Zhe-Zuo Zhang, Xiao-Ying Lyu, Xiang-Wei Dai, Jian-Ni Cong, Fu-Xia Yang
{"title":"Validity and Reliability of Outcome Measurement Instruments for Cognitive Function in Alzheimer's Disease: A Systematic Review.","authors":"Zhe-Zuo Zhang, Xiao-Ying Lyu, Xiang-Wei Dai, Jian-Ni Cong, Fu-Xia Yang","doi":"10.1159/000545907","DOIUrl":"https://doi.org/10.1159/000545907","url":null,"abstract":"<p><strong>Introduction: </strong>In this systematic review, we aimed to identify suitable measurement tools for screening individuals for cognitive impairment in Alzheimer's disease (AD). We conducted a comprehensive evaluation of the reliability and validity of cognitive function assessment instruments. We offer insightful suggestions for further research on cognitive function scale development and clinical researchers in AD.</p><p><strong>Methods: </strong>We searched the PUBMED and CNKI databases for studies aimed at developing or evaluating the validity or reliability of cognitive function assessment scales. The methodological quality of the studies was assessed using the consensus-based standards for the selection of health measurement instruments (COSMIN) according to the 'worst score counts' principle. Subsequently, the measurement properties were rated qualitatively. Results were rated using the modified Grading of Recommendations, Assessment, Development, and Evaluation. Recommendations were categorized into four levels: A, B, C, and D.</p><p><strong>Results: </strong>We retrieved a total of 804 studies. Following screening, a total of 62 articles were included, which reported 49 cognitive impairment assessment scales. The methodological quality of studies ranged from inadequate to very good, and the measurement properties varied from sufficient (+) to indeterminate (?). We found that the ADAS-Cog, MoCA, BPMSE, CDR and the other 28 scales had sufficient validity and reliability.</p><p><strong>Conclusion: </strong>Our evaluation according to the COSMIN guidelines suggested that the ADAS-Cog, MoCA, BPMSE, CDR and MMSE could be used to assess the degree of cognitive impairment in patients with AD. When developing cognitive function assessment scales, factors such as time and linguistic and cultural differences could be carefully considered.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-30"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989184","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":"Dose-effect Relationship of Hyperbaric Oxygen Therapy in Rats with Amnestic Mild Cognitive Impairment.","authors":"Yi Chen, Xianzhong Lin, Qian Zhou, Xin Ling","doi":"10.1159/000545906","DOIUrl":"https://doi.org/10.1159/000545906","url":null,"abstract":"<p><strong>Background: </strong>Amnestic mild cognitive impairment (aMCI) represents an intermediate stage between normal aging and dementia. Hyperbaric oxygen (HBO) therapy, has shown promise in enhancing brain oxygenation and promoting neural stem cell proliferation.</p><p><strong>Methods: </strong>80 SD male adult rats were randomly divided into control group, amnestic mild cognitive impairment group(aMCI group) and hyperbaric oxygen group(HBO group).The HBO group was divided into 6 subgroups according to different treatment pressures: 1.6ATA subgroup, 1.8ATA subgroup, 2.0ATA subgroup, 2.2ATA subgroup, 2.5ATA subgroup and 2.8ATA subgroup, with 10 in each group. The HBO group received hyperbaric oxygen therapy at the specified pressure for 60 minutes per day for 5 consecutive days.</p><p><strong>Results: </strong>After hyperbaric oxygen treatment, compared with the aMCI group, the escape latency of each HBO subgroup was significantly shortened (p<0.001). The 2.0ATA subgroup (p=0.001), 2.2ATA subgroup (p=0.001)and 2.5ATA subgroup ( p=0.002) significantly increased the number of platform crossings.the levels of SOD were significantly increased in1.6ATA subgroup (p=0.019), 1.8ATA subgroup(p =0.003), 2.0ATA subgroup(p=0.010 ) and 2.2ATA group(p=0.016) and MDA contents were significantly decreased in the 1.6ATA subgroup(p=0.015), 1.8ATA subgroup(p =0.012), 2.0ATA subgroup(p=0.002), and 2.2ATA subgroups (p<0.001), and the levels of eNOS were significantly decreased in the 1.8ATA subgroup(p=0.007) and 2.0ATA subgroup (p=0.029),and the expression of nNOS were significantly decreased in the 1.8ATA subgroup (p=0.006),2.0ATA subgroup (p<0.001) and the 2.2ATA subgroup ( p< 0.001).</p><p><strong>Conclusions: </strong>In aMCI model rats found that HBO treatment at a pressure of 2.0 ATA with a stabilization time of 60 minutes per day for 5 days was the most effective.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979115","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}
Knut Engedal, Lars-Olof Wahlund, Christian Sandøe Musaeus, Peter Hoegh, Maria Lage Barca, Thorkell Eli Gudmundsson, Birgitte Bo Andersen, Daniel Ferreira, Mala Naik, Anne Rita Oeksengaard, Jon Snaedal
{"title":"The ability of EEG using statistical pattern recognition to predict conversion from subtypes of mild cognitive impairment to dementia: A five years follow-up study.","authors":"Knut Engedal, Lars-Olof Wahlund, Christian Sandøe Musaeus, Peter Hoegh, Maria Lage Barca, Thorkell Eli Gudmundsson, Birgitte Bo Andersen, Daniel Ferreira, Mala Naik, Anne Rita Oeksengaard, Jon Snaedal","doi":"10.1159/000546072","DOIUrl":"https://doi.org/10.1159/000546072","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that quantitative EEG is useful in predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease dementia (ADD) and dementia with Lewy bodies (DLB). As subcortical pathology is present and executive impairment is common in DLB, we hypothesized that EEG could predict conversion in patients with impaired executive function and any subcortical pathology.</p><p><strong>Methods: </strong>We included 113 patients with MCI from five Nordic memory clinics, 80 (71%) with amnestic MCI, 17 (15%) with dysexecutive MCI (deMCI), 3 (3%) with aphasic, 2 (2%) with visuospatial and 11 (10%) with unspecific MCI. Patients were examined with EEG in a resting state applying the statistical pattern recognition (SPR) method and followed up for five years. Eleven drop-outs were assessed after baseline. Receiver operating characteristic (ROC) analyses were used to examine the ability of EEG to predict conversion.</p><p><strong>Results: </strong>Sixty patients converted to dementia, 47 to ADD, eight to vascular dementia, two to DLB, one to frontotemporal dementia and two to unspecific dementia. Eight (11%) recovered and 45 (40%) remained MCI stable. ROC analyses revealed that EEG predicted conversion from dysexecutive MCI to dementia with area under the curve (AUC) of 0.92 (95% CI 0.76-100), sensitivity of 89% and specificity of 100%. Subcortical pathology was present in 89% of the dysexecutive MCI converters. EEG did not predict conversion from amnestic MCI to dementia.</p><p><strong>Conclusion: </strong>This study demonstrates that quantitative EEG using the SPR method predicts conversion from deMCI to dementia disorders with subcortical pathology with high sensitivity and specificity.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-26"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985209","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":"Characteristics of Neuropsychiatric Inventory Questionnaire Domain Scores Related to Cognitive Function in Alzheimer's Disease Dementia.","authors":"Yasuyuki Honjo, Kuniaki Nagai, Takuma Yuri, Hideaki Nakai, Ippei Kawasaki, Shun Harada, Ippei Suganuma, Noriyuki Ogawa","doi":"10.1159/000545759","DOIUrl":"10.1159/000545759","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease dementia (ADD) is a common cognitive disease in Japan. Mild cognitive impairment (MCI) is regarded as an early, but abnormal state of cognitive impairment, and amnestic MCI (aMCI) as a precursor of ADD. The Revised Hasegawa Dementia Scale (HDS-R) and the similar Mini-Mental State Examination (MMSE) are quick cognitive assessments widely used in Japan. Behavioral and psychological symptoms of dementia (BPSD) are commonly assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). However, when the different types of BPSD appear and how they progress with the progression of ADD is not clear.</p><p><strong>Methods: </strong>A total of 553 outpatients with ADD or aMCI participated. We divided the patients into six cognitive function groups. We examined the relationship between the individual NPI-Q domain scores and cognitive function to reveal the appearance and progression of BPSD. We also examined the relationship of the NPI-Q domains with the HDS-R and MMSE domains to reveal the cognitive functions that affect the BPSD.</p><p><strong>Results: </strong>Our results suggested that hallucinations, agitation/aggression, anxiety, irritability/lability appeared in association with high MMSE scores and progressed slowly. Apathy/indifference and aberrant motor behaviors appeared in association with middle MMSE scores and progressed slowly. Delusions and nighttime behavior disturbances appeared in association with high MMSE score and progressed consistently with the ADD. Memory and orientation were the cognitive functions most related to NPI-Q domain scores and thus to progression of BPSD.</p><p><strong>Conclusions: </strong>Memory and orientation may be the most important cognitive functions related to the progression of BPSD in patients with ADD.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982297","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}
Stefano Sacchetti, Giulia Locatelli, Daniele Altomare, Antonio Guaita, Elena Rolandi
{"title":"Evidence on protective factors for dementia and cognitive impairment in older adults: an umbrella review.","authors":"Stefano Sacchetti, Giulia Locatelli, Daniele Altomare, Antonio Guaita, Elena Rolandi","doi":"10.1159/000545503","DOIUrl":"https://doi.org/10.1159/000545503","url":null,"abstract":"<p><strong>Introduction: </strong>Dementia represents a global public health challenge, and no conclusive evidence exists on how to prevent its onset or at least reduce the risk. This umbrella review aims to identify interventions or exposures that can reduce the incidence of dementia or cognitive impairment.</p><p><strong>Methods: </strong>A search of meta-analyses and systematic reviews published from 2018 to 2025 (January) was conducted across four databases. Articles assessing associations between interventions or exposures to protective factors and incidence of dementia or cognitive decline in non-demented older adults were selected.</p><p><strong>Results: </strong>Out of 6,324 articles, 177 underwent full-text screening, and 17 were included. They showed that psychosocial factors (social engagement, purpose in life, life satisfaction, and cognitive reserve) and influenza vaccination protect against dementia. Evidence on antihypertensives is promising, while evidence on low-dose aspirin is promising yet inconclusive. No clear results emerged for both single- and multi-domain lifestyle interventions.</p><p><strong>Conclusions: </strong>These results offer new insight on potential targets for dementia prevention, a global public health priority. In particular, favorable psychosocial factors and influenza vaccination, undervalued in the scientific debate on dementia prevention, emerged as promising and feasible targets for preventive initiatives. Future research should focus on fine-tuning interventions to promote brain health, exploring their underlying mechanisms, and developing targeted and personalized strategies for specific population subgroups.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-24"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779399","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":"Association between Depressive Symptoms and Mild Cognitive Impairment among the Elderly in China: A Community-Based Study.","authors":"Ningling Dai, Yun Sun, Shifu Xiao, Haiya Wang","doi":"10.1159/000545327","DOIUrl":"10.1159/000545327","url":null,"abstract":"<p><strong>Introduction: </strong>Elderly individuals with depressive symptoms often show increased susceptibility to mild cognitive impairment (MCI). This study explores the association between depressive symptoms and MCI among older adults in China.</p><p><strong>Methods: </strong>Data from the Shanghai Brain Aging Study (SBAS) were used in this cross-sectional study. MCI was diagnosed through clinical assessments and Montreal Cognitive Assessment (MoCA) scores (≤23). Depressive symptoms were defined as a Geriatric Depression Scale (GDS) score of >10. Binary logistic regression and restricted cubic spline (RCS) analyses were conducted to evaluate the associations between depressive symptoms and MCI, adjusting for potential covariates.</p><p><strong>Results: </strong>The study included 1,506 participants, with 43.6% diagnosed with MCI. Logistic regression analysis revealed a significant association between depressive symptoms and MCI. In the fully adjusted model, depressive symptoms were associated with a 65% higher likelihood of MCI (odds ratio: 1.65, 95% confidence interval: 1.17-2.34). RCS analysis indicated a significant non-linear relationship between depressive symptoms and MCI (p for non-linear = 0.029). Participants with depressive symptoms scored significantly lower on the MoCA subscores for visuospatial and executive function, as well as language abilities (all p < 0.05).</p><p><strong>Conclusion: </strong>Our findings demonstrate a significant association between depressive symptoms and MCI, with depressive symptoms being linked to a higher prevalence of MCI. Early identification and intervention of depressive symptoms, including community screening, psychological therapies, or pharmacological treatments for older adults, may potentially mitigate cognitive decline. However, the cross-sectional design limits causal conclusions, and generalizability may be affected by self-reported depression measures and regional sampling.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779398","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":"Comparison of CogMate™ and the Mini-Mental State Examination: A New Tool for Assessing the Cognitive Function of Community-Dwelling Older People.","authors":"Yi-Wen Chiu, Po-Chun Hsieh, Kuang-Hsi Chang, Shang-Chien Huang, Hui-Chu Chuang","doi":"10.1159/000545379","DOIUrl":"10.1159/000545379","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive decline causes disability and dependence in older people, affecting the individuals, families, and society. This study aimed to use a gamified smart test, the CogMate™ assessment, to measure the cognitive function of community-dwelling older people and compare the test with the Mini-Mental State Examination (MMSE).</p><p><strong>Methods: </strong>We recruited 150 older people for testing with two cognitive assessment tools, the MMSE and CogMate™. After completing data collection, we conducted descriptive and inferential statistical analyses.</p><p><strong>Results: </strong>The MMSE results showed that only 38% (n = 57) of participants had normal cognitive function and their mean brain age was 79.31 ± 9.00 years, 4.41 years more than the actual mean age. Common factors affecting both MMSE and CogMate™ tests included age, education level, marital status, and health status. The weighted kappa of the MMSE and CogMate™ scores for two categories (participants with normal and impaired cognitive function) showed moderate consistency (correlation coefficient, 0.522) and the Pearson product-moment correlation coefficient showed moderately significant positive correlation (r = 0.480). The CogMate™ brain age and difference in brain age test results showed moderately significant negative correlation with the MMSE results. Receiver operator character curve analysis using the MMSE for validation yielded an area under the curve value of 0.736, showing that the CogMate™ tool had good cognitive function prediction results.</p><p><strong>Conclusion: </strong>CogMate™ is an interesting and simple gamified tool that demonstrates moderate consistency with the MMSE. It can replace the MMSE as a community cognitive screening tool, help community care centers, and identify older people with potential cognitive decline early for referral to interventional medical centers.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699937","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}
Ryuya Okawa, Norio Hayashi, Tetsuhiko Takahashi, Go Yasui, Ban Mihara
{"title":"Relationship between White Matter Hyperintensity Volume Analyzed from Fluid-Attenuated Inversion Recovery Using a Fully Automated Analysis Software and Cognitive Impairment.","authors":"Ryuya Okawa, Norio Hayashi, Tetsuhiko Takahashi, Go Yasui, Ban Mihara","doi":"10.1159/000544083","DOIUrl":"https://doi.org/10.1159/000544083","url":null,"abstract":"<p><strong>Introduction: </strong>White matter hyperintensity (WMH) is associated with cognitive impairment, although the clinical significance of WMH remains unclear. We aimed to elucidate the clinical significance of WMH volume and whether a fully automated quantitative analysis of WMH would be an effective marker of cognitive function.</p><p><strong>Methods: </strong>Patients with suspected cognitive impairment were retrospectively examined. Clinical data, including patient information, neuropsychological examinations, diagnoses of dementia disorders, and fluid-attenuated inversion recovery (FLAIR) images, were collected. Patient information included sex, age, and educational level. Neuropsychological examinations included the Mini-Mental State Examination (MMSE) and Japanese version of the Montreal Cognitive Assessment (MoCA-J). WMH volumes were analyzed from FLAIR images using a fully automatic analysis software. The relationship between WMH volume and clinical data was investigated.</p><p><strong>Results: </strong>WMH volume was analyzed using 889 FLAIR cases. The WMH volume did not differ significantly between the sexes. WMH volume showed a positive correlation with age. Multiple comparison tests showed no significant difference in WMH volume between junior high school and high school graduates, but all other differences were significant. Multiple comparison tests revealed significant differences in mean WMH volume among all groups in the classified MMSE. The Mann-Whitney U test revealed significant differences in WMH volume between the two groups. Multiple comparison tests revealed significant differences in WMH volume among all the groups of classified diagnostic results.</p><p><strong>Conclusion: </strong>Quantitative analysis of WMH volume from FLAIR images may provide useful information for dementia treatment and may be effective as a new marker in cognitive function examinations.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656321","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":"Diagnostics and Ecological Validity of the Italian Version of the Parkinson's Disease Cognitive Rating Scale.","authors":"Alfonsina D'Iorio, Edoardo Nicolò Aiello, Carmine Vitale, Marianna Amboni, Federico Verde, Vincenzo Silani, Nicola Ticozzi, Andrea Ciammola, Barbara Poletti, Gabriella Santangelo","doi":"10.1159/000545090","DOIUrl":"10.1159/000545090","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the diagnostics and ecological validity of the Parkinson's Disease Cognitive Rating Scale (PD-CRS) within an Italian cohort of non-demented Parkinson's disease (PD) patients.</p><p><strong>Methods: </strong>N = 128 non-demented PD patients were administered the PD-CRS, Montreal Cognitive Assessment (MoCA), and Parkinson's Disease Cognitive Functioning Rating Scale (PD-CFRS). Receiver-operating characteristic analyses were performed to explore the diagnostics of both raw and adjusted PD-CRS scores, by operationalizing the positive state as a below-cut-off MoCA score. Correlational analyses were run to test the ecological validity of the PD-CRS against the PD-CFRS.</p><p><strong>Results: </strong>Both raw and adjusted PD-CRS scores accurately identified patients with a defective MoCA scores (AUC = 0.84-0.85), yielding optimal diagnostics. A cut-off of <73.93, as identified on demographically adjusted PD-CRS scores, yielded the best diagnostics (sensitivity = 0.70; specificity = 0.89; positive and negative predictive values = 0.83 and 0.79; positive and negative likelihood ratios: 6.23 and 0.37: number needed for screening utility: 0.78). The PD-CRS was related to the PD-CFRS (rs = -0.24; p = 0.018).</p><p><strong>Conclusions: </strong>The Italian PD-CRS is a diagnostically sound and ecologically valid screener for cognitive impairment in non-demented PD patients.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603524","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}