Complex psychiatry最新文献

{"title":"Psychobehavioural B-criteria of somatic symptom disorder are associated with somatic symptom reporting in a large sample of psychosomatic outpatients","authors":"Matthias Hoheisel, Stoyan Popkirov, Rosa Michaelis, Matthias Rose","doi":"10.1159/000536668","DOIUrl":"https://doi.org/10.1159/000536668","url":null,"abstract":"Introduction: Somatic Symptom Disorder (SSD) as introduced by the DSM-5 is characterized by chronic somatic symptoms not fully explained by underlying pathology and accompanied by psychological factors, the diagnostic B-criteria. These cognitive, affective, and behavioral disturbances are related to increased attention to somatic symptoms. However, there is a lack of empirical evidence regarding the association between the B-criteria and high symptom reporting in clinical settings.\u0000Methods: This 12-year retrospective, cross-sectional, observational study examined 6,491 patients from a german psychosomatic outpatient center. The somatoform subscale of HEALTH-49 was used to evaluate somatic symptom reporting. Excessive health concerns and other potential criteria associated with symptom reporting were determined using the ICD-10-Symptom Rating and other HEALTH-49 subscales. \u0000Results: Regression analysis revealed that the established B-criteria for SSD were the strongest factors associated with somatic symptom reporting, with a standardized beta coefficient of β = 0.31 (R² = .428, df = 24, F = 187.886). Depressive symptoms and impaired activity and participation were clearly less associated with somatic symptom reporting. Sociodemographic factors, such as age (β = 0.16) and gender (β = 0.12), were also independently associated with somatic symptom reporting.\u0000Conclusion: This study provides evidence for the concept of SSD related to specific B-criteria associated with somatic symptom reporting, based on a large patient sample. These results point to an important role of psychological symptomatology in patients with somatic symptoms. The findings also suggest that additional factors contribute to the reporting of somatic symptoms. Our results may inform future diagnostic criteria for SSD.\u0000","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139855847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychobehavioural B-criteria of somatic symptom disorder are associated with somatic symptom reporting in a large sample of psychosomatic outpatients","authors":"Matthias Hoheisel, Stoyan Popkirov, Rosa Michaelis, Matthias Rose","doi":"10.1159/000536668","DOIUrl":"https://doi.org/10.1159/000536668","url":null,"abstract":"Introduction: Somatic Symptom Disorder (SSD) as introduced by the DSM-5 is characterized by chronic somatic symptoms not fully explained by underlying pathology and accompanied by psychological factors, the diagnostic B-criteria. These cognitive, affective, and behavioral disturbances are related to increased attention to somatic symptoms. However, there is a lack of empirical evidence regarding the association between the B-criteria and high symptom reporting in clinical settings.\u0000Methods: This 12-year retrospective, cross-sectional, observational study examined 6,491 patients from a german psychosomatic outpatient center. The somatoform subscale of HEALTH-49 was used to evaluate somatic symptom reporting. Excessive health concerns and other potential criteria associated with symptom reporting were determined using the ICD-10-Symptom Rating and other HEALTH-49 subscales. \u0000Results: Regression analysis revealed that the established B-criteria for SSD were the strongest factors associated with somatic symptom reporting, with a standardized beta coefficient of β = 0.31 (R² = .428, df = 24, F = 187.886). Depressive symptoms and impaired activity and participation were clearly less associated with somatic symptom reporting. Sociodemographic factors, such as age (β = 0.16) and gender (β = 0.12), were also independently associated with somatic symptom reporting.\u0000Conclusion: This study provides evidence for the concept of SSD related to specific B-criteria associated with somatic symptom reporting, based on a large patient sample. These results point to an important role of psychological symptomatology in patients with somatic symptoms. The findings also suggest that additional factors contribute to the reporting of somatic symptoms. Our results may inform future diagnostic criteria for SSD.\u0000","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"15 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139796063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the COVID-19 pandemic on depressive symptoms, including clinical and subthreshold levels, and eating behaviors in first-year university students","authors":"Yoshie Miyake, Koki Takagaki, Atsuo Yoshino, Yuri Okamoto","doi":"10.1159/000535624","DOIUrl":"https://doi.org/10.1159/000535624","url":null,"abstract":"Introduction: During the COVID-19 pandemic, university students experienced unusual environmental stresses, and the number of university students with depressive symptoms increased. The pandemic had a profoundly negative impact on the mental health of first-year students because they were not prepared to face academic and social stresses. The purpose of this study was to investigate the effect of the COVID-19 pandemic on depressive symptoms, eating behaviors and stress coping ability among first-year university students. Methods: A total of 8,424 first-year students, 2,043 males and 1,636 females who entered university in Japan in 2021-2022 (during the pandemic) and 2,912 males and 1,833 females who entered university in Japan in 2018-2019 (before the pandemic), participated. We investigated the differences in depressive symptoms (using BDI-II), eating behaviors (using EAT-26 and BITE) and stress coping (using CISS, which has three subscales) between first-year students before and during the pandemic. We divided the students into three categories (clinical, subthreshold, and nonsymptomatic) according to depressive symptoms and eating behaviors based on BDI-ll and EAT-26 scores and compared the frequencies of the three categories at two time points. Results: First-year students during the pandemic showed a higher percentage of depressive symptoms, including clinical and subthreshold levels, than first-year students before the pandemic but did not show disordered eating behaviors. Additionally, the CISS-T score was significantly lower for students with depressive symptoms, including clinical and subthreshold levels, during the pandemic than before the pandemic in females. Conclusions: This study suggests that it may be important to provide first-year university students with more information about depressive symptom awareness, including clinical and subthreshold levels, and to provide appropriate stress coping from many angles and early support in pandemic conditions.","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138979337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Inflammatory Action of Antidepressants: Investigating the Longitudinal Effect of Antidepressants on White Blood Cell Count.","authors":"Julia M Sealock, Guanhua Chen, Lea K Davis","doi":"10.1159/000528605","DOIUrl":"10.1159/000528605","url":null,"abstract":"<p><strong>Introduction: </strong>Antidepressants have documented anti-inflammatory effects on pro-inflammatory biomarkers. However, the long-term effects of antidepressants on inflammatory markers and the effects of different antidepressant classes on pro-inflammatory biomarkers are largely unexplored. Here, we evaluate the short- and long-term effects of all antidepressant classes on a clinical immune marker, white blood cell count (WBC).</p><p><strong>Methods: </strong>Using a retrospective study design, we extracted WBC count and prescription medications from electronic health records at Vanderbilt University Medical Center. We created a longitudinal model to evaluate the short- and long-term effects of these medications on WBC count. We validated our longitudinal model using two known anti-inflammatory medications, biologic immunosuppressants, and chemotherapy, and one medication class without known immunomodulatory properties, contraceptives. We used the longitudinal model to determine the effects of antidepressant use on WBC count stratified by drug class.</p><p><strong>Results: </strong>Biologic immunosuppressant and chemotherapy use was associated with decreased WBC count, but contraceptive use did not associate with changes in WBC count, validating our longitudinal modeling approach. All antidepressant classes were associated with decreased WBC count in the long-term cohorts. SSRI and atypical use also associated with decreased WBC count in the short-term cohort.</p><p><strong>Conclusions: </strong>Using electronic health record data, we show all antidepressant classes exhibit anti-inflammatory effects on a clinical immune marker, WBC count. Additionally, our results indicate that in some cases the anti-inflammatory effects of antidepressants persist over at least a 1-year time frame. Our work contributes to the immunomodulatory knowledge of antidepressants and motivates future studies investigating alternative therapeutic routes for antidepressants.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/88/cxp-2023-0009-01-4-528605.PMC9892923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9650892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Lipids and Lipid Droplet Dysregulation in Alzheimer’s Disease and Neuropsychiatric Disorders","authors":"Xiaojie Zhao, Siwei Zhang, Alan R. Sanders, Jubao Duan","doi":"10.1159/000535131","DOIUrl":"https://doi.org/10.1159/000535131","url":null,"abstract":"Lipids are essential components of the structure and for the function of brain cells. The intricate balance of lipids, including phospholipids, glycolipids, cholesterol, cholesterol ester, and triglycerides, is crucial for maintaining normal brain function. Brain lipids dysregulation plays a pivotal role in the pathogenesis and progression of neurodegenerative and neuropsychiatric disorders including schizophrenia and Alzheimer’s disease. Understanding the mechanisms of lipids dysregulation in these diseases is crucial for identifying better diagnostic biomarkers and for developing therapeutic strategies aiming at restoring lipid homeostasis. Here, we review the basic role of lipid components as well as a specific lipid organelle, lipid droplets, in brain function, highlighting the potential impact of altered lipid metabolism in the pathogenesis of neuropsychiatric disorders and Alzheimer’s disease.","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":" 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of LINE-1 Methylation Profile in Psychiatric Disorders.","authors":"Vitória Rodrigues Guimarães Alves, Danilo Micali, Vanessa Kiyomi Ota, Amanda Victória Gomes Bugiga, Carolina Muniz Carvalho, Sintia Iole Belangero","doi":"10.1159/000530641","DOIUrl":"10.1159/000530641","url":null,"abstract":"<p><strong>Introduction: </strong>Long interspersed nuclear elements (LINEs) are endogenous retrotransposable elements. A few studies have linked the methylation pattern of LINE-1 to different mental disorders (e.g., post-traumatic stress disorder [PTSD], autism spectrum disorder [ASD], panic disorder [PD]). We sought to unify the existing knowledge in the field and provide a better understanding of the association between mental disorders and LINE-1 methylation.</p><p><strong>Methods: </strong>A systematic review was executed with 12 eligible articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>For psychotic disorders, PTSD, ASD, and PD, lower LINE-1 methylation levels were detected, whereas for mood disorders, the findings are controversial. The studies were conducted with subjects aged 18-80 years. Peripheral blood samples were utilized in 7/12 articles.</p><p><strong>Conclusion: </strong>Although most studies have shown that LINE-1 hypomethylation was associated with mental disorders, there were still some divergences (i.e., hypermethylation associated with mental disorders). These studies suggest that LINE-1 methylation may be an important factor related to the development of mental disorders and highlight the need to better comprehend the biological mechanisms underlying the role of LINE-1 in mental disorders pathophysiology.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"119-129"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Post-Genome-Wide Association Study Analyses Relevant to Psychiatric Disorders: Imputing Transcriptome and Proteome Signals.","authors":"Huseyin Gedik, Roseann E Peterson, Brien P Riley, Vladimir I Vladimirov, Silviu-Alin Bacanu","doi":"10.1159/000530223","DOIUrl":"10.1159/000530223","url":null,"abstract":"<p><strong>Background: </strong>The genome-wide association study (GWAS) is a common tool to identify genetic variants associated with complex traits, including psychiatric disorders (PDs). However, post-GWAS analyses are needed to extend the statistical inference to biologically relevant entities, e.g., genes, proteins, and pathways. To achieve this goal, researchers developed methods that incorporate biologically relevant intermediate molecular phenotypes, such as gene expression and protein abundance, which are posited to mediate the variant-trait association. Transcriptome-wide association study (TWAS) and proteome-wide association study (PWAS) are commonly used methods to test the association between these molecular mediators and the trait.</p><p><strong>Summary: </strong>In this review, we discuss the most recent developments in TWAS and PWAS. These methods integrate existing \"omic\" information with the GWAS summary statistics for trait(s) of interest. Specifically, they impute transcript/protein data and test the association between imputed gene expression/protein level with phenotype of interest by using (i) GWAS summary statistics and (ii) reference transcriptomic/proteomic/genomic datasets. TWAS and PWAS are suitable as analysis tools for (i) primary association scan and (ii) fine-mapping to identify potentially causal genes for PDs.</p><p><strong>Key messages: </strong>As post-GWAS analyses, TWAS and PWAS have the potential to highlight causal genes for PDs. These prioritized genes could indicate targets for the development of novel drug therapies. For researchers attempting such analyses, we recommend Mendelian randomization tools that use GWAS statistics for both trait and reference datasets, e.g., summary Mendelian randomization (SMR). We base our recommendation on (i) being able to use the same tool for both TWAS and PWAS, (ii) not requiring the pre-computed weights (and thus easier to update for larger reference datasets), and (iii) most larger transcriptome reference datasets are publicly available and easy to transform into a compatible format for SMR analysis.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"130-144"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425719/pdf/cxp-2023-0009-01-4-530223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Theory with Education about Genetic Risk for Alcohol Use Disorder: The Effects of a Brief Online Educational Tool on Elements of the Health Belief Model.","authors":"Morgan N Driver, Sally I-Chun Kuo, Jehannine Austin, Danielle M Dick","doi":"10.1159/000530222","DOIUrl":"10.1159/000530222","url":null,"abstract":"<p><strong>Introduction: </strong>The utility of genetic risk information relies on the assumption that individuals will use the information to change behavior to reduce risk of developing health problems. Educational interventions designed to target elements of the Health Belief Model have shown to be effective in promoting behaviors for positive outcomes.</p><p><strong>Methods: </strong>A randomized controlled trial (RCT) was conducted in 325 college students to assess whether a brief, online educational intervention altered elements of the Health Belief Model that are known to be associated with motivations and intentions to change behavior. The RCT included a control condition, an intervention condition that received information about alcohol use disorder (AUD), and an intervention condition that received information about polygenic risk scores and AUD. We used <i>t</i> tests and ANOVA methods to compare differences in beliefs related to the Health Belief Model across study conditions and demographic characteristics.</p><p><strong>Results: </strong>Providing educational information did not impact worry about developing AUD, perceived susceptibility and severity of developing alcohol problems, or perceived benefits and barriers of risk-reducing actions. Individuals in the condition that received educational information about polygenic risk scores and AUD reported higher perceived chance of developing AUD than individuals in the control condition (adj. <i>p</i> < 0.01). Sex, race/ethnicity, family history, and drinking status were associated with several components of the Health Belief Model.</p><p><strong>Conclusion: </strong>Findings from this study demonstrate the need to better design and refine the educational information intended to accompany the return of genetic feedback for AUD to better promote risk-reducing behaviors.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"89-99"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitive Periods for the Effect of Child Maltreatment on Psychopathology Symptoms in Adolescence.","authors":"Erin C Dunn, Daniel S Busso, Kathryn A Davis, Andrew D A C Smith, Colter Mitchell, Henning Tiemeier, Ezra S Susser","doi":"10.1159/000530120","DOIUrl":"10.1159/000530120","url":null,"abstract":"<p><strong>Introduction: </strong>Child maltreatment is among the strongest risk factors for mental disorders. However, little is known about whether there are ages when children may be especially vulnerable to its effects. We sought to identify potential sensitive periods when exposure to the 2 most common types of maltreatment (neglect and harsh physical discipline) had a particularly detrimental effect on youth mental health.</p><p><strong>Methods: </strong>Data came from the Future of Families and Child Wellbeing Study (FFCWS), a birth cohort oversampled from \"fragile families\" (<i>n</i> = 3,474). Maltreatment was assessed at 3, 5, and 9 years of age using an adapted version of the Parent-Child Conflict Tactics Scales (CTS-PC). Using least angle regression, we examined the relationship between repeated measures of exposure to maltreatment on psychopathology symptoms at age 15 years (Child Behavior Checklist; CBCL/6-18). For comparison, we evaluated the strength of evidence to support the existence of sensitive periods in relation to an accumulation of risk model.</p><p><strong>Results: </strong>We identified sensitive periods for harsh physical discipline, whereby psychopathology symptom scores were highest among girls exposed at age 9 years (<i>r</i>² = 0.67 internalizing symptoms; <i>r</i>² = 1% externalizing symptoms) and among boys exposed at age 5 years (<i>r</i>² = 0.41%). However, for neglect, the accumulation of risk model explained more variability in psychopathology symptoms for both boys and girls.</p><p><strong>Conclusion: </strong>Child maltreatment may have differential effects based on the child's sex, type of exposure, and the age at which it occurs. These findings provide additional evidence for clinicians assessing the benefits and drawbacks of screening efforts and point toward possible mechanisms driving increased vulnerability to psychopathology.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"145-153"},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Emotional Dysregulation and Potential Pharmacogenetic Implication of 5-HTTLPR Genotype in Attention Deficit Hyperactivity Disorder.","authors":"Hao Xuan Tan, Adam Md Kamal, Sivakumar Thurairajasingam, Maude Elvira Phipps","doi":"10.1159/000529732","DOIUrl":"10.1159/000529732","url":null,"abstract":"<p><strong>Background: </strong>This review unpacks the emotional presentation of externalizing behaviors in attention deficit hyperactivity disorder (ADHD), by diving into the psychophysiology, neurophysiology, and neurogenetics in relation to executive function. The correlations among these three variables are identified, showing that standard assessments for ADHD leave out the emotional dysregulation element. This may lead to suboptimal management outcomes during the developmental progression into adolescence and adulthood.</p><p><strong>Summary: </strong>The emotional impulsivity manifestation in adolescence and adulthood related to the under-managed emotional dysregulation in childhood is found to be associated with subtle confounding impact of 5-HTTLPR (serotonin-transporter-linked promoter region) genotype. The genotype of interest affects the neurochemistry, neurophysiology, and psychophysiology of the cognition for executive function. The established practice of using methylphenidate in treating ADHD surprisingly has a neurogenetic effect in targeting the genotype of interest. Methylphenidate provides neuroprotective effects throughout the neurodevelopment timeline from childhood to adulthood.</p><p><strong>Key messages: </strong>The emotional dysregulation element in ADHD which is often overlooked should be addressed to improve the prognostic outcomes in adolescence and adulthood.</p>","PeriodicalId":72654,"journal":{"name":"Complex psychiatry","volume":"9 1-4","pages":"70-88"},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10035044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}