medRxiv - Psychiatry and Clinical Psychology最新文献

{"title":"Isolating the genetic component of mania in bipolar disorder","authors":"Giuseppe Pierpaolo Merola, Johan Zvrskovec, Rujia Wang, Yuen Kaye Li, Giovanni Castellini, Valdo Ricca, Jonathan Coleman, Evangelos Vassos, Gerome Breen","doi":"10.1101/2024.08.30.24312859","DOIUrl":"https://doi.org/10.1101/2024.08.30.24312859","url":null,"abstract":"<strong>Objective</strong> Bipolar disorder typically features episodes of mania and depression, frequently accompanied by psychosis. While progress has been made in understanding the genetics of depression and psychosis, mania remains underexplored.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225132","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":"Empathy in psychotherapy: subjective ratings versus remote biosensing of interpersonal heart rate synchrony as outcome predictors","authors":"Clara C. Gernert, Peter Falkai, Christine M. Falter-Wagner","doi":"10.1101/2024.08.29.24312787","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312787","url":null,"abstract":"In addition to understanding empathy in an affective and cognitive dimension, the physiological domain plays a crucial role, especially in the emotional dynamics of interpersonal interactions during psychotherapy. Within the complex bio-psycho-social system of cognitive behavioural therapy language, cognition, emotion and physiological states of both, client and therapist, intertwine through interaction dynamics. The current study aimed to explore interpersonal physiological dynamics during psychotherapy sessions as an objective biomarker for predicting therapy outcome. In a follow-up assessment design, involving 25 client-psychotherapist dyads, wearable sensors monitored individual’s heart rate, while video cameras recorded movement behaviour during regular cognitive behavioural therapy sessions. Post-session reports and symptom questionnaires were collected from both, clients and therapists, after each session. Results showed that synchrony in head movement and heart rate emerged during psychotherapy sessions. Notably, heart rate synchrony from the initial session predicted changes in patients’ self-rated global severity index over time. The objective predictor, heart rate synchrony, emerged as particularly robust, surpassing patients’ subjective ratings of affiliation in explaining a higher variance of the therapy outcome variable. These findings highlight the potential shown by remote biomarker sensing of interpersonal dynamics for the prediction of psychotherapeutic effectiveness.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"192 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196543","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":"A 10 Years Update of Effects of Exercise on Depression Disorders – in otherwise healthy adults: A Systematic Review of Meta-Analyses and Neurobiological Mechanisms","authors":"Henning Budde, Nina Dolz, Anett Mueller-Alcazar, Bruna Velasques, Pedro Ribeiro, Sergio Machado, Mirko Wegner","doi":"10.1101/2024.08.28.24312666","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312666","url":null,"abstract":"<strong>Background</strong> Depression is one of the most common mental illnesses worldwide and is a major burden for those affected. As conventional therapies do not always work and are also associated with side effects, alternative treatment methods are urgently indicated. In the past, exercise has established itself as a seemingly good alternative treatment method. The aim of this work is to provide a state of the art review and to check whether there are new findings since the publication of the article by Wegner et al. [1].","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196542","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":"Biological Insights from Schizophrenia-associated Loci in Ancestral Populations","authors":"Tim B Bigdeli, Chris Chatzinakos, Jaroslav Bendl, Peter B Barr, Sanan Venkatesh, Bryan R Gorman, Tereza Clarence, Giulio Genovese, Conrad O Iyegbe, Roseann E Peterson, Sergios-Orestis Kolokotronis, David Burstein, Jacquelyn L Meyers, Yuli Li, Nallakkandi Rajeevan, Frederick Sayward, Kei-Hoi Cheung, Project Among African-Americans to Explore Risks for Schizophrenia (PAARTNERS), Consortium on the Genomics of Schizophrenia (COGS), Genomic Psychiatry Cohort (GPC) Investigators, Lynn E DeLisi, Thomas Kosten, Hongyu Zhao, Eric Achtyes, Peter Buckley, Dolores Malaspina, Douglas Lehrer, Mark H Rapaport, David L Braff, Michele T Pato, Ayman H Fanous, Carlos N Pato, PsychAD Consortium, Cooperative Studies Program (CSP) #572, Million Veteran Program (MVP), Grant D Huang, Sumitra Muralidhar, J. Michael Gaziano, Saiju Pyarajan, Kiran Girdhar, Donghoon Lee, Gabriel E Hoffman, Mihaela Aslan, John F Fullard, Georgios Voloudakis, Philip D Harvey, Panos Roussos","doi":"10.1101/2024.08.27.24312631","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312631","url":null,"abstract":"Large-scale genome-wide association studies of schizophrenia have uncovered hundreds of associated loci but with extremely limited representation of African diaspora populations. We surveyed electronic health records of 200,000 individuals of African ancestry in the Million Veteran and All of Us Research Programs, and, coupled with genotype-level data from four case-control studies, realized a combined sample size of 13,012 affected and 54,266 unaffected persons. Three genome-wide significant signals - near PLXNA4, PMAIP1, and TRPA1 - are the first to be independently identified in populations of predominantly African ancestry. Joint analyses of African, European, and East Asian ancestries across 86,981 cases and 303,771 controls, yielded 376 distinct autosomal loci, which were refined to 708 putatively causal variants via multi-ancestry fine-mapping. Utilizing single-cell functional genomic data from human brain tissue and two complementary approaches, transcriptome-wide association studies and enhancer-promoter contact mapping, we identified a consensus set of 94 genes across ancestries and pinpointed the specific cell types in which they act. We identified reproducible associations of schizophrenia polygenic risk scores with schizophrenia diagnoses and a range of other mental and physical health problems. Our study addresses a longstanding gap in the generalizability of research findings for schizophrenia across ancestral populations, underlining shared biological underpinnings of schizophrenia across global populations in the presence of broadly divergent risk allele frequencies.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196573","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":"New Eye Tracking Metrics System: The Value in Early Diagnosis of Autism Spectrum Disorder","authors":"Raymond Kong Wang, Kenneth Kwong, Kevin Liu, Xue-Jun Kong","doi":"10.1101/2024.08.28.24312596","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312596","url":null,"abstract":"Background\u0000Eye tracking (ET) is emerging as a promising early and objective screening method for autism spectrum disorders (ASD), but it requires more reliable metrics with enhanced sensitivity and specificity for clinical use. Methods\u0000This study introduces a suite of novel ET metrics: Area of Interest (AOI) Switch Counts (ASC), Favorable AOI Shifts (FAS) along self-determined pathways, and AOI Vacancy Counts (AVC). These metrics were applied to toddlers and preschoolers diagnosed with ASD. The correlation between these new ET metrics and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) scores was assessed using linear regression. Sensitivity and specificity of the cut-off scores were also evaluated to predict diagnosis. Results\u0000Our findings indicate significantly lower FAS and ASC and higher AVC (P &lt; 0.05) in children with ASD compared to their non-ASD counterparts within this high-risk cohort. There were no significant differences in total fixation time or pupil size (p &gt; 0.05). Additionally, FAS was negatively correlated with ADOS-2 total scores and the social affect (SA) subscale (p &lt; 0.05). Among these new ET metrics, AVC yielded the best sensitivity (88-100%) and specificity (80-88%) with a cut-off score of 0.305-0.306, followed by FAS and ASC for distinguishing ASD from non-ASD for diagnosis. Conclusions\u0000This study confirms the utility of innovative ET metrics FAS, AVC, and ASC, which exhibit markedly improved sensitivity and specificity, enhancing ASD screening and diagnostic processes.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196544","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":"Loss to follow-up of ambulatory patients in the transition to telemedicine in the COVID-19 pandemic at a reference center for mental health in Lima, Peru.","authors":"Paulo Ruiz-Grosso, Sonia Zevallos-Bustamante, Abel Sagastegui","doi":"10.1101/2024.08.27.24312689","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312689","url":null,"abstract":"Abstract Problem Statement:\u0000During the COVID-19 pandemic, health care services were limited by the restrictive measures implemented. As an adaptation mechanism, telemedicine was introduced for ambulatory care at the Honorio Delgado Hideyo Noguchi National Institute of Mental Health (NIMH). This study aimed to estimate the survival function (SF) for loss to follow-up (LTFU) over two years before and after the onset of the COVID-19 pandemic, and its association with clinical and sociodemographic variables.\u0000Study Design:\u0000A single-cohort study was conducted, following a random sample of adult ambulatory patients at NIHM from April 15, 2018, to April 15, 2022. Patients were followed until LTFU, referral to another institution, death, or the end of study. The main analysis involved estimating the SF for LTFU for the overall follow up period, as well as separately for the periods pre and post implementation of telemedicine. Also, risk factors hypotheses were tested using Cox regression.\u0000Results:\u0000Data from 4887 visits of 356 patients were collected. A total of 118 (33.1%) presented LTFU, with SF of 53.9% during the overall four years of follow-up. After two years of follow-, those starting treatment at NIMH before the implementation of telemedicine had a higher SF (77.3 vs 63%). A higher hazard ratio (HR) for LTFU was found in the group that started care at NIMH after the implementation of telemedicine, compared to those who started previously (HR=2.53; 95% CI: 1.55-4.51). Additionally, receiving care in the anxiety disorders (HR=1.86; 95% CI: 1.03-3.33) and personality disorders programs (HR=1.81; 95% CI: 1.02-3.22) was associated with a higher risk of LTFU compared to the psychosis program. No significant difference was found in the risk of LTFU between telemedicine vs. face-to face attention. Conclusions:\u0000A significant association was found between LTFU and starting treatment at NIMH after the onset of the COVID-19 pandemic and implementation of telemedicine. However, no evidence supports that this might be due to the practice of telemedicine. A different clinical profile of patients that started treatment at NIMH following the government implementation of changes to the public health system might explain these findings and should be studied. Keywords: COVID-19, telemedicine, psychiatry, health services","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196547","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":"Changes in affect variability after starting gender-affirming hormone therapy","authors":"Margot W.L. Morssinkhof, Marijn Schipper, Baudewijntje P.C. Kreukels, Karin van der Tuuk, Martin den Heijer, Odile A. van den Heuvel, David Matthew Doyle, Birit F.P. Broekman","doi":"10.1101/2024.08.28.24312697","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312697","url":null,"abstract":"Affect variability is determined by how often and how strongly negative affect changes over time. Cisgender women report greater variability in affect than cisgender men. It has been suggested that sex hormone changes may influence affect variability. Transgender people frequently opt to use sex hormones in the form of gender-affirming hormone therapy (GAHT), but the extent to which GAHT can change negative affect variability is not yet clear. Therefore, this study aims to study changes in negative affect variability after starting GAHT.\u0000We have included data from 94 participants from the RESTED study: 49 transmasculine (TM) participants (assigned female at birth, starting testosterone) and 45 transfeminine (TF) participants (assigned male at birth, starting estrogens and anti-androgens). Participants completed up to 7 consecutive daily diaries at each of three time points: before starting GAHT, and after 3 and 12 months of GAHT. The daily diaries collected participants' reports on symptoms related to negative affect: experienced low mood, less interest, tense feelings and restless feelings. We have used linear mixed models to compare negative affect variability during one week, corrected for mean negative affect, between gender groups (TM versus TF) and measurement time points.\u0000Results show that in the TM group, variability in low mood, tense feelings and restless feelings decreases after 12 months of GAHT. In the TF group, variability in low mood increases after 3 months and 12 months of GAHT, as does variability in restless feelings after 3 months of GAHT. Group comparisons indicate significant group differences in changes in variability in low mood and restless feelings, with stronger increases in variability of negative affect in the TF group compared to TM group after 3 and 12 months of GAHT. Our findings indicate that variability patterns in negative affect in transgender persons tend to cross-over from being consistent with sex assigned at birth before GAHT to being more in line with gender identity after 12 months of GAHT. Future studies should focus on measuring both negative and positive affect variability during GAHT, preferably through multiple measurements per day, taking into account diverse social and daily contextual factors during GAHT.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196545","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":"Antidepressant efficacy of administering repetitive transcranial magnetic stimulation (rTMS) concurrently with psychological tasks or interventions: a scoping review and meta-analysis","authors":"Cristian G Giron, Alvin H. P. Tang, Minxia Jin, Georg S. Kranz","doi":"10.1101/2024.08.28.24312728","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312728","url":null,"abstract":"Current approaches to optimize the efficacy of repetitive transcranial magnetic stimulation (rTMS) for depressive symptoms focus on personalizing targets and parameters. But what should occur during these three-to-forty-minute sessions remains under-investigated. Specific concerns include evidence suggesting brain state modulates the brain response to stimulation, and the potential to boost antidepressant efficacy by administering rTMS concurrently with psychological methods. Thus, conducted a scoping review and meta-analysis, per PRISMA-ScR guidelines, to pool studies that administered rTMS during psychological tasks or interventions. PubMed and Web of Science databases were searched from inception to 10 July 2024. Inclusion criteria: neuropsychiatric patients underwent rTMS; studies assessed depressive symptom severity; psychological tasks or interventions were administered during rTMS, or intentionally did not include a wash-out period. Of 8442 hits, 20 studies combined rTMS with aerobic exercise, bright light therapy, cognitive training or reactivation, psychotherapy, sleep deprivation, or a psychophysical task. Meta-analyses with random effects models pooled the efficacy of these combinations, based on change scores on depressive severity scales. The effect size was large and therapeutic for uncontrolled pretest-posttest comparisons (17 studies, 20 datasets, g=-1.91, SE=0.45, 95%CI= -2.80 to -1.03, p&lt;0.01); medium when studies compared active combinations with sham rTMS plus active psychological methods (8 studies, g=-0.55, SE=0.14, 95%CI= -0.82 to -0.28, p&lt;0.01); and non-significant when active combinations were compared with active rTMS plus sham psychological methods (4 studies, p= 0.96). These findings suggest that the antidepressant efficacy of combining rTMS with psychological methods is promising, but not an improvement over rTMS alone.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196546","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 phenomenology of psilocybin's experience mediates subsequent persistent psychological effects independently of sex, previous experience or setting","authors":"Tereza Kluckova, Marek Nikolic, Filip Tyls, Vojtech Viktorin, Cestmir Vejmola, Michaela Viktorinova, Anna Bravermanova, Renata Androvicova, Veronika Andrashko, Jakub Korcak, Peter Zach, Katerina Hajkova, Martin Kuchar, Marie Balikova, Martin Brunovsky, Jiri Horacek, Tomas Palenicek","doi":"10.1101/2024.08.26.24311611","DOIUrl":"https://doi.org/10.1101/2024.08.26.24311611","url":null,"abstract":"Background: Recent studies have intensively explored the potential antidepressant effects of psilocybin. However, important variables such as previous experience, repeated administration, setting and sex remain underexplored. This study describes the acute psilocybin experience and long-term effects in a small sample of healthy individuals.\u0000Methods: In a double-blind, placebo-controlled, cross-over study, 40 healthy participants (20 females, mean age 38, sd 8) received two doses of psilocybin 0.26 mg/kg per os at least 56 days apart (mean 354 days) in two study arms (EEG and fMRI). Near half of participants had experience with psychedelics. The Altered State of Consciousness Scale (ASC) and a visual analogue scale (VAS) on emotional valence of the phenomenology assessed acute phenomenology. The Persisting Effects Questionnaire (PEQ) assessed long-term effects. Venous blood samples were taken to measure serum psilocin levels.\u0000Results: All results were independent of previous experience, sex, EEG or fMRI arm/setting. Acute psychedelic effects were of moderate intensity on ASC. The VAS showed mostly pleasant and fluctuating, and only one unpleasant only experience. All experiences resolved in a positive or neutral state at the end of the session. Psilocybin induced sustained positive effects on all domains of the PEQ, with negligible negative effects. Oceanic Boundlessness and Visual Restructuralization were associated with positive effects on PEQ. Contrary to expectations, Dread of Ego Dissolution, typically associated with fearful experiences, was not associated with PEQ negative outcomes. The type of experience (pleasant or mixed) did not correlate with the intensity or direction of the lasting effect; however, peak experiences culminating in a positive mood were associated with positive long-term effects.\u0000Conclusion: In our sample repeated administration of psilocybin to healthy volunteers, induces positive, lasting effects. This underscores the psychological safety of psilocybin in a laboratory setting and supports its repeated use in clinical trials. In particular, challenging or anxiety-provoking experiences in controlled environments did not lead to adverse long-term outcomes.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"170 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196576","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":"Cross-site predictions of readmission after psychiatric hospitalization with mood or psychotic disorders","authors":"Boyu Ren, WonJin Yoon, Spencer Thomas, Guergana Savova, Timothy Miller, Mei-Hua Hall","doi":"10.1101/2024.08.26.24312586","DOIUrl":"https://doi.org/10.1101/2024.08.26.24312586","url":null,"abstract":"Patients with mood or psychotic disorders have high rates of unplanned readmission, and predicting readmission likelihood may guide discharge decisions. In this retrospective, multi-site study, we assess the predictive power of various structured variables from electronic health records for all-cause readmission in each site separately and evaluate the generalizability of the in-site prediction models across sites. We find that the set of relevant predictors vary significantly across. For example, length of stay is strongly predictive of readmission at only three out of the four sites. We also find a general lack of cross-site generalizability of the in-site prediction models, with in-site predictions having an average F1 score of 0.666, compared to an average F1 score of 0.551 for cross-site predictions. The generalizability cannot be improved even after adjusting for differences in the distributions of predictors. These results indicate that, with this set of predictors, fitting individual models at each site is necessary to achieve reasonable prediction accuracy. Additionally, they suggest that more sophisticated predictors variables or predictive algorithms are needed to develop generalizable models capable of extracting robust insights into the root causes of early psychiatric readmissions.","PeriodicalId":501388,"journal":{"name":"medRxiv - Psychiatry and Clinical Psychology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196574","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}