Revista Brasileira de Psiquiatria最新文献

{"title":"Exploring the role of impulsivity, aggression, lipid profiles, and inflammatory markers in suicide attempts: a crossdiagnostic study.","authors":"Hasan Gokçay, Ugur Takim, Merve Gul Açikgoz, Mustafa Nuray Namli, Yasin Hasan Balcioglu","doi":"10.47626/1516-4446-2024-4026","DOIUrl":"10.47626/1516-4446-2024-4026","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the relationship between suicidal behavior and various factors, including 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 individuals with psychiatric disorders without a recent suicide attempt, and 85 healthy controls (HC). Peripheral inflammatory markers, atherogenic indices, and serum albumin levels were assessed using fasting blood samples. Impulsivity and aggression were measured with the Barratt Impulsiveness Scale-11 (BIS-11) and the 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 significantly higher (p < 0.001) in individuals who had recently attempted suicide, compared to both individuals with psychiatric disorders without a recent suicide attempt and the HC group. Logistic regression identified NAR (p = 0.001), low albumin levels (p = 0.017), impulsivity (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 increased NAR are key predictors of suicide risk, underscoring the role of inflammation. Additionally, addressing educational disparities and substance use is crucial for suicide prevention strategies.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20244026"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681353/pdf/","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":"OA","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":"10.47626/1516-4446-2024-3765","url":null,"abstract":"<p><strong>Objective: </strong>This study's purpose was to characterize copy number variations in a Brazilian cohort regarding frequency and inheritance patterns and to determine the effect of copy number variations previously associated with mental health disorders on the risk of developing these disorders.</p><p><strong>Methods: </strong>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, with copy number variations detected using PennCNV software.</p><p><strong>Results: </strong>In total, 56.03% of the copy number variations were inherited. Among the distinct copy number variations, 96.15% were rare (frequency < 1% in the BHRCS). Duplications in 2q13 and 15q13.3 were less frequent, while those in 2q11.2 and 16p11.2 were more frequent in the BHRCS than in databases such as the Database of Genomic Variants and the Genome Aggregation Database. Of the 40 copy number variations previously associated with mental health disorders, 18 were identified in the sample. While duplication in 7q11.2 has been considered protective for schizophrenia, we found that deletion in 7q11.2 was protective for mental health disorders (p = 0.033, OR = 0.103). No significant results were found for the other copy number variations, despite mild effect sizes.</p><p><strong>Conclusions: </strong>This is one of the largest copy number variation studies to have been conducted in a Brazilian sample, and it will be a valuable resource for future meta-analysis, advancing our understanding of the genetics of mental health disorders, especially in diverse populations.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243765"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815305/pdf/","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":"OA","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":"10.47626/1516-4446-2024-3847","url":null,"abstract":"<p><strong>Objective: </strong>Post-stroke depression 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 post-stroke depression.</p><p><strong>Methods: </strong>We conducted an exploratory analysis of 48 patients from a double-blinded, shamcontrolled, randomized clinical trial that investigated the effects of tDCS on post-stroke depression. A neuropsychological battery was applied at baseline and endpoint. We assessed three key domains: 1) the Stroop effect, measured with Stroop Test components (the color-naming, word-reading, and word-color interference tasks); 2) processing speed, measured with the Trail Making Test and the Digit Symbol-Coding task; 3) executive function, assessed with the Digit Span test and the Frontal Assessment Battery. Linear mixed regression models were used to evaluate group-wise changes.</p><p><strong>Results: </strong>We found that executive function worsened slightly in the active tDCS group and improved in the sham group in the adjusted models. Significant interactions were also found for the Frontal Assessment Battery.</p><p><strong>Conclusions: </strong>We found no consistent evidence that tDCS significantly improved cognitive domains. The bidirectional association with cognition analysis suggests that the effects of tDCS may vary based on depression severity and task complexity.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243847"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815390/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood family adversity and recurrent depression in adulthood: the findings of three ELSA-Brasil follow-up visits.","authors":"Maíra Barroso Léo, Sandhi Maria Barreto, Rosane Harter Griep, Ana Luísa Patrão, Lidyane do Valle Camelo, Maria Carmen Viana, Luana Giatti","doi":"10.47626/1516-4446-2024-3914","DOIUrl":"10.47626/1516-4446-2024-3914","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between childhood family adversity and depression in a cohort of Brazilian adults over three visits.</p><p><strong>Methods: </strong>A total of 12,636 participants from the Longitudinal Study of Adult Health (ELSA-Brasil), baseline (2008-2010) and followed up in 2012-2014 and 2017-2019, were included. Five types of family dysfunction and the childhood family dysfunction score (0, 1, and = 2 dysfunctions) were used. The Clinical Interview Schedule-Revised was used to assess depression in visits 1 and 2 or 3. Multinomial logistic regression models estimated crude and adjusted OR and 95%CI.</p><p><strong>Results: </strong>The mean age of the sample was 59.6 (SD, 8.8) years, 7.4% presented depression in one visit, and 2.2% presented it in two or three visits. After adjustment, compared to no family dysfunction, mental disorder (OR = 3.91; 95%%CI 2.94-5.21), substance abuse (OR = 2.14; 95%CI 1.65-2.77), and parental separation/divorce (OR = 1.55; 95%CI 1.12-2.15) increased the odds of depression in two or three visits. Exposure to = 2 types of family dysfunction increased the odds of depression in one, and two or three visits in a dose-response gradient.</p><p><strong>Conclusion: </strong>Exposure to childhood family dysfunction contributes to the occurrence and recurrence of depression in adults. Interventions to prevent dysfunctional family environments and their repercussions on children can reduce the burden of depression.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243914"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954114","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":"Item-wise validity study of the Impact of Event Scale-Revised: self-reported reactions of hospital personnel exposed to a stressful workplace.","authors":"Vitor A Petrilli-Mazon, Marcos O Carvalho-Alves, Eurípedes Constantino Miguel, Felipe Corchs, Mariana Curi, Yuan-Pang Wang","doi":"10.47626/1516-4446-2024-3882","DOIUrl":"10.47626/1516-4446-2024-3882","url":null,"abstract":"<p><strong>Objective: </strong>Recent studies have revealed a heterogeneous prevalence and presentation of post-traumatic stress disorder across countries. It is crucial to assess the methodological and item-level measurement factors that contribute to variations in mental disorder rates across cultures. This study aimed to investigate the traumatic experiences of hospital workers by employing item analysis of the Impact of Event Scale-Revised.</p><p><strong>Methods: </strong>Data were collected from 1,000 employees of a large hospital during the coronavirus disease 2019 pandemic and were analyzed according to item response theory analysis regarding item pool discrimination (a) and difficulty (b) parameters.</p><p><strong>Results: </strong>The Impact of Event Scale-Revised items had good discriminative ability (a) and covered a range of distress severity (b) associated with traumatic experiences. According to our results, the Impact of Event Scale-Revised is a reliable and informative instrument for assessing individuals with moderate to severe trauma-related distress across the spectrum of trauma symptoms. In particular, items 10 (\"jumpy or easily startled\") and 6 (\"I thought about it when I didn't mean to\") reflected the post-traumatic stress disorder domains of hyperarousal and intrusion and excelled in discriminating between different levels of post-traumatic distress. Conversely, items related to avoidance and sleep disturbance showed lower discriminative ability.</p><p><strong>Conclusions: </strong>Item analysis of the Impact of Event Scale-Revised may be used to assess trauma symptoms in the context of a trauma exposure, identifying the most discriminative and informative items for measuring post-traumatic stress disorder in our context. Our findings may help refine the Impact of Event Scale-Revised and facilitate the development of a more effective scale with optimized item parameters.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243882"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740300","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":"Download to heal: navigating the pixelated path of digital therapeutics in psychiatric care.","authors":"Jai Ahuja, Sanobar Jaka, Sikandar Saeed, Sasidhar Gunturu","doi":"10.47626/1516-4446-2024-3802","DOIUrl":"10.47626/1516-4446-2024-3802","url":null,"abstract":"<p><p>Digital therapeutics have evolved rapidly with technological advances in healthcare. Despite their increasing use, gaps remain in understanding their regulatory frameworks, integration, and efficacy for conditions like substance use disorder, insomnia, attention deficit hyperactivity disorder, and posttraumatic stress disorder. This study evaluates U.S. Food and Drug Administration (FDA)-approved digital therapeutics and explores their potential to revolutionize psychiatric treatments amid ongoing technological and regulatory changes. We conducted a comprehensive review of major databases, focusing on articles published until January 2024 about FDA-approved digital therapeutics. We excluded non-English articles, those lacking empirical data, and those focusing on non-FDA-approved therapeutics. Our analysis covered regulatory compliance, clinical outcomes, and integration with traditional treatments. A review of nine FDA-cleared digital therapeutics revealed benefits, such as improved treatment accessibility and potential reductions in healthcare costs. For example, through Somryst, a cognitive-behavioral therapy-based treatment for insomnia, over 40% of users overcame chronic insomnia, and 60% experienced improvements without adverse effects. However, challenges remain, including low provider adoption, inadequate insurance coverage, and high user dropout rates. While digital therapeutics enhance accessibility, they face regulatory challenges, reimbursement issues, and require robust clinical evidence. Success depends on collaboration among stakeholders to demonstrate value, ensure safety, and integrate them into existing healthcare systems.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243802"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352901","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":"The cost of dementia in Brazil.","authors":"Fabiana Araújo Figueiredo da Mata, Ari Alex Ramos, Laiss Bertola, Thais Suarez, Cleusa Pinheiro Ferri, Haliton Alves de Oliveira Júnior","doi":"10.47626/1516-4446-2024-3611","DOIUrl":"10.47626/1516-4446-2024-3611","url":null,"abstract":"<p><strong>Objective: </strong>Given the increasing number of people with dementia in Brazil, health and social systems must urgently plan strategies to meet the needs of this population and their families. Therefore, research on dementia costs is essential. This study estimated direct and indirect dementia-related costs in Brazil.</p><p><strong>Methods: </strong>We used a cost-of-illness methodology to estimate dementia-related costs, in addition to household interview data from the National Report on Dementia in Brazil (ReNaDe) and public national databases to collect data on health service use and costs. Both a social and a health system perspective were used.</p><p><strong>Results: </strong>The monthly cost of dementia per patient increases with advancing stages of the syndrome: USD 843.04 in the initial stage, USD 1,317.81 in the intermediate stage, and USD 1,576.15 in the advanced stage. Indirect costs represent = 73% of total expenses. The country's total expenses are the highest during the intermediate stage of dementia.</p><p><strong>Conclusion: </strong>Family caregivers shoulder at least 73% of the health-related costs of dementia in Brazil, highlighting the need for better support strategies for people with dementia and their families.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243611"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648416","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":"Addressing the elephant in the screening room: an item response theory analysis of the Prodromal Questionnaire for at-risk symptoms of psychosis.","authors":"Christophe Gauld, Pierre Fourneret, Ben Alderson-Day, Emma Palmer-Cooper, Clément Dondé","doi":"10.47626/1516-4446-2024-3614","DOIUrl":"10.47626/1516-4446-2024-3614","url":null,"abstract":"<p><strong>Objective: </strong>Patients at risk of psychosis present a variety of symptoms, and identifying the most discriminative symptoms is essential for efficient detection and treatment.</p><p><strong>Methods: </strong>This cross-sectional online study analyzed individuals from the general population to better assess their risk of symptoms classified as clinical high risk (CHR) for psychosis. The 16-item Prodromal Questionnaire was applied as a self-report screening tool. Item response theory with a graded response model was used to assess the discrimination and difficulty of the questionnaire's criteria.</p><p><strong>Results: </strong>The analysis included 936 participants (mean age: 21.5 years; 71.9% women). \"Déjà vu\" stood out for its high discriminative power, while the \"voices or whispers\" and \"seeing things\" items had greater precision than the other CHR-related symptoms. Conversely, the \"smell or taste\" and \"changing faces\" items were associated with the most severe cases.</p><p><strong>Conclusion: </strong>This study identified the most indicative CHR-related symptoms for accurate assessment of psychosis severity, which can be used to guide targeted preventative interventions.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243614"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12679692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000665","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":"Potential adverse events of fluoxetine: a real-world study based on the FAERS database.","authors":"Xuezheng Gao, Xiangjun Zhou, Zhiqiang Du, Qin Zhou, Ying Jiang, Haohao Zhu","doi":"10.47626/1516-4446-2024-3879","DOIUrl":"10.47626/1516-4446-2024-3879","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to mine and analyze adverse event signals of fluoxetine using the U.S. Food and Drug Administration's Adverse Event Reporting System database.</p><p><strong>Methods: </strong>This study focused on suspected adverse drug reaction reports between the first quarter of 2004 and the second quarter of 2023 in which fluoxetine was the primary suspected drug. Four signal mining and analysis methods were employed to comprehensively assess adverse event signals.</p><p><strong>Results: </strong>A total of 19,932,732 reports were collected, of which 22,884 primarily suspected fluoxetine. Through analysis, 862 signs involving 27 system organ classes were identified. More adverse events were reported by female patients (58.81%) than male patients (26.84%), with the largest percentage being in the 18-45 year age group. The signal strength of adverse events related to pregnancy and neonatal conditions was notable, including fetal exposure during pregnancy, exposure during pregnancy, and neonatal health-related adverse events, such as atrial septal defect, premature baby, ventricular septal defect, and maternal drugs affecting the fetus.</p><p><strong>Conclusions: </strong>Although fluoxetine has been extensively approved and applied, its use in women who are pregnant or planning to conceive should be approached with caution.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243879"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639812","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":"Signal mining and risk analysis of olanzapine adverse events in the FAERS database.","authors":"Aiguo Dong, Lingyi Shi, Zhiqiang Du, Qin Zhou, Ying Jiang, Haohao Zhu, Anqing Zhu","doi":"10.47626/1516-4446-2024-3880","DOIUrl":"10.47626/1516-4446-2024-3880","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the safety profile of olanzapine by analyzing adverse events reported in the U.S. Food and Drug Administration's Adverse Event Reporting System database, particularly focusing on newly identified risks.</p><p><strong>Methods: </strong>The study involved olanzapine-related adverse events that occurred between January 1, 2004, and June 30, 2023. Four signal mining methods were used for a comprehensive analysis of the frequency and strength of adverse events, including the reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and empirical Bayesian geometric mean.</p><p><strong>Results: </strong>A total of 43,664 reports with olanzapine as the primary suspect drug were collected, and 776 preferred terms signals involving 27 system organ classes were identified. The main affected groups were females and individuals between 18 and 45 years of age. Psychiatric disorders and nervous system disorders were the most common adverse reactions. The analysis also revealed some adverse reactions not recorded in the manual, including cardiovascular risk, such as pancreatitis, increased chylomicron, hyperchylomicronemia, and myocardial reperfusion injury, as well as rare but serious adverse reactions like neuroleptic malignant syndrome and anosognosia.</p><p><strong>Conclusions: </strong>This study identified new cardiovascular risks associated with olanzapine, including pancreatitis and myocardial reperfusion injury, which require further investigation.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243880"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648420","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}