Sylvanna M. Vargas , Luis A. Parra , Stephanie H. Yu , Ashley Flores , Wilmer A. Rivas , Sinan Payat , Roxanne Mistry , Krystal Griffith , Clarence R. Williams , Diana Gamez , Darby Saxbe , Stanley J. Huey Jr. , Anna Lau , Bowen Chung , Jeanne Miranda
{"title":"How intersectional identity and discrimination contribute to depressive symptoms and hair cortisol concentrations among low-income, racially and sexual diverse adults","authors":"Sylvanna M. Vargas , Luis A. Parra , Stephanie H. Yu , Ashley Flores , Wilmer A. Rivas , Sinan Payat , Roxanne Mistry , Krystal Griffith , Clarence R. Williams , Diana Gamez , Darby Saxbe , Stanley J. Huey Jr. , Anna Lau , Bowen Chung , Jeanne Miranda","doi":"10.1016/j.psyneuen.2025.107429","DOIUrl":"10.1016/j.psyneuen.2025.107429","url":null,"abstract":"<div><div>Significant gaps remain in our understanding of how minority stress patterns health outcomes for adults at the intersection of ethnicity/ race and sexual orientation. In particular, little is known about how cumulative cortisol (measured via hair cortisol concentration as an indicator of chronic stress; HCC) and depressive symptoms are related to holding an intersectional minoritized identity (e.g., sexual minority people of color; SM-POC) and experiencing intersectional discrimination (e.g., heterosexism and racism). The current study examined the relationship between intersectional identity or discrimination and HCC or depressive symptoms. Participants were (<em>N</em> = 69) low-income, predominantly sexual minority and people of color in the Greater Los Angeles area. Participants completed self-report measures and provided a hair sample for cortisol assay. Intersectional identity was not associated with greater HCC or depressive symptoms. However, differences in HCC emerged based on discrimination type (<em>F</em> (2, 66) = 3.74, <em>p</em> = .03, η<sup>2</sup>= .10). Participants who reported intersectional heterosexism and racism had greater HCC concentrations (<em>M</em> = 30.71, <em>SD</em> = 29.71) than did participants who reported only a single type of discrimination (i.e., racism only or heterosexism only; <em>M</em> = 15.35, <em>SD</em> = 2.60, <em>p</em> = .03, 95 % CI = [2.01, 28.71]), or than participants who reported neither types (<em>M</em> = 12.40, <em>SD</em> = 16.11, <em>p</em> = .01, 95 % CI [4.85, 31.76]). There were no differences in depressive symptoms by discrimination type. These results provide initial empirical support to largely theoretical arguments about how to investigate mechanisms underlying disparities to understand why and how minority stress is patterned. Findings showing associations between intersectional discrimination and HCC, but not depressive symptoms, provide potential support for theories about examining allostatic load markers to identify stress-related etiological mechanisms linked to health disparities among minoritized populations.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107429"},"PeriodicalIF":3.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of GLP-1RAs on mental health and psychotropics-induced metabolic disorders: A systematic review","authors":"Sigrid Breit, Daniela Hubl","doi":"10.1016/j.psyneuen.2025.107415","DOIUrl":"10.1016/j.psyneuen.2025.107415","url":null,"abstract":"<div><h3>Background</h3><div>Mental illnesses and psychotropic drug use are associated with an increased risk of weight gain and metabolic disorders. Growing evidence suggests that agonists of the glucagon-like peptide-1 receptor (GLP-1RAs) might be safe and effective weight loss medications. However, the current evidence for the use of GLP-1RAs in individuals with obesity and mental illness is limited.</div></div><div><h3>Objective</h3><div>Evaluation of the safety and the impact of GLP-1RAs on mental health and psychotropics-induced metabolic disorders such as obesity and type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>A literature search from January 1st, 2010 to August 31st, 2024 was conducted using PubMed and Cochrane Library online databases. Studies comprising adults with obesity or/and T2D and mental illness were included. Studies that examined individuals with obesity or/and T2D without mental illness and completed psychiatric questionnaires before and after GLP-1RAs treatment were also included.</div></div><div><h3>Results</h3><div>From the 36 included studies 18 examined the weight-reducing effect of GLP-1RAs in patients with mental disorders and the other studies examined patients without mental illness. GLP-1RAs lead to a significant weight loss and improvement of glycemic control in patients with mental illness on psychotropics. They showed a beneficial effect on mental health in patients with and without mental disorders and were not associated with a worsening of mental state, suicidality, new-onset mental illness, or increased psychiatric admissions.</div></div><div><h3>Conclusion</h3><div>GLP-1RAs are safe and effective weight loss treatments for individuals with obesity and mental illness exerting a positive effect on mental state and quality of life. There is a need for RCTs with larger sample sizes, a longer treatment duration and longer follow-up periods to evaluate the long-term effect of GLP-1RAs. It would be of great interest to conduct studies investigating the use of GLP-1RAs with the purpose to treat mental illness in order to directly assess their use in improving mental health.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107415"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of early pregnancy telomere length and mitochondrial copy number with gestational diabetes mellitus and depressive symptoms","authors":"Chinnasamy Thirumoorthy , Ravikumar Pavithra Rekha , Mohan Deepa , Uma Ram , Durai Shalu , Ulagamadesan Venkatesan , Bettadapura N. Srikumar , Ranjit Mohan Anjana , Muthuswamy Balasubramanyam , Viswanathan Mohan , Ponnusamy Saravanan , Periyasamy Govindaraj , Kuppan Gokulakrishnan","doi":"10.1016/j.psyneuen.2025.107431","DOIUrl":"10.1016/j.psyneuen.2025.107431","url":null,"abstract":"<div><h3>Aim</h3><div>A bidirectional link exists between depression and gestational diabetes mellitus (GDM). While telomere length (TL) and mitochondrial DNA copy number (mtDNA-CN) alterations have been reported either in GDM or depression, their predictive ability of GDM with coexisting depression remains unexplored. We, therefore, prospectively investigated the relationship of TL and mtDNA-CN in blood leukocytes during early pregnancy and explored their potential as predictive biomarkers for identifying the risk of developing GDM with depressive symptoms later in pregnancy.</div></div><div><h3>Methods</h3><div>A nested cohort of 301 women with normal fasting glucose and without depressive symptoms in early pregnancy (<16 weeks) were selected from the STratification of Risk of Diabetes in Early Pregnancy (STRiDE) study. At 24–28 weeks (OGTT visit), a 75 g OGTT and PHQ-9 were performed. Women were categorized into four groups: NGT without depressive symptoms (n = 80), NGT with depressive symptoms (n = 105), GDM without depressive symptoms (n = 75), and GDM with depressive symptoms (n = 41). Blood leukocyte TL and mtDNA-CN were assessed using qRT-PCR.</div></div><div><h3>Results</h3><div>TL and mtDNA-CN at early pregnancy were lower in women with GDM, depressive symptoms or both, compared to NGT without depressive symptoms at OGTT visit. TL and mtDNA-CN at early pregnancy were negatively associated with PHQ-9 score and OGTT blood glucose levels at OGTT visit after adjusting for age, pre-pregnancy BMI and family history of diabetes. Higher levels of both TL and mtDNA-CN in early pregnancy were associated with lower adjusted Relative Risk (aRR) (TL; aRR: 0.34; 95 % CI: 0.28, 0.41, mtDNA-CN; aRR: 0.83; 95 % CI: 0.74, 0.93) of GDM with depressive symptoms at OGTT visit.</div></div><div><h3>Conclusion</h3><div>Lower levels of TL and mtDNA-CN in early pregnancy are significantly associated with the later development of GDM and depressive symptoms at OGTT visit. Our findings indicate that early trimester TL and mtDNA-CN could be potential predictive biomarkers for predicting GDM with depressive symptoms and emphasize their potential for improved risk assessment so as to adopt preventive strategies targeting these conditions.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107431"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melina M. Seng , Seth Adarkwah Yiadom , Lauren D. Otto-Dobos , Sagar D. Sardesai , Nicole O. Williams , Margaret E. Gatti-Mays , Daniel G. Stover , Preeti K. Sudheendra , Erica Dawson , Robert Wesolowski , Baldwin M. Way , Erica R. Glasper , Rebecca R. Andridge , Leah M. Pyter
{"title":"The role of oxytocin in mediating the relationships between social factors and chemotherapy-associated cognitive decline in female patients with breast cancer","authors":"Melina M. Seng , Seth Adarkwah Yiadom , Lauren D. Otto-Dobos , Sagar D. Sardesai , Nicole O. Williams , Margaret E. Gatti-Mays , Daniel G. Stover , Preeti K. Sudheendra , Erica Dawson , Robert Wesolowski , Baldwin M. Way , Erica R. Glasper , Rebecca R. Andridge , Leah M. Pyter","doi":"10.1016/j.psyneuen.2025.107428","DOIUrl":"10.1016/j.psyneuen.2025.107428","url":null,"abstract":"<div><div>While chemotherapy can cause debilitating side effects, social support, particularly that of an intimate partner, can be protective. This study examined the relationships between couple satisfaction and chemotherapy-associated subjective and objective cognitive decline in a cohort of breast cancer patients, in addition to the roles of other social factors. Because of oxytocin’s role in social bonding and cognition, circulating oxytocin and oxytocin receptor gene expression in peripheral blood mononuclear cells were investigated as potential mediators. Partnered breast cancer patients (n = 48) completed cognitive assessments and provided blood samples at 3 timepoints: pre-chemotherapy, during chemotherapy, and post-chemotherapy. Participants completed a retrospective couple satisfaction questionnaire, provided information about partner duration as well as other social factors (e.g., number of people in the household, number of dependents under 18), and completed a retrospective perceived general social support questionnaire. Analyses were completed using linear mixed effects and regression models. More satisfaction in an intimate relationship related to both less subjective and objective cognitive decline over chemotherapy. Similarly, higher perceived social support related to less overall objective cognitive decline over chemotherapy, though this relationship was less robust than that observed with high couple satisfaction. Remarkably, circulating oxytocin decreased over chemotherapy but was only associated with partner duration and not with cognitive measures. This study suggests a potential benefit of social-directed interventions for the treatment of cognitive side effects of chemotherapy, either from an intimate partner or more generally. Furthermore, understanding biological mechanisms is important to develop novel preventative and interventional therapies to mitigate the adverse side effects of chemotherapy.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107428"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Çiğdem Tanrıverdi , Ömer Başay , İhsan Kara , Esen Yıldırım Demirdöğen , Fatma Betül Özgeriş , Büşra Nur Akgül
{"title":"Elevated serum angiotensin ii levels in children and adolescents with anxiety disorders","authors":"Çiğdem Tanrıverdi , Ömer Başay , İhsan Kara , Esen Yıldırım Demirdöğen , Fatma Betül Özgeriş , Büşra Nur Akgül","doi":"10.1016/j.psyneuen.2025.107430","DOIUrl":"10.1016/j.psyneuen.2025.107430","url":null,"abstract":"<div><h3>Purpose</h3><div>Angiotensin II peptide is implicated in oxidative stress, neuropathology, and the serotonergic system. We investigated the serum angiotensin II levels in non-medicated children and adolescents with anxiety disorders.</div></div><div><h3>Materials and Methods</h3><div>Thirty-nine children and adolescents diagnosed with anxiety disorders and thirty-five controls participated in this study to investigate the potential association between anxiety disorders and serum angiotensin II levels. Parents of the participants completed the RCADS-P parent version to assess their children’s anxiety and depression levels.</div></div><div><h3>Results</h3><div>Higher serum angiotensin II levels were found in individuals with anxiety disorders compared to the control group. We found that social phobia, panic disorder, low mood (major depressive disorder), and generalized anxiety disorder subscale scores on the RCADS-P were significantly correlated with angiotensin II levels.</div></div><div><h3>Conclusions</h3><div>We found that children and adolescents with anxiety disorders had higher serum angiotensin II levels. The current findings align with previous research on the role of angiotensin II in other mental health conditions. Further research is necessary to elucidate its role in anxiety disorders.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107430"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Distinct cortisol effects on item and associative memory across memory phases","authors":"Monika Riegel , Daniela Barros Rodrigues , Despina Antypa , Ulrike Rimmele","doi":"10.1016/j.psyneuen.2025.107422","DOIUrl":"10.1016/j.psyneuen.2025.107422","url":null,"abstract":"<div><div>Our daily lives are filled with stressful situations, which powerfully shape the way we form, consolidate, and retrieve episodic memories. As such, stress hormones affect different memory phases of both individual <em>items</em> and their <em>associations</em>, whether they are neutral or emotional. However, an interplay between all these factors in our memory of stressful events is still poorly understood. To address this conundrum, we employed a within-subject, double-blind, placebo-controlled design with exogenous cortisol administration (10 mg hydrocortisone) to affect different memory phases (pre-encoding, post-encoding, pre-retrieval). Our participants encoded <em>neutral</em> and <em>emotional</em> noun - image pairs. After a 24 h delay, we tested their memory for individual <em>items</em> (nouns) and their <em>associations</em> (nouns - objects). While accounting for baseline (no stress) memory performance, we found divergent cortisol effects on item and associative memory, depending on affected memory phase and on emotionality of memoranda. While post-encoding cortisol administration enhanced item memory, pre-encoding, and pre-retrieval cortisol administration impaired item memory. Similarly, pre-encoding cortisol administration impaired associative memory, but only for neutral stimuli. Moreover, we observed that both salivary cortisol levels and emotionality of memoranda modulated item and associative memory performance. These findings highlight a complex interplay of how stress hormone cortisol, throughout all memory phases, differently modulates <em>item</em> and <em>associative</em> memory of neutral and emotional events.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107422"},"PeriodicalIF":3.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk factors for precocious puberty: A systematic review and meta‑analysis","authors":"Ya Wang , Hao Gou , Junjun Guo","doi":"10.1016/j.psyneuen.2025.107427","DOIUrl":"10.1016/j.psyneuen.2025.107427","url":null,"abstract":"<div><h3>Purpose</h3><div>Precocious puberty (PP) typically refers to the initiation of puberty prior to the age of eight in females and before the age of nine in males. The objective of this systematic review and meta-analysis is to pinpoint the risk factors linked to PP, thereby facilitating early diagnosis and timely intervention for individuals at high risk.</div></div><div><h3>Methods</h3><div>A thorough search was carried out in the Cochrane Library, PubMed, and Embase databases up to November 10, 2024. The eligible studies comprised participants diagnosed with PP in the exposure group and participants without PP in the control group. The odds ratio (OR) and weighted mean difference (WMD) with 95 % confidence interval (CI) were computed using a random-effects model.</div></div><div><h3>Results</h3><div>Out of 653 initially identified papers, 13 studies involving 15 cohorts were ultimately included. The mate-analysis findings indicated significant associations between several factors and the incidence of PP: BMI, maternal menarche age, and duration of breastfeeding. These three factors are significantly associated with the presence of pp: estrogen (E2) levels, follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels.</div></div><div><h3>Conclusion</h3><div>The occurrence of PP is strongly associated with several factors including BMI, maternal menarche age, and breastfeeding duration. The presence of PP is associated with three factors including E2, LH, FSH.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107427"},"PeriodicalIF":3.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Racism and hypothalamic-pituitary-adrenal axis functioning in childhood as risks for health disparities across the lifespan","authors":"Akira J. Isaac, Sara J. Bufferd, Yara Mekawi","doi":"10.1016/j.psyneuen.2025.107416","DOIUrl":"10.1016/j.psyneuen.2025.107416","url":null,"abstract":"<div><div>Racism is a primary social determinant of health and chronic stressor that affects the physical and mental health of People of Color and Indigenous Individuals (POCI) and perpetuates racial and ethnic health disparities. Despite the impact of racism on POCI, the mechanisms through which experiences of racism result in negative health outcomes remain understudied, in particular among children. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is one of the possible mechanisms. Frequent and prolonged exposure to chronic stressors may result in dysregulation of the HPA axis, and in turn cause adverse physical and psychological health outcomes for POCI children. This paper argues for the importance of examining HPA axis dysregulation as a mechanism that links racism during early childhood to negative health outcomes over the lifespan. Several studies have explored the relationship between racism and HPA axis dysregulation during adulthood and adolescence and have found associations between racism and salivary and hair cortisol. Recent studies have identified racial and ethnic differences in cortisol levels during early childhood, but only one study, to our knowledge, explored whether the differences are attributed to racism. In this paper, we conduct a review of the existing literature on the links between racism and HPA axis dysregulation during adulthood and adolescence given the dearth of studies exploring this relationship during early childhood. We also highlight the importance of utilizing an intersectionality framework in the study of racism and health to provide a more comprehensive and nuanced understanding of health disparities among and within racial/ethnic groups. Using this evidence along with consideration of relevant models, we propose how HPA axis dysregulation identified early in life may foreshadow children’s increased risk for negative health outcomes from racism and other systems of oppression and signal the need for prevention and intervention.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107416"},"PeriodicalIF":3.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shanting Chen , Yongyong Xu , Lester Sim , Wen Wen , Ka Ip , Cherita Antonia Clendinen , Su Yeong Kim
{"title":"Associations of neighborhood contexts and family-level hair cortisol concentration within Mexican immigrant families","authors":"Shanting Chen , Yongyong Xu , Lester Sim , Wen Wen , Ka Ip , Cherita Antonia Clendinen , Su Yeong Kim","doi":"10.1016/j.psyneuen.2025.107426","DOIUrl":"10.1016/j.psyneuen.2025.107426","url":null,"abstract":"<div><div>Many Mexican American immigrant families live in socioeconomically disadvantaged neighborhoods, which are recognized as risk factors influencing residents’ stress. However, how neighborhood contexts can impact physiological stress at the family level, as indicated by hair cortisol concentration (HCC), particularly among Mexican immigrant family members remains unclear. Using a person-centered approach, the current study identified distinct patterns of family-level HCC and examined their associations with neighborhood contexts (i.e., Hispanic/immigrant concentration, socioeconomic disadvantage, affluence). Participants included 398 adolescents (56.5 % female, <em>M</em><sub>age</sub> = 13.26) and their mothers and fathers. Two profiles emerged and suggested that families living in neighborhoods with higher Hispanic/immigrant concentration and lower affluence were more likely to be in the <em>high family-level HCC</em> group compared to the <em>low family-level HCC</em> group. No group differences were found for neighborhood socioeconomic disadvantage. These results highlight the importance of including multiple family members (child and parents) to provide a more comprehensive understanding of how biological stress crossover within families. Our findings also emphasize the importance of integrating neighborhood contexts in shaping the physiological stress levels of Mexican American immigrant families.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":"176 ","pages":"Article 107426"},"PeriodicalIF":3.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}