Annales medico-psychologiques最新文献

{"title":"Surveillance hématologique de la clozapine : les temps sont-ils venus d’assouplir les règles ?","authors":"Hélène Verdoux ,&nbsp;Alexis Lepetit ,&nbsp;Task Force Clozapine","doi":"10.1016/j.amp.2024.09.025","DOIUrl":"10.1016/j.amp.2024.09.025","url":null,"abstract":"<div><h3>Background</h3><div>A significant proportion of people with resistant schizophrenia do not receive treatment with clozapine, despite its clearly established efficacy in this indication. The constraints associated with haematological monitoring are a major obstacle to clozapine use, resulting in a real loss of opportunity for the people concerned.</div></div><div><h3>Objective</h3><div>The aim of this opinion article is to question the relevance of maintaining the existing haematological monitoring rules for clozapine treatment.</div></div><div><h3>Discussion</h3><div>Recent studies on the temporal evolution of agranulocytosis risk attributable to clozapine confirm that this risk becomes negligible after one to two years of treatment. Stringent haematological monitoring leads to unjustified discontinuation of clozapine, as transient neutropenic episodes, which may be linked to other causes are common in the general population. Haematological monitoring requires nursing time and sometimes complex organisational adaptations in outpatient facilities to ensure continuity of care, particularly at a time when medical and paramedical staffing levels are low. Haematological monitoring has already been reduced or suspended in several countries after the period of risk of agranulocytosis.</div></div><div><h3>Conclusion</h3><div>The benefit/risk ratio of maintaining strict haematological monitoring rules for clozapine appears unfavourable, suggesting that the time may have come to reduce the risk of agranulocytosis.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 830-834"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering human faces with artificial intelligence for healthcare","authors":"Antitza Dantcheva","doi":"10.1016/j.amp.2024.09.011","DOIUrl":"10.1016/j.amp.2024.09.011","url":null,"abstract":"<div><h3>Context</h3><div>At a time of a rapid growth in the population of elderly individuals and at a time of decreased/pressed availability of human healthcare-resources, automated face analysis has the potential to offer efficient and cost-effective methods for monitoring of a number of pathologies.</div></div><div><h3>Objectives</h3><div>The author revisits works in automated face analysis, which have focused on designing computer vision algorithms deducing the health state of individuals. Current limitations and benefits are discussed, placing emphasis on the potential that such technology can bring.</div></div><div><h3>Methods</h3><div>Computer vision algorithms, most recently based on deep neural networks have been trained with facial images or videos, jointly with health state annotations from clinical experts, in order to learn such algorithms to deduce facets of health states. Examples of such notable algorithms include approaches detecting stress, depression, apathy, pain, neurological disorder, as well as classification of expressions and phenotypes of genetic disorders.</div></div><div><h3>Conclusions</h3><div>Such algorithms are evolving rapidly, providing increasingly reliable accuracy and can support clinicians by providing objective measures.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 882-884"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659384","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":"Société Médico-Psychologique : séance du lundi 24 avril 2024","authors":"","doi":"10.1016/j.amp.2024.09.012","DOIUrl":"10.1016/j.amp.2024.09.012","url":null,"abstract":"","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Page 835"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659534","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":"Psychose et suicide : comment se développent-ils conjointement ? Une revue narrative","authors":"Roxanne Sicotte ,&nbsp;Amal Abdel-Baki ,&nbsp;Jean R. Séguin ,&nbsp;Srividya N. Iyer","doi":"10.1016/j.amp.2024.04.011","DOIUrl":"10.1016/j.amp.2024.04.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Persons with psychosis are up to 20 times more likely to die by suicide than the general population. Nevertheless, the mechanisms underlying the association between psychosis and suicide remain poorly understood. This narrative review aimed to describe the mechanisms that have been explored in the literature to explain this association.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;A narrative review was conducted in Pubmed and Google Scholar in January 2024 using keywords related to psychosis and suicide. The keywords used for psychosis were: “psychosis”, “psychotic”, “psychotic symptoms”, “psychotic experiences”, “psychotic-like experiences”, “delusions”, “hallucinations”; and for suicide: “suicid*”. Additional keywords were used in Google Scholar to refine the search: “association” OR “mechanisms” OR “pathways” OR “risk factors”. References of selected articles were consulted. The results of the studies have been organized according to the four hypothesized mechanisms explored in the literature.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The four hypotheses explored in the literature were: (1) causal link from psychosis to suicidality, (2) causal link from suicidality to psychosis or bidirectional link, (3) shared risk factors for psychosis and suicidality, (4) indirect link between psychosis and suicidality. In general, studies show that across the continuum of psychosis (from psychotic experiences to schizophrenia spectrum disorders), psychosis symptoms, especially auditory hallucinations and delusions, increase the risk of suicide thoughts and behaviors. Certain factors emerged as being particularly important in understanding the association between psychosis and suicide, whether as confounders or mediators, such as cognitive skills, traumatic events, psychological distress, depressive symptoms and substance use disorder. Recent evidence seems to support the existence of a bidirectional association between psychosis and suicide risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion and conclusion&lt;/h3&gt;&lt;div&gt;Each hypothesis has been explored and supported by at least a few studies, suggesting that the mechanisms underlying the association between psychosis and suicide are potentially multiple and multifactorial. Identifying persons at risk of psychosis among those presenting suicidal thoughts and behaviors, as well as implementing early suicide prevention strategies among persons with psychosis symptoms, could respectively contribute to delaying/preventing the frank onset of a mental health disorder and reduce the risk of suicide. Further, suicide risk assessment and prevention in individuals with psychosis should take into account factors that have emerged as being important in the association between these two phenomena. In order to improve our understanding of the association between psychosis and suicide risk, several recommendations have been made for future research, such as considering the developmental stage and the stage of ","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 772-778"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historique du syndrome de Capgras – est-il une forme naturelle ?","authors":"Jean-Pierre Luauté","doi":"10.1016/j.amp.2024.07.009","DOIUrl":"10.1016/j.amp.2024.07.009","url":null,"abstract":"<div><div>Joseph Capgras (1873–1950) and his pupils described between 1923 and 1924 the 3 first cases of a phenomenon that they called “Illusion des sosies” and quickly designated as Capgras’ syndrome (CS). The 1923 princeps case defined the phenomenon as coming from the impossibility for the patient to have access to the identity of a person and, because the resemblance was preserved, to declare that she dealt with a “sosie” (a double). The explanation was limited to the conjecture that there existed a different emotional factor between the memory image and the actual perception. The 2 following cases were more oriented towards the, then booming, psychodynamic explanations which lead in case 3, where the aetiology was organic, to misunderstand its interest. Afterwards, the syndrome which has been early known in the UK, its second chosen homeland will be the object, from psychologists specialists of face recognition studies, of unitarian explanations in the frame of a Cognitive neuropsychiatry. This approach is challenged in the name of a discontinuity between psychiatric and organic cases by supporters of a “regional epistemology” peculiar to psychiatry. A reflection about terminology concludes, in agreement with the concept of syndrome, that CS is both a natural and a practical kind.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 855-861"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659541","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":"Oméga-3 et psychiatrie : que dit la littérature ?","authors":"Ariel Frajerman","doi":"10.1016/j.amp.2024.08.015","DOIUrl":"10.1016/j.amp.2024.08.015","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Psychiatry is faced with a lack of new treatments despite a great deal of research and is re-exploring the use of old molecules and dietary supplements. Our aim here is to present a narrative review of the indications for omega-3 supplementation in various psychiatric disorders. Omega-3s belong to the family of polyunsaturated fatty acids (PUFAs). The 3 important omega-3 PUFAs in psychiatry are α-linolenic acid (ALA): C18:3n-3, eicosapentaenoic acid (EPA) C20:5n-3 and docosahexaenoic acid (DHA) C22:6n-3. In psychosis, a distinction must be made between 3 categories of patients: patients who have chronic schizophrenia (SCZ), patients with a first psychotic episode (FEP) and patients at ultra-high risk of psychosis (UHR).&lt;/div&gt;&lt;div&gt;The data in the literature indicate that omega-3 supplementation is well tolerated. However, there is an increased risk of atrial fibrillation at doses over 4&lt;!--&gt; &lt;!--&gt;g/d, mainly in people over the age of 65.&lt;/div&gt;&lt;div&gt;Omega-3 supplementation is not recommended for eating disorders, attention deficit hyperactivity disorder or autism spectrum disorders. Omega-3 supplementation could be beneficial in borderline personality disorder and psychotic disorders, particularly in patients at ultra-high risk of psychotic transition (UHR) to prevent psychotic transition and FEP to improve remission, and in bipolar disorder. It is now recommended for unipolar depression by the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. There are a large number of clinical trials of omega-3 supplementation. However, these trials use different types of supplementation (EPA alone, DHA alone, EPA&lt;!--&gt; &lt;!--&gt;+&lt;!--&gt; &lt;!--&gt;DHA, etc.) with different dosages and EPA/DHA ratios and over variable durations. In addition, the origin of the omega-3s may vary, although most of the studies used omega-3s of marine origin (fish). Finally, it has not been studied whether the time of day (fasting, during a meal, morning, evening, etc.) impacts the efficacy of the treatment.&lt;/div&gt;&lt;div&gt;Confounding factors are often not taken into account. For example, some studies suggest a link between the response to omega-3 supplementation and the inflammation or oxidative stress level. Omega-3 supplementation acts on numerous biological pathways: inflammation, oxidative stress, monocarbon metabolism (vitamin B9, B12, homocysteine), myelination,... For psychotic disorders, meta-analyses tend not to distinguish between UHR, PEP and schizophrenic patients.&lt;/div&gt;&lt;div&gt;There have not been enough studies to validate the doses and duration of supplementation. The doses and durations in the recommendations are based solely on incomplete data from published studies. Further studies are needed to optimize these recommendations. Except for UHR patients and those with borderline personality disorder, omega-3 supplementation is always used as a complement to psychotropic treatment.&lt;/div&gt;&lt;div&gt;I","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 799-805"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659540","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":"Cognitive and Computational Accounts of Delusions: Problems and Progress","authors":"Jessica Niamh Harding ,&nbsp;Paul Charles Fletcher","doi":"10.1016/j.amp.2024.09.017","DOIUrl":"10.1016/j.amp.2024.09.017","url":null,"abstract":"<div><div>We discuss the evolution of a computational model of delusions, beginning with a background consideration of how computational psychiatry, with its roots firmly based in cognitive neuropsychiatry, seeks to develop descriptive and mechanistic models that reach across different levels of explanation in order to provide more comprehensive understanding of how neurobiological, cognitive, subjective and sociocultural factors may all contribute to complex psychopathology. This quest for bridging explanations – or “consilience” – across the levels is a shared goal of computational psychiatry and cognitive neuropsychiatry and is, we argue, crucial to explaining delusional beliefs. We outline how early computational models appealed to prediction error disturbances as a basis for understanding the early emergence of delusions and show that, despite empirical support, there have been certain explanatory limitations that make a simple prediction error account partially limited. Embedding the account within the increasingly influential hierarchical predictive processing framework subsequently offered a more powerful and comprehensive account, particularly by encouraging the consideration hierarchically-organized inference and its evolution over time. However, further limitations remain in its explanatory scope, most notably the fact that delusions can emerge rapidly and suddenly in a way that seems revelatory and convincing. This phenomenon is not easily encompassed by the standard predictive processing account which emphasizes an iterative process of optimizing inference. However, more recent development in the form of “Hybrid Predictive Coding” posits a complementary rapid inference mechanism. We discuss how this hybrid approach may be key to a more comprehensive computational understanding of delusions.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 893-898"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating STC-1 and STC-2 mRNA expressions in Schizophrenia patients with increased oxidative stress","authors":"Sevgi Karabulut Uzunçakmak ,&nbsp;Halil Özcan ,&nbsp;Ebubekir Dirican ,&nbsp;Ayşegül Tavacı Özçelik","doi":"10.1016/j.amp.2023.02.005","DOIUrl":"10.1016/j.amp.2023.02.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Schizophrenia is a chronic psychiatric disorder characterized by cognitive impairment. Oxidative stress is associated with disease progression in patients with schizophrenia. Stanniocalcin (STC)-1 and STC-2 are two proteins commonly expressed in mammals belonging to the stanniocalcin family and they are involved in oxidative stress. The aim of this study is to investigate STC-1 and STC-2 mRNA expressions in schizophrenia patients with altered oxidative stress parameters.</div></div><div><h3>Methods</h3><div>For this purpose, 70 patients with schizophrenia and 40 healthy individuals were recruited for the study. Peripheral blood samples were obtained from all participants. Glutathione (GSH) activities, superoxide dismutase (SOD) activities, and malondialdehyde (MDA) levels were measured. STC-1 and STC-2 expressions were assessed by real-time polymerase chain reactions.</div></div><div><h3>Results</h3><div><span>SOD activity levels were lower in patients than in healthy individuals (p</span> <!-->=<!--> <!-->0.0309), while the patients’ MDA levels were higher (p<!--> <!-->=<!--> <!-->0.039). STC-1 and STC-2 expressions were lower in patients than in healthy individuals (p<!--> <!-->=<!--> <!-->0.1049 and p<!--> <!-->&lt;<!--> <!-->0.0001, respectively). Furthermore, these two genes had a positive correlation among the patients (r<!--> <!-->=<!--> <!-->0.435, p<!--> <!-->=<!--> <!-->0.0025). According to area under the curve (AUC) values, STC-2 (AUC<!--> <!-->=<!--> <!-->0.8332, p<!--> <!-->&lt;<!--> <!-->0.0001) had better diagnostic power than STC-1 (AUC<!--> <!-->=<!--> <!-->0.6167, p<!--> <!-->=<!--> <!-->0.1037).</div></div><div><h3>Conclusions</h3><div>The expression of stanniocalcins in schizophrenia was investigated here for the first time. Decreased STC-2 expression in patients with schizophrenia with increased oxidative stress parameters may guide the understanding of the pathophysiological mechanisms caused by oxidative stress, which may be increased in cognitive diseases such as schizophrenia, and it also has the potential to be a prognostic factor that can be used in the diagnosis of schizophrenia.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 785-790"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79640815","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":"Propos introductifs. Capgras et démence à corps de Lewy","authors":"Bruno Dubois","doi":"10.1016/j.amp.2024.09.014","DOIUrl":"10.1016/j.amp.2024.09.014","url":null,"abstract":"","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 867-868"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659382","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":"Le délire est-il un récit ? Une approche narrative de la psychose","authors":"Florent Poupart,&nbsp;Bastien Laigle","doi":"10.1016/j.amp.2023.03.001","DOIUrl":"10.1016/j.amp.2023.03.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Delusion is one of the emblematic symptoms of psychiatry. However, it remains one of the great enigmas of psychopathology. Contemporary psychiatry has not resolved the paradox of delusion: it is incorrigible as a belief, but inconsequential as an imaginary fiction. In this study, the authors consider the extent to which the paradigm of narrativity can inform the understanding of delusion and psychotic experience.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The authors introduce the concept of narrativity, according to the work of French philosopher Paul Ricœur in the 1980s and 1990s. Based on these notions, they propose to identify the psychic functions of storytelling. They discuss the rationale for approaching delusional discourse as a narrative, drawing on the phenomenological and psychoanalytical literature on psychosis and delusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Phenomenologists emphasize that delusion is a translation: it is the expression, in everyday language, of ideas and emotions, of a deformation of the structure of lived space and lived time. But delusion is not a metaphor, since it is associated with conviction. Psychoanalytical literature describes a “work of delusion”: The delusional process seeks to contain and reduce the experience of loss of meaning which is specific to emerging psychosis. Delusional narrative renders the psychotic experience bearable and shareable. It has certain points in common with narrative: it produces sense and organizes the experience of the passing of time. But delusional narrative attests to the failures of narrativity, since it lacks the distance between narrator and narrative. Delusion is a paradoxical form of discourse, both metaphorical (as an attempt to represent the lived experience, it doesn’t claim to describe objective reality) and non-metaphorical (as a part of experience itself, it does claim to describe it). Delusional narrative is not the result of the symbolization process, but it replaces it, which explains its paradoxical nature. Finally, the authors propose to consider delusional narrative as an individual myth: Delusion has the same function as myths in collective psychology. It provides answers to questions about the origins and meaning of life and organizes chaos. Delusional narrative is a matrix of symbolization, in the same way that primal phantasies, complexes, family romance, and childhood sexual theories are.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The issue of considering delusion as a narrative must be addressed carefully: Narrativity provides a better understanding of the psychotic experience, but delusion cannot be reduced to a narrative. This approach suggests scientific and clinical perspectives, which involve the development of a framework for collecting delusional narratives from people with delusional disorders and analyzing them based on the issues of narrativity. This should lead to a better understanding of the psychological status of d","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"182 9","pages":"Pages 779-784"},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83294822","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}