Journal of Child Psychology and Psychiatry最新文献

{"title":"Cross-sectional and prospective relations between dysfunctional cognitive beliefs and obsessive-compulsive symptoms during late childhood and early adolescence: a test of two aetiological models.","authors":"Barbara Barcaccia,Matti Cervin,Davide Fausto Borrelli,Giulia Mignarri,Francesco Mancini,Andrea Pozza","doi":"10.1111/jcpp.70077","DOIUrl":"https://doi.org/10.1111/jcpp.70077","url":null,"abstract":"BACKGROUNDObsessive-compulsive symptoms (OCS) often emerge during childhood and adolescence, and two aetiological models have been proposed. According to the first model, maladaptive cognitive beliefs facilitate the transformation of transient intrusive thoughts into OCS. The second model suggests that dysfunctional cognitive beliefs develop in response to increased levels of OCS. Few studies have contrasted these models, and no study has used a prospective design.METHODSIn this study, dysfunctional cognitive beliefs, OCS, depressive symptoms, and anxiety symptoms were measured repeatedly on three occasions during a year in a sample of 950 late-childhood children and early adolescents (Mage = 10.80 [SD = 1.23], 51% female). Network analysis was used to examine cross-sectional between-person associations, and a random-intercept cross-lagged panel model was used to examine prospective within-person associations.RESULTSCross-sectional network analyses indicated that dysfunctional cognitive beliefs were uniquely linked to OCS and significantly more strongly linked to these symptoms than to depression and anxiety. Prospective data did not support either model, but OCS and anxiety symptoms uniquely predicted each other. Sex-stratified analyses showed that dysfunctional cognitive beliefs predicted all types of symptoms at later time points in boys, while in girls, OCS and anxiety symptoms predicted each other. Assumptions of the two aetiological models of OCD were supported by cross-sectional but not prospective data.CONCLUSIONSDuring late childhood and early adolescence dysfunctional cognitive beliefs may play a more prominent role in the emergence of mental health symptoms in boys than in girls, but more prospective studies are needed.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"29 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491541","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":"Gestational kynurenine metabolites mediate effects of pregnancy adiposity on child negative affect","authors":"Hanna C. Gustafsson, Hanna R. Wright, Jorden E. Jacinto Schreeder, Joel T. Nigg, Elinor L. Sullivan","doi":"10.1111/jcpp.70071","DOIUrl":"https://doi.org/10.1111/jcpp.70071","url":null,"abstract":"Background Mounting evidence links increased adiposity during pregnancy and offspring risk for mental health disorders. Yet the mechanisms underlying this association remain poorly understood, limiting our ability to design effective interventions. We hypothesize that alterations in the kynurenine system of the pregnant woman help to explain this association. Methods Participants were recruited during pregnancy with repeated assessments through 24 months postpartum. Maternal adiposity was assessed using air displacement plethysmography. Liquid chromatography tandem mass spectrometry was used to measure kynurenine system metabolites in maternal plasma. Child negative affect was assessed via maternal report at 6, 12, and 24 months. Results Participants ( <jats:italic>N</jats:italic> = 302) included mother–child dyads (70% non‐Hispanic White, 51% female). The ratio of picolinic to quinolinic acid (PA:QA) predicted child fear (β = −.15, 95% CI −0.27, −0.03, <jats:italic>p</jats:italic> = .02) and sadness (β = −.14, 95% CI −0.28, 0.003, <jats:italic>p</jats:italic> = .045) at 6 months. PA:QA mediated the effect of pregnancy adiposity on child fear (β = .03, bootstrapped 95% CI 0.009, 0.07) and sadness (β = .04, bootstrapped 95% CI 0.006, 0.08). Similar associations were observed when children were 12 and 24 months old, suggesting enduring effects. The ratio of kynurenic to quinolinic acid (KA:QA) was not associated with child negative affect. Conclusions This is the first evidence reporting that alterations in the kynurenine system during pregnancy are associated with increased child negative affectivity, an early life risk factor for psychopathology. Results further suggest that these kynurenine metabolites are a mechanistic link between pregnancy adiposity and child negative affect. Though observed effect sizes were small, results suggest that picolinic and quinolinic acid during pregnancy may be novel biomarkers for offspring behavioral risk.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"4 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484832","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: Are we too high on medicinal cannabis in child psychiatry? Examining the evidence in Tourette syndrome","authors":"Loren S. Hardeman,&nbsp;Luis C. Farhat,&nbsp;Julian Koenig,&nbsp;Michael H. Bloch","doi":"10.1111/jcpp.70075","DOIUrl":"10.1111/jcpp.70075","url":null,"abstract":"<p>There has been renewed interest in elucidating the role of the endocannabinoid system on both brain development and psychological phenomena across the lifespan. In parallel to these efforts, the use of cannabis-related drugs for the treatment of psychiatric disorders in the community has increased considerably over the past several years. In an excellent research review article in <i>JCPP</i>, Tansey et al. provide a comprehensive overview of what the field of developmental psychopathology has learned about the endocannabinoid system. The purpose of this Editorial is to build upon the discussion around the current state of evidence for medicinal cannabis for psychiatric disorders, using Tourette syndrome and chronic tic disorders as an illustrative example.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 12","pages":"1781-1783"},"PeriodicalIF":7.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484712","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":"Individual differences in effects of stressful life events on childhood ADHD : genetic, neural, and familial contributions","authors":"Seung Yun Choi, Jinwoo Lee, Junghoon Park, Eunji Lee, Bo‐Gyeom Kim, Gakyung Kim, Yoonjung Yoonie Joo, Jiook Cha","doi":"10.1111/jcpp.70074","DOIUrl":"https://doi.org/10.1111/jcpp.70074","url":null,"abstract":"Background This study elucidates the intricate relationship between stressful life events and the development of ADHD symptoms in children, acknowledging the considerable variability in individual responses. By examining these differences, we aim to uncover the unique combinations of factors contributing to varying levels of vulnerability and resilience among children. Methods Utilizing longitudinal data from the Adolescent Brain Cognitive Development study (baseline: <jats:italic>N</jats:italic> = 6,303, age = 9.9), we applied Generalized Random Forest (GRF) to model the nonlinear relationships among genetic predispositions, brain features, and environmental factors. Results Significant individual variability was observed in children's ADHD symptoms post‐stress, particularly at the 1‐year and 2‐year follow‐ups. At the 1‐year follow‐up, increased vulnerability was indicated by heightened parental mental health problems and a lower polygenic risk score for smoking. By the 2‐year follow‐up, escalated parental mental health disorders, higher ADHD polygenic risk scores (PRS), and altered structural connectivity in the cognitive control network were significant contributors to individual differences. Conclusions These findings underscore the importance of integrating environmental, genetic, and neural variables to identify children vulnerable or resilient to developing ADHD symptoms following early‐life stress. This study demonstrates how multimodal data combined with nonparametric machine learning can advance precision psychology and psychiatry, aiding targeted support for affected children.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461818","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":"Neurodevelopmental conditions and adaptive functioning - a co-twin control study.","authors":"Johan Isaksson,Filippa Eklund,Karl Lundin Remnélius,Melissa H Black,Sven Bölte","doi":"10.1111/jcpp.70073","DOIUrl":"https://doi.org/10.1111/jcpp.70073","url":null,"abstract":"BACKGROUNDChallenges in adaptive or daily functioning are inherent to diagnostic criteria for neurodevelopmental conditions (NDCs). However, less is known regarding the influence of factors that may confound the association between NDCs and adaptive functioning. Therefore, we examined the associations between different NDCs and adaptive functioning while adjusting for co-occurring conditions, genetics, and shared environment.METHODSWe used a co-twin control study design in a sample of Swedish twins (N = 314, age range 8-21 years), including both monozygotic (MZ) and dizygotic (DZ) twins. Adaptive function was assessed using the parent-rated Adaptive Behavior Assessment System, second edition. A generalized estimating equations (GEE) model was fitted, using NDC diagnoses of Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), and Intellectual Disability (ID), as well as other psychiatric conditions, as exposure and adaptive functioning as the outcome. The model was first fitted across twin pairs and subsequently within the twin pairs, thus adjusting for genetic and shared environmental influences. Interaction effects of age and sex by different NDCs on adaptive functioning were assessed.RESULTSAll forms of NDCs were independently associated with challenges in adaptive function across pairs. The co-occurrence of multiple NDCs was associated with adaptive functioning, with a greater number of NDCs being associated with more functioning challenges. Higher age was associated with more challenges in adaptive functioning among autistic individuals. In the within-pair models, the association remained for autism and ID, but the association between ADHD and adaptive functioning was lost in the MZ sub-sample when adjusting fully for all genetic factors.CONCLUSIONSNDCs are associated with challenges in adaptive function, even when adjusting for other psychiatric conditions, stressing the importance of adequate community support. Findings indicate the importance of non-shared environmental factors for understanding the challenges in adaptive function experienced by individuals with autism and ID and genetic factors for individuals with ADHD.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"90 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440733","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":"Regional cerebellar structural deficits distinguish psychostimulant‐free ADHD youth with and without familial risk for bipolar I disorder: a cross‐sectional morphometric analysis","authors":"Biqiu Tang, L. Rodrigo Patino, Wenjing Zhang, Su Lui, Melissa P. DelBello, Robert K. McNamara","doi":"10.1111/jcpp.70072","DOIUrl":"https://doi.org/10.1111/jcpp.70072","url":null,"abstract":"Background Although attention‐deficit/hyperactivity disorder (ADHD) with familial risk for bipolar I disorder (BD) may represent a more severe illness conferring greater risk for developing BD, associated neurostructural substrates remain poorly understood. This study examined cerebellum structural alterations, which prior studies suggested may be associated with BD risk. Methods We enrolled 151 youth (ages 10–18 years) in three groups: psychostimulant‐free ADHD youth with a biological parent or sibling with BD (high‐risk, <jats:italic>n</jats:italic> = 52, mean age 13.8 ± 2.6 years), psychostimulant‐free ADHD youth without any first‐ or second‐degree relative with mood or psychotic disorders (low‐risk, <jats:italic>n</jats:italic> = 50, mean age 14.1 ± 2.5 years), and healthy controls (HC, <jats:italic>n</jats:italic> = 49, mean age 14.6 ± 2.4 years). ADHD youth were stimulant‐naïve or had no psychostimulant exposure within 3 months prior to enrollment. Region‐of‐interest (ROI) analyses were conducted on the whole cerebellum and 28 lobules to quantify cerebellar volumes using the SUIT toolbox, and voxel‐based morphometry (VBM) analyses were also performed. Exploratory analyses evaluated associations between regional cerebellar volumes and symptom measures. Results Significant group differences in volume were observed for the whole cerebellum, bilateral lobules VIIIa, right VIIb, and left X. Post hoc comparisons showed that the high‐risk group exhibited volume deficits in the whole cerebellum, bilateral lobules VIIIa, and right VIIb, compared with HC and low‐risk groups, whereas both high‐risk and low‐risk groups exhibited left X volume deficits compared to HC. Similar results were obtained using VBM. Among all ADHD youth, significant inverse correlations were observed between significant ROI volumes and Child Behavior Checklist (CBCL) total score and several subscales, including the dysregulation profile. Conclusions Psychostimulant‐free ADHD youth with BD familial risk exhibit whole and regional cerebellar volume deficits compared with those without such risk and healthy youth. Inverse associations between regional cerebellar volumes and CBCL total and subscale scores among ADHD youth suggest clinical relevance and may represent a potential BD risk biomarker.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"152 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427477","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":"A person-centered and genetically informed approach toward characterizing multidomain resilience to neighborhood disadvantage in youth.","authors":"Jessica L Bezek,Elizabeth A Shewark,Gabriela L Suarez,Kelly L Klump,S Alexandra Burt,Luke W Hyde","doi":"10.1111/jcpp.70068","DOIUrl":"https://doi.org/10.1111/jcpp.70068","url":null,"abstract":"BACKGROUNDExamining resilience to adversity across multiple behavioral domains (e.g., psychological well-being, social functioning) can better characterize positive development and inform novel prevention and intervention efforts. However, few studies have employed person-centered methods to examine individual profiles of resilience across multiple domains in youth. Further, research exploring contextual predictors of resilience has rarely used genetically informed designs, which are critical for eliminating potential confounds.METHODSThe current study employed latent profile analysis (LPA) to extract profiles of resilience across psychological, social, and academic domains in 708 adolescent twins exposed to neighborhood disadvantage, a pervasive form of early life adversity. Next, associations between profile membership and parenting, peer, and neighborhood social processes were examined. Lastly, co-twin control analyses were conducted to explore whether associations between resilience profile membership and social processes were environmental versus genetic in origin.RESULTSYouth were grouped into three resilience profiles: (1) High Multidomain Resilience (63%), (2) Low Psychological Resilience, High Social Resilience (19%), and (3) Low Multidomain Resilience (18%). Profiles differed in experiences of parenting (i.e., parental involvement, conflict), peer characteristics (i.e., friend drug-related behaviors, popularity), and neighborhood processes (i.e., social cohesion, informal social control, positive social norms). Follow-up analyses within-twin pairs revealed that the association between higher resilience and parenting (higher nurturance, lower conflict) was at least partially environmental in origin.CONCLUSIONSYouth show distinct profiles of resilience across psychological, social, and academic domains, which are uniquely related to processes at the family, peer, and neighborhood level. Further, the association between resilience and parenting is in part environmentally mediated, suggesting a modifiable pathway to boost resilience in adolescents exposed to neighborhood disadvantage.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"109 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351454","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: The challenge of evaluating ADHD parenting interventions - towards a hybrid approach.","authors":"Saskia van der Oord,Tycho J Dekkers,Barbara J van den Hoofdakker,Manfred Döpfner,Edmund Sonuga-Barke","doi":"10.1111/jcpp.70069","DOIUrl":"https://doi.org/10.1111/jcpp.70069","url":null,"abstract":"Behavioural parent training (BPT) has been recommended as part of multi-modal intervention strategies for children with attention-deficit/hyperactivity disorder (ADHD). The evaluation of its effectiveness, however, is challenging, as meta-analyses have indicated a discrepancy between effects on most proximal (MPROX) and probably blinded (PBLIND) outcome measures. In this editorial perspective, we provide five hypotheses that may explain this discrepancy. The first three hypotheses assume that the MPROX-PBLIND discrepancy demonstrates that BPT does not reduce actual ADHD characteristics and that MPROX is picking up a false positive. The final two focus on the limitations of the PBLIND assessments reported in the meta-analyses and the assumption that they are giving false negatives. We conclude that a hybrid approach, integrating parent ratings and observational measures within a multimethod assessment approach, may provide a path forward. In conclusion, we argue that for parents and clinicians, parent ratings of ADHD characteristics and other parent- or child-rated outcomes, such as mental health, quality of life and general well-being, are more important than 'objective' symptom change, which encourages us to shift the focus from the control of symptoms to the promotion of general functioning and well-being.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"44 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338837","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":"Perinatal hardship and infant neurodevelopment: insights from a global pandemic.","authors":"Jonathan Posner,Andrew Michael,Pratik Kashyap,Meredith Fay,Ana Carolina Coelho Milani,Ivaldo Silva,Nitamar Abdala,Célia Maria de Araújo,Aline Camargo Ramos,Yun Wang,Mateus Mazzaferro,Andrea Jackowski,Cristiane S Duarte","doi":"10.1111/jcpp.70060","DOIUrl":"https://doi.org/10.1111/jcpp.70060","url":null,"abstract":"BACKGROUNDMaterial and emotional hardship during pregnancy can shape early brain development and behavior in infants. This study used the COVID-19 pandemic as a natural context in which such hardships were widespread, particularly in low-resource settings.METHODSThis cohort study examined associations between pandemic-related maternal emotional distress and material hardship during pregnancy and early neurodevelopmental outcomes in infants. A total of 235 mother-infant dyads from low-resource healthcare settings in Brazil were enrolled during the COVID-19 pandemic. Maternal hardships were assessed using a COVID-19-specific questionnaire, which included self-reported COVID-19 exposure/infection. Infant neurodevelopment was evaluated via MRI at 2-6 weeks of age and behavioral assessments at 14 months using the Bayley Scales of Infant Development.RESULTSMaterial hardship was associated with reduced hippocampal volumes in the left (pfdr = .008) and right (pfdr = .025) hemispheres. Among female infants, material hardship was linked to lower functional connectivity between the right hippocampus and the right rostral anterior cingulate cortex (p = .004). Smaller hippocampal volumes correlated with weaker gross motor skills at 14 months (r = .23; p = .02). Maternal emotional distress and self-reported COVID-19 exposure/infection were not significantly associated with infant neurodevelopmental outcomes.CONCLUSIONSMaterial hardship may adversely affect early neurodevelopment, particularly hippocampal structure and connectivity, with potential downstream effects on motor skills. These findings underscore the importance of addressing material hardship during the perinatal period to support infant brain health and development.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338840","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":"Analyzing direct and indirect genetic effects on early neurodevelopmental traits - a commentary on Hegemann et al.","authors":"Yalan Li,Tianjiao Liu,Xin Li","doi":"10.1111/jcpp.70070","DOIUrl":"https://doi.org/10.1111/jcpp.70070","url":null,"abstract":"The study by Hegemann et al. advances understanding of the genetic architecture underlying early neurodevelopmental traits by distinguishing direct and indirect genetic effects using Trio-GCTA and polygenic score models. Findings reveal that indirect genetic effects are particularly pronounced for hyperactivity and restricted and repetitive behaviors, while direct effects dominate in language and motor development. Notably, associations between parental cognitive and educational attainment polygenic scores and child outcomes suggest potential protective genetic influences. However, several methodological considerations may affect interpretation. Excluding closely related individuals could limit the detection of extended familial effects, and reliance on polygenic scores derived from predominantly European GWAS may constrain generalizability. Furthermore, current PGS explain only a portion of trait heritability, possibly underrepresenting true genetic contributions. Future studies incorporating extended family structures, diverse populations, and alternative methods to model gene-environment interplay are essential for refining insights into early neurodevelopmental processes.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339200","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}