Ru-Meng Wei , Meng-Ying Zhang , Shi-Kun Fang , Gao-Xia Liu , Fei Hu , Xue-Yan Li , Kai-Xuan Zhang , Jing-Ya Zhang , Xue-Chun Liu , Yue-Ming Zhang , Gui-Hai Chen
{"title":"Melatonin attenuates intermittent hypoxia-induced cognitive impairment in aged mice: The role of inflammation and synaptic plasticity","authors":"Ru-Meng Wei , Meng-Ying Zhang , Shi-Kun Fang , Gao-Xia Liu , Fei Hu , Xue-Yan Li , Kai-Xuan Zhang , Jing-Ya Zhang , Xue-Chun Liu , Yue-Ming Zhang , Gui-Hai Chen","doi":"10.1016/j.psyneuen.2024.107210","DOIUrl":"10.1016/j.psyneuen.2024.107210","url":null,"abstract":"<div><div>Intermittent hypoxia (IH), a major pathophysiologic alteration in obstructive sleep apnea syndrome (OSAS), is an important contributor to cognitive impairment. Increasing research suggests that melatonin has anti-inflammatory properties and improves functions related to synaptic plasticity. However, it is unclear whether melatonin has a protective effect against OSAS-induced cognitive dysfunction in aged individuals and the involved mechanisms are also unclear. Therefore, in the study, the effects of exposure to IH alone and IH in combination with daily melatonin treatment were investigated in C57BL/6 J mice aged 18 months. Assessment of the cognitive ability of mice in a Morris water maze showed that melatonin attenuated IH-induced impairment of learning and memory in aged mice. Enzyme-linked immunosorbent assay, polymerase chain reaction, and western blotting molecular techniques showed that melatonin treatment reduced the levels of the proinflammatory cytokines, interleukin-1β, interleukin-6, and tumor necrosis factor-α, decreased the levels of NOD-like receptor thermal protein domain associated protein 3 and nuclear factor kappa-B, lowered the levels of ionized calcium-binding adapter molecule 1 and glial fibrillary acidic protein, and increased the levels of the synaptic proteins, activity-regulated cytoskeleton-associated protein, growth-associated protein-43, postsynaptic density protein 95, and synaptophysin in IH-exposed mice. Moreover, electrophysiological results showed that melatonin ameliorated the decline in long-term potentiation induced by IH. The results suggest that melatonin can ameliorate IH-induced cognitive deficits by inhibiting neuroinflammation and improving synaptic plasticity in aged mice.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392734","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}
Andrew Erhart , Sarah Watamura , Aviva K. Olsavsky , Alexander Dufford , Rebekah Tribble , Tom Yeh , Pilyoung Kim
{"title":"Maternal cortisol concentration is associated with reduced brain activation to infant cry and more intrusive parenting behavior","authors":"Andrew Erhart , Sarah Watamura , Aviva K. Olsavsky , Alexander Dufford , Rebekah Tribble , Tom Yeh , Pilyoung Kim","doi":"10.1016/j.psyneuen.2024.107207","DOIUrl":"10.1016/j.psyneuen.2024.107207","url":null,"abstract":"<div><div>Previous research indicates that maternal cortisol function and maternal brain response to infant are each in turn related to variations in parenting behavior. However, little is known about how maternal cortisol and maternal brain function are associated, thus studying these two mechanisms together may improve our understanding of how maternal cortisol assessed during interactions with own infant is associated with brain response to infant cry. First-time mothers (N = 59) of infants aged 3–4 months old were recruited to participate. Mothers’ cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for two parenting behaviors-- maternal sensitivity and non-intrusiveness. In an fMRI session, mothers listened to their own infant and a control infant crying. Higher cortisol concentration was associated with more intrusive behavior. We found greater cortisol concentration was further associated with decreased activation in the brain to infant cry in the right precentral gyrus, the left culmen extending into the left inferior temporal gyrus and fusiform, two clusters in the superior temporal gyrus, and in the medial frontal gyrus. We also found that lower activation in these regions was associated with more intrusive maternal behavior. These data demonstrate the associations between maternal cortisol concentration and reduced brain activation to infant cry in both motor planning and auditory processing regions in predicting intrusive parenting behavior.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441451","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}
Valeska Pérez-Arqueros , Joaquim Soler , Carlos Schmidt , Daniel Vega , Juan C. Pascual
{"title":"Could intranasal oxytocin enhance the effects of psychotherapy in individuals with mental disorders? A systematic review and meta-analysis","authors":"Valeska Pérez-Arqueros , Joaquim Soler , Carlos Schmidt , Daniel Vega , Juan C. Pascual","doi":"10.1016/j.psyneuen.2024.107206","DOIUrl":"10.1016/j.psyneuen.2024.107206","url":null,"abstract":"<div><div>Interest in the therapeutic potential of oxytocin for the treatment of mental health disorders, especially those involving social dysfunction, has increased considerably in recent years. To date, most studies have only evaluated oxytocin as monotherapy, with highly inconsistent results. A new line of research is exploring the effects of combining oxytocin with psychotherapy. The aim of the present review was to evaluate the therapeutic effects of intranasal oxytocin combined with psychotherapy in individuals with psychiatric disorders. Only randomized clinical trial design was eligible for inclusion. A search of relevant databases yielded 2480 articles published through April 30, 2024. Of these, 13 trials (518 participants) were included in this review and 4 of them in a meta-analysis. The trials evaluated a range of different psychotherapeutic interventions, oxytocin doses, and mental disorders. Overall, the trials suggested that combined treatment reduced negative mental representations, decreased stress, and increased therapeutic alliance. Meta-analysis showed that combined treatment significantly reduced depressive symptoms (d= −1.58, 95 % CI: −3.15 to −0.01). However, the treatment with oxytocin had no significant effects on psychiatric symptoms (d= 0.00, 95 % CI: −0.56–0.57) or social functioning (d = 0.21, 95 % CI: −0.07–0.49). Limitations included the heterogeneity and limited sample sizes of the trials. The findings suggest that the combination of intranasal oxytocin and psychotherapy may be an effective therapeutic approach to reduce depressive symptoms in individuals with mental disorders and may improve retention and therapeutic alliance.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375876","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":"Hatha yoga reduces momentary stress but does not impact diurnal profiles of salivary cortisol and alpha-amylase: A randomized controlled trial","authors":"Bence Szaszkó , Hannah Tschenett , Ulrich Ansorge , Urs Markus Nater","doi":"10.1016/j.psyneuen.2024.107191","DOIUrl":"10.1016/j.psyneuen.2024.107191","url":null,"abstract":"<div><div>Does the practice of yoga impact stress? Various studies have suggested that yoga may reduce both self-reported stress and stress biomarkers, but the evidence for such claims remains inconclusive, especially for yoga styles with a focus on physical postures. In a randomized controlled trial with 98 participants, we therefore examined whether an eight-week Hatha yoga intervention (60 min, 3×/week or more) led to reduced levels of diurnal salivary cortisol (sCort), salivary alpha-amylase (sAA), and subjective momentary stress as compared to a waitlist control group. To ensure the concomitant assessment of self-report and biological measures in an ecologically valid setting, and to capture the diurnal profile of cortisol and alpha-amylase, we employed an ecological momentary assessment approach. Five times per day, participants reported their momentary stress levels on a visual analogue scale and collected saliva samples for the assessment of salivary biomarkers. The intervention led to a significant reduction of subjective momentary stress but there was no change in diurnal sCort or sAA levels. There are several potential explanations for these findings: The intervention may have helped participants to cope better with stress while leaving diurnal levels of stress biomarkers unaffected, or the change may at least not have been reflected in sCort and sAA. Alternatively, there may have been a self-report bias, insofar as a favorable disposition towards yoga may have led participants to report reductions in stress in order to indicate positive effects of the intervention. Our findings contribute to a better understanding of the effects of distinct yoga interventions, demonstrating their potential to serve as low-risk stress relief tools.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366355","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}
Sameera Abuaish , Vanessa Babineau , Seonjoo Lee , Benjamin Tycko , Frances A. Champagne , Elizabeth Werner , Catherine Monk
{"title":"Maternal high BMI: Sex-dimorphic alterations in maternal and offspring stress indices","authors":"Sameera Abuaish , Vanessa Babineau , Seonjoo Lee , Benjamin Tycko , Frances A. Champagne , Elizabeth Werner , Catherine Monk","doi":"10.1016/j.psyneuen.2024.107196","DOIUrl":"10.1016/j.psyneuen.2024.107196","url":null,"abstract":"<div><div>Maternal body mass index (BMI) influences pregnancy and birth outcomes along with child metabolic and neurodevelopmental health and fetal sex may be a moderating factor in these effects. Alternations in autonomic nervous system (ANS) functioning, identified in heart rate (HR) measurements, could present early markers of these prenatal programming effects in both the mother and the developing fetus. This study examines the associations between pre-pregnancy BMI and maternal and fetal ANS functioning and infant postnatal behavioral outcomes stratified by fetal sex. Pregnant women (N=176) were recruited at gestational week (GW) T1: 12–22 and categorized into Normal (BMI< 25) or High BMI (BMI > 25). Women attended laboratory sessions at T2: GW 23–28, and T3: GW 34–36 to assess maternal and fetal HR and HR variability (HRV) at baseline and after a stressor at T3. Infant behavior was assessed at 4 months using the Infant Behavior Questionnaire-Revised. Women with high BMI bearing female fetuses had higher HR and lower HRV at both gestational time points. Later in the third trimester, female fetuses of high BMI women exhibited lower HRV when challenged with a stressor. At 4 months, female infants were rated as having lower scores on the Orienting/Regulatory scale. Our findings provide evidence of female sex-specific programming of maternal pre-pregnancy BMI on maternal ANS regulation and neurodevelopment identified <em>in-utero</em> and continuing into early infancy.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324059","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}
Annelies van't Westeinde , Nelly Padilla , Sara Fletcher-Sandersjöö , Olle Kämpe , Sophie Bensing , Svetlana Lajic Näreskog
{"title":"Brain activity during working memory in patients with autoimmune Addison’s disease","authors":"Annelies van't Westeinde , Nelly Padilla , Sara Fletcher-Sandersjöö , Olle Kämpe , Sophie Bensing , Svetlana Lajic Näreskog","doi":"10.1016/j.psyneuen.2024.107195","DOIUrl":"10.1016/j.psyneuen.2024.107195","url":null,"abstract":"<div><div>Autoimmune Addison’s disease (AAD) is treated with daily oral hormone replacements for cortisol and aldosterone. The current treatment is sub-optimal, and frequently results in supra- and infra-physiological cortisol levels that might negatively affect the brain and cognitive functioning. It is currently unclear if the brains of these patients need to be better protected. The present study investigates brain function during working memory in young adults with AAD compared to healthy controls. All participants (56 AAD (33 females), 62 controls (39 females), 19–43 years), underwent MRI brain scanning while performing a visuo-spatial and verbal working memory task. No main group differences in accuracy, reaction time or brain activity during the tasks were found. These findings suggest that patients perform equal to controls, and achieve similar levels of brain activity during working memory. However, variations in the patient population may have confounded this outcome. Controlled studies on larger cohorts are therefore needed to confirm these findings and test if having AAD affects the brain on the long term.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323648","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}
Ciara A. McAfee , Robert A. Josephs , Annabelle DiVita , Michael J. Telch , Frances A. Champagne
{"title":"CO2 challenge-evoked hormonal changes predicting TSST changes in cortisol and subjective distress","authors":"Ciara A. McAfee , Robert A. Josephs , Annabelle DiVita , Michael J. Telch , Frances A. Champagne","doi":"10.1016/j.psyneuen.2024.107187","DOIUrl":"10.1016/j.psyneuen.2024.107187","url":null,"abstract":"<div><div>The importance of stressor response in relation to the development of psychopathology has been recognized for decades, yet the relationship is not fully understood. The Trier Social Stress Test (TSST) is an established conditioned stressor and frequently used to assess cortisol response to acute stress in different psychopathologies. The 35 % CO<sub>2</sub> Challenge is a biological stressor and has mostly been utilized to assess subjective responses in anxiety related disorders. In the current study (N=189), we assessed the hormonal effects (cortisol, testosterone) and subjective distress (stress, anxiety, and fear) of the 35 % CO<sub>2</sub> Challenge, and several days later, assessed the hormonal and subjective distress effects of the TSST in a mixed-sex, college-aged sample, to test for predictive effects of the 35 % CO<sub>2</sub> Challenge on TSST-evoked outcomes. No testosterone by cortisol interaction effects were found in females. In males, the 35 % CO<sub>2</sub> Challenge-evoked interaction of testosterone and cortisol predicted TSST-evoked subjective stress, anxiety, and fear, with higher concentrations of testosterone predicting subjective distress, but only at (relatively) low concentrations of cortisol (one standard deviation below mean concentrations). This result – in line with the dual-hormone hypothesis – suggests the 35 % CO<sub>2</sub> Challenge could be utilized in a wider array of laboratory stress response research.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372703","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}
Kaylin E. Hill , Emilia F. Cárdenas , Eileen Yu , Regina Hammond , Kathryn L. Humphreys , Autumn Kujawa
{"title":"A systematic review of associations between hormone levels in hair and peripartum depression","authors":"Kaylin E. Hill , Emilia F. Cárdenas , Eileen Yu , Regina Hammond , Kathryn L. Humphreys , Autumn Kujawa","doi":"10.1016/j.psyneuen.2024.107194","DOIUrl":"10.1016/j.psyneuen.2024.107194","url":null,"abstract":"<div><div>Peripartum depression is a global health concern, characterized by mood disturbances inclusive of pregnancy through up to 12-months postpartum. Hormones play a vital role in pregnancy maintenance, fetal development, and labor and delivery and change significantly as a function of pregnancy and childbirth. However, such life sustaining changes may have consequences related to risk for peripartum depression. To date, most studies that have examined hormones in relation to peripartum depression have focused on blood or saliva sampling approaches, though hair analysis offers unique information on trajectories of hormone concentrations over more sustained periods of time (i.e., over months). The aim of this systematic review was to provide a comprehensive review of the association between hair measures of hormones (i.e., cortisol, progesterone, estrogen, and testosterone) and depression during the peripartum period. Forty-one studies were identified for inclusion. A majority of studies reported statistically null associations. Between-person studies varied widely in reported direction and magnitude of hair hormone–depression associations, most likely attributable to a wide range of methodological approaches including timing of assessments and sample size. Studies using within-person approaches observed positive coupling of cortisol concentration and symptoms across time. Most studies focused exclusively on cortisol. We recommend future research consider both stress and reproductive hormones, prioritize within-person change in hormone levels given this is a period of dramatic change, and include contextual (e.g., social support, adverse and benevolent childhood experiences, physical and psychiatric conditions) features that may modify both changes in hormones and the association between hormone levels and depression in the peripartum period.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392732","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}
Stephanie M. Koning , Emma K. Adam , Amita Kapoor , Thomas W. McDade
{"title":"Echoes of conflict and displacement in maternal health: Life-course violence, timing, and maternal stress after childbirth at the northern Thailand-Myanmar border","authors":"Stephanie M. Koning , Emma K. Adam , Amita Kapoor , Thomas W. McDade","doi":"10.1016/j.psyneuen.2024.107189","DOIUrl":"10.1016/j.psyneuen.2024.107189","url":null,"abstract":"<div><div>Armed conflict, displacement, and related violence is escalating globally, concentrated among civilians and migrants in border areas, and poses grave harms to women and children. The current study investigates how women’s life-course experiences of conflict and displacement are linked to maternal stress and health outcomes after childbirth at the Thailand-Myanmar border, specifically stress, mental health, and cardiometabolic outcomes. Analyses are based on a cross-sectional population-based maternal and child health survey of 701 mothers, collected in 2017–18 in northern Thailand along the Myanmar border, including in camps, worksites, and residential homes. Results suggest that how conflict violence shapes contemporary stress and health depends on the outcome, level and timing of conflict violence exposure, and subsequent contextual threats and deprivation in displacement contexts. Past conflict violence was associated with symptoms of perceived stress (PS) and generalized anxiety disorder (GAD) but not depression. It was also associated with hypothalamic-pituitary-adrenal (HPA) axis activity (hair cortisol concentration) and adiposity (waist circumference and waist-to-hip ratio). Additionally, past conflict violence that began in childhood was particularly salient for PS, GAD, and adiposity; and level and timing of violence were salient jointly for HPA activity. Post-displacement factors also independently predicted higher blood pressure and played a potentially partial mediating role in the association between conflict exposure and both PS and GAD symptoms.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392733","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}
Benedict Herhaus , Martin Heni , Wilhelm Bloch , Katja Petrowski
{"title":"Dynamic interplay of cortisol and BDNF in males under acute and chronic psychosocial stress – A randomized controlled study","authors":"Benedict Herhaus , Martin Heni , Wilhelm Bloch , Katja Petrowski","doi":"10.1016/j.psyneuen.2024.107192","DOIUrl":"10.1016/j.psyneuen.2024.107192","url":null,"abstract":"<div><div>The neurotrophic protein brain-derived neurotrophic factor (BDNF) plays a pivotal role in brain function and is affected by acute and chronic stress. We here investigate the patterns of BDNF and cortisol stress reactivity and recovery under the standardized stress protocol of the TSST and the effect of perceived chronic stress on the basal BDNF levels in healthy young men. Twenty-nine lean young men underwent the Trier Social Stress Test (TSST) and a resting condition. Serum BDNF and cortisol were measured before and repeatedly after both conditions. The perception of chronic stress was assessed by the Trier Inventory for Chronic Stress (TICS). After the TSST, there was a significant increase over time for BDNF and cortisol. Stronger increase in cortisol in response to stress was linked to an accelerated BDNF decline after stress. Basal resting levels of BDNF was significantly predicted by chronic stress perception. The increased BDNF level following psychosocial stress suggest a stress-induced neuroprotective mechanism. The presumed interplay between BDNF and the HPA-axis indicates an antagonistic relationship of cortisol on BDNF recovery post-stress. Chronically elevated high cortisol levels, as present in chronic stress, could thereby contribute to reduced neurogenesis, and an increased risk of neurodegenerative conditions in persons suffering from chronic stress.</div></div>","PeriodicalId":20836,"journal":{"name":"Psychoneuroendocrinology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323647","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}