Journal of Addictive Diseases最新文献

{"title":"The integration of harm reduction services in the Veterans Health Administration (VHA): a qualitative analysis of barriers and facilitators.","authors":"Leah H Harvey, Samantha K Sliwinski, Kimberlee Flike, Jacqueline Boudreau, Allen L Gifford, Westyn Branch-Elliman, Justeen Hyde","doi":"10.1080/10550887.2023.2210021","DOIUrl":"10.1080/10550887.2023.2210021","url":null,"abstract":"<p><strong>Background: </strong>Substance use is common among U.S. military veterans and veterans are at high risk for negative consequences associated with substance use, such as injection-related infections and overdose. Although harm reduction services (HRS) are highly evidence-based, implementation in traditional healthcare settings has been limited. This formative, qualitative study sought to identify barriers and facilitators to the integration of HRS and identify appropriate implementation strategies to support the optimized integration of a comprehensive bundle of HRS in the Veterans Health Administration (VHA).</p><p><strong>Methods: </strong>Semi-structured interviews explored how harm reduction is currently understood by VHA providers and elicited input on perceived facilitators and barriers to implementation. Data were analyzed using a directed content analysis and the Practical, Robust Implementation and Sustainability Model (PRISM) implementation framework was used to organize findings. Results were then mapped to relevant implementation strategies using the Consolidated Framework for Implementation Research - Expert Recommendations for Implementing Change (CFIR - ERIC) tool.</p><p><strong>Results: </strong>15 interviews with VHA providers were conducted across 5 sites. Respondents reported that current HRS are fragmented and dependent on the knowledge, time, and comfort level of individual providers. Stigma around substance use at the patient, provider, and institutional levels was noted to be a key barrier to HRS adoption. Based on identified barriers and facilitators, strategies that may be effective for increasing adoption of HRS include engagement of champions, communication and educational strategies, and adaptation of existing infrastructure.</p><p><strong>Conclusions: </strong>Many of the barriers identified in this formative study may be addressed using evidence-based implementation strategies. Additional research is needed to identify implementation strategies that are effective for addressing stigma, which is perceived to be a persistent challenge to the provision of integrated harm reduction services.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"326-334"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9800456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and determinants of cannabis use in youth visiting an urban emergency department in France.","authors":"Rdah Touali, Mathieu Chappuy, Julia De Ternay, Aurélie Berger-Vergiat, Julie Haesebaert, Karim Tazarourte, Philippe Michel, Benjamin Rolland","doi":"10.1080/10550887.2023.2279474","DOIUrl":"10.1080/10550887.2023.2279474","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use frequently starts during adolescence and young adulthood and can induce psychosocial and health consequences. Young people constitute hard-to-reach populations. Emergency departments could constitute a key care setting to identify cannabis use and its consequences among young people.</p><p><strong>Objectives: </strong>To estimate the rate of cannabis use in the 16- to 25-year-old population visiting the emergency department for any reason and to assess the psychosocial factors associated with cannabis use.</p><p><strong>Methods: </strong>This was a cross-sectional study among young people who attended the emergency department, over 5-months. Data were sociodemographic characteristics, self-administered questionnaires for problematic substance use screening, and urine drug screening samples. They were classified in the cannabis use (CU) group if they had a positive urine screen or reported cannabis use in the previous month. Characteristics of individuals in the CU and non-CU groups were compared.</p><p><strong>Results: </strong>A total of 460 participants were included, of whom 105 were in the CU group. Cannabis users were more likely to be male (aOR = 1.85; [1.18-2.90]), to be unemployed (aOR = 1.77; [1.03-3.04]), to have a lower mental health status score (aOR = 0. 82; [0.75-0.90]), to report a history of sexual abuse (aOR = 2.99; [1.70-5.25]), and to have a positive AUDIT screen (aOR = 4.23; [2.61-6.86]).</p><p><strong>Conclusions: </strong>The emergency department is a primary care setting for young people, which is conducive to screening for substance use. Cannabis users can be assessed and referred to adapt their treatment, given their lack of adherence to the traditional addictology care system.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"491-499"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483219","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":"Prevalence and drug use correlates of inadvertent fentanyl exposure among individuals misusing drugs in seven U.S. states.","authors":"S Magura, M J Lee-Easton, R Abu-Obaid, P Reed, B Allgaier, E Fish, A L Maletta, P Amaratunga, B Lorenz-Lemberg, M Levitas, E D Achtyes","doi":"10.1080/10550887.2023.2293643","DOIUrl":"10.1080/10550887.2023.2293643","url":null,"abstract":"<p><p>Fentanyl has emerged as the leading cause of fatal drug overdoses in the U.S. Individuals misusing drugs may not always be aware of exposure to fentanyl.</p><p><p>To determine the prevalence of fentanyl use and extent of awareness of fentanyl exposure among a national sample of treatment-seeking individuals with opioid use disorder (<i>n</i> = 1098).</p><p><p>Participants provided oral fluid and urine specimens, which were tested for drugs by liquid chromatography/tandem mass spectrometry. Participants also provided self-reports of fentanyl use.</p><p><p>49.5% tested positive for fentanyl in oral fluid, urine, or both. Of those testing positive for fentanyl, 29.8% were unaware that they had been exposed to fentanyl. Participants testing positive for opioids methadone, and specifically 6-monoacetylmorphine (6-MAM), a unique metabolite of heroin, were significantly more likely to be unaware of fentanyl exposure than participants testing negative for these substances, with a similar trend for oxycodone and tramadol.</p><p><p>These findings may be due to fentanyl's effect being difficult to distinguish from that of other opioids, whereas when other types of drugs are adulterated with fentanyl, the differences in effects are likely to be readily discernable. These results support the importance of expanded drug-checking services.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"515-523"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of intravenous buprenorphine microdosing to initiate medication for opioid use disorder in a patient with co-occurring pain: case report.","authors":"Alia Bodnar, Christine Diffenderffer, Lindsay A Jablonski, Eric Bai, Rosalyn W Stewart","doi":"10.1080/10550887.2023.2285201","DOIUrl":"10.1080/10550887.2023.2285201","url":null,"abstract":"<p><strong>Introduction: </strong>Buprenorphine is used to treat opioid use disorder (OUD). However, therapy is often disrupted during acute pain episodes, and re-initiation is often deferred due to intolerable interruption in opioid analgesics. This case report describes a unique strategy for inducing buprenorphine without stopping opioid analgesics.</p><p><strong>Case: </strong>One patient with OUD and acute pain was initiated on buprenorphine using intravenous microdosing without precipitated withdrawal or pain exacerbation. Full agonist opioids were successfully weaned after discharge and the patient was linked with a community-based treatment program.</p><p><strong>Conclusion: </strong>This case describes use of intravenous buprenorphine to treat OUD and acute pain without adverse consequences.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"567-571"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478973","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":"Effect of pornography use on the sexual satisfaction: a systematic review and meta-analysis.","authors":"Fatemeh Abdi, Reza Pakzad, Farzaneh Alidost, Ehsan Aghapour, Vahid Mehrnoush, Mojdeh Banaei","doi":"10.1080/10550887.2024.2401680","DOIUrl":"https://doi.org/10.1080/10550887.2024.2401680","url":null,"abstract":"<p><strong>Objective: </strong>Dissatisfaction with an inividual's sex life is underlying factor that can lead to pornography addiction. The current research aims to understand the relationship between pornography use and sexual satisfaction.</p><p><strong>Methods: </strong>The pooled correlation coefficient with 95% confidence interval was calculated using random effects. The meta-regression method was used to examine factors affecting heterogeneity between studies and Egger's test was used to evaluate of publication bias.</p><p><strong>Results: </strong>41 studies with a total sample size of 70541 participants were included in the meta-analysis. The pooled estimate for the correlation coefficient in total, in male and in female -0.06 (95% CI: -0.09 to -0.02), -0.07 (95% CI: -0.16 to 0.02) and -0.04 (95% CI: -0.08 to -0.01). The pooled estimate of correlation coefficient was -0.04 (95% CI: -0.07 to -0.02) in cross-sectional, -0.12 (95% CI: -0.19 to -0.05) in cohort, 0.00 (95% CI: -0.15 to 0.15) in studies that used self-report questionnaire and -0.06 (95% CI: -0.08 to -0.03) in studies that used online survey. Based on the results of the meta-regression, the publication year was found to have a significant effect on heterogeneity among studies (<i>B</i> = 0.013, <i>p</i> = 0.018). However, study design, age, data collection method, quality score and sample size did not have a significant effect.</p><p><strong>Conclusions: </strong>There was a significant negative correlation between pornography and sexual satisfaction and the disaggregation of results by gender also indicated this negative correlation among women. However, the relationship between pornography and sexual satisfaction was not significant in men.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":1.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298622","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":"Consumption of tobacco products and associated factors among outpatient visitors of two healthcare facilities in Northern Cyprus: a descriptive cross-sectional study.","authors":"Ozen Asut, Songul Vaizoglu, Gulifeiya Abuduxike, Ebthal Khader, Nada Galal Ramadan, Sanda Cali","doi":"10.1080/10550887.2024.2386492","DOIUrl":"https://doi.org/10.1080/10550887.2024.2386492","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use is one of the leading causes of preventable mortality and morbidity. Although Cyprus is considered a developed country, the tobacco prevalence and related issues have not been explored sufficiently in the general population of North Cyprus.</p><p><strong>Objective: </strong>The objective of this study is to determine the rate of tobacco product consumption and related factors among the visitors of a community health center and a university hospital in Northern Cyprus.</p><p><strong>Methods: </strong>The study was designed as a cross-sectional study The data were collected using a questionnaire developed in compliance with WHO guidelines. The data were analyzed using IBM-SPSS18.0 with <i>p</i> < 0.05 evaluated as significant.</p><p><strong>Results: </strong>Out of a total of 635 individuals approached, 615 provided responses. The participation rate was 96%. The frequency of male smokers was 47.2%, while the frequency of female smokers was 34.0%, with a total smoking rate of 40.7%, much higher than world averages. The survey identified friendship influence as the primary reason for starting tobacco use, accounting for 42%, followed by being stressed at 34.6%. Male gender, being single, having no children, Turkish nationality were predictors of smoking, while financial status was not. The participants indicated a high frequency regarding exposure to passive smoke (51.1%). More than half of the respondents thought tobacco control in Northern Cyprus is not satisfactory.</p><p><strong>Conclusion: </strong>More research needs to be done to determine the exact overall prevalence of tobacco consumption in the population, which was found high in this study. Moreover, implementation of comprehensive tobacco control strategies is essential to control the prevalent tobacco dependence.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120908","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":"High dose opioid agonist therapy for patients with opioid use disorder: a case series exploring this patient-centered approach.","authors":"Priya Nigam, Jennifer Marx, Omolara Olasimbo, Vikranth Induru, Ho-Man Yeung","doi":"10.1080/10550887.2024.2383804","DOIUrl":"https://doi.org/10.1080/10550887.2024.2383804","url":null,"abstract":"<p><strong>Objectives: </strong>Management of opioid withdrawal in the inpatient setting can vary widely depending on the patient, the physician, and the institution. Although buprenorphine and methadone are first-line therapy for withdrawal management, some patients experience barriers to those medications. In this case series, we explore high dose opioid agonist therapy (HDOAT) as a novel and effective option to bridge to recovery in this particular setting.</p><p><strong>Methods: </strong>This retrospective case series includes- five patients with opioid use disorder (OUD) who were treated with HDOAT while hospitalized and reports on their outcomes.</p><p><strong>Results: </strong>All five patients completed lifesaving medical therapy, engaged with community health workers for resources, and successfully transitioned to medications for opioid use disorder (MOUD). More importantly, none of the patients had patient directed discharges (PDDs). Furthermore, there were no inpatient drug uses or overdoses requiring naloxone administration, even with very high doses of oxycodone. None of the five patients were readmitted within thirty days.</p><p><strong>Conclusions: </strong>Although more rigorous research is needed, HDOAT may be a viable strategy for OUD when patients continued to decline buprenorphine or methadone on admission. This case series demonstrated the successful use of this strategy toward preventing PDDs, promoting treatment completion, and allowing substance recovery and rehabilitation, in patients who elected to defer MOUD on arrival.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120909","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":"Inpatient initiation of long-acting injectable buprenorphine at a community hospital: A retrospective case series.","authors":"Clarissa O'Conor, Shai Farhi, Ethan Cowan, Ruchi Fitzgerald","doi":"10.1080/10550887.2024.2391145","DOIUrl":"https://doi.org/10.1080/10550887.2024.2391145","url":null,"abstract":"<p><strong>Objectives: </strong>Determine if long-acting injectable buprenorphine (LAIB) can be successfully and safely administered in the hospital with minimal sublingual buprenorphine lead-in and potentially improve follow-up engagement in care.</p><p><strong>Methods: </strong>We performed a retrospective case series of 46 patients who received LAIB while hospitalized at a safety-net community hospital. We abstracted demographic information, details about substance use disorder treatment history, in-hospital buprenorphine initiation methods and follow-up data from inpatient and outpatient electronic medical records.</p><p><strong>Results: </strong>In total, 46 hospitalized patients received LAIB during the study period. The majority of our patients were older Black adults with Medicaid who self-reported intranasal heroin use. A low-dose buprenorphine initiation protocol was used most commonly, either in sublingual or intravenous form, with only two cases of precipitated withdrawal occurring during the buprenorphine initiation process and no cases of precipitated withdrawal after the administration of LAIB. 87% (40) of the patients received LAIB after receiving either sublingual or IV buprenorphine for fewer than the recommended seven days. Of the 46 hospitalized patients who received LAIB, 23 (50%) attended a follow-up addiction medicine appointment within 30 days of discharge.</p><p><strong>Conclusions: </strong>Hospital administration of LAIB could play an important role in retention in care after hospital discharge.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113335","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":"Associations between ENDS and cigarette use, and compromised immunity in US adults: Findings from the 2021-2022 NHIS.","authors":"Seyedeh Yasaman Alemohammad, Amirmohammad Khalaji, Olatokunbo Osibogun, Rime Jebai, Wei Li, Ateeqa Ijaz, Miranda Gehris, Ghader Dargahi Abbasabad, Kenneth Ward, Zoran Bursac, Ziyad Ben Taleb, Mohammad Ebrahimi Kalan","doi":"10.1080/10550887.2024.2380116","DOIUrl":"10.1080/10550887.2024.2380116","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use presents increased risks for individuals with weakened immune systems (WIS). We investigated the association between cigarette and electronic nicotine delivery systems (ENDS or e-cigarettes) use and WIS in US adults using data from the 2021-2022 National Health Interview Survey.</p><p><strong>Methods: </strong>Data from 57,133 adults were analyzed, focusing on WIS prevalence due to health conditions, prescriptions, or both. Cigarette and ENDS use were categorized as never, former, or current. Weighted multivariable regression models adjusted for demographics and other health conditions to assess associations between tobacco use and WIS.</p><p><strong>Results: </strong>Among US adults, 4.3% had prescription-related WIS, 4.6% had health condition-related WIS, and 7% had WIS due to either reason. Adjusted results from multivariable regression models indicated that adults with WIS due to health conditions were more likely to be current (AOR = 1.21, 95%CI: 1.05-1.40) and former (AOR = 1.25, 95%CI: 1.11-1.39) cigarette smokers compared to counterparts without WIS. Adults with WIS due to prescriptions were more likely to be former cigarette smokers (AOR = 1.19, 95%CI: 1.06-1.34). Those with WIS for any reason were more likely to be current (AOR = 1.19, 95%CI: 1.05-1.35) and former (AOR = 1.24, 95%CI: 1.13-1.36) cigarette smokers. Adults with WIS due to health conditions (AOR = 1.23, 95%CI: 1.06-1.41) or any reasons (AOR = 1.19, 95%CI:1.05-1.34) were more likely to be former ENDS users compared to those without WIS.</p><p><strong>Conclusions: </strong>In this nationally representative study, we found a notable link between cigarette and ENDS use with WIS, particularly among those with health condition-related or prescription-related WIS, underscoring the importance of addressing tobacco use in this vulnerable population.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Years of life lost due to unintentional drug overdose relative to the leading underlying causes of death in the United States: a comparative analysis of excess mortality 2017-2019.","authors":"Stephanie Garcia, Julie Teater, Candice Trimble, Parker Entrup, Orman E Hall, O Trent Hall","doi":"10.1080/10550887.2023.2173929","DOIUrl":"10.1080/10550887.2023.2173929","url":null,"abstract":"<p><p>The present study aims to compare Years of Life Lost for unintentional drug overdose and the leading underlying causes of death in the United States annually from 2017 to 2019. Years of Life Lost provide valuable context to incident deaths when comparing the relative mortality burden of underlying causes of death. Prior research has shown unintentional drug overdose was the third leading cause of Years of Life Lost in the state of Ohio in 2017. However, this finding has yet to be replicated at the national level in the US. Death statistics for 2017-2019 were accessed via CDC WONDER. Years of Life Lost were calculated for unintentional drug overdose and each of the top five causes of incident deaths in the US during the study period. Unintentional drug overdose caused nearly seven million Years of Life Lost in the US during the three-year period of study and was the fourth leading cause of Years of Life Lost after cancer, heart disease and other accidents. Incidence alone provides an incomplete picture of the effect of unintentional drug overdose on overall mortality burden in the US. Years of Life Lost give critical context to the overdose crisis, underscoring unintentional drug overdose as a leading cause of premature mortality.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"205-209"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083159","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}