignancies. The median duration of treatment was 11 months (range 0-35). Progression free survival and overall survival were not reached. Five patients (16.7%) experienced immune related adverse events, resulting in discontinuation of pembrolizumab in 3. PDL-1 expression and TMB did not appear to correspond to treatment outcomes. This analysis provides a real-world dataset of MSI-H/dMMR solid tumor patients being treated with pembrolizumab, outcomes of which are consistent with registry trials.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251331958"},"PeriodicalIF":1.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}