Journal of Geriatric Psychiatry and Neurology最新文献

{"title":"Targeting Inflammation in Alzheimer's Disease: Insights Into Pathophysiology and Therapeutic Avenues-A Comprehensive Review.","authors":"Vasileios Topalis, Charalampos Voros, Mairi Ziaka","doi":"10.1177/08919887251361578","DOIUrl":"https://doi.org/10.1177/08919887251361578","url":null,"abstract":"<p><p>Alzheimer's Disease (AD) is the most common dementia, affecting mainly older adults, particularly over 65. Characterized by progressive cognitive decline-including deficits in memory, executive functions, and language, alongside behavioral disturbances-AD arises from complex pathophysiological mechanisms. These include neurotransmitter imbalances, cholinergic deficits, amyloid-beta (Aβ) toxicity, tau protein hyperphosphorylation, oxidative stress, synaptic dysfunction, and neuroinflammatory processes. Growing evidence highlights the protective role of microglia in AD pathology through their immune functions, phagocytic clearance of Aβ proteins, and trophic support to promote tissue repair and maintain cerebral homeostasis, as alterations in their response to Aβ are linked to an increased risk of AD. However, disruptions in homeostasis or tissue alterations may trigger microglial activation, leading to detrimental effects such as increased inflammatory activity, impaired microglial-mediated clearance, synapse loss, and neuronal damage. Astrocytes, a distinct type of glial cell with homeostatic functions, also exhibit neuroprotective effects. However, the presence of Aβ may result in astrocyte reactivity, leading to neurotoxic effects associated with disturbances of calcium levels, activation of proinflammatory pathways, gliotransmission, altered tau metabolism, and impaired clearance of Aβ. Despite substantial research, AD remains challenging to diagnose early and lacks effective treatments. Given its multifactorial nature, therapeutic approaches primarily aim to slow progression and remain limited in achieving a definitive cure. While most current strategies focus on mitigating the toxic effects of Aβ and tau proteins, growing interest has emerged in addressing neuroinflammation as a potential means to delay or prevent neurodegeneration. Targeting neuroinflammation could open new therapeutic avenues for the treatment of AD.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251361578"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690501","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":"Utilizing Perceived Fatigability to Identify Cognitive and Mobility Impairments in Aging and Multiple Sclerosis.","authors":"Di-Hua Luo, Roee Holtzer","doi":"10.1177/08919887251362468","DOIUrl":"https://doi.org/10.1177/08919887251362468","url":null,"abstract":"<p><p>BackgroundPerceived fatigability-subjective physical or mental energy depletion within specified activity contexts-is prevalent in aging and neurological conditions. Although the Pittsburgh Fatigability Scale (PFS) is validated for older adults and those with multiple sclerosis (OAMS), its subscale cut-offs and clinical relevance for cognitive and mobility outcomes have not been examined in neurologically affected aging populations.MethodsWe studied 224 older adults (≥60 years): 109 OAMS and 115 controls who completed the PFS, neuropsychological testing, the Short Physical Performance Battery (SPPB), and, for OAMS, the Patient Determined Disease Steps (PDDS). Receiver operating characteristic (ROC) analyses assessed PFS subscales' accuracy in discriminating MS, mild cognitive impairment (MCI), mobility impairment (SPPB ≤9), and worse MS-related disability (PDDS ≥2). Logistic regression adjusting for demographic and clinical covariates generated refined ROC curves and cut-offs.ResultsBoth PFS subscales demonstrated moderate accuracy (area under the curve 0.59-0.75) for discriminating MS, MCI, and mobility impairment when unadjusted, with accuracy often exceeding 0.80 after covariate adjustment. Among OAMS, mental fatigability more accurately identified MCI, whereas physical fatigability better detected worse MS-related disability. Cut-offs were higher in OAMS than in healthy controls, varying by subscale and clinical outcome. Adjusted analyses revealed nuances in cut-offs, with physical fatigability thresholds consistently higher than mental fatigability.ConclusionPFS subscales can identify MS, cognitive impairment, and mobility impairment in older adults. Cut-offs appear population- and outcome-specific, indicating that thresholds derived from healthy older cohorts may not apply directly to neurological populations. Covariate adjustment refines discriminative accuracy, potentially guiding need for further functional monitoring.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251362468"},"PeriodicalIF":2.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667807","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":"Comparing the Utility of a Clinical Staging Approach and the DSM-5 in Diagnosing Personality Disorders Among Older Adults.","authors":"Jelle de Jong, Sebastiaan P J van Alphen, Jeroen A P Conjaerts, Roel Schepman, Machteld A Ouwens, Arjan C Videler","doi":"10.1177/08919887251358413","DOIUrl":"https://doi.org/10.1177/08919887251358413","url":null,"abstract":"<p><p>Clinical staging may provide a valuable alternative to the limitations of categorical diagnostic models like the DSM-5 for mental disorders. However, research on the clinical utility of staging models on mental disorders is limited, particularly in comparison to the DSM-5, which hinders the implementation of staging models in clinical practice. The limitations of categorical models are even more pronounced in older adults, as personality disorders (PDs) may manifest differently later in life, potentially leading to over- or underdiagnosis when relying on the DSM-5.AimThis study compared the clinical utility of a clinical staging model (CSM) with the DSM-5 for diagnosing PDs in older adults from the perspective of clinicians.MethodThirty-four Dutch participants, including psychiatrists, geriatricians, psychologists, and psychiatric nurse practitioners (PNP), completed an online questionnaire featuring an introduction to the CSM and the assessment of 2 fictional vignettes. Each vignette represented different stages of PDs and was evaluated using both the CSM and the DSM-5. Participants rated their experiences across 6 domains for both models.ResultsThe clinicians rated the clinical utility of the CSM significantly higher than that of the DSM-5 across all domains, with 55.9% preferring the CSM, 32.8% opting for both models, and 11.8% preferring the DSM-5 in clinical practice.ConclusionsThese findings suggest that the CSM may be a valuable addition to the diagnosis of PDs in older adults. This highlights the need for further research into its clinical application and the general utility of staging models.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251358413"},"PeriodicalIF":2.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667805","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":"Error Monitoring Failure in Metamemory Appraisal: A Visuospatial-Driven Feature of Mild Cognitive Impairment due to Alzheimer's Disease.","authors":"Ciro Rosario Ilardi, Paola Marangolo, Sergio Chieffi, Mario Napoletano, Alessandra Finoja, Giovanni Federico, Gabriella Santangelo, Alessandro Iavarone","doi":"10.1177/08919887251362470","DOIUrl":"https://doi.org/10.1177/08919887251362470","url":null,"abstract":"<p><p>ObjectiveAnosognosia for memory deficits is frequently observed in patients with Alzheimer's disease (AD). Despite its relevance, this phenomenon is understudied in individuals with Mild Cognitive Impairment (MCI). People with MCI often struggle to update self-referential beliefs about memory functioning. Nonetheless, findings on error monitoring capacity are mixed and methodologically weak, especially in visuospatial tasks. Here, we investigated online metamemory appraisal for verbal and visuospatial material in patients with MCI due to AD. The potential diagnostic utility of metamemory accuracy was evaluated.MethodsSixteen patients with MCI and 19 healthy controls completed metamemory tasks involving predictions on list and position memory performance. Metamemory accuracy was quantified using the Objective Judgment Discrepancy (OJD) index, the percentage difference between predicted and actual performance. Linear mixed-effects models were used to analyze main effects and interactions.ResultsCompared to controls, patients overestimated their memory performance (<i>P</i> < 0.001, <i>d</i> = 0.51), with greater overestimation in the visuospatial task (<i>P</i> < 0.001, <i>d</i> = 0.57). After adjusting for cognitive functioning, only overestimation in visuospatial memory persisted. Visuospatial OJD correlated significantly with executive and visuospatial abilities (all <i>r</i>ho ≥ -0.50, <i>P</i> < 0.05). Clinimetric analyses highlighted visuospatial OJD as a promising marker for diagnostic use (AUC = 0.814, <i>P</i> < 0.001, sensitivity = 0.67, specificity = 0.95).ConclusionOverestimation in verbal memory reflects a statistical artifact consistent with the Dunning-Kruger effect. A selective metacognitive deficit was found in visuospatial memory. Our results support the view of AD as a visuospatial-driven disease and underscore the diagnostic potential of visuospatial metamemory assessments.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251362470"},"PeriodicalIF":2.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667806","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":"Anthropometric Indicators of Cognitive Health: An ICMR-MUDRA Toolbox-Based Assessment Among a Geriatric Population of India.","authors":"U Venkatesh, Varkey Nadakkavukaran Santhosh, Ashoo Grover, Om Prakash Bera, Hari Shanker Joshi, Manoj Prithviraj, R Durga","doi":"10.1177/08919887251360260","DOIUrl":"https://doi.org/10.1177/08919887251360260","url":null,"abstract":"<p><p>IntroductionIndia's geriatric population is projected to reach 319 million by 2050, reflecting the global aging trend. Cognitive impairment significantly impacts the quality of life of older adults. Anthropometric measures serve as accessible indicators of nutritional status and body composition with potential associations with cognitive function. This study investigates the relationship between anthropometric measures and cognitive abilities using the Indian Council of Medical Research (ICMR)-Multilingual Dementia Research and Assessment (MUDRA) Toolbox among geriatric populations in Gorakhpur, Uttar Pradesh.MethodsThis cross-sectional study enrolled 1013 participants aged 60 years and above from 7 randomly selected administrative blocks in Gorakhpur. Cognitive assessment was performed using the ICMR-MUDRA Toolbox, evaluating global cognition, attention, executive functioning, episodic memory, language, and visuospatial abilities. Anthropometric measurements included height, weight, BMI, waist circumference, hip circumference, Waist-to-Hip Ratio (WHR), and Mid-Upper Arm Circumference (MUAC). Statistical analysis included Spearman rank correlation and binomial logistic regression.ResultsSignificant positive correlations were observed between MUAC and cognitive domains of the MUDRA toolbox. Conversely, WHR demonstrated significant negative correlations with the domains (<i>P</i> ≤ 0.05). Participants with moderate-risk WHRs had higher odds of impairment in attention/executive function (aOR = 1.79), memory (aOR = 1.69), and visuospatial function (aOR = 2.50), while high-risk WHRs were associated with greater impairment in memory (aOR = 2.18) and language (aOR = 2.21).ConclusionThis study reveals significant relationships between anthropometric measures and cognitive function in the geriatric population, with MUAC positively correlating with cognitive performance while WHR demonstrating negative correlations. The findings indicate that central obesity may be a particular risk factor for cognitive decline.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251360260"},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608483","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":"An SBM and TBSS Analysis in Early-stage Patients With Alzheimer's Disease, Lewy Body Dementias, and Corticobasal Syndrome.","authors":"Alexandros Giannakis, Evrysthenis Vartholomatos, Loukas Astrakas, Emmanouil Anyfantis, Athina Tatsioni, Maria Argyropoulou, Spiridon Konitsiotis","doi":"10.1177/08919887241302110","DOIUrl":"10.1177/08919887241302110","url":null,"abstract":"<p><p>ObjectiveTo compare gray matter (GM) and white matter (WM) changes in patients with Alzheimer's disease (AD), Lewy body dementias (LBD), corticobasal syndrome (CBS), and healthy controls (HC).MethodsSurface-based morphometry (SBM) was assessed on 3D T1-weighted images using FreeSurfer image analysis and WM microstructure was studied using Tract-Based Spatial Statistics (TBSS) in 12 AD, 15 LBD, 10 CBS patients, and 10 HC.ResultsPatients with AD, compared with HC, exhibited reduced cortical surface area and volume in the superior frontal, middle frontal, and medial orbitofrontal cortex. In TBSS, AD patients, compared with HC and LBD, displayed decreased fractional anisotropy, axial diffusivity, and increased radial diffusivity in all major WM tracts. Other comparisons between the groups yielded no differences, either in the SBM or the TBSS analysis.ConclusionsThe results indicate significant early structural changes in the GM of the frontal lobe, along with WM alterations early in AD patients.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"275-285"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621949","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":"Sleep and Depressive Symptoms in Sedentary Community-Dwelling Older Adults With Sleep Complaints: Findings From Ambulatory Sleep EEG.","authors":"Jing Huang, Miranda V McPhillips, Mengchi Li, Adam P Spira, Russell Calderon, Junxin Li","doi":"10.1177/08919887241304769","DOIUrl":"10.1177/08919887241304769","url":null,"abstract":"<p><p>BackgroundThere is limited and inconsistent evidence on the association between electroencephalography (EEG) measured sleep and depressive symptoms among community-dwelling older adults. This study aimed to investigate the cross-sectional association between EEG-measured sleep and depressive symptoms.MethodsUsing baseline data from a randomized clinical trial, we included 66 sedentary community-dwelling older adults with sleep complaints (≥ 1 self-reported insomnia symptom). Sleep was measured using an in-home sleep EEG (Sleep Profiler™) for 2 nights and the Geriatric Depression Scale (GDS-15) was used to measure depressive symptoms. Multiple linear regression analyses were conducted with each sleep parameter as the primary predictor and GDS score as the outcome, adjusting for age, sex, race, education, marital status, chronic conditions, and Montreal Cognitive Assessment (MoCA) score.ResultsSeveral sleep variables were associated with depressive symptoms (GDS score), including a higher percentage of sleep stage N1 (B = 0.11, 95% confidence interval [CI]: 0.02 - 0.20) and N2 (B = 0.04, 95% CI: 0.00 - 0.08), a lower percentage of N3 sleep (B = -0.04, 95% CI: -0.08 to -0.01), greater wake after sleep onset (B = 0.01, 95% CI: 0.00 - 0.02), and a greater number of awakenings ≥90s/hour (B = 0.87, 95% CI: 0.21-1.53).ConclusionsOur study reveals that among sedentary community-dwelling older adults with sleep complaints, more lighter sleep (stage N1, N2), less deep (N3) sleep, and increased awakenings are associated with more depressive symptoms. Sleep interventions aimed at enhancing sleep architecture may also help alleviate depressive symptoms in this population.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"303-308"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in Response Switching in Parkinson's Disease: New Insights Into Cueing.","authors":"Ori Peleg, Rébaï Soret, Pom Charras, Vsevolod Peysakhovich, Anat Mirelman, Daniel A Levy, Inbal Maidan","doi":"10.1177/08919887241311170","DOIUrl":"10.1177/08919887241311170","url":null,"abstract":"<p><p>Switching, a critical executive function, can manifest as task switching (TS) or response switching (RS). Although TS impairments in Parkinson's disease (PD) are well-studied, RS, especially in contexts requiring adaptive behavior to external or internal cues, is less explored. This study evaluated the impact of PD on RS under exogenous and endogenous cueing. Using a gamified, remote task triggering these cues, RS was assessed in 85 PD patients and 82 neurologically healthy participants (NHP). RS cost was quantified by comparing reaction times between repeating and changing responses. A linear mixed model analyzed the effects of group, cueing mode, and their interaction on RS cost. PD patients exhibited increased RS costs under exogenous cueing but not under endogenous cueing. These findings indicate that while PD patients can effectively use predictive endogenous cues, they struggle with less predictive exogenous cues, emphasizing the need for compensatory strategies and technological aids in daily activities.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"295-302"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877317","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":"Impact of Anticholinergic Burden and Clinical-Demographic Characteristics on Incident Dementia in Parkinson Disease.","authors":"Thanh Phuong Pham Nguyen, Dylan Thibault, Shelly L Gray, Daniel Weintraub, Allison W Willis","doi":"10.1177/08919887241313376","DOIUrl":"10.1177/08919887241313376","url":null,"abstract":"<p><p>PurposeAnticholinergic medication use measured via the Anticholinergic Cognitive Burden (ACB) scale has been associated with an increased dementia incidence in older adults but has not been explored specifically for Parkinson disease dementia (PDD). We used adjusted Cox models to estimate the risk of incident PDD associated with demographic factors, clinical characteristics, and time-varying total ACB in a longitudinal, deeply-phenotyped prospective PD cohort.Major findings56.5% of study participants were taking ACB-scale drugs at enrollment. Increasing age, motor symptom burden and psychosis were associated with PDD risk. Female sex and educational achievement were protective against PDD. ACB categories were not associated with PDD overall, but depression and impulse control disorder were strongly associated with PDD in a subsample with high baseline ACB.ConclusionsPatient and clinical factors modify PDD risk. PD drug safety and drug-disease interaction studies may require considering multiple mechanisms and including dose-based, prospectively acquired medication exposure measures.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"254-263"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Bilingual Animal Naming and Memory Among Bilingual Mexican American Older Adults.","authors":"Emily M Briceño, Miguel Arce Rentería, Barbara Mendez Campos, Roshanak Mehdipanah, Wen Chang, Lisa Lewandowski-Romps, Nelda Garcia, Xavier F Gonzales, Deborah A Levine, Kenneth M Langa, Steven G Heeringa, Lewis B Morgenstern","doi":"10.1177/08919887241302109","DOIUrl":"10.1177/08919887241302109","url":null,"abstract":"<p><p>BackgroundMonolingual cognitive assessments are standard for bilinguals; the value of bilingual assessment is unknown. Since declines in animal naming accompany memory declines in dementia, we examined the association between bilingual animal naming and memory among bilingual Mexican American (MA) older adults.MethodsBilingual MA (n = 155) completed the Harmonized Cognitive Assessment Protocol (HCAP) in a Texas community study. Regressions included HCAP memory score (English) as the outcome and English and Spanish animal naming trials as independent variables; demographics and language dominance were covariates.ResultsEnglish animal naming (<i>b</i> = 0.06, <i>P</i> = 0.004) was more reliably associated with memory than Spanish (<i>b</i> = 0.05, <i>P</i> = 0.06). Considered together, only English (<i>b</i> = 0.05, <i>P</i> = 0.02) was associated with memory, not Spanish (<i>b</i> = 0.01, <i>P</i> = 0.63). Conclusions: Spanish animal naming did not uniquely add to English animal naming in its association with memory among bilingual older MA.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"286-294"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}