Sebastian Neuens , Julie Soblet , Aurelie Penninckx , Claire Detry , Cindy Badoer , Laurence Desmyter , Xavier Peyrassol , Françoise Wilkin , Adeline Busson , Marie Bruneau , Marie-Laure Grenet , Alice Le Morillon , Alec Aeby , Nicolas Deconinck , Cynthia Prigogine , Anne Monier , Elodie Juvené , Tom Balfroid , Audrey Van Hecke , Florence Christiaens , Catheline Vilain
{"title":"Diagnostic yield of clinical exome sequencing in 868 children with neurodevelopmental disorders","authors":"Sebastian Neuens , Julie Soblet , Aurelie Penninckx , Claire Detry , Cindy Badoer , Laurence Desmyter , Xavier Peyrassol , Françoise Wilkin , Adeline Busson , Marie Bruneau , Marie-Laure Grenet , Alice Le Morillon , Alec Aeby , Nicolas Deconinck , Cynthia Prigogine , Anne Monier , Elodie Juvené , Tom Balfroid , Audrey Van Hecke , Florence Christiaens , Catheline Vilain","doi":"10.1016/j.ejmg.2025.105030","DOIUrl":"10.1016/j.ejmg.2025.105030","url":null,"abstract":"<div><div>Next generation sequencing has revolutionized the diagnostic approach for patients with neurodevelopmental disorders (NDDs), yields are however highly variable depending on the patient's phenotype. It is often challenging to predict which indications are likely to lead to a molecular diagnosis and which will benefit less from genetic testing.</div><div>To identify phenotypic characteristics associated with higher diagnostic yields we conducted detailed phenotyping of a cohort of 868 children with NDD, who underwent clinical exome sequencing between 2016 and 2021.</div><div>A molecular diagnosis was reached in 27 % of cases. Significantly higher yields of respectively 34 % and 32 % were observed in patients with intellectual disability (ID) or global developmental delay (GDD). Autism spectrum disorders (ASD) were less likely to result in a molecular diagnosis with a diagnostic yield of 16 %. Additional factors linked to higher yields included female gender, the presence of minor dysmorphic features — particularly involving the face, extremities, ears, eyes, and hair — and a syndromic phenotype.</div><div>Additional CNV calling in a subset of 438 patients which consented to reanalysis of sequencing data added 1.5 % to diagnostic yield.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105030"},"PeriodicalIF":1.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523086","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}
S. Magliulo , M.L. Genovesi , L. Lucchetti , V. Orlando , A. Novelli , L. Massella , A. Terracciano
{"title":"Uniparental isodisomy of chromosome 1 involving NPHS2 in steroid-resistant nephrotic syndrome with renal failure","authors":"S. Magliulo , M.L. Genovesi , L. Lucchetti , V. Orlando , A. Novelli , L. Massella , A. Terracciano","doi":"10.1016/j.ejmg.2025.105029","DOIUrl":"10.1016/j.ejmg.2025.105029","url":null,"abstract":"<div><div>Steroid-resistant nephrotic syndrome is a rare condition defined by early severe proteinuria associated with hypoalbuminemia, hyperlipidemia and possible edema, is usually caused by pathogenic variants in genes affecting the establishment and maintenance of the glomerular filtration barrier; among these <em>NPHS1</em> (19q13.12) and <em>NPHS2</em> (1q25.2) are by far the two main autosomal recessive genes implicated. We report on a 23-year-old girl referred to our hospital for Steroid-resistant nephrotic syndrome secondary to focal segmental glomerulosclerosis, onset at the age of 5 months. Next Generation Sequencing analysis showed the homozygous pathogenic variant c.413G > A in the <em>NPHS2</em> gene, leading to the amino acid change p.Arg138Gln (rs74315342). By segregation study the father resulted heterozygous carrier of the same variants, while the mother emerged as wild-type. In order to investigate a possible chromosomal rearrangement in the maternal allele, SNP-array analysis was performed, revealing a paternally chromosome 1 isodisomy in the proband. Uniparental disomy of chromosome 1 is not associated with a specific phenotype but unmasks the autosomal recessive <em>NPHS2</em> mutation paternally inherited and bring it to a homozygosity state. In conclusion, this clinical report demonstrates the importance of parental segregation analysis, especially in patients with recessive conditions, both to search for the disease specific genetic cause and to appropriately estimate the risk of recurrence in the family.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105029"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331088","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":"Epileptic seizures and EEG findings in 3p deletion syndrome involving SLC6A1","authors":"Saori Oguri, Masanori Inoue, Osamu Kobayashi, Maeda Tomoki, Kenji Ihara","doi":"10.1016/j.ejmg.2025.105027","DOIUrl":"10.1016/j.ejmg.2025.105027","url":null,"abstract":"<div><div>3p Deletion syndrome is a rare genetic disorder characterized by intellectual disability, growth delay, hypotonia, and distinctive facial features, with considerable phenotypic variability. Previous reports have highlighted the significance of deletions within the 3p25.3 region contributing to the development of Angelman-like features, such as stereotypic movements, a happy demeanor, epilepsy, and characteristic electroencephalogram (EEG) patterns. This study analyzed 22 patients of 3p deletion syndrome, focusing on epilepsy and EEG findings. A newly defined short smallest region of overlap (sSRO) within 3p25.3, encompassing approximately 52 kb and partially including SLC6A1 and SLC6A11, was associated with Angelman-like features, particularly epilepsy and EEG patterns. Patients with sSRO deletions exhibited a high incidence of seizures (60 %), characterized by myoclonic or absence seizures, with EEG showing generalized high-amplitude slow waves. In contrast, larger deletions beyond the sSRO were linked to dysmorphological features of 3p-syndrome, generalized tonic-clonic seizure, and non-specific EEG findings. These findings suggest that SLC6A1 dysfunction contributes to epilepsy and EEG abnormalities, possibly via impaired GABA transport, whereas patients with larger or non-overlapping deletions exhibited more typical 3p-syndrome features, suggesting that multiple neurological genes in the broader deletion region may independently contribute to more severe neurological phenotypes. In conclusion, it is important to consider GABA-related disorders, including a specific chromosomal abnormality known as 3p-syndrome with a microdeletion in the SRO region, when observing characteristic epilepsy and EEG findings resembling Angelman syndrome.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105027"},"PeriodicalIF":1.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298211","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}
Alexie Ouellette , Eric P. Allain , Abdullah Almaghraby , Dominique Bouhamdani , Mouna Ben Amor
{"title":"A novel RORA genetic variant associated with early-onset obesity and insomnia","authors":"Alexie Ouellette , Eric P. Allain , Abdullah Almaghraby , Dominique Bouhamdani , Mouna Ben Amor","doi":"10.1016/j.ejmg.2025.105028","DOIUrl":"10.1016/j.ejmg.2025.105028","url":null,"abstract":"<div><div>Retinoic acid-related orphan receptor alpha (<em>RORA</em>) pathogenic variants cause intellectual developmental disorder with or without epilepsy or cerebellar ataxia (IDDECA). Herein, we present a female patient with a novel heterozygous likely pathogenic <em>RORA</em> variant, c.484C > T p.(Arg162∗), with a clinical manifestation overlapping IDDECA. The patient also presented previously undocumented symptoms, namely, early-onset obesity and insomnia. Furthermore, parental testing revealed inheritance from the mother who presented a congruent phenotype. This suggests a role for <em>RORA</em> in both sleep and metabolism whilst extending the phenotypic spectrum of IDDECA. Notwithstanding, more fundamental work is needed to delineate the role of <em>RORA</em> variants in disease.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105028"},"PeriodicalIF":1.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293572","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}
Anne Noordhuis-Zijderveld , Dederieke A.M. Festen , Arooj Kharl , Marloes van Gastel , Madeleine Hartman , Hennie T. Bruggenwirth , Shimriet Zeidler , Marlies J. Valstar
{"title":"Clinical variability in individuals with ATR-X syndrome in the Netherlands","authors":"Anne Noordhuis-Zijderveld , Dederieke A.M. Festen , Arooj Kharl , Marloes van Gastel , Madeleine Hartman , Hennie T. Bruggenwirth , Shimriet Zeidler , Marlies J. Valstar","doi":"10.1016/j.ejmg.2025.105026","DOIUrl":"10.1016/j.ejmg.2025.105026","url":null,"abstract":"<div><h3>Background</h3><div>The Alpha Thalassemia mental Retardation syndrome, X-linked (ATR-X syndrome, MIM: 301040) is a rare genetic disorder characterized by alpha thalassemia, intellectual disability, peculier facial characteristics and genital abnormalities. Detailed information regarding the clinical phenotype is lacking.</div></div><div><h3>Aims</h3><div>Detailed descriptions of the clinical phenotype are rare. The aim of this study was to describe the clinical phenotype of ATR-X syndrome.</div></div><div><h3>Methods</h3><div>Data was collected through questionnaires, interviews, physical examination and the study of medical records.</div></div><div><h3>Results</h3><div>Twenty-two individuals, aged 2–68 years old, were included. Three individuals were deceased at the time of the study. The individuals had a variable degree of intellectual disability. Alpha thalassemia was found in 30 % and genital anomalies in 70 % of the individuals. First clinical signs of the syndrome were most frequently feeding problems, started in the neonatal period in the majority. Other main reported health problems were reflux (59 %), constipation (72 %), periods of anorexia and adipsia (45 %), heart defects (28 %), epilepsy (33 %), scoliosis/kyphosis (48 %), visual impairment (61 %) and hearing loss (38 %). Behavioral problems (86 %) and sleeping problems (64 %) also occurred frequently.</div></div><div><h3>Conclusion</h3><div>We report on the largest cohort of clinically studied individuals with ATR-X syndrome, including the eldest individuals, reported to date. Clinical knowledge is essential to improve care and to evaluate future therapies for this group.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105026"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247033","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":"Parental communication about inherited conditions with young Children: Insights from genetic professionals in Portugal","authors":"Catarina Seidi , Liliana Sousa , Álvaro Mendes","doi":"10.1016/j.ejmg.2025.105025","DOIUrl":"10.1016/j.ejmg.2025.105025","url":null,"abstract":"<div><div>Genetic healthcare professionals (GHP) are key in supporting parents in communicating about inherited genetic conditions (IGC) with their young children. This study explored the attitudes, clinical practice and perceptions of Portuguese GHP’ regarding parental communication about IGC with young children. We conducted an observational and cross-sectional study with 32 GHP, 75 % of whom were women, and 37.5 % were aged 31–40 years old. The survey included sociodemographic and professional questions, along with 35 statements to be answered on a 4-point Likert scale (ranging from 1- strongly disagree to 4- strongly agree). Key findings show that GHP: (i) perceive that parents fear the impact of genetic information on their children's emotional wellbeing (3.53 ± 0.51), are receptive to support from GHP (3.16 ± 0.57), and should tailor communication to children's developmental stage (3.56 ± 0.50); (ii) report being available to support parents when asked (3.56 ± 0.62) and encourage parents to communicate openly (3.47 ± 0.57); and (iii) assess parents' level of understanding about the IGC (3.41 ± 0.56), raise parents' awareness of the importance of informing their children (3.28 ± 0.52), and support parents in adapting communication to the type of IGC (3.28 ± 0.58), and the child's developmental stage (3.22 ± 0.55). Results emphasize critical role of GHP in facilitating parent-child communication about IGC, highlighting their commitment to supporting these sensitive conversations.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105025"},"PeriodicalIF":1.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233600","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}
Cormac Duff , Samy Allawendy , Andrew J. Green , Michael Riordan , Eirin Carolan , Jacqueline McBrien
{"title":"Novel STAG2 variant expands Mullegama-Klein-Martinez Syndrome phenotype","authors":"Cormac Duff , Samy Allawendy , Andrew J. Green , Michael Riordan , Eirin Carolan , Jacqueline McBrien","doi":"10.1016/j.ejmg.2025.105024","DOIUrl":"10.1016/j.ejmg.2025.105024","url":null,"abstract":"<div><div><strong>We present a novel case of a female patient with a de novo heterozygous splice site pathogenic variant STAG2 (NM_001042749.3):c.1196 + 4_1196+7del.</strong> The <em>STAG2</em> gene encodes \"Stromal Antigen 2\" (STAG2), a fundamental subunit of the cohesin complex, which regulates the separation of sister chromatids during cell division. Pathogenic STAG2 gene variants are associated with Mullegama-Klein-Martinez Syndrome (MKMS), a rare X-linked cohesinopathy. This patient exhibits symptoms not previously associated with MKMS, thereby expanding the known clinical phenotype of this rare disease. The patient has severe intellectual disability, microcephaly, short stature, and a single front tooth. She also has an ectopic posterior pituitary gland, resulting in vasopressin deficiency (formerly known as central diabetes insipidus), which was associated with adipsia, causing profound hypernatraemic dehydration and acute renal failure necessitating peritoneal dialysis. STAG2 pathogenic variants should prompt in-depth imaging of the pituitary fossa for pituitary malformations. Clinical and biochemical screening and surveillance should be performed to identify pituitary dysfunction.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105024"},"PeriodicalIF":1.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208057","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}
Mads E. Hauberg , Aia E. Jønch , Christina R. Fagerberg
{"title":"Partial 3q tetrasomy: Defining the syndrome, neocentromeres, and an additional case report","authors":"Mads E. Hauberg , Aia E. Jønch , Christina R. Fagerberg","doi":"10.1016/j.ejmg.2025.105021","DOIUrl":"10.1016/j.ejmg.2025.105021","url":null,"abstract":"<div><div>Partial 3q tetrasomy is an ultra-rare genetic condition, with a phenotype that has hitherto not been comprehensively reviewed. In this paper we report the 18th case and re-evaluate those previously published.</div><div>The present case presented with dysmorphic features, malformations, cognitive deficits, end-stage renal disease, a surgically corrected tethered chord/scoliosis along with skin pigmentary changes and had remained without a diagnosis for 23 years. Blood and fibroblast karyotyping and exome sequencing yielded a normal result. Chromosomal microarray analysis on uncultured skin biopsies showed a mosaic amplification of the terminal 34 Mb of 3q. Subsequent fluorescence <em>in situ</em> hybridisation on cultured cells showed that a few metaphases contained a small supernumerary marker chromosome (sSMC) consisting of two head-to-head copies of the amplified 3q-material with neocentromere formation, the lower degree of mosaicism in karyotyping being ascribed to loss of sSMC upon culturing.</div><div>Reviewing the published cases of partial 3q tetrasomy cases we find pigmentary changes along the lines of Blaschko, cognitive deficits, spinal malformations, depressed nasal bridge, and palatal deformities to be frequent findings, and highlight a phenotypic overlap with partial 3q trisomy. Symptoms spanned from mild to severe, likely depending on both the size of the amplification and the degree of mosaicism.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105021"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198600","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}
Charissa Y.Z. Chan , Emma K. Baker , David Francis , Kate Milner , David J. Amor
{"title":"Hexasomy of the 15q11q13 region: a detailed report and review of the literature","authors":"Charissa Y.Z. Chan , Emma K. Baker , David Francis , Kate Milner , David J. Amor","doi":"10.1016/j.ejmg.2025.105023","DOIUrl":"10.1016/j.ejmg.2025.105023","url":null,"abstract":"<div><div>Hexasomy of the Prader-Willi/Angelman Syndrome Critical Region (PWASCR; chromosome 15q11-q13) is very rare with only 13 patients being described to date. The region is known for its high susceptibility to genomic rearrangements, and extra copies within the region have been shown to be associated with distinct but variable clinical features of intellectual disability, epilepsy, global developmental delay amongst others. We present a 10-year-old girl with moderate to severe intellectual disability, cerebral palsy, seizures, autistic features and challenging behaviours. Her karyotype is 47,XX,+mar[25]/46,XX[5]. On chromosome analysis using G-banding, we identified a very large dicentric supernumerary marker chromosome 15q11-q13. Microarray analysis and metaphase fluorescence in-situ hybridisation using the SNRPN gene specific to 15q11.2-q13.3 region showed 87 % of cells containing 6 signals and 13 % of cells containing 2 signals. This represents mosaicism for a partial hexasomy of the long arm of chromosome 15q. We also reviewed and consolidated the literature of all reported patients with hexasomy of PWASCR, and found that amongst all 14 patients (including ours), despite some variation in phenotype, all patients had seizures, and the majority had intellectual disability and challenging behaviours.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105023"},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180547","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}
Ninna Bager Rasmussen , Pernille Axél Gregersen , Trine Østergaard Nielsen , Line Graven Lyngdorf , Christine Kroer Nielsen , Casper Kruse , Michael Bayat , Philippe M. Campeau , Anne Skakkebæk
{"title":"Variable expressivity of a transmitted pathogenic KAT6B variant","authors":"Ninna Bager Rasmussen , Pernille Axél Gregersen , Trine Østergaard Nielsen , Line Graven Lyngdorf , Christine Kroer Nielsen , Casper Kruse , Michael Bayat , Philippe M. Campeau , Anne Skakkebæk","doi":"10.1016/j.ejmg.2025.105020","DOIUrl":"10.1016/j.ejmg.2025.105020","url":null,"abstract":"<div><div>Pathogenic variants in <em>KAT6B</em> (Lysine acetyltransferase 6B) are associated with two clinically overlapping autosomal dominant disorders Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS) (OMIM <span><span>603736</span><svg><path></path></svg></span>), and Genitopatellar syndrome (GPS) (OMIM <span><span>606170</span><svg><path></path></svg></span>). More recently, the clinical spectrum of <em>KAT6B</em> disorders has expanded and <em>KAT6B</em> disorders have been suggested to consist of a spectrum of disorders with intermediate and overlapping clinical manifestations. Pathogenic variants in <em>KAT6B</em> mainly occur <em>de novo</em>, with only 3 reports of inherited variants. Here, we describe clinical and molecular findings in a three-generation Danish family with a segregating, previously unreported, pathogenic <em>KAT6B</em> variant. The variant is associated with a phenotype not otherwise specified (neither SBBYSS nor GPS) and with variable expressivity, adding further evidence that <em>KAT6B</em> disorders should be seen as a broad clinical spectrum. Furthermore, we highlight the existence of intra-familial variability and that pathogenic variants in <em>KAT6B</em> can be inherited from mildly affected parents.</div></div>","PeriodicalId":11916,"journal":{"name":"European journal of medical genetics","volume":"76 ","pages":"Article 105020"},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169560","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}