European Addiction Research最新文献

{"title":"The association of substance use and antisocial behaviours with the probability of gambling among adolescents.","authors":"Emina Mehanović, Mariaelisa Renna, Erica Viola, Giulia Giraudi, Maria Ginechesi, Claudia Vullo, Alberto Sciutto, Marco Martorana, Adalgisa Ceccano, Pietro Casella, Fabrizio Faggiano, Federica Vigna-Taglianti","doi":"10.1159/000546587","DOIUrl":"https://doi.org/10.1159/000546587","url":null,"abstract":"<p><strong>Introduction: </strong>Gambling behaviour among adolescents is a serious public health concern. Adolescents' involvement in gambling is often related with substance use and antisocial behaviours. This study aims to examine the association of substance use and antisocial behaviours with gambling among Italian early adolescents.</p><p><strong>Methods: </strong>The analytical sample of the present study included 1822 students attending 29 secondary schools in nine NHS districts of Piedmont region and the city of Rome who participated in the baseline survey of the experimental controlled trial \"GAPUnplugged\". The association of lifetime cigarette smoking, alcohol drinking, drunkenness, illicit drug use, violence and stealing with the probability of any gambling and regular gambling was estimated through multilevel mixed-effect regression models.</p><p><strong>Results: </strong>The prevalence of any gambling and regular gambling in the last 30 days was 36.4% and 12.7%, respectively. After adjustment for potential confounders, cigarette smoking, alcohol drinking, drunkenness, violence and stealing were significantly associated with an increased probability of both gambling outcomes. The link of gambling outcomes with alcohol drinking and drunkenness was higher for females, whereas the association with violence and stealing was higher for males.</p><p><strong>Conclusion: </strong>Due to the association of gambling with other problem behaviours during early adolescence, school-based health promotion and prevention interventions should address multiple risk behaviours simultaneously. Prevention of one risk behaviour may contribute to the prevention of other risk behaviours.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141741","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":"Changes in inhibition-related brain function and psychological flexibility during smoking abstinence: A machine-learning prediction of time to relapse.","authors":"Louis-Ferdinand Lespine, Laura M Rueda-Delgado, Nigel Vahey, Kathy L Ruddy, Hanni Kiiski, Nadja Enz, Rory Boyle, Laura Rai, Gabi Pragulbickaite, Jonathan B Bricker, Louise McHugh, Robert Whelan","doi":"10.1159/000546112","DOIUrl":"https://doi.org/10.1159/000546112","url":null,"abstract":"<p><strong>Introduction: </strong>Despite substantial health benefits, smoking cessation attempts have high relapse rates. Neuroimaging measures can sometimes predict individual differences in substance use phenotypes - including relapse - better than behavioral metrics alone. No study to date has compared the relative prediction ability of changes in psychological processes across prolonged abstinence with corresponding changes in brain activity.</p><p><strong>Methods: </strong>Here, in a longitudinal design, measurements were made one day prior to smoking cessation, and at 1 and 4 weeks post-cessation (total n=120). Next, we tested the relative role of changes in psychosocial variables vs. task-based functional brain measures predicting time to nicotine relapse up to 12 months. Abstinence was bioverified 4-5 times during the first month. Data were analyzed with a novel machine learning approach to predict relapse.</p><p><strong>Results: </strong>Results showed that increased electrophysiological brain activity during inhibitory control predicted longer time-to-relapse (c-index=0.56). However, reward-related brain activity was not predictive (c-index=0.45). Psychological variables, notably an increase during abstinence in psychological flexibility when experiencing negative smoking-related sensations, predicted longer time-to-relapse (c-index=0.63). A model combining psychosocial and brain data was predictive (c-index=0.68). Using a best-practice approach, we demonstrated generalizability of the combined model on a previously unseen holdout validation dataset (c-index=0.59 vs. 0.42 for a null model).</p><p><strong>Conclusion: </strong>These results show that changes during abstinence - increased smoking-specific psychological flexibility and increased inhibitory control brain function - are important in predicting time to relapse from smoking cessation. In the future, monitoring and augmenting changes in these variables could help improve the chances of successful nicotine smoking abstinence.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-26"},"PeriodicalIF":2.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976173","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":"Development of the Gamma-hydroxybutyrate withdrawal symptom questionnaire (GWSQ).","authors":"Amber M L Wood, Arnt F A Schellekens, Boukje A G Dijkstra, Casper J H Wolf, Harmen Beurmanjer","doi":"10.1159/000545700","DOIUrl":"https://doi.org/10.1159/000545700","url":null,"abstract":"<p><p>Introduction Gamma-hydroxybutyrate (GHB) dependence has been associated with a potentially fulminant withdrawal syndrome. As GHB withdrawal symptoms can rapidly progress from mild to more severe, close monitoring during detoxification is important. However, a concise, GHB-specific withdrawal scale is currently lacking. The aim of this study is to compose a concise GHB-specific withdrawal scale as monitoring instrument. Method This study used monitoring data from 285 patients with GHB use disorder (GUD) admitted for inpatient detoxification. The six-step plan for shortening measurement scales proposed by Goetz et al. (2013) was applied. Only subjective GHB withdrawal symptoms were used. To identify the factor structure, a principal component analysis (PCA) with Direct Oblimin Rotation was performed. The pattern matrix was used to assess the factor loading per item. Item selection was based on factor loadings >0.4 and clinical relevance of the symptoms. Multiple lists were created whose psychometric qualities (concurrent validity, convergent validity, reliability) were compared. Results The PCA resulted in eight components (Eigenvalue > 1.0). Item selection resulted in five candidate lists with 8, 9, 16 (2x) and 27 items. All lists showed good concurrent and convergent validity. Only one with 16 items combined good psychometric properties with the need for a shortened questionnaire combined with all clinically relevant items. Conclusions We recommend a novel 16-item GHB Withdrawal Symptoms Questionnaire (GWSQ) to monitor withdrawal during detoxification in patients with GUD. Implementation of this scale should be evaluated to determine its validity and usefulness in clinical practice.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959968","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":"Erratum.","authors":"","doi":"10.1159/000545157","DOIUrl":"https://doi.org/10.1159/000545157","url":null,"abstract":"","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Moderating Effect of Tobacco Smoking on the Efficacy of a Computer-Based Brief Alcohol Intervention: Results from a Randomized Controlled Trial.","authors":"Cedric Gerbracht, Andreas Staudt, Jennis Freyer-Adam, Gallus Bischof, Christian Meyer, Ulrich John, Sophie Baumann","doi":"10.1159/000545866","DOIUrl":"10.1159/000545866","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol consumption and tobacco smoking may have synergistic harmful effects when present in combination. This combination is highly prevalent and associated with a multitude of diseases. Brief alcohol intervention (BAI) may be less effective among persons who drink alcohol and smoke tobacco than among persons who drink alcohol and do not smoke. The aim of this study was to find out whether BAI is more effective among adults who do not smoke than among those who smoke.</p><p><strong>Methods: </strong>This study reports secondary outcome analyses of the randomized controlled trial \"Testing a proactive expert system intervention to prevent and to quit at-risk alcohol use.\" Among municipal office clients, 1,646 who were aged 18-64 and consumed alcohol in the last year participated. Using latent growth curve models, the impact of BAI was compared by incidence rate ratios (IRRs) of self-reported heavy drinking days and the moderating effect of smoking was investigated.</p><p><strong>Results: </strong>There was no significant difference between intervention and control in reducing heavy drinking days in persons who never smoked (IRR 1.01, 95% confidence interval [CI] 0.92-1.10, p = 0.847), formerly smoked (IRR 0.91, CI 0.77-1.07, p = 0.234), currently smoked less than daily (IRR 0.98, CI 0.86-1.12, p = 0.782) and persons who currently smoked daily (IRR 1.09, CI 0.98-1.22, p = 0.125).</p><p><strong>Conclusion: </strong>The effect of BAI did not differ among study participants who currently smoked as among participants who did not. Although not statistically significant, persons who formerly smoked tended to benefit. Persons who currently smoked did not benefit.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-11"},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003991","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":"Diversion of Diacetylmorphine in Heroin-Assisted Treatment: A Focus Group Study among Patients and Treatment Providers.","authors":"Elisabeth Strickler, Zacharias Wicki, Jean N Westenberg, Johannes Strasser, Undine E Lang, Kenneth M Dürsteler, Maximilian Meyer, Marc Vogel","doi":"10.1159/000545162","DOIUrl":"10.1159/000545162","url":null,"abstract":"<p><strong>Introduction: </strong>Heroin-assisted treatment (HAT) involves the supervised administration of pharmaceutical heroin (diacetylmorphine; DAM), either injectable or oral, for individuals with severe opioid use disorder who have not achieved stabilisation with conventional opioid agonist treatment. Despite its growing adoption, there is limited literature on the phenomenon of diversion in HAT. Diversion refers to the redirecting of legal prescription medications from their intended medical use to illegal or unauthorised use. This study aimed to investigate the reasons for, experiences with, and consequences of DAM diversion, as reported by both patients and treatment providers.</p><p><strong>Methods: </strong>In this qualitative study, two separate focus groups were conducted with patients and treatment providers (nurses, psychiatrists, social workers, and psychologists), respectively. Discussions were audio-recorded, transcribed, and analysed. Mayring's qualitative content analysis was used to evaluate the findings.</p><p><strong>Results: </strong>Five themes with fourteen categories emerged. Providers and patients both described procedures and motives of diversion, discussed the positive and negative consequences, and suggested solutions for reduced future diversion of DAM. An important motif for diversion stemmed from patients' urge for more autonomy over route, timing, and fractioning of administration, while also being used to finance concurrent cocaine use. Treatment providers and patients both noted that diversion may lead to increased overdose risk for individuals in and out of treatment. Nurses noted a substantial negative impact of diversion on the therapeutic relationship. Suggestions for reducing diversion included allowing for more take-home dosing, allowing for more flexibility in routes of administration, adapting HAT clinic opening hours, and providing effective treatment for cocaine use disorder.</p><p><strong>Conclusion: </strong>The main drivers of diversion in HAT included a desire for more autonomy, unaddressed concurrent substance use, and significant barriers to the existing treatment options. Addressing patients' preferred opioid effect profile, accommodating their social needs, and managing concurrent cocaine use disorders may reduce diversion in the future.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-12"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623965","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":"Exploring Associations between Cannabis Prices, Stores, and Usage after Recreational Legalization.","authors":"Michael J Armstrong","doi":"10.1159/000544104","DOIUrl":"https://doi.org/10.1159/000544104","url":null,"abstract":"<p><strong>Introduction: </strong>Canada legalized recreational cannabis in October 2018, but commercial retailing took time to develop. This study first explored how self-reported cannabis use prevalence, daily use, product type use, and age of initial use changed during 2019-2023. It then analyzed whether the changes were associated with rising store numbers or falling prices.</p><p><strong>Methods: </strong>Data on store counts, retail pricing, and cannabis use came from government reports covering 10 provinces over 5 years. Panel data linear regressions analyzed 50 province-year aggregated observations.</p><p><strong>Results: </strong>There were no significant changes in prevalence among males and people aged 16-24 or in the proportion using cannabis daily. Prevalence among females and people aged 25+ increased; those levels showed negative associations with prices but not stores. Dried cannabis use decreased, while edibles use increased; those also showed associations with prices but not stores. Mean initial age of use increased; it was negatively associated with prices and positively with stores.</p><p><strong>Conclusion: </strong>Canada's large cannabis retail expansion was accompanied by relatively modest usage changes, most of which showed associations with falling prices but not rising store counts.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-8"},"PeriodicalIF":2.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585156","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":"Cognitive Function among People with Severe Substance Use.","authors":"Nina Auestad, Stig Tore Bogstrand, Odd Martin Vallersnes, Anners Lerdal, Linda Elise Couëssurel Wüsthoff","doi":"10.1159/000543755","DOIUrl":"10.1159/000543755","url":null,"abstract":"<p><strong>Introduction: </strong>Studies report a high variability of cognitive impairment in people who use drugs, ranging from 20% to 80%. Most research focuses on individuals who use drugs who are either admitted to treatment facilities or incarcerated and being abstinent from substances. The present study aimed to assess cognitive function among populations with ongoing, severe, habitual substance use, mimicking a real-world day-to-day situation.</p><p><strong>Methods: </strong>Cross-sectional design with 171 participants (70.2% male) with severe substance use, recruited from two sites in Oslo, Norway. All participants were screened for cognitive function using the Montreal Cognitive Assessment (MoCA). A cutoff of <26 points was used to classify possible cognitive impairment. Participants also provided information on their alcohol and substance use, as well as demographic data.</p><p><strong>Results: </strong>74.9% of the participants scored below the MoCA cutoff for possible cognitive impairment. We did not find any associations between scoring below the MoCA cutoff <26 and the substance use variables (substance use, number of substances used, history of overdoses, injection drug use, and past substance use treatment).</p><p><strong>Conclusion: </strong>A high proportion of people with severe substance use may experience a functional cognitive impairment. This study provides novel insights into cognitive function within a population actively engaged in habitual substance use, offering a real-world perspective with high external validity. This knowledge is highly relevant for service providers who aim to deliver tailored follow-up services to this population outside of traditional treatment settings.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"1-12"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122605","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":"ESCAPE Study: Cannabidiol Use in Patients Treated for Substance Use Disorders, Prevalence of Use, and Characteristics of Users.","authors":"Mélanie Duval, Marion Istvan, Morgane Rousselet, Edouard-Jules Laforgue, Marie Grall-Bronnec, Claire Mauriat, Caroline Victorri-Vigneau","doi":"10.1159/000541887","DOIUrl":"10.1159/000541887","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabidiol (CBD) is one of the two primary phytocannabinoids found in cannabis. Its diverse pharmacological properties suggest potential benefits for a wide range of medical conditions. The primary objective of this study was to estimate the prevalence of CBD use among patients being treated for substance use disorder. Additionally, we aimed to characterize the pattern of CBD use and describe the profiles of users.</p><p><strong>Methods: </strong>Patients admitted to two substance use disorder departments between May 6, 2020, and July 23, 2021, were included in the study. Sociodemographic, medical and substance use data, including CBD use, were collected. A multiple correspondence analysis (MCA) was performed to identify substance uses most frequently correlated with CBD use. Multivariate analyses were also conducted to identify factors associated with CBD use.</p><p><strong>Results: </strong>The prevalence of CBD use in the past 12 months among the 183 patients was 38.2%. However, at the time of the study, 63% had stopped using CBD, primarily due to its perceived ineffectiveness and cost. CBD was commonly consumed via inhalation, either by smoking the plant or using e-cigarette liquids. The MCA revealed that while there is no typical profile of CBD users, they were more likely to use sedative substances rather than stimulants. CBD users were younger and more likely to have psychiatric comorbidities.</p><p><strong>Conclusion: </strong>The prevalence of CBD use was notably high. Given the significant risk of drug interactions with CBD and its wide variability in composition, it is crucial for clinicians to routinely inquire about CBD use. The potential for self-therapeutic or recreational use in these patients appears to be underestimated.</p>","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"35-46"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767008","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":"Psychometric Evaluation of the Dutch Version of the Substance Use Recovery Evaluator (SURE-NL).","authors":"Charlotte Migchels, Wim van den Brink, Amine Zerrouk, Frieda I A Matthys, Clara De Ruysscher, Dries Debeer, Wouter Vanderplasschen, Cleo Lina Crunelle","doi":"10.1159/000541584","DOIUrl":"10.1159/000541584","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Patient-reported outcome measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The substance use recovery evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD. The objective of this study was to examine the validity and reliability of the Dutch translation of the SURE, the SURE-NL, for measuring indicators of recovery in Dutch-speaking patients with SUD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The original SURE questionnaire was translated from English to Dutch using forward-backward translation. A total of N = 171 participants were recruited as part of a naturalistic multicenter study in inpatient (N = 149) and outpatient (N = 22) SUD treatment centers. We examined the factorial structure, reliability, and concurrent and discriminant validity of the SURE-NL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The original 5-factor structure of the SURE showed acceptable fit for the SURE-NL, and internal consistencies of the subscales ranged from 0.61 to 0.76; internal consistency of the total score was 0.83. Concurrent validity was confirmed through positive correlations of the SURE-NL total and subscale scores with the WHOQoL-BREF subscales, but correlations varied depending on subscale and treatment setting, with higher correlations for the outpatient compared to the inpatient subgroup. Discriminant validity was confirmed through low, mostly non-significant correlations between the SURE-NL and the DASS-21.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although the SURE was originally designed for outpatient settings, our findings in a predominantly inpatient sample indicate that the SURE-NL is suitable for assessing personal recovery and recovery capital in Dutch-speaking Belgian patients with SUD. However, subscales should be used and interpreted with caution. Further research is needed with larger Dutch-speaking outpatient samples and the development of a tailored SURE for inpatient settings should be considered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Patient-reported outcome measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The substance use recovery evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD. The objective of this study was to examine the validity and reliability of the Dutch translation of the SURE, the SURE-NL, for measuring indicators of recovery in Dutch-speaking pat","PeriodicalId":11902,"journal":{"name":"European Addiction Research","volume":" ","pages":"13-22"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}