Journal of Clinical Neuroscience最新文献

{"title":"Direct transfer to angiosuite vs conventional workup for stroke: A systematic review and meta-analysis","authors":"Ali Mortezaei ,&nbsp;Mohammadreza Alizadeh ,&nbsp;Mohammad Mirahmadi Eraghi ,&nbsp;Sogand Sheikholeslami ,&nbsp;Taimur Hasan ,&nbsp;Ramin Shahidi ,&nbsp;Visish M. Srinivasan ,&nbsp;Jan-Karl Burkhardt ,&nbsp;Redi Rahmani","doi":"10.1016/j.jocn.2025.111110","DOIUrl":"10.1016/j.jocn.2025.111110","url":null,"abstract":"<div><h3>Background</h3><div>Reducing the stroke time metric in patients with stroke who underwent thrombectomy is associated with good functional recovery. We compared direct transfer to angiosuite (DTAS) vs conventional workup (CWU) in patients who underwent endovascular treatment due to large vessel occlusion (LVO).</div></div><div><h3>Methods</h3><div>A systematic search was conducted in four electronic databases. The continuous outcomes were analyzed using the standardized mean difference (SMD) and 95 % CI, while the binary outcomes were analyzed using the odds ratio (OR) and 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>We included a total of 3145 patients, which 1168 patients were in DTAS group and 1977 were in CWU group. DTAS showed a significantly higher likelihood of 90-day mRS0-1 (OR 1.6, p = 0.002) and mRS0-2 (OR 1.47, p &lt; 0.0001), successful reperfusion (OR 1.53, 95 % CI 1.1 to 2.1, p = 0.0122), and lower door-to-puncture (SMD −4.36, 95 % CI −7.4 to −1.3, p = 0.0096) than CWU. There was no significant difference between the two triage protocols in 90-day mortality (OR 0.98, 95 % CI 0.6 to 1.64, p = 0.94) and symptomatic intracranial hemorrhage (OR 0.78, p = 0.14). The proportion of patients who were triaged to DTAS with non-LVO on diagnostic angiography in angiosuite was 5.76 % (95 % CI 1.8 % to 11.4 %). There was a significant difference between randomized trials versus observational studies in 90-day mRS0-2 (OR 1.91 vs 1.16, p = 0.0042), 90-day mortality (OR 0.62 vs 1.27, p = 0.12), and door-to-puncture time (SMD −1.25 vs −5.53, p = 0.027).</div></div><div><h3>Conclusion</h3><div>DTAS is a feasible, safe, and cost-effective triage approach for managing patients with acute stroke due to LVO.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111110"},"PeriodicalIF":1.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350532","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":"Investigation of blood carnitine levels in hydrocephalus patients","authors":"Ebru Temiz ,&nbsp;Ismail Koyuncu ,&nbsp;Murat Tiken ,&nbsp;Kadir Egi ,&nbsp;Sukru Akmese ,&nbsp;Gulyara Cigdem ,&nbsp;Huseyin Taskiran ,&nbsp;Mehmet Enes","doi":"10.1016/j.jocn.2025.111098","DOIUrl":"10.1016/j.jocn.2025.111098","url":null,"abstract":"<div><div>Hydrocephalus is a complex neurological disorder that severely impacts the central nervous system. It is a multifactorial disease causing significant neurological deterioration and death in children. Despite numerous studies on hydrocephalus, its pathophysiology remains unclear. This study aims to identify possible changes in carnitine metabolism by comparing the carnitine profiles of children with hydrocephalus to those of healthy children. Additionally, the study seeks to determine the potential use of carnitine derivatives in the diagnosis and treatment of hydrocephalus. Blood samples from 32 hydrocephalic patients and 25 healthy individuals were analyzed. The carnitine profile (C0, C2, C4, etc.) was measured using LC-MS/MS. Statistical analyses of the data were performed using the MetaboAnalyst 5.0 program. The results showed that 23 carnitines were significantly lower in the hydrocephalus group compared to the control group. According to the MetaboAnalyst VIP score, C12 was identified as having high potential as a distinguishing marker. ROC analysis indicated that C12 had a specificity of 100% and a sensitivity of 80%. These findings suggest reduced carnitine profile with hydrocephalus pathology. Therefore, further research should be conducted to explore the addition of carnitine to hydrocephalus treatment protocols.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111098"},"PeriodicalIF":1.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372481","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":"Expanded applications of knotless tissue control devices in neurosurgical cranial and spinal applications","authors":"Samuel A. Tenhoeve ,&nbsp;Clayton Rawson ,&nbsp;Dora R. Tabachnick ,&nbsp;Mohammed A. Azab ,&nbsp;Omowumi Oladipo ,&nbsp;Michael Karsy","doi":"10.1016/j.jocn.2025.111108","DOIUrl":"10.1016/j.jocn.2025.111108","url":null,"abstract":"<div><h3>Objectives</h3><div>Effective wound closure is essential to neurosurgical procedures. Historical rates of neurosurgical wound complications range from 7 to 14 %. Knotless suturing with barbed sutures may offer effective closure rates but has had limited evaluation of safety in neurosurgical applications.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing cranial, spinal, and peripheral nerve neurosurgical procedures from 12/2022 until 7/2024 were included in a quality improvement initiative. A retrospective review of demographics, past medical history, and operative and postoperative variables was undertaken. The primary outcome of interest was wound complications, including surgical site infection (SSI), dehiscence, or CSF leak. A cost analysis of suture treatment was also compared. A comparison to historical control rates (7%) was performed (one-sample proportional z-test).</div></div><div><h3>Results</h3><div>A total of 195 consecutive patients were identified, with 10 wound-related complications including 3 superficial dehiscence treated with washout, 2 pseudomeningoceles, 2 cerebrospinal fluid leaks with meningitis, and 1 each of deep dehiscence with washout, superficial dehiscence with antibiotics, and epidural hematoma. A total of 53 (27.2 %) underwent cranial, 140 (71.8 %) spine, and 3 (1.0 %) peripheral nerve procedures. Ten patients (5.1 %) had incision complications with no difference to historical controls (p = 0.3). Cost analysis showed a range 0.35–3.03X cost differences using the knotless suture technique for different neurosurgical applications.</div></div><div><h3>Conclusion</h3><div>Knotless suture techniques can be an effective closure method for a variety of neurosurgical techniques comparable to expected wound complication rates. We expand on the potential applications of this technology compared with prior studies. Further studies will be necessary to confirm these findings.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111108"},"PeriodicalIF":1.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372482","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":"Time to response and predictors of seizure response to phenobarbitone therapy among neonates admitted with hypoxic-ischemic encephalopathy at Nekemte Comprehensive Specialized Hospital, Ethiopia","authors":"Wase Benti Hailu ,&nbsp;Getnet Yimer ,&nbsp;Serawit Deyno ,&nbsp;Lensa Tamiru Bacha","doi":"10.1016/j.jocn.2025.111104","DOIUrl":"10.1016/j.jocn.2025.111104","url":null,"abstract":"<div><h3>Background</h3><div>Hypoxic-ischemic encephalopathy is a brain injury that occurs in newborns when there is not enough blood flow to the brain. Recent studies have raised concerns about how well phenobarbitone works for treating seizures in newborns, as it may not effectively control seizures with the initial loading and repeated doses.</div></div><div><h3>Objective</h3><div>This study evaluated the time to respond and predictors of seizure response to phenobarbitone therapy among neonates admitted with hypoxic-ischemic encephalopathy.</div></div><div><h3>Methods and Materials</h3><div>A retrospective cohort study was conducted at Nekemte Comprehensive Specialized Hospital, using randomly selected medical records of 284 neonates who were treated between January 2020 and December 31, 2023. The study included neonates diagnosed with perinatal asphyxia stage II and III hypoxic-ischemic encephalopathy, who were treated with nasogastric phenobarbitone. The treatment included an initial loading dose of 20 mg/kg and two repeated doses of 10 mg/kg. Survival analysis was conducted. Predictor variables with a p-value ≤ 0.25 in bivariate Cox regression were included in the multivariable Cox regression analysis. Adjusted Hazard Ratios with 95 % confidence intervals were computed, and a p-value &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Out of the 284 neonates, 210 (73.9 %) responded to the phenobarbitone treatment. The incidence rate of response was 27.73 per 1000 person-hours of observation, with a median time to response of 29 h (IQR 26.5–32 h). Low birth weight (AHR = 0.59; 95 %CI 0.58, 0.98), subtle seizure type (AHR: 2.35; 95 % CI 1.09, 5.08), severe hypothermia (AHR = 0.23; 95 % CI 0.052, 0.26), and seizure frequency of twice or more (AHR = 0.436, 95 % CI 0.31, 0.61) were identified as predictors of seizure response.</div></div><div><h3>Conclusion and recommendations</h3><div>The overall incidence rate of response was low. Having a history of twice or more frequency of seizure insult, severe hypothermia and low birth weight decreased the response rate while subtle types of seizure increased the likelihood of response to phenobarbitone therapy. Electroencephalogram-confirmed seizure treatment and combined management with therapeutic hypothermia for high-risk newborns need to be started for better response and reduced response time. Further controlled studies utilizing both clinical and neuroimaging for definitive outcome measurement are recommended.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111104"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096435","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":"Outcomes of single-session gamma knife radiosurgery for deep-seated arteriovenous malformations","authors":"Mohammed Nadeem,&nbsp;Abhijit Goyal-Honavar,&nbsp;Subhas Konar,&nbsp;Kandimalla Praveen Krishna,&nbsp;Nishanth Sadashiva,&nbsp;Andiperumal Raj Prabhuraj,&nbsp;Vikas Vazhayil,&nbsp;Abhinith Shashidhar,&nbsp;Manish Beniwal,&nbsp;Arivazhagan Arimappamagan","doi":"10.1016/j.jocn.2025.111096","DOIUrl":"10.1016/j.jocn.2025.111096","url":null,"abstract":"<div><h3>Background</h3><div>Deep-seated arteriovenous malformations (AVMs) pose unique surgical challenges due to their proximity to critical structures. Gamma knife radiosurgery (GKRS) thus serves a promising alternative that may reduce treatment-related morbidity of deep-seated AVMs. However, the efficacy of GKRS in achieving obliteration in deep AVMs is not established. Therefore, we examined our experience with GKRS in deep-seated AVMs.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed all deep-seated (thalamic, basal ganglia and brainstem AVMs) that underwent GKRS at our center between 2006 and 2022. Factors that predicted obliteration were assessed, and the incidence of various long-term complications was recorded.</div></div><div><h3>Results</h3><div>The cohort comprised 137 patients, 74 males (54 %) and 63 females (46 %). The mean age was 25.1 ± 11.9 years. The mean dose delivered was 21.7 ± 2.6 Gy. The median volume of AVMs in our cohort was 3.2 cc (IQR: 1.5, 6.3 cc). The median follow-up was 36 months (IQR: 24, 42 months), following which 66 AVMs (48.2 %) were obliterated. Radiation-induced edema occurred in 8 cases (5.8 %), 7 of whom were symptomatic with neurological deficits (5.1 %). However, all patients improved on further follow-up with no residual neurological deficits. The median volume was significantly greater among cases with residual AVM (3.45 cc, IQR: 1.77, 6.85 cc) than those that were obliterated (2.77 cc, IQR: 1.09, 5.10 cc, <em>p = 0.049</em>). The mean Pollock Flickinger score was significantly greater among non-obliterated cases, as was the mean dose delivered (22.3 ± 2.7 Gy vs. 21.5 ± 2.8 Gy, <em>p = 0.044</em>). Multivariate analysis revealed that a nidus volume less than 3 cc was the only factor that predicted obliteration of the nidus (HR: 4.994, 2.139, 9.166, <em>p = 0.016</em>).</div></div><div><h3>Conclusions</h3><div>GKRS is an effective and safe treatment option for deep-seated AVMs. Obliteration occurred in 48.2% of cases, with complications in 5.8%. Nidus volume, rather than other clinical or radiological factors, appears to be the most significant predictor of successful obliteration. Despite the challenges posed by the complex anatomy of deep AVMs, including variable venous drainage and the potential for radiation-induced edema, GKRS is similarly effective in AVMs located in the thalamus, basal ganglia, and brainstem.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111096"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096436","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":"Surgical management of pontine brainstem cavernous malformations: A systematic review Emphasizing safe entry zones and clinical outcomes","authors":"Brandon Edelbach ,&nbsp;Ahmad K. AlMekkawi ,&nbsp;Dylan Glaser ,&nbsp;Vani B. Patel ,&nbsp;Amulya Manchikanti ,&nbsp;Rohit Rajput ,&nbsp;Carlos A. Bagley ,&nbsp;Tarek Y. El Ahmadieh ,&nbsp;Jonathan D. Breshears ,&nbsp;Yifei Duan","doi":"10.1016/j.jocn.2025.111106","DOIUrl":"10.1016/j.jocn.2025.111106","url":null,"abstract":"<div><h3>Objective</h3><div>Safe entry zones (SEZs) have emerged as important corridors for accessing brainstem cavernous malformations (BSCM) while minimizing morbidity. This systematic review and <em>meta</em>-analysis aims to provide a comprehensive analysis of the surgical management of pontine BSCM via SEZs.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed in PubMed for articles reporting on the surgical management of pontine BSCM via SEZ. Data were extracted on patient demographics, clinical presentation, BSCM characteristics, surgical approach, use of SEZs, and clinical outcomes.</div></div><div><h3>Results</h3><div>Fifteen studies with a total of 78 patients were included. The cohort was 62.8 % female with an average age of 37.62 ± 14.7 years. The most common presenting symptoms varied based on BSCM location within the pons. The two most common BSCM locations were peritrigeminal (24.4 %) and middle peduncle (10.3 %). The most frequently used surgical approach was the retrosigmoid approach (41.0 %), and the most commonly utilized SEZ was the lateral pontine zone (52.2 %). Gross total resection was achieved in 69.2 % of cases. Good clinical outcome (follow-up mRS &lt; 2) was observed in 64.1 % of patients, with clinical deterioration observed in 7.7 %.</div></div><div><h3>Conclusion</h3><div>Surgical resection of pontine BSCM can be performed with acceptable morbidity and mortality rates when utilizing SEZs and careful preoperative planning. The lateral pontine, supratrigeminal, and peritrigeminal SEZs are associated with high rates of complete resection and improved neurological outcomes. Future studies with standardized reporting and longer follow-ups are needed to further refine surgical techniques and patient selection.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111106"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135545","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":"Knowledge and diagnostic confidence of general practitioners in managing idiopathic intracranial hypertension: A nationwide survey from the Northern regions of Oman","authors":"Asma AlHosni ,&nbsp;Younis Al-Mufargi ,&nbsp;Manar AL’ Abdulsalam ,&nbsp;Al-Zahraa Al-Arafati ,&nbsp;Abdullah Al Sawafi ,&nbsp;Talal Alkhawaldi ,&nbsp;Tariq Al-Saadi","doi":"10.1016/j.jocn.2025.111080","DOIUrl":"10.1016/j.jocn.2025.111080","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic intracranial hypertension (IIH) is a rare but potentially vision-threatening condition, often underrecognized in primary care settings. Timely diagnosis and effective management are critical to prevent complications, yet knowledge gaps among general practitioners (GPs) may hinder optimal care. This study assessed the knowledge and diagnostic confidence of GPs in Oman regarding IIH.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 150 GPs in the Al Batinah region and Muscat. The survey evaluated familiarity with IIH, recognition of clinical symptoms, diagnostic practices, and confidence in managing the condition. Descriptive statistics, chi-square tests, and ordinal regression analyses were used to assess associations between knowledge levels, professional background, and confidence in IIH management.</div></div><div><h3>Results</h3><div>While 95.3 % of respondents accurately defined IIH, only 20.7 % could identify its symptoms, and 11.3 % were aware of appropriate treatment options. Significant associations were found between higher knowledge scores and international medical training (p = 0.001), as well as internship location (p = 0.001). Confidence in diagnosing IIH was strongly associated with clinical exposure to IIH patients (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The study highlights critical knowledge gaps and low diagnostic confidence among GPs in Oman regarding IIH, particularly in recognizing symptoms and management strategies. Findings suggest that international training and clinical exposure enhance IIH knowledge and confidence, underscoring the need for targeted educational interventions to improve diagnosis and patient outcomes</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111080"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143303446","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":"Preventing postoperative delirium: Advancements in cognitive protection strategies","authors":"Ali Fakhrudin ,&nbsp;Aziziyah Munawaroh ,&nbsp;Donal ,&nbsp;Ramtia Darma Putri ,&nbsp;Rizky Andana Pohan ,&nbsp;Erfan Ramadhani ,&nbsp;Safta Hastini","doi":"10.1016/j.jocn.2025.111102","DOIUrl":"10.1016/j.jocn.2025.111102","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111102"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254754","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":"Clinical trials targeting tau should be halted","authors":"Andi Olluri","doi":"10.1016/j.jocn.2025.111101","DOIUrl":"10.1016/j.jocn.2025.111101","url":null,"abstract":"<div><div>Experimental drugs lowering brain tau are heralded as improvements in the treatment of Alzheimer’s disease. However, the outcomes in clinical trials testing these agents have consistently failed to improve patient outcomes, i.e. slow down disease or improving cognition. Furthermore, the scientific rationale behind such drugs is rather poor in the first place and has been questioned. Therefore, I argue that trials of anti-tau drugs should be halted.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111101"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135694","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":"Response to Letter to The Editor: Hyponatremia is associated with cognitive decline in hospitalized patients after stroke","authors":"Yoshihiro Yoshimura","doi":"10.1016/j.jocn.2025.111103","DOIUrl":"10.1016/j.jocn.2025.111103","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111103"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096437","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}