American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists最新文献

{"title":"Development and validation of a prior-to-admission medication list risk scoring tool.","authors":"Scott D Nelson, Mollie Hobensack, L Montana Fleenor, Lauren McCluggage, Halden Z VanCleave, Allison B McCoy, Wing Liu, Adam Wright","doi":"10.1093/ajhp/zxag311","DOIUrl":"https://doi.org/10.1093/ajhp/zxag311","url":null,"abstract":"<p><strong>Purpose: </strong>To develop, validate, and implement an admission predictive model that estimates the likelihood and expected number of changes to the prior-to-admission (PTA) medication list, to help triage pharmacy-led medication histories.</p><p><strong>Methods: </strong>We performed a retrospective study of adult admissions at a large academic medical center (2019-2025). Using electronic health record (EHR) data available at admission, we built a 2-stage (\"hurdle\") gradient-boosted tree model: Stage 1 predicts whether any PTA list changes will occur; stage 2 predicts the number of changes among encounters with 1 or more changes. The primary outcome was a weighted count of PTA list changes (additions, deletions, and modifications), with triple weight for prespecified high-risk medication classes. We evaluated discrimination, calibration, count error, and capacity-aware ranking (eg, precision at 25%, capture at 25%). Fairness analyses examined performance across age, sex at birth, and race.</p><p><strong>Results: </strong>Among 402,023 encounters, 33.1% had no PTA medication list discrepancies. Stage 1 achieved an area under the curve of 0.816 and an area under the precision-recall curve of 0.886; probability calibration was acceptable (log loss, 0.479; Brier score, 0.15). For stage 2, the mean absolute error was 3.6 and the root mean square error (RMSE) was 5.2; log1p-RMSE was 0.63. Under a 25% review capacity, precision was 90.6% and capture was 57.4% (normalized discounted cumulative gain was 0.762).</p><p><strong>Conclusion: </strong>A 2-stage, calibration-aware model using admission-available EHR data can effectively prioritize patients who are most likely to need pharmacist-obtained medication histories, supporting more efficient use of scarce pharmacy resources.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043347","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":"Patient Perspectives on a Proposed Pharmacist-Led Hypertension Management Program Following Emergency Department Discharge.","authors":"Diane Kuhn, Erika R Cheng, Nithika Sanghi, Terri Wada, Janeth Castano, Paul I Musey","doi":"10.1093/ajhp/zxag303","DOIUrl":"https://doi.org/10.1093/ajhp/zxag303","url":null,"abstract":"<p><strong>Background: </strong>Hypertension contributes substantially to morbidity and mortality, yet patients who rely on the emergency department (ED) may experience gaps in blood pressure management. Although pharmacist-led hypertension programs can improve blood pressure, little is known about ED patients' perspectives. We explored patient perspectives regarding the acceptability of pharmacist-led hypertension management after ED discharge.</p><p><strong>Methods: </strong>We conducted a qualitative study of adults presenting to an urban academic ED from September-December 2025 with likely undiagnosed or undertreated hypertension. Semi-structured interviews examined experiences managing hypertension, communication preferences, and perspectives on pharmacist-led follow-up. Transcripts underwent thematic analysis incorporating deductive and inductive coding.</p><p><strong>Results: </strong>Eleven participants completed interviews. Four themes were identified: limited hypertension-related communication and knowledge gaps, technology mitigating barriers to blood pressure management, pharmacists' expertise and scope, and the importance of rapport and accessibility. Participants described competing responsibilities, time constraints, and limited discussion of hypertension during ED visits. Many favored technology-enabled communication and home monitoring. Most viewed pharmacist-led follow-up favorably because of pharmacists' medication expertise and accessibility, but some expressed uncertainty about pharmacists' clinical training, prescribing authority, and accountability. Participants also valued continuity and collaboration between pharmacists and physicians.</p><p><strong>Conclusion: </strong>In this small sample, most participants viewed pharmacist-led hypertension management after ED discharge favorably while identifying factors that may affect acceptance. Programs should clearly communicate pharmacists' qualifications and scope, make physician collaboration visible, and balance convenient technology-enabled care with relational continuity.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043331","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":"Assessing Impact of Health System Specialty Pharmacy Support on Initiation of Vigabatrin Therapy for Infantile Epileptic Spasms Syndrome.","authors":"Jillian Gould, Kayla Petkus, John R Mytinger, Dana M Wilkerson, Becky Nugent, Taylor M Duque","doi":"10.1093/ajhp/zxag304","DOIUrl":"https://doi.org/10.1093/ajhp/zxag304","url":null,"abstract":"<p><strong>Purpose: </strong>Infantile epileptic spasms syndrome (IESS) is a severe form of pediatric epilepsy requiring urgent diagnosis and treatment. Vigabatrin is a standard therapy but often requires inpatient initiation because of delays in outpatient access due to prior authorization (PA) requirements and distribution restrictions. The primary objective was to determine if a proactive vigabatrin PA workflow through health system specialty pharmacy (HSSP) reduced hospital admission for treatment initiation. This study also explored the time from vigabatrin initiation to PA approval and the number of patients starting vigabatrin within 14 days of prior treatment.</p><p><strong>Methods: </strong>This retrospective, single-center study evaluated patients aged one month to two years with new-onset IESS and treated with vigabatrin. Patients treated between May 1, 2019, and December 31, 2024, were compared with those treated between March 1, 2025, and December 31, 2025. Demographic, clinical, and medication access data were analyzed using descriptive and comparative statistics.</p><p><strong>Results: </strong>Each cohort contained 19 patients with similar baseline characteristics. Hospital admissions for vigabatrin initiation decreased from 57.9% to 5.3% (p < 0.001). In the pre-intervention cohort, PA approval occurred on the day of vigabatrin initiation, whereas in the post-intervention cohort approval occurred a median of 5 days before initiation (p = 0.04). The number of patients starting vigabatrin within 14 days of first treatment was similar between cohorts (12 and 13 respectively, p = 0.73).</p><p><strong>Conclusions: </strong>Implementation of a HSSP-driven proactive PA workflow significantly reduced hospital admissions for vigabatrin initiation and permitted earlier PA approval supporting HSSP integration for time-sensitive therapies.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043275","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 vancomycin Bayesian dose-optimizing software in a neonatal intensive care unit population.","authors":"Chelsey Ivy, Paige Grube, Li Lin, Emily McTish, Brianna Hemmann","doi":"10.1093/ajhp/zxag313","DOIUrl":"https://doi.org/10.1093/ajhp/zxag313","url":null,"abstract":"<p><strong>Purpose: </strong>Infectious Diseases Society of America 2020 guidelines recommend Bayesian-guided area under the curve (AUC) monitoring for vancomycin dosing in pediatric patients. Our institution's neonatal intensive care unit (NICU) utilizes single-level kinetics to monitor AUC using 2 pharmacokinetic models validated in neonates and infants. Anecdotally, preterm infants corrected to a higher postmenstrual age (PMA) may be better suited to the pediatric dosing model (PDM) versus the neonatal dosing model (NDM). This study aims to identify which model is best suited to the NICU population based on factors including gestational age (GA), postnatal age (PNA), and PMA.</p><p><strong>Methods: </strong>A retrospective review including 64 NICU patients who received vancomycin was conducted. Measured vancomycin trough concentrations were compared to Bayesian model predictions using both the NDM and PDM. Model performance was evaluated using median absolute prediction error and stratified by GA, PNA, and PMA. Predicted AUC and pharmacokinetic parameters were also compared between models.</p><p><strong>Results: </strong>The PDM had greater predictive accuracy and less variability in trough concentrations across GA and PNA groups when compared to the NDM. Stratified analysis showed that the PDM was most accurate in term infants and those with a PMA of <29 or >52 weeks. The NDM consistently overpredicted trough levels in extremely preterm and early postnatal infants, leading to larger AUC discrepancies. Alternative models may improve predictive performance, particularly in high-risk neonatal subgroups.</p><p><strong>Conclusion: </strong>The PDM had superior predictive performance when compared to the NDM. Use of the PDM may improve vancomycin dosing accuracy in NICU patients, especially those with more advanced PMA.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043257","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":"Impact of a rural dual-credit high school and college pharmacy technician program with an associate degree pathway on a community hospital and region.","authors":"Elyssa J Bredeson, Maari Loy, Lori Crandall, Amanda Meyer, Brandi Sillerud, Lisa M Richter","doi":"10.1093/ajhp/zxag271","DOIUrl":"https://doi.org/10.1093/ajhp/zxag271","url":null,"abstract":"<p><strong>Purpose: </strong>Pharmacy technicians play an expanding role in clinical support and operational services, yet workforce instability and inconsistent training standards continue to challenge the profession. A highly trained and stable pharmacy technician workforce is essential to achieving the American Society of Health-system Pharmacists (ASHP) Practice Advancement Initiative (PAI) 2030's vision of comprehensive medication management in pharmacy practice. A dual-credit high school and college pharmacy technician program with an associate degree pathway may improve entry-level competency, support professional advancement, and strengthen the pharmacy technician workforce. However, evidence evaluating secondary-level dual-credit pharmacy technician programs remains limited.</p><p><strong>Methods: </strong>A retrospective evaluation of a dual-credit pharmacy technician education program was implemented at a community hospital. Outcomes before implementation were compared with outcomes after program implementation.</p><p><strong>Results: </strong>Comparison of turnover rates showed a statistically significant reduction in turnover following program implementation (χ2(1) =3.89; P=0.048). Pharmacy technician staffing increased from 14.8 full-time equivalents (FTE) pre-implementation to 16.7 FTE post-implementation and an 80% reduction in overtime hours. Professional advancement of pharmacy technicians with career ladder advancement events increased from eight to 16. Estimated program-associated savings resulted in a return on investment of $111,068.</p><p><strong>Conclusion: </strong>Implementation of a rural dual-credit pharmacy technician program with a track to pharmacy technology associate degree training was associated with improved staffing capacity, reduced overtime hours, increased professional advancement, and favorable financial impact. Early accredited training may be a scalable strategy to strengthen the pharmacy technician workforce in rural health systems.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043315","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":"Comparison of Vancomycin Pharmacokinetics Between Ischemic and Hemorrhagic Stroke.","authors":"Adam L Roskam, David S Burgess, Donna R Burgess, Katie M Ruf, Aaron M Cook","doi":"10.1093/ajhp/zxag295","DOIUrl":"https://doi.org/10.1093/ajhp/zxag295","url":null,"abstract":"<p><strong>Purpose: </strong>Acute stroke patients can demonstrate either augmented renal clearance (ARC) or acute/chronic kidney injury, affecting their clearance of vancomycin. This study assessed the pharmacokinetic parameters of vancomycin in stroke patients.</p><p><strong>Methods: </strong>A single-center retrospective, observational, cohort study was conducted to assess pharmacokinetic parameters of vancomycin in stroke patients from June 2021 through June 2024. Evaluation of population pharmacokinetic parameters was completed using Lixoft Monolix Suite (2024R1). Analyses were performed comparing pharmacokinetic parameters among different stroke types and Augmented Renal Clearance in Trauma Intensive Care (ARCTIC) scores ≥6 vs. <6.</p><p><strong>Results: </strong>There were 95 patients included in this study. Forty-six patients (48.4%) presented with acute ischemic stroke, 49 (51.6%) had hemorrhagic stroke. The total daily dose of vancomycin was 27.2 ± 7.8mg/kg/day. Between ischemic and hemorrhagic stroke, differences were seen in clearance (4.36L/hr vs. 5.30L/hr; p=0.018) and AUC0-24 (518.9µg/mL*hr vs. 454.5µg/mL*hr, p=0.038). Patients with an ARCTIC score ≥ 6 had a significantly higher elimination constant (0.105hr-1 vs. 0.070hr-1, p<0.001), shorter half-life (7.3hr vs. 12.1hr, p<0.001), smaller volume of distribution (0.63L/kg vs. 0.70L/kg, p=0.026), and faster systemic clearance (5.46L/hr vs. 4.10L/hr, p<0.001) than patients with an ARCTIC score <6.</p><p><strong>Conclusions: </strong>In this study, patients with the hemorrhagic stroke subtype had significantly higher clearance and lower AUC0-24 compared to ischemic stroke. While the mean AUC0-24 in both groups was within goal range, likely indicating individualized dosing practices, there was high variability in AUC0-24 in this stroke population. This study demonstrates the need for close TDM of vancomycin in the stroke population.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043286","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":"Use of antiobesity medications in a bariatric surgery population: A collaborative approach with ambulatory care pharmacy services.","authors":"Veronica Arceri, Jenna Lee, John Morton, Marie Renauer","doi":"10.1093/ajhp/zxag307","DOIUrl":"https://doi.org/10.1093/ajhp/zxag307","url":null,"abstract":"<p><strong>Purpose: </strong>Antiobesity medications (AOMs) are increasingly utilized in patients before and after bariatric surgery. However, patients experience challenges to initiating and continuing these medications, leading to high real-world rates of discontinuation. We describe collaboration between an ambulatory care pharmacy service and bariatric surgeons as an opportunity to enhance patient care and medication access, with the collaboration encompassing ambulatory care pharmacists, pharmacy technicians, surgeons, advanced practice providers, and clinic support staff. The strategies employed to design, implement, and optimize patient care to meet the increasing demand for support with AOMs are discussed.</p><p><strong>Summary: </strong>The workflow incorporated key activities from highly diverse existing ambulatory care pharmacy and bariatric surgery practices. Resources utilized included an electronic pharmacy referral, collaborative practice agreements, and facilitation of medication access, including through completion of prior authorizations. Enhancements focused on coordination of visits to stagger the timing of follow-up visits, providing support to patients through insurance and coverage challenges, and communication to allow the pharmacy team to focus on all medication-related challenges while triaging other concerns to the multidisciplinary team. A pilot program to assess feasibility was implemented with a single pharmacist in August 2022, and the workflow was expanded by the end of 2024 to include 4 ambulatory care pharmacists and 2 pharmacy technicians collaborating with every bariatric surgeon in a large academic health system.</p><p><strong>Conclusion: </strong>The collaboration created a workflow to support an interdisciplinary standard of care for patients utilizing AOMs before and after bariatric surgery. This implementation approach can serve as a roadmap for other healthcare systems to support use of AOMs.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043297","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":"Clinical Experience with Oral Fecal Microbiota Spores (Vowst®) in a Health System Specialty Pharmacy.","authors":"Stormmy R Boettcher, Rachel M Kenney, Nathan A Everson, Ivan Kashat, Amanda Soyad, Grant Tengler, Mayur Ramesh, Michael P Veve","doi":"10.1093/ajhp/zxag293","DOIUrl":"https://doi.org/10.1093/ajhp/zxag293","url":null,"abstract":"<p><strong>Purpose: </strong>To describe clinical experience and patient outcomes with orally administered fecal microbiota spore (FMS) capsules, live-brpk, for prevention of recurrent Clostridioides difficile infection (rCDI) after workflow implementation into a local health-system specialty pharmacy (HSSP) model.</p><p><strong>Summary: </strong>rCDI carries substantial morbidity, and the approval of orally administered FMS capsules introduced a novel prevention option with new challenges in medication access, prior authorization, and cost. To meet this need, an HSSP workflow was adapted to support acquisition of FMS for adults receiving a prescription order. Over the period from June 1, 2023, through December 31, 2024, a total of 72 FMS prescriptions were generated for 50 patients, of which 29 (58%) ultimately obtained the medication. Patients reflected a real-world population, the median (IQR) age was 70 (55-79) years, 55% were men, the median (IQR) number of previous CDI episodes (including the proximal episode) was 2 (1-3), and 25% were immunocompromised. Among patients who received FMS, rCDI occurred in 2 (7%) patients at eight weeks. Of the 21 prescriptions obtained through the HSSP, 62% required a single prior authorization (PA) attempt, and the median (IQR) time to dispensing from prescription generation was 16 (12-20) days. Copayments ranged from $0 to >$2,500, with most patients (18, 86%) receiving FMS for less than $6.</p><p><strong>Conclusion: </strong>Implementation of an adapted HSSP FMS medication workflow resulted in medication access for more than half of patients and offers a practical, adaptable model for integrating high-cost microbiome therapies into specialty pharmacy practice.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019450","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":"Honorary Fellow Recognition of Pharmacists in Critical Care.","authors":"Brian L Erstad, Christopher K Finch","doi":"10.1093/ajhp/zxag300","DOIUrl":"https://doi.org/10.1093/ajhp/zxag300","url":null,"abstract":"<p><p>Honorary Fellow status is among the highest recognitions granted by professional societies and signifies sustained contributions to clinical practice, scholarship, leadership, and advancement of a specialty. This recognition was awarded to pharmacists soon after it became available to members of the Society of Critical Care Medicine. The percentage of pharmacists receiving honorary Fellow designation by the Society of Critical Care Medicine currently exceeds that of the organization's general membership. However, Fellow recognition of pharmacists in other critical care organizations demonstrates room for improvement.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018985","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":"TBDs: To test or not test.","authors":"Michelle Murray","doi":"10.1093/ajhp/zxag296","DOIUrl":"https://doi.org/10.1093/ajhp/zxag296","url":null,"abstract":"<p><p>This is a personal reflection on my and my family's experience with Telomere Biology Disorders (TBDs). This reviews the journey from identifying a familial pattern with idiopathic pulmonary fibrosis to identifying a genetic cause and a specific gene mutation. It also discusses the journey for the author from wanting to not know whether they had the genetic mutation to deciding to test for TBD and the gene. The reflection also discusses how I have dealt with the grief of losing my father and sister to this disease.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019096","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}