European Neurology最新文献

{"title":"Rare Disorders as Models for De(Re)generation: Is the Vacuolar ATPase a Clue to Understanding Tauopathies?","authors":"Tommaso Nicoletti","doi":"10.1159/000541286","DOIUrl":"10.1159/000541286","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"312-314"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139712","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":"D-Dimer and the Short-Term Prognosis of Patients with Subarachnoid Hemorrhage: A Meta-Analysis.","authors":"Xubin Shang, Xingmin Li","doi":"10.1159/000540163","DOIUrl":"10.1159/000540163","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated plasma D-dimer has been observed in acute phase of subarachnoid hemorrhage (SAH), while a quantitative evaluation for the association between D-dimer level and prognosis of SAH remains lacking. The aim of the meta-analysis was to investigate the potential predictive role of D-dimer for the short-term functional outcome of patients with SAH.</p><p><strong>Methods: </strong>Relevant observational studies were retrieved by searching PubMed, Web of Science, Embase, Wanfang, and CNKI. A poor functional outcome was generally defined by the Glasgow Outcome Scale (1-3) or the modified Rankin Scale (≥3). A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity.</p><p><strong>Results: </strong>Eleven studies involving 3,748 patients with SAH were included. Among them, 1,131 patients (30.2%) developed a poor functional outcome within 6 months. The pooled results showed that a higher plasma D-dimer at admission was associated with a higher risk of poor functional outcome during follow-up (odds ratio per 1 mg/L increment of D-dimer: 1.65, 95% confidence interval: 1.49-1.82, p &lt; 0.001; I2 = 0%). Sensitivity analysis by excluding one study at a time showed similar results. Subgroup analyses suggested that the association between D-dimer and poor functional outcome of patients with SAH was not significantly affected by study design, country, mean age, proportion of men, follow-up duration, methods for defining poor outcome, study quality scores, timing of D-dimer measurement, or the publication year.</p><p><strong>Conclusion: </strong>A high plasma D-dimer at admission is associated with a poor short-term functional outcome of patients with SAH.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"188-202"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590015","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":"Altered Cerebrospinal Fluid Neurofilament Light Chain but Not Neurogranin Levels Are Associated with Response to Ocrelizumab Treatment in Relapsing-Remitting Multiple Sclerosis: A Preliminary Study.","authors":"Tuğçe Kızılay, Ece Akbayir, Ruziye Erol, Ayça Simay Demir, Duygu Özkan Yaşargün, Vuslat Yilmaz, Erdem Tuzun, Recai Turkoglu","doi":"10.1159/000539376","DOIUrl":"10.1159/000539376","url":null,"abstract":"<p><strong>Introduction: </strong>Ocrelizumab is a CD20-targeting monoclonal antibody used for treatment of multiple sclerosis (MS). Serum and cerebrospinal fluid (CSF) neurofilament light (NFL) chain levels are reduced in MS patients under ocrelizumab treatment indicating a preventive action against neuro-axonal degeneration. Our aim, in this preliminary study, was to explore the impact of ocrelizumab treatment on synaptic integrity through assessment of neurogranin levels.</p><p><strong>Methods: </strong>Thirteen relapsing-remitting multiple sclerosis (RRMS) patients resistant to first-line immunomodulating agents were enrolled and followed up for 24 months under ocrelizumab treatment. Disease activity was monitored by periodic EDSS, MSSS, and cranial-spinal MRI assessments. No evidence of disease activity (NEDA)-3 was determined, and CSF levels of NFL (marker of neuro-axonal integrity) and neurogranin (marker of synaptic integrity) were measured by ELISA at baseline and 12-month ocrelizumab treatment.</p><p><strong>Results: </strong>Seven RRMS patients, who preserved NEDA-3 status during 24-month follow-up, showed ≥30% NFL level decrease, whereas 6 patients with stable/increased NFL levels displayed relapse, MRI lesion, or disability progression. Although most RRMS patients exhibited increased CSF levels of neurogranin under ocrelizumab treatment, patients with and without neurogranin level increase did not differ in terms of clinical features and NEDA-3 status. Baseline neurogranin levels negatively correlated with baseline EDSS scores.</p><p><strong>Conclusion: </strong>Our results confirm that NFL effectively monitors treatment response of RRMS patients under ocrelizumab treatment. Neurogranin does not appear to exhibit a similar benefit in screening of RRMS disease activity. Nevertheless, lower neurogranin levels are associated with increased disability in RRMS indicating a potential disease activity biomarker function.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"203-210"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955484","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 of Depression and Cognitive Performance in US Older Adults: A Secondary Analysis of Cross-Sectional Data Using NHANES 2013-2014.","authors":"Lulu Yao, Jingnian Ni, Mingqing Wei, Ting Li, Ziyi Long, Jing Shi, Jinzhou Tian","doi":"10.1159/000540277","DOIUrl":"10.1159/000540277","url":null,"abstract":"<p><strong>Introduction: </strong>Depression has been associated with cognitive performance, but whether sociodemographic and clinical characteristics might influence this association is not well elaborated. This study aimed to further explore this relationship in older adults.</p><p><strong>Methods: </strong>This cross-sectional study is based on data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. A total of 1,433 individuals with complete information on depressive symptoms and cognitive function variables were included in this study. Patient Health Questionnaire 9 (PHQ-9) score ≥10 as the cutoff to identify cases of depression in our study. We defined poor cognitive performance as a composite cognitive score &lt;47. Logistic regression models were used to examine the association of depression with cognitive performance (model 1). We progressively adjusted the covariates as confounders (model 2: model 1 + age, and gender; model 3: model 2 + race, education level, family income, drinking, and smoking; model 4: model 3 + overweight, arthritis, hyperlipidemia, diabetes, hypertension, heart failure, coronary heart disease, heart attack, stroke, and cancer). We then conducted subgroup, interaction, and restricted cubic spline (RCS) analyses to examine this association.</p><p><strong>Results: </strong>The prevalence of poor cognitive performance was 36.6% (53/145) in the depression group and 14.1% (182/1,288) in the non-depression group. In the fully adjusted model, depression was significantly associated with poor cognitive performance (adjusted odds ratio: 2.25; 95% confidence interval: 1.31-3.81). The results were robust to sensitivity analyses. Gender and education level may modify the association between depression and poor cognitive performance. RCS analysis revealed that the PHQ-9 score was related to poor cognitive performance in a nonlinear manner (p for nonlinearity &lt;0.001), and exhibited a J-shaped curve.</p><p><strong>Conclusion: </strong>Depression is associated with poor cognitive performance in US older adults. Early recognition and treatment of depression may be potential intervention strategies to protect cognitive health.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"147-158"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792278","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":"Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence.","authors":"Helene Fenter, Andrea O Rossetti, Isabelle Beuchat","doi":"10.1159/000535085","DOIUrl":"10.1159/000535085","url":null,"abstract":"<p><strong>Background: </strong>Electroencephalography (EEG) has long been used to detect seizures in patients with disorders of consciousness. In recent years, there has been a drastically increased adoption of continuous EEG (cEEG) in the intensive care units (ICUs). Given the resources necessary to record and interpret cEEG, this is still not available in every center and widespread recommendations to use continuous instead of routine EEG (typically lasting 20 min) are still a matter of some debate. Considering recent literature and personal experience, this review offers a rationale and practical advice to address this question.</p><p><strong>Summary: </strong>Despite the development of increasingly performant imaging techniques and several validated biomarkers, EEG remains central to clinicians in the intensive care unit and has been experiencing expanding popularity for at least 2 decades. Not only does EEG allow seizure or status epilepticus detection, which in the ICU often present without clinical movements, but it is also paramount for the prognostic evaluation of comatose patients, especially after cardiac arrest, and for detecting delayed ischemia after subarachnoid hemorrhage. At the end of the last Century, improvements of technical and digital aspects regarding recording and storage of EEG tracings have progressively led to the era of cEEG and automated quantitative analysis.</p><p><strong>Key messages: </strong>As compared to repeated rEEG, cEEG in comatose patients does not seem to improve clinical prognosis to a relevant extent, despite allowing a more performant of detection ictal events and consequent therapeutic modifications. The choice between cEEG and rEEG must therefore always be patient-tailored.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"17-25"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89717422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Safinamide on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease and Motor Fluctuations.","authors":"Jaime Kulisevsky, Henrique B Ferraz, Antonio Suppa, Heinz Reichmann","doi":"10.1159/000541362","DOIUrl":"10.1159/000541362","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) involves the progressive loss of dopaminergic neurons, leading to motor and non-motor symptoms that significantly impact patients' quality of life. Safinamide modulates dopaminergic and glutamatergic systems, offering a promising treatment approach.</p><p><strong>Methods: </strong>This meta-analysis evaluated the efficacy of safinamide as an add-on therapy to levodopa for PD patients with motor fluctuations. Following PRISMA guidelines, literature searches were conducted in PubMed and Embase (2014-2022). Inclusion criteria were studies on adult PD patients receiving safinamide with levodopa. Outcomes included on-time without troublesome dyskinesia, off-time, UPDRS Part III motor scores, UPDRS Part II activities of daily living scores, PDQ-39 emotional well-being, and GRID-HAMD scores.</p><p><strong>Results: </strong>Among thirteen eligible studies, safinamide significantly improved on-time without troublesome dyskinesia at 100 mg/day (mean difference [MD]: -0.90; 95% CI: -1.12 to -0.67; p < 0.00001) and 50 mg/day (MD: -0.77; 95% CI: -1.21 to -0.34; p = 0.0005) compared to placebo. It also reduced off-time (100 mg/day: MD: -0.94; 95% CI: -1.19 to -0.70; p < 0.00001; 50 mg/day: MD: -0.72; 95% CI: -1.03 to -0.41; p < 0.00001) and improved UPDRS-III motor scores (100 mg/day: MD: -3.01; 95% CI: -4.15 to -1.86; p < 0.00001; 50 mg/day: MD: -2.93; 95% CI: -5.14 to -0.71; p = 0.001). Mood improvements were noted in PDQ-39 emotional well-being scores (MD: -5.22; 95% CI: -6.90 to -3.54) and GRID-HAMD scores (MD: -0.60; 95% CI: -0.95 to -0.25; p = 0.0009). Safinamide also positively affected pain (RR: 1.10; 95% CI: 1.03 to 1.18).</p><p><strong>Conclusion: </strong>Compared to placebo, safinamide significantly benefits motor and non-motor symptoms in PD patients, but further research is necessary to fully explore its therapeutic potential.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"291-305"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Perivascular Spaces Burden and Future Stroke Risk in Ischemic Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis.","authors":"Hanhan Lei, Xiaomin Wu, Gareth Ambler, David Werring, Shuangfang Fang, Huiyin Lin, Huapin Huang, Nan Liu, Houwei Du","doi":"10.1159/000539730","DOIUrl":"10.1159/000539730","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aimed to explore the association of perivascular spaces (PVS) burden with the risks of future stroke events and mortality in patients with ischemic stroke and transient ischemic attack (TIA).</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane database from inception to December 31, 2023. We included eligible studies that reported adjusted estimated effects for future intracranial hemorrhage (ICH), ischemic stroke, and mortality with baseline PVS burden in patients with ischemic stroke and TIA. Data were pooled using an inverse-variance method for the fixed effects (FE) model and a restricted maximum likelihood method for the random effects (RE) model.</p><p><strong>Results: </strong>Thirteen observational studies (5 prospective, 8 retrospective) were included, comprising 20,256 patients. Compared to 0-10 PVS at basal ganglia (BG-PVS), a higher burden (&gt;10) of BG-PVS was significantly associated with an increased risk of future ICH (adjusted hazards ratio [aHR] 2.79, 95% confidence interval [CI]: 1.16-6.73, RE model; aHR 2.14, 95% CI: 1.34-3.41, FE model; I2 = 64%, n = 17,084 from four studies) followed up for at least 1 year. There was no significant association between &gt;10 BG-PVS and ICH within 7 days after reperfusion therapy (adjusted odds ratio [aOR] 1.69, 95% CI: 0.74-3.88, RE model; aOR 1.43, 95% CI: 0.89-2.88, FE model; I2 = 67%, n = 1,176 from four studies). We did not detect a significant association of recurrent ischemic stroke, mortality, or disability with BG-PVS burden. Neither &gt;10 PVS at centrum semiovale (CSO-PVS) nor increasing CSO-PVS burden was significantly associated with the risk of future intracranial hemorrhage or ischemic stroke recurrence.</p><p><strong>Conclusions: </strong>Current evidence suggests that a higher BG-PVS burden may be associated with an increased risk of future ICH in patients with ischemic stroke and TIA.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"130-139"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563118","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":"Hemorrhagic Stroke as Inspiration for Poetry: The Case of Alfred Tennyson, Arthur Henry Hallam, and In Memoriam A.H.H.","authors":"Matheus Pedro","doi":"10.1159/000535327","DOIUrl":"10.1159/000535327","url":null,"abstract":"<p><strong>Background: </strong>Neurology and literature have a complex interface; one of the facets is that of works inspired by grief on the passing of a beloved one due to a neurological disease.</p><p><strong>Summary: </strong>In Memoriam A.H.H., written by Alfred Tennyson and published in 1850 in response to the untimely death of Arthur Henry Hallam, is one such elegy, which had a profound impact in Tennyson's body of work and on the history of Victorian poetry in general. In this review, the author delineates biographical notes of both men before analyzing the disease and death of Arthur Hallam due to hemorrhagic stroke.</p><p><strong>Key messages: </strong>By evaluating Hallam's autopsy report and contemplating the different hypotheses on the etiology of his stroke, as well as how his death due to catastrophic neurological disease was memorialized in verse, neurologists may gain better insight on the interface between neurology and literature inspired by grief.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"87 1","pages":"43-48"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461242","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":"The Role of Neurohospitalism in a Specialized Cardiovascular Hospital.","authors":"Miguel Serôdio, Marta Magriço, André Sobral-Pinho, Rita Ventura, Filipa Serrazina, Gonçalo Cabral, Bruna Meira, Marco Fernandes, Manuel Salavisa, Marlene Saraiva, João Pedro Marto, Francisca Sá, Sofia Calado, Miguel Viana-Baptista","doi":"10.1159/000537930","DOIUrl":"10.1159/000537930","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiology and cardiothoracic surgery are among the specialties that most commonly require neurology inpatient consultations. We aimed to study the neurology referrals by the cardiovascular-specialized hospital included in our tertiary hospital center.</p><p><strong>Methods: </strong>Retrospective study of consecutive patients referred for neurology inpatient consultation between January 1, 2020, and December 31, 2022. We analyzed referrals, patients' characteristics, and the approach taken. A detailed subanalysis was performed for patients diagnosed with acute ischemic stroke (AIS).</p><p><strong>Results: </strong>143 patients were observed (mean age 67.3 years, 46 [32.2%] females). Most frequent referral reasons were suspected AIS deficits (39.2%), altered mental status (19.6%), suspected seizures (13.3%), and neuroprognostication (11.9%). Mean referral-to-consult time was 2.7 days, and 117 (81.8%) consults were in-person. Additional investigation, treatment changes, and outpatient clinic referral were proposed, respectively, in 79.7%, 60.1%, and 19.6% of patients. Most common diagnoses were AIS (45.5%), hypoxic-ischemic encephalopathy (18.9%), and delirium (7.0%). Regarding patients with AIS (n = 62), most common stroke causes were post-cardiac procedure (44.6%), infective endocarditis (18.5%), aortic dissection (10.8%), acute myocardial infarction (10.8%), and anticoagulant withdrawal in patients with atrial fibrillation (6.2%). Thirty-four AIS patients were diagnosed less than 24 h since last seen well, of which four (6.2%) were treated (three with thrombolysis and one with mechanical thrombectomy).</p><p><strong>Conclusion: </strong>AIS is the most common reason for referral in our cardiovascular hospital. Our results highlight the importance of the availability of a neurologist/neurohospitalist with stroke expertise for consultation of inpatients admitted in a specialized cardiovascular hospital.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"49-53"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930705","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":"Combined Central and Peripheral Demyelination: Two Case Reports.","authors":"Buse Gül Belen, Nazlı Gamze Bülbül, Sibel Karsidag, Ercan Köse, Atay Vural, Fatih Özdağ","doi":"10.1159/000536167","DOIUrl":"10.1159/000536167","url":null,"abstract":"<p><p>Combined central and peripheral demyelination (CCPD) is a rare disease characterized by demyelinating lesions in both the central nervous system (CNS) and peripheral nervous system (PNS). CCPD can present with acute, subacute, or chronic onset. The initial symptom may be of CNS origin, PNS origin, or both. The clinical manifestations of CCPD are quite heterogeneous, and there are no well-defined diagnostic criteria. In MRI imaging of CCPD cases, demyelinating lesions can be seen in areas such as the brain, cerebellum, brainstem, optic nerve, and spinal cord. Common electromyography (EMG) findings in patients with CCPD include decreased motor nerve conduction velocities, decreased or absent sensory nerve action potentials, prolonged F-wave latency, and decreased amplitude of compound muscle action potentials. Neurofascin (NF) is a transmembrane protein and anti-neurofascin (anti-NF) antibodies directed against NF can be positive in cases of CCPD. Four main NF polypeptides are produced by alternative splicing: NF 186, NF 180, NF 166, and NF 155. The investigation of anti-NF in CCPD cases is therefore important for etiological considerations. Here, we discussed three cases diagnosed with CCPD based on clinical, neuroimaging, EMG, and anti-NF antibody results in light of the literature.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"84-92"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702122","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}