Epilepsy & Behavior最新文献

{"title":"What is the impact of etiology, lead time to treatment, and parental awareness on outcomes in infantile epileptic spasm syndrome?","authors":"Deniz Menderes, Esra Serdaroğlu, Tuğba Hırfanoğlu, Ayşe Serdaroğlu, Ebru Arhan","doi":"10.1016/j.yebeh.2024.110178","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110178","url":null,"abstract":"<p><strong>Objective: </strong>Infantile epileptic spasm syndrome (IESS) is a kind of developmental epileptic encephalopathy that can lead to severe outcomes, including drug-resistant epilepsy and impaired neurodevelopment. The underlying etiology, early diagnosis, and adequate treatment impact the outcome. Our study focused on examining the factors that influence the prognosis and the level of knowledge among families regarding IESS.</p><p><strong>Methods: </strong>In the Department of Pediatric Neurology at Gazi University Hospital, we examined 62 IESS children's demographics, neuroimaging, metabolic and genetic findings, seizure characteristics, treatment choices, and long-term outcomes. Our study examined family awareness of seizures, lead time to treatment(LTT), and their impact on prognosis.</p><p><strong>Results: </strong>Forty-two (67.8 %) patients presented with a symptomatic cause, with over half experiencing intraventricular hemorrhage and/or periventricular leukomalacia attributable to prematurity. The hormonal therapy (tetracosactide or oral prednisolone) was the preferred treatment. Treatment was effective for two-thirds of the patients. Nevertheless, hardly 50 % of the families acknowledged the \"event\" as a seizure. However, 34 (61 %) individuals had sought medical advice from a doctor during the first seven days. The mean time from the start of seizures to seeking medical care was 9.2 ± 5.7 days.</p><p><strong>Conclusion: </strong>Our research revealed that the etiology was the most significant factor influencing the long-term outcomes of IESS. Additionally, we demonstrated that the clinicians who initially encountered the patients promptly referred them to pediatric neurology departments, despite the fact that the families' seizure awareness was poor. To help prevent this circumstance, it is important to provide information about infantile spasms to the families of high-risk infants.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110178"},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791297","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":"External validation of the Memory Assessment Clinics Scale for Epilepsy (MAC-E).","authors":"Kayela Arrotta, Brittany Lapin, Margaret Miller, Thomas Hogan, William B Barr, Daniel Friedman, Erica Cotton, Stephan Schuele, Samuel Wiebe, Lara Jehi, Robyn M Busch","doi":"10.1016/j.yebeh.2024.110168","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110168","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to externally validate the Memory Assessment Clinics Scale for Epilepsy (MAC-E), a brief self-report measure of subjective memory complaints in adults with epilepsy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted including adults with focal pharmacoresistant epilepsy from three Level 4 epilepsy centers in the U.S., who completed the MAC-E as part of a clinical neuropsychological evaluation. Confirmatory factor analysis was conducted, and goodness-of-fit criteria were calculated to assess model fit: comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean residual (SRMR). Item response theory models were constructed, and Mokken analysis was used to assess discrimination and unidimensionality. Internal consistency was evaluated with McDonald's Omega.</p><p><strong>Results: </strong>There were 191 patients included in the study (mean age = 41 ± 14, 51 % female, 87 % white race). Confirmatory factor analysis supported the 5-factor structure of the MAC-E identified in prior research (CFI = 0.989, RMSEA = 0.056, SRMR = 0.069) with high standardized loadings and R² values for each of the 5 factors (0.58-0.91 and 0.34-0.82, respectively). MAC-E items demonstrated high levels of discrimination as well as the ability to evaluate across the entirety of each latent trait. Score responses were uniformly distributed across latent traits, and unidimensionality was established by factor (all H coefficients > 0.4). Internal consistency was high across factors (omega range: 0.77-0.88).</p><p><strong>Conclusions: </strong>Results of this study demonstrate good external validation of the MAC-E in an independent, multicenter cohort of adults with epilepsy. These findings provide further support that the MAC-E is a psychometrically valid, self-report instrument to assess every-day memory abilities in adults with epilepsy in both clinical and research settings.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110168"},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791311","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":"Reconsidering the ethics of provocation techniques for Psychogenic Non-Epileptic Attacks and proposed ethical guidelines for use.","authors":"James Dolbow, Matt Deaton, Marshall Kirsch, Jeanne Lackamp, Jonathan Zande","doi":"10.1016/j.yebeh.2024.110184","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110184","url":null,"abstract":"<p><p>Patients with psychogenic non-epileptic attacks (PNEA) are subject to considerable direct and indirect comorbid psycho-socio-economic impact from their condition. Fortunately, diagnosis and treatment of PNEA has shown to be both medically effective and cost-efficient, ultimately improving PNEA symptoms, mental health, quality of life, and healthcare resource utilization. Though provocation techniques for PNEA have proven highly effective in diagnosing and providing expedited treatment to these patients, they have recently begun to fall out of favor due to ethical concerns about their use. Today, over one-fourth of epilepsy monitoring units do not utilize PNEA provocation techniques in those suspected of the condition. Of the monitoring units that do, less than 10% have an established protocol, and only 20% reported patient consent. The ethics and implications of the methods of diagnosing PNEA have been debated for decades. Specifically, the ethicality of attempting to provoke PNEA episodes using the proven effective methods of suggestion, nocebo, and other techniques have often left clinicians and medical ethicists offering opposing views. Here we review the personal and societal costs of PNEA, the efficacy of these provocation techniques, and the ethical considerations regarding their use, with specific emphasis on the importance of how these techniques are described to patients, as to both ensure informed consent and removed deception. Additionally, addressing these concerns, we propose ethical guidelines for the use of provocation techniques for the diagnosis of PNEA, concluding that such techniques can be ethically applied when certain conditions are met.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110184"},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791317","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":"Age-related semiology changes over time.","authors":"Anthony Fine, Katherine Nickels","doi":"10.1016/j.yebeh.2024.110185","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110185","url":null,"abstract":"<p><p>Understanding how seizure semiology changes with age is essential to determine the seizure onset zone. Epilepsy can be considered the prototypical neurologic disorder for demonstrating age-related changes over time. The maturational changes that occur in the brain over the lifespan demonstrate themselves most clearly through semiologic changes. Due to the immaturity of the neonatal brain, seizure recognition is challenging. Electroclinical seizures are classified as motor, non-motor, sequential, or unclassified and are typically focal in onset. During infancy, the most common seizure types are epileptic spasms, myoclonic, tonic, atonic, clonic, and hypomotor/behavioral arrest seizures. Correlation between seizure semiology and localization of seizure onset zone can be variable. The most observed seizure types in preschool-aged children are generalized myoclonic, generalized tonic, focal tonic, or clonic seizures. Many of the epileptic encephalopathies present at this age. Ictal behaviors continue to be limited, but lateralizing motor manifestations during focal seizures are better developed compared to infants. In school-aged children, the most common seizure types involve change in awareness. Seizure semiology at this age resembles that of adults, with increasing number and complexity of seizure components.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110185"},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791249","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":"Uncovering language deficits in focal epilepsy: Beyond the limits of noun naming and verbal fluency.","authors":"A D Reardon, L Gillinder, D A Copland, K L McMahon, S L E Brownsett","doi":"10.1016/j.yebeh.2024.110181","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110181","url":null,"abstract":"<p><strong>Background: </strong>A range of language impairments have been reported in people with epilepsy both pre- and post-surgically, however language is not routinely comprehensively assessed in epilepsy clinics. When language is assessed, this is typically as part of a broader neuropsychological battery of assessment, often limited to tests of noun naming and/or verbal fluency, despite evidence to suggest these tests are not sufficiently sensitive to detect the often-subtle deficits present in chronic focal epilepsy. Many areas of language function, including the production of connected speech, have also not been adequately explored in this population, and research relating to subjective report of language and communication difficulties is limited. A more comprehensive assessment of language, which includes patient report, is required to determine the presence and extent of language impairment in people with focal epilepsy.</p><p><strong>Aim: </strong>The aim of the present study was to systematically investigate the prevalence and pattern of language impairment in a group of people with chronic focal epilepsy using a comprehensive aphasia battery and a patient reported outcome measure.</p><p><strong>Method: </strong>Language skills were assessed in 26 right-handed people with chronic focal epilepsy using the Comprehensive Aphasia test (CAT), in addition to standard clinical assessments of noun naming and verbal fluency. Participants' self-report of their language and communication skills was also collected, using the La Trobe Communication Questionnaire (LCQ).</p><p><strong>Outcomes and results: </strong>85% of participants with focal epilepsy were impaired on one or more language subtests of the CAT. In contrast, only 15% of participants were impaired on tests of confrontation noun naming, and none were impaired on a test of verbal fluency. The CAT findings were supported by subjective data, with 82% of participants self-reporting a communication difficulty.</p><p><strong>Conclusions: </strong>Our results show that current approaches to language assessment are inadequate for identifying language impairments in people with focal epilepsy, and likely underestimate the prevalence of language impairment in this population. In particular, verb naming and picture description subtests revealed deficits across the majority of the sample, highlighting the need for more comprehensive assessment of language to be routinely conducted in this population.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110181"},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784528","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":"Can people with epilepsy trust AI chatbots for information on physical exercise?","authors":"Rizia Rocha-Silva, Bráulio Evangelista de Lima, Thalles Guilarducci Costa, Naiane Silva Morais, Geovana José, Douglas Farias Cordeiro, Alexandre Aparecido de Almeida, Glauber Menezes Lopim, Ricardo Borges Viana, Bolivar Saldanha Sousa, Diego Basile Colugnati, Rodrigo Luiz Vancini, Marília Santos Andrade, Katja Weiss, Beat Knechtle, Ricardo Mario Arida, Claudio Andre Barbosa de Lira","doi":"10.1016/j.yebeh.2024.110193","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110193","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the similarity, readability, and alignment with current scientific knowledge of responses from AI-based chatbots to common questions about epilepsy and physical exercise.</p><p><strong>Methods: </strong>Four AI chatbots (ChatGPT-3.5,ChatGPT 4, Google Gemini, and Microsoft Copilot) were evaluated. Fourteen questions on epilepsy and physical exercise were designed to compare the platforms. Lexical similarity, response patterns, and thematic content were analyzed. Readability was measured using the Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Seven experts rated the quality of responses on a Likert scale from \"very poor\" to \"very good.\"</p><p><strong>Results: </strong>The responses showed lexical similarity, with approaches to physical exercise ranging from conservative to holistic. Microsoft Copilot scored the highest on the Flesch Reading Ease scale (48.42 ± 13.71), while ChatGPT-3.5 scored the lowest (23.84 ± 8.19). All responses were generally rated as difficult to read. Quality ratings ranged from \"Good\" to \"Acceptable,\" with ChatGPT 4 being the preferred platform, chosen by 48.98 % of reviewers.</p><p><strong>Conclusion: </strong>The findings highlight the potential of AI chatbots as useful sources of information on epilepsy and physical exercise. However, simplifying language and tailoring content to user's needs is essential to enhance their effectiveness.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110193"},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784523","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":"The effect of Mozart's K.448 on epilepsy: A systematic literature review and supplementary research on music mechanism.","authors":"Cheng Yen Wang, Jiayang Guo, Xiaoping Guo","doi":"10.1016/j.yebeh.2024.110108","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110108","url":null,"abstract":"<p><p>The \"Mozart effect\" in epilepsy was first identified by Hughes et al. in 1998. In their treatment of 29 (ages 3-47) patients with epilepsy, including children, the patients showed a significant reduction in epileptic activity on the EEG while listening to \"Mozart's Sonata for Two Pianos K.448\" (Hereafter referred to as \"Mozart's K.448\"), a phenomenon that has come to be known as the \"Mozart effect\" of epilepsy. For more than 26 years now this unique and valuable finding has attracted increasing attention and research. This review aims to examine and discuss the relevant literature on the \"Mozart effect\" and to further explore the adjunctive therapeutic effects of the \"Mozart effect\" in patients with epilepsy. While reviewing the research, we were surprised to find that no one has ever analyzed the unique organization of Mozart's K.448 score based on music theory, and that research on the underlying musical mechanisms of Mozart's K.448 is still stuck on Hughe's \"hypotheses\" and \"computer analyses\" from 26 years ago, this is a regrettable research gap. Therefore, this paper attempts to fill this gap and analyze the unique organizational structure of Mozart's K448 music score from the perspective of music specialty for the first time. We selected three musical segments from the beginning of the piano performance to the 300-second and 30-second piano scores to analyze the internal structure of Mozart's K.448, our analysis results verify that Hughe's hypothesis that Mozart's k.448 has \"periodic repetition\" is reasonable, thus supplementing the research on the potential musical mechanism of Mozart effect.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110108"},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784525","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":"A practical program for responding to epileptic seizures including buccal midazolam administration in schools: Effectiveness evaluation for Yogo teachers in Japan","authors":"Noriko Ozawa ,&nbsp;Etsuko Tomisaki ,&nbsp;Hikaru Sou ,&nbsp;Shoko Miyagawa ,&nbsp;Junki Yoshioka ,&nbsp;Hiroko Horie ,&nbsp;Ayaka Kandatsu ,&nbsp;Naoko Kumada Deguchi ,&nbsp;Etsuko Soeda","doi":"10.1016/j.yebeh.2024.110156","DOIUrl":"10.1016/j.yebeh.2024.110156","url":null,"abstract":"<div><div>Early response to epileptic seizures is critical. In children, epileptic seizures can occur at school, and practical programs are required to enable teachers to respond. In Japan, schoolteachers may administer buccal midazolam orally under certain conditions; however, there are no established training programs for responding to epileptic seizures in schools. In this study, we aimed to develop a training program on how to respond to seizures, including buccal midazolam administration, and evaluate its effectiveness. We conducted a training program for <em>Yogo teachers</em> at special needs schools and evaluated the differences in confidence in responding to epileptic seizures and administering oral buccal midazolam before and after the program. The results demonstrated that confidence in responding to epileptic seizures and administering oral buccal midazolam significantly improved after the program. We concluded that this training program can help special needs <em>Yogo</em> teachers gain confidence in administering buccal midazolam and responding to epileptic seizures in the school setting.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110156"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation of the Epilepsy-Related apathy scale to Turkish in adults with Epilepsy: Validity and reliability study","authors":"Zeynep YANCI,&nbsp;Eylem TOPBAŞ","doi":"10.1016/j.yebeh.2024.110155","DOIUrl":"10.1016/j.yebeh.2024.110155","url":null,"abstract":"<div><h3>Objective</h3><div>To test the validity and reliability of the Turkish version of the Epilepsy-Related Apathy Scale (E-RAS) in adults with epilepsy.</div></div><div><h3>Methods</h3><div>In this methodological study, the E-RAS was translated into Turkish using standard procedures and assessed for content validity by a panel of 8 experts. The draft scale was piloted with 10 people to ensure comprehensibility of the questions. For psychometric validation, the Turkish version of the scale was administered to 209 native Turkish speakers over 18 years of age who had epilepsy for at least 1 year and had been using antiepileptic drugs for at least 1 year.</div></div><div><h3>Results</h3><div>Exploratory and confirmatory factor analysis was performed for construct validity. Internal consistency analysis yielded Cronbach’s alpha reliability coefficients of 0.813 for the whole scale and 0.802–0.864 for the subscales. In exploratory factor analysis, 9 of the original 24 items were removed (factor loadings &lt; 0.30) and the 4 subscales were condensed to 2, called “Motivational and Emotional” and ”Self-Regulatory and Cognitive“.</div></div><div><h3>Conclusion</h3><div>The 15-item, 2-dimensional Turkish version of the E-RAS was determined to be valid and reliable for use in adults with epilepsy in the Turkish population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110155"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746322","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":"Epilepsy surgery for postinfectious lesions: A review","authors":"Georgia Ramantani ,&nbsp;Antonio Giulio Gennari ,&nbsp;Hans Holthausen","doi":"10.1016/j.yebeh.2024.110173","DOIUrl":"10.1016/j.yebeh.2024.110173","url":null,"abstract":"<div><div>Cerebral infections are a common cause of structural focal epilepsy, particularly in developing countries, where the risk of unprovoked seizures is higher and is related to brain lesions and status epilepticus during the acute phase. Despite the prevalence of pharmacoresistant epilepsy after cerebral infections, few patients are referred for epilepsy surgery. However, those with mesial temporal sclerosis (MTS), particularly linked to meningitis or encephalitis in early life, are excellent surgical candidates. Encephalitis before age four is associated with MTS, indicating a period of hippocampal vulnerability. Temporal resections are the most common procedures in these patients. In contrast, extratemporal resections are less common and generally less successful, especially in patients with multifocal epilepsy or parasitic infections. Patients with severe hemispheric damage from infections and contralateral hemiparesis may undergo hemispheric procedures, with overall favorable outcomes. Surgery for post-viral encephalitis, such as herpes simplex virus encephalitis, is often less effective due to widespread brain involvement, though younger patients with unilateral hippocampal atrophy fare better. Although neurocysticercosis is a leading cause of epilepsy in endemic regions, surgery is rarely performed. However, resecting MTS along with calcified lesions can improve seizure control in pharmacoresistant cases. This review emphasizes the importance of surgery for appropriately selected patients with postinfectious epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110173"},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}