Comprehensive psychiatry最新文献

{"title":"Pharmacological management of gambling disorder: A systematic review and network meta-analysis","authors":"Konstantinos Ioannidis ,&nbsp;Cinzia Del Giovane ,&nbsp;Charidimos Tzagarakis ,&nbsp;Jeremy E. Solly ,&nbsp;Samuel J. Westwood ,&nbsp;Valeria Parlatini ,&nbsp;Henrietta Bowden-Jones ,&nbsp;Jon E. Grant ,&nbsp;Samuele Cortese ,&nbsp;Samuel R. Chamberlain","doi":"10.1016/j.comppsych.2024.152566","DOIUrl":"10.1016/j.comppsych.2024.152566","url":null,"abstract":"<div><h3>Background</h3><div>Clinical guidelines remain unclear on which medications for gambling disorder are to be preferred in terms of efficacy and tolerability. We aimed to compare pharmacological treatments for gambling disorder in terms of efficacy and tolerability, using network meta-analysis (NMA).</div></div><div><h3>Methods</h3><div>Based on our pre-registered protocol [CRD42022329520], a structured search was conducted across broad range of databases, for double-blind randomized controlled trials (RCTs) of medications for gambling disorder. Data were independently extracted by two researchers. We used standardized mean differences (SMD) using Hedges' g to measure the efficacy outcomes, and for the effect for tolerability we used dropout rate due to medication side effects, expressed as odds ratio (OR). Confidence in the network estimates was assessed using the CINeMA framework. We followed the PRISMA-NMA guidelines for this work. Outcomes were gambling symptom severity and quality of life (for efficacy), and tolerability.</div></div><div><h3>Findings</h3><div>We included 22 RCTs in the systematic review and 16 RCTs (<em>n</em> = 977 participants) in the NMA. Compared with placebo, moderate confidence evidence indicated that nalmefene [Standardized Mean Difference (SMD): −0.86; 95 % confidence interval (CI: −1.32,-0.41)] reduced gambling severity, followed by naltrexone (SMD: -0.42; 95 %CI: (−0.85,0.01)). Naltrexone (SMD: -0.50; 95 %CI: (−0.85,-0.14)) and nalmefene (SMD: -0.36; 95 %CI: (−0.72,-0.01) were also more beneficial than placebo in terms of quality of life. Olanzapine and topiramate were not more efficacious than placebo. Nalmefene [Odds Ratio (OR): 7.55; 95 %CI: (2.24–25.41)] and naltrexone (OR: 7.82; 95 %CI: (1.26–48.70)) had significantly higher dropout due to side effects (lower tolerability) compared with placebo.</div></div><div><h3>Interpretation</h3><div>Based on NMA, nalmefene and naltrexone currently have the most supportive evidence for the pharmacological treatment of gambling disorder. Further clinical trials of novel compounds, and analysis of individual participant data are needed, to strengthen the evidence base, and help tailor treatments at the individual patient level.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"137 ","pages":"Article 152566"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827616","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":"Longitudinal relationship between internet addiction and psychotic-like experiences among Chinese college students","authors":"Pu Peng ,&nbsp;Hongyu Zou","doi":"10.1016/j.comppsych.2024.152572","DOIUrl":"10.1016/j.comppsych.2024.152572","url":null,"abstract":"<div><h3>Background</h3><div>While previous cross-sectional studies have suggested a link between psychotic-like experiences (PLEs) and internet addiction (IA), longitudinal evidence remains scarce. This study aimed to explore the prospective relationship between IA and PLEs among college students.</div></div><div><h3>Method</h3><div>A total of 636 college students (80 % female) were assessed in November 2022 and again one year later. IA was measured using the Internet Addiction Diagnosis Questionnaire (IADQ), and PLEs were assessed with the 16-item Prodromal Questionnaire (PQ-16). Demographic, psychological, and environmental factors were collected and controlled. Multiple logistic regression and cross-lagged panel analyses examined the longitudinal associations between IA and PLEs.</div></div><div><h3>Results</h3><div>At baseline, the prevalence of IA and PLEs was 11.3 % and 16.8 %, respectively. Higher baseline IADQ scores (Adjusted odds ratio = 1.035; 95 % confidence interval = 1.002–1.069; <em>p</em> = 0.036) were independently associated with an increased risk of PLEs at follow-up, while baseline PQ-16 scores were not linked to later IA. Cross-lagged panel analysis revealed that IA at baseline predicted later PLEs (β = 0.082, <em>p</em> = 0.043), whereas baseline PLEs did not predict IA (β = 0.049, <em>p</em> = 0.255). Specifically, IA predicted unusual thoughts (β = 0.122, <em>p</em> = 0.003) and negative PLEs (β = 0.111, <em>p</em> = 0.008), but not perceptual abnormalities (β = 0.040, <em>p</em> = 0.301).</div></div><div><h3>Conclusion</h3><div>IA may be an independent risk factor for PLEs in college students, particularly for unusual thoughts and negative PLEs, but not for perceptual abnormalities. Targeted interventions addressing IA may help reduce PLEs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"137 ","pages":"Article 152572"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001422","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":"Corrigendum to “An investigation into symptoms of depression and anxiety and emotion regulation among older adolescents from low-income settings in South Africa” [Journal Title volume (year) Start page–End page/Article Number: Comprehensive Psychiatry Volume 132, July 2024, 152476]","authors":"C. Ward-Smith,&nbsp;K. Sorsdahl,&nbsp;C. van der Westhuizen","doi":"10.1016/j.comppsych.2025.152577","DOIUrl":"10.1016/j.comppsych.2025.152577","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152577"},"PeriodicalIF":4.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074151","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":"Sharing knowledge on implementing mental health and wellbeing projects for veterans and first responders","authors":"Cindy Woods,&nbsp;Sally Fitzpatrick,&nbsp;Sue Lukersmith","doi":"10.1016/j.comppsych.2025.152579","DOIUrl":"10.1016/j.comppsych.2025.152579","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to describe the knowledge to action and knowledge transfer approaches used in an international mental health research funding program and its outcomes. A key goal of the evaluation was to maximise organisational learning and knowledge sharing to inform future implementation projects.</div></div><div><h3>Methods</h3><div>A series of interactive knowledge sharing workshops focused on five key themes: peer support; psychoeducation; the involvement of family, friends, and significant others; retreat, residential, or group-based programs; and organisational change. Qualitative descriptive analysis was used to code, summarise and describe themes.</div></div><div><h3>Findings</h3><div>Key learnings that influenced the success of mental health initiatives include building relationships across all organisational levels, involving Veterans and First Responders with lived experience in the design and implementation process, and understanding the unique workplace culture and operations.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the need for collaborative, informed approaches tailored to the culture, organisation and mental health support needs of Veteran and First Responder. These insights enhance understanding of the factors that impact the successful implementation of mental health prevention and support programs for those exposed to work-related trauma.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152579"},"PeriodicalIF":4.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074122","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":"An ecosystem approach to the evaluation and impact analysis of heterogeneous preventive and/or early interventions projects for veterans and first responders in seven countries","authors":"S. Lukersmith ,&nbsp;L. Salvador-Carulla ,&nbsp;C. Woods ,&nbsp;T. Niyonsenga ,&nbsp;M.R. Gutierrez-Colosia ,&nbsp;I. Mohanty ,&nbsp;C.R. Garcia-Alonso ,&nbsp;D. Diaz-Milanes ,&nbsp;J.A. Salinas-Perez ,&nbsp;R. Davey ,&nbsp;A. Aryani","doi":"10.1016/j.comppsych.2025.152578","DOIUrl":"10.1016/j.comppsych.2025.152578","url":null,"abstract":"<div><h3>Background</h3><div>Cumulative exposure to critical incidents and life-threatening events leads to significant risk for Veterans and First Responders (VFRs) developing mental ill health and disorders. Philanthropic organisations, Movember and Distinguished Gentleman's Ride, funded 15 organisations to conduct early intervention Projects across seven countries. The Projects aim to improve the mental health and wellbeing of VFRs, their families/significant others. This paper describes the novel external evaluation and impact analysis methods to identify effective Projects having positive impact on VFRs and their families, provide return on investment and the overall Grant Program.</div></div><div><h3>Methods</h3><div>We take an ecosystem real-world approach, which recognises the context and aims to manage the complexities involved, uses a complexity and systems perspective, multi-step mixed methods and approaches. The evaluation is from three perspectives of: Projects; Project comparisons; Grant program. Embedded in the evaluation design are methods, knowledge sharing and organisational learning activities for all stakeholders. Data is collected by the Projects and evaluation team on input, throughputs, and output indicators. Analysis tools include Global Impact Analytics Framework, multi-layered statistical analysis, performance evaluation using an efficient decision support approach, Project and Grant program social return on investment, visual linking and data connection platform and assessment of gendered lens approaches.</div></div><div><h3>Implications</h3><div>The complexity and heterogeneity of Projects implemented in the real world continues to present significant evaluation challenges and limitations for project leads, stakeholders, researchers and evaluators. Our ecosystem approach and novel evaluation methodology will reduce the uncertainty around real world implementation, provide key learnings for project stakeholders and more broadly implementation researchers.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152578"},"PeriodicalIF":4.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074102","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":"The clinical phenomenology of skin-picking disorder – Are there any obsessive-compulsive components?","authors":"Anne Schienle","doi":"10.1016/j.comppsych.2025.152575","DOIUrl":"10.1016/j.comppsych.2025.152575","url":null,"abstract":"<div><h3>Background</h3><div>Skin-picking disorder (SPD) is currently conceptualized as a condition related to obsessive-compulsive disorder (OCD). The present study investigated whether the emotional, cognitive, and somatic components of skin-picking episodes align with this conceptual framework.</div></div><div><h3>Method</h3><div>A total of 134 patients diagnosed with SPD (mean age = 32 years; 84 % female; average symptom duration: 16 years) underwent in-person clinical assessment. Patients were asked to describe what they experienced directly before, during, and after picking their skin.</div></div><div><h3>Results</h3><div>Patients reported a very strong urge to manipulate their skin, particularly in situations characterized by emotional and/or bodily tension. No obsession-like phenomena preceded the skin-picking episodes. Skin manipulation had an immediately rewarding effect in the majority of patients or induced ‘trance-like’ states. After terminating a skin-picking episode, negative self-conscious emotions were dominant.</div></div><div><h3>Conclusions</h3><div>The interview findings do not align with the conceptualization of SPD as an OCD-related disorder. Patients reported no obsession-like symptoms, and their skin-picking behaviors did not serve harm prevention, which is characteristic of compulsions. Instead, the rewarding nature of skin-picking and its function in experiential avoidance suggests an addiction component to this behavior.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152575"},"PeriodicalIF":4.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028152","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":"Sociocultural and perinatal health factors associated with Autism spectrum disorder (ASD) in children","authors":"Phone Myat (Eric) ,&nbsp;James Rufus John ,&nbsp;Alicia Montgomery ,&nbsp;Valsamma Eapen","doi":"10.1016/j.comppsych.2025.152576","DOIUrl":"10.1016/j.comppsych.2025.152576","url":null,"abstract":"<div><div>While previous research has examined perinatal factors in the context of Autism Spectrum Disorder (ASD), studies focusing on sociocultural factors is limited. We conducted a cross-sectional analysis utilizing data from the Australian Autism Biobank (AAB), which encompasses autistic children aged 2–17, their siblings, parents, and unrelated controls. Employing multivariable regression analyses, we aimed to identify factors associated with ASD across various domains, spanning health and lifestyle, perinatal, and postnatal contexts. Importantly, our analyses were adjusted for critical sociodemographic covariates. Advanced maternal age, male sex at birth, and identifying as from culturally and linguistically diverse (CALD) background, were found to be associated with risk of ASD. Pre-existing chronic health conditions in both parents and paternal medication use before conception were also associated with ASD risk in children. Associations with complications during pregnancy, caesarean delivery, and maternal medication use during pregnancy were also found. Postnatal factors of interest included the presence of health conditions (e.g., epilepsy), infections in early-life (e.g., respiratory infections), and atypical development in the first six months of life (e.g., hypotonia). These insights can guide closer monitoring and support for those with pre-existing vulnerabilities especially in terms of certain perinatal and sociocultural characteristics.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152576"},"PeriodicalIF":4.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001443","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":"Hikikomori (prolonged social withdrawal) and co-occurring psychiatric disorders and symptoms in adolescents and young adults: A scoping review","authors":"Virginia Pupi ,&nbsp;Cinzia Bressi ,&nbsp;Paola Maria Porcelli ,&nbsp;Maria Gloria Rossetti ,&nbsp;Marcella Bellani ,&nbsp;Antonio Trabacca ,&nbsp;Paolo Brambilla ,&nbsp;Antonella Delle Fave ,&nbsp;the SOLITAIRE group","doi":"10.1016/j.comppsych.2024.152573","DOIUrl":"10.1016/j.comppsych.2024.152573","url":null,"abstract":"<div><h3>Background</h3><div>Hikikomori, or prolonged social withdrawal, is a clinical condition usually emerging during adolescence or young adulthood, characterized by severe self-isolation in one's home, and often associated with other psychiatric disorders and symptoms.</div></div><div><h3>Objective</h3><div>The study summarized evidence of hikikomori diagnostic criteria, clinical manifestations, and comorbidity with psychiatric disorders and symptoms in adolescents and young adults.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following PRISMA guidelines, with four electronic databases searched for original works in English, French, and Italian published since 2010.</div></div><div><h3>Results</h3><div>A total of 15 studies were selected, 7 involved adolescents, 4 young adults, and 4 participants from both age groups. Most studies relied on the diagnostic criteria proposed for hikikomori inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Differences in hikikomori and comorbidity profiles were identified between adolescents and young adults.</div></div><div><h3>Conclusions</h3><div>Heterogeneity characterized hikikomori diagnostic criteria, comorbidity, demographic and clinical features of the study samples. Studies adopting more homogeneous populations, shared diagnostic criteria, consistent assessment tools and longitudinal designs are needed to better clarify the clinical features of hikikomori in young people.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"138 ","pages":"Article 152573"},"PeriodicalIF":4.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001442","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":"Adequacy of treatment in outpatients with obsessive-compulsive disorder","authors":"S.E. Cohen ,&nbsp;B.W. Storosum ,&nbsp;N.C. Vulink ,&nbsp;P.P. De Koning ,&nbsp;Y. Namavar ,&nbsp;J.B. Zantvoord ,&nbsp;D. Denys","doi":"10.1016/j.comppsych.2024.152546","DOIUrl":"10.1016/j.comppsych.2024.152546","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether patients with obsessive-compulsive disorder (OCD) are adequately treated with pharmacotherapy before referral to a specialized center for OCD.</div></div><div><h3>Methods</h3><div>We performed a retrospective chart review of patients with OCD who were seen for intake at an academic outpatient center in The Netherlands between 2016 and 2023. We collected data on age, gender, illness severity using the Yale-Brown Obsessive-Compulsive Scale, duration of illness, comorbidity and past pharmacotherapy and psychotherapy. Following the international treatment guidelines, we calculated percentages of patients treated with one SSRI, two or more SSRIs, clomipramine and/or antipsychotic augmentation treatments. Using multiple regression, we analyzed if patient and illness characteristics influenced the adequacy of treatment.</div></div><div><h3>Results</h3><div>We included 673 patients with an average YBOCS score of 27. 76 % had taken at least one SSRI, and 35 % at least two SSRIs before admission. Only 29 % received a high SSRI-dose and 4 % had taken at least two SSRIs in high dose. Clomipramine and antipsychotics augmentation had been taken by less than one-third of patients. Only 3 % of referred patients followed all guideline-recommended treatment steps. Although the vast majority of patients had received some form of psychotherapy, a minority had received exposure and response prevention treatment. Multiple regression showed that illness duration and having received psychotherapy were independent moderators of the adequacy of pharmacological treatment.</div></div><div><h3>Conclusion</h3><div>Patients with OCD are not being treated adequately according to the pharmacological guidelines. Poor pharmacological treatment may lead to increased duration of illness, suboptimal recovery and unnecessary societal costs. Further research could clarify barriers for patients and caregivers, and facilitate improvement of pharmacological treatment for OCS.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152546"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681120","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":"A comparison of firefighter mental health education programs: A descriptive thematic analysis of firefighter experiences","authors":"Sara M. Stretton ,&nbsp;Joy C. MacDermid ,&nbsp;Margaret Lomotan ,&nbsp;Shannon C. Killip","doi":"10.1016/j.comppsych.2024.152547","DOIUrl":"10.1016/j.comppsych.2024.152547","url":null,"abstract":"<div><h3>Background</h3><div>In response to the inherent critical incident exposures experienced by firefighters, various mental health education programs have been developed. The purpose of this study was to explore the perceptions of firefighters who took such programs to understand differences/similarities across these programs.</div></div><div><h3>Methods</h3><div>We recruited 14 participants, who had taken or delivered two or more programs for firefighters (Resilient Minds (RM), Road to Mental Readiness (R2MR), and Before Operational Stress (BOS)). Participants participated in semi-structured interviews, which explored information that they learned, recalled, used, and their preferences. Data was analysed using thematic analysis.</div></div><div><h3>Results</h3><div>Participants believed that all programs had some shared teaching methods, goals, skills, and topics; however, each program had key focuses/distinctive features. RM was said to be largely group participation and focused on assisting yourself, peers, and citizens. R2MR and BOS was said to be largely lecture style with a focus on the self. 70 % of participants who took RM (<em>n</em> = 7) and one other course preferred RM due to the specificity of training to firefighters, more active teaching methods, and focus on practical skill development. Others (43 %) had no program preference. Participants suggest that a tiered approach to mental health education would benefit firefighters.</div></div><div><h3>Conclusions</h3><div>All programs were seen as helpful. Despite some congruency in goals and content, most firefighters preferred RM because the content was fire-specific, and the pedagogical approach was seen as more active and engaging. Program characteristics are important to facilitate appropriate program selection, as such, programs should be explicit about these aspects.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152547"},"PeriodicalIF":4.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681119","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}