Revista de psiquiatria y salud mental最新文献

{"title":"Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia.","authors":"Gerard Anmella,&nbsp;Miriam Sanabra,&nbsp;Mireia Primé-Tous,&nbsp;Xavier Segú,&nbsp;Aleix Solanes,&nbsp;Victoria Ruíz,&nbsp;Ivette Morilla,&nbsp;Antonieta Also Fontanet,&nbsp;Elisenda Sant,&nbsp;Sandra Murgui,&nbsp;Mireia Sans-Corrales,&nbsp;Anabel Martínez-Aran,&nbsp;Giovanna Fico,&nbsp;Michele De Prisco,&nbsp;Vincenzo Oliva,&nbsp;Andrea Murru,&nbsp;Roland Zahn,&nbsp;Allan H Young,&nbsp;Victor Vicens,&nbsp;Clara Viñas-Bardolet,&nbsp;Vicenç Aparicio-Nogué,&nbsp;Juan Francisco Martínez-Cerdá,&nbsp;Ariadna Mas,&nbsp;Bernat Carreras,&nbsp;Jordi Blanch,&nbsp;Joaquim Radua,&nbsp;Miquel A Fullana,&nbsp;Myriam Cavero,&nbsp;Eduard Vieta,&nbsp;Diego Hidalgo-Mazzei","doi":"10.1016/j.rpsm.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.</p><p><strong>Methods: </strong>We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.</p><p><strong>Results: </strong>Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD.</p><p><strong>Conclusions: </strong>Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.</p>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133176","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":"Mental health service requirements after COVID-19 hospitalization: a 1-year follow-up cohort study using electronic health records.","authors":"Roberto Mediavilla, Gonzalo Martínez-Alés, Jorge Andreo-Jover, Iker Louzao-Rojas, Susana Cebolla-Lorenzo, Ainoa Muñoz-San-José, Eduardo Fernández-Jiménez, Pablo Aguirre, José Luis Ayuso-Mateos, María Fe Bravo-Ortiz, Carmen Bayón-Pérez","doi":"10.1016/j.rpsm.2022.09.005","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.09.005","url":null,"abstract":"","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747333","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":"Risk factors of deficit and non-deficit schizophrenia: Results from a cross-sectional study","authors":"Agnieszka Cyran ,&nbsp;Patryk Piotrowski ,&nbsp;Jerzy Samochowiec ,&nbsp;Tomasz Grąźlewski ,&nbsp;Błażej Misiak","doi":"10.1016/j.rpsm.2022.05.005","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.05.005","url":null,"abstract":"<div><h3>Aim</h3><p>It has been observed that deficit and non-deficit schizophrenia (SCZ-D and SCZ-ND) might be characterized by different risk factors. Therefore, the present study aimed to assess as to whether previously reported risk factors of schizophrenia are specifically associated with SCZ-D and SCZ-ND.</p></div><div><h3>Method</h3><p><span>This study was based on a cohort of 118 stable outpatients with schizophrenia. A diagnosis of SCZ-D was established using the Schedule for the Deficit Syndrome (SDS). Risk factors were recorded using structured interview, the Operational Criteria for Psychotic Illness (OPCRIT) checklist and the Traumatic Experience<span> Checklist (TEC). The following risk factors were explored: male sex, a history of schizophrenia in first-degree relatives, seasonality of birth, birth weight &lt;3000</span></span> <span><span>g, delivery by cesarean section, a history of childhood trauma (emotional abuse, </span>emotional neglect, physical abuse and sexual abuse) as well as substance abuse (other than nicotine) and cigarette smoking at psychosis onset.</span></p></div><div><h3>Results</h3><p>Individuals with SCZ-D were more likely to be males as well as reported higher rates of birth weight &lt;3000<!--> <span><span>g and any categories of childhood trauma. In turn, substance abuse (other than nicotine) at psychosis onset was significantly more frequent in patients with SCZ-ND. Binary </span>logistic regression, controlling for multiple comparisons, revealed similar findings, except for the association with any categories of childhood trauma that appeared to be not significant.</span></p></div><div><h3>Conclusion</h3><p>Our findings partially replicate differential patterns of risk factors for SCZ-D (male sex and birth weight &lt;3000<!--> <!-->g) and SCZ-ND (substance abuse at psychosis onset), likely attributable to the effects of timing of exposure.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 223-229"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136704537","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":"Dried Blood Spot (DBS) as a useful tool to improve clozapine, aripiprazole and paliperidone treatment: From adherence to efficiency","authors":"Miguel Bernardo ,&nbsp;Gisela Mezquida ,&nbsp;Paula Ferré ,&nbsp;Bibiana Cabrera ,&nbsp;Mercè Torra ,&nbsp;Ana Maria Lizana ,&nbsp;Mercè Brunet","doi":"10.1016/j.rpsm.2022.04.002","DOIUrl":"10.1016/j.rpsm.2022.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Therapeutic Drug Monitoring<span> (TDM) of antipsychotics in schizophrenia is a powerful tool that allows tailoring the treatment in an individualized approach. Our goals are to develop and validate a Dried Blood Spot (DBS) method for monitoring some commonly used antipsychotics (aripiprazole, clozapine, and paliperidone) and to evaluate its usefulness as a compliance biomarker, as well as in drug-dose adjustment to personalize the antipsychotic treatment to improve its efficacy and safety.</span></p></div><div><h3>Methods</h3><p>31 first-psychotic episode (FEP) and schizophrenia patients were included; 5 refer to naïve FEP who started antipsychotic treatment; 26, to patients with more than one episode and under antipsychotic treatment: aripiprazole (7 cases), clozapine (17), paliperidone (11). For DBS sample collection, 25<!--> <!-->μl of capillary blood were placed in the spot of a FTA™DMPK-C-card. After completely dryness, antipsychotics were extracted and analyzed by a validated UHPLC-MS/MS-method. DBS antipsychotic results were compared with those obtained in venous blood/plasma.</p></div><div><h3>Results</h3><p>Aripiprazole, paliperidone and clozapine showed from good to excellent correlations between concentrations in venous blood and DBS capillary blood (<em>r</em>², from 0.500 to 0.721). The correlation between conventional plasma and DBS concentrations for paliperidone, aripiprazole, clozapine, and their metabolites were moderate, suggesting that optimal drug target concentrations should be established for DBS.</p></div><div><h3>Conclusions</h3><p>In this study, for aripiprazole, dehydroaripiprazole, paliperidone, clozapine and desmethylclozapine, DBS has provided good analytical performance for TDM. Thus, DBS sampling can offer a great alternative over conventional sampling for plasma measurement. The assay provides good analytical performances for TDM and clinical research applicability, suggesting that DBS is a promising clinical application in TDM in psychiatry.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 230-237"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83061022","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":"Estabilidad diagnóstica en la psicosis inducida por sustancias","authors":"Lucía Inchausti ,&nbsp;Iñigo Gorostiza ,&nbsp;Miguel Angel Gonzalez Torres ,&nbsp;Rodrigo Oraa","doi":"10.1016/j.rpsm.2019.10.005","DOIUrl":"10.1016/j.rpsm.2019.10.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse but persists for days and weeks with no substance use. There is as yet little knowledge about the longitudinal course of this psychosis, which suggests that significant numbers go on to be diagnosed with a severe mental disorder (SMD). The objective of this study was to analyse the progression of SIP to SMD in our environment and the possible factors that may be involved in that conversion.</p></div><div><h3>Material and methods</h3><p>We used a retrospective cohort follow-up design. We reviewed all diagnoses of patients discharged from the psychiatric hospitalisation unit of the University Hospital of Basurto from January 2002 to December 2015 inclusively. In addition to sociodemographic and clinical data, information was collected on the consumption of cannabinoids, opioids, amphetamines, cocaine and alcohol. The data were analysed using descriptive analysis, Kaplan-Meier survival curves and Cox regression.</p></div><div><h3>Results</h3><p>Of the 116 patients, 78.4% were male, had an average age of 33.0 (SD: 8.9) years and 44.0% were single; 31.0% had a psychiatric family history; the most commonly used substance was cannabis (60.3%), followed by cocaine (40.5%). The cumulative risk of diagnostic conversion to an SMD in 16<!--> <!-->years was 41.6% (95%<!--> <!-->CI: 32.2-52.2) over a mean 36.43<!--> <!-->months.</p></div><div><h3>Conclusions</h3><p>In interventions in episodes of SIP we must bear in mind that a significant proportion will progress to an SMD in the first three years.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 272-280"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37578273","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":"Clozapine-associated myocarditis in the World Health Organization's pharmacovigilance database: Focus on reports from various countries","authors":"Carlos De las Cuevas ,&nbsp;Emilio J. Sanz ,&nbsp;Can-Jun Ruan ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsm.2021.07.004","DOIUrl":"10.1016/j.rpsm.2021.07.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of clozapine-associated myocarditis varies by country. These variations were explored in VigiBase, the World Health Organization's global database which has &gt;25 million spontaneously reported adverse drug reaction (ADR) reports from 145 national drug agencies.</p></div><div><h3>Methods</h3><p>On January 15, 2021, a search of VigiBase since inception focused on myocarditis in clozapine patients. The 3572 individual reports were studied using the standard VigiBase logarithmic measure of disproportionality called information component (IC). The IC measures the disproportionality between the expected and the reported rates. After duplicates were eliminated there were 3274 different patients with myocarditis studied in logistic regression models.</p></div><div><h3>Results</h3><p>The first case was published in 1980 but since 1993 the VigiBase clozapine-myocarditis IC has been significant; moreover, currently it is very strong (IC<!--> <!-->=<!--> <!-->6.0, IC₀₀₅–IC₉₉₅ <!-->=<!--> <!-->5.9–6.1) and statistically significantly different from other antipsychotics. Of the 3274 different patients with myocarditis, 43.4% were non-serious cases, 51.8% were serious but non-fatal, and 4.8% were fatal. More than half (1621/3274) of the reports came from Australia, of which 69.2% were non-serious, 27.7% serious but non-fatal, and 3.1% fatal. Asian countries contributed only 41 cases.</p></div><div><h3>Conclusions</h3><p>In pharmacovigilance studies, confounding factors may explain statistical associations, but the strength and robustness of these results are compatible with the hypothesis that myocarditis is definitively associated with early clozapine treatment (84% [1309/1560] and 5% [82/1560] in the first and second months). Myocarditis reports from Australia are over-represented to a major degree. Asian countries may be underreporting myocarditis to their drug agencies.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 238-250"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39217047","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":"Clozapine for the treatment of pediatric encephalopathy associated with nonketotic hyperglycinemia","authors":"Sara Jiménez-Fernández ,&nbsp;Manuel Gurpegui ,&nbsp;Jose de Leon ,&nbsp;Luis Gutiérrez-Rojas","doi":"10.1016/j.rpsm.2022.06.003","DOIUrl":"10.1016/j.rpsm.2022.06.003","url":null,"abstract":"","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 287-289"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86163217","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":"Clinical symptoms and social functioning in schizophrenia","authors":"Maria Jose Escandell ,&nbsp;Gemma Prat ,&nbsp;Mar Garcia-Franco ,&nbsp;Jose Ramón Martín-Martínez ,&nbsp;Susana Ochoa ,&nbsp;Ingrid Tortades ,&nbsp;Sonia Vilamala ,&nbsp;Marina Verdaguer-Rodríguez ,&nbsp;Emma Casas-Anguera","doi":"10.1016/j.rpsm.2020.05.009","DOIUrl":"10.1016/j.rpsm.2020.05.009","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms.</p></div><div><h3>Material and methods</h3><p><span>A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the </span>Clinical Global Impression scale for Schizophrenia (CGI-S).</p></div><div><h3>Results</h3><p>SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (<em>p</em> <!-->&lt;<!--> <!-->0.05–0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms.</p></div><div><h3>Conclusions</h3><p>Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 251-258"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38185057","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":"Valproate, obesity and other causes of clozapine poor metabolism in the context of rapid titration may explain clozapine-induced myocarditis: A re-analysis of a Turkish case series","authors":"Aygün Ertuğrul ,&nbsp;A. Elif Anıl Yağcıoğlu ,&nbsp;Esen Ağaoğlu ,&nbsp;Ahmet Alp Karakaşlı ,&nbsp;Sertaç Ak ,&nbsp;M. Kâzım Yazıcı ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsm.2021.10.003","DOIUrl":"10.1016/j.rpsm.2021.10.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Clozapine-induced myocarditis or any clozapine-induced inflammation may be a hypersensitivity reaction due to titration that was too rapid for the patient's clozapine metabolism. Clozapine metabolism is influenced by ancestry, sex, smoking and the presence of confounders including obesity, infections, and inhibitors (e.g., valproate) causing the patient to behave as a clozapine poor metabolizer (PM). A published study in a Turkish hospital identified 1 case of clozapine-induced pancreatitis and hepatitis and 9 cases of clozapine-induced myocarditis. To explore the hypothesis that the 10 patients were clozapine PMs, their serum clozapine concentrations were investigated using concentration-to-dose (C/D) ratios and their titrations carefully reviewed.</p></div><div><h3>Methods</h3><p>Dividing the trough serum concentration by the dose produces the clozapine C/D ratio. The dose required to reach 350<!--> <!-->ng/ml was considered the minimum therapeutic dosage and was used to classify patients according to clozapine PM status. Titration speed was assessed.</p></div><div><h3>Results</h3><p>All 10 patients were possibly clozapine PMs (3 of them had as minimum therapeutic doses: 72, 82 or 83<!--> <!-->mg/day). Nine of the 10 patients may have behaved as clozapine PMs due to obesity and/or valproate co-prescription during titration. One also had an undiagnosed infection. Of the 10 patients, 9 had at least 1 of 3 factors: too-rapid titration in the first or second weeks, or a final dosage that was too high.</p></div><div><h3>Conclusions</h3><p>Future studies using clozapine levels and considering the role of clozapine PM status should explore whether or not all cases of clozapine-induced inflammation could be explained by lack of individualized titration.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 281-286"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73953733","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 Covid-19 outbreak in a Spanish long-term psychiatric hospital led to infections in 6 clozapine patients: elevations in their plasma clozapine levels","authors":"Manuel Arrojo-Romero ,&nbsp;Maria Rosario Codesido-Barcala ,&nbsp;Jose de Leon","doi":"10.1016/j.rpsm.2022.06.001","DOIUrl":"10.1016/j.rpsm.2022.06.001","url":null,"abstract":"","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 290-292"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236066","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}