Journal of affective disorders最新文献

{"title":"Rehospitalization in youth depression: Critical analysis of predictors and the role of immune markers in long-term management.","authors":"Khairiyah Khadijah, Suryadi Suryadi, Reza Oktiana Akbar, Irman Syahriar, Ria Rizki Agustini, Gugun Gunawan, Siti Aisah, Nuraini Nuraini","doi":"10.1016/j.jad.2025.120060","DOIUrl":"10.1016/j.jad.2025.120060","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"120060"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855236","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":"The role of emotional dysregulation and attachment style as indicators of obsessive compulsive symptom-severity.","authors":"Nicole Moriarty, Keith Gaynor, Elif Beyza Koş Yalvaç, Mujgan Inozu","doi":"10.1016/j.jad.2025.119909","DOIUrl":"10.1016/j.jad.2025.119909","url":null,"abstract":"<p><strong>Background: </strong>Existing research has demonstrated an association between obsessive compulsive (OCD) and emotional dysregulation. Additionally, evidence suggests a relationship between OCD and attachment style. The current study (1) investigated if a model made up of emotional dysregulation and related constructs of emotion regulation skills, attachment styles and interpersonal emotion regulation predicted obsessive compulsive symptom severity, and (2) investigated the mediating role of emotional dysregulation between attachment style and OCD in a community sample.</p><p><strong>Methods: </strong>Two hundred and twenty-six participants reported obsessive compulsive symptoms were recruited online and anonymously completed 6 questionnaires. The model was tested through hierarchical linear regressions and mediation analysis. Ethical approval was granted by University College Dublin's Ethics Committee.</p><p><strong>Results: </strong>A hierarchical linear regression employed by the current study indicated that emotional dysregulation and attachment anxiety significantly predicted OCD symptoms (F (5, 1016) = 65.7, p < 0.001). The indirect effect of emotional dysregulation as a mediator of attachment style and OCD symptom-severity was significant (B = 0.4311; 95 % CI: 0.3339 to.5381).</p><p><strong>Limitations: </strong>The current study utilized a cross-sectional design and causation cannot be derived from the results. The use of self-report scales may allow for biased responses and a predominantly Irish sample limits the generalizability of the study.</p><p><strong>Conclusion: </strong>The current study has both clinical and empirical implications as it demonstrates the role of emotional dysregulation and attachment insecurity in OCD severity, potentially advising the direction of future OCD interventions.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119909"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649511","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":"Patterns and trends of medication use among patients with bipolar disorder in Northeast China: A study from a large psychiatric center (2013-2022).","authors":"Yu Zhang, Mingyang Yao, Huanliang Li, Yuehua Wang, Shengyuan Hao, Guoliang Pan, Hefeng Xu, Xiaoyu Han, Guangyu Zhou, Liying Shao, Wei Sun, Yan Luan, Guowei Pan","doi":"10.1016/j.jad.2025.119920","DOIUrl":"10.1016/j.jad.2025.119920","url":null,"abstract":"<p><strong>Background: </strong>The medication patterns and trends among bipolar disorder patients in mainland China remain unclear. This study, as the first attempt in northeast China, is designed to clarify the medication patterns and elucidate medication trends of bipolar disorder patients from 2013 to 2022.</p><p><strong>Methods: </strong>The study included 1812 bipolar disorder patients from a large psychiatric center who received treatment from 2013 to 2022. We examined the episode types of patients and medications for treatment of bipolar disorder, including lithium, anticonvulsants, antipsychotics, antidepressants, and sedative-hypnotics. Trends of episode types, medication, and combinations were analyzed using the Cochran-Armitage Trend test. Patterns of medication use were analyzed using the association rule mining method.</p><p><strong>Results: </strong>Among the patients, manic/hypomanic episode accounted for 63.11 % to 75.39 % from 2013 to 2022. Antipsychotics had the highest usage rate (2022: 97.84 %) and showed a significant increasing trend. Lithium had the lowest usage rate (2022: 7.91 %), with no significant trend. Furthermore, combination therapy, particularly three medications, was the major treatment regimen. The proportion of patients receiving combination therapy involving three types of medications ranged from 46.07 % to 64.03 %. The most common pattern for manic/hypomanic patients was sedative-hypnotics + anticonvulsants + antipsychotics, whereas the preferred medication pattern for depressive patients was antipsychotics + antidepressants + sedative-hypnotics.</p><p><strong>Conclusions: </strong>In China, manic/hypomanic episodes remained the predominant episode type. Combination therapy, particularly with three medications, was most commonly used for treatment of bipolar disorder patients and the patterns were episode-specific. Lithium remained the least commonly prescribed medication for both episode types.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119920"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649547","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":"Subthreshold manic symptoms as a risk factor for depressive, anxiety and substance use: Results of a prospective study in the general population.","authors":"Rosalie A L Beekman, Margreet Ten Have, Ron de Graaf, Ralph W Kupka, Eline J Regeer","doi":"10.1016/j.jad.2025.119873","DOIUrl":"10.1016/j.jad.2025.119873","url":null,"abstract":"<p><strong>Background: </strong>Indicated prevention aimed at high-risk individuals with subthreshold psychiatric symptoms should alleviate the disease burden caused by depressive, anxiety, and substance use disorders (further called: common mental disorders, CMD). This study investigates subthreshold manic symptoms (subM) as a possible risk factor for CMD and, for comparison, bipolar disorder type I and II (BD).</p><p><strong>Methods: </strong>We assessed three-year manifestation of CMD and onset of BD in an adult cohort (n = 4618) representative of the Dutch general population. SubM was defined as elevated mood or irritability lasting at least four days, without meeting DSM-IV criteria for BD. Manifest CMD were absent at baseline and present in the subsequent three years, irrespective of lifetime occurrence (manifestation = onset and recurrence). Onset BD was absent at lifetime and baseline and present in the subsequent three years.</p><p><strong>Results: </strong>Individuals with subM had a significantly increased risk of manifest depressive (odds ratio (OR) 2.3-2.9; p for trend < 0.001) and anxiety disorders (1.5-5.9; <0.001) and of onset BD (6.4-43.8; <0.001), but not of substance use disorders, as compared to those without manic symptoms. BD risk was elevated strongest. Increased risks persisted after adjustment for sociodemographic variables, presence of other CMD and lifestyle factors.</p><p><strong>Conclusions: </strong>SubM precedes forthcoming depressive, anxiety and bipolar disorders on short term. Their presence should be considered a relevant predictor in the psychopathological pathway of mood- and anxiety disorders. Moreover, we recommend to include subM in research on risk prediction tools and preventive interventions for mood- and anxiety disorders.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119873"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649549","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":"Serum Neurofilament Polypeptide Level in Patients with Bipolar Disorder and its Effect on Cognitive Functioning.","authors":"Elif Nur Donbaloğlu, Halil Özcan, Mehmet Ali Donbaloğlu, Ahmet Kızıltunç, Esra Eğilmez","doi":"10.1016/j.jad.2025.119921","DOIUrl":"10.1016/j.jad.2025.119921","url":null,"abstract":"<p><strong>Background: </strong>Elevated neurofilaments in serum are thought to be an indicator of neurodegeneration in bipolar disorder (BD). In our study, we evaluated serum neurofilament light chain (NF-L), medium chain (NF-M) and heavy chain (NF-H) levels in manic, depressive and euthymic phases of BD by ELISA method and investigated the relationship of these levels with neuropsychological functions by CNSVS (Central Nervous System Vital Signs).</p><p><strong>Method: </strong>Patients with manic, depressive and remission periods, aged between 18 and 50, diagnosed with BD according to DSM-5, and healthy volunteers were included in the study. The sociodemographic-clinical data form, clinical scales and CNSVS tests were applied to the participants. Serum values of NF-L, NF-M and NF-H were measured by ELISA method.</p><p><strong>Results: </strong>Mean NF-L, NF-M and NF-H levels showed significant differences between the patient and control groups (p < 0.001). When neurofilament levels and neurocognitive domains were evaluated in bipolar patients; NF-M and NF-H levels showed a negative correlation with NCI, composite memory, verbal and visual memory, cognitive flexibility, executive functions, psychomotor speed.</p><p><strong>Conclusion: </strong>Elevated neurofilament polypeptide levels during all stages of BD compared to controls may be an indicator of inflammatory-mediated axonal damage in bipolar patients and might be used as a biomarker for neurodegeneration in BD. CNSVS neuropsychological test battery has an important place in determining the neurocognitive dysfunctions in individuals with BD. Negative correlation detected between serum NF-M and NF-H levels and cognitive test performance might reflect the neurodegeneration related poor cognitive performance.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119921"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649548","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":"Associations of metabolic heterogeneity of obesity with depression progression among middle-aged and older adults in China: A prospective study.","authors":"Li Huang, Chengcheng Liao, Zhenzhen Liang, Huajian Chen","doi":"10.1016/j.jad.2025.119875","DOIUrl":"10.1016/j.jad.2025.119875","url":null,"abstract":"<p><strong>Background: </strong>In previous studies, there have been few studies focusing on the association between metabolic heterogeneity of obesity and depression. The association between metabolic heterogeneity of obesity and depression progression remains unclear.</p><p><strong>Methods: </strong>This study used data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Metabolic heterogeneity of obesity was assessed according to four obesity and metabolic statuses, namely metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obesity (MHOO) and metabolically unhealthy overweight/obesity (MUOO). Linear mixed-effects models were used to analyze the association between metabolic heterogeneity of obesity and depression progression.</p><p><strong>Results: </strong>After 7 years of follow-up, MUNW, MHOO, and MUOO showed accelerated depression progression compared with MHNW, with additional annual increases of 0.09 (95 % CI: 0.02 to 0.17), 0.12 (95 % CI: 0.03 to 0.20), and 0.10 (95 % CI: 0.04 to 0.17). Participants with stable MUNW, MHOO, MUOO, MHNW transition to MUNW, and weight change in metabolically abnormal states exhibited accelerated depression progression compared to stable MHNW. And accelerated depression progression was significant in MUNW, MHOO, and MUOO among participants without social activities.</p><p><strong>Conclusions: </strong>Although MUNW, MHOO, and MUOO exhibited milder depressive symptoms at baseline compared to MHNW, these phenotypes were associated with an accelerated depression progression over time. Additionally, social activities can mitigate the acceleration of depression progression. Our findings highlighted the important role of obesity and metabolic status and their shifts in the depression progression in middle-aged and older adults, and emphasized the buffering role of positive social activities.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119875"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649433","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":"Baseline glutamate-glutamine complex levels modulate antidepressant response to rTMS in major depressive disorder: Insights from magnetic resonance spectroscopy.","authors":"Andan Qian, Sirui Wang, Gai Kong, Guanfu Wu, Ziyu Meng, Anastasios A Daskalakis, Yingying Tang, Fang Liu","doi":"10.1016/j.jad.2025.120023","DOIUrl":"10.1016/j.jad.2025.120023","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD), but its neurometabolic effects remain unknown. This study examined whether rTMS outcomes depend on baseline medial prefrontal cortex (mPFC) glutamate-glutamine complex (Glx) levels and aimed to identify clinically translatable imaging biomarkers.</p><p><strong>Methods: </strong>Seventy-six MDD patients and 44 healthy controls (HC) were enrolled. 39 patients underwent 20-session rTMS treatments and were divided into high Glx (hGlx, N = 20) and low Glx (lGlx, N = 19) subgroups based on the median baseline Glx levels of all patients in the MDD group (N = 76). Metabolite concentrations (GABA, Glx, Glx/GABA) changes within the mPFC were quantified via magnetic resonance spectroscopy. Baseline subgroup differences and their associations with treatment outcomes investigated. Diffusion MRI metrics were extracted from the corpus callosum (CC) for correlation analysis, including fractional anisotropy, radial diffusivity (RD), mean diffusivity (MD), and axial diffusivity (AD).</p><p><strong>Results: </strong>After rTMS treatment, both Glx subgroups regained significant Glx-GABA coupling, mirroring the HC pattern. In the hGlx subgroup, baseline mPFC Glx, GABA, and Glx/GABA predicted improvements in Montgomery-Åsberg Depression Rating Scale and Hamilton Depression Rating Scale factor scores. Notably, hGlx patients exhibited higher CC RD and MD values, with mPFC Glx levels correlating specifically with the splenium of CC MD and AD.</p><p><strong>Conclusion: </strong>Subgroup analyses demonstrated baseline mPFC excitatory neurotransmission modulates rTMS efficacy. Higher Glx concentrations may synergize with adjacent white matter integrity to restore excitatory-inhibitory balance, supporting higher mPFC Glx as a predictive biomarker for rTMS outcomes.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"120023"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799168","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":"Comparative efficacy of antidepressant augmentation with amantadine vs pramipexole in treatment-resistant unipolar depression: A randomised controlled trial.","authors":"Biswa Ranjan Mishra, Debadatta Mohapatra, Tathagata Biswas, Archana Mishra, Sahadeb Panigrahi, Rituparna Maiti","doi":"10.1016/j.jad.2025.119891","DOIUrl":"10.1016/j.jad.2025.119891","url":null,"abstract":"<p><strong>Background: </strong>Augmentation strategies for treatment-resistant depression (TRD) are limited, with strongest evidence for atypical antipsychotics. Given emerging insights into the neurobiology of TRD, new drug classes merit investigation. We hypothesised that augmentation with amantadine (NMDA antagonist) and pramipexole (dopamine agonist) would show comparable efficacy and safety to quetiapine in TRD.</p><p><strong>Methods: </strong>In this open-label trial, 150 patients with TRD were equally randomised to receive amantadine 200 mg/day, pramipexole 0.375 mg/day, or quetiapine 100 mg/day, as augmentation to ongoing sertraline. The Hamilton Depression Rating Scale (HAM-D21) and Clinical Global Impression (CGI)-Severity and CGI-Improvement scales were assessed and compared within and between the groups at baseline, four, and eight weeks. Serum Brain-Derived Neurotrophic Factor (BDNF) and Nerve Growth Factor (NGF) were measured at baseline, four and eight weeks to evaluate and compare neurotrophic changes between the groups alongside clinical response.</p><p><strong>Results: </strong>Mixed-model ANOVA revealed significant HAM-D and CGI-S reductions in all three groups over eight weeks (p < 0.001). Between-group analysis revealed pramipexole was significantly better compared to both amantadine and quetiapine on all clinical measures at weeks four and eight (p < 0.001). Amantadine and quetiapine showed comparable efficacy (p > 0.05). BDNF and NGF levels increased significantly within each group (p < 0.001), but between-group differences were non-significant (p > 0.05). The three groups reported similar occurence of adverse events (p = 0.184).</p><p><strong>Conclusion: </strong>Augmentation with amantadine and pramipexole were safe and effective in TRD. Additionally, pramipexole showed better efficacy to amantadine and quetiapine. Clinical improvements corroborated with improved BDNF and NGF levels. However, larger multi-centric studies are warranted for generalisability. (ClinicalTrials.gov: NCT04936126).</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119891"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637001","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":"Efficacy of three good things intervention for enhancing exclusive breastfeeding behaviors: a randomized controlled trial.","authors":"Ying Xie, Kechen Xu, Xueyan Han, Ying Yu, Bo Zhu, Jinghua Zhang, Xiujun Han, Qian Yang","doi":"10.1016/j.jad.2025.120020","DOIUrl":"10.1016/j.jad.2025.120020","url":null,"abstract":"<p><strong>Background: </strong>Emotional factors have been linked to breastfeeding behaviors, while evidence remains limited on the efficacy of positive psychology interventions in promoting breastfeeding. This study aims to evaluate the efficacy of \"Three Good Things\" intervention on breastfeeding.</p><p><strong>Methods: </strong>A parallel, two-arm, single-blind randomized controlled trial was conducted in 2022 at a Women's Hospital in China. First-time pregnant women aged >18 years with 34-38 gestational weeks were included. Participants were stratified by family support for breastfeeding and randomly assigned to \"Three Good Things\" intervention group or \"First Three Things\" control group. The primary outcome was exclusive breastfeeding during postnatal hospitalization.</p><p><strong>Results: </strong>A total of 297 participants (141 in intervention and 156 in control group) completed the study. Intention-to-treat analysis using generalized linear models indicated no significant differences in emotional outcomes between two groups. Logistic regression analysis revealed comparable proportion of exclusive breastfeeding (16.3 % vs. 19.9 %, P = 0.43). Notably, higher levels of positive emotions were associated with higher breastfeeding behavior scores (β = 0.046, SE = 0.015, P = 0.002). Among individuals with high levels of positive emotions, higher scores on positive emotion were associated with an increased likelihood of exclusive breastfeeding.</p><p><strong>Conclusions: </strong>While the \"Three Good Things\" intervention did not directly enhance exclusive breastfeeding behaviors, our findings suggested that higher level of positive emotions was associated with higher potential of exclusive breastfeeding and better breastfeeding practices.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"120020"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812023","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":"Conspiratorial thinking in a 50-state survey of American adults.","authors":"Roy H Perlis, Ata Uslu, Sergio A Barroilhet, Paul A Vohringer, Anudeepa K Ramachandiran, Mauricio Santillana, Matthew A Baum, James N Druckman, Katherine Ognyanova, David Lazer","doi":"10.1016/j.jad.2025.119915","DOIUrl":"10.1016/j.jad.2025.119915","url":null,"abstract":"<p><p>Conspiratorial thoughts as a cognitive aspect are understudied outside small clinical cohorts. We conducted a 50-state non-probability internet survey of respondents age 18 and older, who completed the American Conspiratorial Thinking Scale (ACTS) and the 9-item Patient Health Questionnaire (PHQ-9). Across the 6 survey waves, there were 123,781 unique individuals. After reweighting, a total of 78.6 % somewhat or strongly agreed with at least one conspiratorial idea; 19.0 % agreed with all four of them. More conspiratorial thoughts were reported among those age 25-54, males, individuals who finished high school but did not start or complete college, and those with greater levels of depressive symptoms. Endorsing more conspiratorial thoughts was associated with a significantly lower likelihood of being vaccinated against COVID-19. The extent of correlation with non-vaccination suggests the importance of considering such thinking in designing public health strategies.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119915"},"PeriodicalIF":4.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649529","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}