Journal of Pharmacy Technology最新文献

{"title":"A Suspected Case of Amoxicillin-Associated Aseptic Meningitis.","authors":"Charles D Ponte, Kendra Unger","doi":"10.1177/8755122520978403","DOIUrl":"https://doi.org/10.1177/8755122520978403","url":null,"abstract":"","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 3","pages":"165-166"},"PeriodicalIF":1.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520978403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Drug Manufacturer as a Drug Information Resource.","authors":"Cambrey Nguyen","doi":"10.1177/87551225211005427","DOIUrl":"https://doi.org/10.1177/87551225211005427","url":null,"abstract":"<p><p>Pharmacists use a myriad of drug resources for patient care; however, the drug manufacturer is often overlooked and underutilized as a resource for drug information. Pharmaceutical companies have a medical information department that is responsible for providing drug information to pharmacists and the public about the company's products. This article will explain the purpose and functions of the medical information department within a pharmaceutical company. In addition, the type of information that may be requested and the ways to request drug information will be discussed.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 3","pages":"161-164"},"PeriodicalIF":1.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/87551225211005427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39602953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Stability of the Electronic Sensor Component of a Digital Pill System in Real-World Storage Settings.","authors":"Peter R Chai,&nbsp;Georgia Goodman,&nbsp;Majo J Bustamante,&nbsp;Yassir Mohamed,&nbsp;Jose Castillo-Mancilla,&nbsp;Edward W Boyer,&nbsp;Kenneth H Mayer,&nbsp;Rochelle K Rosen,&nbsp;Susan L Baumgartner,&nbsp;Eric Buffkin,&nbsp;Conall O'Cleirigh","doi":"10.1177/8755122520985219","DOIUrl":"https://doi.org/10.1177/8755122520985219","url":null,"abstract":"<p><p><b>Background:</b> Digital pill systems comprise an ingestible sensor integrated into a gelatin capsule that overencapsulates medication allowing real-time measures of medication ingestion. These systems may improve the manner in which medication adherence can be assessed and supported. <b>Objective:</b> In this investigation, we tested the durability of the ingestible sensor as part of a clinical trial to measure the feasibility and acceptability of the system to measure adherence to once daily tenofovir disoproxil fumarate/emtricitabine (NCT03842436). <b>Methods:</b> Digital pills not dispensed during the study were stored in a pharmacy. Seventeen sensors were selected from digital pills stored for at least 12 months and activated in a simulated gastric environment. A radiofrequency spectrum analyzer and the reader device used in the clinical trial to capture ingestion events were used to measure activation of emitters. A passing evaluation was defined as an energized emitter within 30 minutes of immersion, ability to broadcast a signal for 10 minutes, and successful acquisition by the reader. <b>Results:</b> All ingestible sensors passed the stability test. Mean activation time in simulated gastric fluid was 3.33 minutes (SD = 1.47); emitters remained active for a mean of 47.72 minutes (SD = 1.78). These parameters matched guidelines defined in the ID-Cap system requirements for use in patients. <b>Conclusions:</b> Ingestible sensor components of the ID-Cap system were therefore stable after long-term storage.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 3","pages":"135-139"},"PeriodicalIF":1.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520985219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiepileptic Drugs-Induced Enuresis in Children: An Overview.","authors":"Arya Sathyan,&nbsp;Reshma Scaria,&nbsp;Pavithra Arunachalam,&nbsp;Mohanapriya Ramasamy,&nbsp;Dithu Thekkekkara,&nbsp;Shalini Sivadasan","doi":"10.1177/8755122520964047","DOIUrl":"https://doi.org/10.1177/8755122520964047","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate enuresis-induced antiepileptic drugs in children. <b>Data Sources:</b> A PubMed search (1917 to July 2020) was performed using the following keywords and associated medical subject headings: antiepileptic drugs, enuresis, pediatric population, drug-induced enuresis, and epilepsy. <b>Study Selection and Data Extraction:</b> The search was conducted to find the role of antiepileptic drugs-induced enuresis in children in studies published in English. <b>Data Synthesis:</b> Enuresis or bedwetting is an underreported adverse drug reaction of antiepileptic drugs. Owing to that fact, it is a condition that is outgrown with age and also could cause embarrassment. As antiepileptic drugs sometimes need to be taken for a long duration until epilepsy relapses, the occurrence of enuresis in this situation can be troublesome for both the child and the caretaker. Even though enuresis is proposed to have a significant effect on the child's psychology, it is still considered to be a condition that is outgrown with age. This article includes a review of antiepileptic drugs reported to have caused enuresis in children. <b>Conclusions:</b> If a child develops enuresis as an adverse drug reaction, this adds further challenges to their life. A better understanding of this potential adverse effect may help prevent unwanted stress. Though the exact mechanisms are not known, the hypothesis generated is from the occurred cases, most of which relapsed when the drug was withdrawn. Considering the gravity of epilepsy in children, more detailed studies need to be conducted on this adverse effect to ensure a safe and effective treatment in children.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 2","pages":"114-119"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520964047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39602952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Management of Steroid-Induced Psychosis: A Review of Patient Cases.","authors":"Grace Huynh,&nbsp;Justin P Reinert","doi":"10.1177/8755122520978534","DOIUrl":"https://doi.org/10.1177/8755122520978534","url":null,"abstract":"<p><p><b>Objective:</b> To review the efficacy and safety of medications used in the management of steroid-induced psychosis. <b>Data Sources:</b> A comprehensive literature search was conducted using PubMed, MEDLINE, ProQuest, and Scopus between May and October 2020 using the following search terminology: \"steroid-induced psychosis\" OR \"corticosteroid-induced psychosis.\" <b>Study Selection and Data Extraction:</b> Definitive cases, as defined by the <i>Diagnostic and Statistical Manual of Mental Disorders, 5th edition</i>, were included in this review. Geriatric patients >65 years of age, those with a confounding neurological condition such as a traumatic brain or spinal cord injury, or those with active malignancy were excluded. <b>Data Synthesis:</b> A total of 13 patient cases were included in this review, representing 8 male patients and 5 female patients. The mean age at symptom presentation was 42.5 years. Six patients presented with delusions, 5 presented with hallucinations, and 2 presented with both manifestations; 12 patients were managed with an antipsychotic, with haloperidol being the most commonly prescribed, followed by risperidone. One patient was managed with lithium and clonazepam alone. All patients returned to their psychological baseline upon the discontinuation or decreased dose of steroids in combination with Pharmacological intervention, though the time to resolution of symptoms varied significantly. No notable adverse drug events associated with treatments were reported. <b>Conclusions:</b> Steroid-induced psychosis is a serious adverse effect of corticosteroid therapy; however, management strategies that combine a dose reduction or elimination of steroids, in combination with an antipsychotic medication, are effective in resolving this syndrome.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 2","pages":"120-126"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520978534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39709897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Community-Acquired Urinary Tract Infection Treatment in Pediatric Patients Requiring Hospitalization: Opportunity for Use of Narrower Spectrum Antibiotics.","authors":"Jeremy S Stultz,&nbsp;Natalie Francis,&nbsp;Samantha Ketron,&nbsp;Bindiya Bagga,&nbsp;Chasity M Shelton,&nbsp;Kelley R Lee,&nbsp;Sandra R Arnold","doi":"10.1177/8755122520964435","DOIUrl":"https://doi.org/10.1177/8755122520964435","url":null,"abstract":"<p><p><b>Background:</b> The most narrow-spectrum antibiotic possible should be used for empiric and definitive treatment of pediatric urinary tract infections (UTIs). <b>Objectives:</b> The objectives of this study were to determine an appropriate narrow-spectrum antibiotic for empiric UTI treatment, factors differentiating empiric first-generation cephalosporin (FGC) versus third-generation cephalosporin (TGC) coverage, and factors associated with unnecessarily broad-spectrum definitive antibiotic treatment. <b>Methods:</b> This was a retrospective chart review of children admitted from 2013 to 2015 who were diagnosed with a UTI and received treatment. Multivariable logistic regression assessed independent factors associated with our outcomes. <b>Results:</b> Of 568 diagnosed UTIs, 88.6% received empiric TGC treatment. Empiric coverage among cultured organisms was only 5.4% lower in FGC versus TGC. Adolescent age group (odds ratio [OR] = 8.83, 95% confidence interval [CI] = 1.47-53.11), uncircumcised males (OR = 4.52, 95% CI = 1.27-16.08), Hispanic ethnicity (OR = 4.37, 95% CI = 1.14-16.82), and hospitalization within the preceding 3 months (OR = 4.73, 95% CI = 1.38-16.23) were associated with FGC nonsusceptibility among TGC susceptible <i>Enterobacteriaceae</i> pathogens. De-escalation occurred in 55.8% of diagnosed UTIs eligible for de-escalation at discharge. Urine white blood cell (WBC) count >5 (OR = 2.89, 95% CI = 1.14-7.21), serum WBC count (OR = 1.04, 95% CI = 1.01-1.07), and having only one narrow-spectrum treatment option (OR = 5.1, 95% CI = 2.43-10.66) were associated with unnecessarily broad-spectrum definitive treatment. <b>Conclusion and Relevance:</b> FGC would be an appropriate narrow-spectrum empiric agent for UTIs at our institution. The factors associated with FGC nonsusceptibility can further stratify empiric treatment decisions. The factors associated with unnecessarily broad-spectrum definitive treatment illustrate areas for educational efforts and future research regarding UTI treatment.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 2","pages":"79-88"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520964435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypermanganesemia-Induced Cerebral Toxicity Mimicking an Acute Ischemic Stroke: A Case Report and Review of Overlapping Pathologies.","authors":"Justin P Reinert,&nbsp;Michael Garner,&nbsp;Laramie Forbes","doi":"10.1177/8755122520976418","DOIUrl":"https://doi.org/10.1177/8755122520976418","url":null,"abstract":"<p><p><b>Objective:</b> To review and consider risk factors associated with the accumulation of and toxicity from manganese in patients receiving total parenteral nutrition (TPN). <b>Case Summary:</b> A 66-year-old female presented to the emergency department with right facial and arm weakness that initiated 1 hour prior to admission. Past medical history includes oral cancer with chronic aspiration and gastroparesis secondary to chemotherapy, TPN for 9 months, and a previous episode of right facial and arm parasthesias due to hypertensive emergency 4 years prior. The patient was assigned a National Institutes of Health Stroke Scale score of 6, cleared of an intracranial hemorrhage on imaging, and was administered tPA (tissue plasminogen activator) for an acute ischemic stroke after managing her hypertension to <185/110 mm Hg. Resolution of symptoms occurred within 24 hours. A magnetic resonance imaging of the patient's brain 24-hours post-tPA indicated an increased signal density in the globus pallidus, which in turn is linked with encephalopathy and has been described as a marker for hypermanganesemia. <b>Discussion:</b> Manganese is an essential trace element with a critical role in numerous physiologic functions. Though readily obtained from dietary sources and rarely causing issue, manganese provided to patients via TPN may result in toxicities. Though the presentation of neurotoxicities associated with TPN-delivered manganese has been previously documented, the clinical presentation of toxicity has never mimicked an acute ischemic stroke. <b>Conclusion:</b> Though an evaluation of overlapping pathologies is warranted, this patient's clinical presentation of manganese toxicity mimicked an acute ischemic stroke and resulted in the administration of a fibrinolytic. A more comprehensive appreciation of the implications of trace elements is demanded of clinicians.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 2","pages":"127-132"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520976418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AM Versus PM Postoperative Administration of Warfarin With a Mechanical Mitral Valve.","authors":"Justin R Harris,&nbsp;Rachel Hatch,&nbsp;Prashanth Vallabhajosyula,&nbsp;Yancy Lo,&nbsp;Danielle Mowery,&nbsp;Neepa Patel","doi":"10.1177/8755122520973613","DOIUrl":"https://doi.org/10.1177/8755122520973613","url":null,"abstract":"<p><p><b>Background:</b> Currently, there are no guidelines regarding the optimal daily timing of inpatient warfarin administration. <b>Objective:</b> The purpose of this study was to determine whether dosing warfarin in the morning will have a significant impact on therapeutic international normalized ratio (INR) achievement compared with evening administration in mechanical mitral valve patients initiated on warfarin following cardiac surgery. <b>Methods:</b> This was a single-center, pre- and post-retrospective cohort conducted between 2014 and 2018. One-hundred fifty-four adult patients who underwent a mechanical mitral valve replacement or alternative cardiac surgery with a history of a mechanical mitral valve were enrolled. The primary outcome was achievement of therapeutic INR at any time point after initiation of warfarin. Pre-intervention administration timing was 6 pm and post-intervention timing was 10 am. <b>Results:</b> Baseline characteristics including age, sex, and race were similar between the 2 groups (<i>P</i> = NS for each characteristic). Therapeutic INR achievement was significantly improved at all time points following 10 am warfarin administration compared with 6 pm (hazard ratio = 1.69; <i>P</i> = .005). Mean time-to-therapeutic INR was 7.37 days in the post-intervention group and 8.39 days in the pre-intervention group (<i>P</i> = .073). There were no significant differences in INR >4, bleeding, or thrombotic complications between groups. <b>Conclusion and Relevance:</b> This retrospective analysis suggests that there may be a postoperative benefit in therapeutic INR achievement in mechanical valve patients when dosing warfarin in the morning compared with evening administration. Large-scale studies should be conducted to further elucidate the potential benefit across more heterogeneous populations.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 2","pages":"89-94"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520973613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Tertiary Drug Resources' Consistency Regarding Drug-Drug Interactions of Adjunctive Analgesics.","authors":"Andrew Lang,&nbsp;Michael A Veronin,&nbsp;Justin P Reinert","doi":"10.1177/8755122520951331","DOIUrl":"https://doi.org/10.1177/8755122520951331","url":null,"abstract":"<p><p><b>Background:</b> Health care providers routinely rely on tertiary drug information resources to affirm knowledge or proactively verify the safety and efficacy of medications. Though all patient care areas are affected, the reliability of these resources is perhaps nowhere as poignant as it is in high-acuity settings, including the emergency department and the intensive care unit. As providers seek to identify adjunctive analgesics for acute pain in these areas, they must be able to rely on the integrity to whichever resource their institution has granted access. <b>Objective:</b> To determine the congruency of drug-drug interaction information found on 3 tertiary drug resources. <b>Methods:</b> A drug-drug interaction analysis was conducted on Micromedex, Lexicomp, and Medscape. Adjunctive analgesics included dexmedetomidine and ketamine, which were compared with the intravenous opioid products morphine, fentanyl, and hydromorphone. <b>Results:</b> Significant discrepancies were appreciated with regard to the severity of drug-drug interactions. In addition, the heterogeneity in which reaction severity and likelihood are described by each respective resource makes direct comparisons difficult. Interaction warnings for dexmedetomidine and fentanyl included a \"major interaction\" from Micromedex, whereas Lexicomp did not identify a risk and Medscape only recommended increased monitoring on the grounds of respiratory and central nervous system depression. <b>Conclusions:</b> Health care providers must remain vigilant when reviewing tertiary drug information resources. Pharmacists possess the training and skills necessary to assist interdisciplinary medical teams in providing optimal patient care through evaluating and applying the information gleaned from these resources.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 1","pages":"12-16"},"PeriodicalIF":1.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520951331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39709895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Obesity on Clinical Outcomes of Patients Treated With Cefepime.","authors":"Austin R Morrison,&nbsp;Johnathon T Loper,&nbsp;Katie E Barber,&nbsp;Kayla R Stover,&nbsp;Jamie L Wagner","doi":"10.1177/8755122520967398","DOIUrl":"https://doi.org/10.1177/8755122520967398","url":null,"abstract":"<p><p><b>Background:</b> As the prevalence of obesity climbs, dosing of antimicrobials, particularly cephalosporins, is becoming a greater challenge for clinicians. Data are lacking for appropriate dosing of cefepime, an anti-pseudomonal cephalosporin that is widely used as an empiric anti-pseudomonal agent. <b>Objective:</b> The purpose of this study was to determine the rate of clinical treatment failure in obese patients compared with nonobese patients receiving cefepime as definitive monotherapy. <b>Methods:</b> Adult inpatients treated with cefepime monotherapy for ≥72 hours were included. Patients were excluded if they (1) were not able to achieve culture clearance within 72 hours and (2) had polymicrobial infections requiring more than one antibiotic for definitive therapy. <b>Results:</b> Fifty-eight obese patients and 56 nonobese patients were included. <i>Pseudomonas aeruginosa</i>, <i>Escherichia coli</i>, and <i>Enterobacter</i> spp were the most prevalent organisms isolated. Most organisms had a minimum inhibitory concentration of ≤1 µg/mL to cefepime with no differences in minimum inhibitory concentration distributions between groups. Definitively, 60% of patients received cefepime 1 g, while almost 40% received cefepime 2 g. Clinical failure occurred in 52% of patients (67% obese vs 36% nonobese; <i>P</i> = .001), with study group (odds ratio = 1.057, 95% confidence interval = 1.008-1.109) and respiratory source (odds ratio = 3.251, 95% confidence interval = 1.378-7.667) being independent predictors of failure. There were no differences in hospital length of stay, all-cause mortality, or 30-day readmissions. <b>Conclusions:</b> Obese patients treated with cefepime are more likely to experience treatment failure than nonobese patients. Larger trials examining the reasons for clinical failure in obese patients treated with cefepime are needed to confirm the findings from this preliminary work.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"37 1","pages":"30-35"},"PeriodicalIF":1.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/8755122520967398","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39856524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}