Journal of Sleep Research最新文献

{"title":"Sleep and neurology, insomnia, sleep disordered breathing, nightmares and much more!","authors":"Dieter Riemann","doi":"10.1111/jsr.14323","DOIUrl":"10.1111/jsr.14323","url":null,"abstract":"<p>Dear members of the ESRS,</p><p>Dear readers of JSR,</p><p>welcome to the fifth edition of the Journal of Sleep Research in 2024, which will be published in October 2024.</p><p>This issue encompasses several reviews and meta-analyses on very different aspects of sleep research and sleep medicine, for example sensory gating and gaining in sleep or gastro-oesophageal reflux during sleep.</p><p>Furthermore, there is a broad range of articles covering sleep and neurology, insomnia, sleep-disordered breathing, nightmares, pain, memory consolidation, caffeine etc.</p><p>As always let me highlight a few of the articles for you:</p><p>Xie and Feeney (<span>2024</span>) touch on a largely neglected subject in sleep research: what is the impact of non-sexual touch on sleep quality? In their narrative review the authors want to shed light on associations between all kinds of non-sexual touch (affectionate touch, touch therapies, touch with animals and inanimate objects) and several aspects of sleep quality. It seems that so-called touch therapies (e.g. massage etc.) exert a positive influence on sleep quality. The same applies for affectionate touch (e.g. hugging). Touch deprivation and touch aversion, on the other hand, negatively impact sleep quality. Interestingly, positive associations between skin-to-skin contact and sleep quality has been shown clearly for newborns and infants.</p><p>The authors summarise that the existing database supports positive associations between touch and sleep quality, though further controlled studies are needed.</p><p>Sanli et al. (<span>2024</span>) investigated the effect of transcutaneous electrical nerve stimulation (TENS) for the management of Restless Legs Syndrome (RLS). 46 randomly selected patients with RLS were randomized to a) treatment with pramipexole plus 10 sessions of TENS or b) only pramipexole for four weeks. The IRLRS and the PSQI were used as outcome measures. In the combined treatment, stronger effects on both scales were observed for the combination treatment at posttreatment and at follow-up. Thus this study gives preliminary evidence that TENS as add on therapy might be beneficial for patients with RLS.</p><p>Moulder et al. (<span>2024</span>) studied whether the therapeutic effects of cognitive behavioural therapy for insomnia (CBT-I) depend on pre-existing sleep–wake discrepancy. This discrepancy was defined as an inconsistency between a persons's subjective and objective sleep (a common phenomenon in patients with insomnia). To this end, the authors studied a real-world sample of 386 patients who were treated in their outpatient insomnia clinic. All patients received a polysomnographic sleep study and a sleep diary which was used to calculate the sleep–wake discrepancy. CBT-I according to clinical standards was delivered in 6 weekly face to face sessions. Major outcome measures were the Insomnia Severity Index (ISI) and other questionnaires, which were administered pre- and post-treatment and a","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsr.14323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polygenic risk scores for mood disorders and actigraphy estimates of sleep and circadian rhythms: A preliminary study in bipolar disorders.","authors":"Vincent Hennion, Jan Scott, Victoire Martinot, Ophélia Godin, Cynthia Marie-Claire, Frank Bellivier, Stéphane Jamain, Bruno Etain","doi":"10.1111/jsr.14307","DOIUrl":"https://doi.org/10.1111/jsr.14307","url":null,"abstract":"<p><p>In bipolar disorders, abnormalities of sleep patterns and of circadian rhythms of activity are observed during mood episodes, but also persist during euthymia. Shared vulnerabilities between mood disorders and abnormalities of sleep patterns and circadian rhythms of activity have been suggested. This exploratory study investigated the association between polygenic risk scores for bipolar disorder and major depressive disorder, actigraphy estimates of sleep patterns, and circadian rhythms of activity in a sample of 62 euthymic individuals with bipolar disorder. The polygenic risk score - bipolar disorder and polygenic risk score - major depressive disorder were calculated for three stringent thresholds of significance. Data reduction was applied to aggregate actigraphy measures into dimensions using principal component analysis. A higher polygenic risk score - major depressive disorder was associated with more fragmented sleep, while a higher polygenic risk score - bipolar disorder was associated with a later peak of circadian rhythms of activity. These results remained significant after adjustment for age, sex, bipolar disorder subtype, body mass index, current depressive symptoms, current tobacco use, and medications prescribed at inclusion, but not after correction for multiple testing. In conclusion, the genetic vulnerabilities to major depression and to bipolar disorder might be associated with different abnormalities of sleep patterns and circadian rhythms of activity. The results should be replicated in larger and independent samples.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of rapid eye movement atonia in rapid eye movement sleep behaviour disorder and narcolepsy.","authors":"Franziska Edlinger, Marion Böck, Stefan Seidel, Karin Trimmel","doi":"10.1111/jsr.14322","DOIUrl":"https://doi.org/10.1111/jsr.14322","url":null,"abstract":"<p><p>A reduction of physiological muscle atonia during rapid eye movement sleep is characteristic in patients with rapid eye movement sleep behaviour disorder, however, it can also be found in narcolepsy patients. We evaluated rapid eye movement sleep associated electromyographic activity to set cut-off values of rapid eye movement sleep without atonia, differentiating rapid eye movement sleep behaviour disorder and narcolepsy patients from controls to enable more precise future diagnostic criteria for these disorders. We retrospectively analysed polysomnography recordings of 16 rapid eye movement sleep behaviour disorder patients, 15 narcolepsy patients, and 19 controls. The combination of phasic and tonic electromyographic activity was recorded in the mentalis and tibialis anterior muscles and analysed in 3 second miniepochs. The cut-off value for a diagnosis of rapid eye movement sleep behaviour disorder was 17.07% (100% sensitivity, 94.7% specificity, area under the curve 0.997). For the diagnosis of narcolepsy, we yielded a cut-off value of 8.4% (86.4% sensitivity, 68.4% specificity, area under the curve 0.850). Rapid eye movement sleep without atonia significantly (p = 0.046) increased in the second night half in rapid eye movement sleep behaviour disorder patients, while it remained moderately increased in the narcolepsy group. Polysomnographic evaluation proves significantly higher rates of rapid eye movement sleep without atonia in rapid eye movement sleep behaviour disorder than in narcolepsy patients, allowing differentiation from controls with high sensitivity and specificity. An increase throughout the night is characteristic for rapid eye movement sleep behaviour disorder, whereas a consistent elevation is typical in narcolepsy patients.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"States of consciousness and interoceptive hypersensibility: A study in patients with insomnia disorder.","authors":"Gaspare Alfì, Julia Maruani, Giulia Aquino, Danilo Menicucci, Laura Palagini, Angelo Gemignani, Balthazar Bazin, Emmanuelle Clerici, Emilie Stern, Pierre A Geoffroy","doi":"10.1111/jsr.14320","DOIUrl":"https://doi.org/10.1111/jsr.14320","url":null,"abstract":"<p><p>This exploratory study aimed to investigate the relationship between interoceptive sensibility and quality of consciousness in individuals with insomnia disorder, in order to understand how the modulation of internal states may contribute to modifying the experience of consciousness during sleep difficulties. A total of 37 patients with insomnia disorder (mean age = 46.05 ± 18.16) and 41 healthy good sleepers (mean age = 50.2 ± 12.99) underwent a psychometric sleep and interoceptive sensibility assessment, using Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Assessment of Interoceptive Awareness (MAIA). Moreover, patients with insomnia disorder also completed a quality of consciousness evaluation, using the Phenomenology of Consciousness Inventory (PCI). Patients with insomnia disorder exhibited heightened interoceptive sensibility, particularly in noticing body sensations (p < 0.0001) and emotional awareness (p = 0.032), along with diminished abilities in attention regulation (p = 0.040), not-worrying (p = 0.001), and trusting (p = 0.002). Furthermore, correlations between interoceptive sensibility and multiple aspects of the consciousness state during the insomnia night were identified. Specifically, higher emotional awareness was linked to a 2.49-fold increase in the likelihood of subjectively experiencing altered consciousness states during insomnia. The study sheds light on the relationship between interoceptive sensibility and the subjective state of consciousness during insomnia, emphasising the importance of exploring and considering interoception as part of the therapeutic process for insomnia disorder. Given the exploratory nature of the study and the increased risk of type-I error from numerous correlations, the results should be interpreted with caution. Further research is needed to validate and confirm their robustness.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based disparities in dopamine agonist response in patients with restless legs syndrome.","authors":"Maria P Mogavero, Elena Antelmi, Giuseppe Lanza, Sara Marelli, Alessandra Castelnuovo, Michele Tinazzi, Lourdes M DelRosso, Rosalia Silvestri, Raffaele Ferri, Luigi Ferini Strambi","doi":"10.1111/jsr.14311","DOIUrl":"https://doi.org/10.1111/jsr.14311","url":null,"abstract":"<p><p>This study aimed to investigate sex-related differences in the response to ropinirole and pramipexole in patients with restless legs syndrome (RLS). By analysing clinical parameters and polysomnographic (PSG) findings, we sought to elucidate the potential factors related to sex disparities modulating treatment responses and sleep quality in RLS. A total of 41 drug-free patients with RLS, aged ≥18 years, underwent two consecutive nocturnal PSG recordings, without medication at baseline; before the second night, 26 patients received an oral dose of 0.25 mg pramipexole whereas 15 received 0.5 mg ropinirole. After each PSG recording, patients self-evaluated the severity of their previous night symptoms by means of an ad hoc visual analogue scale (VAS). At baseline, sleep efficiency and percentage of Stage N2 tended to be higher in females while wakefulness after sleep onset was significantly higher in males. After treatment, total leg movements during sleep (LMS), periodic LMS (PLMS), and periodicity indexes were significantly lower in females than in males. The VAS score was lower after treatment in all patients, without differences between the two sexes. This study demonstrates a higher acute responsiveness of PLMS to dopamine agonists (pramipexole and ropinirole) in females than in males with RLS. These findings might be explained by differential sex-related expression of dopamine receptors, especially D₃, within the central nervous system. In addition, our findings provide translational hints toward a better tailored and sex-specific approach to the treatment of RLS associated with PLMS, with dopamine agonist possibly associated with a better outcome in females than in males.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronotype in relation to shift work: A cohort study among 37,731 female nurses.","authors":"Linske de Bruijn, Nina E Berentzen, Roel C H Vermeulen, Jelle J Vlaanderen, Hans Kromhout, Flora E van Leeuwen, Michael Schaapveld","doi":"10.1111/jsr.14308","DOIUrl":"https://doi.org/10.1111/jsr.14308","url":null,"abstract":"<p><p>Chronotype may affect tolerance for circadian disruption induced by shift work. This study examines the association between chronotype, self-reported sleep timing, shift type preference, and sleep problems among nurses, and studies chronotype stability over time. The study included 37,731 Dutch female nurses who completed a baseline (2011) and follow-up questionnaire (2017), with information on shift work (e.g., job history, shift type preference [collected in 2017 only]), and sleep characteristics (e.g., chronotype, preferred sleep-wake time in a work-free period [collected in 2017 only], and sleep problems between working days according to Medical Outcomes Study-Sleep Problem Index II [MOS-SPI-II]). The association between chronotype and sleep timing was examined using (age-adjusted) linear regression. Associations between chronotype and shift type preference and sleep problems (MOS-SPI-II >30) were examined using ordered logistic and Poisson regression, respectively. With later chronotype, midsleep time increased (definite evening vs. intermediate types [reference]: β = 55 min, 95% confidence interval [95% CI]: 54-55), the odds ratio (OR) for 1-point increase in preference for night (2.68; 95% CI: 2.48-2.90) and evening shifts increased (OR 2.20; 95% CI: 2.03-2.38), while the odds for day (OR 0.17; 95% CI: 0.16-0.18) and morning shifts (OR 0.22; 95% CI: 0.21-0.24) decreased. Intermediate chronotype was associated with fewer sleep problems (median MOS-SPI-II = 27.2, p < 0.01), compared with definite morning (28.9) and evening types (31.7). This study shows that chronotype is associated with sleep-wake times in a work-free period, shift type preference, and sleep problems in nurses. Future studies on the association of shift work-induced circadian disruption and health outcomes should therefore consider chronotype as effect-modifier.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of hyperarousal for understanding the associations between sleep problems and emotional symptoms in family caregivers of people with dementia. A network analysis approach.","authors":"Lucía Jiménez-Gonzalo, Inés García-Batalloso, María Márquez-González, Isabel Cabrera, Javier Olazarán, Andrés Losada-Baltar","doi":"10.1111/jsr.14310","DOIUrl":"https://doi.org/10.1111/jsr.14310","url":null,"abstract":"<p><p>Caregiving for a family member with dementia is a stressful situation that has been associated with symptoms of depression, anxiety, and insomnia. Several models have highlighted the role of hyperarousal for understanding sleep disorders; however, there is little evidence about how insomnia, depression, and anxiety are linked together. Network analysis could help to explore the mechanisms underlying the associations between these disorders. A total of 368 community-dwelling family caregivers of a person with dementia took part in the study. The depression-anxiety-sleep symptoms network was composed of 26 items using the R package qgraph to estimate and visualise the network. The results showed that the strongest symptoms in the network were shakiness, tension, restlessness, nervousness, and restless sleep. Tension was the symptom with the most predictive power, restless sleep was the most important shortcut node in the connection between other symptoms. The central stability coefficient showed adequate indices. The strength of hyperarousal symptoms suggested a prominent role of this variable. Our results invite the hypothesis that sleep problems may trigger symptoms specific to depression via fatigue or energy loss. This study is the first to examine the network structure of the associations between the symptoms of depression, anxiety, and insomnia in a sample of informal caregivers, and to explore the role of hyperarousal in this network.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic cardiovascular control is unaffected in children referred for assessment of excessive daytime sleepiness.","authors":"Jamilla Francis, Georgina Plunkett, Marisha Shetty, Margot J Davey, Gillian M Nixon, Lisa M Walter, Rosemary S C Horne","doi":"10.1111/jsr.14318","DOIUrl":"https://doi.org/10.1111/jsr.14318","url":null,"abstract":"<p><p>There is conflicting evidence for impaired autonomic control of heart rate (HR) in adults with narcolepsy and idiopathic hypersomnolence (IH). Despite these chronic hypersomnia conditions primarily being diagnosed around the age of puberty, there are limited studies in children. The present study investigated cardiovascular control using heart rate variability (HRV) and the extent of nocturnal HR dipping during sleep in children and adolescents with narcolepsy and IH. Children having an overnight polysomnographic study followed by a multiple sleep latency test (MSLT) for investigation of excessive daytime sleepiness (EDS) between May 2010 to December 2023 were included: 28 children diagnosed with narcolepsy, 11 with IH, and 26 subjectively sleepy children who did not meet the diagnostic criteria for either narcolepsy or IH. Each clinically referred child was matched for age and sex with a control. Time domain and frequency domain HRV were calculated from ECG recorded at 512 Hz. There were no differences in either time domain or spectral analysis of HRV between clinical groups or between clinical groups and their control group. The expected sleep state differences in HRV were observed in all groups. There was also no difference in HR nocturnal dipping between groups. Despite evidence for abnormal autonomic function in adults with narcolepsy and IH, our study did not identify any abnormalities in HR, HR control, or nocturnal dipping of HR in children referred for assessment of EDS. This suggests that autonomic dysfunction may be a feature of these conditions that develops in later life.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of the space environment on circadian rhythm and sleep in astronauts: An emphasis on the telomere length dynamics associated with sleep.","authors":"Ellen M S Xerfan, Priscila F Tempaku, Sergio Tufik, Monica L Andersen","doi":"10.1111/jsr.14312","DOIUrl":"https://doi.org/10.1111/jsr.14312","url":null,"abstract":"","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective alertness, rather than sleep duration, is associated with burnout and depression: A national survey of Japanese physicians.","authors":"Hiroo Wada, Mathias Basner, Makayla Cordoza, David Dinges, Takeshi Tanigawa","doi":"10.1111/jsr.14304","DOIUrl":"https://doi.org/10.1111/jsr.14304","url":null,"abstract":"<p><p>Approximately 40% of Japanese physicians report working more than 960 hr of overtime annually, with 10% exceeding 1860 hr. To protect their health, annual overtime limits went into effect in 2024. The objective of this study was to investigate associations of self-reported sleep duration with psychological health and objective alertness. This was a cross-sectional National Survey for The Work Style Reform of Long Working Physicians. Physicians self-reported daily sleep duration, burnout (Abbreviated Maslach Burnout Inventory), depression (Center for Epidemiologic Studies Depression Scale) and traffic accidents. Alertness was then evaluated using the brief Psychomotor Vigilance Test. Of 20,382 physicians invited, 1226 completed the survey and brief Psychomotor Vigilance Test. Daily sleep duration was inversely associated with weekly work hours (β = -5.4; 95% confidence interval -6.8 to -4.0, p < 0.0001). Sleep duration < 6 hr and ≥ 8 hr per day was associated with slower responses on the brief Psychomotor Vigilance Test (adjusted p < 0.05). An additional 10 hr worked per week was associated with a 0.40 point (95% confidence interval 0.08-0.72) increase in burnout severity and a 1.7% (95% confidence interval 0.1-3.3%) increase in odds of reporting a traffic accident. Increased brief Psychomotor Vigilance Test lapses, indicating lower alertness, were associated with worse symptoms of depression (β = 0.23 points; 95% confidence interval 0.14-0.31, p < 0.0001) and burnout (β = 0.25 points; 95% confidence interval 0.13-0.36, p < 0.0001). This study emphasizes the importance of sufficient sleep to maintain alertness, and supports limiting work hours for Japanese physicians to protect psychological health. Performance on the brief Psychomotor Vigilance Test may be a useful indicator of psychological health.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}