Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

{"title":"French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN) guidelines for the management of patients with partially responsive depression and treatment-resistant depression: Update 2024.","authors":"Antoine Yrondi, Hervé Javelot, Bénédicte Nobile, Ludivine Boudieu, Bruno Aouizerate, Pierre-Michel Llorca, Thomas Charpeaud, Djamila Bennabi, Antoine Lefrere, Ludovic Samalin","doi":"10.1016/j.encep.2023.11.029","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.029","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this update is to add newly approved nomenclatures and treatments as well as treatments yet to be approved in major depressive disorder, thus expanding the discussions on the integration of resistance factors into the clinical approach.</p><p><strong>Methods: </strong>Unlike the first consensus guidelines based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) developed an update of these guidelines for the management of partially responsive depression (PRD) and treatment-resistant depression (TRD). The expert guidelines combine scientific evidence and expert clinicians' opinions to produce recommendations for PRD and TRD.</p><p><strong>Results: </strong>The recommendations addressed three areas judged as essential for updating the previous 2019 AFPBN guidelines for the management of patients with TRD: (1) the identification of risk factors associated with TRD, (2) the therapeutic management of patients with PRD and TRD, and (3) the indications, the modalities of use and the monitoring of recent glutamate receptor modulating agents (esketamine and ketamine).</p><p><strong>Conclusion: </strong>These consensus-based guidelines make it possible to build bridges between the available empirical literature and clinical practice, with a highlight on the 'real world' of the clinical practice, supported by a pragmatic approach centred on the experience of specialised prescribers in TRD.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of mental disorders in closed educational centers in France.","authors":"Guillaume Bronsard, Pierre-Antoine Leroux, Issaga Diallo, Jules Eleuterio, Alban Le Bihan, Laurent Boyer, Nathalie Lavenne-Collot","doi":"10.1016/j.encep.2023.11.026","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.026","url":null,"abstract":"<p><strong>Introduction: </strong>Closed educational centres (CEC) receive young offenders who most often have a conduct disorder (CD). Mental disorders other than conduct disorder are a negative factor in the effect of educational actions. Moreover, adverse life experiences are frequent vulnerability factors in this population. This article aims to document the prevalence and links between psychiatric disorders, exposure to trauma, and the psycho-behavioural characteristics of adolescents placed in CEC.</p><p><strong>Method: </strong>We conducted a multicentre epidemiological study on a sample of 101 adolescents placed in nine closed educational centres in France. Psychiatric disorders were measured by the MINI-KID 2 and Conners Rating Scale questionnaires. Several questionnaires were used to collect sociodemographic data and the psychological profile of each adolescent.</p><p><strong>Results: </strong>Among the adolescents, 90.2% had at least one mental disorder with a predominance of conduct disorder (80%). Comorbidity was also frequently found: among the subjects with conduct disorder, 37% had at least one other psychiatric disorder. Interestingly, the intensity of conduct disorder and the Adverse Childhood Experiences (ACE) score were significantly correlated. Furthermore, two subgroups were identified: adolescents with isolated conduct disorder (44.6%) and adolescents with other psychiatric disorders (45.7%) with or without conduct disorder. The latter subgroup showed higher vulnerability and poorer outcomes in terms of attachment patterns, feelings of abandonment, hostility and impulsivity.</p><p><strong>Conclusion: </strong>This study is the first French epidemiological study of mental disorders in juvenile offenders. It suggests that the detection of psychiatric disorders in young people in CEC is an important prerequisite for the implementation of targeted interventions according to different profiles. Furthermore, collaboration between the medical-psychological and judicial fields, in the form of an operational partnership, is necessary to guarantee better support for these young people.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of hepatitis C, hepatitis B and HIV and their therapeutic management in a French public psychiatric hospital.","authors":"Foulques Icole, Vincent Haghnejad, Cyrille Jeannoel, Philippe Besançon, Frédéric Boulanger, Jean-Pierre Bronowicki","doi":"10.1016/j.encep.2023.11.023","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.023","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies suggest that the prevalence of hepatitis C, hepatitis B and HIV are higher in psychiatric patients than in the general population; however, few French studies have been published. The aims of this study were to determine the seroprevalence of the three viruses, describe the profile of infected patients and evaluate the initiation of antiviral treatment in a population of patients hospitalized in a psychiatric hospital.</p><p><strong>Method: </strong>Between January and October 2020, screening for hepatitis C virus, hepatitis B virus and HIV was systematically offered to all patients admitted to the intersectoral reception and orientation unit of a psychiatric hospital. If serology was positive, viral load was automatically determined from the same blood sample. As direct-acting antivirals (DAAs) are not financed \"in addition\" to hospital charges, it was decided a priori to start treatment for HCV immediately before discharge.</p><p><strong>Results: </strong>Between January 7 and October 1, 2020, 407 patients accepted screening. Of these patients, 17 (4.2%; 95% CI: 2.2-6.1%) were anti-HCV positive and two were anti-HIV+/anti-HCV- (0.49%). HCV RNA was detectable in 9/17 anti-HCV+ patients, with a prevalence of infection of 2.2% (CI: 0.8-3.6%). Drug use was identified in 16 anti-HCV+ patients (94%), ten with active drug use. Of the nine viraemic patients, only four received a prescription for DAA treatment at the end of hospitalization, and only one was followed up by his general practitioner with the confirmation of virological cure three months after treatment cessation. No patient tested positive for hepatitis B surface antigen, but 3% had serological markers indicating HBV past infection. The anti-HBV vaccination coverage rate was only 39% in the entire population and only 41% for patients with a history of drug use.</p><p><strong>Conclusion: </strong>Our study confirms that the prevalence of HCV infection is significantly higher in the psychiatric population than in the general population. By far, the main risk factor for HCV infection is drug use. This justifies the systematic performance of regular screening in this population. The way in which DAAs are financed in psychiatric hospitals seems to be a major obstacle to the initiation of treatment for chronic HCV infection during hospitalization and therefore to the elimination of HCV infection in the psychiatric population.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD","authors":"Research consortium for non-pharmacological interventions on ADHD,&nbsp;Amélie Dentz ,&nbsp;Chantal Martin Soelch ,&nbsp;Cherine Fahim ,&nbsp;Alexandra Torsello ,&nbsp;Véronique Parent ,&nbsp;Albert Ponsioen ,&nbsp;Marie-Claude Guay ,&nbsp;Stéphanie Bioulac-Rogier ,&nbsp;Céline Clément ,&nbsp;Michel Bader ,&nbsp;Lucia Romo","doi":"10.1016/j.encep.2023.04.010","DOIUrl":"10.1016/j.encep.2023.04.010","url":null,"abstract":"<div><p>Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.</p></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of encounters to emergency departments for suicidal attempts in France: Identification of high-risk days, months and holiday periods.","authors":"Michaël Rochoy, Isabelle Pontais, Céline Caserio-Schönemann, Christine Chan-Chee, Luce Gainet, Yann Gobert, Jan Baran, Vincent Dodin, Luc Defebvre, Claire Collins, Emmanuel Chazard, Christophe Berkhout, Pierre Balayé","doi":"10.1016/j.encep.2023.11.018","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.018","url":null,"abstract":"<p><strong>Introduction: </strong>Seasonal change in patterns of suicidal attempts is not well known in France and may differ from other western countries. We aimed to determine the peak times (days, months and holiday periods) of suicidal attempts in France.</p><p><strong>Methods: </strong>We carried out a multicentre retrospective epidemiological study, using data from the Organization for Coordinated Monitoring of Emergencies (OSCOUR®) network. We aggregated daily data from January 1, 2010, to December 31, 2019. Variations in suicidal attempts on specific days were investigated by comparing their frequencies (ad hoc Z-scores).</p><p><strong>Results: </strong>114,805,488 ED encounters were recorded including 233,242 ED encounters regarding suicidal attempts. Men accounted for 45.7%. A significantly higher frequency of ED encounters for suicidal acts were found on Sundays in the months of May-June for both sexes and on New Year's Day for all genders and age groups. An increased risk was also noted on July 14th (National Day) and June 22nd (Summer Solstice). A protective effect was noted on the day after Valentine's Day, on Christmas Day and Christmas time (in particular December 24 and 26).</p><p><strong>Conclusion: </strong>Sundays, June, New Year's Day were at increased risk of suicidal attempts in France requiring a strengthening of prevention.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment with pimavanserin of Lewy body dementia related psychosis with previous clozapine intolerance – A case report","authors":"Dorian Nizon ,&nbsp;Pierre Abdel Ahad ,&nbsp;Valérie Chauviré ,&nbsp;Edouard Godier ,&nbsp;Bénédicte Gohier ,&nbsp;François Kazour","doi":"10.1016/j.encep.2023.11.015","DOIUrl":"10.1016/j.encep.2023.11.015","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the psychometric qualities of prenatal attachment inventory in France.","authors":"Jessica Letot, Emmanuel Devouche, Mélina Audic, Amélie Paul, Jaqueline Wendland","doi":"10.1016/j.encep.2023.11.014","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.014","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to explore the structure of the Prenatal Attachment Inventory (PAI) on a French sample of pregnant women.</p><p><strong>Methods: </strong>Three hundred and nine pregnant women were recruited in gynecology-obstetrics departments and on social networks. To be included, women had to be pregnant, aged between 18 and 45 years old, and not have somatic complications of pregnancy. The women completed a questionnaire including questions on sociodemographic information, and the PAI. The structure of PAI was explored with an exploratory structural equation model (ESEM).</p><p><strong>Results: </strong>Three factorial solutions were explored: two-, three- and four-factor. The 2-factor solution was excluded due to its CFI, TLI and RMSEA indexes, which were lower than the reference values. The choice between the 3- and 4-factor solutions was made according to the clinical meaning of the items included in the factors. The 3-factor solution was retained with the factors: \"current and future representations of the baby\", \"maternal-fetal relationship\", and \"proprioceptive feeling\". The scale had good internal consistency.</p><p><strong>Conclusions: </strong>The PAI is the first standardized multidimensional assessment tool for maternal-fetal attachment in the French language. In view of the results obtained, this tool can be disseminated and used by professionals in perinatal care.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic and lockdowns on emergency data related to mental health disorders in Nouvelle-Aquitaine, France.","authors":"Maëva Rosely, Laure Meurice, Sophie Larrieu, Pascal Vilain, Edouard Chatignoux, Cécile Forgeot, Laurent Filleul","doi":"10.1016/j.encep.2023.11.019","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.019","url":null,"abstract":"<p><p>This study estimates the association between emergency department (ED) visits for mental health disorders (MHDs) and the health context of the COVID-19 pandemic in the French region of Nouvelle-Aquitaine. This retrospective study took place between 2018 and 2021 using ED data. We defined the main exposure according to five periods: \"Pre-pandemic (reference)\", \"First lockdown\", \"Second lockdown\", \"Third lockdown\", and \"Pandemic out-of-lockdown.\" We constructed the daily indicators for each MHD-related ED visit based on medical diagnoses. We described and then modeled the daily time series using generalized additive models with a quasi-Poisson regression. The analysis included 5,693,341 ED visits of which MHDs accounted for 4%. We observed a decline in ED use for most indicators, particularly during the first lockdown. Models revealed a statistically significant relative increase in ED visits for almost all MHDs during the first lockdown; for anxiety and child psychiatric disorders during the second lockdown; and only for child psychiatric disorders during the pandemic out-of-lockdown period. The public health crisis and lockdowns associated with the COVID-19 pandemic have been important sources of stress that could partially explain the deterioration of MHD indicators, thus leading to new public health concerns (notably among the youngest age group). Mental health is a major determinant of overall health and should therefore be considered in the management of crises that may require similar responses in the future.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of a simulation-based training program on suicide risk assessment and intervention for first-year psychiatry residents.","authors":"Océane Richard, Marie-Aude Piot, Fabrice Jollant","doi":"10.1016/j.encep.2023.11.017","DOIUrl":"https://doi.org/10.1016/j.encep.2023.11.017","url":null,"abstract":"<p><strong>Objectives: </strong>Adequate training of mental health professionals in suicide risk assessment and intervention is crucial. Simulation-based education is a relevant method to acquire competences for challenging health interventions. Here, we aimed to evaluate the effects of a simulation-based training program on first-year psychiatry residents' skills, knowledge, attitudes and satisfaction.</p><p><strong>Methods: </strong>We conducted pre- and immediately post-training assessments in 153 psychiatry residents during their first or second postgraduate semester in Paris, France, in 2020 and 2021. The simulation-based training occurred a few weeks after a two-hour theoretical lecture on suicidal behaviors. It consisted of a full-day training of small groups (n=5 to 9) with six scenarios played by professional actors and facilitated by two trained psychiatrists, and a 45-60minute debriefing session after each simulation. Educational objectives focused on basic aspects of patient-psychiatrist relation, the investigation of suicidal ideation, and basic interventions in various contexts (outpatient consultation, emergency room, telephone) and patient profiles. Outcome measures included the Suicide Intervention Response Inventory (SIRI-2), a short questionnaire on basic knowledge, a self-confidence four-item scale, and a satisfaction questionnaire.</p><p><strong>Results: </strong>There were significant improvements in skills, basic knowledge, and self-confidence from pre- to post-training. Trainees also expressed a high level of satisfaction, an appreciation for this innovative pedagogy and a wish for more similar training.</p><p><strong>Conclusions: </strong>This practical training program based on simulation improved self-confidence, knowledge and skills in suicide risk assessment and intervention in the short-term among first year psychiatry residents. Results from this study are therefore promising. Longitudinal studies are, however, needed to evaluate the persistence of changes over time, positive changes in care in real settings and health benefits for patients. In a time of easily accessible and rapidly growing factual medical knowledge, of necessary need for skilled professionals and of growing demand in mental health care, the development of simulation training in psychiatry should be a pedagogical and a public health priority.</p>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constipation in hospitalized psychiatric patients: An underestimated common phenomenon. Retrospective epidemiological study in an adult psychiatric hospital setting","authors":"","doi":"10.1016/j.encep.2023.11.006","DOIUrl":"10.1016/j.encep.2023.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>Constipation is more common in patients with mental disorders than in the general population. However, its frequency in hospitalized patients, its association with drugs and how teams become aware of it and take care of it are not fully identified.</div></div><div><h3>Method</h3><div>The retrospective study included 141 male and 127 female new patients admitted for routine treatment at France's largest psychiatric hospital between November 15 and December 11, 2017. A physician reviewed electronic medical records to diagnose constipation and record variables of interest: socio-demographic factors, diagnosis, drugs prescribed and taken. We calculated an anticholinergic impregnation score (AIS) for each patient by using a validated French scale. Patients were then classified into two groups by state of constipation defined by the physician. Univariate and multivariate analyses were used to study the frequency of constipation, factors associated with it and its management.</div></div><div><h3>Results</h3><div><span>The prevalence of constipation was 38% (95% CI 32–44). Associated factors were taking antipsychotics and the burden of anticholinergic treatment. On multiple regression analysis, the only remaining factor was anticholinergic treatment: AIS</span> <!-->≥<!--> <!-->5 was associated with constipation (odds ratio 1.80 [95% CI 1.07–3.14], <em>P</em> <!-->=<!--> <!-->0.027). Only 44.0% of patients were prescribed a preventive laxative, systematically in half of the cases. Above all, only 11.2% were administered this laxative (i.e., 25% of that prescribed). Digestive transit was poorly recorded in the table of constants (34.7%). We found one case of sub-occlusion as a severe case.</div></div><div><h3>Conclusion</h3><div>Constipation is common in psychiatric inpatients. The more the patient is prescribed drugs with a pronounced anticholinergic effect, the greater the risk. Alongside the preventive measures common to all psychiatric patients which must be promoted (concerning diet, physical activity, etc.), polymedication with this type of anticholinergic must be better monitored to prevent complications: prescription and administration of a preventive laxative, monitoring transit in the table of constants. Thus, a better knowledge of the subject and specific training are essential.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}