Frank Iorfino, Mathew Varidel, William Capon, Matthew Richards, Jacob J. Crouse, Haley M. LaMonica, Shin Ho Park, Sarah Piper, Yun Ju Christine Song, Carla Gorban, Elizabeth M. Scott, Ian B. Hickie
{"title":"Quantifying the interrelationships between physical, social, and cognitive-emotional components of mental fitness using digital technology","authors":"Frank Iorfino, Mathew Varidel, William Capon, Matthew Richards, Jacob J. Crouse, Haley M. LaMonica, Shin Ho Park, Sarah Piper, Yun Ju Christine Song, Carla Gorban, Elizabeth M. Scott, Ian B. Hickie","doi":"10.1038/s44184-024-00078-7","DOIUrl":"10.1038/s44184-024-00078-7","url":null,"abstract":"Mental fitness is a construct that goes beyond a simple focus on subjective emotional wellbeing to encompass more broadly our ability to think, feel, and act to achieve what we want in our daily lives. The measurement and monitoring of multiple (often interacting) domains is crucial to gain a holistic and complete insight into an individual’s mental fitness. We aimed to demonstrate the capability of a new mobile app to characterise the mental fitness of a general population of Australians and to quantify the interrelationships among different domains of mental fitness. Cross-sectional data were collected from 4901 adults from the general population of Australians engaged in work or education who used a mobile app (Innowell) between September 2021 and November 2022. Individuals completed a baseline questionnaire comprised of 26 questions across seven domains of mental fitness (i.e., physical activity, sleep and circadian rhythms, nutrition, substance use, daily activities, social connection, psychological distress). Network analysis was applied at both a domain-level (e.g., 7 nodes representing each cluster of items) and an individual item-level (i.e., 26 nodes representing all questionnaire items). Only 612 people (12%) were functioning well across all domains. One quarter (n = 1204, 25%) had only one problem domain and most (n = 3085, 63%) had multiple problem domains. The two most problematic domains were physical activity (n = 2631, 54%) and social connection (n = 2151, 44%), followed closely by daily activity (n = 1914, 39%). At the domain-level, the strongest association emerged between psychological distress and daily activity (r = 0.301). Psychological distress was the most central node in the network (as measured by strength and expected influence), followed closely by daily activity, sleep and circadian rhythms and then social connection. The item-level network revealed that the nodes with the highest centrality in the network were: hopelessness, depression, functional impairment, effortfulness, subjective energy, worthlessness, and social connectedness. Social connection, sleep and circadian rhythms, and daily activities may be critical targets for intervention due to their widespread associations in the overall network. While psychological distress was not among the most common problems, its centrality may indicate its importance for indicated prevention and early intervention. We showcase the capability of a new mobile app to monitor mental fitness and identify the interrelationships among multiple domains, which may help people develop more personalised insights and approaches.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00078-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560489","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}
Niharika Gajawelli, Andrew D. Geoly, Jean-Marie Batail, Xiaoqian Xiao, Adi Maron-Katz, Eleanor Cole, Azeezat Azeez, Ian H. Kratter, Manish Saggar, Nolan R. Williams
{"title":"Increased anti-correlation between the left dorsolateral prefrontal cortex and the default mode network following Stanford Neuromodulation Therapy (SNT): analysis of a double-blinded, randomized, sham-controlled trial","authors":"Niharika Gajawelli, Andrew D. Geoly, Jean-Marie Batail, Xiaoqian Xiao, Adi Maron-Katz, Eleanor Cole, Azeezat Azeez, Ian H. Kratter, Manish Saggar, Nolan R. Williams","doi":"10.1038/s44184-024-00073-y","DOIUrl":"10.1038/s44184-024-00073-y","url":null,"abstract":"SNT is a high-dose accelerated intermittent theta-burst stimulation (iTBS) protocol coupled with functional-connectivity-guided targeting that is an efficacious and rapid-acting therapy for treatment-resistant depression (TRD). We used resting-state functional MRI (fMRI) data from a double-blinded sham-controlled randomized controlled trial1 to reveal the neural correlates of SNT-based symptom improvement. Neurobehavioral data were acquired at baseline, post-treatment, and 1-month follow-up. Our primary analytic objective was to investigate changes in seed-based functional connectivity (FC) following SNT and hypothesized that FC changes between the treatment target and the sgACC, DMN, and CEN would ensue following active SNT but not sham. We also investigated the durability of post-treatment observed FC changes at a 1-month follow-up. Study participants included transcranial magnetic stimulation (TMS)-naive adults with a primary diagnosis of moderate-to-severe TRD. Fifty-four participants were screened, 32 were randomized, and 29 received active or sham SNT. An additional 5 participants were excluded due to imaging artifacts, resulting in 12 participants per group (Sham: 5F; SNT: 5F). Although we did not observe any significant group × time effects on the FC between the individualized stimulation target (L-DLPFC) and the CEN or sgACC, we report an increased magnitude of negative FC between the target site and the DMN post-treatment in the active as compared to sham SNT group. This change in FC was sustained at the 1-month follow-up. Further, the degree of change in FC was correlated with improvements in depressive symptoms. Our results provide initial evidence for the putative changes in the functional organization of the brain post-SNT.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00073-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545632","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}
Maryam Golafshani, Daniel Z. Buchman, M. Ishrat Husain
{"title":"Disability rights and experiential use of psychedelics in clinical research and practice","authors":"Maryam Golafshani, Daniel Z. Buchman, M. Ishrat Husain","doi":"10.1038/s44184-024-00065-y","DOIUrl":"10.1038/s44184-024-00065-y","url":null,"abstract":"Given the renewed interest in the use of psychedelics for the treatment of mental and substance use disorders in recent decades, there has also been renewed discussion and debate about whether it is necessary or beneficial for those who study and deliver psychedelic-assisted psychotherapy (PAP) to have had personal experience of using psychedelics. This paper provides a brief history of this debate and brings a disability-rights perspective to the discussion, given increasing efforts to dismantle ableism in medical training, practice, and research. Many psychiatric conditions and psychotropic medications, including ones as commonly prescribed as antidepressants, may preclude one from being able to safely and/or effectively use psychedelics. As such, we argue explicitly mandating or even implying the necessity of experiential training for psychedelic researchers and clinicians can perpetuate ableism in medicine by excluding those who cannot safely use psychedelics because of their personal medical histories. As PAP research and practice rapidly grow, we must ensure the field grows with disability inclusion amongst researchers and clinicians.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494484","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}
Ronit Kishon, Nadav Liam Modlin, Yael M. Cycowicz, Hania Mourtada, Tayler Wilson, Victoria Williamson, Anthony Cleare, James Rucker
{"title":"A rapid narrative review of the clinical evolution of psychedelic treatment in clinical trials","authors":"Ronit Kishon, Nadav Liam Modlin, Yael M. Cycowicz, Hania Mourtada, Tayler Wilson, Victoria Williamson, Anthony Cleare, James Rucker","doi":"10.1038/s44184-024-00068-9","DOIUrl":"10.1038/s44184-024-00068-9","url":null,"abstract":"Pre-prohibition psychedelic research with complex psychiatric patients generated a wealth of treatment methodologies and practices, providing invaluable clinical insights pertaining to the medical administration of psychedelics in various mental health diagnoses. Building upon these early studies, which lack the rigor and research tools available today, contemporary psychedelic research has focused on investigating the safety and efficacy of psychedelics in randomized controlled trials via psychometric measures and symptom assessments. Both then and now, the treatment context and the role of clinicians in psychedelic treatment has been recognized as an essential feature for positive patient outcomes. To broaden the knowledge base of modern psychedelic research and support the training of clinicians conducting medically supervised psychedelic research studies, this paper provides a review of pre-prohibition clinical research narratives pertaining to the phenomenology of psychedelic treatment and the role of the non-pharmacological treatment factors in the patient experience. Lastly, this paper explores a range of clinician perspectives and psychological interventions employed in pre-prohibition psychedelic research to inform future research directions and best practice guidelines.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494483","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}
P. M. Briley, L. Webster, S. Lankappa, S. Pszczolkowski, R. H. McAllister-Williams, P. F. Liddle, D. P. Auer, R. Morriss
{"title":"Trajectories of improvement with repetitive transcranial magnetic stimulation for treatment-resistant major depression in the BRIGhTMIND trial","authors":"P. M. Briley, L. Webster, S. Lankappa, S. Pszczolkowski, R. H. McAllister-Williams, P. F. Liddle, D. P. Auer, R. Morriss","doi":"10.1038/s44184-024-00077-8","DOIUrl":"10.1038/s44184-024-00077-8","url":null,"abstract":"Repetitive transcranial magnetic stimulation (rTMS) is an established non-invasive brain stimulation treatment for major depressive disorder, but there is marked inter-individual variability in response. Using latent class growth analysis with session-by-session patient global impression ratings from the recently completed BRIGhTMIND trial, we identified five distinct classes of improvement trajectory during a 20-session treatment course. This included a substantial class of patients noticing delayed onset of improvement. Contrary to prior expectations, members of a class characterised by early and continued improvement showed greatest inter-session variability in stimulated location. By relating target locations and inter-session variability to a well-studied atlas, we estimated an average of 3.0 brain networks were stimulated across the treatment course in this group, compared to 1.1 in a group that reported symptom worsening (p < 0.001, d = 0.893). If confirmed, this would suggest that deliberate targeting of multiple brain networks could be beneficial to rTMS outcomes.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473310","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}
{"title":"Sleep quality mediates the association between chronotype and mental health in young Indian adults","authors":"Satyam Chauhan, Rakesh Pandey, Krupa Vakani, Ray Norbury, Ulrich Ettinger, Veena Kumari","doi":"10.1038/s44184-024-00076-9","DOIUrl":"10.1038/s44184-024-00076-9","url":null,"abstract":"There is increasing recognition of ‘higher preference for eveningness’ as a potential independent risk factor for poor mental health. To examine the chronotype-mental health relationship while also quantifying the potential roles of poor sleep quality, relevant personality traits, and childhood trauma, we assessed 282 young adults (18–40 years; 195 females) residing in North India, between January and March 2023 (to control for seasonal variation), using self-report measures of diurnal preference, sleep patterns, mental health (depression, anxiety, and stress), personality traits (extraversion, neuroticism, schizotypy, and impulsivity), and childhood trauma. The results showed a significant association between eveningness and poor mental health but this association was fully mediated by poor sleep quality. Neuroticism, emotional abuse and cognitive disorganisation were correlated with eveningness as well as with poor mental health and sleep quality. Neuroticism and emotional abuse, but not cognitive disorganisation, also had indirect effects on mental health via sleep quality. Our findings highlight the crucial role played by sleep quality in the chronotype-mental health relationship.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00076-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447727","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}
Caitlin A. Stamatis, Deborah N. Farlow, Catherine Mercaldi, Minny Suh, Amanda Maple, Antonia Savarese, Ann Childress, Raun D. Melmed, Scott H. Kollins
{"title":"Two single arm trials of AKL-T01, a digital therapeutic for adolescents and adults with ADHD","authors":"Caitlin A. Stamatis, Deborah N. Farlow, Catherine Mercaldi, Minny Suh, Amanda Maple, Antonia Savarese, Ann Childress, Raun D. Melmed, Scott H. Kollins","doi":"10.1038/s44184-024-00075-w","DOIUrl":"10.1038/s44184-024-00075-w","url":null,"abstract":"Inattention symptoms represent a key driver of functional impairment in ADHD and often persist into adolescence and adulthood, underscoring a need for novel treatments targeting attentional control. We evaluated AKL-T01—a digital therapeutic that is FDA-cleared for children 8–12 y with ADHD—in adolescents and adults with ADHD in two independent single-arm trials: STARS-ADHD-Adolescent, a 4-week trial in adolescents 13–17 y (n = 162 enrolled), and STARS-ADHD-Adult, a 6-week trial in adults 18 and older (n = 221 enrolled). AKL-T01 was linked with improvements on the Test of Variables of Attention (TOVA®) Attention Comparison Score (ACS) of 2.6 (95% CI: 2.02, 3.26; p < 0.0001) in adolescents and 6.5 in adults (95% CI: 5.35, 7.57; p < 0.0001), along with improvements in secondary endpoints. 15 participants reported adverse device effects, all mild or moderate. Though limited by a single-arm design, results provide preliminary support for the safety and efficacy of AKL-T01 for adolescents and adults with ADHD.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428417","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}
Sumra Bari, Byoung-Woo Kim, Nicole L. Vike, Shamal Lalvani, Leandros Stefanopoulos, Nicos Maglaveras, Martin Block, Jeffrey Strawn, Aggelos K. Katsaggelos, Hans C. Breiter
{"title":"A novel approach to anxiety level prediction using small sets of judgment and survey variables","authors":"Sumra Bari, Byoung-Woo Kim, Nicole L. Vike, Shamal Lalvani, Leandros Stefanopoulos, Nicos Maglaveras, Martin Block, Jeffrey Strawn, Aggelos K. Katsaggelos, Hans C. Breiter","doi":"10.1038/s44184-024-00074-x","DOIUrl":"10.1038/s44184-024-00074-x","url":null,"abstract":"Anxiety, a condition characterized by intense fear and persistent worry, affects millions each year and, when severe, is distressing and functionally impairing. Numerous machine learning frameworks have been developed and tested to predict features of anxiety and anxiety traits. This study extended these approaches by using a small set of interpretable judgment variables (n = 15) and contextual variables (demographics, perceived loneliness, COVID-19 history) to (1) understand the relationships between these variables and (2) develop a framework to predict anxiety levels [derived from the State Trait Anxiety Inventory (STAI)]. This set of 15 judgment variables, including loss aversion and risk aversion, models biases in reward/aversion judgments extracted from an unsupervised, short (2–3 min) picture rating task (using the International Affective Picture System) that can be completed on a smartphone. The study cohort consisted of 3476 de-identified adult participants from across the United States who were recruited using an email survey database. Using a balanced Random Forest approach with these judgment and contextual variables, STAI-derived anxiety levels were predicted with up to 81% accuracy and 0.71 AUC ROC. Normalized Gini scores showed that the most important predictors (age, loneliness, household income, employment status) contributed a total of 29–31% of the cumulative relative importance and up to 61% was contributed by judgment variables. Mediation/moderation statistics revealed that the interactions between judgment and contextual variables appears to be important for accurately predicting anxiety levels. Median shifts in judgment variables described a behavioral profile for individuals with higher anxiety levels that was characterized by less resilience, more avoidance, and more indifference behavior. This study supports the hypothesis that distinct constellations of 15 interpretable judgment variables, along with contextual variables, could yield an efficient and highly scalable system for mental health assessment. These results contribute to our understanding of underlying psychological processes that are necessary to characterize what causes variance in anxiety conditions and its behaviors, which can impact treatment development and efficacy.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422124","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}
{"title":"Advancing mental health parity to ensure children’s access to care","authors":"Nathaniel Z. Counts, Ashwin Vasan","doi":"10.1038/s44184-024-00070-1","DOIUrl":"10.1038/s44184-024-00070-1","url":null,"abstract":"Mental health and substance use parity provides a rhetorical device and policy strategy for achieving more equitable financing of mental health and substance use services, which the U.S. has pursued as a lead policy approach for improving access to mental healthcare. Parity implementation in the U.S. has improved access to care for children, but implementation challenges remain, leading to persistent treatment gaps and disparities, workforce shortages, and variable care quality. In the U.S., a recent policy change required health insurers to make available all of the data on their coverage and reimbursement practices for all health conditions. This new data enables a more detailed conceptualization of what parity means in children’s mental health and how it should be implemented and overseen. Researchers, clinicians, and advocates across the globe can use this data to build the case and the policy approach for parity, supporting more equitable financing of children’s mental health and substance use care and promoting families’ access to evidence-based care.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00070-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141315523","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}
Aada Ståhl, Milla Salonen, Emma Hakanen, Salla Mikkola, Sini Sulkama, Jari Lahti, Hannes Lohi
{"title":"Development and validation of the puppy blues scale measuring temporary affective disturbance resembling baby blues","authors":"Aada Ståhl, Milla Salonen, Emma Hakanen, Salla Mikkola, Sini Sulkama, Jari Lahti, Hannes Lohi","doi":"10.1038/s44184-024-00072-z","DOIUrl":"10.1038/s44184-024-00072-z","url":null,"abstract":"It has been described that many puppy owners experience a state called puppy blues involving stress, worry, anxiety, strain, frustration, or regret. While puppy blues is a commonly used term among dog owners, the term is nearly nonexistent in scientific literature. In turn, analogous phenomenon, postpartum affective disturbance of infant caregivers, is well described in the literature. This study aimed to develop and validate the first questionnaire to evaluate puppy blues. The methodology involved generating scale items based on a qualitative review of 135 pilot survey responses from people who had experienced distress during the puppy period, conducting exploratory factor analysis for the final scale items from a dataset of 1801 answers from Finnish dog owners (92% women), and collecting test-retest data from 265 individuals to assess the consistency of the measurement of items and factor structure across time. In addition, we collected an independent sample of 326 owners of 1–2-year-old dogs who answered the survey both regarding puppy period and current moment. The results indicate that the scale is a valid and reliable tool for measuring dog owners’ negative experiences and feelings related to puppyhood. We discovered three factors that describe different aspects of puppy blues: Frustration, Anxiety, and Weariness, which accounted for a significant proportion of the variance in puppy blues. The study demonstrated good internal consistency and consistency across two independent samples for the three identified factors. The test-retest reliability of the factors was good. Responses for the current timeframe compared to puppyhood experiences revealed significantly lower current scores across all factors for the current period, validating that the scale captures distress during puppyhood that diminishes over time. Interestingly, we found a fading affect bias where recollections of the experiences in the puppy period became more positive with time. Our findings shed light on the characteristics of puppy blues and provide a useful retrospective tool for measuring it.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00072-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287018","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}