International Journal of Eating Disorders最新文献

{"title":"Moving Beyond the Phenotypic Correlation Between Anorexia Nervosa and Autism.","authors":"Karl Lundin Remnélius, Sven Bölte","doi":"10.1002/eat.24332","DOIUrl":"https://doi.org/10.1002/eat.24332","url":null,"abstract":"<p><p>The recent systematic review and meta-analysis by Inal-Kaleli et al. is situated within a growing area of research, investigating the relationship between anorexia nervosa and autistic characteristics. Their synthesis of research within the topic finds support for elevated autistic characteristics and autism in individuals with anorexia nervosa and a small but significant correlation between autistic traits and level of eating disorder symptoms. In this commentary, we discuss the findings of Inal-Kaleli and colleagues and propose further research to generate insights into the nature of this link. We focus on the potential origins of the observed relationship, specific mechanisms, and manifestation of anorexia nervosa in autistic populations, and the influence of sex and gender on the intersection of eating disorders and autism. By addressing these largely unexplored research avenues, future investigations can go beyond the phenotypic correlations and facilitate the development of prevention and intervention suited for individuals experiencing both disordered eating and elevated autistic traits.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695464","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":"The Impact of Family-Based Treatment for Adolescent Anorexia Nervosa on Compulsive Exercise Attitudes and Behaviors.","authors":"Nandini Datta, Brittany Matheson, Franziska Plessow, Kyra Citron, Daniel Le Grange, Sandra Schlegl, James Lock","doi":"10.1002/eat.24334","DOIUrl":"https://doi.org/10.1002/eat.24334","url":null,"abstract":"<p><strong>Objective: </strong>While Family-based treatment for anorexia nervosa (FBT-AN) is effective for weight restoration and improvement in eating-related cognitions, its effect on exercise attitudes and behaviors is little studied. Compulsive exercise is common in AN and often challenging to change.</p><p><strong>Method: </strong>This secondary analysis examined changes in attitudes toward compulsive exercise (Compulsive Exercise Test-CET) and behaviors (Eating Disorder Examination-EDE) using data from a randomized clinical trial testing an adjunctive treatment for adolescents with AN who failed to gain 2.4 kg by Session 4-a predictor of poor outcome. The main hypothesis is that attitudes toward compulsive exercise and decreases in compulsive exercise behavior would improve over the course of treatment.</p><p><strong>Results: </strong>Participants reported decreases in compulsive exercise attitudes by Session 4 and compulsive exercise episodes by end of treatment (EOT). There were no differences between early FBT responders (weight gain of 2.4 kg by session 4) and early non-responders.</p><p><strong>Discussion: </strong>These results suggest that FBT facilitates adolescents with AN to change attitudes toward compulsive exercise early in treatment (by Session 4) as well as reduction in compulsive exercise behaviors by EOT. Future studies should assess whether changes in attitudes toward compulsive exercise early in treatment is a mechanism of FBT treatment effect.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695853","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":"Eating-Specific Interpersonal Difficulties: Changes and Impacts on Outcomes During Ten-Session Cognitive Behavioral Therapy for Eating Disorders (CBT-T).","authors":"Mia Arai, Kate E Tonta, David M Erceg-Hurn, Bronwyn C Raykos, Glenn Waller, Peter M McEvoy","doi":"10.1002/eat.24336","DOIUrl":"https://doi.org/10.1002/eat.24336","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between self-reported interpersonal difficulties and eating disorder symptoms is well-established. The Interpersonal Relationships in Eating Disorders (IR-ED) is a new measure of eating-specific interpersonal difficulties (food-related isolation, avoidance of body evaluation, foot-related interpersonal tension). This study aims to (1) explore changes in IR-ED scores, eating disorder symptoms, and psychosocial impairment during ten-session cognitive behavioral therapy for eating disorders (CBT-T), (2) assess whether pre-treatment IR-ED scores moderate the trajectory of change in eating disorder symptoms and psychosocial impairment during CBT-T and (3) investigate the relationship between changes in the IR-ED and changes in eating disorder symptoms and psychosocial impairment.</p><p><strong>Method: </strong>Individuals with eating disorders (N = 126, M_age = 26.08) received CBT-T and completed questionnaires at pre-, mid-, and post-treatment.</p><p><strong>Results: </strong>Eating-specific interpersonal difficulties, eating disorder symptoms, and psychosocial impairment reduced during CBT-T. Severity of pre-treatment eating-specific interpersonal difficulties was unrelated to change in eating disorder symptoms or psychosocial impairment, irrespective of diagnosis or body mass index. Changes in interpersonal difficulties were associated with concurrent changes in eating disorder symptoms and psychosocial impairment. Early change in interpersonal difficulties did not predict later change in eating disorder symptoms or psychosocial impairment, and early changes in symptoms or psychosocial impairment did not predict later changes in interpersonal difficulties.</p><p><strong>Conclusions: </strong>Eating-specific interpersonal difficulties improve during CBT-T, and individuals benefit from treatment regardless of their pre-treatment interpersonal difficulties. Theoretical and clinical implications are discussed.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689406","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":"Using Bomb Calorimetry to Investigate Intestinal Energy Harvest in Anorexia Nervosa: Preliminary Findings on Stool Calorie Loss.","authors":"Kylie K Reed, Emily C Bulik-Sullivan, Yunzhi Qian, Ella Javorsky, Lisa M Tarantino, Anthony A Fodor, Kristine J Steffen, Stephen A Wonderlich, Philip S Mehler, Cynthia M Bulik, Ian M Carroll","doi":"10.1002/eat.24331","DOIUrl":"10.1002/eat.24331","url":null,"abstract":"<p><strong>Objective: </strong>Renourishment and weight restoration are critical first steps in anorexia nervosa (AN) treatment. The ability of the gastrointestinal tract to harvest and utilize energy from food is essential for successful weight restoration, but the functional capacity of the intestine after prolonged caloric restriction remains unknown. In an exploratory study, we quantified the stool energy content of individuals with AN before and after renourishment.</p><p><strong>Method: </strong>We used archived stool samples from a multisite cohort (NCT03119272) of 103 individuals with AN at admission and discharge from inpatient renourishment and 122 sex-matched non-eating disorder controls (non-ED). To determine whether bomb calorimetry may have utility in AN, we measured stool calorie loss as the number of kilocalories per gram of stool. Analyses included ANOVA, paired/unpaired t-tests, and Spearman rank correlations for associations between stool energy and clinical variables.</p><p><strong>Results: </strong>Following 25.10 ± 19.73 days of renourishment, patients gained an average of 5.67 ± 4.27 kg. Raw stool energy at discharge (AN-DIS: 5.72 ± 0.86 kcal/g) was significantly higher than admission (AN-AD: 5.41 ± 0.86 kcal/g; p < 0.01). Weight and BMI at admission and discharge were negatively correlated with raw stool energy at discharge.</p><p><strong>Discussion: </strong>Energy content in stool increases after inpatient refeeding, likely due to increased calorie consumption. Findings should be interpreted cautiously due to methodological limitations in this post hoc study design. Future studies should use a priori, gold-standard protocols to investigate stool calorie loss in AN, as prolonged restriction in AN may disrupt the gut and impede energy harvest.</p><p><strong>Trial registration: </strong>clinicaltrials.gov: NCT03119272.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683205","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":"Examining Dimensionality and Item-Quality of the Eating Disorder Examination Questionnaire in Individuals With Eating Disorders Using Item Response Theory Analysis.","authors":"Rachel Dufour, Howard Steiger, Linda Booij","doi":"10.1002/eat.24330","DOIUrl":"https://doi.org/10.1002/eat.24330","url":null,"abstract":"<p><strong>Objective: </strong>The Eating Disorder Examination Questionnaire (EDE-Q) is a widely-used measure of eating-disorder symptoms. However, inconsistent replication of the subscale structure raises concern about validity. To provide a rigorous test of the EDE-Q's dimensionality and item-quality, we applied modern and classical test theory approaches to data obtained from a large, transdiagnostic sample of people with clinical eating disorders.</p><p><strong>Method: </strong>We analyzed data from 1197 individuals (M_age = 27.9 years, SD = 10.08, 95% female) with various eating disorders, who had been assessed for treatment at a specialized program. Exploratory analyses (including Parallel Analyses), Confirmatory Factor Analyses (CFA) and graded-response Item Response Theory (IRT) analyses, were conducted with Mplus.</p><p><strong>Results: </strong>Factor analyses showed inappropriate fit to the original EDE-Q subscales, as well as for alternative 1,2,3, and 4-factor solutions. Parallel analyses suggested a one-dimensional structure as best fit. IRT analyses showed substantial variability in EDE-Q-item quality and indicated that five items (fear of weight gain, feeling fat, desire to lose weight, importance of weight, importance of shape) were most pertinent to determining severity. The construct validity of the five EDE-Q items was confirmed by a CFA, showing excellent fit.</p><p><strong>Discussion: </strong>Our results suggest that EDE-Q scores are best interpreted as spanning a one-factor continuum. IRT results suggest that some items are more pertinent than others for determining eating-disorder severity. Results could be useful for establishing short EDE-Q versions, such as a five-item version, which, in turn, would be helpful for measurement-based clinical practice and for data-collection in epidemiological and experimental studies.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645036","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":"Ketogenic Food Ameliorates Activity-Based Anorexia of Adult Female Mice.","authors":"Yiru Dong, Yuki Lin, Latika Khatri, Moses Chao, Chiye Aoki","doi":"10.1002/eat.24323","DOIUrl":"https://doi.org/10.1002/eat.24323","url":null,"abstract":"<p><strong>Objective: </strong>Genome-wide association studies implicate metabo-psychiatric origins for anorexia nervosa (AN). There are two case reports totaling six adult females who experienced complete remission of AN following a treatment comprised of ketogenic diet (targeting metabolism) with ketamine infusions (targeting psychiatric origins), but no study has determined the efficacy of ketogenic diet, alone. We addressed this gap in knowledge, with exploration of potential molecular mechanisms, using an animal model.</p><p><strong>Method: </strong>Adult C57BL6 female mice underwent 2 or 3 cycles of activity-based anorexia (ABA1, ABA2, ABA3), an animal model of AN relapse, in which AN-like maladaptive behaviors of hyperactivity and voluntary food restriction are elicited when wheel access is combined with food restriction. ABA was categorized as severe, based on weight loss ≥ 20%, food restriction-evoked increase in wheel counts > 10,000/6 h, and crouching/grimace, and compared across two groups: (1) KG, fed ketogenic food continuously (N = 25); and (2) CON, fed standard diet (N = 28).</p><p><strong>Results: </strong>86% of CON versus none of the KG were crouching with grimace during ABA1. 93% of CON versus 11% of KG lost weight severely during ABA2 (p < 0.001, 8% difference of group mean weights). Severe hyperactivity was prevalent among CON (86%) and rare for KG (4%) during ABA2 (p < 0.001 on all food-restricted days). ABA up-regulated BDNF (brain-derived neurotrophic factor) in the hippocampus of both groups but ketone body, β-hydroxybutyrate, in urine was increased only among KG.</p><p><strong>Discussion: </strong>Ketogenic diet may reduce severity of AN relapse through reduction of compulsive exercise, via mechanisms that are in addition to BDNF up-regulation and involve β-hydroxybutyrate.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645042","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":"Exploring Reciprocal Associations Between Self-Reported Anxiety and Eating Disorder Symptoms Longitudinally: A Bivariate Latent Change Score Approach.","authors":"Erin E Reilly, Tiffany A Brown, Christopher R DeJesus, Walter H Kaye, Christina E Wierenga","doi":"10.1002/eat.24329","DOIUrl":"10.1002/eat.24329","url":null,"abstract":"<p><strong>Objective: </strong>Consistent data support an association between anxiety and eating disorders (EDs), and theoretical models of EDs suggest that anxiety may be involved in the etiology and maintenance of ED symptoms over time. However, the directionality of relations between these variables remains under-characterized, particularly within treatment settings.</p><p><strong>Method: </strong>We used bivariate latent change score models to explore longitudinal associations between anxiety and ED symptoms in a sample of ED patients (N = 548, 93.2% female, Mage = 21.16, 78.8% White, 79.6% Non-Hispanic/Latinx) throughout intensive treatment and at 6- and 12-month follow-up.</p><p><strong>Results: </strong>Best-fitting models exploring change in each variable independently (i.e., univariate models) suggested that changes in ED and anxiety symptoms decreased over time, but that change was influenced by an individual's symptom severity at the previous timepoint. Models exploring associations between changes in both variables over time (i.e., bivariate latent change score models) suggested the best fit for a model where both anxiety and ED symptoms at one timepoint were associated with later change in the other. Specifically, parameters within these models suggested that higher levels of anxiety were associated with increased subsequent reductions in ED symptoms, whereas elevations in ED symptoms were associated with decreased later reductions in anxiety.</p><p><strong>Conclusions: </strong>Our findings suggest that anxiety and ED symptoms are intricately related both within and outside of intensive treatment. Future multi-modal research exploring real-time links between anxiety and ED symptoms throughout treatment is critical to extend this work and inform improvements in targeted, mechanistic interventions for this population.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645039","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":"A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits.","authors":"Emy Nimbley, Helen Sharpe, Ellen Maloney, Karri Gillespie-Smith, Kate Tchanturia, Fiona Duffy","doi":"10.1002/eat.24311","DOIUrl":"https://doi.org/10.1002/eat.24311","url":null,"abstract":"<p><strong>Objective: </strong>Our understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits.</p><p><strong>Method: </strong>A convergent, segregated approach was used, independently evaluating quantitative then qualitative studies before integrating findings into a coherent narrative synthesis.</p><p><strong>Results: </strong>Autistic people and people with higher Autistic traits report poorer experiences of treatment and may be at increased risk of inpatient admission and prolonged inpatient treatment, possibly explained by difficulties with treatment timeframes and a lack of autism-informed support. Both groups reported similar improvements in ED symptoms and BMI. Higher rates of psychosocial difficulties pre-and post-treatment were reported in those with higher Autistic traits, and emotion-focused interventions were felt to be particularly relevant to Autistic presentations of EDs. Concerns were reported as to how well aligned group-based programs and cognitive-based interventions are for Autistic individuals and those reporting higher Autistic traits.</p><p><strong>Discussion: </strong>Future research in diagnosed autism samples is urgently needed to develop a more robust understanding of Autistic outcomes and experiences. Review findings demonstrate the need for increased understanding of ED presentations and the possible need for treatment adaptations, for Autistic people or those with higher Autistic traits.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632102","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":"Global and Regional Economic Burden of Eating Disorders: A Systematic Review and Critique of Methods.","authors":"Moin Ahmed, Md Deen Islam, Phillip Aouad, Jane Miskovic-Wheatley, Stephen Touyz, Sarah Maguire, Michelle Cunich","doi":"10.1002/eat.24302","DOIUrl":"https://doi.org/10.1002/eat.24302","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to comprehensively examine up-to-date evidence on the economic burden of eating disorders (EDs), both globally and by region.</p><p><strong>Methodology: </strong>A comprehensive search within five electronic databases, MEDLINE, Embase, CINAHL, PsycINFO, and EconLit, retrieved studies published from August 1, 2013, to June 30, 2024. Cost of illness (COI) studies, burden of disease, and other cost studies that reported costs in monetary values were included, and cost-effectiveness analysis studies were excluded. The quality of COI studies was assessed using Schnitzler's checklist. All cost estimates were converted into 2024 USD purchasing power parity (PPP). The PROSPERO registration number is CRD42022358136.</p><p><strong>Findings: </strong>Twenty-six studies were identified for inclusion in this review, with 11 COI studies. The nationwide annual financial cost of EDs is estimated at PPP-USD 70.5 billion. Indirect costs contributed 70%-93% of total financial costs in the reviewed studies. Intangible costs (burden of disease) were estimated to be PPP-USD 355.6 billion. About half of the COI studies met 60% of the elements of Schnitzler's checklist, either completely or partly.</p><p><strong>Discussion: </strong>The number of COI studies has more than doubled in the last 10 years. Findings can inform healthcare administrators/policymakers to understand the magnitude of this burden when setting healthcare priorities and allocating resources to maximize social welfare. However, there are variations in the methods (thus quality) and perspectives used to assess this economic burden. Findings suggest that there is potential for enhancing the methodological rigor of future research.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632136","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":"From Silos to Synergy: A Scoping Review of Team Approaches to Outpatient Eating Disorder Treatment.","authors":"Megan Bray, Gabriella Heruc, Olivia R L Wright","doi":"10.1002/eat.24328","DOIUrl":"https://doi.org/10.1002/eat.24328","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review synthesizes the available evidence on team outpatient eating disorder treatment, focusing on team composition, reported health and service outcomes, and reported principles of Interprofessional Collaborative Practice (IPCP), a synergistic healthcare approach characterized by shared values and ethics, clear roles, communication, and teamwork.</p><p><strong>Method: </strong>A comprehensive search was conducted across five databases, targeting studies published between January 2004 and August 2024 that discussed team-based outpatient eating disorder treatment. Peer-reviewed and gray literature were included if they detailed team composition, characteristics, dynamics, experiences, processes, or outcomes.</p><p><strong>Results: </strong>Forty-five studies met the inclusion criteria; nearly half were case reports or lacked primary data. Treatment teams commonly comprised mental health professionals, dietitians, and medical practitioners. Clinical outcomes, such as body mass index and psychopathology, were the most frequently reported, while satisfaction and organizational outcomes were underrepresented. IPCP principles were inconsistently reported, with \"Roles/Responsibilities\" and \"Communication\" most frequently mentioned but often superficially addressed.</p><p><strong>Discussion: </strong>The evidence base for team outpatient eating disorder treatment lacks rigor and depth. Future research should focus on refining the integration of roles across disciplines, developing comprehensive outcome measures for benchmarking, and applying IPCP principles more systematically.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632127","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}