Journal of neurotrauma最新文献

{"title":"Analgesic Modulation of Neuroendocrine and Region-Specific Neuropathological Responses Following Blast-Induced Traumatic Brain Injury in Rats.","authors":"Rex Jeya Rajkumar Samdavid Thanapaul, Manoj Y Govindarajulu, Mital Y Patel, Jishnu K S Krishnan, Deepak Menon, Chetan Pundkar, Gaurav Phuyal, Laura M Anderson, Sridhar Samineni, Joseph B Long, Peethambaran Arun","doi":"10.1177/08977151261442479","DOIUrl":"10.1177/08977151261442479","url":null,"abstract":"<p><p>Blast-induced traumatic brain injury is a significant health concern among military personnel and civilians exposed to explosive devices. Although analgesics are routinely used in laboratory animal studies, their effects on neuroendocrine and neuropathological responses to blast remain insufficiently understood. This study investigated how preinjury administration of buprenorphine (BUP) or meloxicam (MEL) modulates hypothalamic-pituitary-adrenal axis activation, axonal injury, tau phosphorylation, and astroglial responses following blast exposure. Male Sprague Dawley rats were assigned to sham, blast, blast + MEL, or blast + BUP groups and subjected to two tightly coupled ∼19-psi blast waves using an advanced blast simulator. Serum corticosterone and adrenocorticotropic hormone (ACTH) levels and cerebrospinal fluid (CSF) levels of phosphorylated neurofilament heavy chain (pNFH) were quantified on days 1 and 30, alongside regional (cortex, hippocampus, cerebellum, brainstem) protein expression of pNFH, pTau (Ser396), and glial fibrillary acidic protein (GFAP). Repeated blast exposure caused strong acute elevations in corticosterone, ACTH, and pNFH. BUP suppressed both hormones, whereas MEL selectively reduced ACTH. Both analgesics significantly attenuated acute increases in pNFH, while MEL further mitigated chronic regional elevations in pNFH and GFAP, indicating stronger long-term suppression of axonal and astroglial pathology postblast. Tau hyperphosphorylation was predominantly an acute event, with MEL producing modest region-specific reduction. Region-dependent analyses revealed persistent cortical and brainstem axonal injury, biphasic hippocampal responses, and minimal cerebellar involvement. By day 30, endocrine and CSF biomarkers showed biochemical normalization in analgesic-treated animals but remained elevated in untreated blast-exposed rats. Our findings indicate that routine laboratory analgesics substantially modulate key biomarkers of blast-induced neurotrauma, introducing methodological and interpretive confounds that can impact cross-study reproducibility. Thus, the study should be interpreted primarily as evidence of analgesic-induced biomarker modulation rather than therapeutic neuroprotection.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1856-1868"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Leakage Sign Patterns in Acute Subdural Hematoma.","authors":"Keiichiro Furuta, Jin Kikuchi, Kohei Miyagi, Kimihiko Orito, Osamu Takasu, Motohiro Morioka","doi":"10.1177/08977151261436374","DOIUrl":"10.1177/08977151261436374","url":null,"abstract":"<p><p>The leakage sign (LS), defined as contrast medium extravasation on the 5-minute delayed phase after computed tomography (CT) angiography, has been reported as a predictive imaging marker for hematoma expansion in acute subdural hematoma (ASDH). We recently identified two different patterns of LS: local and diffuse. This study aimed to evaluate the clinical importance of these LS types in predicting brain swelling and determining the appropriate surgical intervention. We retrospectively reviewed 98 patients with LS-positive ASDH on contrast-enhanced CT between January 2013 and September 2024. LS was classified as local-type when one or two positive areas were observed and as diffuse-type when three or more positive areas were present and/or when contrast medium extended along the brain surface. Brain swelling was defined based on radiological findings and the requirement for decompressive craniectomy. Clinical data, treatment modalities, and outcomes were analyzed in both groups. Among the 98 LS-positive patients, 40 were classified as having local-type and 58 as having diffuse-type. The diffuse-type LS group had a significantly greater proportion of patients in severe admission Glasgow Coma Scale category (<i>p</i> = 0.027), underwent decompressive craniectomy more frequently (<i>p</i> = 0.04), and had higher indicators of coagulopathy, including elevated activated partial thromboplastin time, prothrombin time-international normalized ratio, and D-dimer levels (all <i>p</i> < 0.05).　Brain swelling occurred in 70.7% of patients in the diffuse-type group compared with 17.5% in the local-type group (<i>p</i> < 0.001). Poor outcomes were significantly more common in the diffuse-type group (67.2% vs. 32.5%, <i>p</i> = 0.001), along with a higher mortality rate (56.9% vs. 22.5%, <i>p</i> < 0.001). Diffuse-type LS was independently associated with poor outcomes and was associated with clinical severity, coagulopathy, and brain swelling. Conversely, local-type LS was associated with favorable outcomes and a low rate of brain swelling. Because most patients with LS-positive ASDH show progressive ASDH, emergency hematoma evacuation is generally required. Patients with diffuse-type LS may be more likely to require decompressive craniectomy, whereas endoscopic hematoma removal via a small craniotomy may be a feasible option for local-type LS, where the bleeding point can be detected using the LS-positive area.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1778-1788"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Autoregulation in Severe Traumatic Brain Injury: Source of Index, Timing, and Relationship to Spreading Depolarization.","authors":"Alexandria Marino, Abhinav Kareddy, Xin-Qun Wang, Chaitali Harge, Thomas R Jones, C William Shuttleworth, Andrew P Carlson","doi":"10.1177/08977151261438296","DOIUrl":"10.1177/08977151261438296","url":null,"abstract":"<p><p>Impaired cerebral autoregulation is a contributor to secondary injury in traumatic brain injury (TBI) and is associated with worse outcomes. The mechanism of injury progression from impaired autoregulation is suggested to be related to triggering of spreading depolarization (SDs) events-massive waves of cellular dysfunction implicated in secondary injury. The most-studied continuous measurement of autoregulation is the pressure reactivity index (PRx), a rolling correlation between waveform level mean arterial pressure (MAP) and intracranial pressure. However, alternative indices using correlation of MAP with brain tissue oxygen tension (PbtO₂), probe-derived cerebral blood flow (CBF), and regional brain oxygen saturation (rSO₂) can also be performed and may have advantages. Our objective was to evaluate the predictive value of different multimodal autoregulation indices for 30-day mortality in TBI and to assess the relationship between impaired autoregulation and SD. Autoregulation indices including PRx, oxygen reactivity index (ORx; from PbtO₂), CBF reactivity (CBFRx; from thermal diffusion), and oxygen saturation reactivity index (OSRx; from rSO₂) were obtained in a cohort of 218 patients with TBI requiring invasive monitoring. Associations between autoregulation indices and 30-day mortality were evaluated using multivariable logistic regression models, adjusting for age and admission Glasgow Coma Scale (GCS). A subset of postsurgical patients with SD monitoring was evaluated to assess for a potential relationship between SD and autoregulation. Within the first 24 h, univariable analysis demonstrated significant associations between 30-day mortality and ORx (<i>p</i> = 0.0078) or OSRx (<i>p</i> = 0.0014), but not other indices. In multivariable models adjusting for age and admission GCS, both ORx (<i>p</i> = 0.044) and OSRx (<i>p</i> = 0.027) remained significant predictors of 30-day mortality. In the overall monitoring time, only ORx (<i>p</i> = 0.008) and PRx from the parenchymal monitor (<i>p</i> = 0.027) were significantly associated with mortality. In patients with SD monitoring, we noted an inflection in the predicted probability of SD below MAP 85 mmHg, which may be supportive of the lower limit of autoregulation being a threshold for increased SD probability. We conclude that early (first 24 h) impairment in ORx and OSRx is associated with worse outcomes in TBI, while ORx and PRx are more strongly associated throughout the window of invasive monitoring. This effect may be mediated by increased SD with impaired autoregulation. OSRx can be derived from noninvasive near-infrared spectroscopy monitoring. This presents an opportunity to assess and optimize impaired autoregulation earlier in a patient's course without invasive monitoring. This could enhance outcome prediction and guide therapeutic strategies, particularly early after TBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1814-1823"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWAL-Administrative Duplicate Publication: Simultaneous Reactive Change in Unmyelinated and Myelinated Axon Segments Following Experimental Diffuse Traumatic Brain Injury.","authors":"","doi":"10.1177/08977151261432168","DOIUrl":"https://doi.org/10.1177/08977151261432168","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261432168"},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychoplastogens to Reduce Persistent Cognitive Symptoms for Traumatic Brain Injury as a Chronic Condition.","authors":"Hoda K AbouEich, Ali Izadi, Jonathan Lifshitz, David E Olson, Gene G Gurkoff","doi":"10.1177/08977151261495030","DOIUrl":"https://doi.org/10.1177/08977151261495030","url":null,"abstract":"<p><p>There are currently no available effective pharmacological therapies for treating chronic cognitive deficits after traumatic brain injury (TBI). Psychoplastogens, including atypical psychedelics, classical serotonergic psychedelics, and neuroplastogens, are a class of small molecule drugs that can enhance neuroplasticity by inducing rapid and sustained effects on neuronal architecture and function, with the potential to have broad therapeutic effects. Ketamine, psilocybin, and dimethyltryptamine (DMT) have demonstrated therapeutic efficacy for treating multiple psychiatric conditions, and their ability to enhance neuroplasticity is hypothesized to be the primary mechanism. However, the administration of psychoplastogens for the treatment of cognitive impairments in TBI and other neurodegenerative diseases is nascent. In this review, we discuss the following: (1) relevant TBI pathologies and how neuroplasticity is impaired following TBI, (2) psychoplastogens and their use in neural repair models, and (3) the potential of psychoplastogens as treatments for TBI to alleviate various pathologies and improve cognitive behavioral outcomes. The underlying pathologies observed after TBI, including impaired neuroplasticity, synaptic dysfunction, neuronal atrophy, altered neurotransmission, and cellular dysfunction, are shared with several psychiatric disorders. Based on the multiple pathophysiological targets, there is a critical unmet need to investigate psychoplastogens as therapeutic interventions during the chronic phase of TBI for cognitive outcomes and underlying impact on neuroplasticity.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261495030"},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Outcomes from the BRITE Study: Secondary Outcomes of a Multisite Pragmatic Randomized Controlled Trial of Post-Rehabilitation Discharge Transitional Support after Traumatic Brain Injury.","authors":"John Whyte, Stacey Jou, Tessa Hart, Marcia A Ciol, Jesse R Fann, Flora Hammond, Megan Moore, Jeanne M Hoffman","doi":"10.1177/08977151261495028","DOIUrl":"https://doi.org/10.1177/08977151261495028","url":null,"abstract":"<p><p>Caregivers of individuals admitted to inpatient rehabilitation following traumatic brain injury (TBI) often experience high burden and unmet needs after hospital discharge. Transitional periods are challenging, and standard discharge planning with referrals to outpatient care is typically not enough support for this critical phase. We sought to evaluate the impact of a post-inpatient rehabilitation patient/caregiver intervention (rehabilitation transition planning; RTP) on caregiver burden and quality of life, compared to standard rehabilitation discharge planning (RDP). Of 925 randomized patient participants at six inpatient rehabilitation centers, 591 had caregivers who enrolled in the study. Patients and caregivers in the RTP group (<i>N</i> = 295) received up to 12 remote follow-up support contacts for 6 months post-discharge. The RDP control group (<i>n</i> = 296) received standard discharge planning. Caregiver outcomes (Bakas, Zarit, PROMIS, SF-12 Physical/Mental) were assessed at 6 and 12 months. Data analysis used intention-to-treat principles. No significant differences were observed in any caregiver outcome measures at 6 or 12 months between RTP and RDP groups. In exploratory analyses, greater functional impairment, need for assistance, and a history of prior mental health problems on the part of the patient were associated with greater burden and reduced quality of life for caregivers irrespective of treatment assignment. Female caregivers, White caregivers, and those with greater education tended to show greater burden on some measures. No patient or caregiver attributes were consistently associated with a differential response to the intervention. Future research should explore alternative or more targeted interventions for this vulnerable population using both intervention-sensitive and global measures of outcome.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261495028"},"PeriodicalIF":3.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidomain Post-Concussive Symptom Trajectories and Biopsychosocial Correlates Following Pediatric Concussion.","authors":"Daniel A P Geraghty, Vicki Anderson, Stephen J C Hearps, Jesse Shapiro, Michael Takagi, Fabian Fabiano, Gavin A Davis, Katherine O Bray, Cathriona Clarke, Georgia M Parkin, Vanessa C Rausa, Nicholas Anderson, Vera Ignjatovic, Marc Seal, Silvia Bressan, Franz E Babl","doi":"10.1177/08977151261499596","DOIUrl":"https://doi.org/10.1177/08977151261499596","url":null,"abstract":"<p><strong>Importance: </strong>Understanding how post-concussive symptoms (PCS) evolve across multiple domains and how these patterns relate to biopsychosocial factors is critical for identifying children at risk of prolonged recovery following concussion.</p><p><strong>Objective: </strong>To identify clinically meaningful recovery groups characterized by shared trajectories of cognitive, physical, emotional, and fatigue PCS over 3 months post-injury, and to examine associations between trajectory group membership and pre-injury, injury-related, and biopsychosocial factors.</p><p><strong>Design, setting, and participants: </strong>This prospective longitudinal cohort study was conducted at the Royal Children's Hospital, Victoria, Australia. Participants were children aged 5-18 years presenting to the emergency department (ED) with concussion.</p><p><strong>Main outcomes and measures: </strong>Cognitive, physical, emotional, and fatigue PCS above pre-injury baseline were assessed via parent report using the Postconcussion Symptom Inventory at ED presentation and at 2-4 days, 2 weeks, 1 month, and 3 months post-injury. Group-based multi-trajectory modeling identified recovery groups. Associations with pre-injury, injury-related, psychosocial, and child factors were examined.</p><p><strong>Results: </strong>Among 326 children (231 males [70.9%]; mean [SD] age, 11.6 [3.2] years), five recovery trajectories were identified: <i>resilient</i> (<i>n</i> = 45, 14%), <i>early recovery</i> (<i>n</i> = 28, 9%), <i>typical recovery</i> (<i>n</i> = 146, 45%), <i>delayed symptom exacerbation</i> (<i>n</i> = 24, 7%), and <i>persistently high symptom endorsement</i> (<i>n</i> = 83, 25%). Exploratory comparisons suggested that persisting trajectories were associated with prior child mental health history and greater post-injury psychosocial difficulties.</p><p><strong>Conclusions and relevance: </strong>Pediatric concussion symptom domains followed broadly similar time courses for most children; however, among children with delayed or persisting symptoms, some domains differed in the shape and timing of change. Recovery profiles characterized by persisting symptom endorsement were more strongly associated with psychosocial and mental health factors than with injury-related characteristics, underscoring the importance of early psychosocial screening and ongoing monitoring.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261499596"},"PeriodicalIF":3.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of Resilience and Depression and Associations with Hope Between Discharge and 12 Months Post-Discharge after Acquired Neurological Injury.","authors":"Tamara Ownsworth, Jayke Bennett, Rachel Brough, Timothy Geraghty, Jessie Mitchell, Kerrin Watter, Melissa Kendall, Delena Amsters, Emily Bray, Areti Kennedy, Rachel Jones, Kylie Ferguson, Ryan Bell, Christy Hogan","doi":"10.1177/08977151261497616","DOIUrl":"https://doi.org/10.1177/08977151261497616","url":null,"abstract":"<p><p>The hospital-to-home transition is a heightened period of psychological vulnerability after acquired brain injury (ABI) and spinal cord injury (SCI), during which individuals draw on internal resources such as resilience to cope. However, the stability of resilience during the first 12 months post-discharge is largely unknown. This study aimed to examine trajectories of resilience and depressive symptoms and associations with levels of hope during the first 12 months post-discharge after ABI and SCI. Individuals with ABI and SCI were recruited between June 2023 and July 2024 from specialist inpatient rehabilitation units and were administered measures of resilience, depressive symptoms, and hope at discharge and at 3 and 12 months post-discharge. In total, 125 individuals with ABI (<i>n</i> = 70) and SCI (<i>n</i> = 55) were recruited at discharge, with longitudinal data available for 107 of these participants. Latent Class Growth Mixture Modeling identified four trajectories of resilience over 12 months post-discharge, including two stable (high-stable <i>n</i> = 27; moderate-stable <i>n</i> = 67) and two changing (stable-decreasing <i>n</i> = 6; decreasing-stable <i>n</i> = 7). Four depression trajectories were also identified, including low-stable (<i>n</i> = 70), moderate-fluctuating (<i>n</i> = 25), decreasing-increasing (<i>n</i> = 7), and increasing-stable (<i>n</i> = 5). In terms of group membership across trajectories, individuals with high-stable resilience typically had low-stable depression (85%), whereas other resilience trajectories had more variable membership across depression trajectories. Levels of hope were significantly higher and more stable for the high-stable resilience trajectory than for other resilience trajectories. However, levels of hope significantly decreased for the low-stable depression trajectory. Overall, patterns of resilience post-discharge after SCI and ABI were related to, but distinct from, depressive symptoms and hope. While resilience was largely stable over time, depressive symptoms increased for nearly one-third of individuals, and hope often decreased in the context of stable levels of resilience and depression, thus informing priorities for clinical management.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261497616"},"PeriodicalIF":3.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> A Brock String Procedure Is Not Comprehensive Optometric Vision Therapy.","authors":"David H Biberdorf","doi":"10.1177/08977151261497217","DOIUrl":"https://doi.org/10.1177/08977151261497217","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261497217"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Response to Letter:</i> \"A Brock String Procedure Is Not Comprehensive Optometric Vision Therapy\".","authors":"Alicia M Trbovich, Aaron J Zynda, Anne Mucha, Anthony Kontos","doi":"10.1177/08977151261497218","DOIUrl":"https://doi.org/10.1177/08977151261497218","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"8977151261497218"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}