Schizophrenia Bulletin最新文献

{"title":"Deletion of Bmal1 in the Prelimbic Cortex Glutamatergic Neurons Triggers Schizophrenia-Like Behaviors in Mice.","authors":"Yi-Qin Yao, Bo-Wei Guo, Zhi-Yi Xu, Cun Wang, Hao Hong, Zhi-Gang Chen, Su-Su Tang","doi":"10.1093/schbul/sbag090","DOIUrl":"10.1093/schbul/sbag090","url":null,"abstract":"<p><strong>Background: </strong>While circadian disturbances are commonly comorbid with schizophrenia (SCZ), whether deficits in clock genes can induce SCZ-like behaviors in mice remains poorly understood. Brain and muscle Arnt-like protein 1 (Bmal1, also known as Mop3 or Arntl), a core circadian clock gene, is implicated in the regulation of circadian rhythms, and its single nucleotide polymorphism rs1982350 has been linked to the pathogenesis of SCZ.</p><p><strong>Study design: </strong>In the present study, we employed global or conditional Bmal1 knockout mouse models to explore the effects of Bmal1 deficiency on SCZ-like phenotypes.</p><p><strong>Study results: </strong>We found that global Bmal1 deletion resulted in hyperactivity, social impairment, anhedonia-like behavior, impaired pre-pulse inhibition, and cognitive deficits in mice, all of which recapitulate the core behavioral abnormalities characteristic of SCZ. Furthermore, enhanced excitability of glutamatergic neurons was identified in the prelimbic cortex (PrL) of Bmal1 knockout mice. Importantly, conditional Bmal1 deletion that specifically triggers localized circadian disruption in PrL glutamatergic neurons replicated the negative symptoms and cognitive deficits associated with SCZ, in the absence of hyperactivity and anhedonia-like behaviors. Mechanistically, Bmal1 in PrL glutamatergic neurons mediates SCZ-related negative symptoms and cognitive deficits via the glutamatergic projection from the PrL to the striatum.</p><p><strong>Conclusions: </strong>Together, these results reveal a previously unidentified role for Bmal1 deficiency in the PrL in driving SCZ-relevant negative symptoms and cognitive dysfunction. Our findings provide experimental evidence supporting a putative role for dysregulated circadian clock gene expression in the pathogenesis of SCZ.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813870","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":"Coping Style as a Predictor of Relapse and Functioning in First Episode Psychosis.","authors":"Anna Georgiades, Ryan Hammoud, Shangqing Liu, Maria Chiara Del Piccolo, Aljawharah Almuqrin, Alina Jorovat, Nandinee Rajkhowa, Stefania Tognin, Andrea Mechelli","doi":"10.1093/schbul/sbag079","DOIUrl":"10.1093/schbul/sbag079","url":null,"abstract":"<p><strong>Background: </strong>Compromised coping responses to life stressors may influence the development, maintenance, and recovery of psychosis.</p><p><strong>Study design: </strong>A longitudinal design assessed 269 First Episode Psychosis (FEP) patients at baseline, 4, 8, and 12 months. Linear/logistic regressions and machine learning techniques evaluated whether baseline coping styles predicted clinical and functional outcomes.</p><p><strong>Study results: </strong>Relapse occurred in 22 (9%), 35 (14%), and 50 (20%) participants within 4, 8, and 12 months, respectively. Maladaptive coping was associated with higher odds of relapse within 12 months (OR = 1.06, 95% CI: 1.00-1.12), hallucinations (OR = 1.07, 95% CI: 1.01-1.13) and delusions (OR = 1.07, 95% CI: 1.02-1.13), and with poorer Global Assessment of Functioning symptom and disability scores across follow-up. Adaptive coping was significantly associated with lower odds of hallucinations (OR = 0.96, 95% CI: 0.92-1.00) and delusions (OR = 0.95, 95% CI: 0.91-0.99) and with better functioning at 4 months (B = 0.35, SE = 0.13). Machine learning indicated that maladaptive (AUC = 0.770, accuracy [ACC] = 0.750) and adaptive coping (AUC = 0.729, ACC = 0.696) were significantly associated with relapse within 12 months, with maladaptive coping showing stronger predictive accuracy. Key contributors included self-distraction and substance use for maladaptive coping, and spiritual/religious coping and active problem-solving for adaptive coping.</p><p><strong>Conclusions: </strong>Baseline coping styles were associated with clinical and functional outcomes in FEP. These findings suggest that targeting maladaptive coping, particularly self-distraction and substance use, while promoting active problem-solving and spiritual/religious coping, may inform future intervention development aimed at improving symptom trajectories and long-term functional recovery.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813841","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":"Advancing Generative Artificial Intelligence for Clinical Assessment: Commentary on Chen, Horga, and Escola 2026.","authors":"George Chatzisofroniou, Alex S Cohen","doi":"10.1093/schbul/sbag174","DOIUrl":"10.1093/schbul/sbag174","url":null,"abstract":"<p><p>Chen et al. provide proof-of-concept evidence that a general-purpose LLM, using zero-shot training, can derive clinical ratings from transcripts of semi-structured interviews in the AMP-SCZ. In this commentary, we complement this line of research with three considerations. First, the psychometric evaluation strategy would benefit from explicit \"use case\" specifications, since acceptable performance thresholds differ substantially across various uses. In the Chen et al., data, there is relatively compressed symptom-severity distribution in the data that may obscure its reliability and validity for some, but not all, use cases. Second, defining benchmarks requires consideration. The reliability benchmark used in this study are defensible but may not be ideal for CHR populations and may not fully account for information asymmetries (e.g., evaluating nonverbal behavior from transcripts) between human and LLM raters. Involving consensus or multi-rater benchmarks might better establish ground truth and help evaluate the scientific value of these technologies. Third, involves reproducibility, as single-prompt and single-system validation leaves open how results may be idiosyncratically tied to a specific prompt wording of a specific LLM model. This is a particular issue given the rapid deprecation and change associated with LLM models. To advance the authors ambitious and important research agenda, we recommend fixed annotated validation sets with consensus benchmarks tied to pre-specified use-cases and validation protocols. Additionally, multi-model and ensemble approaches may be important for generalizing results beyond specific LLM technologies. Addressing these issues would strengthen confidence in deploying LLM-derived ratings as a scalable, multilingual tool for schizophrenia research and clinical practice.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945498","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":"Seven Times Stronger.","authors":"","doi":"10.1093/schbul/sbaf182","DOIUrl":"10.1093/schbul/sbaf182","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128474","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":"What Kurt Schneider Also Said: The Primacy of Subjective Experience in the Concept of First Rank Symptoms.","authors":"Luis F Varela, Pablo López-Silva","doi":"10.1093/schbul/sbag123","DOIUrl":"10.1093/schbul/sbag123","url":null,"abstract":"","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128550","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":"Corollary Discharge Dysfunction to Inner Speech and its Relationship to Auditory Verbal Hallucinations in Patients with Schizophrenia Spectrum Disorders.","authors":"Thomas J Whitford, Lawrence Kin-Hei Chung, Oren Griffiths, Bradley N Jack, Mike E Le Pelley, Kevin M Spencer, Ana R Barreiros, Anthony W Harrison, Nathan T Han, Sol Libesman, Daniel Pearson, Ruth B Elijah, Marianthe Godwin, Carla Haroutonian, Angela Nickerson, Sandra Sau-Man Chan, George Heung-Chuen Chong, Gary Kar-Wai Lau, Yip-Chau Wong, Jason Wai-Yiu Wong, Judith M Ford, Daniel H Mathalon, Anthony W F Harris, Suzanne Ho-Wai So","doi":"10.1093/schbul/sbaf167","DOIUrl":"10.1093/schbul/sbaf167","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Auditory-verbal hallucinations (AVH)-the experience of hearing voices in the absence of auditory stimulation-are a cardinal psychotic feature of schizophrenia-spectrum disorders. It has long been suggested that some AVH may reflect the misperception of inner speech as external voices due to a failure of corollary-discharge-related mechanisms. We aimed to test this hypothesis with an electrophysiological marker of inner speech.</p><p><strong>Study design: </strong>Participants produced an inner syllable at a precisely specified time, when an audible syllable was concurrently presented. The inner syllable either matched or mismatched the content of the audible syllable. In the passive condition, participants did not produce an inner syllable. We compared the amplitude of the N1, P2, and P3-components of the auditory-evoked potential between: (1) schizophrenia-spectrum patients with current AVH (SZAVH+, n = 55), (2) schizophrenia-spectrum patients without current AVH (SZAVH-, n = 44), (3) healthy controls (HC, n = 43).</p><p><strong>Study results: </strong>The HC group showed reduced N1-amplitude in the Match condition (relative to Passive and Mismatch), replicating our previous results. In contrast, the SZAVH+ group showed the opposite effect: enhanced N1-amplitude in the Match condition (relative to Passive and Mismatch). The SZAVH- group showed reductions in the Mismatch condition (relative to Passive and Match).</p><p><strong>Conclusions: </strong>This study provides empirical support for the theory that AVH are related to abnormalities in the normative suppressive mechanisms associated with inner speech. This phenomenon of \"inner speaking-induced suppression\" may have utility as a biomarker for schizophrenia-spectrum disorders generally, and may index a tendency for AVH specifically at more extreme levels of abnormality.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337748","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":"Psychosocial Interventions for Older Adults With Severe Mental Illness: A Systematic Scoping Review and Meta-analysis.","authors":"Macarena Sánchez-Izquierdo, Ignacio Echegoyen, Ellen Lee, Vanesa Peinado, Francisco López-Arroyo, Rocío Caballero","doi":"10.1093/schbul/sbaf169","DOIUrl":"10.1093/schbul/sbaf169","url":null,"abstract":"<p><strong>Background: </strong>Older adults with severe mental illness (SMI) experience complex rehabilitative needs that are often neglected in clinical and research settings. Psychosocial interventions are key to supporting recovery; however, evidence specific to this population remains fragmented. This scoping review and meta-analysis aims to synthesize available research on psychosocial interventions designed for older adults with SMI and evaluate their effectiveness.</p><p><strong>Study design: </strong>Following the Arksey and O'Malley framework and PRISMA-ScR guidelines, we conducted a comprehensive search across PubMed, PsycINFO, and Scopus for studies published between 2000 and 2023. Eligibility was based on the PICO framework, focusing on adults aged ≥ 50 with SMI. Data were extracted and analyzed using descriptive synthesis and meta-analytic techniques.</p><p><strong>Study results: </strong>Sixteen studies met the inclusion criteria, encompassing 884 participants. Interventions primarily targeted clinical recovery, with limited focus on aspects of personal recovery. Meta-analysis indicated a moderate overall effect size (ES = 0.366, P < .0001) with low heterogeneity (I2 = 18.81%). Quality assessment revealed that 62.5% of studies had medium to high risk of bias.</p><p><strong>Conclusions: </strong>While psychosocial interventions show promise in improving clinical outcomes for older adults with SMI, there is a significant gap in addressing personal recovery dimensions. Future research should emphasize holistic, long-term interventions to enhance both clinical and personal recoveries.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150437","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":"Associations Between Area Deprivation and Paranoia in Serious Mental Illness.","authors":"Sarah A Berretta, Robert A Ackerman, Raeanne C Moore, Colin A Depp, Philip D Harvey, Arundati Nagendra, Amy E Pinkham","doi":"10.1093/schbul/sbaf193","DOIUrl":"10.1093/schbul/sbaf193","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Though linked to paranoia in the general population and high-risk groups, neighborhood deprivation remains underexplored in serious mental illness. Paranoia also varies by demographic subgroup, potentially reflecting exposure to place-based disadvantage. Advances in the measurement of neighborhood deprivation and momentary experiences of suspiciousness could shed light on these relationships. This study uses neighborhood-level data to examine associations between area deprivation and paranoia in schizophrenia spectrum disorders (SSDs) and bipolar disorder (BD).</p><p><strong>Study design: </strong>Data from 293 participants with SSD (n = 148) and BD (n = 145) from three US sites were analyzed. Neighborhood disadvantage was quantified using the National Area Deprivation Index (ADI). Clinician-rated paranoia was assessed using the Positive and Negative Syndrome Scale; momentary feelings of threat/suspiciousness (MFTS) was measured across 30 days of Ecological Momentary Assessments (EMAs). Analyses examined the relationships between ADI and paranoia and tested if ADI explains observed demographic differences in paranoia. To assess specificity, hallucinations were examined in parallel.</p><p><strong>Study results: </strong>Greater neighborhood disadvantage was associated with higher clinician-rated paranoia and MFTS; no association was observed for hallucinations. Participants with SSD and those with racial backgrounds other than White had higher ADI scores and higher paranoia. The ADI-paranoia relationship did not differ in strength across clinical or demographic groups, nor across study sites. Area Deprivation Index significantly mediated the association between racial background and paranoia.</p><p><strong>Conclusions: </strong>Neighborhood deprivation is associated with paranoia but not hallucinations, supporting a specific link between environment and paranoia. Improvement of neighborhood-level conditions may offer a pathway to reducing paranoia and improving functioning.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401654","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":"Stress Sensitivity and the Extended Psychosis Phenotype: Results from the Experience Sampling Method Study.","authors":"Tomasz Grąźlewski, Jerzy Samochowiec, Hanna Gelner, Łukasz Gawęda, Patryk Piotrowski, Błażej Misiak","doi":"10.1093/schbul/sbaf196","DOIUrl":"10.1093/schbul/sbaf196","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Individuals with psychosis might show heightened sensitivity to minor daily stressors. However, it is unclear if this sensitivity extends to the broader population with subclinical psychopathology, reflected in psychotic-like experiences (PLEs). This study examined whether individuals with PLEs show increased symptom and cortisol responses to minor daily stressors.</p><p><strong>Study design: </strong>Altogether, 99 individuals with PLEs and 102 controls without PLEs were enrolled from the general population (aged 18-35 years). Using the experience sampling method over 7 days, participants reported PLEs, negative affect, threat anticipation, aberrant salience, and stress across different categories: area-related, activity-related, event-related, and social stress. Saliva samples for cortisol measurement were collected after each prompt.</p><p><strong>Study results: </strong>Participants with PLEs demonstrated significantly greater symptom and threat anticipation responses to all stress categories compared to controls. Aberrant salience responses to stress showed sex differences; females with PLEs exhibited stronger aberrant salience responses to most stress categories compared to males, a pattern not observed in controls. Elevated salivary cortisol levels were found among participants with PLEs (Cohen's d = 0.265) regardless of stress exposure, though this effect varied across stress categories in different models.</p><p><strong>Conclusions: </strong>The extended psychosis phenotype might be linked to elevated salivary cortisol and heightened responses to minor stressors in affective symptoms and threat anticipation, supporting the presence of increased stress sensitivity in people with PLEs. The observed sex-specific differences indicate that aberrant salience may play a distinct and nuanced role in stress sensitivity among individuals with PLEs, especially in females.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422622","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":"Cross-Modal Brain Network Disruptions in Schizophrenia: Insights from Multiplex Modeling and Transcriptomic Associations.","authors":"Wei Zhao, Hanrui Chen, Hairong Xiao, Yingzhuo Wan, Shengyi Wang, Shih-Jen Tsai, Shuixia Guo, Ching-Po Lin","doi":"10.1093/schbul/sbag127","DOIUrl":"10.1093/schbul/sbag127","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Conventional multimodal neuroimaging studies in schizophrenia (SCZ) typically model brain networks as independent single-layer systems, overlooking their coordinated cross-modal organization. The molecular and genetic underpinnings of these network alterations remain poorly understood.</p><p><strong>Study design: </strong>We employed a multiplex network approach integrating functional, anatomical, and morphological networks in 135 individuals with SCZ and 148 healthy controls. Global network integration and local segregation were assessed using the multiplex participation coefficient (MPC) and multiplex clustering coefficient (MCC), respectively. Group differences were tested, and support vector machine (SVM) classifiers were constructed to evaluate diagnostic utility. Associations between multiplex network alterations and whole-brain gene expression were examined, followed by pathway and cell-type enrichment analyses.</p><p><strong>Study results: </strong>Individuals with SCZ showed reduced cross-modal network integration, reflected by decreased MPC across cortical and subcortical regions. Alterations in local segregation, indexed by MCC, were more regionally restricted, predominantly affecting frontal and limbic systems. SVM models using MPC and MCC demonstrated robust diagnostic performance, outperforming single-layer network features. Transcriptional association analyses revealed that MPC reductions were significantly enriched for genes related to Wnt signaling and axonal and dendritic architecture, whereas MCC alterations were associated with transcriptional regulation and synaptic processes. Positively weighted genes were enriched in endothelial cells, microglia, oligodendrocytes, and vascular leptomeningeal cells, whereas negatively weighted genes were enriched in excitatory and inhibitory neurons.</p><p><strong>Conclusions: </strong>Multiplex network modeling uncovers cross-modal disruptions in brain organization in SCZ and links these alterations to specific molecular pathways and glial-neuronal substrates, providing multiscale insights into the disorder's neurobiology.</p>","PeriodicalId":21530,"journal":{"name":"Schizophrenia Bulletin","volume":"52 5","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813806","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}