Muscle & Nerve最新文献

{"title":"Comparison of Consumer Smartwatch and Research-Grade Accelerometer-Derived Step Counts in Amyotrophic Lateral Sclerosis.","authors":"Gordon Jewett, Reed Ferber, Colin B Josephson, Lawrence Korngut, Joon Lee","doi":"10.1002/mus.70323","DOIUrl":"10.1002/mus.70323","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Objective, scalable measures of function are needed in amyotrophic lateral sclerosis (ALS). Research-grade accelerometers are promising but may be difficult to deploy for prolonged remote monitoring, whereas consumer smartwatches offer a practical alternative. We evaluated the feasibility of long-term smartwatch monitoring in ALS and compared smartwatch- and accelerometer-derived daily step counts.</p><p><strong>Methods: </strong>In this single-centre prospective observational study, participants wore a Fitbit Sense (smartwatch) on the wrist longitudinally and an ActiGraph GT9X Link (accelerometer) on the opposite wrist during clinic-aligned assessment periods. Device comparison was restricted to concurrent valid days (≥ 10 h wear) and included paired comparison of mean daily step counts, Pearson correlation, Bland-Altman analysis, and proportional bias assessment.</p><p><strong>Results: </strong>Forty participants were enrolled and 39 contributed data across 8093 smartwatch and 915 accelerometer days. Step count comparison included 503 concurrent valid days from 34 participants. Mean daily step counts were 3480 (SD 4365) for smartwatch and 4066 (SD 4797) for accelerometer (p < 0.0001), with strong correlation (r = 0.91, p < 0.0001). Mean bias was -586 steps for smartwatch, with 95% limits of agreement from -4193 to 3021. Among participants with ≥ 6 months of concurrent data, devices showed similar decline over time (interaction p = 0.76).</p><p><strong>Discussion: </strong>Long-term remote monitoring using a smartwatch was feasible in ALS. Smartwatch-derived step counts were strongly correlated with accelerometer-derived estimates but were systematically lower and showed wide day-level limits of agreement. Smartwatch-derived step counts may be useful for group-level analyses and longitudinal monitoring, though device-specific bias should be considered in interpretation.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"580-589"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Anterior Belly of the Digastric Muscle as a Novel Target for Needle Electromyography in Amyotrophic Lateral Sclerosis.","authors":"Tatsuya Fukumoto, Yusuke Osaki, Kenta Hanada, Koji Fujita, Ryuji Kaji, Yuishin Izumi","doi":"10.1002/mus.70354","DOIUrl":"10.1002/mus.70354","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Needle electromyography (EMG) in the bulbar region aids in the diagnosis of amyotrophic lateral sclerosis (ALS) but remains technically challenging. The genioglossus muscle (GM) is commonly examined; however, pain and poor relaxation may limit its evaluation. The trapezius is an alternative target but is innervated by the spinal accessory nerve. We investigated the utility of the anterior belly of the digastric muscle (ABDM), innervated by the trigeminal nerve, for bulbar EMG evaluation.</p><p><strong>Methods: </strong>In this unblinded, prospective observational study, consecutive patients with suspected ALS underwent needle EMG of the ABDM, GM, masseter muscle (MM), and trapezius. Relaxation levels, EMG abnormalities, and pain (100-mm visual analog scale [VAS]) were assessed.</p><p><strong>Results: </strong>Twenty-seven clinically diagnosed ALS patients were analyzed. Relaxation was better in the ABDM than in the GM (p < 0.001) and comparable to that in the MM and trapezius. Fasciculation potentials were detected more often in the ABDM (52%) than in the GM (0%) and MM (22%; p = 0.039) and were comparable to the trapezius (59%). Chronic denervation occurred at similar frequencies across muscles (33%-59%). The combination of abnormal spontaneous activity and chronic denervation was most frequent in the ABDM (37%). Pain was lower with the ABDM (median VAS score of 21) than with the GM (28; p = 0.0052) and MM (32; p < 0.001) and was similar to the trapezius (23).</p><p><strong>Discussion: </strong>The ABDM may be a practical additional target for bulbar EMG in ALS, with favorable relaxation, lower pain, and potentially improved electrodiagnostic yield.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"685-691"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sexuality in Patients With Motor Neuron Disease.","authors":"R Yolanda Morgado Linares, Íñigo Rojas-Marcos, Marco Mesa, Eva Martínez, Macarena Cabrera-Serrano, Carmen Paradas","doi":"10.1002/mus.70348","DOIUrl":"10.1002/mus.70348","url":null,"abstract":"<p><strong>Introduction: </strong>Sexuality is a relevant yet understudied aspect in people living with motor neuron disease (MND). This study aimed to assess whether sexuality in people with MND is influenced by motor, cognitive, behavioral, or mood disturbances, and to explore whether being sexually active impacts caregiver burden.</p><p><strong>Methods: </strong>We conducted a cross-sectional observational study involving participants with MND and their primary caregivers from three ALS multidisciplinary units in Seville, Spain. Data were collected between October 2018 and July 2021. Functional, cognitive, behavioral, and mood assessments were conducted. Sexuality was evaluated through sex-specific questionnaires. Caregiver burden was assessed using the Zarit Burden Interview.</p><p><strong>Results: </strong>Among 66 participants who completed the sexuality assessment, 42.9% reported sexual activity in the previous month. Of these, 70% had no sexual dysfunction, while 26.7% had moderate and 3.3% severe dysfunction. No correlation was found between sexual activity and motor function. Sexual activity was less frequent in participants with apathy (p = 0.026), depression (p = 0.021), and frontotemporal dementia (p = 0.013). Among sexually active patients, those with cognitive impairment-particularly memory dysfunction-had higher rates of orgasm difficulties (p = 0.019). No other clinical parameters were related to sexuality. Sexuality of participants with MND did not influence caregiver burden.</p><p><strong>Discussion: </strong>Sexuality in MND is more associated with cognitive and mood factors than with motor disability. Addressing sexuality in clinical practice may contribute to improving quality of life and should be integrated into the multidisciplinary care of MND patients.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"669-677"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Research Operations and Resource Utilization in ALS Care: Insights From the Tofersen Antisense Oligonucleotide Expanded Access Protocol.","authors":"Alison Wheeler, Kush Mehta, Danica Sanders, Cathy Chin, Hannah Zivalic, Judith Carey, Alexandra McCaffrey, Pravin Pant, Carl Lewenhaupt, Sarah Luppino, Gabriel Jacobs, Shea Golden, Ryan Gifford, Erica Scirocco, Mackenzie Keegan, Munaf Hatem, Taravat Yazdanian, Sanem P Uysal, Natalie Susco, Shauna Schwartzman, Karen Branch, Kathryn E Hall, Joanna Barnas, Jenny Lam, Jennifer Hagar, Carol Ann Hannan, Sabrina Paganoni, James D Berry, Mark Garret, Jennifer Scalia, Suma Babu","doi":"10.1002/mus.70310","DOIUrl":"10.1002/mus.70310","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Tofersen is a gene-targeted therapy for individuals with superoxide dismutase 1 (SOD1) (+) amyotrophic lateral sclerosis (ALS). Prior to U.S. Food and Drug Administration (FDA) approval, tofersen was made available through expanded access protocol. This study describes the clinical and operational experience of administering tofersen through expanded access protocols at a single academic medical center in the U.S.</p><p><strong>Methods: </strong>Individuals with symptomatic SOD1(+) ALS (≥ 18 years), who were ineligible for traditional ALS clinical trials, received tofersen via bedside lumbar punctures at Massachusetts General Hospital. Treatment was provided through single-patient and intermediate-sized expanded access protocols prior to FDA approval. Demographic and clinical characteristics, referral-to-treatment timelines, safety outcomes, and operational costs were collected.</p><p><strong>Results: </strong>Eleven individuals with SOD1(+) ALS received monthly intrathecal tofersen over a two-year period (July 2021 to July 2023). Most participants were female, and 81.8% had leg-onset ALS. The mean (SD) referral-to-first dose duration was 36 (22.4) days. A total of 120 doses were administered over a two-year period. Tofersen was safe and well tolerated, with no treatment-related serious adverse events. Operational costs totaled $336,620, supported by philanthropy and insurance. The company provided the drug for free.</p><p><strong>Discussion: </strong>This experience demonstrates the feasibility of implementing a resource-intensive expanded access protocol within an academic medical center using a mixed funding model to facilitate early access to emerging ALS therapies.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"692-697"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Bortezomib-Lenalidomide-Dexamethasone Therapy in a 72-Year-Old Patient With Sporadic Late-Onset Nemaline Myopathy Associated With Monoclonal Gammopathy of Muscle Significance.","authors":"Hiroki Komatsu, Shogo Komaki, Meiko Maeda, Akatsuki Kubota, Mitsuhiro Yuasa, Mineo Kurokawa, Ryo Morishima, Satoko Uruha, Akinori Uruha, Ichizo Nishino, Masashi Hamada, Tatsushi Toda, Wataru Satake","doi":"10.1002/mus.70342","DOIUrl":"10.1002/mus.70342","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"756-758"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Resolution Ultrasound for Differentiation Between Leprosy-Associated Neuropathy and Vasculitic Peripheral Neuropathy: A Pilot Study.","authors":"Nan Hu, Jingwen Niu, Lin Chen, Min Qian, Mingsheng Liu","doi":"10.1002/mus.70353","DOIUrl":"10.1002/mus.70353","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Leprosy-associated neuropathy and vasculitic neuropathy (VN) share overlapping clinical features, making differentiation challenging in nonendemic regions. High-resolution ultrasound may aid in distinguishing these conditions, but comparative data are limited. This pilot study aimed to characterize and compare ultrasound findings in biopsy-confirmed leprosy-associated neuropathy and VN, and to identify distinctive sonographic features for early differential diagnosis.</p><p><strong>Methods: </strong>We retrospectively included 12 patients with biopsy-confirmed neuropathy (3 leprosy-associated, 6 systemic VN, 3 nonsystemic VN) from a prospectively maintained database at Peking Union Medical College Hospital (2020-2025). All had undergone standardized clinical assessments, nerve conduction studies, and high-resolution ultrasound of median, ulnar, tibial, fibular, and sural nerves, cervical roots, and brachial plexus. Cross-sectional areas (CSA) were measured at predetermined sites. Power Doppler assessed intraneural vascularization in enlarged segments.</p><p><strong>Results: </strong>In leprosy patients, nerve enlargement predominated proximal to entrapment sites (carpal tunnel, cubital tunnel/above-elbow, fibular head), with moderate-to-marked CSA increases. Intraneural power Doppler signals were detected in all enlarged segments (12/12, 100%). In VN patients, enlargement was mild-to-moderate, predominantly in nonentrapment regions (mid-forearm, upper arm), with less frequent vascularization (SVN: 25.0%; NSVN: 83.3%). Brachial plexus/cervical root enlargement was uncommon in both groups. Lower limb nerve enlargement occurred exclusively in leprosy.</p><p><strong>Discussion: </strong>Distinct ultrasound patterns may help distinguish leprosy-associated neuropathy from VN. Marked enlargement near entrapment sites with increased vascularization was more commonly observed in leprosy, while mild nonentrapment enlargement was more frequent in VN.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"678-684"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Millesi's Classification of Nerve Fibrosis Remains Underutilized in Modern Peripheral Nerve Research.","authors":"Johannes C Heinzel, Natalie Winter, Adrien Daigeler, Alexander Grimm, Jonas Kolbenschlag, Robert Schmidhammer, Sami Tuffaha, Henrik Lauer","doi":"10.1002/mus.70344","DOIUrl":"10.1002/mus.70344","url":null,"abstract":"<p><p>Peripheral nerve fibrosis is a major determinant of surgical outcome and functional recovery after nerve injury, yet standardized approaches to assess its extent remain scarce. Decades ago, Hanno Millesi introduced a comprehensive classification system that grades the degree of fibrosis according to the anatomical layers affected, ranging from paraneurial to endoneurial involvement. Despite its conceptual clarity and clinical relevance, this system remains largely underutilized in contemporary peripheral nerve research. Recent experimental models addressing perineural scarring and anti-fibrotic strategies rarely apply Millesi's classification, thereby limiting comparability and translation of findings. Here, we argue that greater integration of Millesi's classification could enhance experimental design, improve standardization, and guide the interpretation of preclinical and clinical studies on peripheral nerve regeneration. Renewed attention to this underutilized framework may bridge the gap between histological observations, experimental interventions, and the surgical decision-making process in peripheral nerve surgery.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"547-552"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mismatch Between the Distribution of Neuromuscular Specialists and Myasthenia Gravis Patients in the US Medicare Fee-for-Service Population.","authors":"Lauren Herrera, David Bruckman, Ikjae Lee, Jesse D Schold, Benjamin Claytor, Nicholas Silvestri, Yuebing Li, Michael K Hehir","doi":"10.1002/mus.70345","DOIUrl":"10.1002/mus.70345","url":null,"abstract":"<p><strong>Introduction/aims: </strong>There is a mismatch between clinical need and access to neurologists across the US. Myasthenia gravis (MG) incidence and prevalence are increasing, particularly in US patients older than 65 years, raising concern for access to neuromuscular specialists that represent only 4% of neurologists. We sought to compare the prevalence of MG patients over 65 years of age to the number of board-certified neuromuscular physicians (BCNMP) across the US.</p><p><strong>Methods: </strong>Utilizing Medicare fee-for-service Parts A/B coverage non-HMO claims data, MG cases were ascertained using a validated algorithm. Number of BCNMP per state was determined using American Board of Psychiatry and Neurology and American Board of Physical Medicine and Rehabilitation resources. MG prevalence, BCNMP number, and ratios of cases per BCNMP were calculated by state, census division and region for 2012-2013 and 2018-2019. Ratios between periods were tested using Poisson regression.</p><p><strong>Results: </strong>The number of MG cases increased from 29,038 in 2012-2013 to 35,691 in 2018-2019. BCNMP increased from 585 in 2012-2013 to 806 in 2018-2019. At the national level, the ratio of Medicare MG cases per BCNMP improved from 49.5 in 2012-2013 to 44.3 in 2018-2019. The south region had highest ratios at both timeframes, while the northeast had the lowest ratios. Six states had no BCNMP at both timeframes.</p><p><strong>Discussion: </strong>While the number of BCNMP has increased nationally, supply and demand may be unequally distributed. Regions across the US demonstrate disparate ratios of MG cases per BCNMP.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"714-719"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-Up Studies of Nerve Ultrasound and Motor Conduction in Patients With Autoimmune Nodopathy.","authors":"Jingwen Niu, Qingyun Ding, Huihong Tian, Nan Hu, Liying Cui, Mingsheng Liu","doi":"10.1002/mus.70328","DOIUrl":"10.1002/mus.70328","url":null,"abstract":"<p><strong>Introduction/aims: </strong>This study aimed to investigate long-term ultrasound and electrophysiological follow-up findings and their associations with antibody (Ab) titers in patients with autoimmune nodopathy. Longitudinal data correlating imaging, electrophysiological changes, and Ab dynamics remain scarce.</p><p><strong>Methods: </strong>A total of 16 patients with autoimmune nodopathy were prospectively recruited between August 2016 and July 2025. Patients underwent follow-up clinical, electrophysiological, and ultrasound assessments at intervals of approximately 6-12 months. Bilateral nerve ultrasound was performed on the median nerve, ulnar nerve, and brachial plexus in all patients, and nerve conduction studies (NCS) were performed concurrently. The median follow-up duration was 13.5 months.</p><p><strong>Results: </strong>Cross-sectional area (CSA) changes were significantly associated with Ab titer changes (p = 0.010). The CSA changes were not associated with those of motor conduction velocity (MCV) (p = 0.171). No significant associations were observed between MCV changes and Ab titer changes (p = 0.853). Five patients exhibited a reduction in nerve CSA: four of these converted to seronegative status, and one showed a decrease in Ab titer during follow-up. Among the six patients with increased nerve CSA, five had unchanged or higher Ab titers, while the remaining patient was seronegative at follow-up. The changes in CSA and Ab titer were consistent with one another in individual patients throughout follow-up.</p><p><strong>Discussions: </strong>Changes in nerve CSA were closely associated with those of Ab titers, even during long-term follow-up of individual patients. These findings suggest that nerve ultrasound may serve as a supplementary biomarker for disease activity in patients with autoimmune nodopathy.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"636-643"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sural/Radial Amplitude Ratio in Non-Length-Dependent Neuropathy (NLDN): A Call for More Standardized Methodology and Further Evaluation of Distal NLDN.","authors":"David A Shirilla, Paul E Barkhaus, Michael P Collins","doi":"10.1002/mus.70298","DOIUrl":"10.1002/mus.70298","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"759-760"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}