Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-05-24DOI: 10.1097/PSY.0000000000001326
Shaddy K Saba, Anthony Rodriguez, Daniel L Dickerson, Lynette Mike, Kurt Schweigman, Virginia Arvizu-Sanchez, George Funmaker, Carrie L Johnson, Ryan A Brown, Nipher Malika, Elizabeth J D'Amico
{"title":"Physical Pain Among Urban Native American Emerging Adults: Sociocultural Risk and Protective Factors.","authors":"Shaddy K Saba, Anthony Rodriguez, Daniel L Dickerson, Lynette Mike, Kurt Schweigman, Virginia Arvizu-Sanchez, George Funmaker, Carrie L Johnson, Ryan A Brown, Nipher Malika, Elizabeth J D'Amico","doi":"10.1097/PSY.0000000000001326","DOIUrl":"10.1097/PSY.0000000000001326","url":null,"abstract":"<p><strong>Objective: </strong>American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique sociocultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional sociocultural factors, and pain among urban AI/AN emerging adults.</p><p><strong>Methods: </strong>AI/AN participants aged 18-25 years ( N = 417) were recruited via social media. Regression models tested associations between socioeconomic disadvantage (income and ability to afford health care) and pain as well as additional sociocultural factors (discrimination, historical loss, cultural pride and belonging, visiting tribal lands) and pain. Multigroup regression models tested whether associations between sociocultural factors and pain differed between participants who were socioeconomically disadvantaged and those who were less disadvantaged.</p><p><strong>Results: </strong>In the full sample, lower income ( b = 1.00-1.48, p < .05), inability to afford health care ( b = 1.00, p = .011), discrimination ( b = 0.12, p = .001), and historical loss ( b = 0.24, p = .006) were positively associated with pain, whereas visiting tribal lands was negatively associated with pain ( b = -0.86 to -0.42, p < .05). In the multigroup model, visiting tribal lands 31+ days was negatively associated with pain only among the less socioeconomically disadvantaged group ( b = -1.48, p < .001).</p><p><strong>Conclusions: </strong>Socioeconomic disadvantage may, in part, drive pain disparities among AI/AN emerging adults and act as a barrier to benefitting from visiting tribal lands. Results support a biopsychosocial approach to targeting pain in this population, including addressing socioeconomic challenges and developing culturally informed, strengths-based interventions.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"615-624"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-09-01Epub Date: 2024-05-16DOI: 10.1097/PSY.0000000000001322
Stephen Gallagher, Ruth Ryan, Irene Cassidy, Wenyi Tang, Anna C Whittaker
{"title":"Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination.","authors":"Stephen Gallagher, Ruth Ryan, Irene Cassidy, Wenyi Tang, Anna C Whittaker","doi":"10.1097/PSY.0000000000001322","DOIUrl":"10.1097/PSY.0000000000001322","url":null,"abstract":"<p><strong>Objective: </strong>Antibody response to vaccination is a powerful paradigm for studying the effects of chronic stress on immune function. In the present study, we used this paradigm to examine the interaction between caregiving (as a type of chronic stress) and sex on the antibody response to a single dose of a COVID-19 vaccination; recent research has called for examination of sex differences on health outcomes among family caregivers. A three-way interaction between caregiving, sex, and psychological distress was also examined.</p><p><strong>Methods: </strong>COVID-19 antibody data were extracted from 165 caregivers (98 females) and 386 non-caregivers (244 females) from the UK's Understanding Society COVID-19 study. Relevant sociodemographics, health and lifestyle, and distress variables were gathered as potential covariates.</p><p><strong>Results: </strong>In a 2 × 2 ANOVA, we found that the interaction between caregiving and sex was significant; male caregivers had a lower antibody response to the vaccine compared to female caregivers ( F (1,547), =24.82, p < .001, η2p = 0.043). Following adjustment, male caregivers had the lowest antibody response relative to all other groups. The three-way interaction model, controlling for covariates, was also significant ( R2 = 0.013, p = .049); the conditional effects for the three-way interaction revealed that male caregivers, compared to the other groups, had a lower antibody response at both low and medium levels of psychological distress.</p><p><strong>Conclusion: </strong>This study found evidence of a three-way interaction between caregiving, sex, and distress on antibody response. Male caregivers had poorer antibody response to a single shot of the COVID-19 vaccination than female caregivers and male and female non-caregivers, and this was evident at low and medium levels of distress. Our findings will be discussed in relation to the caregiver and sex interactions during the pandemic.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"633-639"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-07-01Epub Date: 2024-05-06DOI: 10.1097/PSY.0000000000001319
Benjamin W Nelson, Nicholas C Peiper, Kirstin Aschbacher, Valerie L Forman-Hoffman
{"title":"Evidence-Based Therapist-Supported Digital Mental Health Intervention for Patients Experiencing Medical Multimorbidity: A Retrospective Cohort Intent-to-Treat Study.","authors":"Benjamin W Nelson, Nicholas C Peiper, Kirstin Aschbacher, Valerie L Forman-Hoffman","doi":"10.1097/PSY.0000000000001319","DOIUrl":"10.1097/PSY.0000000000001319","url":null,"abstract":"<p><strong>Objective: </strong>Multimorbidity or the co-occurrence of multiple health conditions is increasing globally and is associated with significant psychological complications. It is unclear whether digital mental health (DMH) interventions for patients experiencing multimorbidity are effective, particularly given that this patient population faces more treatment resistance. The goal of the current study was to examine the impact of smartphone-delivered DMH interventions for patients presenting with elevated internalizing symptoms that have reported multiple lifetime medical conditions.</p><p><strong>Methods: </strong>This preregistered (see https://osf.io/vh2et/ ) retrospective cohort intent-to-treat study with 2819 patients enrolled in a therapist-supported DMH intervention examined the associations between medical multimorbidity (MMB) and mental health outcomes.</p><p><strong>Results: </strong>Results indicated that more MMB was significantly associated with greater presenting mental health symptom severity. MMB did not have a deleterious influence on depressive symptom trajectories across treatment, although having one medical condition was associated with a steeper decrease in anxiety symptoms compared to patients with no medical conditions. Finally, MMB was not associated with time to dropout, but was associated with higher dropout and was differentially associated with fewer beneficial treatment outcomes, although this is likely attributable to higher presenting symptom severity, rather than lesser symptom reductions during treatment.</p><p><strong>Conclusions: </strong>Overall, the Meru Health Program was associated with large effect size decreases in depressive and anxiety symptoms regardless of the number of MMB. Future DMH treatments and research might investigate tailored barrier reduction and extended treatment lengths for patients experiencing MMB to allow for greater treatment dose to reduce symptoms below clinical outcome thresholds.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"547-554"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-07-01Epub Date: 2024-05-13DOI: 10.1097/PSY.0000000000001321
Ali A Weinstein, Robbie C M van Aert, Kiersten Donovan, Lotte Muskens, Willem J Kop
{"title":"Affective Responses to Acute Exercise: A Meta-Analysis of the Potential Beneficial Effects of a Single Bout of Exercise on General Mood, Anxiety, and Depressive Symptoms.","authors":"Ali A Weinstein, Robbie C M van Aert, Kiersten Donovan, Lotte Muskens, Willem J Kop","doi":"10.1097/PSY.0000000000001321","DOIUrl":"10.1097/PSY.0000000000001321","url":null,"abstract":"<p><strong>Objective: </strong>Acute exercise elicits various biobehavioral and psychological responses, but results are mixed with regard to the magnitude of exercise-induced affective reactions. This meta-analysis examines the magnitude of general mood state, anxiety, and depressive symptom responses to acute exercise while exploring exercise protocol characteristics and background health behaviors that may play a role in the affective response.</p><p><strong>Methods: </strong>A total of 2770 articles were identified from a MEDLINE/PubMed search and an additional 133 articles from reviews of reference sections. Studies had to have measured general mood before the acute exercise bout and within 30 minutes after exercise completion. Effect sizes were estimated using Hedges' g , with larger values indicating improvement in the outcome measure.</p><p><strong>Results: </strong>A total of 103 studies were included presenting data from 4671 participants. General mood state improved from preexercise to postexercise ( g = 0.336, 95% confidence interval [CI] = 0.234-0.439). Anxiety ( g = 0.497, 95% CI = 0.263-0.730) and depressive symptoms ( g = 0.407, 95% CI = 0.249-0.564) also improved with exercise. There was substantial and statistically significant heterogeneity in each of these meta-analyses. This heterogeneity was not explained by differences in participants' health status. Meta-regression analyses with potential moderators (intensity of exercise, mode of exercise, usual physical activity level, or weight status of participants) also did not reduce the heterogeneity.</p><p><strong>Conclusion: </strong>This meta-analysis shows significantly improved general mood, decreased anxiety, and lower depressive symptoms in response to an acute bout of exercise. There was substantial heterogeneity in the magnitude of the effect sizes, indicating that additional research is needed to identify determinants of a positive affective response to acute exercise.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"486-497"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-07-01Epub Date: 2024-03-18DOI: 10.1097/PSY.0000000000001294
Natalie Ella Miller, Abigail Fisher, Philipp Frank, Phillippa Lally, Andrew Steptoe
{"title":"Depressive Symptoms, Socioeconomic Position, and Mortality in Older People Living With and Beyond Cancer.","authors":"Natalie Ella Miller, Abigail Fisher, Philipp Frank, Phillippa Lally, Andrew Steptoe","doi":"10.1097/PSY.0000000000001294","DOIUrl":"10.1097/PSY.0000000000001294","url":null,"abstract":"<p><strong>Objective: </strong>Evidence shows that higher depressive symptoms are associated with mortality among people living with and beyond cancer (LWBC). However, prior studies have not accounted for a wider range of potential confounders, and no study has explored whether socioeconomic position (SEP) moderates the association. This study aimed to examine the association between depressive symptoms and mortality among people LWBC, and moderation by SEP.</p><p><strong>Methods: </strong>Participants from the English Longitudinal Study of Aging, diagnosed with cancer and with a measure of depressive symptoms within 4 years after their diagnosis, were included. Elevated depressive symptoms were indicated by a score of ≥3 on the eight-item Center for Epidemiologic Studies Depression Scale. Cox regression models examined associations with all-cause mortality. Competing risk regression examined associations with cancer mortality.</p><p><strong>Results: </strong>In 1352 people LWBC (mean age = 69.6 years), elevated depressive symptoms were associated with a 93% increased risk of all-cause mortality (95% confidence interval = 1.52-2.45) within the first 4 years of follow-up and a 48% increased risk within a 4- to 8-year follow-up (95% confidence interval = 1.02-2.13) after multivariable adjustment. Elevated depressive symptoms were associated with a 38% increased risk of cancer mortality, but not after excluding people who died within 1 year after baseline assessments. There were no interactions between depressive symptoms and SEP.</p><p><strong>Conclusions: </strong>Elevated depressive symptoms are associated with a greater risk of all-cause mortality among people LWBC within an 8-year follow-up period. Associations between depressive symptoms and cancer mortality might be due to reverse causality.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"523-530"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-06-01Epub Date: 2023-10-24DOI: 10.1097/PSY.0000000000001257
Sumaiyah U Syed, Jared I Cortez, Stephanie J Wilson
{"title":"Depression, Inflammation, and the Moderating Role of Metformin: Results From the Midlife in the United States Study and Sacramento Area Latino Study on Aging.","authors":"Sumaiyah U Syed, Jared I Cortez, Stephanie J Wilson","doi":"10.1097/PSY.0000000000001257","DOIUrl":"10.1097/PSY.0000000000001257","url":null,"abstract":"<p><strong>Objective: </strong>Depression can promote inflammation and accelerate aging. Metformin, a widely prescribed antidiabetic, has shown promising preclinical evidence of aging-related health benefits, including decreased inflammation. The current study examined whether metformin usage buffers the association between depressive symptoms and inflammatory markers in two large samples of middle-aged and older, primarily White adults, and older Latino adults.</p><p><strong>Methods: </strong>Data from the Midlife in the United States Study ( N = 1255) and the Sacramento Area Latino Study on Aging ( N = 1786) included information on medication use, depressive symptoms, and inflammatory markers, namely, interleukin 6 (IL-6), tumor necrosis factor α, and C-reactive protein (CRP). These data were merged into a harmonized sample, and the sample group variable was included in a three-way interaction for analysis.</p><p><strong>Results: </strong>Specifically, in the Midlife in the United States Study sample, metformin buffered the association between depressive symptoms and CRP ( b = -0.029, standard error [SE] = 0.013, p = .007) and IL-6 ( b = 0.21, SE = 0.010, p = .046), whereas no significant association was found with tumor necrosis factor α. Metformin nonusers displayed higher depressive symptoms associated with elevated CRP ( b = 0.01, SE = 0.003, p < .001) and IL-6 ( b = 0.011, SE = 0.003, p < .001), whereas this association was not present among metformin users ( p values > .068). Conversely, in the Sacramento Area Latino Study on Aging sample, metformin use did not show a significant protective link.</p><p><strong>Conclusions: </strong>Results from mostly White, highly educated adults supported a mitigating role of metformin in ties between depression, a well-known behavioral risk factor, and inflammation, a key source of biological aging. However, the benefits did not extend to a large sample of older Mexican Americans. The findings reveal a hidden potential benefit of this therapeutic agent and raise important questions around its health equity.</p><p><strong>Trial registration: </strong>The study was preregistered on OSF ( https://osf.io/c92vw/ ).</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"473-483"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11039570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-06-01Epub Date: 2024-01-15DOI: 10.1097/PSY.0000000000001278
Anne-Josee Guimond, Shanlin Ke, Shelley S Tworoger, Tianyi Huang, Andrew T Chan, Laura D Kubzansky, Yang-Yu Liu
{"title":"Fulfilled Mind, Healthy Gut? Relationships of Eudaimonic Psychological Well-Being With the Gut Microbiome in Postmenopausal Women.","authors":"Anne-Josee Guimond, Shanlin Ke, Shelley S Tworoger, Tianyi Huang, Andrew T Chan, Laura D Kubzansky, Yang-Yu Liu","doi":"10.1097/PSY.0000000000001278","DOIUrl":"10.1097/PSY.0000000000001278","url":null,"abstract":"<p><strong>Objective: </strong>Eudaimonic facets of psychological well-being (PWB), like purpose in life and sense of mastery, are associated with healthy aging. Variation in the gut microbiome may be one pathway by which mental health influences age-related health outcomes. However, associations between eudaimonic PWB and the gut microbiome are understudied. We examined whether purpose in life and sense of mastery, separately, were associated with features of the gut microbiome in older women.</p><p><strong>Methods: </strong>Participants were from the Mind-Body Study ( N = 206, mean age = 61 years), a substudy of the Nurses' Health Study II cohort. In 2013, participants completed the Life Engagement Test and the Pearlin Mastery Scale. Three months later, up to two pairs of stool samples were collected, 6 months apart. Covariates included sociodemographics, depression, health status, and health behaviors. Analyses examined associations of PWB with gut microbiome taxonomic diversity, overall community structure, and specific species/pathways. To account for multiple testing, statistical significance was established using Benjamini-Hochberg adjusted p values (i.e., q values ≤0.25).</p><p><strong>Results: </strong>We found no evidence of an association between PWB and gut microbiome alpha diversity. In multivariate analysis, higher purpose levels were significantly associated with lower abundance of species previously linked with poorer health outcomes, notably Blautia hydrogenotrophica and Eubacterium ventriosum ( q values ≤0.25). No significant associations were found between PWB and metabolic pathways.</p><p><strong>Conclusions: </strong>These findings offer early evidence suggesting that eudaimonic PWB is linked with variation in the gut microbiome, and this might be one pathway by which PWB promotes healthy aging.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"398-409"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psychosomatic MedicinePub Date : 2024-06-01Epub Date: 2023-11-17DOI: 10.1097/PSY.0000000000001264
Emily K Lindsay, Anna L Marsland, Steven W Cole, Janine M Dutcher, Carol M Greco, Aidan G C Wright, Kirk Warren Brown, John David Creswell
{"title":"Mindfulness-Based Stress Reduction Reduces Proinflammatory Gene Regulation But Not Systemic Inflammation Among Older Adults: A Randomized Controlled Trial.","authors":"Emily K Lindsay, Anna L Marsland, Steven W Cole, Janine M Dutcher, Carol M Greco, Aidan G C Wright, Kirk Warren Brown, John David Creswell","doi":"10.1097/PSY.0000000000001264","DOIUrl":"10.1097/PSY.0000000000001264","url":null,"abstract":"<p><strong>Objective: </strong>Aging is associated with increased proinflammatory gene expression and systemic inflammation, and psychosocial stress may accelerate these changes. Mindfulness interventions show promise for reducing psychosocial stress and extending healthspan. Inflammatory pathways may play a role. In a sample of lonely older adults, we tested whether mindfulness training reduces proinflammatory gene expression and protein markers of systemic inflammation.</p><p><strong>Methods: </strong>Lonely older adults (65-85 years; N = 190) were randomly assigned to an 8-week Mindfulness-Based Stress Reduction (MBSR) or matched Health Enhancement Program (HEP). Blood was drawn before and after the intervention and at 3-month follow-up. In peripheral blood mononuclear cells, RNA profiling was used to assess transcriptional regulation by proinflammatory nuclear factor κB (NF-κB) as well as β-adrenergic cAMP response element-binding protein (CREB), antiviral interferon regulatory factor (IRF), and glucocorticoid receptor (GR) transcription factors. Plasma was assayed for proinflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP). Analyses tested time (pre, post, follow-up) by condition (MBSR versus HEP) effects.</p><p><strong>Results: </strong>MBSR reduced NF-κB ( d = 0.17, p = .028) but did not alter CREB ( d = 0.10, p = .20), IRF ( d = 0.13, p = .086), or GR activity ( d = 0.14, p = .063) relative to HEP over time. Contrary to predictions, there were no time by condition effects of MBSR compared with HEP on reducing circulating IL-6 or CRP.</p><p><strong>Conclusions: </strong>In lonely older adults, MBSR reduced cellular proinflammatory gene regulation in ways that would predict reduced disease risk. However, no similar effect was observed for circulating protein markers of inflammation. These results provide specificity about how mindfulness interventions may impact distinct inflammatory markers among aging adults in ways that may have important implications for healthspan.</p><p><strong>Trial registration: </strong>Clinical Trials identifier NCT02888600.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"463-472"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}