Pub Date : 2001-10-01DOI: 10.1053/SCNP.2001.0060277
C. Raison, Andrew H. Miller
This article reviews evidence that shows a bidirectional relationship between the brain and the immune system. As a result of this relationship, mental factors such as stress and depression have been shown to affect immune system functioning, with both immunosuppression and immune activation being reported. Stress and depression also have been associated with worse outcomes in immune-related disorders including cancer and infectious diseases suggesting that stress/depression effects on the immune system are clinically relevant to disease expression. Conversely, several lines of evidence suggest that immune system activation such as during infectious diseases, cancer, and autoimmune disorders is associated with the development of behavioral symptoms similar to those seen in the context of chronic stress or major depression. These findings implicate a role for the immune system in the cause of behavioral disorders in a wide range of medical illnesses. Finally, a paradigm is proposed in which abnormal functioning of either the hypothalamic-pituitary-adrenal (HPA) axis or the inflammatory response system disrupts feedback regulation of both neuroendocrine and immune systems contributing to the development of neuropsychiatric and immunologic disorders.
{"title":"The neuroimmunology of stress and depression.","authors":"C. Raison, Andrew H. Miller","doi":"10.1053/SCNP.2001.0060277","DOIUrl":"https://doi.org/10.1053/SCNP.2001.0060277","url":null,"abstract":"This article reviews evidence that shows a bidirectional relationship between the brain and the immune system. As a result of this relationship, mental factors such as stress and depression have been shown to affect immune system functioning, with both immunosuppression and immune activation being reported. Stress and depression also have been associated with worse outcomes in immune-related disorders including cancer and infectious diseases suggesting that stress/depression effects on the immune system are clinically relevant to disease expression. Conversely, several lines of evidence suggest that immune system activation such as during infectious diseases, cancer, and autoimmune disorders is associated with the development of behavioral symptoms similar to those seen in the context of chronic stress or major depression. These findings implicate a role for the immune system in the cause of behavioral disorders in a wide range of medical illnesses. Finally, a paradigm is proposed in which abnormal functioning of either the hypothalamic-pituitary-adrenal (HPA) axis or the inflammatory response system disrupts feedback regulation of both neuroendocrine and immune systems contributing to the development of neuropsychiatric and immunologic disorders.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 4 1","pages":"277-94"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58315278","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}
The bulk of cancer research has productively focused on the pathophysiology of the disease, emphasizing tumor biology, especially tumor characteristics such as DNA ploidy and estrogen/progesterone receptor status as predictors of disease outcome, at the expense of studying the body's psychophysiological reactions to tumor invasion. These reactions are mediated by brain/body mechanisms, including the endocrine, neuroimmune, and autonomic nervous systems. Although a large portion of the variance in any disease outcome is accounted for by the specific local pathophysiology of that disease, some variability must also be explained by 'host resistance' factors, which include the manner of response to the stress of the illness. The evidence of links between social support, stress, emotional state, and immune and endocrine function is growing. Here we examine evidence that 2 especially promising mechanisms, one immune, one endocrine, may mediate the relationship between stress and social support on the one hand and cancer progression on the other. We chose natural killer (NK) cells and cortisol because they are particularly good examples of mediating mechanisms for which there is solid basic and clinical evidence. NK cells are of great interest because they are involved in tumor surveillance, and because their activity can be measured in vitro.
{"title":"Psychoneuroimmune and endocrine pathways in cancer: effects of stress and support.","authors":"David Spiegel, S. Sephton","doi":"10.1053/SCNP.2001.26995","DOIUrl":"https://doi.org/10.1053/SCNP.2001.26995","url":null,"abstract":"The bulk of cancer research has productively focused on the pathophysiology of the disease, emphasizing tumor biology, especially tumor characteristics such as DNA ploidy and estrogen/progesterone receptor status as predictors of disease outcome, at the expense of studying the body's psychophysiological reactions to tumor invasion. These reactions are mediated by brain/body mechanisms, including the endocrine, neuroimmune, and autonomic nervous systems. Although a large portion of the variance in any disease outcome is accounted for by the specific local pathophysiology of that disease, some variability must also be explained by 'host resistance' factors, which include the manner of response to the stress of the illness. The evidence of links between social support, stress, emotional state, and immune and endocrine function is growing. Here we examine evidence that 2 especially promising mechanisms, one immune, one endocrine, may mediate the relationship between stress and social support on the one hand and cancer progression on the other. We chose natural killer (NK) cells and cortisol because they are particularly good examples of mediating mechanisms for which there is solid basic and clinical evidence. NK cells are of great interest because they are involved in tumor surveillance, and because their activity can be measured in vitro.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 4 1","pages":"252-65"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316393","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}
D. Cruess, J. Leserman, J. Petitto, R. Golden, M. Szuba, M. Morrison, D. Evans
Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consists of a wide array of recurrent and sometimes severe psychosocial stressors. An individual's response to these multiple challenges over time may impact their health. In this article, we review research examining the relationship of psychologic factors (eg, depression, stressful life events, coping, social support) with immune system function and disease course. We also explore some of the potential physiologic pathways that may underlie these types of psychosocial-immune relationships, as well as the effects of psychologic interventions, particularly cognitive-behavioral stress management (CBSM), on the psychosocial, neuroendocrine, and immune functioning of people living with HIV. We conclude by suggesting some areas for future research, particularly the study of HIV-positive women.
{"title":"Psychosocial-immune relationships in HIV disease.","authors":"D. Cruess, J. Leserman, J. Petitto, R. Golden, M. Szuba, M. Morrison, D. Evans","doi":"10.1053/SCNP.2001.26996","DOIUrl":"https://doi.org/10.1053/SCNP.2001.26996","url":null,"abstract":"Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consists of a wide array of recurrent and sometimes severe psychosocial stressors. An individual's response to these multiple challenges over time may impact their health. In this article, we review research examining the relationship of psychologic factors (eg, depression, stressful life events, coping, social support) with immune system function and disease course. We also explore some of the potential physiologic pathways that may underlie these types of psychosocial-immune relationships, as well as the effects of psychologic interventions, particularly cognitive-behavioral stress management (CBSM), on the psychosocial, neuroendocrine, and immune functioning of people living with HIV. We conclude by suggesting some areas for future research, particularly the study of HIV-positive women.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 4 1","pages":"241-51"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316475","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}
This report provides a behavioral account of gambling and its treatment. It describes the similarities between gambling and other behaviors maintained by intermittent schedules of reinforcement, the relationship between response cost and gambling behaviors, and how magnitudes of reinforcers affect gambling behaviors. In addition, the relationship between immediacy of reinforcement and behavior is described. Using these behavioral phenomena, behavioral and cognitive-behavioral treatments of pathological gambling are described. Finally, we present the rationale and framework for our cognitive-behavioral treatment, and we provide a behavioral interpretation of 12-step groups.
{"title":"A behavioral approach to understanding and treating pathological gambling.","authors":"N. Petry, J. Roll","doi":"10.1053/SCNP.2001.22920","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22920","url":null,"abstract":"This report provides a behavioral account of gambling and its treatment. It describes the similarities between gambling and other behaviors maintained by intermittent schedules of reinforcement, the relationship between response cost and gambling behaviors, and how magnitudes of reinforcers affect gambling behaviors. In addition, the relationship between immediacy of reinforcement and behavior is described. Using these behavioral phenomena, behavioral and cognitive-behavioral treatments of pathological gambling are described. Finally, we present the rationale and framework for our cognitive-behavioral treatment, and we provide a behavioral interpretation of 12-step groups.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"177-83"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58315729","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}
Despite relatively high prevalence rates and significant morbidity and mortality associated with pathological gambling (PG), our understanding of the neurobiological basis of PG lags in comparison to that for other psychiatric illnesses of comparable magnitude. An improved understanding of the neurobiology of PG would facilitate targeted investigations into more effective treatments. Emerging data suggest shared neurobiological features determine in part pathological gambling and substance use disorders. These findings both challenge current conceptualizations of addictions and provide a substantial basis of knowledge on which to design investigations into the understanding and treatment of pathological gambling. The findings that substance use disorders and the behavioral "addiction" of PG share common causative features raise the question as to what extent other compulsive disorders (eg, compulsive shopping, compulsive sexual behaviors, compulsive computer use) might be biologically related.
{"title":"The neurobiology of pathological gambling.","authors":"M. Potenza","doi":"10.1053/SCNP.2001.22929","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22929","url":null,"abstract":"Despite relatively high prevalence rates and significant morbidity and mortality associated with pathological gambling (PG), our understanding of the neurobiological basis of PG lags in comparison to that for other psychiatric illnesses of comparable magnitude. An improved understanding of the neurobiology of PG would facilitate targeted investigations into more effective treatments. Emerging data suggest shared neurobiological features determine in part pathological gambling and substance use disorders. These findings both challenge current conceptualizations of addictions and provide a substantial basis of knowledge on which to design investigations into the understanding and treatment of pathological gambling. The findings that substance use disorders and the behavioral \"addiction\" of PG share common causative features raise the question as to what extent other compulsive disorders (eg, compulsive shopping, compulsive sexual behaviors, compulsive computer use) might be biologically related.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"217-26"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316101","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}
Neurological patients with bilateral ventromedial (VM) lesions of the prefrontal cortex often deny, or they are not aware that they have a problem. Furthermore, they often pursue actions that bring some reward in the immediate run, despite severe long-term consequences such as the loss of job, home, and family. The somatic marker hypothesis, which provides an account of this defect in decision-making, posits that the impairment is the result of defective activation of somatic markers that normally function as covert or overt signposts for helping with the process of making choices that are advantageous to the organism. Failure to enact somatic states results from dysfunction in a neural system in which the VM cortex is one critical region. However, other neural regions, including the amygdala, and somatosensory cortices (SI, SII, and insula) are also hypothesized to be components of that same neural system. Recent evidence reveals that substance abusers suffer from decision-making deficit akin to that seen with patients with VM lesions. Thus, the strategies used to study decision-making in neurological patients have direct implications for understanding several neuropsychiatric disorders including addiction and pathological gambling.
{"title":"Neurobiology of decision-making: risk and reward.","authors":"A. Bechara","doi":"10.1053/SCNP.2001.22927","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22927","url":null,"abstract":"Neurological patients with bilateral ventromedial (VM) lesions of the prefrontal cortex often deny, or they are not aware that they have a problem. Furthermore, they often pursue actions that bring some reward in the immediate run, despite severe long-term consequences such as the loss of job, home, and family. The somatic marker hypothesis, which provides an account of this defect in decision-making, posits that the impairment is the result of defective activation of somatic markers that normally function as covert or overt signposts for helping with the process of making choices that are advantageous to the organism. Failure to enact somatic states results from dysfunction in a neural system in which the VM cortex is one critical region. However, other neural regions, including the amygdala, and somatosensory cortices (SI, SII, and insula) are also hypothesized to be components of that same neural system. Recent evidence reveals that substance abusers suffer from decision-making deficit akin to that seen with patients with VM lesions. Thus, the strategies used to study decision-making in neurological patients have direct implications for understanding several neuropsychiatric disorders including addiction and pathological gambling.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"205-16"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58315980","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}
Increased attention has been given to the disorder of pathological gambling, especially since the formation of the latest Presidential Commission to study its social and economic impact on the nation. Researchers have experienced difficulty in establishing the prevalence of pathological gambling disorder attributable to several factors, namely: debate and confusion on the best way to define and classify the disorder; assessments of the disorder that are not diagnostic or comprehensive; and, methodological weaknesses in the majority of gambling studies caused primarily by sampling biases. This article summarizes prevalence estimates of pathological gambling disorder in the general population and for subpopulations while addressing the difficulties inherent in their interpretation. Recommendations are offered for future research into this disorder.
{"title":"The epidemiology of pathological gambling.","authors":"R. Cunningham-Williams, L. Cottler","doi":"10.1053/SCNP.2001.22919","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22919","url":null,"abstract":"Increased attention has been given to the disorder of pathological gambling, especially since the formation of the latest Presidential Commission to study its social and economic impact on the nation. Researchers have experienced difficulty in establishing the prevalence of pathological gambling disorder attributable to several factors, namely: debate and confusion on the best way to define and classify the disorder; assessments of the disorder that are not diagnostic or comprehensive; and, methodological weaknesses in the majority of gambling studies caused primarily by sampling biases. This article summarizes prevalence estimates of pathological gambling disorder in the general population and for subpopulations while addressing the difficulties inherent in their interpretation. Recommendations are offered for future research into this disorder.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"155-66"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58315639","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}
S. Eisen, W. Slutske, M. Lyons, J. Lassman, H. Xian, R. Toomey, S. Chantarujikapong, M. Tsuang
Problem and pathological gambling (PG) occurs in about 5% of Americans. Gambling is associated with substantial psychosocial and psychiatric health problems, and the increasing ease of access to gambling may increase its future prevalence. Therefore, it is important to gain greater insight into the causes of PG. Family studies of PG are consistent with a substantial familial impact on vulnerability to PG. However, family studies cannot distinguish genetic from family environmental influences. By contrast, the study of twin pairs permits the genetic and environmental influences on PG to be estimated. The study of gambling behavior among 3,359 twin pair members of the Vietnam Era Twin Registry suggests that: (1) inherited factors explain a substantial proportion of the variance in the report of symptoms of gambling; (2) there is a single continuum of genetic vulnerability that underlies gambling problems of varying severities; and, (3) the co-occurrence of PG with conduct disorder, antisocial personality disorder, and alcohol abuse/dependence is partially explained by genes that influence both PG and these other psychiatric disorders. Neurophysiological correlates of gambling problems and genetically based differences in neurotransmitter systems may provide biological mechanisms that explain the genetic basis for a predisposition to PG.
{"title":"The genetics of pathological gambling.","authors":"S. Eisen, W. Slutske, M. Lyons, J. Lassman, H. Xian, R. Toomey, S. Chantarujikapong, M. Tsuang","doi":"10.1053/SCNP.2001.22931","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22931","url":null,"abstract":"Problem and pathological gambling (PG) occurs in about 5% of Americans. Gambling is associated with substantial psychosocial and psychiatric health problems, and the increasing ease of access to gambling may increase its future prevalence. Therefore, it is important to gain greater insight into the causes of PG. Family studies of PG are consistent with a substantial familial impact on vulnerability to PG. However, family studies cannot distinguish genetic from family environmental influences. By contrast, the study of twin pairs permits the genetic and environmental influences on PG to be estimated. The study of gambling behavior among 3,359 twin pair members of the Vietnam Era Twin Registry suggests that: (1) inherited factors explain a substantial proportion of the variance in the report of symptoms of gambling; (2) there is a single continuum of genetic vulnerability that underlies gambling problems of varying severities; and, (3) the co-occurrence of PG with conduct disorder, antisocial personality disorder, and alcohol abuse/dependence is partially explained by genes that influence both PG and these other psychiatric disorders. Neurophysiological correlates of gambling problems and genetically based differences in neurotransmitter systems may provide biological mechanisms that explain the genetic basis for a predisposition to PG.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"195-204"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316159","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}
C. Blanco, P. Moreyra, E. Nunes, J. Saiz-Ruiz, Á. Ibáñez
There is considerable debate about the appropriate conceptualization of pathological gambling and its place in psychiatric nosology. The authors examined the existing research on different areas of pathological gambling to find evidence for a particular model of this disorder. There are 2 dominant models of pathological gambling: as a nonpharmacologic addiction and as an obsessive-compulsive spectrum disorder. The data available from different areas seem to converge in suggesting that pathological gambling has characteristics that are similar to those of substance abuse, and less close to those of obsessive-compulsive disorder, although those conceptualizations are not mutually exclusive. An alternative model of pathological gambling is that it constitutes a heterogeneous disorder with some subtypes resembling obsessive-compulsive disorder, and other subtypes being closer to substance abuse disorders. Improved understanding of the conceptualization of this disorder may help improve the quality of the treatments available.
{"title":"Pathological gambling: addiction or compulsion?","authors":"C. Blanco, P. Moreyra, E. Nunes, J. Saiz-Ruiz, Á. Ibáñez","doi":"10.1053/SCNP.2001.22921","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22921","url":null,"abstract":"There is considerable debate about the appropriate conceptualization of pathological gambling and its place in psychiatric nosology. The authors examined the existing research on different areas of pathological gambling to find evidence for a particular model of this disorder. There are 2 dominant models of pathological gambling: as a nonpharmacologic addiction and as an obsessive-compulsive spectrum disorder. The data available from different areas seem to converge in suggesting that pathological gambling has characteristics that are similar to those of substance abuse, and less close to those of obsessive-compulsive disorder, although those conceptualizations are not mutually exclusive. An alternative model of pathological gambling is that it constitutes a heterogeneous disorder with some subtypes resembling obsessive-compulsive disorder, and other subtypes being closer to substance abuse disorders. Improved understanding of the conceptualization of this disorder may help improve the quality of the treatments available.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"167-76"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316272","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}
We discuss the rationale of the pharmacological approaches to pathological gambling and review the current status of drug treatments in this area. Specifically, we summarize the treatment study results of serotonin reuptake inhibitors, mood stabilizers, and opioid antagonists in pathological gambling. We also briefly describe the animal and human studies of other pharmacologic agents that show future promise in treating this disorder. Finally, we discuss a research agenda to be addressed in future drug treatment studies in pathological gambling.
{"title":"The psychopharmacology of pathological gambling.","authors":"S. W. Kim, J. Grant","doi":"10.1053/SCNP.2001.22924","DOIUrl":"https://doi.org/10.1053/SCNP.2001.22924","url":null,"abstract":"We discuss the rationale of the pharmacological approaches to pathological gambling and review the current status of drug treatments in this area. Specifically, we summarize the treatment study results of serotonin reuptake inhibitors, mood stabilizers, and opioid antagonists in pathological gambling. We also briefly describe the animal and human studies of other pharmacologic agents that show future promise in treating this disorder. Finally, we discuss a research agenda to be addressed in future drug treatment studies in pathological gambling.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"6 3 1","pages":"184-94"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58316405","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}
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