Sage E. Hawn , Taylor Kliebhan , Niya Richardson , Mellyssa Deoliveira , Kristin E. Heron , Karen Mitchell
{"title":"Psychometric evaluation of a novel measure of trauma-related eating to cope","authors":"Sage E. Hawn , Taylor Kliebhan , Niya Richardson , Mellyssa Deoliveira , Kristin E. Heron , Karen Mitchell","doi":"10.1016/j.xjmad.2024.100102","DOIUrl":"10.1016/j.xjmad.2024.100102","url":null,"abstract":"<div><div>Posttraumatic stress disorder (PTSD) and disordered eating often co-occur, and this comorbidity is linked to a heightened clinical burden compared to either condition alone. One possible explanation for this co-occurrence is the self-medication model, which proposes that individuals may use food to cope with PTSD symptoms, a concept we refer to as trauma-related eating to cope. Although there is both theoretical and empirical support for this construct, no specific measure has been developed until now. In this study, we aimed to create and validate a novel measure, the Trauma-Related Eating to Cope (TREC) questionnaire, among a diverse sample of 726 trauma-exposed undergraduate students (<em>M</em><sub>age</sub>=22.87, <em>SD</em>=7.20; 49.9 % White; 77 % women). Our data support the 20-item TREC questionnaire as a four-factor scale that can be used to evaluate eating to cope with symptoms specific to each of the four <em>DSM-5</em> PTSD symptom clusters (χ<sup>2</sup>(164)= 330.23, <em>p</em> < .001; CFI= .959; TLI= .953; RMSEA= .038). The study findings indicate that the TREC questionnaire is a more precise and targeted tool for measuring eating to cope with PTSD symptoms compared to existing measures of eating to cope motives. Strong evidence was found for the construct and criterion validity of the TREC questionnaire, particularly in relation to PTSD symptoms and a range of disordered eating behaviors, including binge eating, caloric restriction, and emotional eating. These results underscore the potential of the TREC questionnaire for future research on self-medication and its clinical utility as a screening tool for identifying individuals with PTSD who are at risk for developing pathological eating behaviors.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Roger Claver Kouakou , Matea Bélan , Thomas G. Poder , Maude Laberge
{"title":"Care trajectories of people with mood disorders in Quebec using latent class and latent profile analysis methods","authors":"Christian Roger Claver Kouakou , Matea Bélan , Thomas G. Poder , Maude Laberge","doi":"10.1016/j.xjmad.2024.100101","DOIUrl":"10.1016/j.xjmad.2024.100101","url":null,"abstract":"<div><div>The prevalence of mood disorders has increased globally. People with mood disorders have been found to use more health services than the general population, although a mood disorder diagnosis does not necessarily entail utilization of health services. This heterogeneity in health services utilization could make it difficult for governments to plan resources to meet the needs of people with mood disorders. A patient-level linked database from residents of Quebec, Canada was used to model care trajectories of people who self-reported having been diagnosed with a mood disorder. The data from the Canadian Community Health Survey were linked to health administrative data for a 21-year period. We used latent class analysis and latent profile analysis to group people into categories. Four care trajectories were identified using the latent class analysis: 1) people who only used services of a general practitioner; 2) people having seen a psychiatrist or having at least one ED visit or hospitalization; 3) people consulting other types of specialists; 4) null utilization. The latent profile analysis on medical services yielded four profiles, with average numbers of services of 41, 33, 7, and 1, while that on hospitalization yielded two profiles, with 20 % of the population having had at least one hospitalization and the remainder none. By classifying people into service utilization groups, these methods enable determining needs for a given population and can support resource allocation for health care decision makers.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diane Joss , Michael Datko , Charisma I. Washington , Mary A. Tresvalles , Mihriye Mete , Sara W. Lazar , Zev Schuman-Olivier , Elizabeth A. Hoge
{"title":"Neural correlates of reduction in self-judgment after mindful self-compassion training: A pilot study with resting state fMRI","authors":"Diane Joss , Michael Datko , Charisma I. Washington , Mary A. Tresvalles , Mihriye Mete , Sara W. Lazar , Zev Schuman-Olivier , Elizabeth A. Hoge","doi":"10.1016/j.xjmad.2024.100096","DOIUrl":"10.1016/j.xjmad.2024.100096","url":null,"abstract":"<div><div>Self-judgment is a trans-diagnostic symptom among various psychological disorders, therefore can be a therapeutic target for many common psychiatric conditions. Self-judgment often arises among those who experienced childhood maltreatment, which increases the risk for developing comorbid psychiatric disorders that are resistant to traditional pharmacological and psychological interventions. Understanding the neural correlates of the therapeutic effect of behavioral interventions for reducing self-judgment is key for developing and refining evidence-based intervention programs. This single arm pilot study (N = 24) explored the neural correlates of reduction in self-judgment after an eight-week mindful self-compassion (MSC) intervention program for a sample of adult patients with either anxiety or depressive disorders, with 83 % having more than one diagnoses. The results demonstrated significant reduction of self-judgment after the intervention (<em>p</em> < 0.001, <em>d</em> = −1.04) along with increased self-compassion (<em>p</em> < 0.001, <em>d</em> =1.20); in particular, participants with above median score on the Childhood Trauma Questionnaire had significantly more improvement than those with below median scores (<em>p</em> < 0.05). Resting state fMRI was used to study neural correlates and showed that reduced self-judgment was associated with increased posterior cingulate cortex functional connectivity with dorsal lateral prefrontal cortex, inferior frontal gyrus, and dorsal medial prefrontal cortex, accompanied by reduced posterior cingulate cortex functional connectivity with the amygdala-hippocampal complex. These findings suggest reduced self-judgment after MSC training was substantiated by reduced fear circuitry influences on self-referential processes along with enhanced frontal regulation from the executive network and language network.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angie M. Gross , Madeleine Rassaby , Samantha N. Hoffman , Colin A. Depp , Raeanne C. Moore , Charles T. Taylor
{"title":"Driven by rewards or punishments? Understanding real world social functioning in anxiety and depressive disorders","authors":"Angie M. Gross , Madeleine Rassaby , Samantha N. Hoffman , Colin A. Depp , Raeanne C. Moore , Charles T. Taylor","doi":"10.1016/j.xjmad.2024.100097","DOIUrl":"10.1016/j.xjmad.2024.100097","url":null,"abstract":"<div><h3>Background</h3><div>Social disconnection is prevalent in anxiety and depressive disorders and adversely impacts well-being. Prevailing treatment approaches assume social disconnection is a by-product of anxiety or depressive symptoms; however, social impairments often persist following symptom reduction. To advance understanding of why people with anxiety or depression experience social disconnection, we tested a framework in which daily social experiences were predicted from dispositional sensitivities to positive (rewarding) vs. negative (aversive) outcomes.</div></div><div><h3>Method</h3><div>Adults (<em>N</em> = 112; aged 18–55) seeking treatment for anxiety or depression completed a measure assessing approach temperament (i.e., general sensitivity to positive outcomes) and avoidance temperament (i.e., general sensitivity to negative outcomes). They subsequently received 20 ecological momentary assessment (EMA) surveys over five consecutive days measuring current social activity, perceived connectedness, loneliness, and positive and negative affect.</div></div><div><h3>Results</h3><div>Individuals higher in approach temperament reported greater momentary social connectedness, lower loneliness, and more frequent social interactions (medium to large effects). They also experienced greater momentary positive affect, which was associated with all real-time social outcomes (medium to large effects). Avoidance temperament overall was not associated with daily social experiences nor affect; however, in subjects with low approach temperament, higher avoidance temperament predicted greater momentary negative affect. Real-time loneliness was linked to momentary negative affect, but only when momentary positive affect was low.</div></div><div><h3>Limitations</h3><div>The study was correlational; thus, causal claims cannot be made.</div></div><div><h3>Conclusions</h3><div>Approach temperament and its associated affective states may be uniquely related to daily social experiences in anxiety and depression and could serve as targets for interventions intended to remediate social disconnection.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Bomyea , Morgan M. Caudle , Nathalie Dugas , Raeanne C. Moore , Alan N. Simmons , Michael L. Thomas
{"title":"A randomized controlled trial of computerized cognitive training to improve working memory in individuals with elevated repetitive negative thinking: Behavioral and neural outcomes","authors":"Jessica Bomyea , Morgan M. Caudle , Nathalie Dugas , Raeanne C. Moore , Alan N. Simmons , Michael L. Thomas","doi":"10.1016/j.xjmad.2024.100095","DOIUrl":"10.1016/j.xjmad.2024.100095","url":null,"abstract":"<div><div>Individuals with mood, anxiety, and traumatic stress disorders frequently experience distressing repetitive negative thinking (RNT) symptoms, which are characterized by pervasive, uncontrollable negative thoughts. Dysfunction in executive functioning processes, particularly the ability to regulate the contents of working memory, are implicated in the development and maintenance of RNT. Guided by the National Institute of Mental Health experimental therapeutics framework, this study aimed to investigate the cognitive effects and effects of two doses of a novel working memory training (WMT) intervention in individuals with elevated RNT across mood, anxiety, and traumatic stress disorders. We conducted a three-arm randomized controlled trial with 8-session and 16-session WMT interventions and a waitlist control group (N = 73). Our primary goal was to establish target engagement of WMT as measured by behavioral and neural indicators of working memory performance. Results revealed that WMT significantly improved working memory performance and resulted in reduced frontoparietal neural activity during a working memory task compared to the waitlist control group, providing evidence of target engagement. Exploratory analyses revealed a potential transfer of training effects to fluid intelligence, a construct related to but distinct from working memory, suggesting broader cognitive benefits of WMT. These data provide evidence that WMT can enhance working memory performance in individuals with RNT. This intervention holds promise as a transdiagnostic approach for ameliorating RNT-related clinical burden, with the 8-session regimen showing pragmatic advantages. Further research is needed to elucidate its impact on clinical symptoms and explore potential cognitive benefits beyond working memory.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lance M. Rappaport , Emily Jerome , Michael Van Ameringen , Maureen Whittal , Carmen P. McLean
{"title":"Corrigendum to “North American open-label 16-week trial of the MindShift smartphone app for adult anxiety” [J Mood Anxiety Disord 4C (2023) 100036]","authors":"Lance M. Rappaport , Emily Jerome , Michael Van Ameringen , Maureen Whittal , Carmen P. McLean","doi":"10.1016/j.xjmad.2024.100093","DOIUrl":"10.1016/j.xjmad.2024.100093","url":null,"abstract":"","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143097365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dana Kanel , Andre Zugman , Grace Stohr , Beck Scheinberg , Elise Cardinale , Anderson M. Winkler , Katharina Kircanski , Nathan A. Fox , Melissa A. Brotman , Julia O. Linke , Daniel S. Pine
{"title":"Structure-function coupling in network connectivity and associations with negative affectivity in a group of transdiagnostic adolescents","authors":"Dana Kanel , Andre Zugman , Grace Stohr , Beck Scheinberg , Elise Cardinale , Anderson M. Winkler , Katharina Kircanski , Nathan A. Fox , Melissa A. Brotman , Julia O. Linke , Daniel S. Pine","doi":"10.1016/j.xjmad.2024.100094","DOIUrl":"10.1016/j.xjmad.2024.100094","url":null,"abstract":"<div><div>The study of brain connectivity, both functional and structural, can inform us on the development of psychopathology. The use of multimodal MRI methods allows us to study associations between structural and functional connectivity, and how this relates to psychopathology. This may be especially useful during childhood and adolescence, a period where most forms of psychopathology manifest for the first time. The current paper explores structure-function coupling, measured through diffusion and resting-state functional MRI, and quantified as the correlation between structural and functional connectivity matrices. We investigate associations between psychopathology and coupling in a transdiagnostic group of adolescents, including many treatment-seeking youth with relatively high levels of symptoms (<em>n</em> = 72, M<sub>age</sub> = 13.3). We used a bifactor model to extract our main outcome measure, Negative Affectivity, from anxiety and irritability ratings. This provided the principal measure of psychopathology. Supplementary analyses investigated ‘domain-specific’ factors of anxiety and irritability. Findings indicate a positive association between negative affectivity and structure-function coupling between the default mode and the fronto-parietal control networks. Higher structure-function coupling may indicate heightened structural constraints on function, which limit functional network reorganization during adolescence required for healthy psychological outcomes.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"9 ","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malin Au , Rebecca Lipschutz , Yara Mekawi , Emma C. Lathan , H. Drew Dixon , Sierra Carter , Rebecca Hinrichs , Bekh Bradley , Nadine J. Kaslow , Nicole R. Nugent , Abigail Powers
{"title":"The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results","authors":"Malin Au , Rebecca Lipschutz , Yara Mekawi , Emma C. Lathan , H. Drew Dixon , Sierra Carter , Rebecca Hinrichs , Bekh Bradley , Nadine J. Kaslow , Nicole R. Nugent , Abigail Powers","doi":"10.1016/j.xjmad.2024.100092","DOIUrl":"10.1016/j.xjmad.2024.100092","url":null,"abstract":"<div><div>Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, posttraumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults (<em>N</em> = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group (<em>F</em>[1, 68.10] = 5.98, <em>p</em> = .017; <em>t</em>[71.60] = 3.61, <em>p</em> < .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chantal Kasch , Cameron E. Lindsay , Stefan G. Hofmann
{"title":"Heteronormative and cisnormative stereotypes in commonly-used social anxiety scales: A scoping review","authors":"Chantal Kasch , Cameron E. Lindsay , Stefan G. Hofmann","doi":"10.1016/j.xjmad.2024.100091","DOIUrl":"10.1016/j.xjmad.2024.100091","url":null,"abstract":"<div><div>Social anxiety is a common, but under-researched topic in the LGBTQIA+ community. We conducted a scoping review of studies between January 2014 and April 2024 that included LGBTQIA+ samples with social anxiety scales evaluating scales for outdated language. The search produced 1155 results out of which 17 articles fit the inclusion criteria. The results suggest that 47 % of the measures include items that reinforce heteronormative or cisnormative stereotypes and 29.4 % of studies included scales inappropriate for the population under investigation. Therefore, the wordings of certain items need to be adapted to fit the investigated population and a re-examination of the psychometric properties of the revised scales is needed.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yinru Long , Samantha Pegg , Christian A.L. Bean , Andrew Kittleson , Kirsty Clark , Autumn Kujawa
{"title":"Depressive symptoms and suicidal ideation in sexual minority adolescents: An examination of social reward responsiveness and support as moderators","authors":"Yinru Long , Samantha Pegg , Christian A.L. Bean , Andrew Kittleson , Kirsty Clark , Autumn Kujawa","doi":"10.1016/j.xjmad.2024.100090","DOIUrl":"10.1016/j.xjmad.2024.100090","url":null,"abstract":"<div><div>Sexual minority (SM) youth are at increased risk of depression and suicidal ideation (SI), due in part to discrimination and other stressors. This raises questions about social factors that may increase risk or resilience to stressors commonly faced by SM youth. The goal of this multimethod study was to examine both neural processing of social feedback and perceived social support as potential moderators of the association between SM identity, depressive symptoms, and endorsement of SI in adolescents. For this study, 165 adolescents aged 14–17 (22.42 % identifying as SM) were oversampled for current depression. Participants self-reported social support, depressive symptoms, and SI. Electroencephalogram (EEG) was recorded while participants completed a computerized peer interaction task in which the reward positivity (RewP) component was measured in response to social acceptance vs. rejection feedback. We tested social RewP and social support as moderators of associations between SM identity, depressive symptoms, and whether SI was reported. SM youth reported lower social support and elevated depressive symptoms and were more likely to endorse SI compared to non-SM youth. Social RewP moderated the associations between SM identity, depressive symptoms, and SI such that SM youth with blunted neural responses to social acceptance had higher depression and were more likely to endorse SI. Lower social support was associated with greater depressive symptoms and SI, but social support was not a significant moderator of the association between SM identity and symptoms. This is among the first studies to use affective neuroscience methods to examine social processes in SGM youth and our findings underscore the role of social factors in SGM youth mental health.</div></div>","PeriodicalId":73841,"journal":{"name":"Journal of mood and anxiety disorders","volume":"8 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}