Journal of the American Pharmacists Association最新文献

{"title":"Updates to a pharmacy-technician driven centralized medication refill service in a large community health system","authors":"Elizabeth G. Schlosser,&nbsp;Leandro Llambi,&nbsp;Thomas J. Hoffman,&nbsp;Ana L. Hincapie","doi":"10.1016/j.japh.2024.102142","DOIUrl":"10.1016/j.japh.2024.102142","url":null,"abstract":"<div><div>In 2020, we published a description of the newly implemented centralized refill service (CRS) led by pharmacy technicians in our large community health system. Since that time, the CRS has been refined, updated, and expanded. We have also received many inquiries with common questions about the process from those who seek to implement a similar process. The purpose of this commentary is to 1) provide updates to the process in the 5 years since its implementation, and 2) provide additional insights on specific topics from inquiries to the organization.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102142"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288844","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":"The Public Health Informatics Fellowship Program: Training pharmacists as data detectives","authors":"Sena Seged,&nbsp;Kevin Lan,&nbsp;Sonya Zhan,&nbsp;Jessica Eloso,&nbsp;Bradley Biggers,&nbsp;Roua El Kalach","doi":"10.1016/j.japh.2024.102216","DOIUrl":"10.1016/j.japh.2024.102216","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102216"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564917","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":"Beyond the fill: Navigating pharmacy's technological future in 2050","authors":"Timothy Dy Aungst","doi":"10.1016/j.japh.2024.102285","DOIUrl":"10.1016/j.japh.2024.102285","url":null,"abstract":"<div><div>The pharmacy profession stands at a pivotal juncture as it faces unprecedented technological advancements that will rapidly reshape the healthcare landscape by 2050. This commentary explores the implications of technological advancements for pharmacy practice and how it may impact the workforce in the coming decades. The advent of digital health technologies (DHTs), artificial intelligence (AI), and automation is poised to transform patient engagement and care delivery. The Covid-19 pandemic has accelerated this shift, and traditional pharmacy roles have evolved to meet these expectations. As AI and DHT adoption increase, it will push the profession beyond its historical focus on logistics and medication dispensing. Several potential scenarios may unfold by 2050, ranging from a diminished workforce overshadowed by technology to an evolved profession that leverages novel technologies to enhance clinical services and patient care. To prepare for these changes, the profession must address key challenges, including advancing education and training to incorporate new competencies, establishing sustainable financial models for emerging roles, embracing advocacy and navigating regulatory constraints to expand scopes of practice, and overcoming societal resistance to change. By embracing continuous learning and adaptability, pharmacists can seize the opportunity to redefine their roles, ensuring they remain indispensable in an evolving healthcare environment.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102285"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607300","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":"Provision of maternal health services among Ohio community pharmacists practicing in maternity care deserts","authors":"Maria Duodu,&nbsp;Natalie DiPietro Mager","doi":"10.1016/j.japh.2024.102292","DOIUrl":"10.1016/j.japh.2024.102292","url":null,"abstract":"<div><h3>Background</h3><div>Over 2.3 million reproductive-age women in the United States live in a maternity care desert, a county without obstetric services or providers; over 3 million more reside in a county with low access to maternity care. The National Alliance of State Pharmacy Associations (NASPA) issued a toolkit outlining maternal health services community pharmacists are positioned to provide within their scope of practice.</div></div><div><h3>Objectives</h3><div>The primary objective of this study was to determine whether community pharmacists practicing in maternity care deserts/low access areas in Ohio provide NASPA-recommended maternal health services. Secondary objectives were to assess knowledge and attitudes related to maternal health; interest and barriers for developing new services; and screening and referrals for key social determinants of health.</div></div><div><h3>Methods</h3><div>An anonymous cross-sectional survey was electronically distributed to Ohio community pharmacists working in maternity care deserts/low access areas (n = 216) in fall/winter 2023 to evaluate their awareness, practices, and attitudes.</div></div><div><h3>Results</h3><div>Thirty-one pharmacists responded (14%). Almost half knew that maternal mortality had increased in recent years. Although 61% reported familiarity with the term “maternity care desert,” only 35% recognized they are currently practicing in one. Provision of NASPA-recommended services to reproductive-age women ranged from 90% (immunizations) to 11% (alcohol use screening/counseling). About 96% believed that community pharmacists can help optimize women’s health before and during pregnancy. The majority of respondents reported “never” screening for social determinants of health, but 48% were interested in learning more. While 67% of respondents are interested in providing more services for women at their pharmacy, they also reported obstacles like lack of time and staff.</div></div><div><h3>Conclusion</h3><div>There is a need to raise awareness about maternal mortality and maternity care deserts among Ohio community pharmacists. Given the interest expressed in providing additional services, pharmacists should receive more support to provide needed care for medically-underserved populations.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102292"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631388","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":"Implementation of an adult life-course vaccine review service, VaxCheck, in community pharmacy: A qualitative analysis","authors":"Elizabeth Vernon-Wilson,&nbsp;Michaela L. Comrie,&nbsp;Kyla Barrera,&nbsp;Molly Yang,&nbsp;Lisa Dolovich,&nbsp;Nancy M. Waite,&nbsp;Sherilyn K.D. Houle","doi":"10.1016/j.japh.2024.102294","DOIUrl":"10.1016/j.japh.2024.102294","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists are well placed to identify and vaccinate unimmunized or under-immunized individuals who can put themselves and communities at risk of preventable disease. We designed and tested VaxCheck, a novel life-course vaccine review service that can be used to raise awareness and guide personal vaccination action plans, in community pharmacies in Ontario, Canada.</div></div><div><h3>Objective</h3><div>To understand the experiences of community pharmacists and staff directly involved with providing the VaxCheck service as part of initial testing.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were performed with pharmacy staff from 9 pharmacies who participated in the study. Interviews were conducted at baseline and following each of 3 Plan-Do-Study-Act quality improvement cycles. Activities undertaken to perform VaxCheck were assessed. An inductive thematic analysis was performed to identify dominant themes and subthemes. Activities and descriptive codes were then correlated to the Consolidated Framework for Implementation Research (CFIR).</div></div><div><h3>Results</h3><div>Twenty-six interviews were conducted. Pharmacy staff described VaxCheck activities as spanning 3 stages: (1) Promotion/offering of VaxCheck, (2) Completing the VaxCheck, and (3) Enacting recommendations and follow-up. VaxCheck activities were compatible with workflow related to delivery of other vaccines and medication reviews. Thematic analysis found 3 considerations guided VaxCheck adoption: (1) Aligning VaxCheck with workflow through flexible integration, (2) Enabling patient-oriented vaccination services, and (3) Contributing to community healthcare provision. Data aligned with all CFIR domains with strengths noted in constructs from the “Innovation characteristics” and “Individuals” domains. Barriers to implementation were identified in “Inner setting,” “Outer setting,” and “Process” domains, such as pharmacy workflow capacity, patient knowledge about vaccination, availability of vaccine records, and interactions with other healthcare providers.</div></div><div><h3>Conclusion</h3><div>Community pharmacists found VaxCheck to be a valuable, accessible service that was well-received by patients and supported adult vaccination reviews and individualized recommendations. VaxCheck was compatible with pharmacy workflow but needed additional resources for sustainability and promotion with stakeholders.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102294"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631435","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":"The role of pharmacy in promoting public health: Pharmacy and public health in 2050","authors":"Mark A. Strand","doi":"10.1016/j.japh.2024.102272","DOIUrl":"10.1016/j.japh.2024.102272","url":null,"abstract":"<div><div>From 2000 to 2025, the profession of pharmacy expanded into vaccinations, point-of-care testing, and chronic disease prevention and management. In the next 25 years, pharmacy will continue to advance in new ways. This paper focuses on expanded roles of community and ambulatory care pharmacy to more directly improve public health. Built around the ten essential services of public health, this paper calls upon the profession of pharmacy to stretch beyond traditional roles to assume roles that would strengthen the public health workforce and make seminal contributions to improved population health. Barriers to be overcome in pursuit of that future are also addressed. The paper will conclude with a public health-focused call to pharmacy.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102272"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631456","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":"Vaccination payments in states with provider status for pharmacists: A claims analysis","authors":"Rachel Wittenauer,&nbsp;Jennifer L. Bacci,&nbsp;Parth D. Shah,&nbsp;Andy Stergachis","doi":"10.1016/j.japh.2024.102301","DOIUrl":"10.1016/j.japh.2024.102301","url":null,"abstract":"<div><h3>Background</h3><div>Federal-level legislation to recognize pharmacists as providers and thus allow insurance reimbursement for health services claims, not just prescription drug claims (known as provider status), has been advocated for by the profession but is yet to be passed into federal law. Several state governments have enacted this recognition for commercial insurance and/or Medicaid plans. However, the impact of these laws on reimbursement and access to health services has yet to be explored empirically.</div></div><div><h3>Objective</h3><div>Compare commercial reimbursements for influenza and herpes zoster vaccinations for adults in provider status vs. non-provider status states to determine whether these laws have had the intended effect of increasing reimbursement to pharmacists for provided services.</div></div><div><h3>Methods</h3><div>We used pharmaceutical and outpatient services claims from a national claims database, Marketscan, to examine payments made to pharmacies for all codes billed during vaccination visits. We then used a multivariable logistic regression model to compare the net revenue of vaccination visits in commercial provider status states vs. non-commercial provider-status states.</div></div><div><h3>Results</h3><div>Our dataset contained 2.3 million vaccination visits for influenza and herpes zoster during 2021–2022. We found that the odds of a vaccination visit having positive net revenue were slightly higher in provider status states (shingles odds ratio [OR]: 1.03, <em>P</em> &lt; 0.001; influenza OR 1.01:, <em>P</em> &lt; 0.001). These findings are limited by the stark lack of health services claims by pharmacies in our dataset; only 0.4% of visits included any outpatient services claims, even among provider status states.</div></div><div><h3>Conclusion</h3><div>This indicates that pharmacists are not submitting claims for reimbursement to payors for health services they are providing. This absence could be due to several reasons and limits the ability to generate evidence about the effect of these laws on health and economic outcomes for patients and health systems. Further research is needed to identify and address barriers to implementation of provider status laws.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102301"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711181","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":"Unlocking the future of patient Education: ChatGPT vs. LexiComp® as sources of patient education materials","authors":"Elizabeth W. Covington,&nbsp;Courtney S. Watts Alexander,&nbsp;Jeanna Sewell,&nbsp;Amber M. Hutchison,&nbsp;Julie Kay,&nbsp;Lucy Tocco,&nbsp;Melanie Hyte","doi":"10.1016/j.japh.2024.102119","DOIUrl":"10.1016/j.japh.2024.102119","url":null,"abstract":"<div><h3>Background</h3><div>ChatGPT is a conversational artificial intelligence technology that has shown application in various facets of healthcare. With the increased use of AI, it is imperative to assess the accuracy and comprehensibility of AI platforms.</div></div><div><h3>Objective</h3><div>This pilot project aimed to assess the understandability, readability, and accuracy of ChatGPT as a source of medication-related patient education as compared with an evidence-based medicine tertiary reference resource, LexiComp®.</div></div><div><h3>Methods</h3><div>Patient education materials (PEMs) were obtained from ChatGPT and LexiComp® for 8 common medications (albuterol, apixaban, atorvastatin, hydrocodone/acetaminophen, insulin glargine, levofloxacin, omeprazole, and sacubitril/valsartan). PEMs were extracted, blinded, and assessed by 2 investigators independently. The primary outcome was a comparison of the Patient Education Materials Assessment Tool-printable (PEMAT-P). Secondary outcomes included Flesch reading ease, Flesch Kincaid grade level, percent passive sentences, word count, and accuracy. A 7-item accuracy checklist for each medication was generated by expert consensus among pharmacist investigators, with LexiComp® PEMs serving as the control. PEMAT-P interrater reliability was determined via intraclass correlation coefficient (ICC). Flesch reading ease, Flesch Kincaid grade level, percent passive sentences, and word count were calculated by Microsoft® Word®. Continuous data were assessed using the Student’s t-test via SPSS (version 20.0).</div></div><div><h3>Results</h3><div>No difference was found in the PEMAT-P understandability score of PEMs produced by ChatGPT versus LexiComp® [77.9% (11.0) vs. 72.5% (2.4), <em>P</em>=0.193]. Reading level was higher with ChatGPT [8.6 (1.2) vs. 5.6 (0.3), <em>P</em> &lt; 0.001). ChatGPT PEMs had a lower percentage of passive sentences and lower word count. The average accuracy score of ChatGPT PEMs was 4.25/7 (61%), with scores ranging from 29% to 86%.</div></div><div><h3>Conclusion</h3><div>Despite comparable PEMAT-P scores, ChatGPT PEMs did not meet grade level targets. Lower word count and passive text with ChatGPT PEMs could benefit patients, but the variable accuracy scores prevent routine use of ChatGPT to produce medication-related PEMs at this time.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102119"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905226","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":"Implementation of a specialty pharmacy in an ambulatory care setting in Saudi Arabia: Patient experience and operational outcomes","authors":"Abdulrazaq S. Al-Jazairi,&nbsp;Roa'a Al-Gain,&nbsp;Nasser I. Alrubayan,&nbsp;Alhanouf F. Almousa,&nbsp;Lina M. Aldawood,&nbsp;Reem A. Alshammari,&nbsp;Ghayda H. Alzaidi,&nbsp;Qasem A. Bahri,&nbsp;Sakra S. Balhareth,&nbsp;Norah Almalhooq,&nbsp;Yousef Binamer,&nbsp;Hisham Alomran","doi":"10.1016/j.japh.2024.102302","DOIUrl":"10.1016/j.japh.2024.102302","url":null,"abstract":"<div><h3>Background</h3><div>Specialty pharmacy practice requires unique patient-centric care, emphasizing high-cost medications, complex treatment regimens, and medications requiring special handling.</div></div><div><h3>Objective</h3><div>We conducted this study to assess the effect of specialty pharmacy practice on patient and healthcare provider (HCP) satisfaction and pharmacy practice–related outcomes.</div></div><div><h3>Methods</h3><div>This prospective, concurrent, and historically controlled cohort study was performed in an ambulatory care setting for over 6 months and included 6 specialties: neurology, pediatrics, dermatology, gastroenterology, pediatric liver transplantation, and medical genetics. The workflow of the pharmacy was redesigned to serve the objective of specialized counseling and dispensing windows. Patients who visited selected clinics during the study period were included. The primary endpoint was the weighted scores for patient and HCP satisfaction obtained via a validated satisfaction survey. The secondary endpoints included pharmacy operation-related outcomes, such as patient's waiting time, pharmacist intervention, and patient adherence to specialty medications.</div></div><div><h3>Results</h3><div>Of the 3827 patients approached for study participation, 3620 were recruited (94.5%). Of the 175 HCPs approached, 161 were recruited. Patient satisfaction scores improved from 4.27 to 4.69 after intervention (<em>P</em> &lt; 0.05). Although there was no significant change in pharmacists’ satisfaction, a significant improvement in other HCP satisfaction was observed (3.7–4; <em>P</em> = 0.008). The average wait time was reduced from 25 to 12 min (<em>P</em> &lt; 0.05). The number of documented pharmacist interventions was 3 per 100 patients. Patient adherence improved from 73.6% to 85.6% based on the number of days covered (<em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Implementing specialty pharmacies improved the overall satisfaction of patients and health care providers and enhanced work efficiency, as demonstrated by reduced pharmacy waiting time and patient adherence to specialty medications.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102302"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774261","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":"Exploring the pharmacist role in insomnia management and care provision: A scoping review","authors":"Mariam M. Basheti,&nbsp;Christopher Gordon,&nbsp;Ronald Grunstein,&nbsp;Bandana Saini","doi":"10.1016/j.japh.2024.102312","DOIUrl":"10.1016/j.japh.2024.102312","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately 30% in adults. Insomnia has negative effects on daily functioning and can play a pivotal role in the development and progression of comorbid mental and physical disease. Therefore, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in care provision, would be able to alleviate the burden of insomnia in the community by delivering evidence-based management.</div></div><div><h3>Objective</h3><div>To describe the current practice and potential roles of pharmacists in insomnia management.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed in this scoping exercise. An extensive search of 5 databases (MEDLINE, Embase, Scopus, IPA, and CINAHL) was conducted, generating 1057 initial results. Titles, abstracts, and full-text articles were screened in a two-step process to identify relevant studies for review inclusion. Studies reporting on insomnia management by pharmacists in primary care settings were included in the review. Articles were reviewed and data extracted, analyzed, and grouped categorically based on study design.</div></div><div><h3>Results</h3><div>Twenty-eight studies met inclusion criteria with 5 qualitative, 8 observational and 15 interventional studies. Over a third of the studies were conducted in Australia (n = 11). Insomnia management across these studies ranged from 1) screening/assessment services (n = 5), 2) pharmacological and nonpharmacological care provision (n = 16), and 3) sedative-hypnotic deprescribing services (n = 7). It was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending cognitive behavioral therapy as first-line. The results show that with adequate training and education, pharmacists have the potential to provide insomnia screening, behavioral therapy, and pharmacological deprescribing services, improving overall insomnia management in primary care.</div></div><div><h3>Conclusion</h3><div>The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for expanded roles and improved care provision when pharmacists are upskilled with specialized training/education.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102312"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822660","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}