Journal of Geriatric Psychiatry and Neurology最新文献

{"title":"A Comparison of Test-Retest Reliability and Practice Effects of Short Portable Mental State Questionnaire and Montreal Cognitive Assessment in Patients with Stroke.","authors":"Ta-Cheng Chen, Ya-Chen Lee, Yi-Ching Wang, Ton-Lin Hsieh, Mei-Hsiang Chen","doi":"10.1177/08919887241266793","DOIUrl":"10.1177/08919887241266793","url":null,"abstract":"<p><strong>Objective: </strong>To compare the test-retest reliabilities and minimal detectable change (MDC) of the Short Portable Mental State Questionnaire (SPMSQ) and the Montreal Cognitive Assessment (MoCA) in patients with stroke.</p><p><strong>Methods: </strong>63 patients were recruited from 1 medical center. The SPMSQ and MoCA were administered twice, 2 weeks apart.</p><p><strong>Results: </strong>Both measures showed high intraclass correlation coefficients (SPMSQ: 0.87; MoCA: 0.89) and acceptable MDC%s (SPMSQ: 14.8%; MoCA: 19.6%). A small correlation (<i>r</i> = 0.30) was found between the absolute difference and average in each pair of assessments in the SPMSQ, which was close to the criterion of heteroscedasticity. A small practice effect was observed in the MoCA (Cohen's <i>d</i> = 0.30).</p><p><strong>Conclusion: </strong>The SPMSQ demonstrated smaller random measurement error and an absence of practice effect. When comparing the psychometric properties of the SPMSQ and MoCA as outcome measures for assessing cognitive function in patients with stroke, the SPMSQ appears to be a more suitable choice than the MoCA.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"53-61"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751900","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":"Clinical Staging for Personality Disorders in Older Adults.","authors":"Jeroen A P Conjaerts, Arjan C Videler, Roel Schepman, Iman Elfeddali, Erlene Rosowsky, Sebastiaan P J van Alphen","doi":"10.1177/08919887241254467","DOIUrl":"10.1177/08919887241254467","url":null,"abstract":"<p><strong>Objective: </strong>This scientific research aimed to investigate the feasibility of implementing a clinical staging (CS) model for personality disorders (PDs) in older adults. The CS model could provide valuable insights into the life course of personality pathology, prognosis, and treatment decisions for PDs in older adults.</p><p><strong>Methods/design: </strong>The study employed an international Delphi methodology with three rounds and involved 21 experts.</p><p><strong>Results: </strong>Consensus was achieved on 12 out of 17 statements, confirming the viability of a CS model for PDs in older adults. The proposed model incorporates the Alternative Model for PDs, criterion A, and integrates life course information, distinguishing between chronic PD, re-emergent PD, late-onset PD, and past PD.</p><p><strong>Conclusion: </strong>The findings suggest that international experts support the implementation of a CS model for PDs in older adults, considering both the severity of personality functioning and the retrospective life course of PD expression.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"32-43"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161932","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":"Neurofilament Light Chain as a Biomarker of Global Cognition in Individuals With Possible Vascular Mild Cognitive Impairment.","authors":"Amish Gaur, Damien Gallagher, Nathan Herrmann, Jinghan Jenny Chen, Susan Marzolini, Paul Oh, Yutaka Amemiya, Arun Seth, Alex Kiss, Krista L Lanctôt","doi":"10.1177/08919887241254469","DOIUrl":"10.1177/08919887241254469","url":null,"abstract":"<p><strong>Background: </strong>Neurofilament Light Chain (NfL) is a biomarker of axonal injury elevated in mild cognitive impairment (MCI) and Alzheimer's disease dementia. Blood NfL also inversely correlates with cognitive performance in those conditions. However, few studies have assessed NfL as a biomarker of global cognition in individuals demonstrating mild cognitive deficits who are at risk for vascular-related cognitive decline.</p><p><strong>Objective: </strong>To assess the relationship between blood NfL and global cognition in individuals with possible vascular MCI (vMCI) throughout cardiac rehabilitation (CR). Additionally, NfL levels were compared to age/sex-matched cognitively unimpaired (CU) controls.</p><p><strong>Method: </strong>Participants with coronary artery disease (vMCI or CU) were recruited at entry to a 24-week CR program. Global cognition was measured using the Montreal Cognitive Assessment (MoCA) and plasma NfL level (pg/ml) was quantified using a highly sensitive enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Higher plasma NfL was correlated with worse MoCA scores at baseline (<i>β</i> = -.352, <i>P</i> = .029) in 43 individuals with vMCI after adjusting for age, sex, and education. An increase in NfL was associated with worse global cognition (<i>b</i>[SE] = -4.81[2.06], <i>P</i> = .023) over time, however baseline NfL did not predict a decline in global cognition. NfL levels did not differ between the vMCI (n = 39) and CU (n = 39) groups (<i>F</i>(1, 76) = 1.37, <i>P</i> = .245).</p><p><strong>Conclusion: </strong>Plasma NfL correlates with global cognition at baseline in individuals with vMCI, and is associated with decline in global cognition during CR. Our findings increase understanding of NfL and neurobiological mechanisms associated with cognitive decline in vMCI.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"62-72"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957231","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":"Two-Year Longitudinal Outcomes of Subjective Cognitive Decline in Hispanics Compared to Non-hispanic Whites.","authors":"Carolina Boza-Calvo, Arline Faustin, Yian Zhang, Anthony Q Briggs, Mark A Bernard, Omonigho M Bubu, Julia A Rao, Lindsey Gurin, Sakina Ouedraogo Tall, Ricardo S Osorio, Karyn Marsh, Yongzhao Shao, Arjun V Masurkar","doi":"10.1177/08919887241263097","DOIUrl":"10.1177/08919887241263097","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD), considered a preclinical dementia stage, is less understood in Hispanics, a high-risk group for dementia. We investigated SCD to mild cognitive impairment (MCI) progression risk, as well as baseline and longitudinal features of depressive symptoms, SCD complaints, and objective cognitive performance among Hispanics compared to non-Hispanic Whites (NHW).</p><p><strong>Methods: </strong>Hispanic (n = 23) and NHW (n = 165) SCD participants were evaluated at baseline and 2-year follow-up. Evaluations assessed function, depressive symptoms, SCD, and objective cognitive performance.</p><p><strong>Results: </strong>Hispanics were at increased risk of progression to MCI (OR: 6.10, 95% CI 1.09-34.20, <i>P</i> = .040). Hispanic participants endorsed more depressive symptoms at baseline (<i>P</i> = .048) that worsened more longitudinally (OR: 3.16, 95% CI 1.18-8.51, <i>P</i> = .023). Hispanic participants had increased SCD complaints on the Brief Cognitive Rating Scale (BCRS) (β = .40 SE: .17, <i>P</i> = .023), and in specific BCRS domains: concentration (β = .13, SE: .07, <i>P</i> = .047), past memory (β = .13, SE: .06, <i>P</i> = .039) and functional abilities (β = .10, SE: .05, <i>P</i> = .037). In objective cognitive performance, Hispanic ethnicity associated with decline in MMSE (β = -.27, SE: .13, <i>P</i> = .039), MoCA (β = -.80 SE: .34, <i>P</i> = .032), Trails A (β = 2.75, SE: .89, <i>P</i> = .002), Trails B (β = 9.18, SE: 2.71, <i>P</i> = .001) and Guild Paragraph Recall Delayed (β = -.80 SE: .28, <i>P</i> = .005). <b>Conclusions:</b> Hispanic ethnicity associated with a significantly increased risk of 2-year progression of SCD to MCI compared to NHW. This increased risk associated with increased depressive symptoms, distinctive SCD features, and elevated amnestic and non-amnestic objective cognitive decline. This supports further research to refine the assessment of preclinical dementia in this high-risk group.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"23-31"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751903","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":"Dementia Specialty Care Clinicians' Perspectives on Their Role in the Dementia Diagnostic Process and Diagnostic Disclosure.","authors":"Alissa B Sideman, Krista L Harrison, Sarah B Garrett, Joanna Paladino, Georges Naasan, Christine S Ritchie","doi":"10.1177/08919887241254468","DOIUrl":"10.1177/08919887241254468","url":null,"abstract":"<p><strong>Background: </strong>Delivering a diagnosis of Alzheimer's disease and related dementias (ADRD) can be challenging not just for patients and families, but also for clinicians. Our objective was to understand dementia specialty care clinicians' perspectives on their role in diagnosis and diagnostic disclosure in dementia.</p><p><strong>Methods: </strong>Qualitative interviews with clinicians from a specialty tertiary dementia care center focused on practices, challenges, and opportunities addressing patient and caregiver needs in dementia. Data was analyzed by an interdisciplinary team using thematic analysis.</p><p><strong>Results: </strong>The 16 participants included behavioral neurologists, social workers, neuropsychologists, and nurses. Themes included the value of providing an accurate diagnosis, the timing and challenges of delivering a diagnosis, the central focus on diagnosis alongside the need for more education on care management, and the role of the interdisciplinary team.</p><p><strong>Discussion: </strong>We identified areas for improvement and strengths that can be built upon or adapted to other settings, including providing clinicians in specialty and primary care settings more guidance and support when diagnostic challenges arise, strengthening interdisciplinary teamwork, and making dementia diagnosis and care more accessible.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"3-12"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759142","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":"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":"https://doi.org/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":"8919887241311170"},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","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":"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":"https://doi.org/10.1177/08919887241304769","url":null,"abstract":"<p><strong>Background: </strong>There 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.</p><p><strong>Methods: </strong>Using 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.</p><p><strong>Results: </strong>Several 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).</p><p><strong>Conclusions: </strong>Our 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":"8919887241304769"},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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><strong>Background: </strong>Monolingual 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.</p><p><strong>Methods: </strong>Bilingual 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.</p><p><strong>Results: </strong>English 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":"8919887241302109"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","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}

{"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><strong>Objective: </strong>To 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).</p><p><strong>Methods: </strong>Surface-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.</p><p><strong>Results: </strong>Patients 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.</p><p><strong>Conclusions: </strong>The 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":"8919887241302110"},"PeriodicalIF":2.9,"publicationDate":"2024-11-14","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":"Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis.","authors":"Valton Costa, José Mario Prati, Alice de Oliveira Barreto Suassuna, Thanielle Souza Silva Brito, Thalita Frigo da Rocha, Anna Carolyna Gianlorenço","doi":"10.1177/08919887241237223","DOIUrl":"10.1177/08919887241237223","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD.</p><p><strong>Methods: </strong>Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate.</p><p><strong>Results: </strong>Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety.</p><p><strong>Conclusion: </strong>Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"415-435"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039577","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}