Journal of Psychosomatic Research最新文献

{"title":"Alexithymia is associated with higher pain ratings and greater pressure pain tolerance in adolescents with major depressive disorder: Evidence consistent with sensory-affective dissociation","authors":"Qing Zhang ,&nbsp;Jingwen Shang ,&nbsp;Jinyue Xue ,&nbsp;Qingqing Shen ,&nbsp;Yudong Shi ,&nbsp;Zhichun Liu ,&nbsp;Zhiwei Liu ,&nbsp;Liang Sun ,&nbsp;Kai Zhang ,&nbsp;Huanzhong Liu","doi":"10.1016/j.jpsychores.2026.112538","DOIUrl":"10.1016/j.jpsychores.2026.112538","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations of alexithymia with subjective pain intensity and pressure pain tolerance in adolescents with major depressive disorder (MDD), and to test whether alexithymia shows indirect effects linking depressive severity with these pain outcomes in cross-sectional models.</div></div><div><h3>Methods</h3><div>193 adolescents with MDD completed the Hamilton Depression Rating Scale (HAMD) and Toronto Alexithymia Scale-20 (TAS-20). Subjective pain intensity was rated with the NRS-11. Experimental pain indicators included pressure pain threshold (PPT) and pressure pain tolerance (PTO).</div></div><div><h3>Results</h3><div>Pain intensity was associated with HAMD (OR = 1.054, <em>P</em> = 0.010) and TAS-20 (OR = 1.045, <em>P</em> = 0.008). TAS-20 was associated with higher pain tolerance (PTO-1: B = 0.003, <em>P</em> = 0.014; PTO-2: B = 0.004, <em>P</em> = 0.021). Depressive severity was associated with alexithymia (<em>P</em> &lt; 0.001). Indirect effects via alexithymia were significant for tolerance with nonsignificant direct effects (both <em>P</em> &lt; 0.05). For pain intensity, both the direct effect (0.247, <em>P</em> = 0.001) and the indirect effect (0.064, <em>P</em> &lt; 0.05) were significant, with the indirect effect accounting for 20.7% of the total effect.</div></div><div><h3>Conclusion</h3><div>Alexithymia is associated with altered pain perception in adolescents with MDD and may statistically account for part of the association between depressive severity and pain outcomes. The pattern is consistent with sensory-affective dissociation and supports considering emotional processing difficulties when assessing and managing pain complaints in depressed adolescents.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112538"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between disability and alexithymia in lumbar disc herniation: A cross-sectional study","authors":"Kubra Neslihan Kurt Oktay ,&nbsp;Ebru Yilmaz ,&nbsp;Ismail Gunes Gokmen ,&nbsp;Hudanur Coskun ,&nbsp;Muhammet Sahin Elbasti ,&nbsp;Osman Tufekci ,&nbsp;Songul Ince ,&nbsp;Emre Uzun ,&nbsp;Duygu Geler Kulcu","doi":"10.1016/j.jpsychores.2026.112544","DOIUrl":"10.1016/j.jpsychores.2026.112544","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar disc herniation (LDH) is a common cause of low back pain (LBP) and disability. Psychosocial factors, including alexithymia, may influence patient-reported outcomes, but evidence in LDH remains limited. We examined associations among alexithymia, pain intensity, and disability in LDH.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 105 patients with LDH confirmed by clinical examination and magnetic resonance imaging (MRI) were assessed. Pain intensity was measured using the Visual Analog Scale (VAS), disability with the Oswestry Disability Index (ODI), and alexithymia with the 20-item Toronto Alexithymia Scale (TAS-20). Spearman correlations tested relationships between TAS-20 scores and demographic/clinical variables.</div></div><div><h3>Results</h3><div>Mean age was 51.6 ± 13.0 years; 66.7% were female. Possible/definite alexithymia was present in 39.0% (<em>n</em> = 41). BMI showed weak positive correlations with TAS-Difficulty Identifying Feelings (DIF), TAS-Externally Oriented Thinking (EOT), and TAS-total. Higher education and employment were weakly negatively correlated with TAS-DIF, TAS-Difficulty Describing Feelings (DDF), and TAS-total. Symptom duration showed weak inverse correlations with TAS scores. ODI showed weak positive correlations with TAS-DIF and TAS-total; VAS was not correlated with TAS scores. No significant associations were observed with age, sex, smoking, marital status, comorbidities, disc pathology, or neurological deficits.</div></div><div><h3>Conclusions</h3><div>Alexithymia is relatively common in LDH and shows weak associations with disability and selected sociodemographic factors but not pain intensity. These findings should not be interpreted as evidence of prediction or causality. Psychological assessment may help identify emotional processing difficulties and support comprehensive rehabilitation.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112544"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep quality and its determinants among family caregivers of patients with cancer in oncologic centers of Northwest Ethiopia: A multicenter cross-sectional study","authors":"Fasil Bayafers Tamene ,&nbsp;Endalamaw Aschale Mihiretie ,&nbsp;Tirsit Ketsela Zeleke ,&nbsp;Getachew Yitayew Tarekegn ,&nbsp;Tilaye Arega Moges ,&nbsp;Akalu Fetene Desalew ,&nbsp;Ashenafi Kibret Sendekie ,&nbsp;Samuel Agegnew Wondm","doi":"10.1016/j.jpsychores.2025.112515","DOIUrl":"10.1016/j.jpsychores.2025.112515","url":null,"abstract":"<div><h3>Objective</h3><div>Sleep quality plays a crucial role in overall well-being, and many caregivers of cancer patients report being dissatisfied with their sleep. The aim of this study was to assess sleep quality and its determinants among caregivers of patients with cancer at oncologic centers of Northwest Ethiopia.</div></div><div><h3>Methods</h3><div>An institution-based, multicenter cross-sectional study was conducted among 412 family caregivers of patients with cancer at oncologic centers in Northwest Ethiopia from August to October 2023. Study participants were enrolled using systematic random sampling. Data entry and analysis were done using EpiDdata version 4.6.0 and Statistical Package for Social Sciences (SPSS) version 26, respectively. A multivariable logistic regression model was used to identify determinants of sleep quality. Variables with a <em>p</em>-value &lt;0.05 at a 95 % Confidence Interval (CI) were defined as statistically significant.</div></div><div><h3>Results</h3><div>Out of a total of 422 approached participants, 412 eligible caregivers were included in the study. Poor sleep quality was reported among 68.9 % of caregivers. The presence of chronic illness [Adjusted Odds Ratio (AOR) = 2.19, 95 % CI: 1.18, 4.03, P: 0.012], depression [AOR = 3.40, 95 % CI: 2.04, 5.68, P: &lt;0.001], anxiety [AOR = 2.27, 95 % CI: 1.29, 3.99, P: 0.004], and poor social support [AOR = 2.06, 95 % CI: 1.04, 4.06, P: 0.036] were significantly associated with poor sleep quality.</div></div><div><h3>Conclusion</h3><div>In this study, two-thirds of caregivers were found to have poor sleep quality. Participants with chronic illness, depression, anxiety, and poor social support need prompt screening and follow-up in order to improve sleep quality.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112515"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on Somatic Symptom disorder – Understanding the underlying concepts","authors":"Francis Creed ,&nbsp;Bernd Löwe","doi":"10.1016/j.jpsychores.2026.112557","DOIUrl":"10.1016/j.jpsychores.2026.112557","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112557"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of somatic comorbidities on mortality rates and clinical progression of unipolar depression: A 10-year prospective study with depressed inpatients","authors":"Bruno Perosa Carniel ,&nbsp;Luísa Monteiro Burin ,&nbsp;Giulio Bertollo Alexandrino ,&nbsp;Pedro Henrico Grazziotin Portal ,&nbsp;Marina Ribeiro de Matos ,&nbsp;Graziella Nunes Peixoto ,&nbsp;Neusa Sica da Rocha","doi":"10.1016/j.jpsychores.2025.112510","DOIUrl":"10.1016/j.jpsychores.2025.112510","url":null,"abstract":"<div><h3>Introduction</h3><div>Somatic comorbidities and unipolar depression (UD) are frequent comorbidities and can lead to some diseases being overlooked, complicating treatment and recovery. Patients with UD die on average more than 10 years younger than those in the overall population. No study has evaluated the association between somatic comorbidities and mortality in the progression of UD using a clinical staging model. We assessed the prevalence of somatic comorbidities in a sample of inpatients with UD at different stages of progression and the mortality rates after a 10-year follow-up, identifying the underlying causes and predictors of mortality.</div></div><div><h3>Methods</h3><div>Longitudinal study with 151 inpatients with UD, evaluated at hospital admission and 10 years after discharge. The UD progression was assessed using the clinical staging model of UD. The <em>t</em>-test and chi-square test were used to compare the groups' survival and mortality rates. A multivariable Poisson regression model with robust variance estimation was used to evaluate mortality risk and predictors.</div></div><div><h3>Results</h3><div>Of the 151 patients, 28 (19 %) died after 10 years of follow-up. The most frequent underlying cause of death was cardiovascular diseases (32 %). Somatic comorbidities were more prevalent in the residual (67 %) and recurrent (71 %) stages of UD. Age (<em>p</em> = 0.000) and the number of somatic comorbidities (p = 0.000) were predictors of mortality.</div></div><div><h3>Conclusions</h3><div>The majority of patients exhibited somatic comorbidities, which were more prevalent in the residual and recurrent stages of UD. Somatic diseases, especially cardiovascular diseases, were the leading causes of underlying mortality. Moreover, the number of comorbidities significantly predicted mortality among inpatients with UD.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112510"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional relationship between social frailty and mild cognitive impairment in older patients with chronic heart failure: A two-wave longitudinal study","authors":"Jiurui Wang ,&nbsp;Cuicui Xin ,&nbsp;Jian Liu ,&nbsp;Zeping Yan ,&nbsp;Qiuyue Zhang","doi":"10.1016/j.jpsychores.2025.112514","DOIUrl":"10.1016/j.jpsychores.2025.112514","url":null,"abstract":"<div><h3>Background</h3><div>Although both social frailty (SF) and mild cognitive impairment (MCI) are common comorbidities in older patients with chronic heart failure (CHF) and they interact with each other, their relationship remains unclear.</div></div><div><h3>Objective</h3><div>The aim of this study was to explore the bidirectional relationship between SF and MCI in older patients with CHF.</div></div><div><h3>Methods</h3><div>Using the convenience sampling method, 288 older patients with CHF were recruited from China from November 2022 to April 2024 (T₁) and followed up 6-month (T₂) after their discharge from the hospital. Spearman correlation analysis and the cross-lagged panel analysis were used to test the proposed model, adjusted for potential confounding factors.</div></div><div><h3>Results</h3><div>SF and MCI coexisted in 79 (27.4 %) patients at T₁ moment; however, 84 (29.2 %) patients had coexisting SF and MCI at T₂ moment. The results showed a good model fit: Chi-squared with degrees of freedom<span><math><mspace></mspace><mo>(</mo><msup><mi>x</mi><mn>2</mn></msup></math></span>/<span><math><mi>ⅆ</mi><mi>f</mi></math></span>) = 1.820, goodness of fit index (GFI) = 0.996, comparative fit index (CFI) =0.991, root mean square error of approximation (RMSEA) = 0.068. After controlling the factors influencing SF and MCI at the T1 moment, SF at the T₁ moment could predict MCI at the T₂ moment (effect: – 0.578，95 % CI: −0.694, −0.423); MCI at the T₁ moment could also predict SF at the T₂ moment (effect: - 0.646，95 % CI: −0.801, −0.493).</div></div><div><h3>Conclusions</h3><div>There was a significant bidirectional relationship between SF and MCI. Interventions targeting either SF or MCI may have mutually beneficial effects.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112514"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative visual and auditory hallucinations after cardiac surgery: VAACS umbrella study","authors":"Haitham Abu Khadija ,&nbsp;Nizar Abu Hamdeh ,&nbsp;Duha Najajra ,&nbsp;Wafiq Othman ,&nbsp;Hamza A. Abdul-Hafez ,&nbsp;Anwar Zahran ,&nbsp;Omar Heih ,&nbsp;Yahya Z. Fraitekh ,&nbsp;Mohammad Masu'd ,&nbsp;Mahdi Awwad ,&nbsp;Idiberto José Zotarelli Filho ,&nbsp;Alaa Zayed ,&nbsp;Moaath Sawalha ,&nbsp;Sara Ismail ,&nbsp;Izzeddin Swidan ,&nbsp;Omar Abu-Hamda ,&nbsp;Oday Nana ,&nbsp;Kasem Hamoudy ,&nbsp;Basem Bali ,&nbsp;Moaath Nairat ,&nbsp;Mohammad Alnees","doi":"10.1016/j.jpsychores.2025.112480","DOIUrl":"10.1016/j.jpsychores.2025.112480","url":null,"abstract":"<div><h3>Background</h3><div>Hallucinations are underrecognized neuropsychiatric complications after cardiac surgery. Data on incidence and type-specific predictors in coronary artery bypass grafting (CABG) and valvular surgery are limited.</div></div><div><h3>Methods</h3><div>We conducted a multicenter prospective cohort study (September 2022 to May 2025) across West Bank cardiac surgery centers. A total of 1332 adults (997 CABG, 335 valve) were assessed daily for 7 days postoperatively using the Questionnaire for Psychotic Experiences. Predictors of visual and auditory hallucinations evaluated with Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Visual hallucinations occurred in 11.5 % of CABG patients and 10.0 % of valve surgery patients, while auditory hallucinations were reported in 7.0 % and 5.0 %, respectively. In the CABG group, the multivariable Cox regression models stratified by hospital showed that auditory hallucinations were significantly associated with lower left ventricular ejection fraction (HR = 1.05 per 1 % decrease; 95 % CI 1.01–1.09), longer aortic cross-clamp time (HR = 1.01 per minute; 95 % CI1.0004–1.02), and immunosuppressive therapy (HR = 4.81; 95 % CI 1.13–20.53). Postoperative blood transfusion was associated with an increased risk of visual hallucinations in univariate analysis (HR = 1.87; 95 % CI 1.05–3.33), but the association became borderline after adjustment (HR = 1.97; 95 % CI 0.95–4.09). Among the valve surgery cohort, the hospital-stratified models indicated that prolonged postoperative ventilation was independently protective against visual hallucinations (adjusted HR = 0.78; 95 % CI 0.68–0.90), whereas noradrenalin use (adjusted HR = 6.07; 95 % CI 2.18–16.93) and immunosuppressive therapy (adjusted HR = 5.13; 95 % CI 1.14–23.09) markedly increased the risk. For auditory hallucinations in valve surgery patients, adrenaline exposure emerged as a significant independent predictor (adjusted HR = 3.40; 95 % CI 1.21–9.54).</div></div><div><h3>Conclusions</h3><div>Postoperative hallucinations affected ∼1 in 10 patients; visual hallucinations were more frequent, auditory hallucinations linked to stress and medications, with risks varying by surgery type, supporting tailored monitoring and prevention.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112480"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors influencing cognitive impairment among older adult stroke survivors in Taiwan: A national cross-sectional study","authors":"Shu-Chun Lee ,&nbsp;Hsiang-Ru Lai ,&nbsp;Pei-I Lee ,&nbsp;Henny Dwi Susanti ,&nbsp;Yu-Lin Wu ,&nbsp;Pi-Hsia Lee","doi":"10.1016/j.jpsychores.2026.112541","DOIUrl":"10.1016/j.jpsychores.2026.112541","url":null,"abstract":"<div><h3>Background</h3><div>Stroke survivors may experience cognitive impairment, which can seriously affect their lives and increase the burdens of main caregivers. Factors affecting cognitive impairment in stroke survivors are less well investigated nationally.</div></div><div><h3>Aims</h3><div>This study estimated the prevalence of and applied a biopsychosocial framework to explore physiological, psychological, and social factors influencing cognitive impairment among older adult stroke survivors in Taiwan.</div></div><div><h3>Methods</h3><div>This was a secondary data analysis study using a database from the Taiwan Longitudinal Study on Aging, a population-based survey. Potential risk factors of cognitive impairment in stroke survivors included demographic characteristics, chronic diseases, oral health problems, basic activities of daily living (ADLs), instrumental ADLs (IADLs), weekly exercise behavior, depression, and emotional support. Logistic multiple regression analysis was used to analyze the data.</div></div><div><h3>Results</h3><div>Among 495 stroke survivors, 222 participants were experiencing cognitive impairment, for a prevalence rate of 44.9%. The results showed that the higher the oral health problems score (odds ratio [OR]: 1.09, <em>p</em> = .003) and the IADL score (OR: 1.19, <em>p &lt;</em> .001) were associated with increased risk of cognitive impairment.</div><div>By contrast, a higher emotional support score was associated with a lower cognitive impairment risk (OR: 0.74, <em>p =</em> .008).</div></div><div><h3>Conclusion</h3><div>Stroke patients are predisposed to cognitive impairment. This study highlights the importance of maintaining oral health, promoting IADLs, and providing emotional support to prevent cognitive impairment in stroke survivors.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112541"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on “Biopsychosocial risk factors for the transition from acute to chronic back pain: A prospective cohort study”","authors":"Petra Engelmann,&nbsp;Mareike Busmann,&nbsp;Bernd Löwe,&nbsp;Paul Hüsing","doi":"10.1016/j.jpsychores.2026.112543","DOIUrl":"10.1016/j.jpsychores.2026.112543","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112543"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Biopsychosocial risk factors for the transition from acute to chronic back pain: A prospective cohort study”","authors":"Bhumesh Tyagi ,&nbsp;Leelabati Toppo ,&nbsp;Aishwarya Biradar","doi":"10.1016/j.jpsychores.2026.112559","DOIUrl":"10.1016/j.jpsychores.2026.112559","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"202 ","pages":"Article 112559"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}