Schizophrenia Bulletin最新文献

{"title":"Effectiveness of Omega-3 Fatty Acids Versus Placebo in Subjects at Ultra-High Risk for Psychosis: The PURPOSE Randomized Clinical Trial.","authors":"Inge Winter-van Rossum, Margot I E Slot, Hendrika H van Hell, Matthijs G Bossong, Gregor Berger, Harald Aschauer, Arija Maat, Susanne Walitza, Orly Lavan, Inmaculada Baeza, Montserrat Dolz, Elena Monducci, Paolo Fiori Nastro, Rune Andreas Kroken, Stephen M Lawrie, Covadonga Martinez Díaz-Caneja, Tobias Renner, Monika Schlögelhofer, Christian Scharinger, Gianfranco Spalletta, Nerisa Banaj, Soraya Otero, Maria Schipper, Dorieke Brink- Kwakkel, Rene S Kahn","doi":"10.1093/schbul/sbae186","DOIUrl":"10.1093/schbul/sbae186","url":null,"abstract":"<p><strong>Background and hypotheses: </strong>In the past 2 decades, substantial effort has been put into research on therapeutic options for people at ultra-high risk (UHR) for developing a first episode of psychosis (FEP), focusing on omega-3 polyunsaturated fatty acids (PUFAs) in preventing transition to psychosis. Despite an initial positive finding, subsequent studies failed to find a beneficial effect. The current study aimed to further investigate the effect of omega-3 PUFAs in UHR, to determine whether this line of research is worth pursuing.</p><p><strong>Study design: </strong>A double-blind, randomized, placebo-controlled study testing the efficacy of 6-month treatment with omega-3 PUFAs in 135 subjects at UHR for FEP, aged 13 to 20 years on the prevention of a transition to psychosis, followed up for 18 months post-treatment. The trial was conducted at 16 general hospitals and psychiatric specialty centers located in 8 European countries and Israel.</p><p><strong>Study results: </strong>There was no beneficial effect of treatment with omega-3 PUFAs compared to placebo; the rate of transition over 2 years did not differ between treatment arms nor was there a difference in change in symptom severity after 6-month treatment. Dropout rates and serious adverse events were similar across the groups.</p><p><strong>Conclusions: </strong>This is the third study that fails to replicate the original finding on the protective effect of omega-3 PUFAs in UHR subjects for transition to psychosis. The accumulating evidence therefore suggests that omega-3 PUFAs do not reduce transition rates to psychosis in those at increased risk at 2 years follow-up.</p><p><strong>Clinical trials: </strong>This trial is registered with ClinicalTrials.gov (NCT02597439; Study Details | Placebo-controlled Trial in Subjects at Ultra-high Risk for Psychosis With Omega-3 Fatty Acids in Europe | ClinicalTrials.gov).</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1082-1091"},"PeriodicalIF":4.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timeframe for Conversion to Psychosis From Individuals at Clinical High-Risk: A Quantile Regression.","authors":"TianHong Zhang, YanYan Wei, XiaoChen Tang, LiHua Xu, YeGang Hu, HaiChun Liu, ZiXuan Wang, Tao Chen, ChunBo Li, JiJun Wang","doi":"10.1093/schbul/sbae129","DOIUrl":"10.1093/schbul/sbae129","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The time taken for an individual who is at the clinical high-risk (CHR) stage to transition to full-blown psychosis may vary from months to years. This temporal aspect, known as the timeframe for conversion to psychosis (TCP), is a crucial but relatively underexplored dimension of psychosis development.</p><p><strong>Study design: </strong>The sample consisted of 145 individuals with CHR who completed a 5-year follow-up with a confirmed transition to psychosis within this period. Clinical variables along with functional variables such as the Global Assessment of Function (GAF) score at baseline (GAF baseline) and GAF-drop from the highest score in the past year. The TCP was defined as the duration from CHR identification to psychosis conversion. Participants were categorized into 3 groups based on TCP: \"short\" (≤6 months, ≤33.3%), \"median\" (7-17 months, 33.3%-66.6%), and \"long\" (≥18 months, ≥66.6%). The quantile regression analysis was applied.</p><p><strong>Study results: </strong>The overall sample had a median TCP of 11 months. Significant differences among the three TCP groups were observed, particularly in GAF-drop (χ2 = 8.806, P = .012), disorganized symptoms (χ2 = 7.071, P = .029), and general symptoms (χ2 = 6.586, P = .037). Greater disorganized symptoms (odds ratio [OR] = 0.824, P = .009) and GAF-drop (OR = 0.867, P = .011) were significantly associated with a shorter TCP, whereas greater general symptoms (OR = 1.198, P = .012) predicted a longer TCP. Quantile regression analysis demonstrated a positive association between TCP and GAF baseline above the 0.7 quantile and a negative association between TCP rank and GAF drop below the 0.5 quantile.</p><p><strong>Conclusions: </strong>This study underscores the pivotal role of functional characteristics in shaping TCP among individuals with CHR, emphasizing the necessity for a comprehensive consideration of temporal aspects in early prevention efforts.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1030-1041"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis Risk: Time to Look Empirically at a First-step Economical-pragmatic Way to Examine Anomalous Self-experience. Exploring the SQuEASE-11.","authors":"Paul Møller, Barnaby Nelson, Patrick D McGorry, Cristina Mei, G Paul Amminger, Hok Pan Yuen, Melissa Kerr, Jessica Spark, Nicky Wallis, Andrea Polari, Shelley Baird, Kate Buccilli, Sarah-Jane A Dempsey, Natalie Ferguson, Melanie Formica, Marija Krcmar, Amelia L Quinn, Yohannes Mebrahtu, Arlan Ruslins, Rebekah Street, Lisa Dixon, Cameron Carter, Rachel Loewy, Tara A Niendam, Martha Shumway, Cassandra Wannan","doi":"10.1093/schbul/sbae149","DOIUrl":"10.1093/schbul/sbae149","url":null,"abstract":"<p><strong>Background: </strong>Since the late 1990s, there has been a worldwide surge of scientific interest in the pre-psychotic phase, resulting in the introduction of several clinical tools for early detection. The predictive accuracy of these tools has been limited, motivating the need for methodological and perspectival improvements. The EASE manual supports systematic assessment of anomalous self-experience, and proposes an overall model of understanding how most psychotic experiences may be initially generated on the basis of a unifying, fundamental, pre-reflective distortion of subjectivity.</p><p><strong>Study design: </strong>The EASE is time-consuming, so in order to spread the use of this essential perspective of psychosis risk we selected prototypical and frequent phenomena from the EASE, combining them into SQuEASE-11. To investigate this instrument for clinical relevance, basic psychometric properties, factor structure, and relationships with gold standard instruments and the full EASE, it was administered as an interview in the STEP intervention trial (Melbourne, Australia), with 328 clinical high-risk for psychosis (CHR-P) patients.</p><p><strong>Study results: </strong>The SQuEASE-11 had moderate internal consistency and revealed two correlated factors. Significant relationships were observed between the SQuEASE-11 and the widely used and validated instruments CAARMS, BPRS, SANS, MADRS, DACOBS, and SOFAS. The correlation with the full EASE was very strong.</p><p><strong>Conclusions: </strong>These 11 items do not necessarily relate specifically to ipseity disturbance, but the SQuEASE-11 seems to be a clinically relevant and brief supplementary first-line interview in CHR-P subjects. It may give a qualified indication of the need for a complete EASE interview, and it may also, importantly, inform treatment planning.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1104-1117"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing a Motor Score Based on PANSS Ratings: A Proxy for Comprehensive Motor Assessment.","authors":"Niluja Nadesalingam, Alexandra Kyrou, Victoria Chapellier, Lydia Maderthaner, Sofie von Känel, Florian Wüthrich, Melanie G Nuoffer, Stephanie Lefebvre, Anastasia Pavlidou, Thomas Wobrock, Wolfgang Gaebel, Joachim Cordes, Berthold Langguth, Peter Falkai, Thomas Schneider-Axmann, Wolfgang Strube, Alkomiet Hasan, Sebastian Walther","doi":"10.1093/schbul/sbae153","DOIUrl":"10.1093/schbul/sbae153","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Abnormal psychomotor behavior is a core schizophrenia symptom. However, assessment of motor abnormalities with expert rating scales is challenging. The Positive and Negative Syndrome Scale (PANSS) includes 3 items broadly related to hypokinetic motor behavior. Here, we tested whether a sum score of the PANSS items mannerisms and posturing (G5), motor retardation (G7), and disturbance of volition (G13) corresponds to expert ratings, potentially qualifying as a proxy-marker of motor abnormalities.</p><p><strong>Study design: </strong>Combining baseline datasets (n = 196) of 2 clinical trials (OCoPS-P, BrAGG-SoS), we correlated PANSS motor score (PANSSmot) and 5 motor rating scales. In addition, we tested whether the cutoff set at ≥3 on each PANSS motor item, ie, \"mild\" on G05, G07, and G13 (in total ≥9 on PANSSmot) would differentiate the patients into groups with high vs low scores in motor scales. We further sought for replication in an independent trial (RESIS, n = 102), tested the longitudinal stability using week 3 data of OCoPS-P (n = 75), and evaluated the validity of PANSSmot with instrumental measures of physical activity (n = 113).</p><p><strong>Study results: </strong>PANSSmot correlated with all motor scales (Spearman-Rho-range 0.19-0.52, all P ≤ .007). Furthermore, the cutoff set at ≥3 on each PANSS motor item was able to distinguish patients with high vs low motor scores in all motor scales except using Abnormal Involuntary Movement Scale (Mann-Whitney-U-Tests: all U ≥ 580, P ≤ .017).</p><p><strong>Conclusions: </strong>Our findings suggest that PANSSmot could be a proxy measure for hypokinetic motor abnormalities. This might help to combine large datasets from clinical trials to explore whether some interventions may hold promise to alleviate hypokinetic motor abnormalities in psychosis.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1162-1172"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Vexing Uncertainty to Intellectual Humility.","authors":"Michael Dickson","doi":"10.1093/schbul/sbad173","DOIUrl":"10.1093/schbul/sbad173","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"843-844"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-Methyl-d-Aspartate Receptor Antibody and Sensory Gating Deficits in Non-smoking, Minimal Antipsychotic Medication Exposure, and First-Episode Patients With Schizophrenia.","authors":"Jinghui Tong, Kebing Yang, Wei Li, Leilei Wang, Yi Yin, Yanfang Zhou, Junchao Huang, Ping Zhang, Yanli Zhao, Song Chen, Hongzhen Fan, Yimin Cui, Xingguang Luo, Shuping Tan, Zhiren Wang, Wei Feng, Baopeng Tian, Chiang-Shan R Li, L Elliot Hong, Yunlong Tan","doi":"10.1093/schbul/sbae180","DOIUrl":"10.1093/schbul/sbae180","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Sensory gating deficit is considered a pathophysiological feature of schizophrenia, which has been linked to N-methyl-d-aspartate receptor (NMDAR) hypofunction as one of the potential underlying mechanisms. Here, we hypothesize that higher levels of NMDAR antibody (Ab) may contribute to the sensory gating deficits in schizophrenia.</p><p><strong>Study design: </strong>We enrolled 72 non-smoking inpatients with first-episode schizophrenia (FES), most of them with only a relatively short duration of exposure to antipsychotic medications, and 51 non-smoking healthy controls (HC). Sensory gating was measured by P50 evoked potentials ratio and the difference between the two stimuli in an auditory paired-stimuli paradigm and serum NMDAR Ab levels were quantified by enzyme-linked immunosorbent assay.</p><p><strong>Study results: </strong>The FES group showed higher serum NMDAR Ab levels [(9.23 ± 4.15) ng/mL vs. (7.08 ± 2.83) ng/mL; P = .002], higher P50 ratio (P = .002), and less P50 difference (P = .001) than HC. In partial correlation analysis, serum NMDAR Ab levels were positively correlated with the P50 ratio (r = 0.36, P = .003) and negatively with the P50 difference (r = -0.39, P = .001) in the FES group. The NMDAR Ab levels mediated the diagnosis of schizophrenia and P50 sensory gating deficits (P50 ratio and P50 difference).</p><p><strong>Conclusions: </strong>Autoimmunity targeting NMDAR is a crucial intermediate mechanism in impaired sensory gating in patients with schizophrenia. The findings support early intervention targeting NMDAR for patients with schizophrenia.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1072-1081"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Exploring the Interactions Between Psychotic Symptoms, Cognition, and Environmental Risk Factors: A Bayesian Analysis of Networks.","authors":"","doi":"10.1093/schbul/sbae203","DOIUrl":"10.1093/schbul/sbae203","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1175"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Effects of N-Methyl-d-Aspartate Receptor Antagonists on Gamma-Band Activity During Auditory Stimulation Compared With Electro/Magneto-encephalographic Data in Schizophrenia and Early-Stage Psychosis: A Systematic Review and Perspective.","authors":"","doi":"10.1093/schbul/sbaf082","DOIUrl":"10.1093/schbul/sbaf082","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"1173"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Use of Visuospatial Context in Psychotic Psychopathology: A Meta-analysis.","authors":"Victor J Pokorny, Samuel D Klein, Collin D Teich, Scott R Sponheim, Cheryl A Olman, Sylia Wilson","doi":"10.1093/schbul/sbae081","DOIUrl":"10.1093/schbul/sbae081","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Visual perception in people with psychotic disorders is thought to be minimally influenced by surrounding visual elements (ie, visuospatial context). Visuospatial context paradigms have the unique potential to clarify the neural bases of psychotic disorders because the neural mechanisms are well studied in both animal and human models. However, the published literature on the subject is conflicting and heterogeneous. A systematic consolidation and evaluation of the published evidence is needed.</p><p><strong>Study design: </strong>We conducted a meta-analysis of 54 articles spanning over 50 years of research. Articles included behavioral, functional magnetic resonance imaging, and electroencephalogram reports of size, contrast, contour, lightness, orientation, and motion perception in schizophrenia (SCZ), bipolar disorder, and subclinical populations.</p><p><strong>Study results: </strong>When pooling across all task types, we found weak evidence of reduced use of visuospatial context in SCZ (Hedges' g = 0.20) and bipolar disorder (g = 0.25). The strongest evidence was observed for altered contrast perception in SCZ (g = 0.73). With respect to subclinical populations, we observed immense heterogeneity in populations of interest and study designs.</p><p><strong>Conclusions: </strong>We observed surprisingly weak evidence that psychotic disorders are associated with generally reduced use of visuospatial context. Instead, we observed the strongest evidence for a specific alteration in contrast perception. We propose altered feedback to the primary visual cortex as a potential neural mechanism underlying this effect. Moderating factors such as stage and phase of illness may explain some of the heterogeneity we observed in effect sizes; further research is needed to clarify how disease state relates to altered use of visuospatial context.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"51 4","pages":"983-996"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia Quality of Life Scale and Schizophrenia Quality of Life Scale Revision 4: A Systematic Review of Measurement Properties.","authors":"Milena Zúñiga Le-Bert, Max Wiessner, Sophia Wehr, Lucia Weigel, Stefan Leucht","doi":"10.1093/schbul/sbae119","DOIUrl":"10.1093/schbul/sbae119","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Schizophrenia is a severe mental disorder that has a significant impact on quality of life (QOL). Measuring QOL can offer insights into treatment efficacy and areas of intervention, highlighting the importance of valid tools assessing QOL in people with schizophrenia.</p><p><strong>Study design: </strong>We employed the COSMIN systematic review guideline to assess the psychometric properties of the schizophrenia quality of life scale (SQLS) and its 4th revision, the schizophrenia quality of life scale revision 4 (SQLS-R4), as patient-reported outcome measures (PROMs).</p><p><strong>Study results: </strong>The search yielded 455 papers, 16 were included, 7 for the SQLS and 9 for the SQLS-R4. Both scales demonstrated good results in risk of bias assessment for internal consistency and convergent validity, the SQLS-R4 additionally for known-groups validity. For the SQLS, PROM development, structural validity, and reliability were suboptimal. The SQLS-R4 showed suboptimality regarding structural validity and reliability and inadequacy for cross-cultural validity and responsiveness. The updated criteria for good measurement properties indicated good convergent validity for the SQLS and good internal consistency, reliability, and convergent validity for the SQLS-R4. The SQLS showed suboptimal results for reliability and known-groups validity, while the SQLS-R4 demonstrated suboptimality in structural validity and known-groups validity. The SQLS had indeterminate structural validity and internal consistency; the SQLS-R4 showed indeterminate responsiveness, and insufficient cross-cultural validity. When using the updated GRADE approach of the COSMIN group, both scales received a very low grade.</p><p><strong>Conclusions: </strong>The SQLS and SQLS-R4 hold the potential for recommendation in rating QOL. Identified weaknesses necessitate further validations.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":"997-1008"},"PeriodicalIF":5.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}