Adrian A Doerr, Christiane Dings, Omar Zaher, Frederike Nordmeier, Nadja Walle, Matthias W Laschke, Michael D Menger, Peter H Schmidt, Markus R Meyer, Thorsten Lehr, Nadine Schaefer
{"title":"Toxicokinetic modelling of the synthetic cannabinoid 5F-MDMB-P7AICA and its main metabolite in pigs following pulmonary administration.","authors":"Adrian A Doerr, Christiane Dings, Omar Zaher, Frederike Nordmeier, Nadja Walle, Matthias W Laschke, Michael D Menger, Peter H Schmidt, Markus R Meyer, Thorsten Lehr, Nadine Schaefer","doi":"10.1111/bcp.16340","DOIUrl":"https://doi.org/10.1111/bcp.16340","url":null,"abstract":"<p><strong>Aims: </strong>Since their emergence on the drug market, synthetic cannabinoids (SC) are still gaining increasing importance in forensic toxicology. The representatives of the so-called new psychoactive substances have in common that they have not undergone preclinical safety studies. Hence, knowledge on toxicokinetic (TK) data is sparse. As an alternative to human studies not being allowed for ethical reasons, a sophisticated pig model was applied in the present study to assess the TK of the SC 5F-MDMB-P7AICA.</p><p><strong>Methods: </strong>Pigs pulmonarily received 5F-MDMB-P7AICA via an ultrasonic nebulizer. The parent compound and its main metabolite 5F-MDMB-P7AICA dimethyl butanoic acid were determined in serum and whole blood using liquid chromatography-tandem mass spectrometry. Obtained data was analysed by population (pop) TK modelling. The final pop TK model parameters for pigs were upscaled via allometric scaling techniques for the prediction of human exposure.</p><p><strong>Results: </strong>The serum concentration-time profiles of the parent and the pop TK analysis revealed that a 4-compartment model best describes the TK data. The administration of the aerosol into the lung compartment follows zero-order kinetics. A transit compartment was further included to accurately describe the time delay between detection of the parent and the metabolite. Despite the different structure, TK parameters were found to be comparable to other examined SC.</p><p><strong>Conclusion: </strong>The predictions of human SC exposure suggest that multiple administration of 5F-MDMB-P7AICA substantially enhances the window of detection. The simulations pose extrapolation of the data used for model development with respect to dose linearity and allometric scaling to humans.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680798","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}
Gregory W Roberts, Viviane De Menezes Caceres, Anthony Damiani, Nicholas Scarfo, Desmond B Williams, Patrick T Russell
{"title":"Determination of the optimal obesity-adjusted dosing weight for enoxaparin.","authors":"Gregory W Roberts, Viviane De Menezes Caceres, Anthony Damiani, Nicholas Scarfo, Desmond B Williams, Patrick T Russell","doi":"10.1111/bcp.16338","DOIUrl":"https://doi.org/10.1111/bcp.16338","url":null,"abstract":"<p><strong>Aims: </strong>The ideal dosing weight metric for enoxaparin remains elusive. Dosing remains focused on actual body weight, which may inadvertently increase the risk of bleeding in those with obesity, or ideal weight, which may underdose those with obesity. Our aim was to determine the optimal obesity-adjusted enoxaparin dosing weight.</p><p><strong>Methods: </strong>Multisite retrospective data were collected over a 2.0-year period for those with minimum 48 h of in-hospital twice-daily enoxaparin and factor anti-Xa level 3-5 h postdose (n = 220). Multiple linear regression calculated the associated variance between a range of nominal dosing weights and factor anti-Xa levels, adjusted for renal function. Dosing weights were calculated as ideal body weight (IBW) and then adjusted for increasing percentages of weight above IBW, i.e. IBW + 10% above IBW, IBW + 20% etc. up to actual body weight. A similar approach was used for lean body weight (LBW).</p><p><strong>Results: </strong>For body mass index ≥30 kg/m<sup>2</sup> optimal variance explained by dosing weight metrics was at IBW + 40% (23%) and similarly for LBW + 40% (23%). Using actual body weight (ABW) had lowest associated variance with factor anti-Xa levels (18%) followed by unadjusted IBW (13%) or unadjusted LBW (19%). In those with body mass index <30 kg/m<sup>2</sup> there was similar associated variance in the ranges of IBW + 20-50% and LBW 10-40% (21%).</p><p><strong>Conclusion: </strong>Compared to IBW + 40% or LBW + 40% use of ABW to calculate dose was poorly associated with factor anti-Xa levels, as was IBW or LBW. IBW + 40% and LBW + 40% require further study as a dosing weight metric and may provide a more consistent factor anti-Xa response in those with obesity.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680775","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":"Risk factors for lenvatinib-induced hypertension in patients with hepatocellular carcinoma: A retrospective study.","authors":"Shusuke Uekusa, Misaki Nakashin, Yuki Hanai, Maho Nemoto, Sachiko Yanagino, Yoshiki Arita, Takahiro Matsumoto, Noritaka Wakui, Hidenari Nagai, Koji Higai, Kazuhiro Matsuo","doi":"10.1111/bcp.16337","DOIUrl":"https://doi.org/10.1111/bcp.16337","url":null,"abstract":"<p><strong>Aims: </strong>Lenvatinib mesylate (LEN) is an orally administered tyrosine kinase inhibitor used to treat various cancers, including hepatocellular carcinoma (HCC). LEN therapy for HCC is associated with a high incidence of adverse events, including hypertension (HTN). However, the risk factors associated with LEN therapy remain unclear. This study investigated the incidence of LEN-induced HTN (LENiHTN), and the relationship between HTN incidence and patient demographics in patients with HCC receiving LEN therapy.</p><p><strong>Methods: </strong>This was a single-centre, retrospective study of patients with HCC who received LEN therapy between 19 April 2018 and 30 September 2020. The observation period was from 1 week before the start to 1 month after the end of LEN administration.</p><p><strong>Results: </strong>Seventy-five patients with HCC were enrolled. Any grade LENiHTN was found in 74.7% of patients. Among patients with LENiHTN, the use of 2 or more antihypertensive agents before starting LEN was less common (P = .007); serum potassium (K) and albumin-bilirubin score (ALBI) were lower (P = .013 and 0.038, respectively); and albumin (Alb) was higher (P = .025). The cut-off values of K, Alb and ALBI for HTN were estimated at 4.1 mEq L<sup>-1</sup>, 3.1 g dL<sup>-1</sup> and -1.736, respectively. In the multivariable analysis, low K (adjusted HR: 2.078) and low ALBI (adjusted HR: 2.845) were independent risk factors for LENiHTN.</p><p><strong>Conclusion: </strong>Low K, high Alb and low ALBI were independent risk factors for LENiHTN. Systematic evaluation of HTN risk and early intervention for HTN prevention among high-risk patients can markedly enhance LEN therapy efficacy and use.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680792","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}
Dorian Protzenko, Benjamin Bouchacourt, Laure Carriat, Paul Maroselli, Clara Boéri, Raynier Devillier, Joseph Ciccolini
{"title":"Adaptive dosing of high-dose busulfan in real-world adult patients undergoing haematopoietic cell transplant conditioning.","authors":"Dorian Protzenko, Benjamin Bouchacourt, Laure Carriat, Paul Maroselli, Clara Boéri, Raynier Devillier, Joseph Ciccolini","doi":"10.1111/bcp.16343","DOIUrl":"https://doi.org/10.1111/bcp.16343","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effectiveness of a Bayesian adaptive dosing strategy in achieving target busulfan exposure in adult patients undergoing haematopoietic cell transplantation (HCT).</p><p><strong>Methods: </strong>This study included 71 adult patients scheduled to receive high-dose busulfan. Busulfan was administered to achieve a cumulative area under the curve (AUC) of 66.0 mg/L/h (16 000 μM/min), 82.60 mg/L/h (20 000 μM/min) or 87.6 mg/L/h (21 200 μM/min) depending on the regimen. Individual pharmacokinetic (PK) parameters of busulfan were estimated from three blood samples using a one-compartment model and Bayesian estimation after the first standard dose. Individual PK parameters were used to adjust subsequent doses to achieve the target exposure.</p><p><strong>Results: </strong>All patients had their dose adjusted after the first dose administration. The final deviation from the target AUC was significantly improved compared to the initial deviation after standard mg/kg dosing (mean absolute deviation 19.5% vs 11.7%, P < .01). In addition, the proportion of patients with marked deviation from target exposure (ie, >25%) decreased significantly from 31% after standard dosing to 10% after PK-guided dosing (P < .01). Canonical busulfan-related toxicity, specifically veno-occlusive disease, was observed in 5% of patients who achieved successful PK-guided dosing. In contrast, one-third of patients with off-target exposure with poor dosing experienced toxicity.</p><p><strong>Conclusion: </strong>The Bayesian adaptive dosing strategy significantly improves the accuracy of achieving the target busulfan AUC in patients undergoing HCT. This approach not only reduces marked deviations from target exposure, but also reduces the incidence of busulfan-related toxicity, thereby maintaining a favourable toxicity/efficacy ratio.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675184","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}
Krzysztof Kalwak, Ajay Vora, Peter Bader, Birgit Burkhardt, Selim Corbacioglu, Katarzyna Drabko, Jolanta Gozdzik, Johann Greil, Bernd Gruhn, Katharine Patrick, Ansgar Schulz, Petr Sedlacek, Jan Styczynski, Monika Mielcarek-Siedziuk, Franco Locatelli, Dirk Reinhardt, Paul-Gerhardt Schlegel, Joachim Baumgart, Jochen Kehne, Xieran Li, Rita Beier
{"title":"Impact of treosulfan exposure on clinical outcome after allogeneic stem cell transplantation in children: A substudy of 2 phase 2 trials.","authors":"Krzysztof Kalwak, Ajay Vora, Peter Bader, Birgit Burkhardt, Selim Corbacioglu, Katarzyna Drabko, Jolanta Gozdzik, Johann Greil, Bernd Gruhn, Katharine Patrick, Ansgar Schulz, Petr Sedlacek, Jan Styczynski, Monika Mielcarek-Siedziuk, Franco Locatelli, Dirk Reinhardt, Paul-Gerhardt Schlegel, Joachim Baumgart, Jochen Kehne, Xieran Li, Rita Beier","doi":"10.1111/bcp.16339","DOIUrl":"https://doi.org/10.1111/bcp.16339","url":null,"abstract":"<p><strong>Aims: </strong>Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a vital treatment for various paediatric malignant and nonmalignant diseases. The conditioning treatment before allo-HSCT is crucial for successful engraftment. Treosulfan, a cytotoxic prodrug, has gained popularity due to its lower toxicity compared to traditional alkylating agents used for conditioning treatment.</p><p><strong>Methods: </strong>We investigated the relationship between pharmacokinetics and pharmacodynamics of treosulfan in paediatric patients, in a substudy pooling from 2 multicentre phase 2 clinical trials. A total of 83 children with malignant and nonmalignant diseases received treosulfan-based conditioning. Treosulfan exposure and its relationship with clinical outcomes, including survival, graft failure and graft-vs.-host disease, were investigated.</p><p><strong>Results: </strong>Our findings reveal no significant association between treosulfan exposure and the key clinical outcomes or toxicity (P-values between .22 and .99), if the dosing is based on the approved product information.</p><p><strong>Conclusion: </strong>These findings suggest that treosulfan exposure after standardized body surface area-based dosing is appropriate in paediatric allo-HSCT.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675196","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 2023: Big studies, big results, big implications, big responsibilities: Editorial.","authors":"Ann K Daly, Andrew A Somogyi","doi":"10.1111/bcp.16351","DOIUrl":"https://doi.org/10.1111/bcp.16351","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675110","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}
Francis Williams Ojara, Aida N Kawuma, Catriona Waitt
{"title":"What can pharmacokinetic modelling do for you? Rational design and interpretation of clinical studies.","authors":"Francis Williams Ojara, Aida N Kawuma, Catriona Waitt","doi":"10.1111/bcp.16341","DOIUrl":"10.1111/bcp.16341","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614479","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}
Gianmaria F Bernasconi, Gregorio P Milani, Elisabetta L T De Felice, Craig Laurence, Pietro B Faré, Benedetta Terziroli Beretta-Piccoli, Mario G Bianchetti, Sebastiano A G Lava
{"title":"Acute aseptic meningitis temporally associated with trimethoprim and sulfamethoxazole: Systematic review.","authors":"Gianmaria F Bernasconi, Gregorio P Milani, Elisabetta L T De Felice, Craig Laurence, Pietro B Faré, Benedetta Terziroli Beretta-Piccoli, Mario G Bianchetti, Sebastiano A G Lava","doi":"10.1111/bcp.16346","DOIUrl":"https://doi.org/10.1111/bcp.16346","url":null,"abstract":"<p><p>Sulphonamides and trimethoprim, although generally well-tolerated, have been temporally associated with aseptic meningitis. To address its presentation and outcome, a literature search was performed. We retained articles reporting patients with features of acute aseptic meningitis following intake of trimethoprim, sulfamethoxazole or sulfisoxazole. A cerebrospinal fluid investigation in ≥1 episode was a prerequisite for inclusion. Sixty articles reporting on 74 patients experiencing a total of 155 episodes were retained. Forty-five (61%) patients had one or more recurrences. Median age at first episode was 43 (interquartile range [IQR] 23-61) years. Symptoms presented within 48 (IQR 6-168) hours of intake at the first episode and within 1.3 (IQR 1-5) hours at recurrences (p < .0001). Cerebrospinal fluid analysis revealed a predominantly neutrophilic (82%, IQR 65%-94%) pleocytosis (180, IQR 38-507 10<sup>6</sup> cells/L), without low glucose or high proteins. Recovery took place within 2 (IQR 1-3) days after stopping the suspected agent. All but one patient completely recovered.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614398","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}
Nuno Duarte, João Paulo Martins, Jose-Ángel García-Pedraza, Marlene Santos
{"title":"Ten-year analgesic utilization patterns and economic implications in Portugal.","authors":"Nuno Duarte, João Paulo Martins, Jose-Ángel García-Pedraza, Marlene Santos","doi":"10.1111/bcp.16333","DOIUrl":"https://doi.org/10.1111/bcp.16333","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated the 10-year consumption and economic patterns of classical analgesics, adjuvants and opioids in Portugal (2012-2022), and conducted a comparative analysis between Portugal, Spain and Denmark to explore the consumption patterns among these countries for 2022.</p><p><strong>Methods: </strong>Data on sales and national health service (NHS) costs were obtained from the Portuguese National Authority of Medicines and Health Products. Sales data were converted to defined daily dose (DDD) per 1000 inhabitants per day according to the Anatomical Therapeutic Chemical (ATC) classification/DDD methodology, while comparisons between Spain and Denmark were evaluated with the chi-square test, when appropriate.</p><p><strong>Results: </strong>The findings reveal that classical analgesics use in Portugal remained stable during the period 2012-2022, with ibuprofen being the most consumed. Adjuvants, specifically gabapentinoids, experienced an 84% increase in use, primarily attributed to pregabalin. Weak opioids, led by tramadol, witnessed a 117% rise in use, while strong opioid use, led by tapentadol, increased by 618%. Portugal presented the lowest overall opioid consumption when compared to Denmark and Spain in 2022. Economic trends indicated a heightened NHS expenditure on analgesics, primarily driven by increased opioid use. Notwithstanding, there was no significant burden on relative expenditure over the 10-year period.</p><p><strong>Conclusions: </strong>Portugal presented a major increase in both weak and strong opioid prescriptions, aligning with the trends for Spain and Denmark. The development and approval of generic medicines and vigilant market monitoring are imperative strategies for managing the escalated costs resulting from heightened consumption, particularly concerning opioids.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614421","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}
Cheng Ji, Jonathan Garcia, Argem Joy Sabuga, Maurane Ricard, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot, Van Dong Nguyen
{"title":"External evaluation of intravenous vancomycin population pharmacokinetic models in adults receiving high-flux intermittent haemodialysis.","authors":"Cheng Ji, Jonathan Garcia, Argem Joy Sabuga, Maurane Ricard, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot, Van Dong Nguyen","doi":"10.1111/bcp.16334","DOIUrl":"https://doi.org/10.1111/bcp.16334","url":null,"abstract":"<p><strong>Aims: </strong>Patients undergoing haemodialysis (HD) are at greater risk of methicillin-resistant Staphylococcus aureus infections requiring intravenous vancomycin. Close vancomycin therapeutic drug monitoring is warranted in HD patients as renal clearance is the primary elimination pathway. Clinically, population pharmacokinetics (popPK) model-informed dosing is commonly used. This study aimed to perform an external evaluation of published vancomycin popPK models developed for adults undergoing high-flux intermittent HD, and to create a dosing nomogram derived from the model that performed best.</p><p><strong>Methods: </strong>A literature review was conducted through PubMed and EMBASE to identify relevant popPK models. an external dataset was collected retrospectively from patients of 2 healthcare centres in Quebec, Canada. Selected models were implemented in NONMEM (v7.5; ICON Development Solutions). Predictive performance was assessed through prediction and simulation-based diagnostics.</p><p><strong>Results: </strong>In total, 2386 vancomycin concentrations were collected from 274 patients and 476 antibiotic courses. Four vancomycin popPK models were selected for evaluation. None of the models demonstrated overall satisfactory or clinically acceptable predictive performance. Nonetheless, Bae et al.'s model performed best with a median prediction error of 16.25% and median absolute prediction error of 34.66%. Different predictive performance was also observed for vancomycin concentrations from samples collected during and between HD sessions.</p><p><strong>Conclusion: </strong>All evaluated models presented poor overall predictive performance. Further studies are required, through existing popPK model parameter re-estimation or new model development, to adequately describe vancomycin pharmacokinetics for our high-flux intermittent HD patient cohort.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614403","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}