Psychiatry and Clinical Neurosciences最新文献

{"title":"Risk of post-COVID-19 mental and physical health outcomes among SARS-CoV-2-immunologically naïve people.","authors":"Pao-Huan Chen, Pao-Yu Chen, Shang-Ying Tsai, Yueh-Pin Lin, Sheng-Siang Su, Chiao-Chicy Chen, Chian-Jue Kuo","doi":"10.1111/pcn.13899","DOIUrl":"https://doi.org/10.1111/pcn.13899","url":null,"abstract":"<p><strong>Background: </strong>Emerging studies link COVID-19 to adverse multi-organ outcomes. To better estimate psychiatric and physical illness after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we analyzed a nationally representative cohort with minimal prior infection (>99% uninfected) and low vaccination coverage (<1%) in Taiwan.</p><p><strong>Methods: </strong>We conducted a cohort study comprising 11,185 individuals who survived the first 30 days following SARS-CoV-2 infection (alpha variant) between May 1, 2021, and September 30, 2021, confirmed by reverse transcription polymerase chain reaction, along with three age- and sex-matched comparison groups: a contemporary control group (n = 223,700) with no COVID-19 diagnosis, a historical control group (n = 223,700) predating the pandemic, and seasonal influenza group (n = 44,740). We calculated the adjusted incidence rate ratios (aIRRs) of specific psychiatric and physical illnesses to compare their occurrence between the COVID-19 cohort and comparison groups.</p><p><strong>Results: </strong>During the 6 months after the first COVID-19 diagnosis, aIRRs for psychiatric illnesses in the COVID-19 group were higher across diagnostic categories than those of comparison groups. Moreover, aIRRs of physical illnesses in the COVID-19 group were higher across nearly all major organ systems compared to the comparison ones. The absolute rate difference for overall psychiatric illnesses was 7921.0 (COVID-19 vs contemporary control) and 7226.9 per 100,000 person-years (COVID-19 vs historical control), respectively.</p><p><strong>Conclusions: </strong>SARS-CoV-2-immunologically naïve individuals have heightened risks of psychiatric illnesses across diagnostic categories and physical illnesses spanning nearly all major organ systems after the infection. Future studies warrant to explore the pathogenesis of these postacute effects.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150473","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":"Neurometabolic dysregulation within the cortico-striatal-thalamo-cortical circuits in obsessive-compulsive disorder: A ¹H-MRS meta-analysis.","authors":"Fei Zhu, Qiao Wen, Senhao Liu, Ziyang Gao, Bo Tao, Na Hu, Qiannan Zhao, Wei Yu, Yuan Xiao, Su Lui","doi":"10.1111/pcn.13895","DOIUrl":"https://doi.org/10.1111/pcn.13895","url":null,"abstract":"<p><strong>Aim: </strong>Changes in neurometabolites are believed to have a significant impact on the underlying mechanisms of obsessive-compulsive disorder (OCD). However, current findings regarding the neurometabolite levels of OCD patients remain inconsistent. To address this issue, we conducted a comprehensive meta-analysis of proton magnetic resonance spectroscopy studies to investigate the differences in neurometabolite levels in OCD patients relative to healthy controls (HCs).</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, and Embase included 55 original studies that compared the levels of eight in vivo neurometabolites in OCD patients (n = 1270) and HCs (n = 1186). Hedge's g with random effects model was employed to calculate the effect sizes for the between-group differences in neurometabolite levels. Meta-regression and subgroup analyses were conducted to examine confounding effects.</p><p><strong>Results: </strong>Compared to HCs, OCD patients exhibited decreased N-acetylaspartate compounds (NAA) in the striatum, as well as elevated choline-containing compounds (Cho) levels in the thalamus. The symptom severity of OCD patients showed positive associations with Cho in the striatum. Subgroup analyses showed that decreased striatal NAA in OCD patients remained evident in both the medicated and 1.5T subgroups. Additionally, significantly increased thalamic Cho in OCD patients was also observed in the unmedicated, adult, 3.0T, and non-comorbid subgroups.</p><p><strong>Conclusion: </strong>This study reveals neurometabolic dysregulation within the cortico-striatal-thalamo-cortical circuits in OCD, offering integrated insights into its underlying neurobiological mechanisms.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138639","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":"Repurposed antihypertensive drugs for negative symptoms in schizophrenia: A systematic review and meta-analysis.","authors":"Thiago Carnaval, My Bui, Jesús Villoria, Dolores Rodríguez, José Manuel Menchón, Francisco Ciruela, Sebastián Videla","doi":"10.1111/pcn.13892","DOIUrl":"https://doi.org/10.1111/pcn.13892","url":null,"abstract":"<p><p>Schizophrenia is a complex psychiatric disorder characterized by positive, negative, and general psychopathological symptoms. While antipsychotic drugs are effective for positive symptoms, they provide limited benefit for negative symptoms, which are often persistent and strongly associated with functional disability. Additionally, up to 30% of patients exhibit resistance to current treatments, including clozapine. These challenges underscore the need for novel adjunctive strategies. This systematic review and meta-analysis, preregistered in PROSPERO (CRD42022359199), evaluated the efficacy and safety of repurposed antihypertensive drugs (AHTs) as adjunctive treatments for schizophrenia. PubMed, Web of Science, and Scopus were searched for double-blind, randomized controlled trials (RCTs) published since 2000. Twelve studies were included (n = 436; sodium nitroprusside = 6; diuretics = 4; telmisartan = 1; clonidine = 1). Meta-analyses were conducted on Positive and Negative Syndrome Scale (PANSS) outcomes and adverse event (AE) rates. Standardized mean differences (SMDs) were calculated as Hedges' g using a restricted maximum likelihood estimator. Incidence rate ratios modeled AE rates. AHTs significantly improved negative symptoms (SMD = -0.37 [-0.59, -0.15]; I² = 43.8%), positive symptoms (SMD = -0.29 [-0.53, -0.06]; I² = 25.1%), general psychopathology (SMD = -0.28 [-0.48, -0.08]; I² = 0.0%), and total symptoms (SMD = -0.44 [-0.66, -0.21]; I² = 0.0%). No significant increase in AEs was observed. Overall, repurposed AHTs-particularly sodium nitroprusside-may offer adjunctive therapeutic benefits for schizophrenia treatments. Some diuretics also showed preliminary signals of efficacy. However, findings are preliminary and require confirmation in larger, long-term RCTs.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024138","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":"Serum ergothioneine and risk of dementia in a general older Japanese population: the Hisayama Study.","authors":"Xiangyin Meng, Tomoyuki Ohara, Kentaro Nishioka, Mao Shibata, Makoto Katsube, Norifumi Tateishi, Yumi Nakamura, Emi Oishi, Satoko Sakata, Yoshihiko Furuta, Tomohiro Nakao, Toshiharu Ninomiya","doi":"10.1111/pcn.13893","DOIUrl":"https://doi.org/10.1111/pcn.13893","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between serum ergothioneine and risk of developing dementia and its subtypes in a community-dwelling older population.</p><p><strong>Methods: </strong>In this prospective longitudinal analysis of participants enrolled in the Hisayama Study, 1344 Japanese community-residents aged 65 years and over without dementia at baseline were followed prospectively for a median of 11.2 years (2012-2023). Serum ergothioneine levels were quantified using liquid chromatography-mass spectrometry and divided into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals for the association between serum ergothioneine levels and the risk of dementia subtypes.</p><p><strong>Results: </strong>During the follow-up, 273 participants developed all-cause dementia. Among them, 201 had Alzheimer's disease (AD) and 72 had non-Alzheimer's disease (non-AD) dementia. The age- and sex-adjusted HRs for all-cause dementia, AD, and non-AD dementia decreased progressively across increasing quartiles of serum ergothioneine (all P for trend <0.05). These associations remained significant after adjustment for a wide range of cardiovascular, lifestyle, and dietary factors, including daily vegetable intake (P for trend <0.05). In subgroup analyses stratified by daily vegetable intake, higher serum ergothioneine levels were consistently associated with lower dementia risk, irrespective of vegetable consumption.</p><p><strong>Conclusions: </strong>Our findings showed that higher serum ergothioneine levels were associated with a lower risk of developing all-cause dementia, AD, and non-AD dementia in an older Japanese population. Since ergothioneine cannot be synthesized in the human body, a diet rich in ergothioneine may be beneficial in reducing the risk of dementia.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001432","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":"Norman Sartorius: A true legend in psychiatry, renowned for inspiring and mentoring early-career psychiatrists across the globe.","authors":"Masaru Tateno, Takahiro A Kato, Hidehiko Takahashi","doi":"10.1111/pcn.13868","DOIUrl":"10.1111/pcn.13868","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"603"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619859","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":"Depression, antidepressant use, and breast cancer incidence: results from the E3N prospective cohort.","authors":"Romain Colle, Eric Deflesselle, Océane Mohamed, Bruno Falissard, Gianluca Severi, Agnès Fournier, Marie-Christine Boutron-Ruault, Emmanuelle Corruble","doi":"10.1111/pcn.13852","DOIUrl":"10.1111/pcn.13852","url":null,"abstract":"<p><strong>Aim: </strong>Depression and antidepressant drugs may both impact breast cancer incidence, potentially in opposite directions. The few epidemiological studies attempting to disentangle their effects have been inconclusive. We aimed to assess within the same prospective cohort the association between depression, antidepressant use, and breast cancer risk, while controlling for potential confounders.</p><p><strong>Methods: </strong>The study population included 47,791 women from the E3N (Etude Epidémiologique Auprès de Femmes de la Mutuelle Générale de l'Education Nationale) prospective cohort, born between 1925 and 1950 and followed for breast cancer incidence from 2005 to 2014. Depression was defined by a Center for Epidemiologic Studies-Depression Scale (CES-D) score ≥17. Exposure to antidepressants was identified from drug claims data available from 2004 onwards. Hazard ratios (HRs) and 95% confidence intervals (CIs) for invasive breast cancer were calculated using Cox proportional hazards models adjusted for breast cancer risk factors. Antidepressant exposure was time-varying.</p><p><strong>Results: </strong>During a mean follow-up of 7.2 years, 1365 breast cancers occurred. Depression was associated with a higher incidence of breast cancer (HR, 1.14 [95% CI, 1.01-1.29]), while exposure to antidepressants was associated with a lower risk (HR, 0.85 [95% CI, 0.74-0.98]). No association was observed for treatment durations <6 months (HR, 1.02 [95% CI, 0.79-1.32]), while antidepressant use for at least 24 months was associated with an HR of 0.80 (95% CI, 0.64-0.99).</p><p><strong>Conclusion: </strong>These findings from a prospective cohort suggest that depression and antidepressant drugs exert opposing effects on breast cancer incidence. While these results require replication in future studies, they could help promote adherence to antidepressant drugs in women with depression.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"554-560"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310423","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":"Mental health of sexual and gender minorities and its association with outings in Japan: A web-based cross-sectional study.","authors":"Yusuke Kanakubo, Yoshifumi Sugiyama, Eriko Yoshida, Takuya Aoki, Rieko Mutai, Takahiro Tabuchi, Masato Matsushima","doi":"10.1111/pcn.13858","DOIUrl":"10.1111/pcn.13858","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minorities (SGMs) are known to experience mental health disparities. Outing, the non-consensual disclosure of one's sexual orientation or gender identity, has been suggested to exacerbate these issues. This study aimed to investigate the mental health status, outing experiences and their associations among SGMs in Japan.</p><p><strong>Methods: </strong>This cross-sectional study used data from 'the Japan COVID-19 and Society Internet Survey' conducted in September-October 2022, analyzing SGMs aged 18-79. Outing experiences were assessed across family, friends and school/workplace. Mental health was measured using the Kessler 6-Item Psychological Distress Scale (K6) and self-reported suicidal ideation within the past year. Modified Poisson regression was used to estimate prevalence ratios for mental health outcomes associated with outing experiences and the outing ranges within communities while adjusting for sociodemographic factors.</p><p><strong>Results: </strong>Of the 2596 SGM participants analyzed, 50.8% exhibited moderate-to-high K6 scores and 9.3% reported experiencing outings, with transgender and gender non-binary individuals being the most affected. Outing experience was significantly associated with moderate-to-high K6 scores (adjusted prevalence ratios [aPR], 1.43; 95% confidence interval [CI], 1.33-1.55), high K6 scores (aPR, 1.36; 95% CI, 1.10-1.68) and suicidal ideation within the past year (aPR, 1.39; 95% CI, 1.17-1.66). Additionally, experiencing outings within broader communities showed a dose-dependent association with higher levels of mental distress (aPR of moderate-to-high K6 for one to three communities: 1.31, 1.52 and 1.58, respectively).</p><p><strong>Conclusion: </strong>Outings can be a significant minority stressor among SGMs in Japan, contributing to elevated psychological distress and suicidal ideation.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"572-579"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333816","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":"Increased granulovacuolar degeneration in the thalamus and higher neurofibrillary tangle Braak stages in bipolar disorder.","authors":"Akito Nagakura, Ito Kawakami, Araki Kimura, Kenji Ikeda, Kenichi Oshima, Mie Kubota-Sakashita, Tadafumi Kato","doi":"10.1111/pcn.13891","DOIUrl":"https://doi.org/10.1111/pcn.13891","url":null,"abstract":"<p><strong>Aim: </strong>Recent neuropathological studies suggest that the accumulation of neurodegenerative disease-associated proteins in subcortical structures may contribute to mood symptoms. Animal models have highlighted the role of the paraventricular thalamic nucleus (PVT) in bipolar disorder (BD) pathophysiology. However, neuropathological investigations in the thalamus in BD remain limited. This study aimed to examine neurodegenerative pathology in the thalamus and medial temporal region including the hippocampus in patients with BD.</p><p><strong>Methods: </strong>Postmortem brain tissues of the thalamus and medial temporal region of nine patients with BD and nine age-matched controls were obtained from Matsuzawa Hospital, with additional medial temporal samples of 14 BD cases acquired from the Stanley Foundation Brain Bank. Immunohistochemical analyses were performed using antibodies against phosphorylated tau, amyloid-β, α-synuclein, TDP-43, and granulovacuolar degeneration (GVD) markers including CHMP2B and CK-1δ.</p><p><strong>Results: </strong>The 23 BD cases exhibited a significantly greater burden of tau pathologies, including higher neurofibrillary tangle Braak stages (P = 0.015) and more severe argyrophilic grain Saito stage (P = 0.029), compared with the nine controls. Notably, CHMP2B-positive GVD was significantly more frequently observed in the PVT of BD cases than in the controls (five of nine vs. zero of nine, P = 0.029).</p><p><strong>Conclusions: </strong>These findings suggest that neurodegenerative processes, particularly tau pathology and CHMP2B-positive GVD in the PVT may play a role in BD pathophysiology.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966784","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":"Comment on: Is clozapine use a risk of hematological malignancies? Insights from a meta-analysis \"Clozapine and Malignancy Risk\".","authors":"Kazuki Nishida, Basile Chrétien","doi":"10.1111/pcn.13839","DOIUrl":"10.1111/pcn.13839","url":null,"abstract":"<p><p>This article relates to Comment on: Is clozapine use a risk of hematological malignancies? Insights from a meta-analysis \"Clozapine and Malignancy Risk\".</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"604-605"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045154","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":"Long-acting antipsychotics and mortality in patients with schizophrenia receiving homecare case management.","authors":"Wen-Yin Chen, Po-Yu Chen, Chih-Chiang Chiu, Chun-Hung Pan, Sheng-Siang Su, Chiao-Chicy Chen, Chian-Jue Kuo","doi":"10.1111/pcn.13853","DOIUrl":"10.1111/pcn.13853","url":null,"abstract":"<p><strong>Aim: </strong>Long-acting injectable antipsychotics (LAIs) offer several advantages over oral antipsychotic medications for treating schizophrenia. However, whether the benefits of LAIs extend to patients receiving homecare case management (CM) remains unclear.</p><p><strong>Methods: </strong>This cohort study used Taiwan's National Health Insurance Research Database, enrolling 19,680 nationwide patients with schizophrenia who began homecare CM between January 1, 2000, and December 31, 2019. Each patient was followed for 5 years or to the data censored, with 30-day periods serving as follow-up units. We evaluated LAI and other medication usage during each period and their associations with mortality outcomes. Additionally, we investigated whether consistent users of homecare CM services (maintenance group) receiving specific LAI treatments had better prognoses.</p><p><strong>Results: </strong>In the cohort (n = 19,680), 6428 received first-generation antipsychotic long-acting injectables (FGA-LAIs) and 4954 received second-generation antipsychotic long-acting injectables (SGA-LAIs). The FGA-LAI group had a mean age of 39.27 years (55.13% male), while the SGA-LAI group had a mean age of 41.25 years (53.75% male). Of 1366 deaths within 5 years, 980 were from natural causes and 254 from suicide. FGA-LAIs reduced natural mortality (HR: 0.67, P = 0.001) but increased suicide risk (HR: 1.52, P = 0.01). SGA-LAIs lowered all-cause (HR: 0.53, P < 0.001) and natural mortality (HR: 0.42, P < 0.001) without affecting suicide mortality (HR: 0.82, P = 0.384). In the maintenance group, FGA-LAIs showed no mortality benefit and increased suicide risk (HR: 2.07, P < 0.001), while SGA-LAIs consistently reduced all-cause (HR: 0.39, P < 0.001), natural (HR: 0.31, P < 0.001), and suicide mortality (HR: 0.54, P = 0.034).</p><p><strong>Conclusions: </strong>SGA-LAIs could be a preferable treatment for reducing mortality in patients with schizophrenia receiving homecare CM, particularly for those in the maintenance group.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"545-553"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310424","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}