Journal of Sleep Research最新文献

{"title":"The impact of a 20-h rotating watch schedule on cognitive and mood states in submarine operations.","authors":"David Erez, Harris R Lieberman, Nadav Rafael, Itay Ketko, Daniel S Moran","doi":"10.1111/jsr.14400","DOIUrl":"10.1111/jsr.14400","url":null,"abstract":"<p><p>This is the first study to provide valuable insights into the effects of the Israeli Navy's 20-h rotating watch schedule on submariners' alertness, mood states, risk-taking behaviours, and sleep. Specifically, we assessed the impact of the non-circadian-aligned schedule on cognitive performance, mood, and behavioural outcomes in a highly controlled submarine environment. A total of 20 male submariners participated in an at-sea mission, where their cognitive performance, mood states, risk-taking propensity, and caffeine consumption were measured. A psychomotor vigilance task (PVT) assessed alertness, the propensity for risky behaviour (Evaluation of Risks Scale) measured risk-taking behaviours, and the Profile of Mood States evaluated mood disturbances. Actigraphy was used to monitor sleep times. Data were analysed according to seven watch schedule segments. Submariners slept a mean (standard error of the mean [SEM]) of 8.3 (0.2) h/24 h, fragmented into 3.7 (0.8) h epochs. Caffeine consumption decreased at sea (mean [SEM] 149.3 [6.0] mg) compared to land (mean [SEM] 205.5 [7.2] mg; p = 0.027). In the PVT, premature responses significantly increased during Watch VI (5:00-8:00 p.m.) and Watch VII (8:00 p.m.-12:00 a.m.; p = 0.014). In the mood subscales, tension was significantly higher during Watch II (4:00-8:00 a.m.; p = 0.002), indicating greater stress. Risk-taking propensity significantly increased during afternoon shifts (p = 0.050). The 20-h watch schedule led to fragmented sleep, reduced alertness in the evening, worsened mood states in the early morning, and increased risk-taking propensity in the afternoon. These findings suggest the need for the Israeli Navy to establish evidence-based caffeine guidelines and optimise the watch schedule to improve submariners' sleep, performance, and overall well-being.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14400"},"PeriodicalIF":3.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between sleep difficulties and externalizing and internalizing problems in children and adolescents with mental illness.","authors":"Emilie M A van Tetering, Gabry W Mies, Helen Klip, Sigrid Pillen, Jet B Muskens, Tinca J C Polderman, Malindi van der Mheen, Wouter G Staal, Sara Pieters","doi":"10.1111/jsr.14398","DOIUrl":"https://doi.org/10.1111/jsr.14398","url":null,"abstract":"<p><p>Sleep difficulties are presumably a transdiagnostic factor in the complex aetiology of psychiatric disorders in youth. This study assessed the prevalence of sleep difficulties in children and adolescents seeking specialized psychiatric care, examined the relationships of internalizing and externalizing problems, and considered the moderating role of sex and age on these relationships. Parent-reported data on difficulties initiating sleep, difficulties maintaining sleep, early morning awakenings and daytime fatigue from a large sample of children and adolescents referred for specialized psychiatric care (n = 4638; < 18 years) were used to estimate prevalence rates. To examine associations between these sleep difficulties and internalizing/externalizing problems, multiple linear regression analyses were conducted on available data (n = 3768) stratified in three age groups (1.5-5 years; 6-11 years; 12-18 years). Overall prevalence, i.e. at least one sleep difficulty was reported to be often or always present, was 65%. Difficulties initiating sleep occurred the most, closely followed by daytime fatigue. In all age groups, sleep difficulties were positively related to internalizing and externalizing problems. In young children and school-age children, age moderated the interaction between sleep difficulties and internalizing problems. To conclude, prevalence rates of sleep difficulties in children with mental illness appear higher than it has been reported in the general youth population, especially difficulties initiating sleep and daytime fatigue. We observed that the associations between internalizing problems and sleep difficulties in young children and school-age children seemed to be amplified with age, suggesting a negative, bidirectional, spiral in development.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14398"},"PeriodicalIF":3.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating digital behavioural therapy for insomnia into primary care: A feasibility mixed-methods study.","authors":"Christopher J Gordon, Janet M Y Cheung, Zoe Menzel Schrire, Matthew Rahimi, Melissa Aji, Helena Salomon, Iliana Doggett, Nick Glozier, Keith K H Wong, Nathaniel S Marshall, Delwyn J Bartlett, Ron R Grunstein","doi":"10.1111/jsr.14401","DOIUrl":"https://doi.org/10.1111/jsr.14401","url":null,"abstract":"<p><p>Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single-arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post-trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real-world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14401"},"PeriodicalIF":3.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep schedules and MSLT-based diagnosis of narcolepsy type 2 and idiopathic hypersomnia: Exploring potential associations in a large clinical sample.","authors":"Kentaro Matsui, Akira Usui, Yoichiro Takei, Kenichi Kuriyama, Yuichi Inoue","doi":"10.1111/jsr.14402","DOIUrl":"https://doi.org/10.1111/jsr.14402","url":null,"abstract":"<p><p>Differential diagnosis of narcolepsy type 2 and idiopathic hypersomnia relies on the frequency of sleep-onset rapid eye movement periods observed on the Multiple Sleep Latency Test. This study investigated whether variations in sleep schedules, particularly delayed sleep-wake patterns, contribute to the diagnostic distinction between narcolepsy type 2 and idiopathic hypersomnia. The study included 871 patients aged 18-39 years (316 with narcolepsy type 2, 555 with idiopathic hypersomnia). These patients were diagnosed based on MSLT results following polysomnography from November 2013 to November 2017. Patients' sleep habits, including bedtime and wake-up times on weekdays and weekends during the 2 weeks preceding the polysomnography/Multiple Sleep Latency Test, were assessed using self-reported sleep logs. A multivariate logistic regression analysis was conducted to identify factors associated with narcolepsy type 2 diagnosis. The analysis revealed that being male (p < 0.001), younger age (p < 0.001), shorter weekday sleep duration (p < 0.05), and a delayed weekday sleep midpoint time (p < 0.01) were significantly associated with a diagnosis of narcolepsy type 2. The study suggests that the conventionally fixed schedule of polysomnography and Multiple Sleep Latency Test administration may have contributed to the increased occurrence of sleep-onset rapid eye movement periods particularly in individuals with a delayed sleep-wake schedule.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14402"},"PeriodicalIF":3.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New European guidelines for the accreditation of sleep medicine centres and more!","authors":"Dieter Riemann","doi":"10.1111/jsr.14408","DOIUrl":"10.1111/jsr.14408","url":null,"abstract":"&lt;p&gt;Dear members of the ESRS,&lt;/p&gt;&lt;p&gt;Dear readers of JSR,&lt;/p&gt;&lt;p&gt;Welcome to the sixth edition of the &lt;i&gt;Journal of Sleep Research&lt;/i&gt; in 2024, which will be published in December 2024.&lt;/p&gt;&lt;p&gt;This issue encompasses a variety of articles covering many facets of sleep medicine and sleep research.&lt;/p&gt;&lt;p&gt;Firstly, I would like to highlight the work by Hartley et al. (&lt;span&gt;2024&lt;/span&gt;) who have provided us with a revision of the European guidelines for the accreditation of sleep medicine centres. The first such position paper was published in 2006, and therefore it is very timely that this update was written. In this paper, several levels of sleep medicine centres are suggested: Levels 1 and 2 would offer full diagnostic testing in a laboratory setting including polysomnography and other sophisticated diagnostic methods – this type of centre would usually be university based. Levels 3 and 4 would be ambulatory services, offering also polysomnography (Level 3) or polygraphy (Level 4). The paper outlines the role of the medical and paramedical teams, equipment and many other important issues for conducting proper sleep medicine according to our patients' needs.&lt;/p&gt;&lt;p&gt;Tse et al. (&lt;span&gt;2024&lt;/span&gt;) from Oxford investigated whether single-component sleep restriction therapy may have a significant effect on depressive symptoms also, besides the well-known effects on sleep parameters in patients suffering from insomnia. To this end, a state of the art systematic review and meta-analysis on the relevant literature was conducted. Seven controlled and two uncontrolled trials met inclusion and exclusion criteria for the study, encompassing over 1100 patients with insomnia and some subclinical forms of depressive symptoms. Data analysis revealed that sleep restriction alone had a medium effect on depressive symptoms, apart from the effects on sleep. These promising data suggest to perform further trials encompassing patients with insomnia and clinical depression, to test whether also in this population depressed symptomatology will be reduced.&lt;/p&gt;&lt;p&gt;Meers et al. (&lt;span&gt;2024&lt;/span&gt;) deal with a still widely neglected area, i.e. the relationships between sleep and emotion across the menstrual cycle. They studied 51 women aged from 18 to 35 years. Actigraphy and daily sleep/emotion diaries were collated over two menstrual cycles. Four phases of the menstrual cycle were compared with each other: peri-menstrual; mid-follicular; periovulatory; and mid-luteal. Relationships between menstrual phase, sleep parameters and emotions were estimated with multistep hierarchical linear modelling. Mean menstrual cycle length was 28.6 days. Interestingly, peri-menstrual phase predicted anger, but none of the other emotions; it also predicted total wake time at night measured subjectively and with actigraphy. Poor sleep during the peri-menstrual phase correlated with reduced positive emotions. The authors suggest that improving sleep during the peri-menstrual phase may have a positive","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":"33 6","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsr.14408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes to human sleep architecture during long-duration spaceflight.","authors":"Oliver Piltch, Erin E Flynn-Evans, Millennia Young, Robert Stickgold","doi":"10.1111/jsr.14345","DOIUrl":"https://doi.org/10.1111/jsr.14345","url":null,"abstract":"<p><p>Both rapid eye movement and non-rapid eye movement sleep are important for cognitive function and well-being, yet few studies have examined whether human sleep architecture is affected by long-duration spaceflight. We recorded 256 nights of sleep from five crew members before (n = 112 nights), during (n = 83 nights) and after (n = 61 nights) ~6-month missions aboard the Mir space station, using the Nightcap sleep monitor. We compared sleep outcomes (including total sleep time, efficiency, latency, rapid eye movement and non-rapid eye movement) during spaceflight with those on Earth. We also evaluated longitudinal changes over time in space. We found that wakefulness increased by 1 hr in space compared with on Earth. Over time in space, rapid eye movement was initially reduced and then recovered to near preflight levels at the expense of non-rapid eye movement sleep. Upon return to Earth, sleep architecture returned to preflight distribution. Our findings suggest that spaceflight may alter sleep architecture and should be explored further.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14345"},"PeriodicalIF":3.4,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising the power spectrum dynamics of the non-REM to REM sleep transition.","authors":"Diego Serantes, Matías Cavelli, Joaquín Gonzalez, Alejandra Mondino, Luciana Benedetto, Pablo Torterolo","doi":"10.1111/jsr.14388","DOIUrl":"https://doi.org/10.1111/jsr.14388","url":null,"abstract":"<p><p>The transition from non-rapid eye movement (NREM) to rapid eye movement (REM) sleep is considered a transitional or intermediate stage (IS), characterised by high amplitude spindles in the frontal cortex and theta activity in the occipital cortex. Early reports in rats showed an IS lasting from 1 to 5 s, but recent studies suggested a longer duration of this stage of up to 20 s. To further characterise the IS, we analysed its spectral characteristics on electrocorticogram (ECoG) recordings of the olfactory bulb (OB), primary motor (M1), primary somatosensory (S1), and secondary visual cortex (V2) in 12 Wistar male adult rats. By comparing the IS with consolidated NREM/REM epochs, our results reveal that the IS has specific power spectral patterns that fall out of the NREM and REM sleep state power distribution. Specifically, the main findings were that sigma (11-16 Hz) power in OB, M1, S1, and V2 increased during the IS compared with NREM and REM sleep, which started first in the frontal part of the brain (OB -54 s, M1 -53 s) prior to the last spindle occurrence. The beta band (17-30 Hz) power showed a similar pattern to that of the sigma band, starting -54 s before the last spindle occurrence in the M1 cortex. Notably, sigma infraslow coupling (~0.02 Hz) increased during the IS but occurred at a slower frequency (~0.01 Hz) compared with NREM sleep. Thus, we argue that the NREM to REM transition contains its own local spectral profile, in accordance with previous reports, and is more extended than described previously.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14388"},"PeriodicalIF":3.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No effect of napping on episodic foresight and prospective memory in kindergarten children.","authors":"Carolin Konrad, Babett Voigt","doi":"10.1111/jsr.14387","DOIUrl":"https://doi.org/10.1111/jsr.14387","url":null,"abstract":"<p><p>Preschool children often have problems in remembering to carry out a planned behaviour. This study investigated the impact of napping on episodic foresight (planning for future events) and prospective memory (remembering to perform an action in the future) in 2-3-year-old children. In a quasi-experimental design, we compared children who napped (nap condition, n = 20) after receiving information about an upcoming problem (episodic foresight task) and a delayed intention (prospective memory task) with those who stayed awake (wake condition, n = 43). We hypothesised that napping would improve performance in the episodic foresight and the prospective memory tasks. Contrary to the hypothesis, napping did not significantly affect children's episodic foresight or prospective memory performance, even after controlling for the group difference in age. Task performance was primarily explained by memory effects and age. Further research that incorporates stricter controls and evaluates pre-nap memory strength is necessary fully to elucidate the complex interplay between napping, age, episodic foresight, and prospective memory performance in young children.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14387"},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insomnia symptoms predict systemic inflammation in women, but not in men with inflammatory bowel disease.","authors":"Andrea Ballesio, Mariacarolina Vacca, Valeria Fiori, Federica Micheli, Flavia Baccini, Giovanni Di Nardo, Caterina Lombardo","doi":"10.1111/jsr.14395","DOIUrl":"10.1111/jsr.14395","url":null,"abstract":"<p><p>Insomnia has been suggested as a potential modulator of systemic inflammation. However, few studies have examined the longitudinal association between insomnia and inflammation as well as the role of sex differences, despite accumulating evidence of the vulnerability of women to immune consequences of disturbed sleep. In this study, we tested the association between self-reported insomnia symptoms and serum C-reactive protein, a marker of systemic inflammation, at 1-year follow-up, in 54 outpatients with inflammatory bowel disease (52.81 ± 16.09, 40.7% women). Insomnia symptoms were measured using the Insomnia Severity Index. After controlling for baseline inflammation and health variables, longitudinal moderated regression analysis showed that baseline insomnia symptoms predicted C-reactive protein levels at follow-up in women (β = 0.416, p = 0.014), but not in men (β = -0.179, p = 0.212). Results were not influenced by sex differences in insomnia severity or C-reactive protein levels. This study suggests insomnia symptoms may partially influence systemic inflammation in women with inflammatory bowel disease. Sex-specific psychological, immune and neuroendocrine pathways linking sleep to inflammation should be further elucidated.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14395"},"PeriodicalIF":3.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-care behaviours in patients with restless legs syndrome (RLS): development and psychometric testing of the RLS-Self-care Behaviour questionnaire.","authors":"Elzana Odzakovic, Christina Sandlund, Amanda Hellström, Martin Ulander, Kerstin Blom, Susanna Jernelöv, Viktor Kaldo, Maria Björk, Susanne Knutsson, Jonas Lind, Amir Pakpour, Anders Broström","doi":"10.1111/jsr.14390","DOIUrl":"https://doi.org/10.1111/jsr.14390","url":null,"abstract":"<p><p>Restless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self-care, the RLS-Self-care Behaviour questionnaire (RLS-ScBq). Self-care, defined as an active decision-making process, can empower patients to effectively participate in their own healthcare through awareness, self-control, and self-reliance to cope with their disease. Self-care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS-ScBq in patients with RLS. A cross-sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS-related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS-6 scale) were collected. The validity and reliability of the RLS-ScBq were investigated using exploratory factor analysis and Rasch models. The two-factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self-care Behaviour Frequency part and 36.28% for The Benefit of Self-care Behaviour part. The internal consistency measured by Cronbach's α was 0.57 and 0.60, and McDonald's ω was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight-item RLS-ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self-care activities in patients with RLS.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e14390"},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}