FARMACIA HOSPITALARIA最新文献

{"title":"Immunotherapy in advanced endometrial cancer with microsatellite instability: A systematic review.","authors":"Cristina Moreno-Ramos, Manuel David Gil-Sierra, María Del Pilar Briceño-Casado","doi":"10.1016/j.farma.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Endometrial cancer with microsatellite instability (MSI) involves 30% of diagnosed cases. There are some uncertainty about second-line treatment, after platinum-based first-line treatment. The aim of this study was to perform a systematic review on the scientific evidence of immunotherapies for endometrial cancer with MSI.</p><p><strong>Methods: </strong>PubMed and Embase databases were searched up to May 28, 2024. We included clinical trials about patients with mismatch repair deficiency (dMMR) or high microsatellite instability (MSI-H) diagnosed with advanced and/or metastatic endometrial cancer who had previously received platinum-based chemotherapy. Clinical trials with a dMMR or MSI-H population size of less than 10 patients were discarded. Efficacy results in overall survival, progression-free survival and objective response rate were used to determine the most interesting drugs. A safety analysis of therapies was developed.</p><p><strong>Results: </strong>Fifty-four studies were found in a systematic search. Fourteen clinical trials were selected. The following drugs were evaluated: pembrolizumab monotherapy, pembrolizumab plus lenvatinib, durvalumab, durvalumab-tremelimumab combination, dostarlimab, nivolumab and avelumab. The greatest numerical efficacy effect was achieved by pembrolizumab, followed by pembrolizumab in combination with lenvatinib. The most common adverse events were fatigue and gastrointestinal disorders.</p><p><strong>Conclusion: </strong>The efficacy of pembrolizumab and pembrolizumab-lenvatinib regimen appears promising. However, studies with larger sample size, longer follow-up and comparative design with subgroup analysis based on differences in microsatellite repair mechanisms are needed for proper therapeutic positioning.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545429","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":"Evaluation of penicillin allergy labeling in the emergency department: Retrospective study on the impact of a hospital pharmacist-led intervention algorithm.","authors":"Fernando Salazar González, Mireia Iglesias Rodrigo, Gemma Garreta Fontelles, Mireia Mensa Vendrell, Jordi Nicolás Picó","doi":"10.1016/j.farma.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of an intervention algorithm on penicillin allergy label reassessment in emergency department patients, aiming to optimize antibiotic selection and improve patient safety.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in a 450-bed hospital, including adult patients with a penicillin allergy label admitted to the emergency department between November 2023 and August 2024. An algorithm developed by the pharmacy service in collaboration with the ASP team was applied, based on validated tools such as the Penicillin Allergy De-Labelling Toolkit, PEN-FAST, and Antibiotic Allergy Assessment Tool. Demographic data, allergy history, and clinical outcomes were collected. The acceptance of recommendations and the incidence of adverse reactions were analyzed.</p><p><strong>Results: </strong>A total of 66 patients were evaluated. Delabeling was proposed in 35 (53.03%) patients, skin testing in 13 (19.69%), oral provocation testing in 9 (13.63%), and label maintenance in 9 (13.63%). A total of 89.39% of the recommendations were accepted, achieving effective delabeling in 42 patients. No adverse reactions were recorded. In 21 cases, antibiotic therapy was optimized following the intervention.</p><p><strong>Conclusions: </strong>The implementation of a structured algorithm for penicillin allergy reassessment in emergency settings is effective and safe. Its application facilitates antibiotic optimization, improves patient safety, and reduces broad-spectrum antibiotic use. This study highlights the role of hospital pharmacists in drug allergy management and antimicrobial stewardship.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545428","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":"Contribution of N-oxide metabolite in the therapeutic drug monitoring of voriconazole in a patient with invasive aspergillosis.","authors":"Irene Orozco Cifuentes, Adrián Domínguez García, María Jiménez Meseguer, Elena García Benayas, Benito García Díaz","doi":"10.1016/j.farma.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.012","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530306","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":"Medication Safety Officers: A pillar of patient safety in hospital pharmacy.","authors":"Elizabeth Hess Ford, Christina Michalek","doi":"10.1016/j.farma.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.017","url":null,"abstract":"<p><p>The role of a Medication Safety Officer has emerged as a critical element in hospital pharmacy, addressing the persistent issue of medication errors. These errors, which can cause significant patient harm, have been documented for decades, prompting the establishment of formal roles dedicated to medication safety. Organizations such as the Institute for Safe Medication Practices (ISMP), the American Society of Health System Pharmacists (ASHP) as well as the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) and National Health Service (NHS) have been instrumental in supporting the Medication Safety Officer role. Medication errors can result in severe consequences, including patient harm and death. Landmark publications like the Institute of Medicine's \"To Err is Human\" and \"Crossing the Quality Chasm\" have highlighted the prevalence and impact of these errors, advocating for system improvements and the necessity of dedicated safety roles. Medication Safety Officers lead strategies and processes related to medication safety, develop strategic plans, and implement error prevention strategies. They analyze medication error reports, collaborate with healthcare staff, and optimize medication safety technologies. Medication Safety Officers play a key role in fostering a culture of safety within organizations, influencing practices to minimize harm and support second victim programs. Studies have shown that employing a Medication Safety Officer can significantly improve hospital safety scores, demonstrating the effectiveness of this role in enhancing patient safety. The daily responsibilities of a Medication Safety Officer include reviewing medication errors, assessing harm, attending meetings, and collaborating with healthcare practitioners. Overall, the role of a Medication Safety Officer is essential in identifying and mitigating medication risks, making hospitals safer, and ensuring the delivery of high-quality patient care.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486532","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":"Knowledge, perception, and willingness to implement the CMO methodology among specialist physicians caring for patients with HIV in Spain.","authors":"Enrique Contreras Macías, Pilar Taberner Bonastre, Anaïs Corma Gómez, José Ramón Blanco Ramos, Ramón Morillo Verdugo","doi":"10.1016/j.farma.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.007","url":null,"abstract":"<p><strong>Introduction: </strong>The CMO (Capability-Motivation-Opportunity) methodology is an innovative pharmaceutical care model designed to improve the quality of care for people living with HIV (PLWH). This approach evaluates the knowledge, perception, and willingness to implement the methodology among specialist physicians in Spain.</p><p><strong>Methods: </strong>This observational and descriptive study utilized a validated questionnaire distributed among clinicians involved in the care of PLWH. The survey assessed their knowledge and perception of the methodology. Associations between variables were analyzed using bivariate tests.</p><p><strong>Results: </strong>Thirty physicians participated. Sixty percent reported moderate-to-high knowledge of the methodology, correlating with a positive perception of its clinical relevance (p = 0.02). Motivational interviewing and remote follow-up were identified as key tools.</p><p><strong>Conclusion: </strong>Knowledge of the CMO methodology is limited but positively valued. Its association with improved quality of health care underscores the importance of strategies to enhance its dissemination and adoption in clinical practice.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303258","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":"Reduction of unnecessary repackaging as an environmental sustainability measure.","authors":"David García-Martínez, Manuela Martínez-Camacho, Aida Rueda-Naharro, David García-Marco","doi":"10.1016/j.farma.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.farma.2025.05.005","url":null,"abstract":"<p><strong>Objective: </strong>The main objective is to describe the project and evaluate the impact of replacing repackaged medications with unit dose presentations in 15 public hospitals within a regional health system. Secondary objectives include identifying differences in the changes implemented across the 15 audited hospitals and conducting an exploratory analysis of the potential impact in other non-audited centers that requested participation in the project.</p><p><strong>Method: </strong>A database containing over 2,000 medications available in unit dose format was developed and is updated monthly. In parallel, an automated system based on decision-making algorithms was implemented to identify improvement opportunities in medication procurement. The system was adopted either individually by hospitals or through centralized structures at the regional or private level. The analysis included data from 15 public hospitals, where the reduction in repackaging and its environmental, economic, and operational impact were assessed by measuring material, time, and cost savings. The results were subsequently extrapolated to the 172 hospitals that applied.</p><p><strong>Results: </strong>In the 15 monitored hospitals, repackaging of approximately 1.27 million tablets per year was avoided, resulting in estimated savings of 170 km of packaging material, 866 kg in weight, and 113,693 min of labor. The avoided costs in materials and machinery amounted to 36,274€ annually. No statistically significant differences were observed in project adoption across the hospitals (p = 0.234). The extrapolation to 172 hospitals suggests a potential impact of 16.67 million tablets no longer requiring repackaging per year, with an estimated savings of 2220.13 km of material, 24,723 h of labor, and 451,768€ annually.</p><p><strong>Conclusions: </strong>Replacing repackaged medications with commercially available unit dose formats significantly reduced material consumption, labor time, and repackaging-related costs in the evaluated hospitals. The implementation of the project was consistent across the 15 monitored hospitals. Furthermore, the model proved to be scalable. The main limitation identified was the limited availability of unit dose medications on the market; therefore, it is recommended to prioritize their inclusion in procurement processes and to promote their development by the pharmaceutical industry.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295096","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":"Knowledge, perception and predisposition to implement the MAPEX strategy in hospital pharmacy residents in Spain. FIRMAPEX project.","authors":"María Alfonsín Lara, Vera Áreas Del Águila, Enrique Contreras Macías, Almudena Mancebo González, Beatriz Martínez Castro, Covadonga Pérez Menéndez-Conde, Patricia Sanmartín Fenollera, Ramón Morillo-Verdugo","doi":"10.1016/j.farma.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.farma.2025.04.007","url":null,"abstract":"<p><strong>Objective: </strong>To assess the level of knowledge, perception, and willingness of hospital pharmacy residents in Spain to implement the initiatives of the MAPEX project (Strategic Map for Outpatient Pharmaceutical Care) by the Spanish Society of Hospital Pharmacy in the future, as well as to analyze the influence of outpatient pharmacy rotations on these aspects.</p><p><strong>Methods: </strong>A four-phase study was conducted: information review and analysis, questionnaire design, survey administration, and final report development. A questionnaire was designed to assess knowledge, perception, and application of MAPEX, as well as experience in outpatient pharmacy rotations. Factorial and bivariate analyses were performed to evaluate the questionnaire structure and identify associations between variables.</p><p><strong>Results: </strong>A total of 143 residents participated. Of these, 78.3% had completed an outpatient pharmacy rotation, which was significantly associated with greater knowledge (p = 0.02) and application (p = 0.01) of MAPEX. However, only 15.4% had a high level of knowledge, and 12.6% frequently applied the Capacity-Motivation-Opportunity (CMO) methodology. Although 71.3% positively valued motivational interviewing, only 28% used it frequently. Willingness to implement MAPEX was high (73.4%), reaching 100% among those with a high level of knowledge about the project (p = 0.04). Factor analysis identified six factors explaining 66.8% of the total variance.</p><p><strong>Conclusions: </strong>Hospital pharmacy residents demonstrated a positive perception and a high willingness to implement MAPEX, highlighting the need for its structured integration into specialized training. Outpatient pharmacy rotations significantly improve knowledge and application of the CMO methodology, emphasizing their importance in pharmaceutical care training.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250208","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":"Cost-utility of sacubitril/valsartan in heart failure with reduced ejection fraction in Spain.","authors":"Antonio García-Quintana, Héctor Alonso Ramos, Javier Parrondo","doi":"10.1016/j.farma.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.farma.2025.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hospital discharges in Spain.</p><p><strong>Objective: </strong>To analyze the economic impact of new treatments for heart failure with reduced ejection fraction such as sacubitril/valsartan in out-patient and in-patient setting.</p><p><strong>Material and methods: </strong>The present economic evaluation study was carried out by developing a Markov model. Treatment with sacubitril/valsartan from admission or after hospital discharge was compared, with enalapril being the comparator. Total costs, years of life gained, quality-adjusted life years, and incremental cost-effectiveness ratio and incremental cost-utility ratio were analyzed. Data were obtained from the PARADIGM-HF and PIONEER-HF studies.</p><p><strong>Results: </strong>The results of the base cases of the three comparisons made showed that sacubitril/valsartan produced benefits in years of life gained and quality-adjusted life years compared to enalapril showing incremental cost-utility ratio below €20,000/QALY and that this ratio was better in scenarios starting sacubitril/valsartan in the hospital setting once decompensation was resolved.</p><p><strong>Conclusion: </strong>This study shows that starting sacubitril/valsartan from hospital admission for heart failure is cost-effective from the perspective of the National Health Service in Spain.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128872","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":"Standarization and characterization of intravenous drug dilutions in critically ill pediatric patients.","authors":"Laura Torralba-Fernández, Marta García-Palomo, Miguel López de Abechuco-Ruiz, Natalia Ramos-Sánchez, Clara Jiménez-Méndez, Rocío Prieto-Galindo, María Carmen Lorenzo-Lozano, Pablo Aguado-Barroso","doi":"10.1016/j.farma.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.farma.2025.03.020","url":null,"abstract":"<p><strong>Objective: </strong>To standardize the drug dilutions administered intravenously in a Pediatric Intensive Care Unit and to characterize these dilutions based on their pH, osmolarity, and vesicant nature. This aims to guide the selection of the most appropriate vascular access device, minimizing associated complications, and preserving the patient's venous capital.</p><p><strong>Methods: </strong>Through a consensus between Pharmacy and Pediatric Services, the most frequently administered intravenous drugs in the Pediatric Intensive Care Unit were selected. Two different dilutions were established for each drug, followed by the determination of their respective osmolarity and pH values. The vesicant nature of each drug was assessed according to the classification proposed by Clark et al. Additionally, vascular access device selection was guided by the algorithm proposed by Manrique et al., which considers the drug's properties, the duration of intravenous therapy, and the patient's venous capital status.</p><p><strong>Results: </strong>A total of 60 dilutions corresponding to 30 drugs from the following therapeutic groups were analyzed: antimicrobials (56%), antiepileptics (13%), sedatives (7%), diuretics (7%), anti-inflammatory and analgesics (7%), and others (10%). Twenty-five percent of the dilutions exhibited at least one high-risk factor for phlebitis (osmolarity >600 mOsm/L or pH < 4 or > 9), while 35% were classified as intermediate risk (osmolarity 450-600 mOsm/L or pH 4-5 or > 7.5-9). Only 10% of the analyzed drugs were classified as vesicants (acyclovir, phenytoin, and vancomycin). Seventeen dilutions of nine different drugs were identified that should not be administered through a peripheral venous catheter, even in short-term treatments. Of these, 15 had a high risk of causing phlebitis, while 2 had an intermediate risk.</p><p><strong>Conclusions: </strong>The physicochemical properties (osmolarity and pH) and vesicant nature of drugs are key factors contributing to the development of phlebitis in critically ill pediatric patients. Standardizing and characterizing drug dilutions will facilitate the selection of the most appropriate vascular access device, improving the safety and effectiveness of intravenous therapy.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128859","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":"Development of the mobile application Guide to medication reconciliation in the critically ill patient.","authors":"María Martín Cerezuela, Fernando Becerril Moreno, Jesús Ruiz Ramos, Ana de Lorenzo Pinto, Esther Domingo Chiva, Marta Valera Rubio, Irene Aquerreta González, Carla Bastida Fernández, Laura Doménech Moral, Amaia Egüés Lugea, Miguel Ángel Amor García, Tatiana Betancor García, Sara Cobo Sacristán, Marta Albanell Fernández, Sara Ortiz Pérez, Luis Pérez de Amezaga Tomás","doi":"10.1016/j.farma.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.farma.2025.03.021","url":null,"abstract":"<p><strong>Objective: </strong>Medication reconciliation is an essential process in the care of critically ill patients, ensuring that patients' chronic medication is adapted to the patient's clinical situation and administered safely during hospitalisation. Given the profile of the patient admitted to a critical care unit (ICU), this becomes even more relevant. Reconciliation minimises possible medication errors and adverse effects, improving safety in the critically ill patient.</p><p><strong>Methods: </strong>The project, carried out between 2021 and 2024, was led by the FarMIC (Pharmacists in Intensive Care Medicine and Critical Care) and RedFaster (Pharmaceutical Care in Emergencies) groups of the Spanish Society of Hospital Pharmacy (SEFH), and included: selection of the drugs, review of the available literature and previous conciliation guidelines in similar areas of application, preparation of the drug information with the recommendations issued by the working group, the review of the same and the development of the mobile application.</p><p><strong>Results: </strong>In October 2024, the app 'Conciliation Guide for Critically Ill Patients®' was published, available free of charge for iOS and Android. It provides a drug index with detailed information on medication reintroduction schedules, routes of administration, monitoring, and drug-specific considerations. In addition, the tool includes information on withdrawal syndromes, drug-drug interactions with the usual ICU drugs and hazardous drugs information according to the NIOSH list.</p><p><strong>Conclusions: </strong>This app facilitates pharmacotherapeutic reconciliation process in the ICU, supporting healthcare professionals in making personalised decisions. Its use can optimise patient safety, reduce adverse events and improve critical patient care. Finally, this tool reinforces the role of the clinical pharmacist in the ICU, who must lead this process in all care transitions and adapt it to the clinical situation of the patient.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081278","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}