Contraception最新文献

{"title":"Using updated clinical recommendations to support contraceptive decision-making: U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.","authors":"Kathryn M Curtis, Antoinette T Nguyen, Naomi K Tepper, Maura K Whiteman","doi":"10.1016/j.contraception.2025.111015","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111015","url":null,"abstract":"<p><strong>Objectives: </strong>In August 2024, the U.S. Centers for Disease Control and Prevention updated U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC), which provides recommendations for safe use of contraception for women with certain characteristics and medical conditions. This paper provides a summary of the evidence and context for new and updated U.S. MEC recommendations.</p><p><strong>Study design: </strong>The 2024 U.S. MEC was updated through a rigorous, multi-year process of determining priorities that would have high impact on clinical care, conducting systematic reviews of the evidence, and considering perspectives of health care providers and patients on how the evidence could best support updated recommendations.</p><p><strong>Results: </strong>New U.S. MEC recommendations were added for chronic kidney disease, specifically for three subconditions: current nephrotic syndrome, hemodialysis, and peritoneal dialysis. Revisions were made to several existing recommendations, such as those for sickle cell disease, anticoagulant therapy use, various thrombogenic conditions, cirrhosis, liver tumors, solid organ transplantation, and intrauterine device placement in the postpartum period. Updated recommendations include those that reflect decreased safety concerns for some medical conditions (e.g., progestin-only contraception and some liver diseases) and increased safety concerns for others (e.g., combined hormonal contraception and depot medroxyprogesterone acetate for women with sickle cell disease). Recommendations for new contraceptive methods were added.</p><p><strong>Conclusions: </strong>Evidence-based clinical guidelines can be used by health care providers to support patient-centered contraceptive counseling and services and remove unnecessary barriers to accessing and using contraception. Provider tools including a mobile app are available to help with implementation of the updated recommendations.</p><p><strong>Implications: </strong>Keeping U.S. MEC up-to-date is critical for supporting contraceptive decision-making and improving access to contraception and reproductive health care. This includes new research to address current evidence gaps, rigorous methodology for continuous evidence identification and synthesis, state-of-the-art methods for guideline development, and a broad range of dissemination and implementation strategies.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111015"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651530","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":"Vaginal Contraception with NuvaRing^@ Decreases Symptoms and Uterine Features of Adenomyosis. A Prospective Evaluation.","authors":"Anjeza Xholli, Francesca Oppedisano, Mattia Francesco Ferraro, Isabella Perugi, Ambrogio P Londero, Angelo Cagnacci","doi":"10.1016/j.contraception.2025.111016","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111016","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the effects of contraception with NuvaRing^@ on ultrasound signs and symptoms of women with adenomyosis.</p><p><strong>Study design: </strong>We conducted a prospective self-controlled observational study on women with adenomyosis who required contraception with NuvaRing^@. Exclusion criteria were actual use or contraindications to hormonal contraception. NuvaRing^@ was administered in a continuous regimen, one ring every three weeks without hormone-free intervals, to avoid menses. Adenomyosis, suggested by clinical signs, was confirmed by ultrasonography. Before and after six months of NuvaRing^@, we evaluated uterine volume, direct and indirect ultrasound signs of adenomyosis, and the severity of menstrual, intermenstrual pain, and pain during intercourse, by a 10-cm visual analog scale (VAS).</p><p><strong>Result(s): </strong>This study included 42 women, 30.0 ± 4.5 years old, with a BMI of 22.8 ± 1.8 kg/m². All were nulliparous except one. Following six months of NuvaRing^@, uterine volume decreased of 14.4 ± 13.5% (p=0.001). A similar decrease was observed in six women switching from dienogest. Direct ultrasound signs of adenomyosis per patient (total signs/n women) decreased from 0.5 (range 0-3) to 0.08 (range 0-2) (p=0.003), and indirect signs, from 2.8 (range 1-5) to 1.5 (range 0-5) (p=0.001). The VAS for menstrual pain decreased from 8.3 ± 1.2 to 3.9 ± 2.5 (p=0.001), for intermenstrual pain from 6.6 ± 1.4 to 2.9 ± 1.7 (p=0.001), and for pain during intercourse from 7.0 ± 1.4 to 2.9 ± 1.7 (p=0.001). The decrease of menstrual pain was significantly associated with the reduction of uterine volume (p=0.003).</p><p><strong>Conclusion(s): </strong>Our findings demonstrate that contraception with NuvaRing^@is a viable contraceptive option for women with adenomyosis.</p><p><strong>Implications: </strong>In women with adenomyosis contraception with NuvaRing^@ is useful and can be proposed because it reduces the clinical signs and the uterine ultrasound features of adenomyosis.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111016"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651531","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":"Perspectives on options for self-sourcing medication abortion after implementation of Texas Senate Bill 8.","authors":"Whitney Arey, Klaira Lerma, Anna Chatillion, Kari White","doi":"10.1016/j.contraception.2025.111017","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111017","url":null,"abstract":"<p><strong>Objectives: </strong>To examine experiences of pregnant Texans who considered self-sourcing medication abortion following the September 2021 implementation of Texas Senate Bill 8, which prohibited abortions after detectable embryonic cardiac activity.</p><p><strong>Study design: </strong>This qualitative research study used in-depth telephone interviews conducted between October 2021 and August 2022 with pregnant and recently pregnant Texas residents ≥16 years of age who considered abortion. We recruited participants from two sources: flyers posted at abortion facilities in nearby states and an online survey of Texans seeking abortion care. We interviewed participants who obtained out-of-state abortion care or who reported self-managing their abortion, having a miscarriage or an ectopic pregnancy, or continuing their pregnancy. We used inductive and deductive coding in our thematic analysis examining perceptions of self-sourcing medication abortion and potential use of a hypothetical telehealth abortion model.</p><p><strong>Results: </strong>Of the 120 participants interviewed, 50 researched or considered self-sourcing medication abortion, including 15 who ultimately sourced medications to self-manage their abortion. Participants described uncertainty about the safety and legality of their options for self-sourcing abortion medications, and most would have preferred to use telehealth abortion in a hypothetical legal policy context, including those who self-managed their abortion.</p><p><strong>Conclusions: </strong>In the context of an abortion ban, people considered self-sourcing abortion medications, but had concerns about the legality and safety of doing so. People in states with restrictive abortion laws may benefit from information about how to access medication abortion from safe and reliable sources and mitigate their legal risks.</p><p><strong>Implications: </strong>People perceive meaningful differences between the legality and safety of telehealth and self-managed medication abortion. Strategies are needed to provide pregnant people in restricted settings with clear information so they can make an informed choice for their personal circumstances.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111017"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628023","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":"A Novel Approach to Cervical Dilation for Second Trimester Dilation and Evacuation in a Myomatous Uterus.","authors":"S J Gross, L Kus, A Jacobs, A Goldman","doi":"10.1016/j.contraception.2025.111008","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111008","url":null,"abstract":"<p><p>Cervical preparation prior to dilation and evacuation can be challenging in the presence of uterine or cervical fibroids. In cases of distorted cervical anatomy, a transcervical foley balloon with stylet can be considered to achieve cervical dilation.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111008"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621544","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":"Communication with Patients Using Asynchronous Telehealth Medication Abortion Services.","authors":"Anna Fiastro, Nikeeta Shah, Rebecca Gomperts, Jessica Gipson, Emily Godfrey","doi":"10.1016/j.contraception.2025.111014","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111014","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding patient communication with clinic providers or staff in telemedicine abortion can inform appropriate staffing.</p><p><strong>Methodology: </strong>We describe patient-service communication when using asynchronous telemedicine abortion services from April-November 2020 (n=504) and compare patient demographics with number of messages using Kruskal-Wallis rank sum test.</p><p><strong>Results: </strong>About half of patients communicated with staff (56%, n= 287), median 6 messages per patient (Interquartile range: 3-10 messages). Primary topics included 1) eligibility, 2) payment, 3) medication delivery, and 4) physical process. Message volume did not differ by patient demographics.</p><p><strong>Implications: </strong>Our findings inform communication and staffing quantity and quality in telemedicine abortion provision.</p><p><strong>Implications statement: </strong>Asynchronous telehealth abortion patients require minimal communication, and most inquiries can be addressed by non-clinical staff. These insights can inform resource allocation and staffing decisions in telehealth abortion services, improving efficiency while maintaining patient satisfaction.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111014"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621545","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":"An Opportunity for Guidance on Reproductive Health Tracking Technologies in a Post-Roe United States.","authors":"Gali Katznelson, Isabella McNamara, Carmel Shachar","doi":"10.1016/j.contraception.2025.111013","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111013","url":null,"abstract":"<p><p>Reproductive tracking technologies are widely used by women to track their menstrual cycles or fertility. While there are many benefits to reproductive tracking technologies, there are also risks with respect to privacy and quality assurance. This commentary outlines the current U.S. regulatory landscape of reproductive tracking technologies following the Supreme Court ruling that eliminated the constitutional right to abortion. There is risk that information from reproductive tracking technologies regarding cessation in menstruation can be investigated as an aborted pregnancy and used against a defendant in a lawsuit. There is also risk that poor quality technologies can have adverse implications on users' health and wellbeing. Individual clinicians can find it challenging to safeguard patients from these legal and health risks. Sexual and reproductive health providers and researchers have an important opportunity to provide guidance on the safe use of reproductive tracking technologies. This guidance can include the implementation of an app evaluation model, curating a database of reproductive tracking technologies or developing an evidence-based app to be the \"gold standard.\"</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111013"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602470","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":"Safety of hormonal contraception among women with liver disease: an updated systematic review.","authors":"Nathalie Kapp, Naomi K Tepper, Antoinette T Nguyen, Sophia Garbarino, Katherine Kortsmit, Kathryn M Curtis, Maura K Whiteman","doi":"10.1016/j.contraception.2025.111012","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111012","url":null,"abstract":"<p><strong>Objective: </strong>We sought to assess whether, among women with liver disease, there is an increased risk of adverse health effects with use of hormonal contraception (HC).</p><p><strong>Methods: </strong>We conducted a systematic review of six databases from database inception through December 13, 2022. We searched for articles that examined changes in liver lesions and acute and chronic liver disease with use of HC or after discontinuation of HC. We assessed risk of bias for each study and certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Thirteen articles met inclusion criteria, one with low risk of bias and the others with high risk of bias: three studies (four articles) were of women with focal nodular hyperplasia (FNH), five studies were of hepatocellular adenoma (HCA) and four studies were of acute or chronic hepatitis. The size and/or number of FNH lesions were generally not influenced by HC use. HCA progression was generally higher among current combined oral contraception (COC) users than those who discontinued, and lesions were stable or regressed in most women who discontinued COC or used progestin-only contraception. Studies found that viral hepatitis generally did not progress or increase in severity with use of COC.</p><p><strong>Conclusion: </strong>Overall, a limited body of evidence suggested changes in FNH lesions were independent of hormonal contraceptive use. Estrogen-containing contraceptive method use was associated with HCA lesion progression; lesions generally remained stable with progestin-only contraceptive use. COC use did not increase progression or severity of disease among those with viral hepatitis. The certainty of evidence for all outcomes was very low.</p><p><strong>Implications: </strong>Liver conditions such as liver lesions, viral hepatitis, and cirrhosis are increasingly common in women of reproductive age. Information in this review can be used by health care providers when counseling women with liver disease about safe use of contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111012"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602471","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":"OBGYN resident experiences in an abortion-ban state post-Dobbs.","authors":"Lana Nguyen, Sophie Ulene, Julia E Kohn, Erika Levi","doi":"10.1016/j.contraception.2025.111011","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111011","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of the June 24, 2022 anti-abortion legislation (Dobbs) on trainees, we examined the experiences of OBGYN residents within a single program in a state with a complete abortion ban with rare exceptions.</p><p><strong>Study design: </strong>We conducted semi-structured interviews with OBGYN residents at an institution in an abortion ban state. Domains of inquiry included: residency selection process, experiences with/attitudes toward abortion training, perspectives on legislation and advocacy, and career plans. We conducted thematic analysis of transcribed interviews, which were coded by two independent coders using Dedoose.</p><p><strong>Results: </strong>We enrolled 19 participants from May-December 2023, representing trainees from all years who entered the program between 2018-2023. We identified four main themes: 1) Abortion restrictions increased residents' moral distress and frustration due to strain on the patient-physician relationship, increased barriers to care, and decreased quality of care; 2) Residents receiving abortion training post-Dobbs reported concerns about clinical competence due to decreased volume at their institution and away rotation. 3) Residents considered availability of abortion training in residency program choice more highly after the Dobbs decision. 4) Practicing in an abortion-restricted state reinforces residents' desires to receive abortion training and informs where they choose to practice after graduation.</p><p><strong>Conclusions: </strong>In a residency program where post-Dobbs legislation resulted in one of the most restrictive abortion bans, OBGYN residents reported an impact on their well-being amid increasing patient care challenges, concerns of competence due to limited abortion training, and a desire for future abortion provision.</p><p><strong>Implications: </strong>This study highlights the significant impact of the Dobbs decision on OBGYN trainees in abortion-restricted states. By revealing how these restrictions affect residents' training, well-being, and career choices, our findings underscore the urgent need for adaptive strategies to ensure comprehensive abortion education in a rapidly evolving legal landscape.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111011"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585852","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":"Experience of nulliparous patients under thirty seeking permanent female contraception: A qualitative study.","authors":"Marielle E Meurice, Kendahl Wallis-Lang, Marisa C Hildebrand, Tim K Mackey, Sheila K Mody","doi":"10.1016/j.contraception.2025.111010","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111010","url":null,"abstract":"<p><strong>Objective: </strong>To describe the experience of nulliparous individuals under thirty years old when seeking permanent female contraception.</p><p><strong>Study design: </strong>We recruited nulliparous individuals under thirty years old who underwent permanent female contraception in the United States in the last two years through a clinical listserv, Facebook, and Reddit to participate in semi-structured in-depth interviews. We summarized themes using the socio-ecological model (SEM).</p><p><strong>Results: </strong>Thirty individuals from 20 states participated. The average age was 25 (range 21-30). Most participants identified as White (25, 83%), non-Latine (28, 93%), had attended some college (27, 90%), and used online resources to seek permanent female contraception (22, 73%). On an individual level, childfree identity and the experience of trying other contraception methods led participants to choose permanent female contraception. On an interpersonal level, participants reported others' support of bodily autonomy and childfree identity as facilitators and questioning permanent female contraception decisions as a barrier. On an institutional level, insurance coverage created confusion and stress. At the community level, social media interactions provided information and support. At the public policy level, the Dobbs decision increased the urgency to seek permanent female contraception.</p><p><strong>Conclusions: </strong>This qualitative study of young, nulliparous individuals focuses on characterizing patients' lived experiences and motivations for seeking permanent female contraception. Key findings included support stemming from a clinician's acceptance of childfree identity, stressors from insurance coverage, benefits of using online resources, and the impact of the Dobbs decision on the urgency to seek permanent female contraception due to perceived threats to reproductive autonomy.</p><p><strong>Implications: </strong>This study provides insights into the perspectives of young, nulliparous people who underwent permanent female contraception. Clinicians' acceptance of childfree-identity and online resources are facilitators and the Dobbs decision impacted urgency of seeking surgery. Findings should be integrated into policy and practice for improved person-centered care in a post-Dobbs society.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111010"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577261","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":"Facilitators and Barriers to Implementation of Immediate Postpartum LARC Programs within Pennsylvania Hospitals 7 Years after PA Medicaid Reimbursement.","authors":"Grace Ferguson, Emma G Guare, Candace Bordner, Cynthia H Chuang, Sarah Horvath","doi":"10.1016/j.contraception.2025.111009","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.111009","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate facilitators and barriers to implementation of immediate postpartum LARC (IPLARC) within Pennsylvania (PA) hospitals seven years after PA Medicaid adopted coverage of IPLARC outside the pregnancy care bundled payment, with particular attention to rural, small, or non-academic hospitals.</p><p><strong>Study design: </strong>We conducted ten qualitative interviews representing ten unique hospitals from an opt-in subset of participants in our quantitative survey of clinician leaders at PA Labor and Delivery units. Transcripts were analyzed using grounded theory methodology. We coded and analyzed transcripts using MAXQDA software.</p><p><strong>Results: </strong>Several themes emerged from the data; three of which are novel. Firstly, that passage of Medicaid reimbursement was necessary but not sufficient for widespread implementation of IPLARC. We also found that hospital mergers and consolidations facilitated the capacity of smaller hospitals to implement and sustain IPLARC and that the Pennsylvania Perinatal Quality Collaborative was a utilized resource.</p><p><strong>Conclusion: </strong>Medicaid coverage of IPLARC is a necessary facilitator but not sufficient for all hospitals to implement this service. Smaller, non-urban hospitals may benefit more from network-level support and state Perinatal Quality Collaboratives than their larger, academic urban hospital counterparts.</p><p><strong>Implications: </strong>Medicaid coverage of IPLARC was a necessary facilitator but not sufficient for all PA hospitals to implement this care. Internal support from larger hospital systems via buyouts/mergers and external support programs (state Perinatal Quality Collaboratives) may play a larger role in implementation at smaller, rural, or non-academic hospitals.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111009"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577262","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}