Revista Brasileira de Psiquiatria最新文献

{"title":"Exploring the role of impulsivity, aggression, lipid profiles, and inflammatory markers in suicide attempts: A cross-diagnostic study.","authors":"Hasan Gökçay, Uğur Takım, Merve Gul Açıkgöz, Mustafa Nuray Namli, Yasin Hasan Balcioglu","doi":"10.47626/1516-4446-2024-4026","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-4026","url":null,"abstract":"<p><strong>Objective: </strong>The current study aimed to investigate the relationship between suicidal behavior and peripheral inflammatory markers, atherogenic indices, serum albumin levels, impulsivity, and aggression.</p><p><strong>Methods: </strong>This cross-sectional study included 100 patients hospitalized for a recent suicide attempt, 74 psychiatric patients without a recent suicide attempt, and 85 healthy controls. Inflammatory markers, atherogenic indices, and serum albumin levels were assessed from fasting blood samples. Impulsivity and aggression were measured using the Barratt Impulsiveness Scale (BIS-11) and Buss-Perry Aggression Questionnaire (BPAQ).</p><p><strong>Results: </strong>Serum albumin levels were significantly lower (p = 0.001), and the Neutrophil-to-Albumin Ratio (NAR) was elevated (p < 0.001) in the group of individuals who recently attempted suicide compared to both psychiatric patients without a recent suicide attempt and healthy controls. Logistic regression identified NAR (p = 0.001), low albumin (p = 0.017), impulsivity (β = 0.041, p = 0.001), and aggression (p < 0.001) as significant predictors of suicidal behavior. Lower education (p = 0.001) and lifetime substance use disorders (p = 0.003) were also significant predictors. No significant differences were found in atherogenic indices.</p><p><strong>Conclusion: </strong>Low albumin levels and elevated NAR are significant predictors of suicide risk, highlighting the role of inflammation.Moreover, educational disparities and substance use must be addressed in suicide prevention strategies.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527989","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":"Copy Number Variations in the Brazilian High-Risk Cohort for Mental Conditions.","authors":"Júlia Arendt, Malú Zamariolli, Liriel Almodobar, Lucas Toshio Ito, Rafaella Ormond, Adrielle M Oliveira, Vanessa Ota, Luis Augusto Rohde, Euripedes Constantino Miguel, Pedro Pan, Rodrigo Bressan, Giovanni Salum, Sintia Belangero, Marcos Santoro","doi":"10.47626/1516-4446-2024-3765","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3765","url":null,"abstract":"<p><p>Copy number variations (CNVs) are genetic variants with a known major impact on the development of mental health disorders (MHDs). Here, we aim to characterize CNVs in a Brazilian cohort regarding frequency and inheritance pattern and verify the impact of CNVs previously associated with MHDs on the risk of developing these disorders in the cohort. A total of 2,250 probands and 3,174 parents (897 trios) from the Brazilian High-Risk Cohort Study for Mental Conditions (BHRCS) were genotyped and CNVs were detected using PennCNV software. In total, 56.03% of the CNVs were inherited. Among the distinct CNVs, 96.15% were rare (frequency lower than 1% in the BHRCS). Duplications at 2q13 and 15q13.3 showed lower frequencies, while those at 2q11.2 and 16p11.2 exhibited higher frequencies in the BHRCS when compared to databases such as the Database of Genomic Variants (DGV) and the Genome Aggregation Database (gnomAD). Of 40 previously associated CNVs with MHDs, 18 were identified in the sample. While the 7q11.2 duplication has been considered protective for Schizophrenia, we identified that 7q11.2 deletion was protective for MHDs in BHRCS (p-value=0.033, OR=0.103). For the other CNVs, no statistical significance was identified, even with mild effect sizes. This is one of the largest CNV studies in a Brazilian sample and will be a valuable resource for future meta-analysis to advance the understanding of the genetics of MHDs, especially regarding diverse populations.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524160","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":"Effects of home-use transcranial direct current stimulation on clusters of depressive symptoms: an ancillary analysis of the PSYLECT study.","authors":"Matthias S Luethi, Lucas Borrione, Beatriz A Cavendish, Luana V M Aparicio, Stephan Goerigk, Matheus R F Ramos, Natasha K S Moran, Adriana M Carneiro, Leandro Valiengo, Darin O Moura, Juliana P de Souza, Mariana P Batista, Valquiria Aparecida da Silva, Izio Klein, Paulo Suen, José Gallucci-Neto, Frank Padberg, Lais B Razza, Marie-Anne Vanderhasselt, Paulo A Lotufo, Isabela M Bensenor, Felipe Fregni, Andre R Brunoni","doi":"10.47626/1516-4446-2024-3972","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3972","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) is heterogeneous. While transcranial direct current stimulation (tDCS) is an effective treatment, its impact on symptoms remains underexplored. This ancillary study investigated home-use tDCS effects on depression symptom clusters.</p><p><strong>Methods: </strong>Data were from the Psylect study, where 210 depressed patients were randomized to active (n = 137) or sham tDCS (n = 73) for six weeks. Items from the Hamilton Depression Rating Scale were grouped into symptom clusters using hierarchical clustering. Treatment effects were analyzed with mixed regressions. An alternative clustering solution, established with a bigger sample, was also evaluated.</p><p><strong>Results: </strong>Four clusters were identified: emotional, sleep, psychomotor, and psychosomatic symptoms. None showed significant group differences (sleep: P = 0.058, Cohen's d = 0.36, emotional: P = 0.976, d = -0.01, psychosomatic: P = 0.157, d = 0.27, psychomotor: P = 0.944, d = 0.01). The alternative clustering solution produced a similar sleep cluster, where tDCS led to significant reductions (P = 0.033, d = 0.41), while other clusters exhibited no differences (emotional: P = 0.707, d = 0.07, atypical: p = 0.537, d = 0.12).</p><p><strong>Conclusions: </strong>Associations of tDCS with sleep improvements warrant further study. tDCS may be more effective for specific symptom clusters.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524168","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":"Candidate Genes Related to Spiritual Mediumship: A Whole Exome Sequencing Analysis of Highly Gifted Mediums.","authors":"Wagner Farid Gattaz, Marianna de Abreu Costa, Angélica Salatino-Oliveira, Daniel Gaspar Gonçalves, Leda L Talib, Alexander Moreira-Almeida","doi":"10.47626/1516-4446-2024-3958","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3958","url":null,"abstract":"<p><strong>Objective: </strong>There has been a call for neuroscientific studies of spiritual experiences due to their global prevalence, significant impact, and importance for understanding the mind-brain problem. Mediumship is a spiritual experience where individuals claim to communicate with or be influenced by deceased persons or non-material entities. We assessed whether mediums possess specific genetic alterations.</p><p><strong>Methods: </strong>We selected highly gifted mediums (n = 54) with over 10 years of experience who engaged in mediumistic work without material benefits, analyzed whole exome sequencing, and compared them to non-medium first-degree relatives (n = 53).</p><p><strong>Results: </strong>We identified 15,669 variants exclusively found in mediums, likely to impact the function of 7,269 genes. Thirty-three of these genes were altered in at least one-third of all mediums but in none of their relatives. The inflammatory pathway was the most frequently affected (43.9%) with the translocation of ZAP-70 to the immunological synapse being particularly prominent.</p><p><strong>Conclusion: </strong>This is the first exome-wide investigation of genes possibly related to mediumistic experiences. We identified gene variants that are presented in mediums but not in their first-degree non-medium relatives. These genes emerge as possible candidates for further investigations of the biological underpinnings that allow spiritual experiences such as mediumship.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053477","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":"Patterns of drug combinations used by men who have sex with men in Brazil.","authors":"Rodrigo Nikobin, Julio Mella-Cobas, Maria Amelia Veras, Francisco Inácio Bastos, Jordi Casabona Barbarà, Valeria Stuardo Ávila, Dartiu Xavier da Silveira","doi":"10.47626/1516-4446-2024-3874","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3874","url":null,"abstract":"<p><strong>Background: </strong>The practice of using drugs to modulate experiences is a well-documented phenomenon worldwide, particularly among men who have sex with men (MSM). This study aims to describe patterns of drug combinations used by Brazilian MSM, embracing a detailed examination of the Brazilian context, which may inspire research elsewhere while enriching the global panorama on MSM drug use. By focusing on Brazilian MSM, the study sheds light on specific drug use combinations, which may help in the development of effective, culturally sensitive public health strategies.</p><p><strong>Methods: </strong>This investigation was conducted within the Latin American MSM Internet Survey (LAMIS), a pioneer online study addressing psycho-social and sexual health of MSM in the region. Conducted from January to May 2018, the survey garnered responses from over 18,139 Brazilian MSM. Using exploratory factor analysis through maximum likelihood estimation, the study identifies distinct sub-groups of drug users among 15,499 participants after exclusion due to the presence of discrepant responses. Kaiser-Meyer-Olkin measure (KMO) = 0.94) and Bartlett's Test = < 0.01) indicating adequate sampling and suitability for factor analysis across all substances.</p><p><strong>Findings: </strong>The factor analysis revealed four primary drug combination groups among participants: Group One (Heavy Drugs Users), Group Two (Party Drug Users), Group Three (Conservative Users), and Group Four (Classic Chemsex Users). Each group represents unique drug use patterns and preferences, from the use of potent stimulants to more socially accepted substances like tobacco and cannabis. Notably, Group One, identified as \"heavy\" drugs users, engaged in the use of particularly risky substances, including mephedrone, crack, crystal meth, heroin and other synthetic stimulants.</p><p><strong>Interpretation: </strong>The findings reveal diverse and complex drug use patterns among MSM in Brazil. Understanding these patterns is essential for developing targeted interventions and support mechanisms for various sub-groups within MSM. Future research should focus on the health outcomes associated with these patterns and the social and psychological contexts of drug use.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010760","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":"Subjective Sleep Quality and Its Subcomponents Among Homeless Individuals in São Paulo.","authors":"Rafael Eduardo Benavides Gélvez, Debora Cristina Hipolide, Julia Ribeiro da Silva Vallim, Juliana Garcia Cespedes, Anderson da Silva Rosa","doi":"10.47626/1516-4446-2024-4078","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-4078","url":null,"abstract":"<p><strong>Objective: </strong>Sleep quality is essential for health, with sleep deprivation linked to physical and mental issues. Homeless populations face additional sleep challenges, yet this topic remains underexplored. This study assessed sleep quality among homeless individuals in São Paulo, Brazil, considering demographics and substance use.</p><p><strong>Methods: </strong>A psychiatrist conducted interviews to collect demographic and substance use data assessing sleep quality using the Pittsburgh Sleep Quality Index (PSQI). A Generalized Linear Model analyzed PSQI scores, considering sleeping location, gender, substance use, and interactions as fixed factors, with homelessness duration as a covariate. The sample comprised 177 participants (22% female, 7 transgenders; mean age: 42.8 ± 11.4 years), with an average homelessness duration of 10.5 ± 8.4 years (range: 1-40). Among them, 33% slept in shelters, 83% used depressants, 83% stimulants, and 59% hallucinogens.</p><p><strong>Results: </strong>Approximately 67% reported good subjective sleep quality (mean PSQI: 4.9 ± 2.7). Depressant and stimulant use correlated with poorer sleep. Women had poorer sleep, longer sleep latency, and greater daytime dysfunction than men.</p><p><strong>Conclusions: </strong>Positive sleep quality reports may reflect adaptive expectations from prolonged adversity and substance use. The findings highlight the need for improved shelters and targeted interventions to address sleep challenges in this vulnerable population.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639814","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":"Predictive Factors of Alcohol Initiation among Brazilian Adolescents: Assessing the Role of Attitudes, Decision-Making, Communication, and Resistance Skills.","authors":"Juliana Y Valente, Sheila C Caetano, Miguel Henrique da Silva Dos Santos, Zila M Sanchez","doi":"10.47626/1516-4446-2024-3896","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3896","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate if attitudes toward drug use, decision-making, communication, and alcohol resistance skills act as predictors of alcohol use and binge drinking initiation among Brazilian students, considering the sex differences.</p><p><strong>Methods: </strong>We used a longitudinal sample of 1,103 seventh-grade students from 15 Brazilian public schools. We explored if attitudes toward drug use, decision-making, communication, and alcohol resistance skills at baseline predicted alcohol outcomes nine months later.</p><p><strong>Results: </strong>We found that lower levels of resistance skills (i.e., ORboys=0.29, 95% CI: 0.12; 0.70) and positive attitudes toward drugs (i.e., ORgirls:=1.41, 95% CI: 1.02; 1.94) are predictors of alcohol use onset and binge drinking, independently of sex. Decision-making predicts binge drinking initiation only for girls (OR=0.73, 95% CI: 0.59; 0.91). Negative attitudes toward drugs are a risk factor for alcohol use initiation only for boys (OR=0.78, 95% CI: 0.64; 0.95).</p><p><strong>Conclusion: </strong>Our findings highlighted the importance of understanding the predictors of adolescents' alcohol outcomes to inform the key components that preventive programs should address in their activities to achieve the expected preventive outcomes.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984667","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":"A call for greater diversity and representativity within countries in psychiatric research: Lessons and challenges from a systematic review of schizophrenia research in Brazil.","authors":"Thiago Holanda Freitas, Carolina Ziebold, Marcos Leite Santoro, Sintia Iole Nogueira Belangero, Pedro Gabriel Lorencetti, Larissa Medeiros Barros Leal, Gustavo Magalhães de Almeida E Vasconcelos, Lucas de Castro Quarantini, Mateus Jose Abdalla Diniz, Saulo Giovanni Castor Albuquerque, Nayana Holanda de Oliveira, André Luiz de Souza Rodrigues, Ary Gadelha","doi":"10.47626/1516-4446-2024-3834","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3834","url":null,"abstract":"<p><strong>Objective: </strong>This article aims to systematically review the studies on schizophrenia in Brazil, addressing geographical coverage as an indicator of sampling representativeness, essential to infer results' generalization. It also highlights the variation in research funding across different regions.</p><p><strong>Methods: </strong>We searched for studies carried out until July 2023. Inclusion criteria encompassed studies of patients diagnosed with schizophrenia (or its spectrum) recruited in Brazil. Data extraction comprised geographic region of first and last authors, place recruitment, research subfield, and funding sources. The review followed PRISMA guidelines for systematic reviews and meta-analyses.</p><p><strong>Results: </strong>Out of 296 studies reviewed, most (63.18%) took place in the Southeast, particularly São Paulo (48.98%). Clinical trials comprised the majority (41.6%), with genetic studies primarily conducted in the Southeast or South (81.5%). Funding was reported in 64% of papers. The Northeast region was less likely to receive study funding compared to the Southeast.</p><p><strong>Conclusion: </strong>Schizophrenia research in Brazil shows a clear geographic concentration, with significant disparities in funding allocation and underrepresentation of certain regions. Broadening research coverage through equitable distribution of funding opportunities and fostering collaborations with local institutions are of utmost importance to enhance the understanding and treatment of schizophrenia within Brazil's diverse socio-economic and ethnic landscape.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971694","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":"Mind the gap: the inconceivable void on the epidemiology of autism spectrum disorders in Brazil.","authors":"Lucas Dellazari, Érica Bonganhi de Bem, Arthur Bezerra Falcão, Felipe de Moura Manjabosco, Gabriela Bezerra Sorato, Laura Fernandes Berto, Vitor Azevedo Dantas, André Luiz Schuh Teixeira Da Rosa, Ana Soledade Graeff-Martins, Renata Rocha Kieling, Giovanni Abrahão Salum Junior, Luis Augusto Rohde, Arthur Caye","doi":"10.47626/1516-4446-2024-3956","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3956","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971973","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":"Cognitive changes in post-stroke depression patients undergoing treatment with transcranial direct current stimulation (tDCS): an exploratory, ancillary analysis of a randomized, sham-controlled clinical trial.","authors":"Tamires Zanão, Roberta A M P F D Mattar, Bianca S Pinto, Janaina Oliveira, Renata R Vaughan, Isabela M Benseñor, Alessandra Goulart, André R Brunoni, Leandro Valiengo","doi":"10.47626/1516-4446-2024-3847","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3847","url":null,"abstract":"<p><strong>Objective: </strong>Post-stroke depression (PSD) affects approximately 40% of stroke survivors, with cognitive deficits being frequently observed. Transcranial Direct Current Stimulation (tDCS) has shown promise in improving cognitive performance in stroke patients. We explored the effects of tDCS on cognitive performance in PSD.</p><p><strong>Methods: </strong>An exploratory analysis was conducted in 48 patients from a double-blinded, sham-controlled, randomized clinical trial that investigated the effects of tDCS for treating PSD. A neuropsychological battery was applied at baseline and endpoint. We assessed three key domains: (1) Stroop effect, measured by the Stroop test components (color naming, word-reading and word-color interference); (2) processing speed, assessed using the Trail Making Test and the Digit Symbol coding test; (3) executive function, evaluated with the Digit Span test and the Frontal Assessment Battery (FAB). A Linear mixed regression models were used to evaluate changes according to groups.</p><p><strong>Results: </strong>We found that the active tDCS group worsened slightly, while the sham group improved in Executive Function for the adjusted models. Significant interactions were also found for FAB.</p><p><strong>Conclusions: </strong>We found no consistent evidence that tDCS significantly improved the cognitive domains. The bidirectional association with cognition analysis suggest that tDCS effects may vary based on depression severity and task complexity.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966406","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}