Journal of child and adolescent psychopharmacology最新文献

{"title":"<i>Letter:</i> Can Epileptic Seizures Explain Hyperactive Catatonia in Patients with Autism and Intellectual Disability?","authors":"João Gama Marques","doi":"10.1089/cap.2025.0033","DOIUrl":"10.1089/cap.2025.0033","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"316"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780225","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":"The Safety and Clinical Effects of Amisulpride in Children and Adolescents with Psychiatric Disorders: A Case Series.","authors":"Osman Özdemir","doi":"10.1089/cap.2024.0139","DOIUrl":"10.1089/cap.2024.0139","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The objective of this study was to explore the safety and clinical effects of amisulpride in children and adolescents with psychiatric disorders. <b><i>Methods:</i></b> This case series included six patients, aged 11 to 19 years, diagnosed with affective disorder, autism, anxiety, psychosis, and obsessive-compulsive disorder, and treated with amisulpride at doses ranging from 100 to 400 mg per day. <b><i>Results:</i></b> Amisulpride appeared to reduce psychotic and behavioral symptoms. Observed side effects included increased appetite, weight gain, sedation, and mild extrapyramidal symptoms. <b><i>Conclusion:</i></b> Amisulpride may have promise for study and future use in children and adolescents with psychiatric disorders and severe symptoms.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"312-315"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441034","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":"Determining Clinically Meaningful Improvement in Children and Adolescents with Tourette Syndrome Receiving Pharmacotherapy.","authors":"Joseph F McGuire, George B Karkanias, Richard M Bittman, Sarah D Atkinson, Frederick E Munschauer, Stephen P Wanaski, Timothy M Cunniff, Donald L Gilbert","doi":"10.1089/cap.2025.0036","DOIUrl":"10.1089/cap.2025.0036","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Accurate assessment of treatment outcomes in patients with Tourette syndrome (TS) is essential for evidence-based clinical care. This report determined the minimal clinically important difference (MCID) on the Yale Global Tic Severity Scale (YGTSS) Total Tic Score (YGTSS-TTS) and YGTSS Impairment Scale (YGTSS-I), using the Clinical Global Impression of TS Severity (CGI-TS-S) and Improvement (CGI-TS-I) as anchors, in pediatric patients with TS receiving pharmacotherapy. <b><i>Materials and Methods:</i></b> Analyses used data from two clinical trials of ecopipam (a randomized controlled trial and its open-label extension). Receiver operating characteristic (ROC) analysis determined the percentage reduction in YGTSS scores that distinguished patients with improvement from those with no change or worsening on the CGI-TS-S and CGI-TS-I. Spearman's correlation, empirical cumulative distribution function, and probability distribution function analyses examined relationships between YGTSS-TTS and CGI-TS-S or CGI-TS-I. <b><i>Results:</i></b> Overall, 133 patients (75.2% male; mean [SD] age, 12.7 [2.8]) were included; 63.2% had improvement on the CGI-TS-S, and 78.2% showed improvement on the CGI-TS-I. Percentage reduction in YGTSS scores that distinguished improvement from no change or worsening on the CGI-TS-S and CGI-TS-I ranged from 18.6%-33.3% (area under the ROC curve range, 0.71-0.81). Improvement on the YGTSS-TTS was correlated with posttreatment CGI-TS-S (<i>r</i> = -0.65; <i>p</i> < 0.001) and CGI-TS-I (<i>r</i> = -0.61; <i>p</i> < 0.001) scores. The MCID for YGTSS-TTS was achieved by 67% and 62% of patients with improvement on the CGI-TS-S and CGI-TS-I, respectively. <b><i>Conclusions:</i></b> This analysis is the first to determine the MCID for YGTSS in a pediatric population with TS receiving pharmacotherapy. Whether using CGI-TS-S or CGI-TS-I as the anchor, a 25% reduction in YGTSS scores was a generally appropriate minimum threshold to define clinically meaningful improvement in this population. Findings offer an objective threshold for classifying clinically meaningful improvement in children and adolescents receiving pharmacotherapy for TS in clinical practice.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025307","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":"<i>Letter:</i> Extended-Release Lorazepam as a Safe and Effective Option for Treating Catatonia in an Individual with Down Syndrome.","authors":"Kyung Eun Paik, Aaron Hauptman","doi":"10.1089/cap.2025.0061","DOIUrl":"https://doi.org/10.1089/cap.2025.0061","url":null,"abstract":"","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142491","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":"Strategies to Facilitate Intravenous Access for Electroconvulsive Therapy Procedures in Pediatric and Neurodivergent Patients: A Case Series.","authors":"Adrian Cuellar, Michael E Henry, Joshua R Smith, Karen Turner, Ryan Horvath, James Luccarelli","doi":"10.1089/cap.2025.0031","DOIUrl":"https://doi.org/10.1089/cap.2025.0031","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Electroconvulsive therapy (ECT) is an effective treatment for severe and treatment-resistant psychiatric disorders, particularly depression and catatonia. ECT requires intravenous (IV) access, which can pose a barrier for pediatric patients and those with neurodevelopmental disorders who may have difficulty tolerating IV placement. This case series highlights individualized pharmacologic and nonpharmacologic strategies that facilitate IV placement in pediatric and neurodivergent patients receiving ECT. <b><i>Methods:</i></b> We reviewed the medical records of five patients aged 14-27 who required ECT but experienced barriers to tolerating IV placement and described strategies used to overcome these limitations. <b><i>Results:</i></b> We describe five strategies: (1) oral anxiolytic premedication, (2) planned physical restraint, (3) intramuscular (IM) ketamine induction, (4) inhalational sevoflurane anesthesia, and (5) placement of an implanted venous access device. Using these strategies, all patients were able to tolerate IV placement and ECT treatment. Consistent treatment protocols, multidisciplinary planning, and engagement of outpatient care teams facilitated the success of these interventions. <b><i>Conclusions:</i></b> Pediatric and neurodivergent patients face unique barriers to ECT, particularly related to IV placement. Our case series demonstrates that individualized, multidisciplinary approaches can enable successful ECT treatment. These findings underscore the importance of adaptive strategies to promote health equity and ensure access to effective psychiatric interventions in special needs populations.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093843","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":"Lifestyle Effects in a Randomized Controlled Trial of Neurofeedback for Attention-Deficit/Hyperactivity Disorder.","authors":"L Eugene Arnold, Kyle Hendrix, Xueliang Pan, Madelon A Vollebregt, Mengda Yu, Cynthia Kerson, Martijn Arns, Irene E Hatsu, Roger DeBeus, Jill Hollway, Michelle E Roley-Roberts","doi":"10.1089/cap.2025.0019","DOIUrl":"https://doi.org/10.1089/cap.2025.0019","url":null,"abstract":"<p><p><b><i>Objectives/Background:</i></b> Multiple factors influence symptom severity in Attention Deficit/Hyperactivity Disorder (ADHD). We examined four of these: diet, sleep hygiene, exercise, and lighting, in the International Collaborative ADHD Neurofeedback (ICAN) randomized clinical trial, which found large significant improvement with both active neurofeedback and control condition without treatment difference. <b><i>Methods:</i></b> A total of 142 participants aged 7-10 had breakfast and lunch intake and exercise recorded at each neurofeedback session. Parents completed the Children's Sleep Habits Questionnaire (CSHQ). Parents and teachers rated inattention on Conners3. Lifestyle changes were correlated with inattention changes. <b><i>Results:</i></b> At baseline, CSHQ correlated with parent-rated inattention (<i>r</i> = 0.17, <i>p</i> = 0.04), and length of sleep correlated with teacher-rated inattention (<i>r</i> = 0.20, <i>p</i> = 0.03). From baseline to treatment end food group variety (<i>p</i> = 0.029, <i>d</i> = 0.22) and sleep problems (<i>p</i> < 0.0001, d = -0.49) improved significantly, exercise time and protein intake marginally (<i>p</i> = 0.06 - 0.08). Parent-rated inattention improvement correlated with CSHQ improvement (Rho = 0.26, <i>p</i> = 0.002) and marginally with protein intake increase (Rho = 0.18, <i>p</i> = 0.06). The three components of the light-emitting-diode (LED)-induced circadian pathway hypothesis were significant. <b><i>Conclusions:</i></b> Most measures improved, but few significantly. How much they impact classroom attention remains unclear. Although parent ratings of inattention improvement correlated with sleep problems improvement, composited parent/teacher ratings (primary outcome) did not. The circadian pathway hypothesis associated with LED lighting was supported. These findings warrant further studies examining the role sleep hygiene can play in improving ADHD symptoms. Meanwhile, attention to sleep hygiene seems appropriate in any treatment plan for ADHD.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078405","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":"Definition of Response in Randomized Controlled Trials of Medications for Attention-Deficit/Hyperactivity Disorder Across the Lifespan: A Systematic Review.","authors":"Sulagna Roy, Giuseppe Colacicco, Giorgia Frigeri, Fabio Tarantino, Emilia Matera, Maria Giuseppina Petruzzelli, Samuele Cortese","doi":"10.1089/cap.2025.0029","DOIUrl":"https://doi.org/10.1089/cap.2025.0029","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Randomized controlled trials (RCTs) are the gold standard for evaluating medication efficacy. The absence of a universal definition of treatment response, based on the degree of symptom improvement measured by standardized rating scales in the field of attention-deficit/hyperactivity disorder (ADHD), makes it difficult to compare treatment outcomes across RCTs. Here, we aimed to assess to what extent and how \"treatment response\" is defined across RCTs of ADHD medications. <b><i>Methods:</i></b> We identified eligible RCTs via the MED-ADHD database (https://med-adhd.org/), which compiles RCTs evaluating the efficacy and safety of pharmacological treatments for children, adolescents, and adults with ADHD, based on a comprehensive search in multiple electronic databases, including PubMed, BIOSIS Previews, CINAHL, the Cochrane Central Registry of Controlled Trials, and EMBASE, up to 17 January 2025, alongside additional unpublished information gathered from manufacturers/study authors. <b><i>Results:</i></b> Out of 167 RCTs in MED-ADHD, 88 defined treatment response based on reductions in ADHD core symptom severity using rating scale scores. The most frequently used threshold was a ≥30% reduction in attention-deficit/hyperactivity disorder (ADHD-RS) scores, with other RCTs using ≥25%, ≥40%, or ≥50%. In addition, RCTs applied similar cutoff values to alternative scales, including Conner's Adult ADHD Rating Scale, SNAP-IV, Adult ADHD Investigator Rating Scale, and Wender-Reimherr Adult Attention Deficit Disorder Scale. However, 79 studies did not specify any response threshold. <b><i>Conclusion:</i></b> Our review underscores and quantitatively defines the inconsistency in the definition of treatment response across ADHD medication trials, highlighting the urgent need for the field to reach a consensus on the use of a standardized definition of \"treatment response\" for each rating scale, based on the percentage reduction in ADHD core symptom severity.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002396","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":"Safety and Efficacy of Brexpiprazole in the Treatment of Irritability Associated with Autism Spectrum Disorder: An 8-Week, Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial and 26-Week Open-Label Extension in Children and Adolescents.","authors":"Caroline Ward, Ann Childress, Krista Martinko, Dalei Chen, Klaus Groes Larsen, Alpesh Shah, Pamela Sheridan, Nanco Hefting, James Knutson","doi":"10.1089/cap.2024.0118","DOIUrl":"10.1089/cap.2024.0118","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The effective management of irritability is a key need in young people with autism spectrum disorder (ASD). We evaluated the efficacy and safety of brexpiprazole in children and adolescents with irritability associated with ASD. <b><i>Methods:</i></b> This was an 8-week, phase 3, randomized, double-blind, placebo-controlled trial (NCT04174365) and 26-week, open-label extension (OLE, NCT04258839) of brexpiprazole (0.25-3 mg/day based on body weight) in children and adolescents (5-17 years) with a diagnosis of ASD, score ≥18 on the Aberrant Behavior Checklist-Irritability (ABC-I) subscale, and score ≥4 on the Clinical Global Impressions-Severity scale. <b><i>Results:</i></b> Of the 119 randomized participants (brexpiprazole = 60, placebo = 59), 104 completed double-blind treatment, and 95 enrolled and 70 completed the OLE. Similar reductions in mean ABC-I subscale score were seen in both groups (least-squares mean ± standard error reduction from double-blind baseline of -10.1 ± 1.3 with brexpiprazole vs -8.9 ± 1.3 with placebo). Thus, the primary endpoint did not show a significant treatment effect (LS-mean [95% confidence interval] treatment difference: -1.22 [-4.49, 2.05], <i>p</i> = 0.46) and the hierarchical efficacy analysis ended at this point. At the end of the OLE, participants had a mean ± SD reduction from open-label baseline of -6.1 ± 8.2 in ABC-I subscale score. During double-blind treatment, 51.7% participants treated with brexpiprazole had ≥1 treatment-emergent adverse event (TEAE) versus 35.1% with placebo; no severe or serious TEAEs were reported. The only potentially treatment-related TEAE that occurred in ≥5% of participants was somnolence (12.1% for brexpiprazole vs 5.3% for placebo). During the OLE, the most commonly reported TEAE was increased weight (<i>n</i> = 13, 13.7%). <b><i>Conclusions:</i></b> Treatment with brexpiprazole did not demonstrate significant efficacy versus placebo for the treatment of irritability associated with ASD. The safety profile was consistent with that observed in adult and adolescent patients with schizophrenia.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"194-201"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458157","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 Blueprint for Translational Precision Medicine in Autism Spectrum Disorder and Related Neurogenetic Syndromes.","authors":"Robyn P Thom, Tracy L Warren, Suha Khan, Rebecca A Muhle, Paul P Wang, Kristen Brennand, Nicole R Zürcher, Jeremy Veenstra-VanderWeele, Ellen J Hoffman","doi":"10.1089/cap.2025.0023","DOIUrl":"10.1089/cap.2025.0023","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Despite growing knowledge of the underlying neurobiology of autism spectrum disorder (ASD) and related neurogenetic syndromes, treatment discovery has remained elusive. In this review, we provide a blueprint for translational precision medicine in ASD and related neurogenetic syndromes. <b><i>Methods:</i></b> The discovery of trofinetide for Rett syndrome (RTT) is described, and the role of nonmammalian, mammalian, and stem cell model systems in the identification of molecular targets and drug screening is discussed. We then provide a framework for translating preclinical findings to human clinical trials, including the role of biomarkers in selecting molecular targets and evaluating target engagement, and discuss how to leverage these findings for future ASD drug development. <b><i>Results:</i></b> Multiple preclinical model systems for ASD have been developed, each with tradeoffs with regard to suitability for high-throughput small molecule screening, conservation across species, and behavioral face validity. Future clinical trials should incorporate biomarkers and intermediate phenotypes to demonstrate target engagement. Factors that contributed to the approval of trofinetide for RTT included replicated findings in mouse models, a well-studied natural history of the syndrome, development of RTT-specific outcome measures, and strong engagement of the RTT family community. <b><i>Conclusions:</i></b> The translation of our growing understanding of the neurobiology of ASD to human drug discovery will require a precision medicine approach, including the use of multiple model systems for molecular target selection, evaluation of target engagement, and clinical trial design strategies that address heterogeneity, power, and the placebo response.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"178-193"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730201","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":"Probing the Neurodynamic Mechanisms of Cognitive Flexibility in Depressed Individuals with Autism Spectrum Disorder.","authors":"Rana Elmaghraby, Elizabeth Blank, Makoto Miyakoshi, Donald L Gilbert, Steve W Wu, Travis Larsh, Grace Westerkamp, Yanchen Liu, Paul S Horn, Craig A Erickson, Ernest V Pedapati","doi":"10.1089/cap.2024.0109","DOIUrl":"10.1089/cap.2024.0109","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Autism spectrum disorder (ASD) is characterized by deficits in social behavior and executive function (EF), particularly in cognitive flexibility. Whether transcranial magnetic stimulation (TMS) can improve cognitive outcomes in patients with ASD remains an open question. We examined the acute effects of prefrontal TMS on cortical excitability and fluid cognition in individuals with ASD who underwent TMS for refractory major depression. <b><i>Methods:</i></b> We analyzed data from an open-label pilot study involving nine participants with ASD and treatment-resistant depression who received 30 sessions of accelerated theta burst stimulation of the dorsolateral prefrontal cortex, either unilaterally or bilaterally. Electroencephalography data were collected at baseline and 1, 4, and 12-weeks posttreatment and analyzed using a mixed-effects linear model to assess changes in regional cortical excitability using three models of spectral parametrization. Fluid cognition was measured using the National Institutes of Health Toolbox Cognitive Battery. <b><i>Results:</i></b> Prefrontal TMS led to a decrease in prefrontal cortical excitability and an increase in right temporoparietal excitability, as measured using spectral exponent analysis. This was associated with a significant improvement in the NIH Toolbox Fluid Cognition Composite score and the Dimensional Change Card Sort subtest from baseline to 12 weeks posttreatment (t = 3.79, p = 0.005, <i>n</i> = 9). Improvement in depressive symptomatology was significant (HDRS-17, F (3, 21) = 28.49, <i>p</i> < 0.001) and there was a significant correlation between cognitive improvement at week 4 and improvement in depression at week 12 (r = 0.71, <i>p</i> = 0.05). <b><i>Conclusion:</i></b> These findings link reduced prefrontal excitability in patients with ASD and improvements in cognitive flexibility. The degree to which these mechanisms can be generalized to ASD populations without Major Depressive Disorder remains a compelling question for future research.</p>","PeriodicalId":15277,"journal":{"name":"Journal of child and adolescent psychopharmacology","volume":" ","pages":"231-243"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962280","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}