International Journal of Drug Policy最新文献

{"title":"Stimulant-involved overdose deaths: Constructing dynamic hypotheses","authors":"Zeynep Hasgul ,&nbsp;Arielle R. Deutsch ,&nbsp;Mohammad S. Jalali ,&nbsp;Erin J. Stringfellow","doi":"10.1016/j.drugpo.2025.104702","DOIUrl":"10.1016/j.drugpo.2025.104702","url":null,"abstract":"<div><div>The overdose epidemic in the United States is evolving, with a rise in stimulant (cocaine and/or methamphetamine)-only and opioid and stimulant-involved overdose deaths for reasons that remain unclear. We conducted interviews and group model building workshops in Massachusetts and South Dakota. Building on these data and extant research, we identified six dynamic hypotheses, explaining changes in stimulant-involved overdose trends, visualized using causal loop diagrams. For stimulant- and opioid-involved overdose deaths, three dynamic hypotheses emerged: (1) accidental exposure to fentanyl from stimulants; (2) primary stimulant users increasingly using opioids, often with resignation; (3) primary opioid (especially fentanyl) users increasingly using stimulants to balance the sedating effect of fentanyl. For stimulant-only overdose deaths, three additional dynamic hypotheses emerged: (1) disbelief that death could occur from stimulants alone, and doubt in testing capabilities to detect fentanyl; (2) the stimulant supply has changed, leading to higher unpredictability and thus higher overdose risk; and (3) long-term stimulant use contributing to deteriorating health and increasing overdose risk. These hypotheses likely each explain a portion of the recent trends in stimulant-involved overdoses. However, confusion and uncertainty around the drug supply emerged as a central theme, underscoring the chaotic and unpredictable nature of the stimulant market. Our findings indicate the need for research to develop targeted public health interventions, including analyzing the extent of the effect of contamination on overdoses, reducing confusion about the stimulant supply, and examining historical stimulant use trends.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"136 ","pages":"Article 104702"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Riding the wave or controlling the flow? Commentary on Room (2025) ‘Long waves of alcohol consumption and the Sustainable Development Goals’","authors":"James Nicholls","doi":"10.1016/j.drugpo.2025.104723","DOIUrl":"10.1016/j.drugpo.2025.104723","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104723"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of risk mitigation prescribing during dual public health emergencies: A qualitative study among Indigenous people who use drugs and health planners in Northern British Columbia, Canada","authors":"Brittany Barker ,&nbsp;Alexa Norton ,&nbsp;Shawn Wood ,&nbsp;Celeste Macevicius ,&nbsp;Katherine Hogan ,&nbsp;Katt Cadieux ,&nbsp;Louise Meilleur ,&nbsp;Bohdan Nosyk ,&nbsp;Karen Urbanoski ,&nbsp;Bernie Pauly ,&nbsp;Nel Wieman","doi":"10.1016/j.drugpo.2024.104679","DOIUrl":"10.1016/j.drugpo.2024.104679","url":null,"abstract":"<div><h3>Background</h3><div>In response to the dual public health emergencies of COVID-19 and the overdose crisis, the Government of British Columbia (BC) introduced risk mitigation prescribing, or prescribed safer supply. In the context of colonialism and racism, Indigenous people are disproportionately impacted by substance use harms and experience significant barriers to receiving care, particularly those living in rural and remote communities. As part of a larger provincial evaluation, we sought to assess the implementation of risk mitigation prescribing as experienced by Indigenous people who use drugs (IPWUD) in Northern BC.</div></div><div><h3>Methods</h3><div>We used the Consolidated Framework for Implementation Research and the First Nations Perspective on Health and Wellness as conceptual frameworks to guide the study. In partnership with people with lived/living experience, we conducted 20 qualitative interviews with IPWUD. Data were supplemented by four interviews with health planners and analyzed thematically.</div></div><div><h3>Results</h3><div>Participants reported limited implementation of risk mitigation prescribing in Northern BC, with unique regional challenges and innovative facilitators to access. Analysis of supplementary health planner data was consistent with the experiences of IPWUD and together provided a comprehensive picture of implementation in Northern BC. Four themes emerged: 1) Northern socio-politico-cultural barriers to implementation (outer setting), 2) rural and remote healthcare delivery challenges (inner setting), 3) adaptability of risk mitigation prescribing on Northern wellness (intervention characteristics), and 4) Northern ingenuity, relationality and champions facilitating access (implementation process).</div></div><div><h3>Conclusions</h3><div>Implementation and access to risk mitigation prescribing in Northern BC was limited, with region-specific applicability challenges and a health service delivery model that was not able to sufficiently meet the unique service needs of IPWUD. Demonstrating Northern ingenuity, peer groups, harm reduction community champions, and telehealth services were identified as stopgap measures that promoted access and reduced inequitable implementation within the region.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"136 ","pages":"Article 104679"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of hepatitis C testing using point-of-care testing and dried blood spot collection among people at risk of hepatitis C infection","authors":"Annabelle Stevens ,&nbsp;Lise Lafferty ,&nbsp;Carla Treloar ,&nbsp;Evan B. Cunningham ,&nbsp;Gregory J. Dore ,&nbsp;Jason Grebely ,&nbsp;Alison D. Marshall","doi":"10.1016/j.drugpo.2025.104720","DOIUrl":"10.1016/j.drugpo.2025.104720","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis C (HCV) testing innovations such as dried blood spot (DBS) and point-of-care testing should have fewer client-related barriers than traditional diagnostic pathways, yet there is limited evidence on their acceptability among people who inject drugs. To address this gap, this study sought to evaluate the acceptability of DBS and point-of-care testing among people at risk of HCV infection and understand the circumstances in which such testing is most preferred.</div></div><div><h3>Methods</h3><div>Participants were recruited from community sites involved in the Australian HCV Point-of-Care Testing Program. Inclusion criteria were aged ≥18 years, sufficient proficiency in the English language, history of HCV testing at least once, and informed consent. Between June and August 2023, in-depth, semi-structured interviews were conducted via telephone with clients on their perceptions and experiences of HCV DBS and point-of-care testing. Data were coded and analysed thematically with Sekhon's theoretical framework of acceptability.</div></div><div><h3>Results</h3><div>Forty participants were interviewed: 18 had previously received HCV DBS testing, 8 had received HCV point-of-care testing, 8 had experience with both, and 6 had no prior experience with either test. Most participants preferred point-of-care compared to DBS and venepuncture due to the shorter time to result and some identified that this reduced anxiety while waiting for results (burden). Among participants in this study, many felt that the provision of non-judgemental care was more important than whether testing was performed by peers (ethicality). Many participants indicated a preference for assisted collection when compared to self-collected or mail testing service (self-efficacy).</div></div><div><h3>Conclusion</h3><div>Applying Sekhon's acceptability framework highlighted remaining service gaps to bridge client HCV testing experiences, including enhanced education on testing modalities and their results, an increased need for non-judgemental care, and the use of peer support in community settings.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104720"},"PeriodicalIF":4.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Basically every safety protocol we have in place to protect against overdose, parents can't access”: Mothers who use unregulated drugs’ experiences of dual public health emergencies","authors":"Jade Boyd","doi":"10.1016/j.drugpo.2025.104719","DOIUrl":"10.1016/j.drugpo.2025.104719","url":null,"abstract":"<div><h3>Background</h3><div>A growing body of research details the impacts of COVID-19 pandemic-related public health directives and service disruptions on people who use unregulated drugs, however, there is limited research on the gendered impacts, particularly among mothers.</div></div><div><h3>Methods</h3><div>To explore experiences navigating the COVID-19 pandemic during a toxic drug crisis, phone-based semi-structured interviews were conducted from May 2020–Sept. 2021 with 45 women who use unregulated drugs in British Columbia. Iterative-based thematic analysis informed by intersectional theory identified unaccounted for impacts on parents.</div></div><div><h3>Findings</h3><div>Respondents’ experiences of the COVID-19 pandemic involved contending with an increasingly toxic drug supply alongside reduced resources, including service reductions and closures and reduced access to harm reduction supplies in a context already marked by women's marginalization within treatment and policy. Mothers described pandemic-related increased custody and care barriers and burdens, resulting in inability to prioritize self-care. Decisions to prioritize associated risks of either COVID-19 or drug toxicity, given conflicting public health guidelines, were experienced as high stakes for mothers, due to their unique vulnerability to institutional scrutiny. Pandemic-informed overdose risk mitigations, such as access to legal pharmaceutical-grade alternatives to the toxic drug supply, also involved additional risks for mothers (e.g., heightened monitoring; child apprehension), thus, some respondents, responsibilized for their health and childcare, resourcefully relied upon informal, social networks to help mitigate potential harms.</div></div><div><h3>Conclusion</h3><div>While mothers and their experiences are heterogeneous, gendered distinctions impact provision and experience of health care, harm reduction and social supports. Mothers who use drugs must navigate health and care responsibilities, exacerbated by pandemic-related health barriers, while simultaneously inhabiting an unremitting state of fear of punitive measures or postapprehension despair. The continued social exclusion of mothers who use drugs, propelled by moralizing discourses framing them as deviant and consequentially undeserving, can have devastating health impacts (on individuals and communities) yet remain underaddressed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104719"},"PeriodicalIF":4.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding the optimal length of stay for veterans in substance use disorder residential treatment using generalized propensity score modeling","authors":"Gregory M. Dams ,&nbsp;Georgina M. Gross ,&nbsp;Bethany R. Ketchen ,&nbsp;Noelle B. Smith ,&nbsp;Jennifer L. Burden","doi":"10.1016/j.drugpo.2025.104715","DOIUrl":"10.1016/j.drugpo.2025.104715","url":null,"abstract":"<div><div>Substance use disorder (SUD) residential treatment provides critical services to patients with complex clinical needs. The Department of Veterans Affairs (VA) has over 70 SUD residential programs to meet the needs of veterans with severe SUD. Prior research is mixed on what SUD residential length of stay (LOS) duration maximizes average treatment outcomes, with some studies advocating for around 30 days and others advocating for at least 90 days. Much of this research is limited by methodological issues and fails to consider both outcomes for established patients and timely access for prospective patients. The present study sought to clarify the relative benefits of different LOSs to be considered by SUD residential program decision-makers as default LOSs, upon which to be personalized by individual patient needs and clinical assessment. Using medical record data associated with N = 15,889 veterans discharging from a VA SUD residential center between 10/1/2021 and 9/30/2022, we identified an optimal LOS range balancing average treatment outcomes and ensuring new patient access/minimizing established patient diminished returns from treatment. Using a generalized propensity-weighted dose-response curve, we identified key LOSs between 35 and 49 days with different tradeoffs between enhancing outcomes and access.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104715"},"PeriodicalIF":4.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring hepatitis C elimination among people who inject drugs: A broader approach is required","authors":"Gregory J. Dore","doi":"10.1016/j.drugpo.2025.104712","DOIUrl":"10.1016/j.drugpo.2025.104712","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104712"},"PeriodicalIF":4.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of implementing viral hepatitis services into a correctional service facility in Cape Town, South Africa","authors":"Andrew Scheibe ,&nbsp;Joel Steingo ,&nbsp;Gaynor Grace ,&nbsp;Helen Savva ,&nbsp;Mark Sonderup ,&nbsp;Harry Hausler ,&nbsp;C. Wendy Spearman","doi":"10.1016/j.drugpo.2025.104710","DOIUrl":"10.1016/j.drugpo.2025.104710","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis B virus (HBV) and hepatitis C virus (HCV) are estimated to be of the most prevalent infectious diseases in correctional settings worldwide. However, viral hepatitis services have not been routinely integrated into South African correctional facilities. We aimed to assess prevalence of HBV infection and HCV infection among people accessing HIV services and assess the feasibility of viral hepatitis service integration in a South African correctional centre.</div></div><div><h3>Methods</h3><div>Voluntarily participating people in a correctional services facility were offered free hepatitis B surface antigen (HBsAg) and anti-HCV point-of-care testing in addition to routine HIV testing and treatment services on a first-come, first-served basis during June 2021–March 2022. Off-site laboratory testing (HBV and HCV molecular testing and non-invasive liver fibrosis staging) and screening for hepatocellular carcinoma informed further management. A general practitioner at the facility managed participants, with virtual support from hepatologists. Data on age and history of injecting was collected and point-of-care and laboratory results were recorded. Data were analysed using descriptive statistics.</div></div><div><h3>Results</h3><div>The median age of the 765 people who participated was 32.5 years (IQR 27.5 – 38.2), with 2.2% (17/765) reporting having ever injected a drug. The sample prevalence was 3.9% (30/765) for HBV infection, 0.5% (3/665) for HCV infection, and 1.2% (9/765) for HIV-HBV coinfection. Thirty people had reactive HBsAg point-of-care tests. Among those with reactive HBsAg point-of-care tests 90.0% (27/30) received work-up, among whom 48.1% (13/27) were monitored, 44.4% (12/27) were placed on treatment and two people were released before a management plan could be finalised. Of those treated 33.3% (4/12) started tenofovir/emtricitabine and 66.7% (8/12) antiretroviral therapy. Of the eligible participants, 27.3% (201/735) received at least one hepatitis B vaccine dose and 26.9% (54/201) received three doses. All three participants who had confirmed HCV infection were started on direct-acting antivirals. Of the two completing treatment one achieved sustained virological response at 12 weeks (SVR12), one person was released before SVR12 was done. One person was lost to follow-up. No clinical adverse events were reported.</div></div><div><h3>Conclusion</h3><div>There was a notable viral hepatitis burden among people in this correctional centre and integration of viral hepatitis services into the existing HIV services was acceptable and feasible. Further efforts to sustain and expand access to viral hepatitis services in South African correctional centres could catalyse national viral hepatitis elimination efforts.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104710"},"PeriodicalIF":4.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do restrictions on opioid prescribing, harm reduction, and treatment coverage policies relate to opioid overdose deaths in the United States in 2013–2020? An application of a new state opioid policy scale","authors":"Samantha M. Doonan ,&nbsp;Katherine Wheeler-Martin ,&nbsp;Corey Davis ,&nbsp;Christine Mauro ,&nbsp;Emilie Bruzelius ,&nbsp;Stephen Crystal ,&nbsp;Zachary Mannes ,&nbsp;Sarah Gutkind ,&nbsp;Katherine M. Keyes ,&nbsp;Kara E. Rudolph ,&nbsp;Hillary Samples ,&nbsp;Stephen G. Henry ,&nbsp;Deborah S. Hasin ,&nbsp;Silvia S. Martins ,&nbsp;Magdalena Cerdá","doi":"10.1016/j.drugpo.2025.104713","DOIUrl":"10.1016/j.drugpo.2025.104713","url":null,"abstract":"<div><h3>Background</h3><div>Identifying the most effective state laws and provisions to reduce opioid overdose deaths remains critical.</div></div><div><h3>Methods</h3><div>Using expert ratings of opioid laws, we developed annual state scores for three domains: opioid prescribing restrictions, harm reduction, and Medicaid treatment coverage. We modeled associations of state opioid policy domain scores with opioid-involved overdose death counts in 3133 counties, and among racial/ethnic subgroups in 1485 counties (2013–2020). We modeled a second set of domain scores based solely on experts’ highest 20 ranked provisions to compare with the all-provisions model.</div></div><div><h3>Results</h3><div>From 2013 to 2020, moving from non- to full enactment of harm reduction domain laws (i.e., 0 to 1 in domain score) was associated with reduced county-level relative risk (RR) of opioid overdose death in the subsequent year (adjusted RR = 0.84, 95 % credible interval (CrI): 0.77, 0.92). Moving from non- to full enactment of opioid prescribing restrictions and Medicaid treatment coverage domains was associated with higher overdose in 2013–2016 (aRR 1.69 (1.35, 2.11) and aRR 1.20 (1.11, 1.29) respectively); both shifted to the null in 2017–2020. Effect sizes and direction were similar across racial/ethnic groups. Results for experts’ highest 20 ranked provisions did not differ from the all-provision model.</div></div><div><h3>Conclusions</h3><div>More robust state harm reduction policy scores were associated with reduced overdose risk, adjusting for other policy domains. Harmful associations with opioid prescribing restrictions in 2013–2016 may reflect early unintended consequences of these laws. Medicaid coverage domain findings did not align with experts’ perceptions, though data limitations precluded inclusion of several highly ranked Medicaid policies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104713"},"PeriodicalIF":4.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“We can't change that while they're in the hospital”: Unveiling the manifestations of infrastructural violence and wound care for people who inject drugs","authors":"Suzanne J. Block,&nbsp;Laura N. Sisson,&nbsp;Yasemin Taban,&nbsp;Tricia Triece,&nbsp;Susan G. Sherman,&nbsp;Kristin E. Schneider,&nbsp;Jill Owczarzak","doi":"10.1016/j.drugpo.2025.104716","DOIUrl":"10.1016/j.drugpo.2025.104716","url":null,"abstract":"<div><div>Healthcare avoidance or delays for wounds and related skin- and soft-tissue infections are often attributed to negative interactions with medical providers. An infrastructural violence framework posits that healthcare infrastructure serves as a material channel for structural violence, maintaining inequities in healthcare experiences and outcomes. Infrastructural violence ensues when infrastructure is designed for some members or groups within a society while perpetuating violence among others. This study draws on the concept to understand how healthcare infrastructure creates and perpetuates inequities within the healthcare system for people who inject drugs for their wound care-related needs. Between January and September 2023, semi-structured interviews were conducted with 12 medical providers in Maryland. An abductive thematic analysis approach was followed. Healthcare infrastructure mediated the relationship between structural factors, such as policies on prescribing privileges of medications for opioid use disorder and subsequent individual health experiences. Medical providers also described how their access to training, protocols, and other resources was insufficient to meet the needs of people who inject drugs presenting to healthcare settings for wound care. A new conceptual grounding provides recommendations on extending beyond medical provider behavior change interventions in healthcare settings to create supportive infrastructure, which includes readily available and accessible policies, protocols, and resources to care for this patient population.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"137 ","pages":"Article 104716"},"PeriodicalIF":4.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}