Psychiatric Quarterly最新文献

{"title":"Cognitive Behavioral Therapy Alone or in Combination with Eszopiclone in Comorbid Insomnia and Obstructive Sleep Apnea in Veterans with Posttraumatic Stress Disorder: A Randomized Trial.","authors":"Ali A El-Solh, Yolanda Lawson, Amber Martinson, Gregory Wilding","doi":"10.1007/s11126-025-10143-9","DOIUrl":"https://doi.org/10.1007/s11126-025-10143-9","url":null,"abstract":"<p><p>We sought to assess the augmentation of brief behavioral therapy for insomnia (BBTI) with eszopiclone (ESZ) over BBTI alone for the treatment of chronic insomnia on sleep quality, sleep indices, and continuous positive airway pressure (CPAP) adherence in PTSD veterans with COMISA. The pilot trial involved 53 PTSD patients (46 males and 7 females, mean age 48.2±8.3 years) with COMISA randomized to combination therapy of BBTI plus 2 weeks of eszopiclone (2 mg/d) or BBTI alone with follow-up visits conducted at 6 and 24 weeks. The main outcome measure was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI). A significant decrease in PSQI scores was observed between baseline and 24 weeks for BBTI plus ESZ (-5.24 [95% CI, -6.55 to -3.94]; p < 0.001) and BBTI-only (-5.45 [95%CI, -6.75 to -4.14]; p < 0.001). No significant group allocation effects x time interactions were detected. Similar improvements were recorded for ISI between baseline and 24 weeks (BBTI plus ESZ (-8.32 [95%CI, -10.51 to -6.14]; p < 0.001) and BBTI-only (-8.64 [95%CI, -10.88 to -6.41]; p < 0.001)) with no interaction effect between treatment groups x time. Combination therapy produced a higher remission rate of insomnia at 6 weeks, with both interventions achieving comparable rates at 24 weeks. Results of the mixed effect models for CPAP use revealed no group x time interaction effects. In patients with COMISA, the combination of eszopiclone with BBTI resulted in comparable improvement in sleep quality of life to that achieved with BBTI-only therapy. Although the addition of eszopiclone to BBTI conferred an early benefit in remission rate of insomnia relative to BBTI, both modalities achieved similar outcomes at long-term follow-up. Clinical Trial Registration This study was registered with ClinicalTrials.gov (Identifier NCT03937713).</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812158","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":"Validation of the Romanian Version of Autism Spectrum Quotient (AQ) and Empathy Quotient (EQ) in the General Population.","authors":"Alexandra Dolfi, Darian Faur, Mihai-Rare Scălcău, Emilia-Maria Sorescu, Mugur-Daniel Ciumăgeanu, Cătălina Tudose","doi":"10.1007/s11126-025-10144-8","DOIUrl":"https://doi.org/10.1007/s11126-025-10144-8","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of Autism Spectrum Disorder (ASD) can be difficult to achieve, especially since the diagnostic criteria have changed in the last decade. This challenge is even greater for Romanian clinicians, as there are currently no screening tools validated for diagnosing ASD in adults within the Romanian population.</p><p><strong>Purpose: </strong>This study aims to validate two screening instruments used to identify autistic traits in the Romanian general population: the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ).</p><p><strong>Methods: </strong>Data was collected by administering the Romanian version of the scales to a sample of 916 Romanian native speakers from the non-clinical population. 108 individuals were re-tested after 2 years. The scales were validated by determining their reliability with respect to the stability of the results and evaluating their construct and structural validity in correlation with the following instruments: QCAE (Questionnaire of Cognitive and Affective Empathy), PAQ (Perth Alexithymia Questionnaire) and BVAQ (Bermond-Vorst Alexithymia Questionnaire).</p><p><strong>Results: </strong>Our data revealed that, regarding reliability, the Romanian version of AQ presents slightly lower internal consistency compared to the original validation study. Concerning structural validity, confirmatory factor analysis (CFA) revealed suboptimal fit indices for the original 5-factor structure. Based on a subsequent exploratory factor analysis (EFA), a 2-factor solution returned improved fit indices.</p><p><strong>Conclusion: </strong>Despite employing more items to measure the constructs than needed, this study confirmed that both instruments present a valuable resource for clinicians working with neurodivergent patients, as interest in this area of pathology has increased greatly in Romania over the past few years. Practical implications and methodological issues regarding the two instruments are discussed.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812159","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":"Underlying Dimensions of Borderline Personality Disorder: A Systematic Review of Factor Analytic Studies.","authors":"Alexandra Triantafyllou, George Konstantakopoulos, Pentagiotissa Stefanatou, Eleni Giannouli, Ioannis A Malogiannis","doi":"10.1007/s11126-025-10141-x","DOIUrl":"https://doi.org/10.1007/s11126-025-10141-x","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is considered to be a heterogeneous diagnostic entity, with multiple facets of the disorder influencing its course. Disentangling the structure of BPD criteria is fundamental to better understanding the disorder and targeting problematic behaviors. To identify and critically appraise factor analytic studies examining the structure of BPD criteria. A systematic review was conducted according to PRISMA guidelines. Three computerized databases (Pubmed, Scopus,PsycNET) were searched, resulting in the inclusion of 27 relevant studies. The unified model of BPD has been confirmed by a number of studies, while among multidimensional models, a three-factor model has also gained considerable empirical support. Multidimensional models of BPD tend to cluster together \"disordered self\" symptoms (identity disturbance and emptiness), affective symptoms (affective instability and anger), and behavioral symptoms (impulsivity and self-harming behaviors). Unidimensional and multidimensional models of the BPD structure are not necessarily in competition. An understanding of BPD as a unified diagnosis composed of three underlying dimensions, could serve the purpose of recognizing and targeting different aspects of the disorder, while maintaining a robust, and clinically useful diagnosis.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788706","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 Role of Sleep Quality and Sleepiness in the Relationship Between Cognitive Flexibility and Fatigue.","authors":"Ozge Ozkutlu, Ozgu Inal Ozun","doi":"10.1007/s11126-025-10135-9","DOIUrl":"https://doi.org/10.1007/s11126-025-10135-9","url":null,"abstract":"<p><p>This study aimed to determine the pathways linking cognitive flexibility to fatigue through the serial mediation effect of sleep quality and sleepiness in 564 healthy adults using various scales, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, and Cognitive Flexibility Inventory. Analysis was performed using two mediating variables (sleep quality and sleepiness) with age and gender as covariates. The simple mediation effect was evaluated using the Causal Step. The indirect effect was examined using bootstrap method and Sobel test. The total and direct effects of cognitive flexibility on fatigue were both found to be statistically significant. The research model revealed three significant indirect effects: cognitive flexibility affecting fatigue through sleep quality, cognitive flexibility affecting fatigue through sleepiness and cognitive flexibility affecting fatigue through both sleep quality and sleepiness. Additionally, serial mediation analysis showed that the relationship between cognitive flexibility and fatigue is sequentially mediated by sleep quality and sleepiness (B = -0.064, SE = 0.013, 95% CI: -0.070 to -0.017). All effects were confirmed through the 95% confidence intervals, which did not include zero, and with significant p values. These findings highlight the role of sleep quality and sleepiness as serial mediators of the relationship between cognitive flexibility and fatigue. The study's major contribution is to provide insight on the independent and serial mediating role of sleep quality and sleepiness in the relationship between cognitive flexibility to fatigue.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788703","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":"Associations of Lifestyle Behaviors with Anxiety and Depression in Type 2 Diabetes Mellitus Patients with Hypertension: A Cross-Sectional Study.","authors":"Ziling Feng, Hongying Liu, Wenyan Zhang, Yamin Liu, Ni Xiong, Wenhang Chen, Jianzhou Yang, Xinyin Wu, Wenjie Dai","doi":"10.1007/s11126-025-10136-8","DOIUrl":"https://doi.org/10.1007/s11126-025-10136-8","url":null,"abstract":"<p><p>This study aimed to identify the prevalence of anxiety and depression, as well as the associations of lifestyle behaviors with anxiety and depression in type 2 diabetes mellitus (T2DM) patients with hypertension. This cross-sectional study was conducted in Hunan Province of China, with 475 participants included. Data on sociodemographic, lifestyle behaviors, and disease-related characteristics were collected. Anxiety and depression were assessed using self-report questionnaires. This study indicated that the prevalence of anxiety and depression was 37.47% (95% confidence interval [95% CI]: 33.37-42.07%) and 40.63% (95% CI: 36.43-45.26%), respectively. Multivariable logistic regression analyses showed that playing cards or mahjong (adjusted odds ratio [aOR] = 0.46 [95% CI: 0.28-0.76] and aOR = 0.57 [95% CI: 0.34-0.94] for anxiety and depression, respectively) and performing physical activity for > 30 min per day (aOR = 0.32 [95% CI: 0.19-0.52] and aOR = 0.23 [95% CI: 0.14-0.38] for anxiety and depression, respectively) were associated with lower odds of both anxiety and depression, while reading books or newspapers (aOR = 0.34, 95% CI: 0.12-0.93) were associated with lower odds of anxiety alone. Therefore, regular reading, social activities and physical activities can be considered as intervention targets for the prevention and management of anxiety and depression in T2DM patients with hypertension.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780959","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":"Dysfunctional Pandemic Grief Model Among Nursing Professionals Who Experienced Death of Patients.","authors":"Seockhoon Chung, Young Rong Bang, Mohd Ashik Shahrier, Youjin Hong, Junseok Ahn","doi":"10.1007/s11126-025-10142-w","DOIUrl":"https://doi.org/10.1007/s11126-025-10142-w","url":null,"abstract":"<p><p>Dysfunctional grief was not addressed adequately during the COVID-19 pandemic. This study aimed to develop a dysfunctional pandemic grief model specific to healthcare workers who experienced patient deaths during the COVID-19 pandemic. We conducted an anonymous online survey among 568 nursing professionals who had experienced a patient's death while working at three tertiary-level hospitals. We further assessed psychological status using the Pandemic Grief Scale (PGS) for Healthcare Workers, Pandemic Grief Risk Factors (PGEF), Utrecht Grief Rumination Scale (UGRS), Grief Support HealthCare Scale (GSHCS), Patient Health Questionnaire-9 (PHQ-9), and Stress and Anxiety in Viral Epidemic-9 (SAVE-9). PGS correlated with PGRF, UGRS, GSHCS, PHQ-9, and SAVE-9 (all p < 0.01). Linear regression analysis revealed that PGRF (𝛽=0.44, p < 0.001), UGRS (𝛽=0.24, p < 0.001), GSHCS (𝛽=-0.09, p = 0.004), and PHQ-9 (𝛽=0.23, p < 0.001) expected pandemic dysfunctional grief. Mediation analysis showed that PGRF directly influenced PGS; UGRS and GSHCS positively and negatively mediated the relationship between PGRF and PGS, respectively. The dysfunctional pandemic grief model shows that it is important to address grief risk factors, manage rumination, and provide effective psychological support to healthcare workers.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780972","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 Mediating Role of Internalized Stigma and Illness Knowledge in the Relationship Between Psychological Flexibility and Symptom Severity in Schizophrenia.","authors":"Buket Koparal, İlknur Kiraz Avci","doi":"10.1007/s11126-025-10140-y","DOIUrl":"https://doi.org/10.1007/s11126-025-10140-y","url":null,"abstract":"<p><p>Schizophrenia is a chronic mental illness that affects daily functioning and quality of life. Many patients experience internalized stigma, which worsens symptoms and quality of life. Psychological flexibility may help reduce stigma's negative effects. This study explores how psychological flexibility, internalized stigma, and illness knowledge relate to symptom severity in schizophrenia. We hypothesized that internalized stigma mediates the link between psychological flexibility and symptoms, and that greater illness knowledge leads to lower stigma and better outcomes. This cross-sectional study included patients diagnosed with schizophrenia at a Community Mental Health Center (CMHC) in Turkey. 253 participants completed standardized scales of psychological flexibility(AAQ-II), internalized stigma(ISMI), knowledge about schizophrenia(KASQ), and symptom severity(PANSS). Mediation analysis was performed using the PROCESS macro for SPSS to assess the indirect effects of stigma and illness knowledge on symptom severity. Psychological flexibility was significantly associated with lower levels of internalized stigma (β = -1.046, p < 0.001). Internalized stigma mediated the relationship between psychological flexibility and symptom severity(β = 0.506, p < 0.001), whereas illness knowledge had a protective effect on symptom severity(β = -1.582, p < 0.001). However, illness knowledge did not significantly mediate the relationship between psychological flexibility and stigma. The findings highlight the critical role of psychological flexibility in mitigating the negative impact of internalized stigma, suggesting that interventions aimed at enhancing flexibility could improve clinical outcomes. Psychoeducation programs may further reduce symtom severity by increasing ilness knowledge. Future research should explore longitudinal interventions targeting stigma reduction and psychological flexibility to enhance functional recovery in schizophrenia.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780973","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":"Psychological Problems and Academic Motivation in University Students: A Cross-Sectional Study One Year after the COVID-19 Lockdown in Italy.","authors":"Alda Troncone, Gaia Caldarelli, Marina Cosenza, Gaetana Affuso, Mariagiulia Sacco, Maria Ciccarelli, Barbara Pizzini","doi":"10.1007/s11126-025-10138-6","DOIUrl":"https://doi.org/10.1007/s11126-025-10138-6","url":null,"abstract":"<p><p>This study was aimed at exploring students' psychological condition (operationalized through psychological distress and perceived loneliness) one year after the COVID-19 lockdown and testing its role in predicting academic motivation. The possible mediating role of emotional regulation in this relationship was also investigated. A non-random sample of university students completed a cross-sectional online survey assessing their psychological distress, feelings of loneliness, emotion regulation strategies, and academic motivation. Structural equation modeling multi-group analysis was used to examine the relation between variables. The final sample comprised 479 students (62.8% female, Mage = 22.16 ± 2.79 years) from several degree courses attending Italian universities. Of these, 56.6% and 41.5% of the participants showed high levels of psychological distress and perceived loneliness, respectively. Psychological distress and loneliness were positively associated with problems with emotion-regulation abilities and negatively associated with academic motivation. The lack of emotional awareness, in turn, reduced their academic motivation levels. Analysis of the indirect effects showed that psychological distress affected academic motivation via awareness (β = -.02, p < .05 and β = -.03, p < .05 in males and females, respectively). Overall, the model was able to predict academic motivation in university students, explaining a reasonable percentage of the variance (14% for males and 17% for females). These results indicate a meaningful effect of students' psychological condition on academic motivation. Implications for the definition and implementation of actions to support students in managing psychological problems and feelings of loneliness and to foster students' psychological health in university settings are discussed.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773229","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":"Childhood Psychological Maltreatment, Psychological Flexibility, Family Conflict, and Subjective Happiness in University Students: A Serial Mediation Model.","authors":"Muhammed Akat, Sinan Okur, Ömer Faruk Akbulut, Seydi Ahmet Satıcı, Erdal Hamarta","doi":"10.1007/s11126-025-10134-w","DOIUrl":"https://doi.org/10.1007/s11126-025-10134-w","url":null,"abstract":"<p><p>Childhood psychological maltreatment has psychological, behavioral, and emotional repercussions on individuals in adulthood. These reflections play a role in both the internal distress of individuals and the deterioration of their interpersonal relationships. The aim of this study was to examine the serial mediating role of psychological flexibility and family conflict in the relationship between childhood psychological maltreatment and subjective happiness. The study was conducted with 493 university students (61.7% female, 38.3% male), with ages ranging from 18 to 53 years (M_age = 24.02, SD = 6.342). The data of this research was analyzed using structural equation modeling. The findings of the study indicate that psychological flexibility and family conflict have a serial mediating role in the relationship between childhood psychological maltreatment and subjective happiness. The results demonstrated that to improve the subjective happiness of people who have been psychologically abused as children, it is necessary to make them more psychologically flexible and teach them how to deal with family conflict. Overall, these findings emphasize the importance of fostering psychological flexibility and conflict resolution skills as key intervention targets to mitigate the long-term negative effects of childhood psychological maltreatment on subjective happiness. The findings of the study were discussed and interpreted in detail in the light of the relevant literature.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780970","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 Relationship Between Physical Activity and Problematic Internet Use in Turkish College Students: The Chain-Mediated Role of Self-Control and Distress.","authors":"Fatih Gür, Ganime Can Gür","doi":"10.1007/s11126-025-10133-x","DOIUrl":"https://doi.org/10.1007/s11126-025-10133-x","url":null,"abstract":"<p><p>This study aims to investigate the impact of physical activity on problematic internet use and to reveal the mediating role of self-control and psychological distress in the path relationship between them, providing a theoretical foundation for reducing problematic internet use and promoting mental health among college students. This cross-sectional study was conducted with undergraduate students. Data were collected online using network sampling through the online survey platform Google Forms. Data were collected using the Demographic Data Form (DDF), Physical Activity Scale-2 (PAS-2), the Addiction Profile Index Internet Addiction Form (BAPINT), the Brief Self-Control Scale (BSCS), and the Psychological Distress Scale (K10-PDS). In order to evaluate the adequacy of the research model, path analysis, a component of structural equation modeling (SEM), was used using AMOS software. The structural model also exhibits a good fit, with x² /df = 3.105, RMSEA = 0.081, GFI = 0.964, AGFI = 0.924, CFI = 0.948, TLI = 0.914, and IFI = 0.949. Physical activity could directly negatively predict the problematic internet use of college students. Self control and distress partially mediate the relationship between physical activity and problematic internet use, and the mediating pathways included \"physical activiy-self control- problematic internet use\", \"physical activity-distress- problematic internet use\", and \"physical activity-self conrtol-distress- problematic internet use\", accounting for 12.6%, 33.7% and 4.7% of the total effect, respectively. The results of this study provide an important framework for understanding internet addiction in this population, supporting the I-PACE model.</p>","PeriodicalId":20658,"journal":{"name":"Psychiatric Quarterly","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780975","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}