Journal of affective disorders最新文献

{"title":"A plasma proteome-mediated Mendelian randomization study reveals the impact of rheumatoid arthritis on mental disorders in a European population.","authors":"Jiachen Wang, Guoqiang Wang, Shuang Han, Ruoyang Feng, Junxiang Wang, Mingyi Yang, Ke Xu, Peng Xu, Jing Li","doi":"10.1016/j.jad.2025.119804","DOIUrl":"https://doi.org/10.1016/j.jad.2025.119804","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the potential mediating role of the plasma proteome in the association between rheumatoid arthritis (RA) and mental disorders.</p><p><strong>Methods: </strong>A two-sample, two-step mediation Mendelian randomization (MR) approach was used to investigate the causal relationship between RA and mental disorders and the role of plasma proteins in these associations. Sensitivity analyses were conducted to validate the MR results.</p><p><strong>Results: </strong>Through MR analysis, we identified associations between RA subtypes (seropositive RA [SPRA] and seronegative RA [SNRA]) and various mental disorders, including bipolar disorder (BD), anxiety disorder (AD), and hoarding disorder (HD). Significant positive correlations were observed between RA and AD (odds ratio [OR]: 1.1547; P = 0.0304), SPRA and HD (OR: 1.0138; P = 0.0464), and SNRA and BD (OR: 1.0530; P = 0.0382). Protein association analysis identified 167, 71, and 95 plasma proteins significantly associated with BD, AD, and HD, respectively. After sensitivity testing and false discovery rate (FDR) correction, 15 proteins were significantly associated with BD. Mediation analysis indicated that EF-hand calcium-binding domain-containing protein 14 (EFCAB14) played a major mediating role in the pathway between SNRA and BD, accounting for 45.8 % of the effect followed by Cadherin-related family member 1 (CDHR1), which accounted for 23.2 %.</p><p><strong>Conclusion: </strong>This study highlighted the significant role of RA in mental disorder development, with plasma proteins partially mediating this effect and lays the groundwork for future diagnostic biomarkers and intervention strategies.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119804"},"PeriodicalIF":4.9,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dietary patterns, sleep disturbance and stroke: A large cross-sectional study in US adults","authors":"Kai Su ,&nbsp;Yuwei Dai ,&nbsp;Tianxiang Yuan ,&nbsp;Qing Yin ,&nbsp;Dan Wang ,&nbsp;Li Yang","doi":"10.1016/j.jad.2025.119806","DOIUrl":"10.1016/j.jad.2025.119806","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbance and stroke are closely linked to dietary patterns. But how nutritional patterns modulate the bidirectional relationship between sleep disturbance and stroke incidence remains to be investigated. This epidemiological investigation seeks to the tripartite associations among dietary patterns, sleep disturbance, and stroke of adults in united states.</div></div><div><h3>Methods</h3><div>Our analysis included participants from the NHANES repositor during the 2005–2018 surveillance period. Healthy Eating Index (HEI)-2020 score, Alternate Mediterranean Diet Score (MED), and Dietary Approaches to Stop Hypertension Index (DASH) are three quantified scores, which rely on dietary data. To assess the relationships among dietary patterns, sleep disturbance, and stroke risk, we employed linear regression models, restricted cubic spline (RCS) analysis, mediation analyses, and weighted quartile sum (WQS) methods.</div></div><div><h3>Results</h3><div>The findings of this study demonstrated that participants afflicted with stroke and/or sleep disturbance exhibited lower diet scores for three distinct dietary patterns when compared with those not experiencing stroke or sleep disturbance. Furthermore, the use of RCS models revealed a negative linear exposure-response gradient of diet quality scores in the odds of sleep disturbance and stroke. The WQS regression also demonstrated a beneficial impact of dietary composition on sleep disturbance and stroke, with high-quality protein, fish, nuts and fiber being the food groups that contributed most significantly to health across different dietary indices.</div></div><div><h3>Conclusion</h3><div>Whichever dietary pattern is referred, low-quality diets are linked with a high odds of sleep disturbance and stroke. Changes in dietary composition are necessary to prevent sleep disturbance and stroke.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119806"},"PeriodicalIF":4.9,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex brain networks mediation of neuroticism and extraversion on obsessive-compulsive disorder","authors":"Binxin Huang ,&nbsp;Jiayue Cheng ,&nbsp;Jian Gao ,&nbsp;Yang Wang ,&nbsp;Chaoyi Wu ,&nbsp;Hanyang Ruan ,&nbsp;Puyu Li ,&nbsp;Huiqin Han ,&nbsp;Zhen Wang","doi":"10.1016/j.jad.2025.119795","DOIUrl":"10.1016/j.jad.2025.119795","url":null,"abstract":"<div><h3>Background</h3><div>Personality traits significantly influence obsessive-compulsive disorder (OCD), yet their underlying neural mechanisms remain poorly defined. This study aimed to identify complex brain networks that mediate the association between personality traits and OCD, offering novel insights for personalized interventions.</div></div><div><h3>Methods</h3><div>We recruited 211 OCD patients who underwent clinical evaluations and rs-EEG recordings. Personality traits were measured using the Revised NEO-Five Factor Inventory, and OCD severity was assessed with the Yale-Brown Obsessive-Compulsive Scale by clinicians. Complex brain networks were analyzed using minimum spanning tree. Machine learning and mediation analyses validated relationships between personality traits, complex brain networks, and OCD.</div></div><div><h3>Results</h3><div>Neuroticism positively correlated, and extraversion negatively correlated with OCD. Delta and theta bands complex brain networks (diameter, mean eccentricity, leaf fraction, kappa) significantly associated with OCD. Theta diameter partially mediated associations between both neuroticism and extraversion with OCD, whereas theta mean eccentricity partially mediated the relationship specifically between extraversion and OCD.</div></div><div><h3>Conclusions</h3><div>Our findings highlight distinct theta diameter as neural mediators linking neuroticism and extraversion to OCD. These results suggest theta band focused neuromodulation as a potential therapeutic strategy tailored to individual personality profiles.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119795"},"PeriodicalIF":4.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Enhancing suicide risk models: Methodological and contextual considerations","authors":"Baochun Ren","doi":"10.1016/j.jad.2025.119797","DOIUrl":"10.1016/j.jad.2025.119797","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119797"},"PeriodicalIF":4.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of self-stigma on empowerment in major depressive disorder: The mediating role of self-esteem and the moderating effects of socioeconomic and cultural context in an international multi-site study","authors":"Antonio Lasalvia ,&nbsp;Chiara Bonetto ,&nbsp;Tine Van Bortel ,&nbsp;Doriana Cristofalo ,&nbsp;Evelien Brouwers ,&nbsp;Mariangela Lanfredi ,&nbsp;Jaap van Weeghel ,&nbsp;Chih-Cheng Chang ,&nbsp;Kok-Yoon Chee ,&nbsp;Judit Harangozó ,&nbsp;Chantal Van Audenhove ,&nbsp;Bola Ola ,&nbsp;Fátima Jorge-Monteiro ,&nbsp;Bawo James ,&nbsp;Uta Ouali ,&nbsp;Arūnas Germanavičius ,&nbsp;Jibril Abdulmalik ,&nbsp;Alp Ucok ,&nbsp;Yewande Oshodi ,&nbsp;Graham Thornicroft","doi":"10.1016/j.jad.2025.119802","DOIUrl":"10.1016/j.jad.2025.119802","url":null,"abstract":"<div><h3>Background</h3><div>Major Depressive Disorder (MDD) is a prevalent mental health condition often accompanied by self-stigma, negatively impacting self-esteem and empowerment. This study examines the mediating role of self-esteem in the relationship between self-stigma and empowerment and explores the moderating influence of socioeconomic and cultural contexts in an international sample.</div></div><div><h3>Methods</h3><div>This cross-sectional study, part of the ASPEN/INDIGO-Depression project, included participants with a diagnosis of MDD from 34 countries. Self-stigma, self-esteem, and empowerment were assessed using, respectively, the Internalized Stigma of Mental Illness (ISMI) scale, the Boston University Empowerment Scale (BUES), and the Rosenberg Self-Esteem Scale (RSES). A mediation model examined self-esteem's role in the self-stigma–empowerment relationship, and a conditional mediation model examined the moderating effect of the Human Development Index (HDI). All effects were adjusted for socio-demographic and clinical covariates.</div></div><div><h3>Results</h3><div>A total of 1058 people participated. Mediation analysis confirmed that self-esteem significantly mediated the negative association between self-stigma and empowerment, suggesting that lower self-stigma leads to higher self-esteem, which in turn enhances empowerment. Moderation analysis revealed that the mediation effect varied across countries with different socioeconomic and cultural contexts. The indirect effect of self-stigma on self-esteem was stronger in countries with higher HDI, indicating that individuals in these settings experience greater vulnerability to the negative effects of self-stigma on self-esteem.</div></div><div><h3>Conclusions</h3><div>Self-esteem buffers the negative impact of self-stigma on empowerment in people with MDD. The strength of this effect varies by socioeconomic and cultural context, with stronger mediation in higher-HDI countries. These findings highlight the need for tailored interventions addressing self-stigma in specific contexts to enhance empowerment and recovery.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119802"},"PeriodicalIF":4.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of rehospitalization in youth depression patients: A 10-year longitudinal study.","authors":"Lennart Seizer, Tobias Renner, Johanna Löchner","doi":"10.1016/j.jad.2025.119800","DOIUrl":"https://doi.org/10.1016/j.jad.2025.119800","url":null,"abstract":"<p><p>Depression affects approximately one in ten children and adolescents, with severe cases often requiring full or partial hospitalization. Despite the effectiveness of these treatments, about one third of the patients are readmitted after release, highlighting the need to identify predictors of rehospitalization. This study examined demographic, clinical, biological, and treatment-related factors in 1114 depression patients aged 8 to 18 years admitted to the Child and Adolescent Psychiatry at the University Hospital of Tübingen between 2014 and 2024. Cox regression analyses revealed that symptom severity, presence of psychotic symptoms, antidepressant medication use, and crisis ward admission significantly increased the risk of rehospitalization. Notably, immune markers such as C-reactive protein and white blood cell counts were not associated with rehospitalization risk. These findings suggest that clinical severity and specific treatment factors are critical in predicting rehospitalization, underscoring the importance of comprehensive discharge planning to reduce readmission rates and improve patient outcomes.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119800"},"PeriodicalIF":4.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pathway from childhood unpredictability to somatic symptoms among college students: The mediating role of anxiety symptoms and the moderating role of coping strategies","authors":"Shiyuan Xiang ,&nbsp;Xiaojiao Ye ,&nbsp;Xuanjing Li ,&nbsp;Pujing Chen ,&nbsp;Shan Zhao","doi":"10.1016/j.jad.2025.119749","DOIUrl":"10.1016/j.jad.2025.119749","url":null,"abstract":"<div><div>Although it has been suggested that childhood adversity could have a long-lasting influence on health, such as somatic symptoms in later life, less is known about the role of childhood unpredictability, an independent and important environmental signal, and the potential mechanism underlying this association. Besides, the extent to which different coping strategies may either mitigate or amplify this negative association is not adequately investigated. To fill this research gap, the present study investigated the relationship between childhood unpredictability and somatic symptoms among college students, whilst exploring the mediating role of anxiety symptoms and the moderating role of coping strategies. Using two-wave longitudinal data over a six-month period, a total of 992 Chinese college freshmen (67.7 % female; ages 17 to 23, <em>M</em>_<em>age</em> = 18.32, <em>SD</em>_<em>age</em> = 0.62) completed self-reported questionnaires measuring childhood unpredictability, coping strategies, anxiety symptoms, and somatic symptoms. Results showed that childhood unpredictability significantly predicted subsequent somatic symptoms among college students through increased anxiety symptoms. Moreover, both approach and avoidant coping significantly moderated the indirect association between childhood unpredictability and somatic symptoms. Specifically, employing approach coping was beneficial in reducing anxiety symptoms only among participants who experienced low childhood unpredictability. Conversely, adopting low levels of avoidant coping was particularly effective in reducing anxiety symptoms among participants who experienced high childhood unpredictability. These effects, in turn, further influenced somatic symptoms. Recommended intervention and prevention strategies include raising parental awareness of childhood unpredictability, reducing anxiety symptoms, and promoting specific coping strategies for particular stressors to alleviate somatic symptoms among college students.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119749"},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of depression and anxiety among reproductive-aged women in Bangladesh: Insights from national survey","authors":"Ehsan Ahmed ,&nbsp;Md Injamul Haq Methun ,&nbsp;Masudur Rahman Siam","doi":"10.1016/j.jad.2025.119771","DOIUrl":"10.1016/j.jad.2025.119771","url":null,"abstract":"<div><h3>Background</h3><div>Depression and anxiety are highly prevalent yet underexplored mental health issues among reproductive-aged women in Bangladesh. This study aims to investigate the determinants of depression and anxiety symptoms among reproductive-aged women in Bangladesh using data from a national survey.</div></div><div><h3>Methods</h3><div>Data from 20,029 ever-married reproductive-aged women were utilized for analysis to investigate the association between various socioeconomic and demographic, reproductive, and community-level factors. The chi-square test was used to determine the association between the outcome and various explanatory variables. The variables with P-value &lt; 0.25 in the chi-square test were only included in the Binary logistic regression model.</div></div><div><h3>Results</h3><div>Our findings reveal that depressive symptoms were reported by 4.9 % of women, while 19.5 % experienced anxiety symptoms. The main factors associated with depressive symptoms were lower educational attainment, pressure to become pregnant, and a partner occupation. These factors are also significantly associated with anxiety symptoms along with age at first birth, pregnancy termination history, and unwanted pregnancy.</div></div><div><h3>Conclusion</h3><div>The study provides an update on the determinants of depressive and anxiety symptoms, two giant components of mental health problems. This could help the policymaker to take steps to improve the overall well-being of reproductive-aged women in Bangladesh.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119771"},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar disorder: Systematic review of approved psychiatric medications (2008-2024) and pipeline Phase-3 medications.","authors":"Salma Ramadan, Laurel Tay, Harlene Kaur, Thomas Parrish, Salma Abdelmoteleb, Jayant Totlani, Emile Tadros, Drew Hirsch, Nathalie Murphy, Ashley Meyer, Macie Miller, Mia Pasini, Aasim Naqvi, Angela Liu, Sabrina Renteria, Rebecca Hedrick, Itai Danovitch, Robert Pechnick, Waguih William IsHak","doi":"10.1016/j.jad.2025.119778","DOIUrl":"https://doi.org/10.1016/j.jad.2025.119778","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluates psychiatric medications for bipolar disorder (BP) approved by the U.S. FDA between 2008 and 2024, alongside investigational agents in advanced clinical development, in addition to medications with exploratory evidence. It categorizes these treatments by clinical relevance, mechanism of action, efficacy, dosing, adverse effects, and guideline and real-world use.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, FDALabel, and ClinicalTrials.gov databases for studies published between 2008 and 2024, using keywords including \"bipolar\" AND \"psychopharm*\" OR \"medic*\" OR \"pharm*.\" Two reviewers independently assessed the resulting publications, resolving any discrepancies through consensus to finalize the studies for inclusion in this review. Key findings from the selected full-text articles were extracted to compile data for the review tables. We also utilized practice guidelines for BP from the US, Canada, the UK, and Australia/New Zealand.</p><p><strong>Results: </strong>BP medications were categorized into three tiers: (1) FDA-approved and guideline-endorsed, (2) FDA-approved, with emerging clinical use, and (3) Phase 3 agents. We described eight Tier 1 and eight Tier 2 medications that received FDA approval from 2008 to 2024, seven that are actively in pipeline Phase 3 clinical trials, and six more medications with exploratory evidence.</p><p><strong>Conclusion: </strong>Advances in pharmacologic treatment for bipolar disorder over the past 16 years reflect a shift towards individualized, mechanism-based care. Our tiered framework offers clinicians and researchers a structured approach to evaluate treatment maturity and real-world applicability. Continued research and careful interpretation of the evolving pipeline and medications with exploratory evidence are essential to optimize long-term management.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119778"},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood adversities and depression according to sexual orientation and gender identity among university students in Chile","authors":"Marcelo A. Crockett ,&nbsp;Vania Martínez ,&nbsp;Daniel Núñez ,&nbsp;Scarlett Mac-Ginty ,&nbsp;Álvaro I. Langer ,&nbsp;Jorge Gaete ,&nbsp;Irene Léniz","doi":"10.1016/j.jad.2025.119758","DOIUrl":"10.1016/j.jad.2025.119758","url":null,"abstract":"<div><div>Childhood adversities (CA) are a recognized risk factor for depression. However, research on how these adversities differ based on sexual orientation and gender identity remains limited. This study aimed to examine differences in the type, number, and frequency of CA and analyze their association with depression according to sexual orientation and gender identity among university students in Chile. A total of 7213 first-year students (34 % lesbian, gay, bisexual, transgender, questioning and other diverse sexual orientations and gender identities [LGBTQ+], aged 18–30) from five Chilean universities completed an online survey assessing seven types of adversity experienced before age 18 and the occurrence of 12-month major depressive episode (MDE). Regression models were employed for the analyses. LGBTQ+ students reported significantly more types, a higher number, and a greater frequency of CA compared to heterosexual/cisgender students. No significant differences were found between the groups regarding the associations between the type or number of CA and the occurrence of 12-month MDE. However, a significant group difference emerged concerning the frequency of CA. A greater frequency of CA was associated with an increased likelihood of experiencing 12-month MDE across both groups. Notably, LGBTQ+ students exhibited a higher proportion of 12-month MDE, even with no reported CA; this difference diminished and disappeared as the frequency of CA increased. CA are highly prevalent among LGBTQ+ individuals and are associated with depression in both LGBTQ+ and heterosexual/cisgender university students. These findings underscore the urgent need for interventions to prevent exposure to CA and mitigate their detrimental effects.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119758"},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528083","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}