Behavioral Sleep Medicine最新文献

{"title":"Considering Substance Use in Dysfunctional Beliefs About Sleep: Validation of the DBAS-S.","authors":"Mary Beth Miller, Cassandra L Boness, Sydney D Shoemaker, Katie R Moskal, Anna M Porter, Ashley F Curtis, Christina S McCrae","doi":"10.1080/15402002.2026.2685145","DOIUrl":"10.1080/15402002.2026.2685145","url":null,"abstract":"<p><strong>Objective: </strong>Alcohol and cannabis are commonly used as sleep aids that inadvertently perpetuate symptoms of insomnia over time, but substance use is not a standard component of sleep assessments. This pre-registered study aimed to expand the validity and clinical utility of the Dysfunctional Beliefs about Sleep Scale (DBAS) by incorporating substance use expectancies for sleep.</p><p><strong>Method: </strong>After using cognitive interviewing to improve the content validity of items (<i>N</i> = 24, age <i>M</i> = 33.3y, 83% female), iterative factor analyses and tests of external validation were used to refine and psychometrically evaluate the revised scale (full sample <i>N</i> = 966, age <i>M</i> = 42.6, 60% female, 65% with at least mild insomnia).</p><p><strong>Results: </strong>The final set of 11 items was best represented by two factors (9 sleep and 2 substance use items; <i>r</i> = 0.15). The sleep subscale was strongly correlated with the DBAS-16 (<i>r</i> = 0.95, <i>p</i> < .001) and demonstrated measurement invariance across those who did (<i>n</i> = 309) and did not (<i>n</i> = 318) drink alcohol. The substance use subscale (β = 0.16, <i>p</i> < .001) accounted for a small but significant amount of unique variance in insomnia severity (sleep subscale β = 0.59, <i>p</i> < .001) and demonstrated concurrent and prospective associations with alcohol/cannabis use. Surprisingly, the single cannabis belief item was more strongly associated with cannabis use than longer validated scales of cannabis sleep expectancies.</p><p><strong>Conclusions: </strong>The substance use version of the DBAS (DBAS-S) is a brief, reliable, and valid measure of dysfunctional sleep beliefs and substance use expectancies that will improve clinical practice by flagging substance use as a potential contributor to insomnia for clinicians.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201024","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":"Design and Recruitment for the Comparative Effectiveness of Zolpidem/Trazodone and Cognitive Behavioral Therapy for Insomnia (COZI) Study in Rural Adults.","authors":"Eileen Johnson, Daniel J Buysse, Jerry A Krishnan, Sairam Parthasarathy, Lee M Ritterband, S Justin Thomas, Eric M Davis, Julio Fernandez-Mendoza, Asha Singh, Richelle J Koopman, Christina S McCrae, Daniel J Taylor, Andrew D Krystal, Arthur R Brothman, Katie L Stone","doi":"10.1080/15402002.2026.2678881","DOIUrl":"https://doi.org/10.1080/15402002.2026.2678881","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive behavioral therapy for insomnia (CBT-I) is widely recommended, but access remains limited, particularly among rural adults. Medications to treat insomnia, including zolpidem and trazodone, are widely used but can have significant side effects. Empirical evidence remains sparse to support the choice of CBT-I, medication, or combined treatment in clinical practice.</p><p><strong>Method: </strong>This paper describes the Comparative Effectiveness of Zolpidem/Trazodone and Cognitive Behavioral Therapy for Insomnia (COZI) study, which aimed to compare the effectiveness of medications and behavioral interventions for chronic insomnia.</p><p><strong>Results: </strong>COZI was a multi-center randomized trial in rural adults (aged 18-80) with chronic insomnia. The effects of three insomnia treatments were compared: digital CBT-I (dCBT-I), medication (patient/provider choice of zolpidem or trazodone), and the combination of medication plus dCBT-I. Treatment outcomes were measured at 9 weeks, 6 months, and 12 months. The primary outcome was change in severity of insomnia symptoms (ISI) over 6 months. Secondary outcomes included change in insomnia symptom severity at 9 weeks and 12 months, adverse events, and other patient-centered outcomes.</p><p><strong>Conclusions: </strong>Study results will provide support for clinical decision-making in insomnia treatment.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165659","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":"Non-24-Hour Sleep-Wake Disorder in Children and Adolescents: A Case Series.","authors":"Ruo Yan Chen, Gurinder Grewal, James Lee, Lena Xiao","doi":"10.1080/15402002.2026.2678880","DOIUrl":"https://doi.org/10.1080/15402002.2026.2678880","url":null,"abstract":"<p><strong>Purpose: </strong>To describe clinical characteristics, comorbidities, diagnostic approaches, and treatment outcomes in six pediatric cases of non‑24‑hour sleep‑wake disorder (N24SWD).</p><p><strong>Methods: </strong>We conducted a single‑center retrospective case series of children and adolescents diagnosed with N24SWD clinically evaluated by histories, sleep diaries, actigraphy, and available treatment outcomes.</p><p><strong>Results: </strong>Six sighted children with N24SWD were identified; five had autism spectrum disorder, three had attention-deficit/hyperactivity disorder, and two had anxiety disorders. All demonstrated free‑running sleep cycles (24-29 hours) with progressive delays in sleep and periodic daynight reversal. Behavioral and functional impairments were exacerbated during circadian misalignment. Entrainment strategies utilizing melatonin, bright light therapy, and behavioral interventions showed variable success; long‑term entrainment was rarely achievable due to adverse effects, inconsistent adherence, and family burden. Several families opted to maintain flexible, free‑running schedules, reporting improved mood and function when natural sleep patterns were accommodated.</p><p><strong>Conclusion: </strong>Pediatric N24SWD in sighted individuals is frequently associated with neurodevelopmental comorbidities. In all of our reported cases, children with N24SWD were sighted and had neurodevelopmental disorders. Standard circadian‑based treatments may be difficult to sustain. Management should be individualized, family‑centered, and supported by improved diagnostic tools and research into long‑term therapeutic strategies.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102147","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":"Digital Cognitive Behavioral Treatment of Insomnia in Youth: Protocol for an RCT Examining Feasibility, Acceptability, and Efficacy of LAMBI.","authors":"Christina S McCrae, Melanie A Stearns, Micah O Mazurek, Jessica Page, Britani Holland, Jennifer Takagishi, Patricia Emmanual, Xiaoli Zhang, Melissa Kapolka, Cole Craggs, Daniel Gonzalez, Judith Owens","doi":"10.1080/15402002.2026.2667840","DOIUrl":"https://doi.org/10.1080/15402002.2026.2667840","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic insomnia is associated with negative effects for children (impaired academic performance, mood and behavioral dysregulation) and their caregivers (poor sleep, stress, fatigue). Chronic insomnia is also common (up to 20% of children, 50-80% in the context of comorbidities), but underdiagnosed/treated in pediatric primary care (<10% treated). Cognitive behavioral treatment for insomnia (CBTi) is the recommended \"first-line\" treatment for insomnia and systematic reviews and meta-analyses provide evidence of its short-term efficacy and safety in children with chronic insomnia. Unfortunately, in-person CBTi is not widely available due to a lack of and limited access to behavioral providers. Digital forms of CBTi (dCBTi) have shown promise to improve sleep and secondary outcomes in children and have the potential to rapidly increase treatment accessibility and feasibility. However, while randomized controlled trials (RCTs) of dCBTi in adolescents and adults exist, these are lacking in children. This trial will be the first to investigate the impact of a moderated dCBTi on sleep and associated outcomes of school-aged children and their caregivers compared to a waitlist control.</p><p><strong>Methods & analysis: </strong>Dyads of caregivers and children (<i>N</i> = 40) 6-12 years of age with insomnia will be recruited from pediatric clinics, social media, and community outreach in Tampa, FL, Gainesville, FL, Columbia, MO, Charlotteville, VA, Boston, MA, and surrounding areas. Participants will be randomized to immediate dCBTi (LAMBI^SM) or dCBTi a month later (waitlist control). Participants will be assessed at baseline, post-treatment, 1 and 3-month follow-ups. Child assessments include objective/subjective sleep measures, daytime functioning (mood, executive functioning), quality of life (QOL), and physiological arousal (heart rate variability). Caregiver assessments include: objective/subjective sleep measures, daytime functioning (anxiety, depression, fatigue), physiological arousal, and caregiver stress.</p><p><strong>Ethics & dissemination: </strong>Ethics approval was obtained in February 2025 from the University of South Florida. All data are expected to be collected by Spring 2027. Full trial results are planned to be published in 2027. Secondary analyses of baseline data will be subsequently published.</p><p><strong>Clinical trial registration number: </strong>NCT07091149.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058381","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":"Feasibility and Initial Benefit of a Brief Group CBT-I Intervention for Reducing Suicidality in Adolescents.","authors":"Afsoon Gazor, Stephen Buerkert, Savannah Dieste, W David Brown, Kamal Naqvi, Beth Kennard, Sunita Stewart","doi":"10.1080/15402002.2026.2673892","DOIUrl":"https://doi.org/10.1080/15402002.2026.2673892","url":null,"abstract":"<p><strong>Objectives: </strong>This multi-method study examined the feasibility, acceptability, and initial benefit for a brief, group CBT-I adapted for adolescents in treatment for suicidality (CBT-IAsi).</p><p><strong>Method: </strong>Measures of subjective and objective (actigraphy) sleep and suicidality were collected from adolescents (N <i>=</i> 242, <i>M</i> = 14.6 years) in both intervention (CBT-IAsi) and control groups, at four time points across treatment.</p><p><strong>Results: </strong>Feasibility findings indicated high rates of subjective measures completion (75.2%) and CBT-IAsi attendance (88.0%), but lower compliance with actigraphy (18.8%). Acceptability was high, with almost all adolescents reporting CBT-IAsi as helpful and enjoyable. Generalized Estimating Equations models evidenced benefit via significant improvements of suicidality and subjective sleep quality, but not objective sleep, over treatment. Adolescents in the CBT-IAsi group showed significantly greater reductions in suicidal thoughts compared to the active treatment control group.</p><p><strong>Conclusions: </strong>This real-world study supports CBT-IAsi as a promising intervention that augments reductions in suicidal thoughts, with the potential to reduce health care burden and enhance access to care.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044639","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":"Fear of Missing Out and Disrupted Sleep in the Digital Age: The Protective Function of Psychological Capital in Emerging Adults.","authors":"Gopika Satish, Navin Kumar","doi":"10.1080/15402002.2026.2679677","DOIUrl":"https://doi.org/10.1080/15402002.2026.2679677","url":null,"abstract":"<p><strong>Objective: </strong>In recent times, Fear of Missing Out (FoMO) has emerged as a significant psychological construct adversely impacting the well-being and emotional health of social media users. Among the many psychological and physiological impacts of FoMO, its relation with sleep is frequently examined, considering its influence on disruption of sleep. This study intended to explore the association between FoMO, Psychological Capital (PsyCap), and sleep quality among college students and to determine whether PsyCap moderates the relationship between FoMO and sleep quality.</p><p><strong>Method: </strong>A total of 110 college students aged between 18 and 25 participated in the study. Standardized self-report measures, including the Fear of Missing Out Scale (FoMOs), Psychological Capital Questionnaire (PCQ-24), and Pittsburgh Sleep Quality Index (PSQI), were employed to assess FoMO, PsyCap, and sleep quality. Descriptive statistics, Pearson correlations, independent sample t-tests, and moderation analysis using the Hayes PROCESS macro (Model 1) were executed.</p><p><strong>Results: </strong>Findings demonstrated that FoMO was positively correlated with poor sleep quality. PsyCap, on the other hand, was negatively correlated to FoMO and poor sleep quality. Further, it was observed that FoMO significantly correlates with poorer sleep in those students with low PsyCap levels.</p><p><strong>Conclusion: </strong>PsyCap appears to play a moderating role against the effects of FoMO on sleep. The study highlights the need to conduct PsyCap-based interventions for enhancing the sleep quality and overall well-being among young adults.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018928","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":"Correction.","authors":"","doi":"10.1080/15402002.2026.2679363","DOIUrl":"https://doi.org/10.1080/15402002.2026.2679363","url":null,"abstract":"","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"i"},"PeriodicalIF":1.6,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007671","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":"Are Wearable Sleep-Tracking Devices Reliable Alternatives to Polysomnography? A Systematic Review and Meta-Analysis.","authors":"Margarida Agostinho, Maria Borges, Telmo Pereira, Daniel Filipe Borges, Joana Isabel Soares","doi":"10.1080/15402002.2026.2673893","DOIUrl":"https://doi.org/10.1080/15402002.2026.2673893","url":null,"abstract":"<p><strong>Background: </strong>Polysomnography (PSG) is the reference method for characterizing sleep architecture, but it is resource-intensive and difficult to scale for large cohort assessments. This has in creased interest in wearable devices for naturalistic sleep monitoring. This systematic review and meta-analysis evaluated how wearable sleep-tracking devices compare with laboratory PSG in healthy adults across standard sleep metrics and sleep stage durations.</p><p><strong>Methods: </strong>PubMed, Scopus, Scielo, Web of Science, and the Cochrane Library were searched following PRISMA guidelines. Eligible studies included healthy adults undergoing simultaneous wearable and PSG recordings. Mean differences were synthesized for total sleep time, sleep latency, sleep efficiency, wake after sleep onset, and time spent in light (N1+N2), deep (N3), and REM sleep using fixed or random effects models based on heterogeneity, with significance set at <i>p</i> < .01. Risk of bias and applicability were assessed using QUADAS-2.</p><p><strong>Results: </strong>Sixteen studies met the inclusion criteria, and ten contributed to the meta-analysis. Wearable devices overestimated total sleep time and sleep efficiency and underestimated wake after sleep onset, with substantial variability between devices. No device demonstrated consistently superior performance. In individual studies, the closest agreement with PSG was observed for the Oura Ring (third generation) for sleep latency and sleep efficiency, and for selected Fitbit models for deep and REM sleep.</p><p><strong>Conclusions: </strong>Wearable devices provide reasonable estimates of global sleep metrics and may complement PSG for population monitoring and longitudinal self-tracking. However, variable performance, methodological heterogeneity, and risk-of-bias considerations currently limit their use as stand-alone diagnostic tools or for detailed sleep-stage characterization.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007627","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":"Can Cognitive Behavioral Therapy for Insomnia (CBT-I) Reduce Biomarkers of Inflammation? A Systematic Review of Randomized Controlled Trials.","authors":"Valeria Fiori, Andrea Ballesio","doi":"10.1080/15402002.2026.2674793","DOIUrl":"https://doi.org/10.1080/15402002.2026.2674793","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with insomnia show increased concentrations of pro-inflammatory biomarkers including C-reactive protein (CRP), interleukin-1β (IL-β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) compared to controls. Insomnia-related inflammation may contribute to poorer health outcomes and may need to be clinically addressed. Whether guideline-recommended insomnia treatment (i.e. cognitive behavior therapy for insomnia, CBT-I) can reduce inflammation is unclear.</p><p><strong>Method: </strong>This systematic review synthesize and assessed the risk of bias of randomized controlled trials (RCTs) reporting on the effects of CBT-I on CRP, IL-1β, IL-6, and TNF-α. PubMed, Scopus, CINAHL, and PsycINFO were searched up to June 2025.</p><p><strong>Results: </strong>From the initial 2206 records retrieved, 11 RCTs were included. IL-6 (k = 7) and CRP (k = 5) were the most assessed markers of inflammation while fewer RCTs assessed TNF-α (k = 4) and IL-1β (k = 3) in the context of CBT-I. Results from RCTs largely varied, with CBT-I more consistently reported to decrease CRP than cytokines. The synthesis of outcome using meta-analysis was precluded by considerable differences in population, measurement, and outcome reporting.</p><p><strong>Conclusions: </strong>We conclude that research on CBT-I and inflammation is still developing and propose a research agenda aimed at advancing our understanding of the potential anti-inflammatory properties of CBT-I, the mediators of change, and implications for comorbidity prevention.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984356","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":"Bedtime Consistency as a Behavioral Pathway Linking Screen Time to Short Sleep Duration Among U.S. School-Aged Children.","authors":"Adam P Knowlden, Sarah M Flora, Ashley L Merianos","doi":"10.1080/15402002.2026.2673890","DOIUrl":"https://doi.org/10.1080/15402002.2026.2673890","url":null,"abstract":"<p><strong>Objectives: </strong>Adequate sleep is essential for healthy development during middle childhood, yet many school-aged children do not meet recommended sleep duration. Excessive screen exposure and inconsistent bedtime schedules are modifiable behaviors associated with inadequate sleep. This study examined whether bedtime consistency accounted for the association between screen time and short sleep duration among U.S. children ages 6-11 years.</p><p><strong>Method: </strong>Secondary analysis of the 2021-2022 National Survey of Children's Health was conducted using weighted data for primary regression models and a supplemental unweighted mediation decomposition. Screen time (ST) was categorized as 0 hours, <1 hour, 1 hour, 2 hours, and ≥3 hours. Bedtime consistency (BC) was dichotomized as consistent or inconsistent. Short sleep duration (SSD) was defined as <9 hours per night. Logistic regression models examined associations between ST and BC, BC and SSD, and whether BC served as an indirect pathway linking ST and SSD.</p><p><strong>Results: </strong>Lower ST levels were associated with lower odds of inconsistent bedtimes relative to ≥3 hours of weekday ST (aOR range 0.27-0.48, all <i>p</i> < .001). Consistent BC was associated with lower odds of SSD (aOR 0.39, 95% CI 0.32-0.48). The association between ST and SSD was attenuated and not statistically significant in the supplemental mediation decomposition after accounting for BC. Bootstrapped mediation decomposition indicated a statistically significant indirect association between ST and SSD through BC (B = -0.021, 95% CI -0.025 to -0.017).</p><p><strong>Conclusions: </strong>BC functions as a behavioral pathway linking screen exposure to inadequate sleep in middle childhood.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960615","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}