International Journal of Psychiatry in Clinical Practice最新文献

{"title":"The efficacy of metformin in counteracting olanzapine-induced hyperprolactinemia: an open-label prospective study.","authors":"Kah Kheng Goh, Tzu-Hua Wu, Chun-Hsin Chen, Po-Yu Chen, Mong-Liang Lu","doi":"10.1080/13651501.2025.2550501","DOIUrl":"https://doi.org/10.1080/13651501.2025.2550501","url":null,"abstract":"<p><strong>Objectives: </strong>Prolactin elevation is a common adverse effect of antipsychotic medications. The study aimed to explore the potential of metformin in managing olanzapine-induced hyperprolactinaemia.</p><p><strong>Methods: </strong>A prospective study was designed to investigate the changes in prolactin levels over an eight-week metformin treatment. Thirty-one patients with schizophrenia (aged 18-60 years) on a stable dose of olanzapine for at least three months were enrolled. Participants received metformin at 1500 mg/day for eight weeks. Prolactin levels and metabolic parameters were measured at baseline and at weeks 2, 4, 6, and 8.</p><p><strong>Results: </strong>After eight weeks of metformin intervention, prolactin levels significantly decreased from 39.7 ± 20.0 ng/mL at baseline to 35.7 ± 15.7 ng/mL (<i>p</i> = 0.005) with a moderate effect size (Cohen's <i>d</i> = 0.545). Reductions in prolactin levels correlated positively with baseline prolactin levels (<i>r</i> = 0.72, <i>p</i> < 0.001) and baseline glucose levels (<i>r</i> = 0.47, <i>p</i> = 0.008). Body weight, BMI, insulin level, glucose level, and insulin resistance significantly decreased after metformin treatment.</p><p><strong>Conclusion: </strong>Although participants experienced mild hyperprolactinaemia, metformin effectively counteracted prolactin elevation and improved metabolic parameters. This study highlights metformin's potential to mitigate antipsychotic-induced adverse effect.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"1-7"},"PeriodicalIF":2.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of binge eating disorder in obese or overweight individuals with stable bipolar disorder participating in a weight loss trial - a post hoc analysis.","authors":"Anna I Guerdjikova, Thomas J Blom, Nicole Mori, Francisco Romo-Nava, Susan L McElroy","doi":"10.1080/13651501.2025.2549307","DOIUrl":"https://doi.org/10.1080/13651501.2025.2549307","url":null,"abstract":"<p><strong>Objective: </strong>To inform clinical decision-making for patients with obesity, binge eating disorder (BED) and bipolar disorder (BD), we compared individuals with BED and those without BED who participated in a randomised controlled trial (RCT) of liraglutide for weight loss in stable BD with obesity.</p><p><strong>Methods: </strong>This was a post hoc analysis of a published, 40-week, placebo-controlled, double-blind trial of liraglutide in 60 participants with stable BD and obesity or overweight. Participants with BED were compared to those without BED regarding demographics, psychiatric and medical comorbidity, BD treatment, and response to liraglutide versus placebo.</p><p><strong>Results: </strong>Compared to those without BED (<i>N</i> = 43), participants with BED (<i>N</i> = 17) had a higher body mass index (BMI) and higher HbA1c levels, were taking more antidepressants, and had higher Binge Eating Scale (BES) scores and Three Factor Eating Questionnaire (TFEQ) disinhibition of eating and hunger subscale scores. Among the 17 BED participants, liraglutide (<i>N</i> = 9) and placebo (<i>n</i> = 8) were associated with similar reductions in percent change of body weight and BES scores. Liraglutide was well tolerated, but the BED group experienced significantly more nausea/vomiting (<i>p</i> = .04), constipation (<i>p</i> = .02) and anxiety (<i>p</i> = .02).</p><p><strong>Conclusions: </strong>RCTs are warranted to enrich the pharmacological armamentarium available to treat such complex patients.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"1-4"},"PeriodicalIF":2.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mRNA levels of HPA axis mediators in drug-naïve, first episode psychosis patients before and after antipsychotic treatment.","authors":"Daniela Theodoridou, Christos-Orestis Tsiantis, Georgios Markozannes, Vasiliki Chondrou, Angeliki-Maria Vlaikou, Andreas Karampas, Georgios Georgiou, Argyro Sgourou, Michaela D Filiou, Maria Syrrou, Petros Petrikis","doi":"10.1080/13651501.2025.2549306","DOIUrl":"https://doi.org/10.1080/13651501.2025.2549306","url":null,"abstract":"<p><strong>Objective: </strong>In this study we assessed if the genetic variation and gene expression of stress-associated mediators contribute to First Episode in Psychosis (FEP) and explored how mRNA levels of Hypothalamus-Pituitary-Adrenal (HPA) axis mediators change after treatment with antipsychotics.</p><p><strong>Methods: </strong>We genotyped <i>FKBP5</i> and <i>SLC6A4</i> variants and associated them with Positive and Negative Syndrome Scale (PANSS). We assessed the mRNA levels of HPA axis mediators in FEPs before and after treatment with antipsychotics, while comparing them to matched controls.</p><p><strong>Results: </strong><i>FKPB5</i> rs1360780 T allele was associated with higher and lower scores in the PANSS-Negative and PANSS-General scales. <i>FKPB5</i> rs3800373 C allele carriers had lower risk to suffer from FEP. FEP individuals had decreased <i>NR3C2</i> and increased <i>FKBP5</i> and <i>GILZ/TSC22D3</i> mRNA levels. After treatment, the mRNA levels of <i>GILZ/TSC22D3</i> were comparable to those of the control group. Higher <i>FKBP5</i> and <i>GILZ</i> expression levels were associated with higher risk for FEP occurrence and the difference in <i>FKBP5</i> and <i>GILZ</i> expression levels before and after treatment with antipsychotics was associated with the difference in PANSS-T scores.</p><p><strong>Conclusion: </strong>The data above, pinpoint towards a dysregulated HPA axis, that putatively affects the outcome and symptomatology of a First Episode in Psychosis.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"1-13"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the effect of exercise on clinical symptoms, cognitive performance, and quality of life in schizophrenia patients treated with clozapine.","authors":"İsmail Koç, Ebru Akbuğa Koç","doi":"10.1080/13651501.2025.2542785","DOIUrl":"https://doi.org/10.1080/13651501.2025.2542785","url":null,"abstract":"<p><strong>Background: </strong>This prospective study aims to investigate the effects of exercise on clinical symptoms, cognitive performance, and quality of life in schizophrenia patients treated with clozapine.</p><p><strong>Methods: </strong>Fifty-six (<i>n</i> = 56) participants were completed as the physical exercise group (PEG) (<i>n</i> = 28) and control group (CG) (<i>n</i> = 28). The PEG participated in an exercise program lasting 30 min, three times a week, for 12 weeks, in addition to a routine ergotherapy programme. The CG did not receive any treatment other than ergotherapy programme. Sociodemographic characteristics, Positive and Negative Syndrome Scale (PANNS), Brief Psychiatric Rating Scale (BPRS), Montreal Cognitive Assessment (MOCA), and The World Health Organisation Quality of Life (WHQOL-BREF) evaluated at baseline and after 12 weeks for both groups.</p><p><strong>Results: </strong>After intervention, a statistically significant increase was observed in the MOCA and the psychological health sub-parameter of WHQOL-BREF in the PEG (<i>p</i> ≤ 0.05). According to the intergroup change analysis, the changes in the cognitive performance and psychological health sub-parameter of quality-of-life scores were significantly higher in the PEG than in the CG (<i>p</i> ≤ 0.05).</p><p><strong>Conclusion: </strong>The demonstrated improvement in cognitive performance and psychological health in patients with schizophrenia treated with Clozapine through physical exercise strongly advocates for the inclusion of structured exercise programs in comprehensive treatment plans.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term association of Ramadan fasting and depression score: results from MASHAD Cohort Study.","authors":"Habibollah Esmaily, Susan Darroudi, Maryam Saberi-Karimian, Mobina Imannezhad, Gordon A Ferns, Mohammad Reza Mohammad Taghizadeh Sarabi, Majid Ghayour-Mobarhan, Maryam Alinezhad-Namaghi","doi":"10.1080/13651501.2025.2489944","DOIUrl":"10.1080/13651501.2025.2489944","url":null,"abstract":"<p><strong>Background: </strong>Depression is a mood-related disease that affects a person's life. The effects of Ramadan fasting on mental health, including depression, have been investigated in a few previous studies. So, this study examines the long-term association between fasting during Ramadan and depression.</p><p><strong>Methods: </strong>This was a retrospective cohort study based on the data of the MASHAD (Mashhad stroke and heart atherosclerotic disorder) study. Depression was considered as scores >13 using Beck's depression inventory II (BDI II). The study subjects included three groups of healthy, people who developed depression during follow-up (Dep1-, Dep2+), and people who suffered from depression during study (Dep1+, Dep2+).</p><p><strong>Results: </strong>A total of 8609 individuals completed the study. There was no significant association between fasting throughout life and Ramadan with the incidence of depression (<i>p</i> > 0.05). However, an earlier age of initiation for the first experience of Ramadan fasting was associated with 8.4% higher incidence of depression (OR: 0.916, CI (0.889-0.944)) in Dep1-, Dep2 + group and 10.7% for Dep1+, Dep2+ (OR: 0.893, CI: (0.861-0.925)) (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Fasting during Ramadan may not be associated with the incidence of depression, but the lower age of first Ramadan fasting could be related to depression.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"66-73"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of children's emotional and behavioural problems and parents' psychological distress in child and adolescent psychiatric clinic Hospital Sultan Abdul Aziz Shah.","authors":"Ruziana Masiran, Kit-Aun Tan, Muhammad Afiq Ismanizan, Nordiana Alina Roslee, Priyadarshika Prabaharan","doi":"10.1080/13651501.2025.2500543","DOIUrl":"10.1080/13651501.2025.2500543","url":null,"abstract":"<p><strong>Objective: </strong>There is a growing concern regarding the increasing trend of emotional and behavioural problems (EBP) in children, alongside rising mental health challenges among Malaysian parents. This study aims to delineate the prevalence of EBP in children attending the child and adolescent psychiatric (CAP) clinic at Hospital Sultan Abdul Aziz Shah and assess the levels of psychological distress in their parents.</p><p><strong>Methods: </strong>In this cross-sectional study, 125 parents assessed the severity of their children's EBP and their own mental health using validated self-administered questionnaires.</p><p><strong>Results: </strong>The prevalence of EBP among children was 48.0%, while the prevalence of depression, anxiety, and stress among their parents was 32.8%, 45.6%, and 32.8%, respectively.</p><p><strong>Conclusion: </strong>In line with global literature, this study emphasises the critical need to address the mental health of parent-child dyads <i>via</i> the implementation of integrated services that manage these intertwined issues.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"91-95"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a predictive model for readmission of major depressive disorder patients with suicide attempts.","authors":"Xinmei Hao, Ligang Wang, Liqiang Dou, Yingying Huang, Jun Chen, Ping Sun","doi":"10.1080/13651501.2025.2510244","DOIUrl":"10.1080/13651501.2025.2510244","url":null,"abstract":"<p><p>The study aimed to investigate the determinants associated with readmission in first-hospitalised major depressive disorder (MDD) patients with suicide attempts. The study included a cohort of 3977 patients diagnosed with MDD, as retrieved from the hospital information system (HIS). The data were split into a training set and a validation set using R software. To develop a stepwise regression model, the multivariate logistic analysis included significant factors (p threshold <0.2 in univariate analysis).(1) There was a significant difference in the incidence of readmission between first-hospitalised MDD patients with suicide attempts and those without; (2) Length of stay, course of disease, somatic symptoms, psychosis symptoms, anxiety symptoms, alcohol/tobacco dependence, family history of psychiatric disease, continued use of antidepressants combined with antipsychotics or not after discharge, and total bilirubin (TBIL) were included in these variables to build a predictive model in R software; (3) The area under the curve (AUC) was 0.783 for the training set and 0.778 for the validation set. The Hosmer-Lemesho (H-L) test for calibration was <i>p</i> = 0.3521 for the training set and <i>p</i> = 0.8497 for the validation set. The study revealed a significantly increased risk of readmission in first-hospitalised MDD patients with suicide attempts compared to their counterparts.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"82-90"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive analysis of medical malpractice claims related to psychotropic substances: which psychotrop substances should be considered more medico-legal cautious?","authors":"Muhammed Emin Boylu, Caner Beşkoç, Yusuf Atan, Muhammed Oduncu, Hızır Aslıyüksek, Şenol Turan","doi":"10.1080/13651501.2025.2496504","DOIUrl":"10.1080/13651501.2025.2496504","url":null,"abstract":"<p><strong>Introduction: </strong>Psychotropic drugs are commonly employed in the treatment of various psychiatric disorders, yet they carry a number of risks due to their potential side effects and interactions with other drugs. Some medical errors in the prescribing of psychotropic medication may have adverse consequences for patients, which may result in physical harm or even death. The objective of this study is to define the processes to be considered by investigating medical malpractice claims related to psychotropic drug treatment.</p><p><strong>Method: </strong>A retrospective examination was conducted of the sociodemographic and clinical characteristics of medical malpractice cases alleged and reported by the relevant boards of the Turkish Council of Forensic Medicine (2nd Specialised Board, 7th Specialised Board, 8th Specialised Board, and 3rd Supreme Board) between 2013 and 2022.</p><p><strong>Results: </strong>The majority of cases were male (72%), with an average age of 33.10 ± 16.63 years. The most common diagnosis was schizophrenia (28%), and the most frequent malpractice claims involved the effects of antipsychotic medications (50%). The most common side effects leading to claims were cardiac side effects (34%) in cases that resulted in death (<i>p</i> < 0.001) and extrapyramidal system side effects in other cases (14%) (<i>p</i> < 0.001). It was observed that 29 cases (58%) resulted in death. Antidepressants were more often claimed for causing deaths (<i>p</i> = 0.045), while mood stabilisers were more often claimed for resulting in injuries (<i>p</i> = 0.039). In 81% of non-fatal cases, the clinical side effect in question was determined to be related to the treatment (<i>p</i> = 0.002) and was managed appropriately as a complication (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Psychotropic drugs can carry serious risks, especially cardiac and extrapyramidal side effects. Careful monitoring and management of these medicines are essential for patient outcomes and safety. These side effects may lead to medical error claims in some cases; however, when managed correctly, they are not considered malpractice.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"57-65"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion regulation difficulties are associated with psychosocial functioning via trait anxiety levels in remitted bipolar disorder patients.","authors":"Sezgi İlke Danacı Sezgin, Tayfun Turan, Akif Asdemir, Saliha Özsoy","doi":"10.1080/13651501.2025.2492159","DOIUrl":"10.1080/13651501.2025.2492159","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the effects of anxiety levels and emotion dysregulation on each other and their effects on psychosocial functioning in remitted BD patients.</p><p><strong>Methods: </strong>Sixty-six patients with BD and 38 healthy controls were included in this study. All the patients were assessed with the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Bipolar Disorder Functioning Questionnaire, the State-Trait Anxiety Inventory (STAI) and the Difficulties in Emotion Regulation Scale (DERS). Healthy controls were only assessed with the STAI and the DERS.</p><p><strong>Results: </strong>STAI and DERS scores were significantly higher in the patient group than in the control group. Higher scores of STAI and DERS were found to be associated with lower functionality in the patient group. The trait anxiety scores explained 22% of the variance in the psychosocial functionality scores of the patients while the total DERS score explained 51.5% of the variance in the trait anxiety scores. Patients on lithium treatment had less difficulty in regulating their emotions than those on valproic acid treatment.</p><p><strong>Conclusions: </strong>In light of these findings, planning interventions for emotion regulation difficulties during the management of patients would reduce anxiety levels and contribute to improving patients' psychosocial functionality.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"51-56"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do emotional intelligence, dysregulation and theory of mind predict irritability in adolescents with DMDD and ADHD?","authors":"Gonca Özyurt, Yusuf Öztürk, Ali Evren Tufan, Serkan Turan, Ezgi Karagöz Tanıgör, Aynur Akay, Neslihan İnal","doi":"10.1080/13651501.2025.2498997","DOIUrl":"10.1080/13651501.2025.2498997","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare adolescents with disruptive mood dysregulation disorder (DMDD) and comorbid attention deficit hyperactivity disorder (ADHD) and healthy control adolescents in terms of emotional intelligence (EI), emotion regulation (ER) and theory of mind (ToM) abilities.</p><p><strong>Methods: </strong>Twenty-eight adolescents with DMDD and ADHD formed the DMDD group were compared to 31 healthy controls. We administered the Affective Reactivity Index (ARI), Difficulties in Emotion Regulation Scale (DERS), Kiddie-SADS, Bar-On Emotional Intelligence Test, Faux Pas, Comprehension Test, Unexpected Outcomes Test, Faces Test and Reading Mind in the Eyes Test (RMET) as ToM skills.</p><p><strong>Results: </strong>ARI and DERS scores were significantly elevated in the DMDD-ADHD group. The DMDD-ADHD group had significantly lower ToM skills and emotional intelligence (<i>p</i> < .05). When RMET, Bar-On Emotional Intelligence Test -general mood, DERS- impulsivity scores were compared between the groups, their effect sizes were as follows: 0.52, 0.81, 0.79, respectively. DERS, emotional intelligence and ToM scores were correlated in the DMDD group. In the linear regression analysis, the sole significant predictors of self-reported irritability were EI and ED total scores.</p><p><strong>Conclusions: </strong>This study suggests that adolescents with DMDD and ADHD face difficulties in peer relationships, mentalizing, various domains of emotional intelligence andregulation. .</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":" ","pages":"74-81"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}