The American journal of psychiatry最新文献

{"title":"Clinical and Cognitive Outcomes Comparing Right Unilateral Ultrabrief Electroconvulsive Therapy Versus Magnetic Seizure Therapy for Bipolar Depression: The CORRECT-BD Trial.","authors":"Daniel M Blumberger, Fidel Vila Rodriguez, Shawn M McClintock, Kevin E Thorpe, Amer M Burhan, Karen Foley, Michelle S Goodman, Elizabeth C Gregory, Tyler S Kaster, Yuliya Knyahnytska, Joseph Tham, Allison P Trevizol, Daphne Voineskos, Brigitte Zrenner, Zafiris J Daskalakis","doi":"10.1176/appi.ajp.20250955","DOIUrl":"10.1176/appi.ajp.20250955","url":null,"abstract":"<p><strong>Objective: </strong>Despite the established clinical effectiveness of electroconvulsive therapy (ECT) in the treatment of bipolar depression, its acceptance is limited by concerns over cognitive adverse effects. Magnetic seizure therapy (MST) has shown promise in treating patients with depression, with fewer cognitive adverse effects. The aim of this pilot study was to assess the clinical efficacy and cognitive adverse effects of MST compared to right unilateral ultrabrief-pulse (RUL-UB) ECT in patients with bipolar depression.</p><p><strong>Methods: </strong>In this double-blind, randomized, parallel-group pilot clinical trial, participants with bipolar depression received either RUL-UB ECT or MST until they achieved remission, dropped out, or received a maximum of 21 treatments. The primary outcomes were 1) clinical remission as assessed with the 24-item Hamilton Rating Scale for Depression and 2) cognitive adverse effects as assessed with the Autobiographical Memory Test (AMT).</p><p><strong>Results: </strong>Of 55 participants who were randomized, 45 received an adequate trial of treatment, of whom 6/20 (30%) in the ECT group and 5/25 (20%) in the MST group achieved remission. Clinically important worsening in autobiographical memory (≥25% decline in AMT score) occurred in 6/27 (22.2%) participants in the ECT group and 2/28 (7.1%) in the MST group. Secondary clinical outcomes were similar in both groups.</p><p><strong>Conclusions: </strong>This pilot study demonstrated similar effects on depression symptoms between MST and ECT. MST appeared to have resulted in less worsening of autobiographical memory and was better tolerated, suggesting that it may be a safe clinical application to treat bipolar depression. Given the relatively small sample size of this pilot study, these findings should be considered preliminary.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"754-763"},"PeriodicalIF":14.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Trends in Benzodiazepine Dispensing.","authors":"Naomi Cruz, Hillary Samples, Stephen Crystal, Mark Olfson, Fangzhou Xie, Greta Bushnell","doi":"10.1176/appi.ajp.20251346","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251346","url":null,"abstract":"<p><strong>Objective: </strong>Benzodiazepines (BZDs) are commonly prescribed medications in the United States. Up-to-date BZD dispensing trends can inform whether and where improvements in prescribing practices are needed. The objective of this study was to evaluate national changes in BZD dispensing from 2013 to 2024 by patient age and prescriber type.</p><p><strong>Methods: </strong>A repeated, cross-sectional analysis using the IQVIA Longitudinal Prescription dataset was conducted to examine trends in BZD prescription dispensing between 2013 and 2024 (a total of 1,100,233,787 prescription fills). BZD prescription fill counts, prevalence, and mean total dose dispensed per BZD prescription were reported annually, stratified by patient age and prescriber type.</p><p><strong>Results: </strong>From 2013 to 2024, the annual U.S. prevalence of BZDs dispensed declined by 26.7%, from 7.5% to 5.5%. Net decreases in prevalence occurred across age groups, with the largest relative reduction among young adults ages 18-29 (-44.8%). Primary care physicians dispensed the most BZD prescriptions, followed by advanced practice providers and psychiatrists/mental health specialists. There were sharp relative declines in the number of BZDs dispensed by pain medicine specialists (-62.5%), primary care physicians (-44.3%), and psychiatrists/mental health specialists (-38.3%), with an increase observed among advanced practice providers (+101.5%). The mean total dose dispensed per BZD prescription decreased across all patient ages and prescriber types, with large declines in doses prescribed by pain medicine specialists (-65.3%).</p><p><strong>Conclusions: </strong>National declines in BZD prescription fills and total dose dispensed over the past decade may indicate greater caution or selectiveness in BZD dispensing, potentially related to safety considerations and drug labeling changes. Shifts in dispensing patterns among select patient and prescriber populations warrant ongoing monitoring.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20251346"},"PeriodicalIF":14.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic Signatures in Major Depressive Disorder and Depression Symptom Subtypes.","authors":"Kathleen T Watson, Mariska Bot, Idit Kosti, Yuri Milaneschi, Audrey Evers, Natalie Rasgon, Karolyi Nikolich, Benoit Lehallier, Alan F Schatzberg, Brenda W J H Penninx","doi":"10.1176/appi.ajp.20250891","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250891","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) is biologically heterogeneous and encompasses diverse symptom presentations. The authors used large-scale plasma proteomics to examine proteomic associations with categorical MDD status, continuous depression symptom severity, and DSM-IV-defined melancholic and atypical symptom dimensions.</p><p><strong>Methods: </strong>Using the SomaScan platform, the authors conducted plasma proteomic profiling of 7,289 analytes in 1,881 participants from the Netherlands Study of Depression and Anxiety, including individuals with current MDD (N=469), individuals with remitted MDD (N=918), and healthy control subjects (N=494). They evaluated associations with diagnostic status, symptom severity, and melancholic and atypical symptom dimensions, followed by pathway enrichment analyses.</p><p><strong>Results: </strong>Eight aptamers, representing seven unique proteins, differed significantly between the current MDD and healthy control groups after false discovery rate (FDR) correction. Overall depression symptom severity was associated with 18 significant aptamers corresponding to 18 unique proteins, whereas atypical symptoms were associated with 58 significant aptamers corresponding to 57 unique proteins. In contrast, no individual proteins reached FDR significance for melancholic symptoms. Pathway analyses showed enrichment for extracellular matrix organization, collagen formation, complement cascade signaling, platelet activation, and hemostasis in relation to overall depression symptom severity. Gene set enrichment analysis of proteins ranked by association with melancholic symptoms identified pathway-level enrichment despite the absence of FDR-significant individual proteins, including mitochondrial stress response, protein translation, complement signaling, and nervous system development. Atypical symptoms showed enrichment of extracellular matrix organization, collagen formation, complement cascade signaling, insulin-like growth factor transport, and chromatin regulatory processes.</p><p><strong>Conclusions: </strong>These findings support biological heterogeneity within MDD and suggest that peripheral proteomic alterations are more strongly represented for specific symptom dimensions than for categorical diagnosis alone. Atypical symptoms showed pathway-level enrichment with significant individual protein associations. A dimensional framework may improve biological stratification of depression and refine biomarker-informed approaches to clinical symptom profiles.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20250891"},"PeriodicalIF":14.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Transcriptional Features of Layer 3 Pyramidal Neurons Projecting to the Monkey Dorsolateral Prefrontal Cortex.","authors":"Dominique Arion, John F Enwright, Fenna M Krienen, Guillermo Gonzalez-Burgos, David A Lewis","doi":"10.1176/appi.ajp.20251018","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251018","url":null,"abstract":"<p><strong>Objective: </strong>Layer 3 (L3) pyramidal neurons projecting to the primate dorsolateral prefrontal cortex (DLPFC) convey essential information for core cognitive processes. Alterations in these neurons could contribute to cognitive deficits in schizophrenia. This study was designed to determine whether DLPFC-projecting L3 pyramidal neurons have a distinctive transcriptional profile.</p><p><strong>Methods: </strong>Laser microdissection was used to capture Nissl-stained and retrogradely labeled L3 pyramidal neurons that project to the DLPFC from the superior temporal cortex or posterior cingulate cortex of eight (four female) young adult (54-60 months of age) macaque monkeys. All samples were subjected to RNA sequencing. The results were compared to 1) data from L3 pyramidal neurons that project to the DLPFC from the posterior parietal cortex (lateral intraparietal cortex/area 7a [LIP/7a]) or contralateral DLPFC and 2) new single-nucleus RNA-sequencing data from multiple cortical regions of two female, young adult (77 and 96 months of age) monkeys and from similar publicly available human data.</p><p><strong>Results: </strong>Numerous genes (N=2,876) were differentially expressed between Nissl-stained L3 pyramidal neurons from the superior temporal cortex and posterior cingulate cortex. In contrast, only 527 genes were differentially expressed between DLPFC-projecting L3 pyramidal neurons from these regions. Transcriptional profiles were concordant between genes enriched in DLPFC-projecting L3 pyramidal neurons from the superior temporal cortex and posterior cingulate cortex and those enriched in DLPFC-projecting L3 pyramidal neurons from LIP/7a and contralateral DLPFC. The 91 genes enriched in samples from all four regions represent a transcriptional profile of DLPFC-projecting L3 pyramidal neurons. This profile was detected in specific clusters in both new monkey data and published human single-nucleus RNA-sequencing data from cortical regions that project to the DLPFC, but not from primary visual cortex (V1), which lacks these projections.</p><p><strong>Conclusions: </strong>These findings indicate that DLPFC-projecting L3 pyramidal neurons can be identified by a shared transcriptional profile, regardless of cortical region. The transcriptional identification of these and other L3 pyramidal neurons with specific cortical projections will provide the means to determine which specific subtype or subtypes of pyramidal neurons contribute to cognitive impairments in schizophrenia.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20251018"},"PeriodicalIF":14.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lasch et al.","authors":"","doi":"10.1176/appi.ajp.20251035correction","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251035correction","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20251035correction"},"PeriodicalIF":14.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Long-Acting Injectable and Oral Antipsychotics in Bipolar Disorder.","authors":"Eunice Kehui Deng, Caige Huang, Vincent K C Yan, Kyung Jin Lee, Shek-Ming Leung, Vanessa W S Ng, David J Castle, Sherry Kit Wa Chan, Francisco Tsz Tsun Lai, Andrew A Nierenberg, Yue Wei, Esther W Chan","doi":"10.1176/appi.ajp.20250793","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250793","url":null,"abstract":"<p><strong>Objective: </strong>Long-acting injectable antipsychotics (LAIAs) can improve adherence, but their optimal use in bipolar disorder needs to be further explored. This study compared LAIAs and oral antipsychotics with respect to health care utilization, illness relapse, and safety in individuals with bipolar disorder.</p><p><strong>Methods: </strong>A self-controlled case series study was conducted using data from Hong Kong's electronic health records on individuals with bipolar disorder who received prescriptions for both LAIAs and oral antipsychotics during the period of January 1, 2004, through December 31, 2023. Outcomes included measures of health care utilization, illness relapse, and safety. Adjusted incidence rate ratios (aIRRs) for LAIA versus oral antipsychotic treatment periods were estimated using conditional Poisson regression.</p><p><strong>Results: </strong>Among 17,841 people with bipolar disorder, 2,086 (11.7%) received prescriptions for both LAIAs and oral antipsychotics. Compared with oral antipsychotics, LAIAs were associated with statistically significantly lower risks of all-cause emergency department visits (aIRR=0.85, 95% CI=0.81, 0.89), all-cause hospitalizations (aIRR=0.79, 95% CI=0.73, 0.85), psychiatric hospitalizations (aIRR=0.67, 95% CI=0.61, 0.74), hospitalizations for manic episodes (aIRR=0.51, 95% CI=0.44, 0.59), and hospitalizations for mixed episodes (aIRR=0.31, 95% CI=0.14, 0.66). No statistically significant difference was found for hospitalizations for depressive episodes (aIRR=1.34, 95% CI=0.94, 1.93), nonpsychiatric hospitalizations (aIRR=0.97, 95% CI=0.87, 1.08), or cardiovascular hospitalizations (aIRR=0.84, 95% CI=0.62, 1.14). LAIAs were initially associated with an increased risk of extrapyramidal symptoms (aIRR=2.95, 95% CI=1.40, 6.22), but this difference was not statistically significant beyond 90 days of treatment.</p><p><strong>Conclusions: </strong>LAIAs were associated with substantially less health care utilization and fewer relapses of manic and mixed episodes, and they were not associated with increased risk of nonpsychiatric hospitalizations, notably for cardiovascular disease. These findings support the use of LAIAs for bipolar disorder, with close monitoring for extrapyramidal symptoms during initiation.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20250793"},"PeriodicalIF":14.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Misinformation as a Public Health Problem: The Case for Psychiatric Public Scholarship.","authors":"Adrian Preda","doi":"10.1176/appi.ajp.20260522","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260522","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20260522"},"PeriodicalIF":14.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pharmacotherapeutic Alliance: An Evidence-Based Intervention for Enhancing Psychiatric Outcomes.","authors":"David L Mintz, Kevin P Kennedy, Janet H Pine, Calvin R Sumner, Jeanne L Alexander, Lawrence S Gross, Tapan Parikh, Amir Garakani, David A Baron","doi":"10.1176/appi.ajp.20260142","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260142","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20260142"},"PeriodicalIF":14.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Moderated and Sex-Specific Effects of Adverse Childhood Experiences on Neural Alcohol Cue Reactivity and Daily Craving in Individuals With Alcohol Use Disorder.","authors":"Lilli Rötzer, Judith Zaiser, Sabine Hoffmann, Inka Hiß, Iris Reinhard, Christine Heim, Heike Tost, Falk Kiefer, Bernd Lenz, Patrick Bach","doi":"10.1176/appi.ajp.20251163","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251163","url":null,"abstract":"<p><strong>Objective: </strong>Adverse childhood experiences (ACEs) play a pivotal role in alcohol use disorder (AUD), and evidence suggests that this role differs by sex. Neural alcohol cue reactivity may represent one pathway linking ACEs to alcohol craving and use. The authors examined whether cue reactivity is differentially associated with the relationship between ACEs and alcohol-related outcomes in males and females with AUD.</p><p><strong>Methods: </strong>Functional MRI data were analyzed from 231 non-treatment-seeking individuals (40.7% female; mean age=39.1 years, SD=13.5) with mainly mild to moderate AUD (mean number of <i>DSM-5</i> criteria, 3.92, SD=1.6) from a 12-month prospective multicenter study. ACEs were assessed via Childhood Trauma Screener score. Participants completed a functional MRI alcohol cue reactivity task, followed by ecological momentary assessment of daily craving and consumption. Linear regression, general linear models, and sex-moderated mediation examined associations among ACEs, brain activation, and alcohol outcomes. Sensitivity analyses controlled for age, AUD severity, baseline consumption, tobacco use, Brief Symptom Inventory score, and progesterone-to-estradiol ratio.</p><p><strong>Results: </strong>Higher Childhood Trauma Screener scores were associated with significantly greater left superior frontal gyrus/anterior cingulate cortex (SFG/ACC) activation during alcohol-related cues than during neutral cues in females compared with males. This activation significantly predicted prospective daily craving only in females. Sex-moderated mediation showed opposing indirect effects of ACEs on craving via SFG/ACC activation (ab=path a × path b; females: ab=0.008, 95% CI=0.001, 0.022; males: ab=-0.013, 95% CI=-0.034, -0.002). Sensitivity analyses supported robust SFG/ACC activation and directional consistency after adjustment for covariates.</p><p><strong>Conclusions: </strong>Sex-specific prefrontal cue reactivity patterns suggest differential neural pathways linking ACEs to craving vulnerability in early AUD, particularly in females. The findings support sex-sensitive, trauma-informed intervention strategies.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20251163"},"PeriodicalIF":14.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Longevity of Mental Health Apps: A Survival Analysis of the Largest Mental Health App Database.","authors":"Julian Herpertz, Bridget Dwyer, Matthew Flathers, Nils Opel, Christian Otte, Stefan M Gold, Ulrich W Ebner-Priemer, Julian Schwarz, Jake Linardon, Sean Ryan, John Torous","doi":"10.1176/appi.ajp.20260155","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260155","url":null,"abstract":"<p><strong>Objective: </strong>Despite over 10,000 mental health apps available, app marketplaces are unstable, characterized by high attrition rates and technological obsolescence. This study analyzed factors associated with app survival to help patients and clinicians in selecting more durable mental health apps and inform developers in creating more stable ones.</p><p><strong>Methods: </strong>Using data from the M-Health Index and Navigation Database (MIND; MindApps.org), the authors performed a 5-year longitudinal survival analysis on 865 apps. App longevity was evaluated using Kaplan-Meier estimates, and Cox regression was used to assess the impact of 54 clinical, technical, and commercial predictors of attrition. Additionally, a random forest classifier was used to identify app characteristics associated with 2-year survival status.</p><p><strong>Results: </strong>Of 865 apps identified, 464 (53.6%) were removed from MindApps.org during the 2,142-day study period. Disparities in longevity were observed across clinical targets; aside from the small cohort of apps for schizophrenia, smoking cessation apps presented the highest risk for attrition. Sleep-related apps demonstrated the greatest longevity. Cox regression (C-index=0.77) and an exploratory random forest analysis (area under the receiver operating characteristic curve=0.82) identified platform exclusivity (not working on both Android and iOS) as the most prominent characteristic associated with removal from MindApps.org, with Android-only apps exhibiting a significantly elevated risk, carrying more than double the hazard of attrition (Gini feature importance=0.12; hazard ratio=2.32).</p><p><strong>Conclusions: </strong>The findings provide a roadmap for identifying durable mental health apps, thereby minimizing the risk of treatment attrition. The predictors of removal from MindApps.org provide critical lessons for the new era of AI-based tools.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20260155"},"PeriodicalIF":14.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}