International psychogeriatrics最新文献

{"title":"Important for preventing but also living well with cognitive impairment - The associations between social relationships, well-being, and cognition in very old adults.","authors":"Selina Vogel, Susanne Zank","doi":"10.1016/j.inpsyc.2025.100109","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100109","url":null,"abstract":"<p><strong>Objectives: </strong>Social relationships are well-researched as protective factors against cognitive impairment, but their role for individuals experiencing cognitive impairment is less clear. The present study examined the associations between cognitive impairment, social relationships, and well-being in very old adults (80 + years), a high-risk group for cognitive impairment.</p><p><strong>Design: </strong>Using representative data from the Study on Quality of Life and Well-Being in North-Rhine Westphalia (NRW80+ Study), we analyzed three social factors (close network, leisure activity, loneliness) and two well-being measures (depressiveness, positive affect) across very old individuals with and without cognitive impairment. We also investigated whether cognitive impairment affected the associations between social factors and well-being.</p><p><strong>Setting: </strong>Computer-assisted interviews were conducted with target persons or proxies in private housing and care facilities.</p><p><strong>Participants: </strong>The final sample included 1516 participants: 66.80 % without cognitive impairment, 15.00 % with mild impairment, and 18.20 % with major impairment.</p><p><strong>Measurements: </strong>Social and well-being measures were assessed through standardized interviews.</p><p><strong>Results: </strong>Cognitive impairment was associated with poorer social outcomes and lower well-being. Meanwhile, stronger social connections were linked to higher well-being. The associations were partially influenced by cognitive impairment. Notably, low leisure engagement was more strongly associated with increased depressiveness in individuals with major cognitive impairment than in those without (B = -0.53 [-0.83, -0.23], p < .001).</p><p><strong>Conclusions: </strong>Our findings emphasize the importance of social integration in preserving well-being for individuals with cognitive impairment. As the incidence of cognitive impairment rises, future research should not only focus on prevention but also on improving the situation for those affected.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100109"},"PeriodicalIF":4.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575477","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":"Worldwide changes in self-stigma among people with mental illness from 2005 to 2023: A cross-temporal meta-analysis and systematic review.","authors":"Xianying Lu, Huan Chen, Dingxi Bai, Xinyu Chen, Wenting Ji, Huiting Gao, Yijia Yuan, Chaoming Hou, Jing Gao","doi":"10.1016/j.inpsyc.2025.100106","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100106","url":null,"abstract":"<p><strong>Background: </strong>Self-stigma in mental illness constitutes a growing public health imperative, with limited longitudinal data available to characterize its evolution over time. Here, we employed cross-temporal meta-analysis to systematically assess whether self-stigma levels have escalated, leveraging standardized measurement tools to quantify potential changes.</p><p><strong>Methods: </strong>We searched six databases (inception to July 2024) for studies measuring self-stigma using the Internalized Stigma of Mental Illness Inventory (ISMI). Two researchers independently screened studies and extracted data. SPSS 25.0 and R 4.4.2 were used for correlation, regression, and quantification of self-stigma differences.</p><p><strong>Results: </strong>179 articles involving 33,046 people were identified. Self-stigma levels increased across all ISMI dimensions from 2005 to 2023 (β = 0.086-0.283), corresponding to small-to-large effect size (d = 0.30-0.89). Notably, stigma resilience increased significantly (d = 0.89), which is a noteworthy observation, suggesting a positive shift in their ability to cope with stigmatizing experiences. Subgroup analyses further revealed that people with mild mental illnesses experienced more severe and frequent self-stigma (d = 1.07-2.80) than those with severe mental illnesses (d = 0.13-1.02). Geographically, self-stigma increased in Asian regions (d > 0), while trends in other regions were mixed (d > 0 or < 0). Importantly, statistically significant differences (P^a <0.05 in ISMI and its dimensions) across illness severities and continents mental illness located further validated these subgroup findings.</p><p><strong>Conclusions: </strong>Self-stigma within the studied age group has indeed increased from 2005 to 2023, underscoring an immediate need for intervention. Consequentially, continuous data is essential to monitor its persistence. Moreover, exploring self-stigma's social determinants to provide effective intervention strategies is necessary.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100106"},"PeriodicalIF":4.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496666","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":"Clinical trials for neuropsychiatric syndromes in major and mild neurocognitive disorders: A CONSORT-based approach.","authors":"Jeffrey L Cummings, Kate Zhong, Clive Ballard, Mary Sano, Jacobo Mintzer","doi":"10.1016/j.inpsyc.2025.100107","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100107","url":null,"abstract":"<p><p>Neuropsychiatric syndromes (NPS) such as agitation, psychosis, apathy, and irritability are among the most disabling features of major and mild neurocognitive disorders including Alzheimer's disease, other neurodegenerative disorders (NDD), and vascular cognitive impairment. Clinical trial methodologies for the treatment of these syndromes are evolving and the first agents to reduce NPS severity has been approved. Biomarkers are rapidly becoming available to guide clinical trial decision-making. Biomarkers can confirm the diagnosis of Alzheimer's disease and are playing a larger role in non-Alzheimer trials. The Consolidated Standards for Reporting Trials (CONSORT) specify the elements of clinical trials that must be reported when clinical trials are published. These criteria provide conventions for uniform reporting of all key aspects of a clinical trial and facilitate comparisons across trials. We describe best practices for clinical trials of NPS including research definitions of the NDD, use of biomarkers to support clinical diagnosis, research criteria for NPS, use of rating scales to define the severity of NPS at baseline and as endpoints for the clinical trial, and approaches to data analysis of specific interest in NPS trials. Standards for describing the limitations of trials and their generalizability are provided. The goal is to inform planning and reporting of NPS trials including the use of biomarkers based on CONSORT guidelines for best trial practices.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100107"},"PeriodicalIF":4.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496665","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":"Brain morphological characteristics predicting clinical response to selective serotonin reuptake inhibitors or cholinesterase inhibitors: A study of electronic medical records in patients with cognitive disorders.","authors":"Kengo Onda, Jill S Chotiyanonta, Hannah P Cowley, Yuto Uchida, Milap A Nowrangi, Roy Adams, Constantine G Lyketsos, Peter P Zandi, Kenichi Oishi","doi":"10.1016/j.inpsyc.2025.100105","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100105","url":null,"abstract":"<p><strong>Objectives: </strong>Current treatments for cognitive and neuropsychiatric symptoms in Alzheimer's disease and related dementias (ADRD), such as cholinesterase inhibitors (CEIs) and selective serotonin reuptake inhibitors (SSRIs), show inconsistent effectiveness, necessitating a personalized therapy approach. We aimed to develop predictive models using MRI-derived brain neuroanatomical features and clinical data to forecast responses to CEIs and SSRIs in ADRD patients.</p><p><strong>Design and setting: </strong>This was a retrospective observational analysis of electronic health records (EHRs) and MRI data conducted within Johns Hopkins Medical Systems.</p><p><strong>Participants: </strong>Cohort 1 comprised 179 patients prescribed CEIs or SSRIs for the first time with over a year of follow-up. Cohort 2 included 1244 patients with similar criteria to explore clinical characteristics linked to MRI features affecting treatment benefits.</p><p><strong>Measures: </strong>Medication efficacy was assessed via a Likert scale based on EMR descriptions. We quantified brain volumes across 280 anatomical areas on T1-weighted MRIs and applied an elastic net model after harmonizing volumes with the ComBat model. Predictive model efficacy was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Preserved volume in the nucleus basalis of Meynert correlated with better responses to both CEIs and SSRIs. Specific white matter volumes related to CEI benefits, while SSRI efficacy was linked to gray matter in the Nucleus Accumbens and frontal cortex. Area under ROC curve values were 0.82 for CEI and 0.75 for SSRI predictions. Older age and vascular factors were associated with reduced medication benefits.</p><p><strong>Conclusions: </strong>MRI-derived neuroanatomical features effectively predict medication responses in ADRD, potentially enabling more tailored treatment strategies.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100105"},"PeriodicalIF":4.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496664","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":"Globalization of Alzheimer's disease clinical trials: Current characteristics and future goals.","authors":"Jeffrey L Cummings, Josie Lindle, Ibrahim Dalla, Yadi Zhou, Kate Zhong, Feixiong Cheng","doi":"10.1016/j.inpsyc.2025.100108","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100108","url":null,"abstract":"<p><p>There are 182 active trials and 138 unique drugs in the current Alzheimer's disease drug development pipeline. Of these, 33 % of trials are global involving both North American and non-North American sites. Phase 3 clinical trials are more likely to have a global distribution of sites (73 %) than Phase 1 or Phase 2 trials. Considering all global trials together, 32,284 participants are needed to populate the ongoing trials; 25,628 of these are required for Phase 3 trials. From a world region perspective, 100 % of global trials include North America, 45 % involve South America or Mexico, 71 % include Europe Western Europe or Israel, 39 % include Eastern Europe or Russia, 30 % include Asia (not including Japan), 39 % include Japan, and 43 % include South Africa, Australia, or New Zealand. A total of 46 countries are participating in current global trials. Of the 46 countries, 28 % are classified as low-and-middle-income countries. There are 5361 trial sites in active global trials; of these, 50 % are in the United States and 50 % are in other global regions. Seven percent of sites are in low-and-middle income countries. Eighty-nine percent of global trials are sponsored and funded by biopharmaceutical companies. Together these observations suggest that many global regions are involved in Alzheimer's disease clinical trials. North America has a larger number of trials and trials sites than other global regions. Low- and middle-income countries are poorly represented in terms of clinical trial sites. These regions have many patients with Alzheimer's disease and are well suited to advance trial recruitment if adequate infrastructure can be developed.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100108"},"PeriodicalIF":4.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484344","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":"Ageism, ableism, and their intersection: Evidence from the Longitudinal Ageing Study in India wave 1.","authors":"Sayani Das, Liat Ayalon","doi":"10.1016/j.inpsyc.2025.100104","DOIUrl":"10.1016/j.inpsyc.2025.100104","url":null,"abstract":"<p><strong>Objectives: </strong>Ageism and ableism significantly affect the well-being, social inclusion, and access to resources of older adults, often shaped by socio-cultural factors, yet remain underexplored within the heterogeneous context of India. This study examines the prevalence and associated factors of ageism, ableism, and their intersection among older adults in India.</p><p><strong>Design, setting, participants, & measurements: </strong>Utilizing data from the Longitudinal Aging Study in India (LASI) Wave 1, this study analyzed responses from 30,728 community-dwelling older adults (aged 60 +) across all states and union territories. Participants were categorized into four groups: ageism, ableism, intersection, or none, based on their everyday experiences of discrimination related to age, physical disability, or both. Multinomial logistic regression identified sociodemographic factors associated with these discriminations, with the cumulative advantage/disadvantage theory serving as conceptual framework.</p><p><strong>Results: </strong>The weighted prevalence of ageism was 10.3 %, ableism was 0.5 %, and 0.4 % reported both. Men were more likely to report ableism (AOR2.66) and intersectional discrimination (AOR2.03) but less likely to report ageism (AOR 0.89). Increasing age (AOR 1.24) and lower education (AOR1.48) were associated with ageism, while unemployment was linked to ableism (AOR2.07) and intersectional discrimination (AOR 2.21). Notably, participants in poorer health were more likely to report ageism (AOR 1.29), ableism (AOR 3.15), and intersectional discrimination (AOR 5.14) based on the Healthy Aging Index, compared to healthier participants.</p><p><strong>Conclusions: </strong>The findings highlight how different factors shape experiences of discrimination, underscoring the importance of adopting both individual and intersectional perspectives to effectively address these issues and design targeted interventions.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100104"},"PeriodicalIF":4.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336526","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":"Social determinants and mental health in older adults.","authors":"Latha Velayudhan","doi":"10.1016/j.inpsyc.2025.100095","DOIUrl":"10.1016/j.inpsyc.2025.100095","url":null,"abstract":"","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100095"},"PeriodicalIF":4.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336527","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":"Pre-psychosis in later life as a risk factor for progressive cognitive decline: Findings from the IPA psychosis in neurodegenerative disease working group.","authors":"Byron Creese, Jeffrey Cummings, Corinne Fischer, Dilip Jeste, Manibou Ikeda, Kathryn Mills, Zahinoor Ismail, Clive Ballard","doi":"10.1016/j.inpsyc.2025.100094","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100094","url":null,"abstract":"<p><p>Pre-clinical Alzheimer's disease (AD) has traditionally been characterized by subtle cognitive deficits alongside biomarker changes. However, emerging evidence suggests a spectrum of neuropsychiatric changes, including apathy, affective disturbances, agitation, impulse control deficits, and psychosis, may precede cognitive decline. Late-onset psychotic disorders, such as Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP), differ from pre-psychosis, the latter presenting with subtle symptoms and retained insight. These subtler late-life onset symptoms are associated with incident cognitive decline, particularly in APOE4 carriers. Screening with tools such as the Mild Behavioral Impairment Checklist (MBI-C) enables the standardisation of measurement, facilitating identification of at-risk individuals. Plasma biomarkers and neuropsychological assessments further aid diagnosis and risk stratification. Understanding the link between pre-psychosis and dementia-related psychosis will be crucial, as AD with psychosis is associated with a more aggressive disease course. Identifying and treating these individuals early may improve clinical outcomes and facilitate timely intervention with disease-modifying therapies. Moreover, there remains a need to better define in what circumstances treatment interventions are indicated and what those interventions should be.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100094"},"PeriodicalIF":4.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293763","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":"A novel psychoeducational intervention to promote well-being in older adult nursing home patients: Combining survey preferences with evidence-based practices in the design of a comprehensive curriculum.","authors":"Arielle Silbersweig, Cristina M Pritchett, Monica Gavaller, Hyungseok Oh, Rachel Hershenberg, Jocelyn Wise, Kendra Le, Emma Blythe, Adriana P Hermida","doi":"10.1016/j.inpsyc.2025.100093","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100093","url":null,"abstract":"<p><strong>Background: </strong>Older adults comprise an especially vulnerable population with unique challenges associated with aging. Current mental health interventions for this population focus on different important components of well-being but do not combine them into one curriculum that is widely accessible to those who could benefit. We have chosen 3 pillars (mindfulness, meaning in life, and social connection) and developed a comprehensive curriculum to be shared with others by combining survey preferences from our population sample with evidence-based practices from the literature including positive psychiatry and psychotherapy.</p><p><strong>Methods: </strong>Long-term care and subacute rehabilitation patients from 2 nursing homes in Atlanta were recruited to participate in a survey. Categorical frequency calculations were used to evaluate participant interest and logistical preferences. Ranked scores and distribution columns were used to evaluate course content.</p><p><strong>Results: </strong>100 participants completed the survey. 55.1 % expressed interest in attending this type of course. For class length, frequency, duration, and size, average preference was for 30 min, once a week, 2-4 weeks, and 6-10 people, respectively. Between pillars, preferences in order of priority were: meaning in life (ranked score 215), mindfulness (198), and social connection (157). The subtopics with the highest ranked scores within each pillar were: gratitude for life lived, emotional stability, and increasing opportunities for social connections.</p><p><strong>Conclusion: </strong>Based on survey results and the literature, we have developed a psychoeducational course to promote well-being in older adult nursing home patients. A curriculum syllabus complete with course description, learning objectives, weekly topics and timelines, materials needed, notes, and handouts is included with the manuscript.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100093"},"PeriodicalIF":4.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284345","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":"Dementia, cognitive impairment in Nigerians aged 90 years or older: A 20-year follow up of survivors of Ibadan study of aging cohort.","authors":"Olusegun Baiyewu, Olufisayo Elugbadebo, Sujuan Gao, Michael L Cuccaro, Jeffery M Vance, Temitope H Farombi, Kathleen A Lane, Pedro Mena, Farid Rajabil, Rufus Akinyemi, Adesola Ogunniyi, Akin Ojagbemi, Agboola J Adigun, Hugh C Hendrie, Margaret A Pericak-Vance","doi":"10.1016/j.inpsyc.2025.100090","DOIUrl":"https://doi.org/10.1016/j.inpsyc.2025.100090","url":null,"abstract":"<p><strong>Objective: </strong>Studies of dementia involving the oldest old are few in Sub-Saharan Africa. Survivors of the Ibadan arm of the Indianapolis-Ibadan Dementia Project who were enrolled in 1992 or 2001 were re-examined between 2021 and 2022.</p><p><strong>Aim: </strong>To revisit these subjects and evaluate them for the presence of cognitive and functional impairment and assign diagnoses as relevant as well as determine factors that mitigate development of dementia and cognitive impairment and thus promote healthy aging.</p><p><strong>Design: </strong>Evaluation consisted of the CERAD neuropsychological battery, an informant interview, and a clinical examination by physicians with expertise in cognitive disorders of aging. Diagnoses were adjudicated by consensus between psychiatrists and neurologists using ICD-10 and DSM-IV criteria and diagnosis of Mild Cognitive Impairment based on the National Institute of Aging- criteria RESULT: One hundred and thirty-five of the original 4425 persons ever recruited were re-evaluated. Mean age was 93·0±2·8 years (range 89-106 years); 103 (76 %) were females, 29 (21 %) were diagnosed dementia, 25 (18 %) had AD, 44 (32·6 %) had diagnosis of Mild Cognitive Impairment (MCI) and 62 (45·9 %) were cognitively normal. Using logistic regression model for the combined dementia and MCI group with predictor variables collected during the 2001 evaluation wave, we found that cognitive score (Odds Ratio (OR)= 0·94, p = 0·024 (95 % CI:0.09-0.99), diastolic blood pressure (OR=1·04, p = 0·015 (95 % CI:1.01-1.07) and regular alcohol use (OR=0·42, p = 0·041(95 % CI:0.18-0.96) were associated with 20-year prevalence of cognitive impairment after adjusting for age, sex, and education. ApoE4 allele was neither a risk factor for dementia nor Cognitive Impairment in this cohort.</p><p><strong>Conclusion: </strong>Prevalence of cognitive impairment in this oldest old survivor cohort was associated with cognitive performance, diastolic blood pressure and regular use of alcohol 20 years before.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100090"},"PeriodicalIF":4.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215797","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}