Journal of Psychosomatic Research最新文献

{"title":"Resilience, psychosomatic health, and support needs of Ukrainian healthcare professionals in wartime: A cross-sectional study","authors":"Anastasiia Yuriivna Sydorenko ,&nbsp;Lennart Kiel ,&nbsp;Helle Spindler","doi":"10.1016/j.jpsychores.2024.111995","DOIUrl":"10.1016/j.jpsychores.2024.111995","url":null,"abstract":"<div><h3>Background</h3><div>As Ukraine enters its third year of war, healthcare professionals (HPs) continue to face ongoing challenges to their adaptability and resilience. This study aimed to assess the emotional and physical well-being of HPs, evaluate their resilience levels, and identify the most anticipated types of psychological support that would benefit them.</div></div><div><h3>Methods</h3><div>Emotional and somatic states were assessed using the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire (PHQ-15). Resilience was measured by the Connor-Davidson Resilience Scale (CD-RISC-10). Open-ended questions were used to identify anticipated measures of psychological support.</div></div><div><h3>Results</h3><div>A total of 1442 HPs participated in the study. The majority exhibited high levels of anxiety and depression. Resilience scores showed negative correlations with anxiety (<em>r</em> = −0.34), depression (<em>r</em> = −0.53), and somatic symptom severity (<em>r</em> = −0.36). The most desired types of psychological support included psychological counselling, spiritual support, and opportunities for rest.</div></div><div><h3>Conclusion</h3><div>It is essential to address the primary needs of HPs in Ukraine to support their professional and personal resilience during wartime. Psychological support should not only focus on treating symptoms and distress but also respond to deeper needs that foster hope and faith in a better future.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111995"},"PeriodicalIF":3.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695823","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":"Heart rate variability is not associated with multiple chemical sensitivity in a cross-sectional population-based study - The Danish study of functional disorders","authors":"Anne Ahrendt Bjerregaard ,&nbsp;Louise Brinth ,&nbsp;Marie W. Petersen ,&nbsp;Signe U. Schovsbo ,&nbsp;Lene Eplov ,&nbsp;Susanne Brix ,&nbsp;Allan Linneberg ,&nbsp;Lise Gormsen ,&nbsp;Torben Jørgensen ,&nbsp;Thomas M. Dantoft","doi":"10.1016/j.jpsychores.2024.111992","DOIUrl":"10.1016/j.jpsychores.2024.111992","url":null,"abstract":"<div><h3>Objective</h3><div>Multiple chemical sensitivity (MCS), a functional somatic disorder (FSD), is a multisystem, polysymptomatic disease, characterized by various individual symptoms attributed to low level of volatile chemical exposures. Symptoms relate to the autonomic nerve system (ANS) among others which is mandatory in the MCS delimitations. An accepted measure of ANS is heart rate variability (HRV). The aim was to explore associations between HRV and MCS in the general Danish population.</div></div><div><h3>Methods</h3><div>In the Danish Study of Functional Disorders, 7493 adults filled in questionnaires and participated in a physical health examination (2012–2015). The “E motion” heart rate monitor device assessed time and frequency measures of HRV. For this study, 143 were categorized with MCS of which, 84 were subcategorized as MCS without comorbid FSD. The remaining population (<em>n</em> = 5525) was used as comparison group. Logistic regression models to assess odds ratio (OR) with 95 % confidence intervals (95 % CI) of MCS, and MCS without comorbid FSD for each HRV exposure adjusted for age, sex, and chronic stress.</div></div><div><h3>Results</h3><div>Compared to the general population, median resting heart rate was higher (64.7 vs 63.1 bpm, <em>p</em> = 0.007) and median normal-to-normal intervals was lower (930 vs 952 ms, p = 0.007) in MCS individuals. Resting heart rate was associated with MCS (OR: 1.019, 95 %CI: 1.003; 1.037); but not after adjustment for chronic stress. No other associations with other HRV measures nor in MCS without comorbid FSD were found.</div></div><div><h3>Conclusion</h3><div>HRV was not associated with MCS. The magnitude of the differences between groups was small and of uncertain clinical significance.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111992"},"PeriodicalIF":3.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695463","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":"Metabolomics profiling of Type D personality traits","authors":"Ruifang Li-Gao ,&nbsp;Mariska Bot ,&nbsp;Alexander Kurilshikov ,&nbsp;Gonneke Willemsen ,&nbsp;Marleen M.J. van Greevenbroek ,&nbsp;Miranda M.T. Schram ,&nbsp;Coen D.A. Stehouwer ,&nbsp;Jingyuan Fu ,&nbsp;Alexandra Zhernakova ,&nbsp;Brenda W.J.H. Penninx ,&nbsp;Eco J.C. De Geus ,&nbsp;Dorret I. Boomsma ,&nbsp;Nina Kupper ,&nbsp;for the BBMRI-NL Metabolomics Consortium","doi":"10.1016/j.jpsychores.2024.111994","DOIUrl":"10.1016/j.jpsychores.2024.111994","url":null,"abstract":"<div><h3>Objective</h3><div>Type D (Distressed) personality combines negative affectivity (NA) and social inhibition (SI) and is associated with an increased risk of cardiometabolic diseases. Here, we examined the association of Type D traits with 230 (predominantly) lipid metabolites and metabolite ratios.</div></div><div><h3>Methods</h3><div>Four Dutch cohorts were included, comprising 10,834 individuals. Type D personality traits were measured by self-report questionnaires. A proton nuclear magnetic resonance (NMR) metabolomics platform provided 149 absolute measures (98 belonging to lipoprotein subclasses) and 81 derived ratios. For all, linear regression analyses were performed within each cohort, followed by random-effects meta-analyses. A per-measure FDR q-value&lt;0.05 was set as a study-wise significant association.</div></div><div><h3>Results</h3><div>SI was significantly associated with a lower omega-3 fatty acids to total fatty acids (FAw3.FA%) ratio, and a lower free cholesterol to total lipids ratio in very small VLDL (XS.VLDL.FC%). FAw3.FA% was also associated to NA (no study-wise significance though). NA showed a suggestive replication (<em>p</em>-value&lt;.05) of the previous reported associations with depression for 5 out of 18 metabolites from the same metabolomics platform: triglycerides in HDL, serum total triglycerides, VLDL cholesterol, mean diameter for VLDL particles and VLDL triglycerides.</div></div><div><h3>Conclusions</h3><div>In this large meta-analysis, SI was associated with omega-3 fatty acids to total fatty acids ratio, which is suggestive of lower omega-3 fatty acid intake. Only some metabolite biomarkers showed tentative links to Type D and NA. In sum, it seems that there are no major alterations in lipid metabolism associated with Type D traits.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111994"},"PeriodicalIF":3.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692432","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":"Clinical and metabolic correlates of DSM-5 mixed features in subjects with bipolar depression and mania: A cross-sectional study","authors":"Francesco Bartoli,&nbsp;Daniele Cavaleri,&nbsp;Tommaso Callovini,&nbsp;Dario Palpella,&nbsp;Susanna Piacenti,&nbsp;Cristina Crocamo,&nbsp;Giuseppe Carrà,&nbsp;NOMIAC Investigators","doi":"10.1016/j.jpsychores.2024.111990","DOIUrl":"10.1016/j.jpsychores.2024.111990","url":null,"abstract":"<div><h3>Objective</h3><div>Evidence on the clinical and metabolic characterization of mixed features (MFs) in bipolar disorder (BD) is limited. We performed a cross-sectional study analyzing clinical and metabolic correlates of MFs in people with bipolar depression or mania/hypomania.</div></div><div><h3>Methods</h3><div>We included people with BD consecutively admitted for inpatient treatment from May 2020 to July 2023 as part of the Northern Milan Area Cohort (NOMIAC) project. The SCID-5 was used to confirm the diagnosis and assess DSM-5 specifiers. Young Mania Rating Scale and Montgomery-Åsberg Depression Rating Scale were used to measure symptom severity. Information on socio-demographic, clinical, and metabolic conditions – including obesity, diabetes, hypertension, dyslipidemia, and hypothyroidism – were collected. Multiple logistic regression models were used to compare clinical and metabolic correlates between subjects with and without DSM-5 MFs.</div></div><div><h3>Results</h3><div>We included 163 inpatients with BD (111 admitted for a manic/hypomanic episode and 52 for a major depressive episode), 39 of whom with MFs. The overall logistic regression model showed that MFs were associated with anxious distress (z = 2.44; <em>p</em> = 0.015) and obesity (z = 2.39; <em>p</em> = 0.017), also being less frequent among moderately/markedly ill people as compared with those borderline/mildly ill (z = −2.71; <em>p</em> = 0.007). Additional analyses corroborated the association between MFs and these characteristics in people with a depressive episode, though not in those with mania/hypomania.</div></div><div><h3>Conclusion</h3><div>Notwithstanding some limitations, our study provides additional insight into the characterization of individuals with MFs, highlighting that anxious distress and symptom severity, along with obesity, may represent core features helpful for the assessment and management of MFs in BD.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111990"},"PeriodicalIF":3.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699694","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":"Strengthening cancer-spirituality research: A comprehensive analysis of methodological considerations in biomarker studies","authors":"Mahindra Bandari ,&nbsp;Cindy Osei ,&nbsp;Manisha Bandari","doi":"10.1016/j.jpsychores.2024.111991","DOIUrl":"10.1016/j.jpsychores.2024.111991","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111991"},"PeriodicalIF":3.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689422","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":"The factor structure of the Patient Health Questionnaire-9 in stroke: A comparison with a non-stroke population","authors":"J.J. Blake ,&nbsp;T. Munyombwe ,&nbsp;F. Fischer ,&nbsp;T.J. Quinn ,&nbsp;C.M. Van der Feltz-Cornelis ,&nbsp;J.M. De Man-van Ginkel ,&nbsp;I.S. Santos ,&nbsp;Hong Jin Jeon ,&nbsp;S. Köhler ,&nbsp;M.T. Schram ,&nbsp;J.L. Wang ,&nbsp;H.F. Levin-Aspenson ,&nbsp;M.A. Whooley ,&nbsp;S.E. Hobfoll ,&nbsp;S.B. Patten ,&nbsp;A. Simning ,&nbsp;F. Gracey ,&nbsp;N.M. Broomfield","doi":"10.1016/j.jpsychores.2024.111983","DOIUrl":"10.1016/j.jpsychores.2024.111983","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear if certain post-stroke somatic symptoms load onto items of the Patient Health Questionnaire-9 (PHQ-9), a self-report depression questionnaire. We investigated these concerns in a stroke sample using factor analysis, benchmarked against a non-stroke comparison group.</div></div><div><h3>Methods</h3><div>The secondary dataset constituted 787 stroke and 12,016 non-stroke participants. A subsample of 1574 comparison participants was selected via propensity score matching. Dimensionality was assessed by comparing fit statistics of one-factor, two-factor, and bi-factor models. Between-group differences in factor structure were explored using measurement invariance.</div></div><div><h3>Results</h3><div>A two-factor model, consisting of somatic and cognitive-affective factors, showed better fit than the unidimensional model (CFI = 0.984 versus CFI = 0.974, <em>p</em> &lt; .001), but the high correlation between the factors indicated unidimensionality (<em>r</em> = 0.866). Configural invariance between stroke and non-stroke was supported (CFI = 0.983, RMSEA = 0.080), as were invariant thresholds (<em>p</em> = .092) and loadings (<em>p</em> = .103). Strong invariance was violated (p &lt; .001, ΔCFI = −0.003), stemming from differences in the tiredness and appetite intercepts. These differences resulted in a moderate overestimation of depression in stroke when using a summed score approach, relative to the comparison sample (Cohen'<em>s d = 0.</em>434).</div></div><div><h3>Conclusions</h3><div>The findings suggest that the PHQ-9 measures a single factor in stroke. Because stroke patients may report higher tiredness on item 4, caution is advisable when classifying patients as depressed if they are near the cut-off and have significant post-stroke fatigue. Caution is also advised when comparing total scores between stroke and other populations.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111983"},"PeriodicalIF":3.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720666","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":"Association of stressful life events with subjective age and the mediating role of depression: A cross-sectional study of older adults in China","authors":"Xiaoting Liu ,&nbsp;Jie Lin ,&nbsp;Jiaming Shi ,&nbsp;Qi Zhao","doi":"10.1016/j.jpsychores.2024.111979","DOIUrl":"10.1016/j.jpsychores.2024.111979","url":null,"abstract":"<div><h3>Objective</h3><div>While previous studies have examined the relationship between stressful life events (SLEs) and subjective age (SA), the results were inconclusive and the mechanisms linking the association were unclear. This study investigated whether the experience of SLEs was associated with an older SA and the potential mediating role of depression linking this association in a cross-sectional study of older adults in China.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 7643 participants aged 60 and older. The association between SLEs and SA was examined using multivariate linear regression, and the mediation effect of depression was evaluated.</div></div><div><h3>Results</h3><div>Experiencing SLEs over the past year was associated with a 0.018 increase in proportional felt age (95 % CI: 0.012, 0.024) and a 0.011 increase in proportional look age (95 % CI: 0.005, 0.016), respectively. Depression appeared to be a significant mediator, accounting for 22.2 % and 27.3 % of the association of SLEs with proportional felt age and proportional look age, respectively.</div></div><div><h3>Conclusion</h3><div>Findings revealed that having SLEs was associated with an older SA, partially through the pathway of depression. More attention and appropriate intervention should be given to the older adults incurring SLEs to prevent the adverse effect of older SA.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111979"},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683168","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":"Circadian rhythm regulation as a target for alleviating bridge symptoms in comorbid internalizing and functional disorders","authors":"Akhmad Rizkhi Ridhani ,&nbsp;Rudi Haryadi ,&nbsp;Hartono ,&nbsp;Laelatul Anisah ,&nbsp;Jarkawi ,&nbsp;Eka Sri Handayani","doi":"10.1016/j.jpsychores.2024.111981","DOIUrl":"10.1016/j.jpsychores.2024.111981","url":null,"abstract":"","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111981"},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683235","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":"A qualitative study exploring the experiences and needs of fear of disease progression in patients after open-heart surgery","authors":"Zilu Liang ,&nbsp;Shaoyan Lin ,&nbsp;Huimei Sun ,&nbsp;Yingying Liao ,&nbsp;Muchen Zhang ,&nbsp;Cuishan Chen ,&nbsp;Huijuan Song","doi":"10.1016/j.jpsychores.2024.111980","DOIUrl":"10.1016/j.jpsychores.2024.111980","url":null,"abstract":"<div><h3>Objective</h3><div>Open-heart surgery (OHS) is a stressful event for patients, all of whom experience varying levels of worry and fear, leading to fear of disease progression (FoP). An in-depth understanding of the experiences and needs of FoP in patients after OHS is beneficial for healthcare providers to make optimal decisions, but this has not been reported. We aimed to explore the experiences and needs of FoP in patients after OHS by adopting a qualitative interview method.</div></div><div><h3>Methods</h3><div>A qualitative study was performed to recruit 18 qualified patients through purposive sampling and then conduct face-to-face, semi-structured interviews. The research setting was the cardiovascular surgery ward of a tertiary hospital in Guangdong, China, in 2024. The data were analyzed and extracted using conventional content analysis.</div></div><div><h3>Results</h3><div>In the study, four themes emerged: a) sources of FoP; b) effects of FoP; c) attitudes towards FoP; d) supportive service needs. The desire to obtain meaningful assistance and the profound experiences of FoP in patients after OHS gave rise to these themes.</div></div><div><h3>Conclusions</h3><div>FoP following OHS is a subjective feeling characterized by fear and discomfort. Care workers must completely grasp the patients' fear and provide personalized interventions to support them through the difficult recovery phase, which will also be the focus of future efforts in this area.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111980"},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645114","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":"Non-pharmacologic interventions for treating fear of cancer recurrence in patients with cancer: A network meta-analysis of randomized controlled trials","authors":"Fei Dong ,&nbsp;Di Yang ,&nbsp;Na Dong ,&nbsp;Yujing Li ,&nbsp;Hongjuan Wan ,&nbsp;Jiangxia Gao","doi":"10.1016/j.jpsychores.2024.111970","DOIUrl":"10.1016/j.jpsychores.2024.111970","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the impact of non-pharmacological interventions on fear of cancer recurrence in patients with cancer by synthesizing evidence from various studies using the net meta-analysis (NMA) approach. Additionally, the study sought to rank the efficacy of these interventions.</div></div><div><h3>Methods</h3><div>Two investigators independently searched the PubMed, Cochrane Library, Embase, and Web of Science databases to identify randomized controlled trials(RCTs) that met the inclusion criteria. The search encompassed the period from the inception of the database to December 2023. The included studies were then subjected to a quality assessment, and a network meta-analysis was performed to evaluate and compare the effectiveness of the interventions.</div></div><div><h3>Results</h3><div>This study included 27 RCTs involving 3009 patients and examined seven types of non-pharmacological interventions. The NMA results indicated that, based on the Surface Under the Cumulative Ranking curve, Cancer and Living Meaningfully (CALM) was the most effective intervention (100 %), followed by Mindfulness Therapy (MT) at 76.5 % and Couples' Skills Training (CST) at 60.6 %. However, the league table results showed that, compared to the waitlist group, the effects of CALM [SMD = −4.83, 95 % <em>CI</em> (−5.93, −3.73)] and CST [SMD = −0.86, 95 % <em>CI</em> (−1.65, −0.07)] were significant, while MT [SMD = −1.52, 95 % <em>CI</em> (−3.46, 0.43)] did not reach statistical significance. Furthermore, CST was more effective than Cognitive Behavioral Therapy [SMD = −2.98, 95 % <em>CI</em> (−5.40, −0.56)].</div></div><div><h3>Conclusion</h3><div>The results of this study indicate that CALM is the most effective intervention for addressing mental health issues.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"188 ","pages":"Article 111970"},"PeriodicalIF":3.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640147","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}