{"title":"Association between methylmalonic acid and prevalence of depression in US adults: evidence from NHANES 2011-2014.","authors":"Siqi Li, Wenbin Nan, Zhenyu Peng, Qiong Huang, Qiong Chen, Baimei He","doi":"10.1080/20008066.2025.2450109","DOIUrl":"10.1080/20008066.2025.2450109","url":null,"abstract":"<p><p><b>Background</b>: Depression is a prevalent mental disorder with high morbidity and mortality globally. Methylmalonic acid (MMA) is involved in the pathogenesis of numerous diseases. However, it is unclear whether there is an association between MMA and the prevalence of depression.<b>Methods</b>: This study enrolled 7866 US adults from the 2011-2014 survey of the National Health and Nutrition Examination Survey (NHANES). Individuals were categorized into depression group and non-depression group based on Patient's Health Questionnaire-9 (PHQ-9) score. The association between MMA concentrations and prevalence of depression was analysed by multivariate logistic and linear regression, restricted cubic spline regression, and subgroup analysis. Mediation analysis was used to explore the role of inflammation in the relationship between MMA and depression.<b>Results</b>: MMA concentrations were higher in participants with depression than those without depression. There was a positive and linear relationship of MMA concentrations with PHQ-9 score and depression risk, respectively. Moreover, the association was stable in most subgroups. Furthermore, inflammatory factors were positively correlated to MMA concentrations and prevalence of depression. In addition, white blood cell, neutrophil and alkaline phosphatase (ALP) mediated the relationship between MMA and depression.<b>Conclusion:</b> Our findings revealed that there was a linear and positive correlation between MMA and the prevalence of depression in US adults, which might be mediated by inflammation.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2450109"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eirini Aikaterini Melegkovits, Ava Mason, Jordan Reid, Hind Akooly, Paul Jung, Michael Bloomfield
{"title":"Dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma: a qualitative study.","authors":"Eirini Aikaterini Melegkovits, Ava Mason, Jordan Reid, Hind Akooly, Paul Jung, Michael Bloomfield","doi":"10.1080/20008066.2025.2472473","DOIUrl":"10.1080/20008066.2025.2472473","url":null,"abstract":"<p><p><b>Background:</b> Among individuals with psychotic experiences, those with a history of developmental trauma face greater symptom severity and worse clinical outcomes compared to those without. Dissociation constitutes a prominent, characteristic of this group's clinical presentation, whose nuances and associated characteristics remain however understudied in psychosis research. We aimed to address this gap by conducting a qualitative study to investigate the phenomenology, context, and impact of dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma.<b>Methods:</b> 25 UK-based participants with a history of developmental trauma and meeting criteria for subclinical psychosis, based on the CAPE-15, were recruited via social media. Participants attended semi-structured interviews online, which were transcribed verbatim and analysed with thematic analysis by two researchers.<b>Results:</b> Thematic analysis yielded the following themes: (1) Phenomenology of Dissociation; (2) Context of Dissociation; (3) Impact of Dissociation; (4) Dissociation and Psychotic-like Phenomena. Participants described experiences of detachment and compartmentalisation, which when experienced were confusing and often distressing. Dissociation was linked to affective experiences, their history of developmental trauma and psychotic-like experiences.<b>Conclusion:</b> This study elucidates the complex and varied nature of dissociative experiences in individuals with subclinical psychosis with a history of developmental trauma. These findings highlight the need for further research to understand the manifestation of dissociation in this population and the links with distress and other aspects of psychopathology. Importantly, it is essential to use this understanding to inform the development of interventions and improve clinical recognition and management.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2472473"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of prenatal stress and maternal trauma responses in predicting children's mental health during war.","authors":"Karen Yirmiya, Amit Klein, Shir Atzil, Noa Yakirevich-Amir, Rena Bina, Inbal Reuveni","doi":"10.1080/20008066.2025.2468542","DOIUrl":"10.1080/20008066.2025.2468542","url":null,"abstract":"<p><p><b>Background:</b> The negative effects of prenatal stress on children's development and the buffering effects of maternal behaviour are well documented. However, specific maternal responses to trauma, particularly among families experiencing cumulative stressors during pregnancy and early childhood, remain less understood.<b>Objective:</b> This study investigated the interplay between prenatal stress in the context of the coronavirus disease 2019 (COVID-19) pandemic and consequent maternal trauma responses and children's difficulties in the context of war-related trauma.<b>Methods:</b> We recruited 318 pregnant women in Israel during the first wave of the COVID-19 pandemic (Time 1). Prenatal depression, anxiety, and COVID-related stress symptoms were assessed. When children were approximately 3.5 years old (<i>SD</i> = 0.02), the mothers were asked to report on parental responses related to the ongoing war and their child's emotional and behavioural difficulties (Time 2). Structural equation modelling was used to examine how maternal trauma responses mediate the association between prenatal stress-related mental health symptoms and children's difficulties during war.<b>Results:</b> Maternal prenatal depressive, anxious, and COVID-19-related stress symptoms predicted maladaptive maternal trauma responses during the war, which in turn were associated with increased emotional and behavioural problems in their children. Among the specific maternal trauma-related responses examined, cognitive avoidance and overprotectiveness were the only behavioural responses during the war significantly associated with children's difficulties.<b>Conclusions:</b> Our study highlights the impact of pandemic-related prenatal stress on maternal responses and children's difficulties during war, emphasizing the importance of identifying at-risk families as well as developing targeted interventions that mitigate negative parenting responses, particularly avoidance and overprotection.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2468542"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victoria Williamson, Dominic Murphy, Danielle Lamb, Radha Kothari, Derek Tracy, Neil Greenberg
{"title":"Experiences and impact of moral injury in prisons.","authors":"Victoria Williamson, Dominic Murphy, Danielle Lamb, Radha Kothari, Derek Tracy, Neil Greenberg","doi":"10.1080/20008066.2024.2445899","DOIUrl":"10.1080/20008066.2024.2445899","url":null,"abstract":"<p><p>Moral injury is the persistent mental or emotional distress resulting from events that challenge one's moral beliefs. It is characterised by intense shame, guilt, worthlessness, disgust or anger and can contribute towards the development of serious mental disorders. The nature of working in prisons means that staff often face physically and psychologically challenging scenarios, and prison staff report high rates of mental ill-health and suicidal thoughts. Equally, detainees may be especially vulnerable to moral injury-related mental health difficulties having engaged in illicit actions and been found guilty by a jury of their peers as well as, in high profile cases, the court of public opinion. Despite this, there is an evidence gap about the extent of moral injury in both prison staff and detainee populations, and about how prison staff/detainees can be better supported. How struggling with moral injury may be linked to reoffending amongst detainees and burnout or resignations in prisons staff is currently unknown. In resource strapped prison settings, emerging treatments for moral injury-related mental health difficulties are unlikely to be appropriate or feasible. In this article, we highlight the contexts in which moral injury may arise; the unique challenges to treatment and support for moral injury in prison settings; and offer targeted recommendations for future research and clinical practice.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2445899"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martina Mesce, Filippo Maria Nimbi, Piercarlo Sarzi-Puttini, Carlo Lai, Federica Galli
{"title":"Towards a better definition of nociplastic pain conditions: a psychological grounded study on fibromyalgia, chronic headache and vulvodynia.","authors":"Martina Mesce, Filippo Maria Nimbi, Piercarlo Sarzi-Puttini, Carlo Lai, Federica Galli","doi":"10.1080/20008066.2025.2461434","DOIUrl":"10.1080/20008066.2025.2461434","url":null,"abstract":"<p><p><b>Background:</b> This study investigates the psychological underpinnings of chronic pain conditions, specifically fibromyalgia, chronic headache, vulvodynia, and mixed condition (consisting of fibromyalgia in comorbidity with chronic headache and/or vulvodynia), with a focus on nociplastic pain mechanisms.<b>Objective:</b> The aim of the study is to better understand the psychological functioning of women with different chronic pain conditions to identify and discuss similarities and differences. In particular, we aim to explore any significant differences in the domain of traumatic experiences, in global defensive functioning, and in the domain of alexithymia among the evaluated groups. Further, the 4 groups with chronic pain will be compared with a healthy control group.<b>Methods:</b> A sample of 1006 Italian women diagnosed with chronic pain participated in the study, categorized into four clinical groups and a healthy control group. Measures were assessed using self-report measures, in particular: Traumatic Experiences Checklist, Defense Mechanism Rating Scales, and Toronto Alexithymia Scale.<b>Results:</b> There are significant differences among groups, with mixed conditions exhibiting the highest levels of traumatic experiences, particularly emotional neglect and physical threats. Fibromyalgia and mixed condition groups displayed greater reliance on neurotic defense mechanisms. Additionally, fibromyalgia and mixed condition participants exhibited higher levels of alexithymia, indicating difficulties in emotional processing.<b>Conclusions:</b> These findings underscore the complex interplay between psychological factors and nociplastic pain conditions, emphasizing the importance of personalized psychological interventions in managing nociplastic pain. The study highlights the need for multidisciplinary approaches to nociplastic pain treatment, considering the diverse psychological profiles of affected individuals.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2461434"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Self-compassion, self-coldness, and social support and their relationship with depression, anxiety, and PTSD symptoms following a massive terror attack: a prospective study.","authors":"Efrat Barel, Lubna Tannous-Haddad, Orna Tzischinsky","doi":"10.1080/20008066.2025.2461948","DOIUrl":"10.1080/20008066.2025.2461948","url":null,"abstract":"<p><p><b>Background:</b> On 7 October 2023, Israel suffered a massive deadly terror attack with 1400 civilians murdered and 240 kidnapped. Recent studies have documented an increase in depression, anxiety, and posttraumatic symptoms in the aftermath of the attack. In the area of trauma, it has been shown that while some individuals are vulnerable to developing psychopathology following exposure to a traumatic event, the majority are not.<b>Objective:</b> In the present prospective study, we examined the contributions of internal (self-compassion and self-coldness) and external (social support) resources to depression, anxiety, and posttraumatic symptoms among civilians following a massive terror attack.<b>Method:</b> A total of 250 participants - 126 females (50.4%) and 124 males (49.6%); 156 Jews (62.4%) and 94 Arabs (37.6%) - aged 21-60 (<i>M</i> = 41.7, <i>SD</i> = 10.63) completed questionnaires at two time points: T1 was in September 2023 (3-4 weeks before the attack) and T2 was in February-March 2024 (19-20 weeks after the attack). Participants were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Self-Compassion Scale - Short Form (SCS-SF)<b>,</b> Depression, Anxiety, and Stress Scale-21 Items (DASS-21), and International Trauma Questionnaire (ITQ).<b>Results:</b> Self-compassion and social support were negatively associated with depression and anxiety, while self-coldness was positively associated with depression and anxiety. In addition, self-coldness uniquely contributed to the prediction of psychopathological outcomes, including the sense of threat symptoms cluster of posttraumatic stress disorder, beyond known risk factors.<b>Conclusions:</b> Our study highlights the role of self-coldness as a vulnerability factor for civilians following a terror attack. It is important to view the distinct facets of self-compassion as a therapeutic target when building both intervention and prevention programs for people exposed directly and indirectly to trauma.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2461948"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karl J Weinreich, Iryna Frankova, Natalie Maksymets, Corrado Barbui, Vitalii Klymchuk, Trudy Mooren, Emilia Olechno, Marianna Purgato, Marit Sijbrandij, Anke B Witteveen, Els van der Ven
{"title":"Implementing scalable face-to-face and digital interventions among forcibly displaced persons from Ukraine in Europe: protocol of The U-RISE Project.","authors":"Karl J Weinreich, Iryna Frankova, Natalie Maksymets, Corrado Barbui, Vitalii Klymchuk, Trudy Mooren, Emilia Olechno, Marianna Purgato, Marit Sijbrandij, Anke B Witteveen, Els van der Ven","doi":"10.1080/20008066.2025.2468117","DOIUrl":"10.1080/20008066.2025.2468117","url":null,"abstract":"<p><p><b>Background</b>: The full-scale Russian invasion of Ukraine on 24 February 2022 has led to millions of forcibly displaced persons (FDPs) within Ukraine and other European countries. Due to war-related exposure and displacement adversities, this group is at significant risk of developing depression, anxiety, post-traumatic stress disorder, and other mental health problems. Systemic barriers, including insufficiently equipped mental health systems and language barriers, prevent FDPs from receiving adequate mental health and psychosocial support (MHPSS). Scalable interventions delivered in person by non-specialist helpers, or digitally, provide opportunities to scale up the MHPSS response.<b>Objectives</b>: This paper aims to provide an overview of the 'Ukraine's displaced people in the EU: Reach out, Implement, Scale-up and Evaluate interventions promoting mental wellbeing' (U-RISE) project. U-RISE aims to improve the mental wellbeing of FDPs from Ukraine by establishing a network of Ukrainian mental health professionals, building sustainable capacity for provision and supporting implementation of scalable face-to-face and digital mental health interventions adapted to the specific needs of this population.<b>Method:</b> We build capacity for and implement scalable face-to-face interventions, including Problem Management Plus, Self Help Plus, and Multi-family Approach, for FDPs from Ukraine in Poland, Slovakia and Romania. Digital interventions, including the Doing What Matters in Times of Stress digital guide and a Telegram-based chatbot 'Friend' using principles of Psychological First Aid, are being implemented in Europe and Ukraine. To monitor the population's mental wellbeing and impact of the interventions, qualitative needs assessments among mental health providers and FDPs, and quantitative assessments pre- and post-intervention are collected.<b>Conclusion</b>: We provide a framework for the rapid implementation of face-to-face and digital interventions in countries that need to scale up their MHPSS in response to humanitarian or complex emergency crises.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2468117"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"'We're all in this together': the protective role of belongingness in the contribution of moral injury to mental health among participants in Israel's civil protest movement.","authors":"Yossi Levi-Belz, Yoav Groweiss, Iris Shachar Lavie, Yael Shoval Zuckerman, Carmel Blank","doi":"10.1080/20008066.2025.2474374","DOIUrl":"10.1080/20008066.2025.2474374","url":null,"abstract":"<p><p><b>Background:</b> Participating in long-term protests against government actions can affect protesters' mental health and expose protesters to potentially morally injurious events (PMIEs), such as the betrayal by leaders they once trusted. This study aimed to shed light on the potential psychological buffers against the deleterious effects of exposure to PMIEs of betrayal among protesters and to examine the moderating role of belongingness in the relationships between protesters' exposure to PMIEs and stress, PTSD and depression levels.<b>Method:</b> The study sample comprised 4036 Israeli protesters (<i>M</i><sub>age </sub>= 54.27, <i>SD </i>= 12.45; 75.6% females) who took part in the unfolding civil protest movement against the government-led judicial and constitutional overhaul between January 2023 and August 2023. Protesters completed validated self-report questionnaires that included measures of PMIEs, stress, depressive and PTSD symptoms (PTSS).<b>Results:</b> Beyond demographic and protest-related characteristics, exposure to PMIEs of betrayal was found to contribute to both PTSD and depression levels. The indirect effects of PMIE-betrayal on PTSS/depressive symptoms through stress levels were significant, particularly when belongingness levels were low. Thus, a greater sense of PMIE-betrayal contributes to stress symptoms, which, in turn, is linked to higher levels of PTSS and depressive symptoms for protesters having low levels of belongingness.<b>Conclusions:</b> The study's findings highlight the critical contribution of PMIE-betrayal to both PTSS and depression levels, which were mediated by levels of stress. Moreover, experiencing belongingness moderated these relationships. Clinicians treating protesters coping with PTSS and depressive symptoms should also adopt therapeutic aims of establishing belongingness and social support among the protesters.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2474374"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer
{"title":"Engaging Ukrainian TF-CBT therapists in a PRACTICE skills course to support their wellbeing.","authors":"Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer","doi":"10.1080/20008066.2025.2476898","DOIUrl":"https://doi.org/10.1080/20008066.2025.2476898","url":null,"abstract":"<p><p><b>Background:</b> Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.<b>Objective:</b> The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of war in Ukraine. Specifically, this study examined if course participation was associated with increased PRACTICE coping skills usage, decreased burnout and STS, increased feelings of TF-CBT competency/confidence, and increased empathy for clients' experiences when implementing the skills.<b>Method:</b> The eight-session virtual course included cultural adaptations to increase its compatibility with Ukrainian culture. Thirteen matched pre-post course surveys were analysed to provide preliminary data on the course's effect on PRACTICE coping skills usage, burnout, and STS. The course's impact on therapist coping/wellbeing, TF-CBT competency/confidence, and empathy for clients was also examined qualitatively.<b>Results:</b> PRACTICE coping skills were utilized significantly more frequently at post-course compared to pre-course (<i>p</i> = .010). Therapists also reported lower average scores for burnout and STS after course completion, though these changes were not statistically significant. Most participants (92.3%) reported professional benefits from course participation including increased competency/confidence and empathy for clients. All therapists (100%) reported personal benefits from course participation including increased use of coping skills.<b>Conclusions:</b> Results indicate that participants experienced professional and personal benefits from course completion. This study provides helpful preliminary evidence of a positive impact, however, given the small sample size, larger scale implementation is needed.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2476898"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709244","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}