Epilepsy & Behavior最新文献

{"title":"Changes in social and human–animal interactions in people with epilepsy during dog-assisted interventions","authors":"Marine Grandgeorge ,&nbsp;Ilona Renaud ,&nbsp;Katy Santos Vieira ,&nbsp;Mathilde Chalendard ,&nbsp;Rachel Lafond ,&nbsp;Nicolas Mezouar ,&nbsp;Nicolas Dollion","doi":"10.1016/j.yebeh.2025.110611","DOIUrl":"10.1016/j.yebeh.2025.110611","url":null,"abstract":"<div><div>Epilepsy is a neurological disorder with physical, psychological, and social consequences that can be alleviated by the integration of a service dog in their daily life. Reports showed that various populations benefit from animal-assisted interventions, particularly dog-assisted interventions (DAI). However, to our knowledge, no study has yet examined the effects of DAI on individuals with epilepsy.</div><div>This study aimed to characterize the interactions of individuals with epilepsy during DAI sessions. Ten adults with epilepsy (five women and five men; mean age: 24.4 ± 3.0 years) participated in three separate groups, each receiving 10 one-hour DAI sessions. Participants’ behaviours were assessed using ethological methods (i.e., scan and focal sampling) and data concerning their quality of life and anxiety were collected before and after the interventions, using standardized scales.</div><div>Our results showed that vocalizations were primarily used in human-to-human exchanges, whereas physical contacts and visual behaviours were more prevalent in human–dog interactions. The therapy dog consistently attracted participants’ attention and was a focal point for physical contact. Over the course of the sessions, interactions with other humans increased, while initial interactions with a therapy dog were strong and remained consistent throughout the interventions. This suggests that a dog may serve as a social catalyst, facilitating affiliative relationships among participants.</div><div>These findings back DAI as a promising non-pharmacological approach to enhance social engagements of individuals with epilepsy. Further research is needed to explore its long-term benefits on social relationships and individuals’ well-being, as well as its underlying mechanisms.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110611"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-management behaviors in patients with epilepsy: A dual-process model","authors":"Xiaoxiao Yin ,&nbsp;Wenhao Tian ,&nbsp;Xiuqin Feng","doi":"10.1016/j.yebeh.2025.110545","DOIUrl":"10.1016/j.yebeh.2025.110545","url":null,"abstract":"<div><h3>Background</h3><div>Effective self-management is essential for patients with epilepsy to achieve optimal health outcomes. However, previous studies indicate that self-management performance remains suboptimal in this population. This study aimed to evaluate the relationships between patient empowerment, disease-related fear, self-regulatory fatigue, and self-management behaviors in patients with epilepsy in China, utilizing dual systems theory as a framework.</div></div><div><h3>Methods</h3><div>A convenience sampling method was employed to collect data from 655 patients with epilepsy at a tertiary hospital in Hangzhou, China, between June and November 2023. Validated scales were used to assess patient empowerment, disease-related fear, self-regulatory fatigue, and self-management behaviors. A structural equation model (SEM) based on dual systems theory was used for data analysis.</div></div><div><h3>Results</h3><div>Among the included patients, 377 (57.60 %) were male, 360 (55.00 %) were from urban areas, and 361 (55.11 %) were unmarried.<!--> <!-->The average score for self-management behavior was 122.91 ± 18.48, indicating a moderate level of performance. SEM analysis revealed that patient empowerment had a direct positive effect on self-management behaviors (β = 0.236), a direct negative effect on illness-related fear (β = -0.608) and self-regulatory fatigue (β = -0.561), and an indirect effect on self-management behaviors (β = 0.433). All path coefficients were statistically significant (p &lt; 0.0001). The model demonstrated excellent fit indices: χ2/df = 1.422, RMSEA = 0.025, GFI = 0.954, AGFI = 0.954, CFI = 0.952, TLI = 0.959, NFI = 0.954, IFI = 0.925.</div></div><div><h3>Conclusion</h3><div>The results of structural equation modeling show that the impact of patient empowerment on self-management is mediated through disease-related fear and self-regulatory fatigue. Therefore, enhancing patient empowerment and reducing patients’ disease-related fear and self-regulatory fatigue may help promote effective self-management in patients with epilepsy.</div></div><div><h3>Clinical trial number</h3><div>Not applicable.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110545"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Epilepsies: Clinical pearls for early career epileptologists","authors":"Danielle M. Andrade ,&nbsp;Victor S.T. Lira ,&nbsp;Farah Qaiser ,&nbsp;Quratulain Zulfiqar Ali ,&nbsp;Kette Valente ,&nbsp;Lysa Boissé Lomax","doi":"10.1016/j.yebeh.2025.110575","DOIUrl":"10.1016/j.yebeh.2025.110575","url":null,"abstract":"<div><div>This review offers a practical look at the most relevant genetic epilepsies that an early-career epileptologist needs to navigate clinical practice, starting with a general overview of molecular genetic mechanisms, then moving to diagnostic testing rationale. The review emphasizes the importance of appropriate pre-testing clinical phenotyping and systematic genetic counseling and provides advice to optimize diagnostic yield and accurate interpretations of findings. Special attention is given to developmental and epileptic encephalopathies, particularly Dravet Syndrome and X-linked epilepsies. An overview of focal epilepsies, from classic syndromes to conditions associated with malformations of cortical development, such as Tuberous Sclerosis Complex and other mTORopathies, highlights advances in the field. The review also reflects on the paradigms of monogenic versus polygenic mechanisms associated with genetic generalized epilepsies. Moreover, critical pearls for diagnosis and management of X-linked epilepsies as well as progressive myoclonic epilepsies are also provided. Finally, an update on precision therapies is provided, ranging from targeting metabolic pathways and cellular signaling mechanisms, to a better understanding of ion channel modulator and repurposing of medications. The former treatments have paved the knowledge to recent breakthroughs on gene-therapies. Now many challenges and promises arise from protein replacement therapies, and gene-based therapies, including anti-sense oligonucleotides (ASOs) and adeno-associated viruses-9 (AAV-9) vectors, that are quickly advancing on multiple clinical trials on this field.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110575"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of road traffic noise with the risk of new-onset epilepsy","authors":"Tresah C. Antaya ,&nbsp;Britney Le ,&nbsp;Tor Oiamo ,&nbsp;Piotr Wilk ,&nbsp;Kathy N. Speechley ,&nbsp;Jorge G. Burneo","doi":"10.1016/j.yebeh.2025.110616","DOIUrl":"10.1016/j.yebeh.2025.110616","url":null,"abstract":"<div><h3>Background and objective</h3><div>The association of environmental noise with new-onset epilepsy has not yet been explored. Therefore, the study’s objective was to assess whether long-term road traffic noise exposure is associated with the risk of new-onset epilepsy among adult residents of Toronto, Canada.</div></div><div><h3>Methods</h3><div>We conducted a nested case-control study using linked health administrative and environmental data. We included adult residents of Toronto as of January 1, 2010, with no history of seizures or epilepsy. Cases were those who developed epilepsy before December 31, 2016, and were each matched with up to five controls. We measured exposure to road traffic noise using three-year averages of the nighttime average (LA_{eq, 8 hr}), daytime average (LA_{eq, 16 hr}), and the 24-hour average (LA_{eq, 24 hr}) road traffic noise levels at participants’ postal code of residence. We estimated the associations of these three-year noise averages with the risk of new-onset epilepsy using conditional logistic regression models.</div></div><div><h3>Results</h3><div>We included 4,608 cases and 20,765 controls; 46.3 % were female and the mean age was 48.3 (± 17.4) years. The incidence rate ratios associated with a 10-dB increase in LA_{eq, 8 hr} was 1.043 (95 % CI: 0.994, 1.095), 0.999 (95 % CI: 0.946, 1.054) for LA_{eq, 16 hr}, and 1.031 (95 % CI: 0.980, 1.086) for LA_{eq, 24 hr}.</div></div><div><h3>Discussion</h3><div>Although not statistically significant, these results point to a potential association between long-term exposure to road traffic noise, particularly average levels at night, and the risk of new-onset epilepsy. Future research should continue to explore this potential association.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110616"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and unmet needs of people with epilepsy and their family caregivers: A systematic scoping review","authors":"Florien Boele ,&nbsp;Carissa Jensen ,&nbsp;Gemma Madigan Johnson ,&nbsp;Annemarie Lammers-Spijker ,&nbsp;Aysun Altinbas ,&nbsp;Lydia van den Berg ,&nbsp;Kamala Broekman-Labinac ,&nbsp;Rolf Fronczek ,&nbsp;Maaike Schuur ,&nbsp;Gemma Vonk ,&nbsp;Maeike Zijlmans ,&nbsp;Gerhard Visser ,&nbsp;Jaap Reijneveld","doi":"10.1016/j.yebeh.2025.110601","DOIUrl":"10.1016/j.yebeh.2025.110601","url":null,"abstract":"<div><h3>Introduction</h3><div>People with epilepsy can experience limitations in their everyday lives due to their condition, impacting on health-related quality of life (HRQOL). We synthesized evidence on HRQOL and unmet needs in adult people with epilepsy and their family caregivers to provide a comprehensive overview of the impact of epilepsy and to identify opportunities for healthcare service improvements.</div></div><div><h3>Methods</h3><div>Systematic literature searches were conducted in CINAHL, Embase, Ovid MEDLINE, APA PsychInfo, Scopus, and grey literature databases (12 August 2024). Articles with primary quantitative, qualitative, or mixed methods data covering HRQOL outcomes or unmet needs of adults with epilepsy, their family caregivers, or healthcare professionals as proxies were included. A reflexive thematic framework analysis approach was taken to interpret findings.</div></div><div><h3>Results</h3><div>Searches yielded 5451 unique publications of which 139 were included. Most publications covered only quantitative data (n = 97, 69.8 %) and utilized a cross-sectional design (n = 121, 87.1 %). All domains of HRQOL (physical, cognitive, emotional/mental, social, and spiritual functioning) were impacted by epilepsy, and intercorrelated. High seizure burden and low socioeconomic status were consistently linked to poor HRQOL outcomes. Adverse HRQOL outcomes were related to high levels of illness intrusiveness, uncertainty, and low levels of perceived control. Caregiver burden was notable. People with epilepsy reported a range of information, healthcare communication, psycho-social and lifestyle, and education/vocational needs.</div></div><div><h3>Discussion</h3><div>Epilepsy impacts patient and caregiver HRQOL outcomes, highlighting profound illness intrusiveness. Addressing unmet needs may enhance clinical care and empower people with epilepsy and their caregivers to better cope with their condition, improving HRQOL.</div><div><strong>Registration:</strong> INPLASY202510047.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110601"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SUDEP: the boundary between risk, care, and uncertainty in epilepsy.","authors":"Giancarlo Di Gennaro, Andrea Tomasini, Damiano Abeni, Angelo Labate, Carlo Di Bonaventura","doi":"10.1016/j.yebeh.2025.110621","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110621","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":" ","pages":"110621"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presenting to emergency departments with functional seizures: Motivators for attendance and experiences of care","authors":"Lana Higson ,&nbsp;Biswadev Mitra ,&nbsp;Rebecca Hope ,&nbsp;Joseph Colclough ,&nbsp;Toby Winton-Brown","doi":"10.1016/j.yebeh.2025.110609","DOIUrl":"10.1016/j.yebeh.2025.110609","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with functional seizures frequently present to emergency departments, and often have unsatisfactory/negative experiences there. It has been proposed that many of these visits are preventable, but the patient perspectives have not been well-studied. <strong>Methods:</strong> Past (≥1 appointment, discharged and no longer engaged with the clinic) and present (≥1 appointment, still engaged with the clinic) patients of the Alfred Hospital Functional Seizures clinic without comorbid epilepsy with an established diagnosis of functional seizure were invited to complete a survey on reasons for attending an emergency department and experiences of emergency care. Themes were identified using descriptive content analysis. <strong>Results:</strong> There were 229 eligible patients, and 94 participants returned the survey (41 % response rate), of whom 58 (62 %) had presented to an emergency department at least once with functional seizures since their diagnosis. The most frequent reason for seeking emergency care was a change in seizure symptomatology (47 %), followed by medical investigation (16 %). Most (62 %) did not make the decision to go to the emergency department themselves, with family members the most reported decision-makers. Almost a quarter (24 %) felt that presenting to emergency was unavoidable. Themes of <em>validation</em>, <em>medical attention</em>, and <em>knowledge/expertise</em> were identified by individuals as useful when attending emergency departments; and a lack of these features featured heavily in responses regarding concerns about (and negative experiences of) seeking treatment for functional seizures in emergency departments. <strong>Conclusions:</strong> The minority of patients make the decision to seek emergency department care themselves with a functional seizure. Further education of ED professionals, including guidelines for screening and quality of care measures, could help to address the needs of people who present to ED with functional seizures.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110609"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Substance use, depression, and anxiety: A cross-sectional study comparing adolescents with epilepsy and diabetes”","authors":"Rachana Mehta ,&nbsp;Ranjana Sah","doi":"10.1016/j.yebeh.2025.110610","DOIUrl":"10.1016/j.yebeh.2025.110610","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110610"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the international classification of cognitive disorders in epilepsy (IC-CoDE) to youths with new and recent onset epilepsies","authors":"Dace N. Almane ,&nbsp;Robyn M. Busch ,&nbsp;Lisa Ferguson ,&nbsp;Ana Arenivas ,&nbsp;Anny Reyes ,&nbsp;Carrie R. McDonald ,&nbsp;Alanna Kessler-Jones ,&nbsp;Michael Seidenberg ,&nbsp;Carl Stafstrom ,&nbsp;David Hsu ,&nbsp;Jack Vogel ,&nbsp;Jana E. Jones ,&nbsp;Bruce P. Hermann ,&nbsp;for the IC-CODE Consortium","doi":"10.1016/j.yebeh.2025.110606","DOIUrl":"10.1016/j.yebeh.2025.110606","url":null,"abstract":"<div><h3>Rationale</h3><div>The International Classification of Cognitive Disorder in Epilepsy (IC-CoDE) is an algorithmic approach to identifying cognitive phenotypes in epilepsy that to date has been investigated only in adults with temporal and frontal lobe epilepsy. The purpose of this investigation is to explore the applicability of IC-CoDE to youths with new and recent onset focal and generalized idiopathic epilepsies as well as the impact of modifications of cognitive domain construction on IC-CoDE outcomes.</div></div><div><h3>Method</h3><div>222 youths (ages 8–18), including 134 with new/recent onset idiopathic epilepsies and 88 typically developing controls, were administered a comprehensive neuropsychological battery assessing 5 cognitive domains (language, visuospatial, memory, attention/processing speed, executive function). Along with the typical IC-CoDE cognitive domain construction, we also examined the impact of using just the two most sensitive tests from each of the 5 cognitive domains on IC-CoDE phenotype distributions, both approaches using −1.0 and −1.5 z-score thresholds as operational definitions of abnormality.</div></div><div><h3>Results</h3><div>Youths with epilepsy exhibited significantly different distributions of IC-CoDE phenotypes at both the &lt;−1.0 (p &lt; 0.001) and &lt;−1.5 (p &lt; 0.01) z-score thresholds compared to controls. At the &lt; -1.0 z threshold, the epilepsy versus control group comparison revealed the following outcomes: intact (59 % vs 89 %), single domain (25 % vs 8 %), bidomain (9 % vs 4 %) and generalized (7 % vs 0 %) impairment profiles. Lower overall proportions but with continuing greater abnormality and similar distribution in the epilepsy compared to control group was observed at the &lt;−1.5 z threshold. Among single domain impairments, the most frequent were language, visuospatial and executive function, with memory the least frequently impaired. Using only the two most sensitive tests for domain construction yielded phenotype distributions that were not significantly different from the method of using all available tests at both the −1.0 and −1.5z thresholds.</div></div><div><h3>Conclusions</h3><div>IC-CoDE is applicable to neuropsychological data from youths with epilepsy and provides a new approach for describing the cognitive morbidity associated with diverse childhood epilepsies. Future multicenter collaborative research will be useful to determine the shared and unique cognitive phenotypes associated with discrete epilepsy syndromes, their predictors, and course.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110606"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies utilized and challenges faced by stakeholders while managing epilepsy in African schools: A scoping review","authors":"Seth Selassie Dzah ,&nbsp;Diana Akoah Mansah Owusu ,&nbsp;Anna Van der Wath ,&nbsp;Susana Aba Abraham ,&nbsp;Mustapha Amoadu ,&nbsp;Ronell Leech","doi":"10.1016/j.yebeh.2025.110612","DOIUrl":"10.1016/j.yebeh.2025.110612","url":null,"abstract":"<div><div>Even though education is an essential element in the development of society, the educational experiences of students living with epilepsy tend to be challenging. This review aimed to map the strategies utilized and challenges faced by stakeholders (teachers, school nurses, and parents) in managing students with epilepsy at school. The six-stage framework of Arksey and O’Malley (2005) was employed in this scoping review. Six electronic databases (PsycINFO, PubMed Central, Scopus, Embase, Dimensions AI, and Medline) and other internet-based resources were searched from 2000 to 2024. Twenty-two articles were found to be eligible and included in this review. Findings reveal critical challenges faced by stakeholders while managing students with epilepsy in schools, including a lack of adequate epilepsy targeted training, cultural beliefs laced with misconceptions, stigma and social isolation, and medication access difficulties. To manage these challenges, strategies utilized included improved access to healthcare and medications, as well as education focusing on epilepsy and first aid. Parents, teachers, and school nurses should collaborate, being guided by clear management guidelines, to manage students with epilepsy in school settings effectively.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110612"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}