Nordic Journal of Psychiatry最新文献

{"title":"Anterior cingulate cortex alterations in children and adolescents with Attention Deficit and Hyperactivity Disorder: a systematic review of neuroimaging studies.","authors":"Tonia Salem, Hayat Harati, Marwa Summaka","doi":"10.1080/08039488.2026.2708719","DOIUrl":"10.1080/08039488.2026.2708719","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review investigates existing evidence regarding the structural and functional alterations of the anterior cingulate cortex (ACC) in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental disorder characterized by persistent inattention and hyperactivity-impulsivity.</p><p><strong>Materials and methods: </strong>Following the PICO framework, inclusion criteria specified populations of children and adolescents aged under 18 years. The intervention comprised neuroimaging modalities assessing the ACC, compared against typically developing controls, with neuroimaging findings as the primary outcomes.</p><p><strong>Results: </strong>Structural MRI findings reported reduced gray matter volume, cortical thinning, and atypical sulcal morphology within the ACC. Functional MRI studies indicated diminished ACC activation during inhibitory control tasks, alongside selective hyperactivation potentially reflecting compensatory mechanisms. Resting-state analyses revealed hypo-connectivity between the ACC and regulatory regions-including the dorsolateral prefrontal cortex, cerebellum, and default mode network-with mixed connectivity patterns suggesting neurofunctional subtypes. Additionally, EEG studies demonstrated attenuated N2/P3 amplitudes and disrupted theta oscillations.</p><p><strong>Conclusions: </strong>This review demonstrates a coherent neurobiological pattern in pediatric ADHD, characterized by both structural alterations (reduced ACC volume, thickness, and atypical folding) and functional dysregulation (abnormal activation, disrupted connectivity, and altered electrophysiological responses) across tasks probing inhibitory control, reward processing, and resting-state dynamics.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"497-515"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minor physical anomalies in ASD and ADHD: a systematic review and meta-analysis.","authors":"Eren Halaç, Nazan Gündoğan Küçükşahin, Emre Bora","doi":"10.1080/08039488.2026.2720122","DOIUrl":"10.1080/08039488.2026.2720122","url":null,"abstract":"<p><strong>Background: </strong>Minor physical anomalies (MPAs) are subtle morphological variants that may reflect atypical prenatal development. Elevated MPAs have been reported in autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but findings have been inconsistent.</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, and grey-literature sources for case-control studies published through December 2025 that reported total MPA scores in ASD or ADHD versus typically developing controls. Pooled effect sizes were calculated as Hedges' g using random-effects models with restricted maximum likelihood estimation. Shared control groups were handled by sample splitting. Heterogeneity, subgroup and moderator effects, and small-study effects were examined.</p><p><strong>Results: </strong>Twelve ASD studies and eight ADHD studies met inclusion criteria. Across disorders, MPAs were significantly elevated relative to controls (pooled <i>g</i> = 0.72, 95% CI 0.56-0.89). Disorder-specific pooled estimates were significant for both ASD (<i>g</i> = 0.69) and ADHD (<i>g</i> = 0.77), with no significant difference between disorders (Q_bet = 0.22, <i>p</i> = 0.64). In ASD, effects were stronger for craniofacial anomalies than for peripheral anomalies, and item-level syntheses highlighted several ear- and palate-related features. In ADHD, evidence of small-study effects suggested possible overestimation, although conclusions remained robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>MPAs are reliably elevated in both ASD and ADHD. Current case-control evidence supports MPAs as a transdiagnostic marker of early developmental perturbation rather than a feature that strongly differentiates between these disorders.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"516-525"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of participation domains with personal recovery process and quality of life among service users in Flexible Assertive Community Treatment (FACT).","authors":"Madeleine Borgh, Torbjörn Falkmer, Elisabeth Argentzell, Ulrika Bejerholm, Annika Lexén","doi":"10.1080/08039488.2026.2725114","DOIUrl":"10.1080/08039488.2026.2725114","url":null,"abstract":"<p><strong>Purpose: </strong>Flexible Assertive Community Treatment (FACT) is being implemented in Swedish <i>general</i> mental health services for persons with complex mental health needs. However, research addressing service users' participation in everyday life and its association to personal recovery is still scarce. The aim of this study was therefore to examine domains of participation and their association with two personal recovery outcomes (the personal recovery process and quality of life) at the 12-month follow-up among persons with complex mental health needs participating in FACT.</p><p><strong>Materials and methods: </strong>An observational study design with secondary data derived from the FACT intervention arm of the <i>UDiM-FACT trial</i> (83 participants). Measurement was obtained before randomisation (baseline) and at 12 months follow-up. Two multiple linear regression models were conducted. Personal recovery process (QPR-Swe-7) and quality of life (MANSA) at 12 months follow-up were specified as dependent variables. Domains of participation were approximated using objective indicators of social inclusion (SIX), including employment, living situation, partnership/family, friendship at 12 months follow-up and were included as independent variables. Each model was adjusted for the corresponding baseline measure of the outcome variable.</p><p><strong>Results: </strong>Participants living alone had higher scores on quality of life compared to those living with a partner or family. No other significant associations were found.</p><p><strong>Conclusions: </strong>The largely non-significant findings may suggest that the FACT model supports personal recovery across a broad range of service users, regardless of differences in participatory domains. However, the results should be interpreted with caution, due to methodological and contextual constraints.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"489-496"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of machine learning models to predict mechanical restraint and related coercive measures in hospital psychiatry.","authors":"Sara Kolding, Jakob Grøhn Damgaard, Martin Bernstorff, Lasse Hansen, Søren Dinesen Østergaard, Andreas Aalkjær Danielsen","doi":"10.1080/08039488.2026.2716241","DOIUrl":"10.1080/08039488.2026.2716241","url":null,"abstract":"<p><strong>Purpose: </strong>Coercive practices in psychiatric hospitals present clinical and ethical challenges. Aiming to support prevention, we developed and evaluated machine learning models predicting mechanical restraint and a composite of related coercive measures.</p><p><strong>Materials and methods: </strong>The dataset comprised electronic health records from adults admitted to the Psychiatric Services in the Central Denmark Region (2015-2021). For each inpatient day, an XGBoost model predicted mechanical restraint or composite (mechanical, chemical, or manual) restraint within 48 h. Hyperparameters were optimised for the area under the receiver operating characteristic curve (AUROC) using five-fold cross-validation on 85% of the data and validated on a held-out 15% test set.</p><p><strong>Results: </strong>The cohort included 16,834 patients with 45,179 inpatient stays, covering 687,388 prediction days. 2,736 days were followed by restraint within 48 h, including 983 mechanical restraint episodes. Predictors were derived from demographics, diagnoses, medications, and clinical notes. The mechanical restraint model achieved an AUROC of 0.921 (95% CI: [0.921-0.924]) and a positive predictive value (PPV) of 4.9% at the top 1% risk threshold. The composite model yielded an AUROC of 0.912 (95% CI: [0.911-0.914]) and a PPV of 4.2% when predicting mechanical restraint, and 0.900 (95% CI: [0.899-0.901]) with a PPV of 10.4% for composite restraint.</p><p><strong>Conclusion: </strong>Incorporating related coercive measures into training did not improve AUROC for predicting mechanical restraint but increased PPV when predicting composite restraint, reflecting the higher outcome prevalence. This suggests related outcomes can inform prediction of rare events in clinical prediction modelling. Future work should include further validation.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"447-458"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fidelity to an evidence-based model for physical healthcare for patients with severe mental illness.","authors":"Stine Larsen, Jūratė Šaltytė Benth, Tordis Sørensen Høifødt, Torleif Ruud, Anne Høye","doi":"10.1080/08039488.2026.2739316","DOIUrl":"https://doi.org/10.1080/08039488.2026.2739316","url":null,"abstract":"<p><strong>Background: </strong>Individuals with severe mental illness have an elevated risk of developing cardiovascular diseases. This study aimed to examine adherence to an evidence-based model for physical healthcare by using the Physical Health Care Fidelity Scale and to explore whether adherence is associated with risk factors in patients.</p><p><strong>Methods: </strong>This multicenter study was conducted at clinical sites within specialist mental health services in Norway. Data were collected from 230 patients aged 16 years or older with schizophrenia or bipolar spectrum disorders, or those currently using antipsychotic medications. Using generalized linear mixed models, we explored the relationship between fidelity scores and cardiometabolic risk factors (daily smoking, hypertension, obesity, sedentary behavior, diabetes, lipid disorder, and unhealthy diet).</p><p><strong>Results: </strong>The sites generally demonstrated poor fidelity scores, reflecting a low level of specialist health care implementation of evidence-based practices. All assessed risk factors were highly prevalent, with daily smoking and/or snuff use being the most common (58.1%). Higher fidelity scores were assessed on the Policies subscale than on the Practices subscale, indicating that evidence-based knowledge regarding the identification and treatment of cardiovascular risk factors was more integrated into established policies and procedures than into the actual implementation of the interventions reaching patients. Associations between fidelity and patient clinical outcomes were non-significant after adjustment.</p><p><strong>Conclusion: </strong>Specialist healthcare providers demonstrated low adherence to evidence-based practices for cardiovascular risk management. Standardized fidelity measures can pinpoint areas for targeted improvement, and future studies should explore how fidelity levels relate to clinical outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03271242 (Registration date: 05.09.2017).</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Danish version of the Questionnaire about the Process of Recovery (QPR): psychometric properties, sensitivity to change, and meaningful difference.","authors":"Ziggi Ivan Santini, Siv-Therese B Bjørkedal, Cecilie Høgh Egmose, Lene F Eplov","doi":"10.1080/08039488.2026.2734995","DOIUrl":"https://doi.org/10.1080/08039488.2026.2734995","url":null,"abstract":"<p><strong>Background: </strong>Validated patient-reported outcome measures are needed to assess personal recovery alongside symptom-based outcomes in mental health care. The Questionnaire about the Process of Recovery (QPR) assesses subjective recovery aligned with CHIME processes, but no version of the QPR has previously been validated in Danish, including the widely used QPR-15 and the more recently developed QPR-7. This study assessed psychometric properties, sensitivity to change, and meaningful difference thresholds for the Danish QPR in community mental health samples.</p><p><strong>Methods: </strong>Pooled analyses were conducted using baseline (<i>n</i> = 353) and follow-up (<i>n</i> = 234) data from adults with mental illness in Danish community mental health services. Confirmatory factor analysis, measurement invariance testing across subgroups, content validity, internal consistency, convergent/discriminant validity, responsiveness analyses were applied, as well as anchor-based methods (CGI-S, MANSA) to establish meaningful difference thresholds.</p><p><strong>Results: </strong>QPR-15 showed poor unidimensional fit. QPR-7 demonstrated satisfactory fit (CFI = 0.96, TLI = 0.95, SRMR = 0.039, RMSEA = 0.061), internal consistency, invariance across sex, age, education, mental disorder type, and over time. The data were normally distributed without floor/ceiling effects, and correlations supported convergent/discriminant validity. QPR-7 change was strongly associated with changes in quality of life. Meaningful difference values: 2.5 (small)/3.5 (moderate) points within-person; 1.5(small)/2.5 (moderate) points between-group.</p><p><strong>Conclusion: </strong>The Danish QPR-7 is a valid and reliable brief measure for patient-centered recovery assessment in mental health care. Its invariance properties, interpretability thresholds, and low respondent burden support its usefulness in routine monitoring of individual recovery gains alongside clinical outcomes.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accident risk and driving performance in traffic among individuals with ADHD. A rapid review.","authors":"Elizabeth Åhsberg, Ylva Ginsberg","doi":"10.1080/08039488.2026.2735474","DOIUrl":"https://doi.org/10.1080/08039488.2026.2735474","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of attention-deficit/hyperactivity disorder (ADHD) and other neurodevelopmental diagnoses on traffic accidents and driving performance.</p><p><strong>Materials and methods: </strong>Systematic searches were conducted in the international databases Medline and PsycInfo (latest search January 2025). The identified articles were assessed for bias, and only data with low or moderate risk of bias was included. The results are reported narratively.</p><p><strong>Results: </strong>Eight studies were included: five non-randomised studies in simulator and three observational studies conducted in real traffic, published 2007-2021. No studies on autism spectrum disorder or other comparable conditions were identified.The five studies in simulator report contradictory results regarding both accident risk and driving performance (including lane position deviation, risky driving behavior, dual-task performance, and speed adaptation). Further, it remains unclear to what extent simulator-based findings reflect real-world driving. Two of the observational studies reported that individuals with ADHD have a higher risk for accidents compared with individuals without an ADHD diagnosis. However, the data in one study (USA) contained some uncertainty about the diagnosis, while data in the other study (Sweden) did not differ between drivers, passengers, cyclists or pedestrians. In the third cohort study (Finland), no differences were found between the groups regarding number of traffic accidents or driving performance. These findings should therefore be interpreted with caution.</p><p><strong>Conclusions: </strong>Based on the current state of research, no firm conclusions can be drawn regarding accident risk or driving performance among individuals with an ADHD diagnosis compared to individuals without an ADHD diagnosis.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drivers with psychotic disorders: the last inpatient or specialized outpatient care prior to a motor vehicle accident death.","authors":"Jussi Koskinen, Helinä Hakko, Pirkko Riipinen, Niina Sihvola, Anu-Helmi Halt","doi":"10.1080/08039488.2026.2701368","DOIUrl":"10.1080/08039488.2026.2701368","url":null,"abstract":"<p><strong>Purpose: </strong>Psychotic disorders are often associated with impaired driving. This study analyses drivers with psychotic disorders killed in fatal motor vehicle accidents (FMVAs) in comparison to controls without psychiatric disorders. The focus was on last care contact prior to FMVA, survival time from last contact to FMVA and official causes of death among deceased drivers.</p><p><strong>Material and methods: </strong>The study includes 94 drivers with psychotic disorders and their 146 matched controls without psychiatric disorders killed in FMVAs in Finland between 1990-2011. Drivers' survival time after their last inpatient or specialized outpatient care, the diagnostic category of the care, and official cause-of-death category were extracted from nationwide registers.</p><p><strong>Results: </strong>Drivers with psychotic disorders were more likely to have a shorter survival time following their last care contact compared to their controls (adj. HR = 5.82, <i>p</i>-value <0.001). Of drivers with psychotic disorders, 70.2% had died in FMVA within 6 months of their last care contact. Among drivers with psychotic disorders whose deaths were classified as suicide, the median survival time after their last contact was only 29 days.</p><p><strong>Conclusions: </strong>Deceased drivers with psychotic disorders were characterised by shorter survival time from their last healthcare contact to FMVA, and increased suicidality compared to controls without psychiatric disorders. Physicians should consider assessing fitness to drive in patients with psychotic disorders at every care contact, particularly when the visit concerns psychiatric problems. Driving bans exceeding six months and police notification should be carefully considered when evaluating fitness to drive in this high-risk group.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"413-421"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/08039488.2026.2709074","DOIUrl":"10.1080/08039488.2026.2709074","url":null,"abstract":"","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"432"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world comparison of one- versus two-injection start regimens of aripiprazole once-monthly in bipolar disorder: implications for relapse-related outcomes.","authors":"Mustafa Kurt, Ali Taşdemir","doi":"10.1080/08039488.2026.2699319","DOIUrl":"10.1080/08039488.2026.2699319","url":null,"abstract":"<p><strong>Objective: </strong>The standard one-injection start (OIS) regimen of aripiprazole once-monthly (AOM) requires a 14-day oral overlap, which may present practical challenges in routine care. This study evaluated whether the accelerated two-injection start (TIS) strategy, which eliminates oral overlap, affects 1-year real-world outcomes in patients with bipolar disorder (BD).</p><p><strong>Methods: </strong>This retrospective observational study included 132 inpatients with Bipolar I disorder hospitalized for an acute manic episode (OIS: <i>n</i> = 88; TIS: <i>n</i> = 44) initiated on AOM between January and December 2024. Primary outcomes were 1-year rehospitalization and emergency room (ER) visits. Exploratory analyses examined relapse-related outcomes, timing of initiation, and baseline illness severity.</p><p><strong>Results: </strong>Baseline and acute-phase characteristics were comparable between groups. Multivariable models confirmed the TIS regimen did not significantly increase the hazard of 1-year rehospitalization (aHR: 0.71, <i>p</i> = 0.435) or ER visits (aHR: 0.76, <i>p</i> = 0.378) compared to OIS. Among patients who relapsed, TIS was associated with fewer recurrent ER visits (<i>p</i> = 0.031) and a longer time to first ER visit (93.5 vs. 40.0 days). Exploratory analyses showed numerically lower ER utilization rates for the TIS regimen when initiated early (≤7 days) and among patients with higher baseline illness severity.</p><p><strong>Conclusions: </strong>The TIS regimen appears to be a feasible and safe alternative to OIS in BD, without compromising 1-year clinical outcomes or increasing adjunctive medication use. Exploratory findings suggested a potential trend toward a less intensive relapse course and delayed acute psychiatric service utilization among patients receiving TIS. Given the exploratory nature of these analyses, these observations require confirmation in larger prospective studies.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"395-403"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}