British journal of clinical pharmacology最新文献

{"title":"Contribution of Addictovigilance data to assess adverse-events linked to psychoactive substances in children and adolescents.","authors":"Hélène Peyrière, Anne Batisse, Nathalie Fouilhé Sam-Laï, Amélie Daveluy, Christine Fournier-Choma, Sylvie Deheul, Cécile Chevalier, Clémence Lacroix, Valérie Gibaja, Aurélie Aquizerate, Stéphanie Pain, Emilie Jouanjus, Marie-Christine Picot, Erika Nogue","doi":"10.1002/bcp.70133","DOIUrl":"https://doi.org/10.1002/bcp.70133","url":null,"abstract":"<p><strong>Aims: </strong>We sought to characterize adverse events and deaths associated with the use of psychoactive substances in children and adolescents.</p><p><strong>Methods: </strong>Two French Addictovigilance databases were analysed: spontaneous reports and deaths over the period 2016-2021, in subjects aged 10-<18 years. An unsupervised classification was implemented on consumption data (medications or nondrug substances [NDS]) to identify subject clusters.</p><p><strong>Results: </strong>A total of 1544 spontaneous reports were analysed, comprising mainly boys (65.6%), aged on average 16 ± 1 years. Four clusters were identified: The cannabinoids users cluster (n = 597) was typified by the use of cannabis or/and synthetic cannabinoids (95.1%), with psychiatric (67.7%) and digestive disorders (16.7%). The medications/solvents/cannabidiol users cluster (n = 699) was distinguished by the use of medications or NDS including nitrous oxide/cannabidiol, with mainly neurological disorders (46.5%). The polydrug users cluster (n = 177) includes polyusers (98.3%) of NDS and medications. These users mainly have substance use disorders (63.8%). The psychotropic medications users cluster (n = 71) was characterized by the use of psychotropic medications. This cluster appeared to be correlated with psychiatric and organic disorders. The death database recorded 44 deaths, mainly in boys (61.4%) aged over 15 years. The main substances involved in the deaths were NDS (70.5%) and methadone. In 68.2% of cases, a single substance was responsible for the death.</p><p><strong>Conclusion: </strong>The adverse events related to the abuse of psychoactive substances identified in children and adolescents and the emerging signals show the need for increased surveillance and the implementation of prevention campaigns adapted to each group of consumers.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravesical antimicrobial administration for urinary tract infections via a dedicated catheter.","authors":"John Posner","doi":"10.1002/bcp.70124","DOIUrl":"https://doi.org/10.1002/bcp.70124","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral vancomycin solution is superior to capsule in inducing clinical biomarker and endoscopic remission in children with atypical ulcerative colitis.","authors":"Laura Räisänen, Fariha Balouch, Claire Reilly, Christopher Burgess, Peter Lewindon","doi":"10.1002/bcp.70121","DOIUrl":"10.1002/bcp.70121","url":null,"abstract":"<p><strong>Aims: </strong>Atypical colitis (presenting reverse gradient colitis, backwash ileitis or rectal sparing) is associated with primary sclerosing cholangitis-ulcerative colitis (PSC). Oral vancomycin has been used to manage paediatric atypical colitis with/without confirmed PSC. Different preparations had shown different efficacy. We compared oral vancomycin solution to capsules in inducing remission in children with atypical colitis, while assessing other potential confounders.</p><p><strong>Methods: </strong>Children using oral vancomycin for at least 3 months to manage atypical colitis were retrospectively identified. Factors associated with colitis remission (Paediatric Ulcerative Colitis Activity Index [PUCAI], faecal calprotectin, colonoscopy and histology) were explored.</p><p><strong>Results: </strong>Of 32/48 children with elevated PUCAI, 27/32 achieved PUCAI < 10 (20/23 after solution vs. 7/9 after capsules, P = .520). Faecal calprotectin <100 μg/g was achieved in 35/48 (28/35 after solution vs. 6/13 after capsules, P = .022). Follow-up colonoscopy during treatment (n = 25) showed reduced Mayo from median 2 to 0 (P < .001) after solution vs. from 2 to 1 (P = .257) after capsules. Pan-colonic histological remission was seen in 14/25 (12/20 after solution vs. 1/5 after capsules, P = .109). In adjusted analysis, use of oral vancomycin solution was a significant predictor for biomarker (adjusted odds ratio 23.1, 95% confidence interval 2.11-253) and pan-colonic histological remission (adjusted odds ratio 900, 95% confidence interval 1.61-504 929). No other predictors were identified. Within 12 months after ceasing oral vancomycin in children who achieved remission, 52% relapsed. No clinical predictors, including vancomycin preparation, were established.</p><p><strong>Conclusion: </strong>Oral vancomycin solution was superior to capsules for inducing biomarker and colonoscopic remission in children with atypical colitis with/without confirmed PSC. This finding warrants further investigation to ensure optimal use.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and leveraging large language models in clinical pharmacology and therapeutics assessment: From exam takers to exam shapers.","authors":"Alexandre O Gérard, Diane Merino, Marc Labriffe, Fanny Rocher, Delphine Viard, Laurence Zemori, Thibaud Lavrut, Erik M Donker, Joost D Piët, Jean-Paul Fournier, Milou-Daniel Drici, Alexandre Destere","doi":"10.1002/bcp.70137","DOIUrl":"https://doi.org/10.1002/bcp.70137","url":null,"abstract":"<p><strong>Aims: </strong>In medical education, the ability of large language models (LLMs) to match human performance raises questions about their potential as educational tools. This study evaluates LLMs' performance on Clinical Pharmacology and Therapeutics (CPT) exams, comparing their results to medical students and exploring their ability to identify poorly formulated multiple-choice questions (MCQs).</p><p><strong>Methods: </strong>ChatGPT-4 Omni, Gemini Advanced, Le Chat and DeepSeek R1 were tested on local CPT exams (third year of bachelor's degree, first/second year of master's degree) and the European Prescribing Exam (EuroPE⁺). The exams included MCQs and open-ended questions assessing knowledge and prescribing skills. LLM results were analysed using the same scoring system as students. A confusion matrix was used to evaluate the ability of ChatGPT and Gemini to identify ambiguous/erroneous MCQs.</p><p><strong>Results: </strong>LLMs achieved comparable or superior results to medical students across all levels. For local exams, LLMs outperformed M1 students and matched L3 and M2 students. In EuroPE⁺, LLMs significantly outperformed students in both the knowledge and prescribing skills sections. All LLM errors in EuroPE⁺ were genuine (100%), whereas local exam errors were frequently due to ambiguities or correction flaws (24.3%). When both ChatGPT and Gemini provided the same incorrect answer to an MCQ, the specificity for detecting ambiguous questions was 92.9%, with a negative predictive value of 85.5%.</p><p><strong>Conclusion: </strong>LLMs demonstrate capabilities comparable to or exceeding medical students in CPT exams. Their ability to flag potentially flawed MCQs highlights their value not only as educational tools but also as quality control instruments in exam preparation.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a preprescribing formative assessment on learning in final-year medical students using hospital inpatient electronic prescribing systems.","authors":"Kellie A Charles, Lorna Pairman, Emily Moon, Daniel Wong, John Quayle, Tim J Wilkinson, Matthew Doogue, Paul Chin","doi":"10.1002/bcp.70126","DOIUrl":"https://doi.org/10.1002/bcp.70126","url":null,"abstract":"<p><strong>Aims: </strong>Graduating medical students consistently report being unprepared for the complexity of prescribing in clinical practice. Current clinical prescribing teaching and authentic assessment are limited due to patient safety concerns. We aimed to examine the educational utility of supervised preprescribing as a learning process and potential authentic workplace-based assessment.</p><p><strong>Methods: </strong>Student preprescriptions and student-authorized prescriptions were extracted from electronic prescribing and administration system data. Patient clinical records were reviewed to identify outcomes of student-authorized prescriptions. All prescription data were analysed with descriptive statistics. Current students, recent graduates (post-graduate year 1 doctors) and supervisors were interviewed to explore of educational impact of supervised preprescribing by inductive reflexive thematic analysis.</p><p><strong>Results: </strong>The live electronic prescribing and administration system was used by 355/370 students over 4 academic years (23 November 2020-19 November 2024). They created 25 324 preprescriptions in 3268 patients. Supervising doctors promoted/authorized 58% (14 684/25324) to live prescriptions. Of 296 student-authorized prescriptions, 33% (97/296) were administered to patients, and only 3% (8/296) were not potentially appropriate. No adverse drug reactions to these 8 prescriptions were documented. The preprescribing model was found to benefit student learning, confidence and identity through 5 themes: Practice, practice, practice, Prescribing with support, Conquering time, Safety protected and Becoming a real medical doctor.</p><p><strong>Discussion: </strong>Supervised preprescribing within clinical settings is feasible and improves student prescribing confidence. Human and system mechanisms managed patient safety concerns and facilitated safe, authentic student preprescribing. This supports inclusion of formative assessment, in the form of supervised preprescribing as authentic workplace-based learning of prescribing.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond right or wrong: How partial credit scoring on multiple-choice questions improves student performance and assessment perceptions.","authors":"Stephen D Schneid, Chris Armour, Katharina Brandl","doi":"10.1002/bcp.70127","DOIUrl":"https://doi.org/10.1002/bcp.70127","url":null,"abstract":"<p><strong>Aims: </strong>In this study, we examined the effects of assigning partial credit to selected answer choices on student performance and perceptions in a pharmacology course using Type A multiple-choice questions (MCQs).</p><p><strong>Methods: </strong>Partial credit scoring was incorporated into quizzes and exams in a 10-week pharmacology course for postbaccalaureate premedical students (n = 27). Selected Type A MCQs were scored using predetermined weights based on the proximity of each option to the best answer. Students selected a single best answer, maintaining the traditional MCQ format. We retrospectively recalculated scores using a conventional dichotomous grading for comparison. At the end of the course, students were asked, \"Did providing partial credit on multiple-choice questions impact your learning in a positive way?\" Responses were analysed using a grounded theory-based approach, with comments grouped into thematic categories.</p><p><strong>Results: </strong>Of the 105 Type A MCQs administered, 31 (30%) were awarded partial credit. The average percentage score on these items was significantly higher with partial credit (86.1%, standard deviation = 5.7%) compared to conventional scoring (76.5%, standard deviation = 9.1%; paired Student t-test, P < .0001). Students with lower performance showed greater score increases compared to high performing students. Qualitative analysis of student reflections provided insights into their experiences with partial scoring. Nine themes emerged from their responses including recognition of effort, reduced pressure, increased confidence and motivation to learn from mistakes.</p><p><strong>Conclusions: </strong>Partial credit scoring on MCQs improved student performance and contributed to a more encouraging assessment experience.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of oncology drugs with a conditional approval: A cross-sectional comparison of the Food and Drug Administration and Health Canada.","authors":"Joel Lexchin","doi":"10.1002/bcp.70135","DOIUrl":"https://doi.org/10.1002/bcp.70135","url":null,"abstract":"<p><strong>Aims: </strong>This study looks at the status of the same drugs conditionally approved by the Food and Drug Administration and Health Canada for the same oncology indication.</p><p><strong>Methods: </strong>Lists of oncology drugs with a conditional approval from the Food and Drug Administration and Health Canada were generated and drug pairs with the same indication were matched. Drugs were categorized by status (benefits verified, benefits not yet verified and withdrawn); the median length of time between approval and status was calculated and the 2 regulators were compared.</p><p><strong>Results: </strong>Eighty-nine drug pairs were analysed. Forty-five (50.6%) drugs had benefits verified by both regulators, 16 (18.0%) had benefits that were not yet verified by both regulators and 6 (6.7%) had been withdrawn by both regulators. The 45 drugs with verified benefits were on the US market for a median of 1120 days before verification compared to a median of 1345 days on the Canadian market (P = .1063, Mann-Whitney test). The 16 drugs with benefits not yet verified had been on the market in the USA for a median of 1373 days vs. a median of 1025 days in Canada (P = .3414, Mann-Whitney test). Out of 67 drugs with concordant status, 14 (20.9%) were on the US market for >1800 days and 27 (40.3%) were on the Canadian market for that length of time (P = .0127, z test).</p><p><strong>Conclusions: </strong>Reforms to conditional approval systems in both countries need to be made to reduce the time products are on the market without a final status.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure-response relationship of fedratinib in patients with intermediate-2 or high-risk myelofibrosis.","authors":"Yizhe Chen, Yan Li, Yongjun Xue, Patrick Brown, Christopher Hernandez, Shelonitda Rose, Richard Pilot, Gopal Krishna, Ken Ogasawara","doi":"10.1002/bcp.70118","DOIUrl":"https://doi.org/10.1002/bcp.70118","url":null,"abstract":"<p><strong>Aims: </strong>Fedratinib is a potent, oral, Janus kinase inhibitor for the treatment of myelofibrosis (MF). This report describes exposure-response (E-R) analyses of fedratinib based on pooled data from phase 2/3 studies in patients with intermediate-2 or high-risk MF, with or without prior ruxolitinib exposure.</p><p><strong>Methods: </strong>Pharmacokinetic (PK) exposures were derived from the population PK analysis. Efficacy endpoints included spleen volume reduction ≥35% (SVR35) and total symptom score reduction ≥50% (TSS response). Safety endpoints included grade ≥3 anaemia or thrombocytopenia, any-grade nausea/vomiting and diarrhoea. The E-R models were developed using logistic regression analyses.</p><p><strong>Results: </strong>Fedratinib exposure was positively associated with SVR35 (odds ratio [OR], 38.2; 95% confidence interval [CI], 12.4-118; P < 0.001) and TSS response (OR, 20.8; 95% CI, 6.27-69.2; P < 0.001), after adjusting for covariates. Baseline spleen volume was inversely associated with SVR35 (P = 0.029). Prior ruxolitinib exposure was not associated with SVR35 (P = 0.090) or TSS response (P = 0.326). Although numerically higher incidence of adverse events was observed in patients with higher fedratinib exposure, there was no statistically significant association between fedratinib exposure and any safety related endpoints. Prior ruxolitinib exposure was associated with experiencing grade ≥3 thrombocytopenia (P = 0.004). Lower baseline haemoglobin level (<10 g/dL) and platelet count (<100 × 10⁹/L) were associated with experiencing grade ≥3 anaemia (P < 0.001) and thrombocytopenia (P < 0.001), respectively. Antiemetic prophylaxis was associated with lower rates of nausea/vomiting (P < 0.001).</p><p><strong>Conclusions: </strong>Fedratinib exposure was positively associated with spleen volume reduction and TSS responses, without having significant impact on safety. Fedratinib 400 mg once daily is an appropriate dose for patients with MF regardless of ruxolitinib exposure.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LLM-based generation of USMLE-style questions with ASPET/AMSPC knowledge objectives: All RAGs and no riches.","authors":"Thomas Thesen, Rupa Lalchandani Tuan, Joe Blumer, Michael W Lee","doi":"10.1002/bcp.70119","DOIUrl":"https://doi.org/10.1002/bcp.70119","url":null,"abstract":"<p><p>Developing high-quality pharmacology multiple-choice questions (MCQs) is challenging in large part due to continually evolving therapeutic guidelines and the complex integration of basic science and clinical medicine in this subject area. Large language models (LLMs) like ChatGPT-4 have repeatedly demonstrated proficiency in answering medical licensing exam questions, prompting interest in their use for generating high stakes exam-style questions. This study evaluates the performance of ChatGPT-4o in generating USMLE-style pharmacology questions based on American Society for Pharmacology and Experimental Therapeutics/Association of Medical School Pharmacology Chairs (ASPET/AMSPC) knowledge objectives and assesses the impact of retrieval-augmented generation (RAG) on question accuracy and quality. Using standardized prompts, 50 questions (25 RAG and 25 non-RAG) were generated and subsequently evaluated by expert reviewers. Results showed higher accuracy for non-RAG questions (88.0% vs. 69.2%), though the difference was not statistically significant. No significant differences were observed in other quality dimensions. These findings suggest that sophisticated LLMs can generate high-quality pharmacology questions efficiently without RAG, though human oversight remains crucial.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacogenomics in the UK National Health Service: Progress towards implementation.","authors":"John H McDermott, Maria Tsakiroglou, William G Newman, Munir Pirmohamed","doi":"10.1002/bcp.70109","DOIUrl":"https://doi.org/10.1002/bcp.70109","url":null,"abstract":"<p><p>Over the past decade there has been considerable and growing enthusiasm about the promise of using genomics to inform healthcare. In particular, using genetic data to inform prescribing practice has emerged as a compelling policy priority for health systems around the world, not least in the NHS. Various initiatives and strategies have been developed to explore the value of pharmacogenomics in the UK National Health Service (NHS) and identify strategies for implementation. The NHS England Network of Excellence for Pharmacogenomics and Medicines Optimisation (PGx-NoE) was launched in 2024 and held two stakeholder meetings over the year in collaboration with the UK Pharmacogenetics and Stratified Medicine Network and the British Pharmacological Society (BPS). This article describes the outputs of those meetings, which are discussed in the context of previously identified challenges and opportunities. Rather than simply identify further barriers or facilitators, outputs are contextualized around tangible recommendations and real-world implementation exercises. These are grouped into three key areas: genetics, data and service. The work of partners across the UK are highlighted, including development of the NHS England Genomic Test Directory, the proof-of-principle informatic patterns demonstrated by the PROGRESS study, and the launch of the Centre for Excellence in Regulatory Science and Innovation (CERSI) in Pharmacogenomics, which will create UK-specific guidance and clarify complex regulatory pathways. Many of the well-defined barriers to the implementation of pharmacogenomics have been addressed in recent years, and this work highlights how the UK has the opportunity to emerge as a global leader in genomics-informed healthcare.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}