Clinical EEG and Neuroscience最新文献

{"title":"Altered Dynamic Brain Connectivity in Individuals With Sickle Cell Disease and Chronic Pain Secondary to Hip Osteonecrosis.","authors":"Jamille Evelyn R S Santana,&nbsp;Abrahão F Baptista,&nbsp;Rita Lucena,&nbsp;Tiago da S Lopes,&nbsp;Raphael S do Rosário,&nbsp;Marjorie R Xavier,&nbsp;André Fonseca,&nbsp;José Garcia V Miranda","doi":"10.1177/15500594211054297","DOIUrl":"https://doi.org/10.1177/15500594211054297","url":null,"abstract":"<p><p>Individuals with sickle cell disease (SCD) exhibit changes in static brain connectivity in rest. However, little known as chronic pain associated with hip osteonecrosis affects dynamic brain connectivity during rest and the motor imagery task. The aim of this study was to investigate the characteristics of the dynamic functional brain connectivity of individuals with SCD and chronic pain secondary to hip osteonecrosis. This is a cross-sectional study comparing the dynamic brain connectivity of healthy individuals (n = 18) with the dynamic brain connectivity of individuals with SCD and chronic pain (n = 22). Individuals with SCD and chronic pain were stratified into high- or low-intensity pain groups based on pain intensity at the time of assessment. Dynamic brain connectivity was assessed through electroencephalography in 3 stages, resting state with eyes closed, and during hip (painful for the SCD individuals) and hand (control, nonpainful) motor imagery. Average weight of the edges and full synchronization time (FST)-time required for 95% of the possible edges to appear over time during a given task-were evaluated. Regarding the average weight of the edges, individuals with SCD and high-intensity pain presented higher edge weight during hip motor imagery. The average weight of the edges correlated positively with pain intensity and depression symptoms. Individuals with SCD and chronic pain complete the cerebral network at rest more quickly (lower FST). Individuals with SCD and chronic pain/hip osteonecrosis have impaired dynamic brain network with shorter FST in rest network and more pronounced diffuse connectivity in individuals with high-intensity pain. The dynamic brain network evaluated by time-varying graphs and motif synchronization was able to identify differences between groups.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9266859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Neuroprognostication Using Frontal Spectrograms in Moderately Sedated Cardiac Arrest Patients.","authors":"Jae Hoon Lee","doi":"10.1177/15500594221074888","DOIUrl":"https://doi.org/10.1177/15500594221074888","url":null,"abstract":"<p><p><i>Introduction.</i> The integrated suppression ratio throughout all electroencephalography (EEG) patterns has rarely been studied. The aim of this study was to evaluate the clinical utility of the suppression ratio and hyperactivity of EEG on spectrograms. <i>Methods.</i> This prospective observational study included 73 cardiac arrest patients. Hardwired frontal EEG monitoring with spectrograms (color density spectral arrays, CDSA) was used to predict neurological outcomes. The mean suppression ratio (MSR) and hyperactivity in the high-frequency band (HHF) in the spectrogram were investigated in moderately sedated patients. Sedative doses were considered to estimate the MSR, which was automatically measured. <i>Results.</i> Using propofol 30 to 40 µg/kg/min and remifentanil 0.1 to 0.15 µg/kg/min, all the patients with an MSR >30% died. At day 2, the MSR in patients with a good outcome was 0%. The cut off values were different as an MSR >30% at day 1 (AUC 0.815) and an MSR >1% at day 2 (AUC 0.891). Of the patients with an MSR ≤30%, HHF was the greatest predictor of a poor outcome (OR 12.858, <i>P</i> = .006). The best predictors of a poor outcome using the spectrogram were suppression ratio (SR) >30% or HHF at day 1 (AUC 0.88) and SR >1% or HHF at day 2 (AUC 0.909). <i>Conclusions.</i> The use of MSR and HHF in frontal spectrograms is convenient and may be successfully employed for early neuroprognostication in moderately sedated cardiac arrest patients. However, spectrograms should be used with electroencephalogram considering the effects of sedatives because of the imperfect detection of electrographic seizures and artifacts.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9267351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline and Depression: A Thin EEG Line.","authors":"Jakša Vukojević,&nbsp;Damir Mulc,&nbsp;Ivana Kinder,&nbsp;Eda Jovičić,&nbsp;Krešimir Friganović,&nbsp;Aleksandar Savić,&nbsp;Mario Cifrek,&nbsp;Domagoj Vidović","doi":"10.1177/15500594211060830","DOIUrl":"https://doi.org/10.1177/15500594211060830","url":null,"abstract":"<p><p>In everyday clinical practice, there is an ongoing debate about the nature of major depressive disorder (MDD) in patients with borderline personality disorder (BPD). The underlying research does not give us a clear distinction between those 2 entities, although depression is among the most frequent comorbid diagnosis in borderline personality patients. The notion that depression can be a distinct disorder but also a symptom in other psychopathologies led our team to try and delineate those 2 entities using 146 EEG recordings and machine learning. The utilized algorithms, developed solely for this purpose, could not differentiate those 2 entities, meaning that patients suffering from MDD did not have significantly different EEG in terms of patients diagnosed with MDD and BPD respecting the given data and methods used. By increasing the data set and the spatiotemporal specificity, one could have a more sensitive diagnostic approach when using EEG recordings. To our knowledge, this is the first study that used EEG recordings and advanced machine learning techniques and further confirmed the close interrelationship between those 2 entities.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9266861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls in EEG Analysis in Patients With Nonconvulsive Status Epilepticus: A Preliminary Study.","authors":"Ying Wang,&nbsp;Ivan C Zibrandtsen,&nbsp;Richard H C Lazeron,&nbsp;Johannes P van Dijk,&nbsp;Xi Long,&nbsp;Ronald M Aarts,&nbsp;Lei Wang,&nbsp;Johan B A M Arends","doi":"10.1177/15500594211050492","DOIUrl":"https://doi.org/10.1177/15500594211050492","url":null,"abstract":"Objective: Electroencephalography (EEG) interpretations through visual (by human raters) and automated (by computer technology) analysis were still not reliable for the diagnosis of nonconvulsive status epilepticus (NCSE). This study aimed to identify typical pitfalls in the EEG analysis and make suggestions as to how those pitfalls might be avoided. Methods: We analyzed the EEG recordings of individuals who had clinically confirmed or suspected NCSE. Epileptiform EEG activity during seizures (ictal discharges) was visually analyzed by 2 independent raters. We investigated whether unreliable EEG visual interpretations quantified by low interrater agreement can be predicted by the characteristics of ictal discharges and individuals’ clinical data. In addition, the EEG recordings were automatically analyzed by in-house algorithms. To further explore the causes of unreliable EEG interpretations, 2 epileptologists analyzed EEG patterns most likely misinterpreted as ictal discharges based on the differences between the EEG interpretations through the visual and automated analysis. Results: Short ictal discharges with a gradual onset (developing over 3 s in length) were liable to be misinterpreted. An extra 2 min of ictal discharges contributed to an increase in the kappa statistics of >0.1. Other problems were the misinterpretation of abnormal background activity (slow-wave activities, other abnormal brain activity, and the ictal-like movement artifacts), continuous interictal discharges, and continuous short ictal discharges. Conclusion: A longer duration criterion for NCSE-EEGs than 10 s that is commonly used in NCSE working criteria is recommended. Using knowledge of historical EEGs, individualized algorithms, and context-dependent alarm thresholds may also avoid the pitfalls.","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9277303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional (un-)Coupling: Impairment, Compensation, and Future Progression in Alzheimer's Disease.","authors":"Jochen A Mosbacher,&nbsp;Markus Waser,&nbsp;Heinrich Garn,&nbsp;Stephan Seiler,&nbsp;Carmina Coronel,&nbsp;Peter Dal-Bianco,&nbsp;Thomas Benke,&nbsp;Manfred Deistler,&nbsp;Gerhard Ransmayr,&nbsp;Florian Mayer,&nbsp;Guenter Sanin,&nbsp;Anita Lechner,&nbsp;Helmut K Lackner,&nbsp;Petra Schwingenschuh,&nbsp;Dieter Grossegger,&nbsp;Reinhold Schmidt","doi":"10.1177/15500594211052208","DOIUrl":"https://doi.org/10.1177/15500594211052208","url":null,"abstract":"<p><p><b>Background:</b> Functional (un-)coupling (task-related change of functional connectivity) between different sites of the brain is a mechanism of general importance for cognitive processes. In Alzheimer's disease (AD), prior research identified diminished cortical connectivity as a hallmark of the disease. However, little is known about the relation between the amount of functional (un-)coupling and cognitive performance and decline in AD. <b>Method:</b> Cognitive performance (based on CERAD-Plus scores) and electroencephalogram (EEG)-based functional (un-)coupling measures (connectivity changes from rest to a Face-Name-Encoding task) were assessed in 135 AD patients (age: <i>M</i> = 73.8 years; <i>SD</i> = 9.0). Of these, 68 patients (<i>M</i> = 73.9 years; <i>SD</i> = 8.9) participated in a follow-up assessment of their cognitive performance 1.5 years later. <b>Results:</b> The amounts of functional (un-)coupling in left anterior-posterior and homotopic interhemispheric connections in beta1-band were related to cognitive performance at baseline (β = .340; <i>p</i> < .001; β = .274; <i>P</i> = .001, respectively). For both markers, a higher amount of functional coupling was associated with better cognitive performance. Both markers also were significant predictors for cognitive decline. However, while patients with greater functional coupling in left anterior-posterior connections declined less in cognitive performance (β = .329; <i>P</i> = .035) those with greater functional coupling in interhemispheric connections declined more (β = -.402; <i>P</i> = .010). <b>Conclusion:</b> These findings suggest an important role of functional coupling mechanisms in left anterior-posterior and interhemispheric connections in AD. Especially the complex relationship with cognitive decline in AD patients might be an interesting aspect for future studies.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroencephalographic Microstates are Correlated with Global Functioning in Schizophrenia But Not in Bipolar Disorder.","authors":"Pao-Huan Chen,&nbsp;Hsiao-Lun Ku,&nbsp;Jiunn-Kae Wang,&nbsp;Jiunn-Horng Kang,&nbsp;Tzu-Yu Hsu","doi":"10.1177/15500594221098286","DOIUrl":"https://doi.org/10.1177/15500594221098286","url":null,"abstract":"<p><p><i>Objectives</i>. Microstate studies of electroencephalograms (EEGs) on schizophrenia (SCZ) and bipolar disorder (BD) demonstrated categorical differences. The relationship between microstate indices and clinical symptoms in each group, however, remained unclear. Our objective was to examine associations between EEG microstates and the core features of SCZ and BD. <i>Methods</i>. This study examined the resting EEG data of 40 patients with SCZ, 19 patients with BD (12 BD type I and 7 BD type II), and 16 healthy controls. EEG topographic maps were divided into four canonical microstate classes: A, B, C, and D. The Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale, Hamilton Depression Rating Scale (HAMD), and Global Assessment of Functioning (GAF) were used to measure clinical symptoms and global functioning. <i>Results</i>. There was a significant inverse correlation between the proportion of time spent in microstate class A and GAF in patients with SCZ but not BD. Furthermore, the occurrence of microstate class A was positively correlated with the Positive Scale scores of the PANSS. Nevertheless, there were no group differences between the microstate classes. <i>Conclusions</i>. The results of this study indicate a negative correlation between microstate class A and global functioning in SCZ but not in BD. The association may be mediated by positive symptoms of SZ. Neural mechanisms underlying this relationship require further investigation.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9262224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hard Boundary-Based Neurofeedback Training Procedure: A Modified Fixed Thresholding Method for More Accurate Guidance of Subjects Within Target Areas During Neurofeedback Training.","authors":"Nasrin Sho'ouri","doi":"10.1177/15500594221100159","DOIUrl":"https://doi.org/10.1177/15500594221100159","url":null,"abstract":"<p><p>In nearly all studies within the domain of neurofeedback, a threshold has been defined for each training feature in a way that subjects' status can be evaluated during training according to the given value. In this study, a hard boundary-based neurofeedback training (HBNFT) method based on the determination of decision boundary using support vector machine (SVM) classifier was proposed in which subjects' status were clarified considering a decision boundary and they could also be encouraged once entering a target area. In this method, a scoring index (SI) was similarly defined whose value was determined in accordance with subject performance during training. The results revealed that employing a classifier and determining a decision boundary instead of using a threshold could prove more successful in accurately guiding them towards a target area and also meet no needs to choose a basis for determining a threshold. Moreover, it was likely that the proposed method could be more efficient in controlling features and preventing extreme changes compared to those using variable thresholds.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9267385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normalized Theta but Increased Gamma Activity after Acetylcholinesterase Inhibitor Treatment in Alzheimer's Disease: Preliminary qEEG Study.","authors":"Ezgi Fide,&nbsp;Deniz Yerlikaya,&nbsp;Didem Öz,&nbsp;İbrahim Öztura,&nbsp;Görsev Yener","doi":"10.1177/15500594221120723","DOIUrl":"https://doi.org/10.1177/15500594221120723","url":null,"abstract":"<p><p>Acetylcholinesterase inhibitors (AChE-I) are the core treatment of mild to severe Alzheimer's disease (AD). However, the efficacy of AChE-I treatment on electroencephalography (EEG) and cognition remains unclear. We aimed to investigate the EEG power and coherence changes, in addition to neuropsychological performance, following a one-year treatment. Nine de-novo AD patients and demographically-matched healthy controls (HC) were included. After baseline assessments, all AD participants started cholinergic therapy. We found that baseline and follow-up gamma power analyzes were similar between groups. Yet, within the AD group after AChE-I intake, individuals with AD displayed higher gamma power compared to their baselines (<i>P</i> < .039). Also, baseline gamma coherence analysis showed lower values in the AD than in HC (<i>P</i> < .048), while these differences disappeared with increased gamma values of AD patients at the follow-up. Within the AD group after AChE-I intake, individuals with AD displayed higher theta and alpha coherence compared to their baselines (all, <i>P</i> < .039). These increased results within the AD group may result from a subclinical epileptiform activity. Even though AChE-I is associated with lower mortality, our results showed a significant effect on EEG power yet can increase the subclinical epileptiform activity. It is essential to be conscious of the seizure risk that treatment may cause.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulus Induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs) and its Association with Non-convulsive Status Epilepticus in Critically Ill Patients.","authors":"Francesco Capecchi,&nbsp;Andrea di Giacopo,&nbsp;Emanuela Keller,&nbsp;Ian Mothershill,&nbsp;Lukas L Imbach","doi":"10.1177/15500594221095434","DOIUrl":"https://doi.org/10.1177/15500594221095434","url":null,"abstract":"<p><p>Stimulus induced repetitive periodic or ictal discharges (SIRPIDs) are a commonly observed EEG pattern in critically ill patients. However, the epileptic significance of SIRPIDs remain unclear. We identified and reviewed 55 cases with SIRPIDs according to the ACNS criteria. SIRPIDs occurred after standardized painful stimuli during a standard 20-minute EEG. These cases were investigated regarding their relation to non-convulsive status epilepticus (NCSE) according to Salzburg Consensus Criteria and in-hospital mortality. In 37/55 patients (67.3%), SIRPIDs were associated with NCSE. In most patients (26/37 cases, 70.3%) with concurrent status epilepticus, SIRPIDs occurred after status epilepticus (on average 4.8 days later), but in 3/37 patients (8.1%) they were observed before a later status epilepticus. In four cases (4/37 cases, 10.8%), SIRPIDs appeared both before and after an episode of NCSE and in other four cases the two patterns coexisted in the same EEG. In 50% of the patients, status epilepticus was refractory, super-refractory or the patient died before its resolution. The overall mortality in the cohort was high at 58.2%. These findings corroborate the hypothesis that SIRPIDs might represent a state with increased epileptogenic potential, commonly co-occurring with NCSE. Furthermore, SIRPIDs are associated with therapy-refractory course of status epilepticus and high mortality.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9330815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Types of Complications Encountered in Patients With Nonconvulsive Status Epilepticus in the Neurological ICU: Impact on Outcome.","authors":"Nese Dericioglu,&nbsp;Cansu Ayvacioglu Cagan,&nbsp;Okan Sokmen,&nbsp;Ethem Murat Arsava,&nbsp;Mehmet Akif Topcuoglu","doi":"10.1177/15500594211046722","DOIUrl":"https://doi.org/10.1177/15500594211046722","url":null,"abstract":"<p><p><i>Objectives</i>. The frequency and types of complications in patients with nonconvulsive status epilepticus (NCSE) who are followed up in the intensive care unit (ICU), and the impact of these complications on outcome are not well-known. We investigated the complications and their effects on prognosis in NCSE patients. <i>Methods</i>. After reviewing the video-EEG monitoring (VEEGM) reports of all the consecutive patients who were followed up in our ICU between 2009 and 2019, we identified two groups of patients: 1-patients with NCSE (study group) and 2-patients who underwent VEEGM for possible NCSE but did not have ictal recordings (no-NCSE group). Electronic health records were reviewed to identify demographic and clinical data, duration of ICU care, medical and surgical complications, pharmacologic treatment, and outcome. These parameters were compared statistically between the groups. We also investigated the parameters affecting prognosis at discharge. <i>Results</i>. Thirty-two patients with NCSE comprised the study group. Infection developed in 84%. More than half were intubated, had tracheostomy or percutaneous endoscopic gastrostomy application. Refractory NCSE was associated with significantly more frequent complications and worse outcome. There was a higher tendency of infections in the study group (<i>P</i> = .059). Higher organ failure scores and prolonged stay in ICU predicted worse outcome (<i>P</i> < .05). <i>Conclusion</i>. The frequency of complications in patients with NCSE who are cared for in the ICU is considerable. Most of the complications are similar to the other patients in ICU, except for the higher frequency of infections. Increased physician awareness about modifiable parameters and timely interventions might help improve prognosis.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9261762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}