Journal of Clinical Sleep Medicine最新文献

{"title":"The effects of cognitive behavioral therapy for insomnia in patients with cardiovascular disease: a systematic review and meta-analysis.","authors":"Silje Glenna Andersen, Henrik Sæterhagen, André Pekkola Pacheco, Are Hugo Pripp, Harald Hrubos-Strøm, Costas Papageorgiou, John Munkhaugen, Toril Dammen","doi":"10.5664/jcsm.11656","DOIUrl":"10.5664/jcsm.11656","url":null,"abstract":"<p><strong>Study objectives: </strong>Insomnia affects up to 50% of patients with cardiovascular disease and is associated with poor clinical outcomes. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia, but little is known about the effects of CBT-I in patients with established cardiovascular disease. We aimed to investigate the effects of CBT-I on insomnia symptom severity, sleep parameters, and daytime symptoms in patients with cardiovascular disease and comorbid insomnia.</p><p><strong>Methods: </strong>Medline, Embase, PsycINFO, and ClinicalTrials.gov were searched for randomized controlled and open trials up to December 2023. Study selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2 tool) were independently conducted by the authors. Data were meta-analyzed using random-effects models.</p><p><strong>Results: </strong>In all, 1,275 records with 5 studies fulfilled the inclusion criteria (n = 352 patients). Compared with active control groups, CBT-I significantly reduced insomnia severity posttreatment (standardized mean difference  = -0.90, 95% confidence interval: -1.43, -0.37; <i>P</i> < .001), sleep onset latency, anxiety, and fatigue. Moreover, CBT-I significantly improved sleep quality (standardized mean difference = -0.77, 95% confidence interval: -1.10, -0.45; <i>P</i> < .001) and sleep efficiency (standardized mean difference = 0.68, 95% confidence interval: 0.12-1.25; <i>P</i> < .001). We regarded 3 randomized controlled trials as having low risk of bias and had some concerns with another.</p><p><strong>Conclusions: </strong>Evidence from our analyses indicated that CBT-I seems to be effective for alleviating insomnia symptoms among patients with cardiovascular disease, largely in line with the results of previous meta-analyses in patients with insomnia. The limited sample size encourages more robust evidence from high-quality, large-scale trials with long-term follow-up.</p><p><strong>Citation: </strong>Andersen SG, Sæterhagen H, Pacheco AP, et al. The effects of cognitive behavioral therapy for insomnia in patients with cardiovascular disease: a systematic review and meta-analysis. <i>J Clin Sleep Med.</i> 2025;21(7):1273-1284.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1273-1284"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671678","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":"A case study of acceptance and commitment therapy for central disorders of hypersomnolence: opportunities to improve patient-centered and comprehensive treatment approaches.","authors":"Alicia J Roth, Nancy Foldvary-Schaefer","doi":"10.5664/jcsm.11634","DOIUrl":"10.5664/jcsm.11634","url":null,"abstract":"<p><p>Beyond daytime sleepiness, central disorders of hypersomnolence (including narcolepsy types 1 and 2 and idiopathic hypersomnia) affect the fundamental aspects of everyday life, including mental health, negative self-esteem, relationships, social stigma, and occupational/school problems, all of which can lead to disability. Limited scientifically tested behavioral treatments designed to address the psychological, social, and economic devastation associated with hypersomnia exist. This case report reviews 1 patient's experience with 2 adjuvant interventions for central disorders of hypersomnolence: group cognitive behavioral therapy for hypersomnia and individual acceptance and commitment therapy intervention for central disorders of hypersomnolence.</p><p><strong>Citation: </strong>Roth AJ, Foldvary-Schaefer N. A case study of acceptance and commitment therapy for central disorders of hypersomnolence: opportunities to improve patient-centered and comprehensive treatment approaches. <i>J Clin Sleep Med</i>. 2025;21(7):1301-1304.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1301-1304"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of cannabinoid therapy in treatment-refractory isolated REM sleep behavior disorder: a case report.","authors":"Sahej Samra, Hrayr Attarian, Roneil Malkani","doi":"10.5664/jcsm.11704","DOIUrl":"10.5664/jcsm.11704","url":null,"abstract":"<p><p>Current treatments for rapid eye movement sleep behavior disorder are not always effective and can lead to dose-limited adverse events, and new treatments are needed for this condition. We present a case of a patient with treatment-refractory isolated rapid eye movement sleep behavior disorder who had a dramatic and sustained improvement in dream enactment behaviors using oral tinctures containing cannabidiol and tetrahydrocannabinol without adverse events over 5 years of follow-up.</p><p><strong>Citation: </strong>Samra S, Attarian H, Malkani R. The use of cannabinoid therapy in treatment-refractory isolated REM sleep behavior disorder: a case report. <i>J Clin Sleep Med</i>. 2025;21(7):1311-1313.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1311-1313"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702099","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":"Personalized endpoints in Prader-Willi syndrome: a case study with goal attainment scaling.","authors":"Amee Revana, Gunes Sevinc, Michelle George, Taylor Dunn, Kari Pope, Justin Stanley, Kenneth Rockwood","doi":"10.5664/jcsm.11664","DOIUrl":"10.5664/jcsm.11664","url":null,"abstract":"<p><p>This case report examines the implementation of goal attainment scaling for a 9-year-old female with Prader-Willi syndrome and narcolepsy-like features who began treatment with Pitolisant, a medication designed to alleviate excessive daytime sleepiness. The individualized goal attainment scaling framework enabled the patient and her caregivers to establish specific treatment goals across cognitive, motor, and physiological domains. Although validated outcome measures for this population are limited, goal attainment scaling effectively captured crucial aspects of the patient's experience, revealing overall improvements in most symptoms during a 6-month follow-up. This method provided an unbiased assessment of treatment effectiveness, underscoring the importance of integrating patient-centered measures in the management of rare diseases like Prader-Willi syndrome. The findings suggest that goal attainment scaling can yield valuable insights into patient priorities and treatment outcomes, highlighting the need for further research into its application in clinical settings for Prader-Willi syndrome and similar conditions.</p><p><strong>Citation: </strong>Revana A, Sevinc G, George M, et al. Personalized endpoints in Prader-Willi syndrome: a case study with goal attainment scaling. <i>J Clin Sleep Med</i>. 2025;21(7):1305-1309.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1305-1309"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671723","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":"A new frontier for positional therapy: obstetrics.","authors":"Allan J Kember, Noa Gilad, Jerry Coleman, Jane Warland, Sebastian R Hobson","doi":"10.5664/jcsm.11616","DOIUrl":"10.5664/jcsm.11616","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1319-1320"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665273","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":"Polysomnographic findings of multiple system atrophy: evidence from case-control studies.","authors":"Meiou Wang, Ye Zhang, Rong Ren, Jiaxue Huang, Xujun Feng, Michael V Vitiello, Larry D Sanford, Xiangdong Tang","doi":"10.5664/jcsm.11758","DOIUrl":"https://doi.org/10.5664/jcsm.11758","url":null,"abstract":"<p><strong>Study objectives: </strong>This study examines the polysomnographic (PSG) differences between multiple system atrophy (MSA) patients and healthy controls.</p><p><strong>Methods: </strong>An electronic literature search was performed in MEDLINE, EMBASE, All EBM databases and the Web of Science database from inception to August 2024.</p><p><strong>Results: </strong>Meta-analysis found significant reductions in percent rapid eye movement (REM) sleep, sleep efficiency, and total sleep time, and increases in the apnea-hypopnea index, percent N1, periodic limb movement index and sleep latency in MSA patients compared with healthy controls.</p><p><strong>Conclusions: </strong>Our meta-analysis found PSG abnormalities in MSA patients compared with controls. Future studies should include methodological considerations (i.e., REM sleep without atonia criteria) to evaluate the contributions of potential heterogeneous factors (i.e., disease duration, presence of stridor, comorbidity of rapid eye movement (REM) sleep behavior disorder) to PSG changes in MSA.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530812","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":"Oral appliance therapy is highly efficacious at reducing sleep apnea-specific hypoxic burden, a metric predictive of cardiovascular morbidity and mortality.","authors":"Erin V Mosca, Joshua Grosse, John E Remmers","doi":"10.5664/jcsm.11622","DOIUrl":"10.5664/jcsm.11622","url":null,"abstract":"<p><strong>Study objectives: </strong>A surrogate metric of obstructive sleep apnea (OSA), sleep apnea-specific hypoxic burden (SASHB), predicts adverse health outcomes associated with the disease and may be useful in assessing therapeutic success. The purpose of this study was to compare outcomes of mandibular protruding oral appliance therapy using apnea-hypopnea index and SASHB in a population with a spectrum of OSA severity.</p><p><strong>Methods: </strong>Individuals with mild, moderate, or severe OSA (n = 152) were treated with mandibular protruding oral appliance therapy in a prospective observational study. Two-night home sleep apnea tests were used to determine baseline and outcome values of apnea-hypopnea index and SASHB.</p><p><strong>Results: </strong>Mean baseline SASHB differed by OSA severity strata, with 0%, 19%, and 94% percent of study participants with mild, moderate, and severe OSA, respectively, having values greater than 60%min/h. At outcome, these values were reduced to 0%, 0%, and 15%, respectively. For the entire population, therapeutic efficacy was 78% using apnea-hypopnea index < 10 events/h as a response criterion and 95% using SASHB < 60%min/h as the criterion.</p><p><strong>Conclusions: </strong>Using a risk-predictive outcome surrogate to assess the efficacy of oral appliance therapy yields a substantially higher estimate of therapeutic efficacy of oral appliance therapy, particularly in patients with severe OSA.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Feasibility and Predictive Accuracy of an In-Home Computer Controlled Mandibular Positioner in Identifying Favorable Candidates for Oral Appliance Therapy; URL: https://clinicaltrials.gov/study/NCT03011762; Identifier: NCT03011762; Registry: ClinicalTrials.gov; Name: Predictive Accuracy of MATRx Plus in Identifying Favorable Candidates for Oral Appliance Therapy; URL: https://clinicaltrials.gov/study/NCT03217383; Identifier: NCT03217383; Registry: ClinicalTrials.gov; Name: Validation of a Simplified MATRx Plus; URL: https://clinicaltrials.gov/study/NCT03812692; Identifier: NCT03812692.</p><p><strong>Citation: </strong>Mosca EV, Grosse J, Remmers JE. Oral appliance therapy is highly efficacious at reducing sleep apnea-specific hypoxic burden, a metric predictive of cardiovascular morbidity and mortality. <i>J Clin Sleep Med.</i> 2025;21(7):1185-1190.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1185-1190"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694026","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":"Leveraging digital therapeutics to improve physician sleep: a pilot implementation study.","authors":"Elizabeth Benge, Julie C Lauffenburger, Michelle Reid, Rebecca Rottapel, Darshan Mehta, Suzanne M Bertisch","doi":"10.5664/jcsm.11666","DOIUrl":"10.5664/jcsm.11666","url":null,"abstract":"<p><p>Given the high prevalence of physician burnout, strategies are needed to improve physician mental health and well-being. As sleep disturbance predicts burnout, there is a need to evaluate evidence-based, potentially scalable treatments that target physician sleep and sleep-related health. This pilot implementation study enrolled physicians and gave them access to the Sleep Healthy Using the Internet, a 6-session self-guided cognitive behavioral therapy for insomnia treatment program. Among 34 consented physicians, 44.1% engaged at least once with the platform. Among those, 23.5% completed all 6 sessions. Among the 8 completers, the program's session length, time requirements, and ease of access received high satisfaction ratings, and 75% reported they would recommend the program to other clinicians. In exploring effectiveness, Sleep Healthy Using the Internet was associated with reductions in insomnia severity, sleep disturbance, and sleep-related impairment postintervention. This pilot study demonstrates the promise of an evidence-based, web-based cognitive behavioral therapy for insomnia program for improving insomnia among physicians.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Identifier: NCT05289596.</p><p><strong>Citation: </strong>Benge E, Lauffenburger JC, Reid M, Rottapel R, Mehta D, Bertisch SM. Leveraging digital therapeutics to improve physician sleep: a pilot implementation study. <i>J Clin Sleep Med</i>. 2025;21(7):1297-1299.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1297-1299"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671720","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":"Correlation of sleep-disordered breathing with anemia and microcytosis in premenopausal females: the Nagahama study.","authors":"Kimihiko Murase, Takeshi Matsumoto, Yasuharu Tabara, Miho Egawa, Takuma Minami, Osamu Kanai, Naomi Takahashi, Satoshi Hamada, Hironobu Sunadome, Jumpei Togawa, Takuma Ohsuga, Tomoko Wakamura, Naoko Komenami, Kazuya Setoh, Takahisa Kawaguchi, Takeo Nakayama, Susumu Sato, Masaki Mandai, Toyohiro Hirai, Fumihiko Matsuda, Kazuo Chin","doi":"10.5664/jcsm.11618","DOIUrl":"10.5664/jcsm.11618","url":null,"abstract":"<p><strong>Study objectives: </strong>While nocturnal hypoxia caused by sleep-disordered breathing (SDB) can result in polycythemia, the association between erythrocyte values and SDB may vary by sex and menopausal status. This study aimed to evaluate the correlation of erythrocyte variables with SDB in a large cohort categorized by sex and menopausal status from the general population.</p><p><strong>Methods: </strong>Sleep duration and SDB were assessed in community residents using a wearable actigraph and pulse oximeter. The actigraph-adjusted 3% oxygen saturation index was calculated by correcting the time measured by the pulse oximeter for sleep duration computed by the actigraph. SDB severity was defined by actigraph-adjusted 3% oxygen saturation index as normal (< 5 events/h), mild (5 to < 15 events/h), and moderate to severe (≥ 15 events/h).</p><p><strong>Results: </strong>Data were obtained from 6,836 participants (premenopausal females, 1,580; postmenopausal females, 3,058; and males, 2,198). Multivariate analysis revealed that actigraph-adjusted 3% oxygen saturation index was negatively correlated with hemoglobin level in premenopausal females (β = -0.13, <i>P</i> < .01), but no significant correlations were found in postmenopausal females and males. In addition, the presence of SDB was a risk factor for microcytic anemia (hemoglobin < 12 g/dL and mean corpuscular volume < 80 fL) in premenopausal females (odds ratio and 95% confidence interval: mild SDB, 1.93 [1.31-2.84], <i>P</i> < .01; moderate to severe SDB, 9.02 [3.02-26.88], <i>P</i> < .01).</p><p><strong>Conclusions: </strong>SDB was associated with microcytic anemia in premenopausal females. When SDB is diagnosed in a premenopausal female, we may need to evaluate her erythrocytic parameters.</p><p><strong>Citation: </strong>Murase K, Matsumoto T, Tabara Y, et al. Correlation of sleep-disordered breathing with anemia and microcytosis in premenopausal females: the Nagahama study. <i>J Clin Sleep Med</i>. 2025;21(7):1155-1164.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1155-1164"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665237","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":"Prevalence and predictors of obstructive sleep apnea in collegiate football players.","authors":"S Raj J Trikha, Richard Raab, Terry DeZeeuw, Steven Moore, Mark Neagle, Mark Petrun, Josiane L Broussard","doi":"10.5664/jcsm.11646","DOIUrl":"10.5664/jcsm.11646","url":null,"abstract":"<p><strong>Study objectives: </strong>Football players are a unique population that present with obstructive sleep apnea (OSA) at rates higher than the general population, likely due to high body mass indices and large neck circumferences. However, few studies have studied the prevalence of OSA in young, collegiate football players. We therefore examined the prevalence of OSA, as well as assessed a simple screening tool to identify OSA risk, in collegiate football players.</p><p><strong>Methods: </strong>Participants from the Colorado State University football team completed anatomical evaluations and in-depth health history and sleep questionnaires and wore a WatchPAT 300 device for 3 consecutive nights for in-home estimations of apnea-hypopnea index and blood oxygen saturation.</p><p><strong>Results: </strong>Fifty-eight young, healthy males completed the study (body mass index: 29.2 ± 4.2 kg/m²; mean ± standard deviation). Thirty-five percent of study participants (n = 18) had mild-to-moderate OSA, and a significantly higher body mass index as compared to no OSA (<i>P</i> = .03). In addition, participants with mild-to-moderate OSA scored significantly higher on the STOP-Bang questionnaire as compared to participants with no OSA (<i>P</i> < .01). The corresponding sensitivity and specificity for the STOP-Bang was 83% and 41%, respectively. When overnight oxygen saturation < 94% was added to the STOP-Bang assessment, the corresponding sensitivity and specificity was 61% and 79%, respectively.</p><p><strong>Conclusions: </strong>Collegiate football players present with OSA at a higher rate than the general population. Incorporating overnight oxygen saturation into the STOP-Bang questionnaire may increase the specificity for detecting OSA and should be included when assessing OSA in this population.</p><p><strong>Citation: </strong>Trikha SRJ, Raab R, DeZeeuw T, et al. Prevalence and predictors of obstructive sleep apnea in collegiate football players. <i>J Clin Sleep Med</i>. 2025;21(7):1233-1243.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1233-1243"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711993","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}