{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:24:59Z","timestamp":1793305499531,"version":"4.5.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The neurobiological underpinnings underlying sex differences in cognition during adolescence are largely unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine sex differences in brain circuitry and their association with cognitive performance in US children.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study analyzed behavioral and imaging data from 9- to 11-year-old children from the Adolescent Brain Cognitive Development (ABCD) study between August 2017 and November 2018. The ABCD study is an open-science, multisite study following up more than 11\u202f800 youths into early adulthood for 10 years with annual laboratory-based assessments and biennial magnetic resonance imaging (MRI). The selection of ABCD study children for the current analysis was based on the availability of functional and structural MRI data sets in ABCD Brain Imaging Data Structure Community Collection format. Five hundred and sixty participants who had excessive level of head motion (&amp;gt;50% of time points with framewise displacement &amp;gt;0.5 mm) during resting-state functional MRI were excluded from the analyses. Data were analyzed between January and August 2022.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcomes were the sex differences in (A) global functional connectivity density at rest and (B) mean water diffusivity (MD) and (C) the correlation of these metrics with total cognitive scores.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 8961 children (4604 boys and 4357 girls; mean [SD] age, 9.92 [0.62] years) were included in this analysis. Girls had higher functional connectivity density in default mode network hubs than boys, predominantly in the posterior cingulate cortex (Cohen d<\/jats:italic>\u2009=\u2009\u22120.36), and lower MD and transverse diffusivity, predominantly in the superior corticostriatal white matter bundle (Cohen d<\/jats:italic>\u2009=\u20090.3). Age-corrected fluid and total composite scores were higher for girls than for boys (Cohen d<\/jats:italic>\u2009=\u2009\u22120.08 [fluid] and \u22120.04 [total]; P<\/jats:italic>\u2009=\u20092.7\u2009\u00d7\u200910\u22125<\/jats:sup>). Although total mean (SD) brain volume (1260\u2009[104] mL in boys and 1160\u2009[95] mL in girls; t<\/jats:italic>\u2009=\u200950; Cohen d<\/jats:italic>\u2009=\u20091.0; df<\/jats:italic>\u2009=\u20098738) and the proportion of white matter (d<\/jats:italic>\u2009=\u20090.4) were larger for boys than for girls, the proportion of gray matter was larger for girls than for boys (d<\/jats:italic>\u2009=\u2009\u22120.3; P<\/jats:italic>\u2009=\u20092.2\u2009\u00d7\u200910\u221216<\/jats:sup>).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this cross-sectional study on sex differences in brain connectivity and cognition are relevant to the future creation of brain developmental trajectory charts to monitor for deviations associated with impairments in cognition or behavior, including those due to psychiatric or neurological disorders. They could also serve as a framework for studies investigating the differential contribution of biological vs social or cultural factors in the neurodevelopmental trajectories of girls and boys.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.0157","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T16:15:58Z","timestamp":1676996158000},"page":"e230157","source":"Crossref","is-referenced-by-count":25,"title":["Measures of Brain Connectivity and Cognition by Sex in US Children"],"prefix":"10.1001","volume":"6","author":[{"given":"Dardo","family":"Tomasi","sequence":"first","affiliation":[{"name":"Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora D.","family":"Volkow","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland"},{"name":"National Institute on Drug Abuse, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"zoi230015r1","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.neubiorev.2017.07.005","article-title":"Sex differences in the brain: implications for behavioral and biomedical research.","volume":"85","author":"Choleris","year":"2018","journal-title":"Neurosci Biobehav Rev"},{"key":"zoi230015r2","doi-asserted-by":"publisher","first-page":"S178","DOI":"10.1016\/S1550-8579(07)80057-X","article-title":"Anxiety disorders: sex differences in prevalence, degree, and background, but gender-neutral treatment.","volume":"4","author":"Bekker","year":"2007","journal-title":"Gend Med"},{"issue":"6","key":"zoi230015r3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6706a1","article-title":"Prevalence of autism spectrum disorder among children aged 8 years: Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014.","volume":"67","author":"Baio","year":"2018","journal-title":"MMWR Surveill Summ"},{"issue":"3","key":"zoi230015r4","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1037\/0033-2909.115.3.424","article-title":"The emergence of gender differences in depression during adolescence.","volume":"115","author":"Nolen-Hoeksema","year":"1994","journal-title":"Psychol Bull"},{"issue":"2","key":"zoi230015r5","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.psc.2010.01.006","article-title":"Gender differences in attention-deficit\/hyperactivity disorder.","volume":"33","author":"Rucklidge","year":"2010","journal-title":"Psychiatr Clin North Am"},{"issue":"pt 9","key":"zoi230015r6","doi-asserted-by":"publisher","first-page":"2799","DOI":"10.1093\/brain\/awt216","article-title":"Biological sex affects the neurobiology of autism.","volume":"136","author":"Lai","year":"2013","journal-title":"Brain"},{"issue":"1","key":"zoi230015r7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s13229-021-00415-z","article-title":"Towards robust and replicable sex differences in the intrinsic brain function of autism.","volume":"12","author":"Floris","year":"2021","journal-title":"Mol Autism"},{"issue":"100","key":"zoi230015r8","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.neubiorev.2013.12.004","article-title":"A meta-analysis of sex differences in human brain structure.","volume":"39","author":"Ruigrok","year":"2014","journal-title":"Neurosci Biobehav Rev"},{"issue":"2","key":"zoi230015r9","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.neuroimage.2005.02.010","article-title":"Mapping cortical gray matter in the young adult brain: effects of gender.","volume":"26","author":"Luders","year":"2005","journal-title":"Neuroimage"},{"key":"zoi230015r10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.intell.2019.01.011","article-title":"The causal influence of brain size on human intelligence: evidence from within-family phenotypic associations and GWAS modeling.","volume":"75","author":"Lee","year":"2019","journal-title":"Intelligence"},{"key":"zoi230015r11","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.conb.2016.02.007","article-title":"Sex and cognition: gender and cognitive functions.","volume":"38","author":"Hyde","year":"2016","journal-title":"Curr Opin Neurobiol"},{"issue":"2","key":"zoi230015r12","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3758\/s13423-016-1085-7","article-title":"Sex differences in visual-spatial working memory: a meta-analysis.","volume":"24","author":"Voyer","year":"2017","journal-title":"Psychon Bull Rev"},{"issue":"2","key":"zoi230015r13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3390\/jintelligence7020011","article-title":"Sex similarities and differences in intelligence in children aged two to eight: analysis of SON-R 2-8 scores.","volume":"7","author":"Buczylowska","year":"2019","journal-title":"J Intell"},{"issue":"2","key":"zoi230015r14","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/0191-8869(94)90030-2","article-title":"Sex differences in intelligence and brain size: a paradox resolved.","volume":"17","author":"Lynn","year":"1994","journal-title":"Pers Individ Dif"},{"key":"zoi230015r15","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.yfrne.2016.12.003","article-title":"Puberty and structural brain development in humans.","volume":"44","author":"Herting","year":"2017","journal-title":"Front Neuroendocrinol"},{"issue":"6","key":"zoi230015r16","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1093\/cercor\/11.6.552","article-title":"Sex differences in brain maturation during childhood and adolescence.","volume":"11","author":"De Bellis","year":"2001","journal-title":"Cereb Cortex"},{"issue":"39","key":"zoi230015r17","doi-asserted-by":"publisher","first-page":"16988","DOI":"10.1073\/pnas.1006025107","article-title":"Longitudinally mapping the influence of sex and androgen signaling on the dynamics of human cortical maturation in adolescence.","volume":"107","author":"Raznahan","year":"2010","journal-title":"Proc Natl Acad Sci U S A"},{"key":"zoi230015r18","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.dcn.2013.02.003","article-title":"Sex differences and structural brain maturation from childhood to early adulthood.","volume":"5","author":"Koolschijn","year":"2013","journal-title":"Dev Cogn Neurosci"},{"issue":"13","key":"zoi230015r19","doi-asserted-by":"publisher","first-page":"3527","DOI":"10.1073\/pnas.1620928114","article-title":"Patterns of coordinated cortical remodeling during adolescence and their associations with functional specialization and evolutionary expansion.","volume":"114","author":"Sotiras","year":"2017","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"20","key":"zoi230015r20","doi-asserted-by":"publisher","first-page":"5065","DOI":"10.1523\/JNEUROSCI.3550-16.2017","article-title":"Age-related effects and sex differences in gray matter density, volume, mass, and cortical thickness from childhood to young adulthood.","volume":"37","author":"Gennatas","year":"2017","journal-title":"J Neurosci"},{"issue":"1","key":"zoi230015r21","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1073\/pnas.1912034117","article-title":"Development of structure-function coupling in human brain networks during youth.","volume":"117","author":"Baum","year":"2020","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"45","key":"zoi230015r22","doi-asserted-by":"publisher","first-page":"15034","DOI":"10.1523\/JNEUROSCI.2612-10.2010","article-title":"Growing together and growing apart: regional and sex differences in the lifespan developmental trajectories of functional homotopy.","volume":"30","author":"Zuo","year":"2010","journal-title":"J Neurosci"},{"issue":"4","key":"zoi230015r23","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1002\/hbm.v33.4","article-title":"Gender differences in brain functional connectivity density.","volume":"33","author":"Tomasi","year":"2012","journal-title":"Hum Brain Mapp"},{"issue":"3","key":"zoi230015r24","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/j.neuroimage.2011.05.024","article-title":"Functional connectivity hubs in the human brain.","volume":"57","author":"Tomasi","year":"2011","journal-title":"Neuroimage"},{"issue":"9","key":"zoi230015r25","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1093\/cercor\/bhu036","article-title":"Linked sex differences in cognition and functional connectivity in youth.","volume":"25","author":"Satterthwaite","year":"2015","journal-title":"Cereb Cortex"},{"issue":"21","key":"zoi230015r26","doi-asserted-by":"publisher","first-page":"9885","DOI":"10.1073\/pnas.1001414107","article-title":"Functional connectivity density mapping.","volume":"107","author":"Tomasi","year":"2010","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"9","key":"zoi230015r27","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.1093\/cercor\/bhq268","article-title":"Association between functional connectivity hubs and brain networks.","volume":"21","author":"Tomasi","year":"2011","journal-title":"Cereb Cortex"},{"issue":"1","key":"zoi230015r29","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/jora.2018.28.issue-1","article-title":"The Adolescent Brain Cognitive Development Study.","volume":"28","author":"Jernigan","year":"2018","journal-title":"J Res Adolesc"},{"key":"zoi230015r30","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.dcn.2018.03.001","article-title":"The Adolescent Brain Cognitive Development (ABCD) study: imaging acquisition across 21 sites.","volume":"32","author":"Casey","year":"2018","journal-title":"Dev Cogn Neurosci"},{"key":"zoi230015r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116091","article-title":"Image processing and analysis methods for the Adolescent Brain Cognitive Development Study.","volume":"202","author":"Hagler","year":"2019","journal-title":"Neuroimage"},{"key":"zoi230015r33","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.neuroimage.2013.04.127","article-title":"The minimal preprocessing pipelines for the Human Connectome Project.","volume":"80","author":"Glasser","year":"2013","journal-title":"Neuroimage"},{"key":"zoi230015r36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v059.i05","article-title":"Mediation: R package for causal mediation analysis.","volume":"59","author":"Tingley","year":"2014","journal-title":"J Stat Softw"},{"issue":"10","key":"zoi230015r37","doi-asserted-by":"publisher","first-page":"4734","DOI":"10.1073\/pnas.0911855107","article-title":"Toward discovery science of human brain function.","volume":"107","author":"Biswal","year":"2010","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"33","key":"zoi230015r38","doi-asserted-by":"publisher","first-page":"13642","DOI":"10.1073\/pnas.1303346110","article-title":"Energetic cost of brain functional connectivity.","volume":"110","author":"Tomasi","year":"2013","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"3","key":"zoi230015r39","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1016\/j.biopsych.2007.06.025","article-title":"Cingulate-precuneus interactions: a new locus of dysfunction in adult attention-deficit\/hyperactivity disorder.","volume":"63","author":"Castellanos","year":"2008","journal-title":"Biol Psychiatry"},{"issue":"12","key":"zoi230015r40","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1001\/jamapsychiatry.2013.2174","article-title":"Attention network hypoconnectivity with default and affective network hyperconnectivity in adults diagnosed with attention-deficit\/hyperactivity disorder in childhood.","volume":"70","author":"McCarthy","year":"2013","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"zoi230015r41","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1097\/WCO.0000000000000714","article-title":"Sex differences in neurodevelopmental disorders.","volume":"32","author":"May","year":"2019","journal-title":"Curr Opin Neurol"},{"issue":"2","key":"zoi230015r42","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1073\/pnas.1316909110","article-title":"Sex differences in the structural connectome of the human brain.","volume":"111","author":"Ingalhalikar","year":"2014","journal-title":"Proc Natl Acad Sci U S A"},{"key":"zoi230015r43","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.neuroimage.2013.12.044","article-title":"Developmental stages and sex differences of white matter and behavioral development through adolescence: a longitudinal diffusion tensor imaging (DTI) study.","volume":"92","author":"Simmonds","year":"2014","journal-title":"Neuroimage"},{"key":"zoi230015r44","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116441","article-title":"Sex effects on structural maturation of the limbic system and outcomes on emotional regulation during adolescence.","volume":"210","author":"Frere","year":"2020","journal-title":"Neuroimage"},{"issue":"4","key":"zoi230015r45","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1002\/(ISSN)1096-8644","article-title":"Normal neuroanatomical variation in the human brain: an MRI-volumetric study.","volume":"118","author":"Allen","year":"2002","journal-title":"Am J Phys Anthropol"},{"issue":"8","key":"zoi230015r46","doi-asserted-by":"publisher","first-page":"2959","DOI":"10.1093\/cercor\/bhy109","article-title":"Sex differences in the adult human brain: evidence from 5216 UK Biobank participants.","volume":"28","author":"Ritchie","year":"2018","journal-title":"Cereb Cortex"},{"issue":"1","key":"zoi230015r47","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1038\/s41386-018-0111-z","article-title":"Sex differences in the developing brain: insights from multimodal neuroimaging.","volume":"44","author":"Kaczkurkin","year":"2019","journal-title":"Neuropsychopharmacology"},{"key":"zoi230015r48","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2021.100928","article-title":"Frontoparietal and default mode network connectivity varies with age and intelligence.","volume":"48","author":"DeSerisy","year":"2021","journal-title":"Dev Cogn Neurosci"},{"issue":"3","key":"zoi230015r49","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1016\/j.neuroimage.2008.02.036","article-title":"Brain spontaneous functional connectivity and intelligence.","volume":"41","author":"Song","year":"2008","journal-title":"Neuroimage"},{"issue":"12","key":"zoi230015r50","doi-asserted-by":"publisher","first-page":"3299","DOI":"10.1002\/hbm.v34.12","article-title":"Functional connectivity between parietal and frontal brain regions and intelligence in young children: the Generation R study.","volume":"34","author":"Langeslag","year":"2013","journal-title":"Hum Brain Mapp"},{"issue":"11","key":"zoi230015r51","doi-asserted-by":"publisher","first-page":"2581","DOI":"10.1097\/00001756-200008030-00046","article-title":"Gender differences in the functional organization of the brain for working memory.","volume":"11","author":"Speck","year":"2000","journal-title":"Neuroreport"},{"key":"zoi230015r52","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.intell.2017.10.002","article-title":"Network connectivity correlates of variability in fluid intelligence performance.","volume":"65","author":"Santarnecchi","year":"2017","journal-title":"Intelligence"},{"issue":"2","key":"zoi230015r53","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.intell.2008.07.001","article-title":"Developmental sex differences in the relation of neuroanatomical connectivity to intelligence.","volume":"37","author":"Schmithorst","year":"2009","journal-title":"Intelligence"},{"issue":"1","key":"zoi230015r54","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.neuroimage.2006.11.046","article-title":"Sex differences in the development of neuroanatomical functional connectivity underlying intelligence found using Bayesian connectivity analysis.","volume":"35","author":"Schmithorst","year":"2007","journal-title":"Neuroimage"},{"issue":"1","key":"zoi230015r55","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.bandc.2009.06.005","article-title":"White matter development during adolescence as shown by diffusion MRI.","volume":"72","author":"Schmithorst","year":"2010","journal-title":"Brain Cogn"},{"key":"zoi230015r56","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0191-8869(03)00053-9","article-title":"Testing the developmental theory of sex differences in intelligence on 12\u201318 year olds.","volume":"36","author":"Colom","year":"2004","journal-title":"Pers Individ Dif"},{"issue":"3","key":"zoi230015r57","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1002\/per.677","article-title":"The nature and nurture of intelligence and motivation in the origins of sex differences in elementary school achievement.","volume":"22","author":"Spinath","year":"2008","journal-title":"Eur J Pers"},{"issue":"3","key":"zoi230015r58","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.paid.2011.02.028","article-title":"A longitudinal study of sex differences in intelligence at ages 7, 11 and 16 years.","volume":"51","author":"Lynn","year":"2011","journal-title":"Pers Individ Dif"},{"issue":"12","key":"zoi230015r59","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2020.107795","article-title":"Sex differences in gene expression and regulatory networks across 29 human tissues.","volume":"31","author":"Lopes-Ramos","year":"2020","journal-title":"Cell Rep"},{"issue":"9","key":"zoi230015r60","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1037\/bul0000270","article-title":"Biological aging in childhood and adolescence following experiences of threat and deprivation: a systematic review and meta-analysis.","volume":"146","author":"Colich","year":"2020","journal-title":"Psychol Bull"},{"issue":"11","key":"zoi230015r61","doi-asserted-by":"publisher","first-page":"6619","DOI":"10.1038\/s41380-021-01130-0","article-title":"Associations of family income with cognition and brain structure in USA children: prevention implications.","volume":"26","author":"Tomasi","year":"2021","journal-title":"Mol Psychiatry"},{"key":"zoi230015r28","unstructured":"The ABCD Consortium. Dataset: Release 2.0 and Fix Release 2.0.12019. Accessed January 13, 2023. https:\/\/nda.nih.gov\/study.html?id=634"},{"key":"zoi230015r32","unstructured":"Community Collection? ABCD-BIDS. (ABCC) Documentation Summary. Accessed January 13, 2023. https:\/\/collection3165.readthedocs.io\/en\/stable\/"},{"key":"zoi230015r34","doi-asserted-by":"crossref","unstructured":"Feczko? E, Conan? G, Marek? S, . Adolescent Brain Cognitive Development (ABCD) Community MRI Collection and Utilities.? bioRxiv. Preprint posted online July 11, 2021. doi:10.1101\/2021.07.09.451638","DOI":"10.1101\/2021.07.09.451638"},{"key":"zoi230015r35","unstructured":"National Institute of Mental Health Data Archive. Accessed January 13, 2023. https:\/\/nda.nih.gov\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2801653\/tomasi_2023_oi_230015_1676274019.87992.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T16:16:04Z","timestamp":1676996164000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2801653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,21]]},"references-count":61,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.0157","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,21]]}}}