Journal of Child Psychology and Psychiatry最新文献

{"title":"No associations between neuroborreliosis in children and psychiatric neurodevelopmental disorders: a nationwide, population‐based, matched cohort study","authors":"Malte M. Tetens, Emma E. Graham, Nanna S. Andersen, Jette Bangsborg, Jacob Bodilsen, Ram B. Dessau, Svend Ellermann‐Eriksen, Charlotte Sværke Jørgensen, Jens Kjølseth Møller, Alex Christian Yde Nielsen, Michael Pedersen, Kirstine K. Søgaard, Dorrit Obel, Ulrikka Nygaard, Niels Obel, Anne‐Mette Lebech, Lars Haukali Omland","doi":"10.1111/jcpp.14079","DOIUrl":"https://doi.org/10.1111/jcpp.14079","url":null,"abstract":"BackgroundIt has been suggested that neuroborreliosis in children can manifest as psychiatric neurodevelopmental disorders or cause long‐term neurodevelopmental sequelae. However, previous studies were limited by size and design.MethodsWe performed a nationwide, population‐based, matched cohort study in Denmark between 1995 and 2021. We included all Danish residents &lt;16 years old with a positive <jats:italic>Borrelia burgdorferi</jats:italic> sensu lato intrathecal antibody index test (children with neuroborreliosis). To form a comparison cohort, we randomly extracted individuals from the general population matched on date of birth and sex 10:1 to children with neuroborreliosis. We calculated hazard ratios (HRs) with 95% CIs of contact to departments of psychiatry, diagnosis of attention deficit disorder, diagnosis of learning or intellectual developmental disorders, or receipt of psychostimulants for attention deficit disorder among children with neuroborreliosis compared with comparison cohort members. We did a sensitivity analysis in the form of a case‐control study, where we examined whether these outcomes were more frequent among children with neuroborreliosis than in the comparison cohort before study inclusion to account for differential delay in diagnosis.ResultsWe included 1,132 children with neuroborreliosis and 11,320 comparison cohort members with an observation time of 168,858 person‐years. We found no associations between neuroborreliosis and contact with departments of psychiatry (HR: 1.0, 95% CI 0.9–1.2), diagnosis of attention deficit disorder (HR: 0.9, 95% CI 0.6–1.3), diagnosis of learning or intellectual developmental disorders (HR 0.8, 95% CI 0.5–1.4), or receipt of psychostimulants for attention deficit disorder (HR: 0.8, 95% CI 0.6–1.1). Also, in the sensitivity analyses, these outcomes were not more present among children with neuroborreliosis than in the comparison cohort before study inclusion.ConclusionsOur results do not support that neuroborreliosis in children manifests as psychiatric neurodevelopmental disorders or causes long‐term neurodevelopmental sequelae.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily fluctuations in adolescents' sleep predict next‐day attention, sleepiness, and fatigue: an ecological momentary assessment study over 28 days","authors":"Lin Shen, Jessica Nicolazzo, Tracey L. Sletten, Clare Anderson, Yang Yap, Joshua F. Wiley, Bei Bei","doi":"10.1111/jcpp.14076","DOIUrl":"https://doi.org/10.1111/jcpp.14076","url":null,"abstract":"BackgroundCurrent understanding of the associations between adolescents' daily sleep and daytime alertness and fatigue under naturalistically occurring restricted (school) and unrestricted (vacation) sleep opportunities is limited.MethodsA convenience sample of adolescents (<jats:italic>n</jats:italic> = 205; 54.1% females, <jats:italic>M</jats:italic><jats:sub>age</jats:sub> ± <jats:italic>SD</jats:italic> = 16.9 ± 0.87 years) completed daily measures of sleep, alertness, and fatigue over 28 days (2 weeks during school, and the subsequent 2‐week vacation). Actigraphy and sleep diary total sleep time (TST) and sleep efficiency (SE) were measured. Participants self‐reported sleepiness and fatigue every morning and afternoon, and completed a tablet‐based, 3.2‐min psychomotor vigilance task (PVT) every afternoon. Cross‐lagged multilevel models tested daily TST and SE as predictors of next‐day subjective sleepiness/fatigue and PVT performance. Between‐ (i.e., differences between individuals) and within‐person associations (i.e., whether nights with higher‐than‐individual's‐average TST/SE, predict next‐day outcomes) were tested simultaneously. Covariates included previous‐day outcome, day of the week, study day (1–28), school/vacation, chronotype, and sociodemographic variables.ResultsWithin‐persons, higher‐than‐average TST and SE (both actigraphy and diary) predicted better next‐day PVT performance (all <jats:italic>p</jats:italic> ≤ .006), and lower subjective sleepiness and fatigue the following morning and afternoon (all <jats:italic>p</jats:italic> ≤ .032). Between‐persons, adolescents with higher overall diary SE had lower morning subjective sleepiness (<jats:italic>p</jats:italic> &lt; .001) and fewer PVT false starts in the afternoon (<jats:italic>p</jats:italic> = 0.02).ConclusionsNights with longer‐ and higher‐than‐average sleep efficiency (both actigraphy and diary) predicted better daytime alertness and fatigue, both when examined objectively via sustained attention and via self‐report. These findings are relevant for understanding the significance of sleep for adolescents' day‐to‐day alertness levels and fatigue, particularly in the context of classroom learning and road safety.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"18 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood","authors":"Virginia Peisch, Erica Ferrara, Gaelle Gourdet, Matthew Zimon, Carissa Mastrangelo, Anne Arnett","doi":"10.1111/jcpp.14083","DOIUrl":"https://doi.org/10.1111/jcpp.14083","url":null,"abstract":"BackgroundThis study investigated associations among temperament, executive functioning (EF), and attention‐deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages.MethodsParticipants were 61 4‐year‐old children and 165 8–11‐year‐old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests.ResultsAmong 4‐year‐olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school‐aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school‐aged children.ConclusionsResults are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow‐up.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"64 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Perspective: A systems approach to addressing young people's mental health","authors":"Tim Hobbs,&nbsp;Vashti Berry,&nbsp;Peter Fonagy","doi":"10.1111/jcpp.14077","DOIUrl":"10.1111/jcpp.14077","url":null,"abstract":"<p>This editorial explores how adopting a social determinants and systemic perspective can enhance preventative measures to boost the mental health of young people. It argues that to effectively elevate the mental health of young people, it is essential to tackle both the overarching influences and their specific local impacts. We maintain that a strategy combining systems thinking with evidence tailored to the local environment and participatory design is essential.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"271-274"},"PeriodicalIF":6.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain tissue microstructure in a prospective, longitudinal, population‐based cohort of preterm and term‐born young adults","authors":"Bradley S. Peterson, Sahar Delavari, Jonathan Sadik, Lars Ersland, Irene B. Elgen, Siddhant Sawardekar, Ravi Bansal, Stein Magnus Aukland","doi":"10.1111/jcpp.14069","DOIUrl":"https://doi.org/10.1111/jcpp.14069","url":null,"abstract":"BackgroundFifteen million infants annually are born prematurely, placing them at high risk for life‐long adverse neurodevelopmental outcomes. Whether brain tissue abnormalities that accompany preterm birth persist into young adulthood and are associated with long‐term cognitive or psychiatric outcomes is not known.MethodsFrom infancy into young adulthood, we followed a population‐based sample of consecutively identified preterm infants and their matched term controls. The preterm group was born at an average gestational age of 31.5 ± 2.6 weeks. We obtained Diffusion Tensor Imaging scans and assessed cognitive and psychiatric outcomes in young adulthood, at a mean age of 19 (range 17.6–20.8) years. Usable data were acquired from 180 participants (89 preterm, 91 term).ResultsPreterm birth was associated with lower fractional anisotropy (FA) and higher average diffusion coefficient (ADC) values in deep white matter tracts of the internal capsule, cerebral peduncles, inferior frontal‐occipital fasciculus, sagittal stratum and splenium of the corpus callosum, as well as in grey matter of the caudate, putamen and thalamus. A younger gestational age at birth accentuated these tissue abnormalities. Perinatal characteristics, including lower 5‐min APGAR score, history of bronchopulmonary dysplasia, more days of oxygen supplementation and multiple births all increased ADC values in deep white matter tracts and grey matter throughout the brain. Preterm individuals had significantly lower full‐scale IQ and more frequent lifetime psychiatric disorders. Those with psychiatric illnesses had significantly higher ADC and lower FA values throughout the deep posterior white matter.ConclusionsAbnormalities in brain tissue microstructure associated with preterm birth persist into young adulthood and likely represent disordered myelination and accompanying axonal pathology. These disturbances are associated with a higher likelihood of developing a psychiatric disorder by young adulthood. Brain tissue disturbances were accentuated in those born at younger gestational ages and in those with a history of perinatal complications associated with infection and inflammation.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"195 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Adolescent mental health in a rapidly changing world","authors":"Gonneke W. J. M. Stevens","doi":"10.1111/jcpp.14065","DOIUrl":"10.1111/jcpp.14065","url":null,"abstract":"<p>There is substantial evidence that adolescent mental health has deteriorated considerably since the early 2010s across many countries, and much more strongly among girls than boys. This is probably due to a combination of societal changes that strongly influenced the lives of adolescents. The societal changes include the rise of social media and of academic pressure, the COVID-19 pandemic and increasing worries about the future. Moreover, the decreasing trend in adolescent mental health might have resulted into more mental health awareness and a tendency to overinterpret negative psychological experiences as signs of mental health problems. Several suggestions for future research are provided to increase our understanding of the origins of the recent trends in adolescent mental health.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 12","pages":"1551-1553"},"PeriodicalIF":6.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An online, father‐inclusive parenting intervention for reducing child conduct problems: a randomised controlled trial of family man","authors":"Lucy A. Tully, Adrienne I. Turnell, Bronte G. Morgan, David J. Hawes, Jenny Anderson, Anna Kean, Mark R. Dadds","doi":"10.1111/jcpp.14068","DOIUrl":"https://doi.org/10.1111/jcpp.14068","url":null,"abstract":"BackgroundParenting interventions are effective for improving child conduct problems (CPs), but online self‐directed interventions are required to improve reach and impact. Mothers are the main users of such programmes; fathers show low participation rates despite evidence of increased efficacy when they participate.MethodsThis randomised controlled trial examined the efficacy of Family Man, a brief, self‐directed online parenting intervention for fathers and mothers of children with CPs. The intervention involves several innovative design features to maximise the engagement of fathers. Families (<jats:italic>N</jats:italic> = 103; 102 mothers, 78 fathers) seeking help with managing their 2‐ to 8‐year‐old child's CPs were randomly assigned to either the Family Man intervention condition (<jats:italic>n</jats:italic> = 53) or a 4‐week waitlist control group (<jats:italic>n</jats:italic> = 50). Primary outcomes were frequency and severity of child CPs and secondary outcomes included dysfunctional parenting, parenting efficacy, parenting stress, parental psychological distress, household disorganisation and interparental conflict.ResultsRepeated measures ANOVAs/MANOVAs found that at 4‐week post‐assessment, parents in the intervention group reported significantly lower levels of child CPs than waitlist. Significant effects for the intervention group relative to waitlist were also found across all secondary outcomes examined. Intervention effects were maintained at 2‐month follow‐up for the intervention group. Outcomes did not significantly differ for mothers and fathers.ConclusionsResults support the efficacy of this brief, self‐directed online parenting intervention in improving child CPs and a range of parent and family outcomes, both for fathers and mothers. Implications for improving the reach and impact of parenting interventions and increasing father engagement, are discussed.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"3 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin‐differences study","authors":"Sarah E. Stock, Rebecca E. Lacey, Louise Arseneault, Avshalom Caspi, Eloise Crush, Andrea Danese, Rachel M. Latham, Terrie E. Moffitt, Joanne B. Newbury, Jonathan D. Schaefer, Helen L. Fisher, Jessie R. Baldwin","doi":"10.1111/jcpp.14070","DOIUrl":"https://doi.org/10.1111/jcpp.14070","url":null,"abstract":"BackgroundAdverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.MethodsWe used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.ResultsAmong children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.ConclusionsThe apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"127 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting caregivers within caregiver-mediated interventions: a commentary on Brown et al. (2024)","authors":"Sarah R. Edmunds,&nbsp;Robert Hock","doi":"10.1111/jcpp.14073","DOIUrl":"10.1111/jcpp.14073","url":null,"abstract":"<p>A substantial portion of interventions designed to support autistic children are also designed to be delivered by caregivers (i.e. are ‘caregiver-mediated’). Brown et al. (Journal of Child Psychology and Psychiatry, 2024) are one of the first groups to critically examine the baseline skills that caregivers bring as they prepare to learn a class of interventions called Naturalistic Developmental Behavioral Interventions (NDBIs), which are designed to support social communication growth in young autistic children. This commentary commends Brown and colleagues for their focus on caregivers, a linchpin within the increasingly prominent caregiver-mediated process of intervention delivery. However, it is imperative that future research understand the potential adverse effects and supports that are needed to bolster caregivers in this crucial role. We present six recommendations for research on caregiver-mediated interventions that build on Brown and colleagues' work and address these needs, which involve: caregiver supports, equitable samples, community settings, adaptive designs, general principles, and implications for NDBI dissemination.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 3","pages":"390-393"},"PeriodicalIF":6.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of attention problems in preschoolers born very preterm","authors":"Marie Camerota, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. McGowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Barry M. Lester","doi":"10.1111/jcpp.14074","DOIUrl":"https://doi.org/10.1111/jcpp.14074","url":null,"abstract":"BackgroundChildren born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born &lt;30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention‐deficit/hyperactivity disorder (ADHD) diagnosis.MethodsWe studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born &lt;30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2‐year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.ResultsA linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.ConclusionsThere is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born &lt;30 weeks of GA and these differences have clinical relevance. These data could inform follow‐up guidelines for preterm infants.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}