Journal of psychiatric research最新文献

{"title":"The impact of antidepressant discontinuation prior to treatment with psilocybin for treatment-resistant depression","authors":"","doi":"10.1016/j.jpsychires.2024.10.009","DOIUrl":"10.1016/j.jpsychires.2024.10.009","url":null,"abstract":"<div><div>It has been suggested that the recent use and discontinuation of antidepressant drugs compromises the action of psilocybin. As evidence is only available from small or uncontrolled samples, this post hoc analysis investigated this using data from the largest, phase II, randomized controlled trial of psilocybin treatment to date. Data from 233 participants with treatment-resistant depression (TRD) who received 25 mg, 10 mg, or 1 mg of investigational drug COMP360 psilocybin (a proprietary, pharmaceutical-grade synthetic psilocybin formulation, developed by the sponsor, Compass Pathfinder Ltd.), administered with psychological support, were compared for groups of participants who either discontinued one or more antidepressant drugs during screening or entered the trial antidepressant drug free. Measures of depression symptom severity change during the antidepressant drug discontinuation period, baseline suicidality, acute subjective psychedelic effects, and the study's primary endpoint (change in depression symptom severity between Baseline and Week 3) are described for both groups. Antidepressant drug discontinuation was not related to worsening of depression severity before Baseline. Suicidality was comparable between groups at Baseline. Psilocybin treatment efficacy and the subjective psychedelic experience did not appear to be compromised by antidepressant drug discontinuation. Thus, it does not limit the feasibility of psilocybin treatment for the future. These findings also support the overall homogeneity of our findings with psilocybin treatment as a monotherapy for TRD. The prior contradictory reports may come to appear misleading.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468366","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":"Investigating DTI-ALPS index and its association with cognitive impairments in patients with alcohol use disorder: A diffusion tensor imaging study","authors":"","doi":"10.1016/j.jpsychires.2024.10.008","DOIUrl":"10.1016/j.jpsychires.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>The glymphatic system, a physiological pathway recently identified, has attracted considerable attention for its potential role in the pathophysiology of neurological disorders. Despite significant research efforts, the exact contribution of the glymphatic system to alcohol use disorder (AUD) remains largely elusive. This study was a secondary analysis by analyzing a subset of the original data to examine changes in the ALPS index and determine its association with cognitive abilities in individuals with AUD.</div></div><div><h3>Methods</h3><div>We recruited 40 individuals with AUD and 40 healthy controls (HC). All subjects underwent MRI scans and clinical cognitive scale assessments. Diffusion tensor imaging along the perivascular space (DTI-ALPS) index was used to estimate the differences in glymphatic activity between both groups, and linear regression analysis was used to examine the association between ALPS index and cognitive performance measures.</div></div><div><h3>Results</h3><div>A statistically significant difference in the ALPS index was observed between both groups (<em>p</em> &lt; 0.001), with the AUD group showing statistically lower ALPS index compared with the HC group (<em>p</em> &lt; 0.001). Additionally, a positive correlation was identified between the ALPS index and MoCA/MMSE scores, indicating that higher ALPS index is indicative of better cognitive performance in individuals with AUD.</div></div><div><h3>Conclusions</h3><div>The findings of this study provide evidence of ALPS index in individuals with AUD and establish a link between the ALPS index and the cognitive impairments observed in AUD patients. These findings might suggest the importance of glymphatic activity in the emergence of cognitive deficits among those impacted by AUD, but a stronger link between ALPS index and glymphatic system is needed to better understand the relationship between glymphatic function and healthy outcomes.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502645","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":"Adverse childhood experiences and left hippocampal volumetric reductions: A structural magnetic resonance imaging study","authors":"","doi":"10.1016/j.jpsychires.2024.09.039","DOIUrl":"10.1016/j.jpsychires.2024.09.039","url":null,"abstract":"<div><h3>Background</h3><div>Adverse childhood experiences (ACEs) have been associated with volume alterations of stress-related brain structures among aging and clinical populations, however, existing studies have predominantly assessed only one type of ACE, with small sample sizes, and it is less clear if these associations exist among a general population of young adults.</div></div><div><h3>Objective</h3><div>The aims were to describe structural hippocampal volumetric differences by ACEs exposure and investigate the association between ACEs exposure and left and right hippocampal volume in a student sample of young adults.</div></div><div><h3>Methods</h3><div>959 young adult students (18–24 years old) completed an online questionnaire on ACEs, mental health conditions, and sociodemographic characteristics. Magnetic resonance imaging (MRI) was used to measure left and right hippocampal volume (mm³). We used linear regression to explore the differences of hippocampal volumes in university students with and without ACEs.</div></div><div><h3>Results</h3><div>Two thirds of students (65.9%) reported ACEs exposure. As ACEs exposure increased there were significant volumetric reductions in left (p &lt; 0.0001) and right hippocampal volume (p = 0.001) and left (p = 0.0023) and right (p = 0.0013) amygdala volume. After adjusting for intracranial brain volume, sex, age, and depression diagnosis there was a negative association between ACEs exposure and left (β = −22.6, CI = −44.5, −0.7, p = 0.0412) but not right hippocampal volume (β = −18.3, CI = −39.2, 2.6, p = 0.0792). After adjusting for intracranial volume there were no associations between ACEs exposure and left (β = −9.2, CI = −26.2, 7.9 p = 0.2926) or right (β = −5.6, CI = −19.9,8.8 p = 0.4466) amygdala volume.</div></div><div><h3>Conclusions</h3><div>Hippocampal volume varied by ACEs exposure in young adult students. ACEs appear to contribute to neuroanatomic differences in young adults from the general population.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468363","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":"Longitudinal analysis of astrocyte-derived protein levels in the blood of drug-naive and relapsed patients with schizophrenia","authors":"","doi":"10.1016/j.jpsychires.2024.10.007","DOIUrl":"10.1016/j.jpsychires.2024.10.007","url":null,"abstract":"<div><div>The potential influence of astrocytes on neuronal circuitry and psychotic symptoms in schizophrenia have recently been highlighted. Human postmortem studies have observed reduced astrocyte numbers in schizophrenia, but whether this pathology is present at disease onset or accumulates progressively with further psychotic episodes remains unclear.</div><div>Therefore, we analysed serum levels of the astrocyte-derived proteins glial fibrillary acidic protein (GFAP) and fatty acid-binding protein 7 (FABP7) in acutely ill first-episode (n = 60) and relapsed (n = 34) schizophrenia patients compared to 94 matched controls. Measurements were taken before and 6 weeks after antipsychotic treatment. We found significantly lower levels of GFAP (p &lt; 0.001) and FABP7 (p &lt; 0.001) in patients compared to controls, with no significant differences between first-episode and relapsed patients or changes after treatment. FABP7 negatively correlated with age in controls (r = −0.319, p = 0.002), but not in patients (r = −0.251, p = 0.015). In contrast, GFAP showed no correlation with age.</div><div>Our findings suggest that lowered GFAP and FABP7 may serve as trait markers of astrocyte pathology in schizophrenia, even prior to antipsychotic treatment. The absent correlation between FABP7 and age in schizophrenia patients, in contrast to controls, may be related to premature brain aging in schizophrenia. Long-term studies are needed to explore the relationship between chronic disease and astrocyte pathology in schizophrenia.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560845","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 association between respiratory failure and psychotropic medications: A systematic review","authors":"","doi":"10.1016/j.jpsychires.2024.10.003","DOIUrl":"10.1016/j.jpsychires.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between psychotropic medication usage and respiratory failure.</div></div><div><h3>Methods</h3><div>A systematic search of Embase, PubMed, CINAHL, PsycINFO, and the Cochrane Trial Registry databases for publications that evaluated the association between respiratory failure and the use of psychotropic medications in patients with chronic mental health disorders was performed.</div></div><div><h3>Results</h3><div>Nine studies were included, with a total of 170,435 participants. There was no association between antidepressant use and respiratory failure reported in the antidepressant studies, however no formal odds ratio was reported in any of these studies. Three antipsychotic studies met inclusion criteria, which included a total of 169,919 participants. However, two of these studies were derived from overlapping datasets, and one of these studies was reported as an abstract. None controlled for the key confounder of smoking status. All three demonstrated an increased risk of respiratory failure with antipsychotic use (adjusted odds ratio ranged from 1.13 95% CI: 1.2–1.89; to 2.33 95% CI: 2.06–2.64). Two out of three antipsychotic studies had a low risk of bias.</div></div><div><h3>Conclusions</h3><div>No clear association between antidepressants and respiratory failure was identified. Three studies examining antipsychotic medications and respiratory failure indicated an increased risk for respiratory failure. However, studies demonstrated significant heterogeneity and confounding factors (e.g. smoking status) and strategies to deal with these were absent. Two studies were derived from overlapping datasets and one study was an abstract. Given the signal towards increased risk of respiratory failure with antipsychotic medications, further reporting on this association through large matched and independent datasets is required to allow meta-analysis to quantify the nature and extent of this increased risk.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433236","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":"Association between adverse childhood experiences and obesity, and sex differences: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.jpsychires.2024.09.042","DOIUrl":"10.1016/j.jpsychires.2024.09.042","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is one of the most common health problems worldwide. Although studies have reported associations between adverse childhood experiences (ACEs) and obesity, specific subtype associations and sex differences are unclear.</div></div><div><h3>Objective</h3><div>To systematically evaluate the association between ACEs and adult obesity risk and sex differences.</div></div><div><h3>Methods</h3><div>Five databases, PubMed, Web of Science, Cochrane Library, Embase, and PsycINFO, were searched with a June 10, 2024 deadline. Included studies investigated the association between at least one ACE and obesity. Two researchers independently assessed the risk of bias using the Newcastle-Ottawa Scale (NOS) and its adaptations and extracted relevant characteristics and outcomes. Statistical analyses were performed using STATA 17.0, including random effects models, heterogeneity tests, sensitivity analyses, publication bias assessments, Meta-regression analyses, and subgroup analyses. Dose-response analyses revealed potential trends between different levels of abuse and risk of obesity.</div></div><div><h3>Results</h3><div>The meta-analysis included 46 studies and showed a notable increased risk of obesity in adults experiencing ACEs (OR: 1.48, 95% CI: 1.38–1.59). Subgroup analyses showed significantly increased risk in Europe and North America, with significant increases observed in both developed and developing countries. Prospective, retrospective, and cross-sectional studies showed strong associations. Different types of ACEs (physical, sexual, psychological, and non-physical, psychological, or sexual abuse) were linked to a higher obesity risk. Sex difference analyses showed that females faced a greater risk when experiencing physical (OR: 1.606), sexual (OR: 1.581), and non-physical, psychological, or sexual (OR: 1.319) abuse; males exhibited increased risk only with non-physical, psychological, or sexual abuse (OR: 1.240). Dose-response analyses indicated that a higher number of ACEs was associated with an increased risk of obesity in adults.</div></div><div><h3>Conclusions</h3><div>ACEs significantly increase the risk of adult obesity, with consistent findings across geographic regions, levels of economic development, and types of study design. Sex difference analysis indicates that females are particularly affected. Future research should prioritize including studies from underrepresented geographic areas to enhance understanding of the global impact of ACEs on obesity risk. Additionally, strengthening child protection and intervention efforts is crucial to mitigate the adverse effects of ACEs on adult health.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391416","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":"Shared and distinct alterations in brain morphology in children with ADHD and obesity: Reduced cortical surface area in ADHD and thickness in overweight/obesity","authors":"","doi":"10.1016/j.jpsychires.2024.10.002","DOIUrl":"10.1016/j.jpsychires.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate shared versus distinct differences in brain structure among children with ADHD and obesity, we examined the morphology of regions implicated in cognitive control and reward function in a single cross-sectional cohort of children with and without ADHD and overweight/obesity (OV/OB).</div></div><div><h3>Method</h3><div>Participants included 471 children ages 8–12 years with ADHD (n = 244; 58 OV/OB) and neurotypical (NT) controls (n = 227; 81 OV/OB) classified as healthy-weight (HW; BMI %ile 5th to &lt;85th) vs. having OV/OB (BMI %ile≥85th). Structural MRI was performed to obtain measures of cortical and subcortical morphology and compared across ADHD × BMI groups.</div></div><div><h3>Results</h3><div>Surface area was generally lower in ADHD vs. NT including in anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (dlPFC), medial (m)PFC, and primary motor (M1) cortex. In contrast, cortical thickness was generally lower in OV/OB vs. HW for ACC, dlPFC, orbitofrontal cortex (OFC), mPFC, and supplementary motor cortex (SMC). Furthermore, ADHD × OV/OB interactions were observed for the ACC and OFC, with the lowest ACC volume in the ADHD + OV/OB group and the highest OFC surface area in the NT + OV/OB group. Subcortical volumes did not differ between groups.</div></div><div><h3>Conclusions</h3><div>Our findings reveal distinct alterations in cortical morphology in association with ADHD and overweight, with cortical surface area reduced in ADHD vs. thickness reduced in OV/OB. Additionally, the findings provide evidence of combined effects of ADHD × OV/OB in brain regions integral to cognition and motivation. Our results support further investigation of causes and correlates of shared and distinct ADHD- and OV/OB-associated differences in developing frontocingulate morphology.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400563","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":"Psychiatric disorder before and after exposure to violent injury: A nationwide Norwegian register-based cohort study","authors":"","doi":"10.1016/j.jpsychires.2024.09.053","DOIUrl":"10.1016/j.jpsychires.2024.09.053","url":null,"abstract":"<div><div>Interpersonal violent injury is associated with increased risk of subsequent psychological problems, but pre-existing psychopathology may complicate this association in ways that are poorly understood. Using nationwide longitudinal registry data from Norway, we tested how psychiatric history modified the association between violent injury exposure and subsequent psychiatric disorder, and examined disorder continuity before vs. after violent injury. We identified all individuals presenting to emergency services in 2010–2018 with a violent injury, along with sex- and age-matched comparison individuals from the general population. The primary outcome was subsequent psychiatric disorder, observed through December 31, 2018, with secondary analyses examining psychiatric diagnoses pre- vs. post-injury. Of the 28,276 violence-injured patients, 20% had a history of psychiatric disorder, vs. 6% of the 282,760 comparison individuals. In Cox regression models, violence-injured patients had substantially higher rates of any subsequent psychiatric disorder when compared to matched peers (HR_adj: 2.36; 95% CI: 2.29, 2.42), but this association was confounded and modified by psychiatric history. Continuity of psychiatric diagnosis before and after injury was high among violence-injured patients, but they were also more likely than the comparison group to receive a new diagnosis, potentially indicating incident onset of new psychiatric disorder associated with violence exposure. Violence-injured patients face substantial burden of psychiatric disorder, especially for substance use and mood/anxiety disorders; clinical and public health strategies are needed to address this burden, which precedes violent injury in some cases but is likely provoked by it in others.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444645","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":"Handgrip strength is associated with functioning in patients with mental disorders: A two-center cross-sectional study","authors":"","doi":"10.1016/j.jpsychires.2024.09.047","DOIUrl":"10.1016/j.jpsychires.2024.09.047","url":null,"abstract":"<div><div>Physical and mental health are intricated, however, there is a paucity of studies investigating the association between self-reported global functioning and handgrip strength and functional capacity in people with mental disorders. This study investigated the association between functioning, handgrip strength, and functional capacity in outpatients with a range of mental disorders. This was a two-center, cross-sectional study. Functioning was assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Handgrip strength was assessed with a hand dynamometer, and functional exercise capacity through the 2-min walk test (2 MW T). Multiple linear regression analysis was used to identify the association between WHODAS 2.0, handgrip strength, and functional capacity, adjusted for study site, age, educational level, and severity of psychiatric symptoms. A total of 91 outpatients (mean age = 40.16 ± 13.49, 63.7% females) participated in the study. The mean functioning score was 26.77 (±8.74) out of 60 points, while the mean distance walked was 142.20 ± 34.40 m and the mean handgrip strength was 30.62 ± 11.17 kgf. The adjusted multiple linear regression analysis revealed that only handgrip strength (p = 0.008, 95%CI = −0.327 to −0.050) was associated with functioning. Thus, our results revealed that muscular strength is associated with functioning in patients with mental disorders. This study suggests the importance of incorporating physical health assessment into mental health care for a comprehensive assessment of functioning levels, which is usually restricted to mental symptoms.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437934","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":"Awareness and use of support services following mass violence incidents","authors":"","doi":"10.1016/j.jpsychires.2024.10.001","DOIUrl":"10.1016/j.jpsychires.2024.10.001","url":null,"abstract":"<div><div>Mass violence incidents (MVIs) result in significant psychological distress for survivors and the broader community. Support services (mental health services, support groups, religious support) can buffer negative effects of MVIs and facilitate recovery. However, the extent to which community members are aware of and use support services post-MVIs is unknown. A probability sample of 5991 adults (M_ean _age = 45.6, SD = 17.6), mostly female (53%) and White (71%), were recruited from six communities that had experienced an MVI. Participants answered questions on their awareness and use of support services after the MVI and completed measures assessing predisposing, enabling, and need factors that may influence service use. Approximately 20% of participants reported they were aware of mental health services, 20% reported awareness of support groups, and 16% reported awareness of religious support. Younger participants with higher income (predisposing factors), high social support (enabling factor), and direct MVI exposure and psychological distress (need factors) were more likely to report awareness of support services. Of those aware of services, approximately 21% reported using support services. Those with direct MVI exposure and psychological distress were more likely to use each type of service. Otherwise, use of mental health services, support groups, and religious support varied across predisposing factors (race, age, income). Overall, findings suggest there is limited awareness of support services post-MVI, despite the well-documented mental health burden after these incidents. This suggests the need for improved communication about available services after MVIs.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391417","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}