Neurology最新文献

{"title":"Racial and Ethnic Differences in Peripheral Neuropathy Risk Factors Among United States Adults.","authors":"Evan L Reynolds,David Russman,Melissa A Elafros,Eva L Feldman,Brian C Callaghan","doi":"10.1212/wnl.0000000000213851","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213851","url":null,"abstract":"BACKGROUND AND OBJECTIVESPeripheral neuropathy (PN) is a morbid condition. In the United States, there is higher prevalence of PN in non-Hispanic Black and Hispanic individuals vs non-Hispanic White individuals. Underlying mechanisms driving this increased prevalence are unknown. We aimed to determine associations between PN and race/ethnicity; other demographic information; and metabolic, lifestyle, and social determinants of health (SDOH) risk factors in a large and diverse sample of adults from the United States.METHODSWe performed a cross-sectional secondary analysis of the National Health and Nutrition Examination Survey from 1999 to 2004. PN was assessed using a monofilament test of reduced sensation. Risk factors included demographic (age, sex, race/ethnicity), metabolic (height, weight, waist circumference, systolic blood pressure, high-density lipoproteins, HbA1c), lifestyle (physical activity, diet), and SDOH (food security, household income, health insurance) information.RESULTSThe study included 8,014 individuals (55% non-Hispanic White, 18% non-Hispanic Black, 24% Hispanic, 3% other). The mean (SD) age was 60.8 (13.3) years, and 50% were female. Logistic regression revealed that non-Hispanic Black (odds ratio: 1.39, 95% CI 1.16-1.66) and Hispanic (1.31, 1.11-1.54) individuals had higher age-adjusted and sex-adjusted odds of PN than White individuals. Male individuals had higher age-adjusted and race-adjusted odds of PN than female individuals (0.55, 0.48-0.63). After adjusting for metabolic, lifestyle, and SDOH factors, we found that non-Hispanic Black individuals had similar odds of PN to White individuals (1.17, 0.93-1.46, p = 0.17) and male individuals (0.83, 0.66-1.05, p = 0.12) had similar odds of PN to female individuals. However, Hispanic individuals maintained a higher likelihood of PN (1.32, 1.07-1.63, p = 0.001) after adjusting for these comprehensive risk factors. Among individual risk factors, we found that age (1.05, 1.04-1.06), height (1.03, 1.02-1.05), HbA1c (1.13, 1.06-1.21), waist circumference (1.011, 1.005-1.017), and lack of health insurance (1.49, 1.16-1.92) were associated with PN. In stratified analyses, among Hispanic individuals, we found that the percentage of caloric intake from saturated fatty acids (1.06, 1.01-1.10) and food insecurity (1.48, 1.06-2.05) were associated with PN.DISCUSSIONWe found that PN risk factors likely explain higher PN prevalence in non-Hispanic Black individuals but not among Hispanic individuals. We also determined SDOH risk factors-including being uninsured, and, in Hispanic individuals, experiencing food insecurity-increased the odds of PN, indicating the need for screening, prevention, and treatment of PN in persons with SDOH risk factors.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"22 1","pages":"e213851"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Disease-Modifying Therapies in Patients With Late-Onset Multiple Sclerosis.","authors":"Camille Robin,Fabien Rollot,Mathilde Lefort,Romain Casey,Sandra Vukusic,Guillaume Mathey,Jonathan Ciron,Jerome De Seze,Bruno Stankoff,Elisabeth Maillart,Aurélie Ruet,Pierre M Labauge,Arnaud Kwiatkowski,Helene Zephir,Caroline Papeix,Gilles Defer,Christine Lebrun-Frenay,Thibault Moreau,David Axel Laplaud,Eric Berger,Pierre Clavelou,Eric Thouvenot,Olivier Heinzlef,Jean Pelletier,Olivier Casez,Bertrand Bourre,Abir Wahab,Laurent Magy,Solène Moulin,Jean-Philippe Camdessanche,Ines Doghri,Mariana Sarov,Karolina Hankiewicz,Corinne Pottier,Amélie Dos Santos,Eric Manchon,Maya Tchikviladze,Chantal Nifle,Anne Kerbrat,Gilles Edan,Emmanuelle Le Page,Laure Michel, ","doi":"10.1212/wnl.0000000000213744","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213744","url":null,"abstract":"BACKGROUND AND OBJECTIVESThe therapeutic strategy in patients with late-onset MS (LOMS) remains poorly defined. In this study, we aimed to evaluate both clinical and MRI outcomes between 2 cohorts of patients with relapsing-remitting LOMS treated or not yet treated.METHODSPatients with relapsing-remitting MS were included for the analysis if disease onset occurred after 55 years and if they had at least one follow-up visit. The primary outcome was time to first relapse between 2 matched groups of patients with LOMS (treated and not yet treated). Secondary outcomes were as follows: (1) time to first confirmed disability progression (CDP), (2) time to first progression independent of relapse activity (PIRA) event, (3) time to secondary progression (SPMS), (4) time to first MRI activity, and (5) serious infection incidence rates (IIRs). For the comparative analyses, we adopted a time-dependent propensity score matching approach.RESULTSA total of 881 patients fulfilled the inclusion criteria. The mean (SD) age at onset was 59.9 (4.43) years. After applying propensity score matching, 436 patients were matched. The mean (SD) follow-up duration was 5.2 (4.27) years in the treated group and 5.0 (3.86) years in the not-yet-treated group. Mean (SD) time to first relapse was significantly longer in the treated group compared with the not-yet-treated group (7.0 years [0.33] vs 5.4 years [0.33]; p = 0.001). Mean (SD) time to first MRI activity was significantly longer in the treated group (5.9 years [0.33] vs 5.0 years [0.33]; p = 0.049). However, the mean time to CDP, PIRA, or SPMS was not different between the 2 groups (difference = 0.32 years; p = 0.585 for CDP; difference = 0.40 years; p = 0.442 for PIRA; difference = -0.02 years; p = 0.952 for SPMS). No increase in serious IIRs was observed with an incidence rate ratio of 0.38 (95% CI 0.07-2.10, p = 0.265) in the never-treated group compared with the treated one.DISCUSSIONThis study demonstrates a beneficial effect of disease-modifying therapy (DMT) on disease activity in patients with LOMS but without significant impact on disability progression. Main limitations are linked to the challenge of data collection and to the baseline imbalances between the 2 groups.CLASSIFICATION OF EVIDENCEThis study provides Class III evidence that in patients with LOMS, treatment with DMTs is associated with a longer time to first relapse compared with those not treated with DMTs.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"2 1","pages":"e213744"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Antiseizure Medications Early in Pregnancy and the Risk of Major Malformations in the Newborn.","authors":"Sonia Hernandez-Diaz,Moira Quinn,Susan Conant,Amy Lyons,Hyun Paik,Jason Ward,Esther Bui,W Allen Hauser,Mark Yerby,Paula Emanuela Voinescu,Deborah G Hirtz,Frances A High,Lewis Ball Holmes","doi":"10.1212/wnl.0000000000213786","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213786","url":null,"abstract":"BACKGROUND AND OBJECTIVESMaternal use of first-generation antiseizure medications (ASMs), such as valproate and phenobarbital, increases the risk of congenital malformations in offspring. Second-generation ASMs, such as lamotrigine and levetiracetam, pose less risk to fetal development, although topiramate seems to increase the risk of oral clefts. Less is known about the safety of newer second-generation ASMs during pregnancy including oxcarbazepine, zonisamide, and lacosamide. The aim of this study was to quantify the relative risk of major malformations in offspring after maternal use of specific ASMs early in pregnancy, with special interest in second-generation ASMs.METHODSThe study population included pregnant women who enrolled in the North American Antiepileptic Drug Pregnancy Registry between 1997 and 2023. Data on ASM use and maternal characteristics were collected through phone interviews at enrollment, at 7 months of gestation, and within 3 months after delivery. Malformations were confirmed by medical records and adjudicated by a dysmorphologist. The risk of major malformations was estimated among infants exposed to specific ASMs in monotherapy during the first trimester of pregnancy. Risk ratios (RRs) and 95% CIs were estimated with logistic regression models.RESULTSA total of 7,311 participants taking an ASM as monotherapy during the first trimester were eligible for analysis. The mean age was 30 years. The risk of major malformations was 2.1% (52/2,461) for lamotrigine, 2.0% (26/1,283) for levetiracetam, 2.8% (32/1,132) for carbamazepine, 5.1% (26/510) for topiramate, 2.8% (12/423) for phenytoin, 9.2% (31/337) for valproate, 1.5% (5/327) for oxcarbazepine, 1.5% (4/270) for gabapentin, 1.3% (3/228) for zonisamide, 6.0% (12/200) for phenobarbital, 3.2% (2/62) for pregabalin, and 0% (0/88) for lacosamide. Compared with lamotrigine, the RR was 5.1 (95% CI 3.0-8.5) for valproate, 2.9 (1.4-5.8) for phenobarbital, and 2.2 (1.2-4.0) for topiramate. Topiramate was specifically associated with a higher risk of cleft lip.DISCUSSIONResults confirm the association between maternal use of valproate, phenobarbital, and topiramate early in pregnancy and a higher risk of major malformations in the infant compared with lamotrigine. However, they do not support meaningful risk elevation for levetiracetam, oxcarbazepine, gabapentin, or zonisamide. Relative risk estimates for lacosamide and pregabalin are still imprecise.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"43 1","pages":"e213786"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Multiple Sclerosis: Is Disease-Modifying Therapy Indicated?","authors":"Dennis Bourdette,Lindsey Wooliscroft","doi":"10.1212/wnl.0000000000213971","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213971","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"13 1","pages":"e213971"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Seizure-Related Impact Assessment Scale: A Novel Patient-Reported Outcome Measure for Epilepsy.","authors":"Emma Foster,Alison Conquest,Chris Ewart,John-Paul Nicolo,Genevieve Rayner,Toby T Winton-Brown,Terence J O'Brien,Patrick Kwan,Charles Malpas,Jacqueline French","doi":"10.1212/wnl.0000000000213900","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213900","url":null,"abstract":"BACKGROUND AND OBJECTIVESThere is a clear need in epilepsy clinical trials and practice for a measure that captures the trade-off between seizure and treatment-related adverse effects, which is reliable over time and across different treatment regimens. We aimed to create and validate the Seizure-Related Impact Assessment Scale (SERIAS) to fill this need.METHODSThis was a prospective longitudinal study of adults with epilepsy recruited from an Australian comprehensive epilepsy center. Participants completed SERIAS at baseline and 3 and 6 months later. SERIAS has 6 self-report items. Five items record the number of days per month that seizures or treatment-related adverse effects partially or fully affect work/home/school and family/social/nonwork activities. The final item is an epilepsy disability visual analog scale. SERIAS is scored by adding the days per month of disability, with scores ranging from 0 to 150 (higher scores indicate more disability). SERIAS was completed alongside 7 validated instruments measuring seizure-related and treatment-related adverse effects (Work and Social Adjustment Scale [WSAS], Liverpool Adverse Events Profile [LAEP]), mood disorders (Neurological Disorders Depression Inventory for Epilepsy [NDDI-E], Generalized Anxiety Disorder [GAD-7]), somatic symptoms (Somatic Symptom Scale [SSS-8]), and quality of life (Quality of Life in Epilepsy Inventory [QOLIE]-31, EuroQol 5 Dimensions [EQ-5D]). General linear mixed models were used to investigate the relationship between the SERIAS and other relevant clinical and psychometric data. Standardized model coefficients β are presented with 95% confidence intervals.RESULTSA total of 90 patients (64.4% female, mean age 43.1 years) completed baseline SERIAS. Most patients reported at least 1 day of disability (62%, median SERIAS score = 3, interquartile range = 18.3). Greater disability was negatively correlated with QOLIE-31 total score (β = -0.17, 95% CI -0.27 to -0.07) and positively correlated with scores on 5-level EQ-5D (β = 0.15, 95% CI 0.04-0.25), NDDI-E (β = 0.22, 95% CI 0.13-0.31), GAD-7 (β = 0.21, 95% CI 0.09-0.32), SSS8 (β = 0.29, 95% CI 0.17-0.41), LAEP (β = 0.29, 95% CI 0.20-0.39), WSAS seizure-related adverse events (β = 0.23, 95% CI 0.14-0.33), and WSAS treatment-related adverse events (β = 0.36, 95% CI 0.26-0.46). Higher seizure frequency was associated with higher SERIAS score (β = 0.07, 95% CI 0.03-0.11). Psychometric reliability for the SERIAS was acceptable (all coefficients >0.70) as was test-retest reliability (n = 35 patients, intraclass correlation coefficient = 0.72, 95% CI 0.51-0.85).DISCUSSIONSERIAS shows good psychometric reliability and strong test-retest stability. These findings suggest that SERIAS is a valid scale to measure epilepsy-related disability.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"7 1","pages":"e213900"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Meds Are Not Enough: The Need for Continued Prospective Antiseizure Medication Pregnancy Research.","authors":"Elizabeth E Gerard","doi":"10.1212/wnl.0000000000213959","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213959","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"1 1","pages":"e213959"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Video NeuroImage: Crossed Vertical Gaze Paresis: A Sign of a Supranuclear Lesion.","authors":"Sofia Mônaco Gama,Pedro Fraiman,Gabriel Lopes da Silva,Flavio Moura Rezende Filho","doi":"10.1212/wnl.0000000000213870","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213870","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"10 1","pages":"e213870"},"PeriodicalIF":9.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Is Time for Drug Repurposing in Parkinson Disease.","authors":"Carlo Colosimo,Luca Marsili","doi":"10.1212/wnl.0000000000213972","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213972","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"96 1","pages":"e213972"},"PeriodicalIF":9.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Medication Use and 8-Year Mortality Risk in Patients With Parkinson Disease: Drug-Wide Trial Emulation.","authors":"Julia A Tuominen,Trond Riise,Julia Romanowska,Mario H Flores-Torres,Marianna Cortese,Clemens R Scherzer,Kjetil Bjornevik,Jannicke Igland","doi":"10.1212/wnl.0000000000213783","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213783","url":null,"abstract":"BACKGROUND AND OBJECTIVESThere are currently no treatments that can halt or slow the progression of Parkinson disease (PD). The aim of this study was to identify new drug repurposing candidates for PD among existing prescription drugs that could be used to modify the disease course.METHODSThis nationwide observational cohort study (2004-2020) used Norwegian health registries and was conducted as a high-throughput drug screen using an emulated target trial design. All individuals who met our prescription-based classification criteria for PD, were older than 25 years at the time of diagnosis, and were not prescribed the target drug in the past 2 years were included. We emulated a target trial for any drug filled by a minimum of 100 individuals at any pharmacy in Norway, which amounted to a total of 219 drugs. Mortality was used as an outcome to indicate disease progression. We estimated the effect of drug initiation, an observational analog of the intention-to-treat effect, on the 8-year risk of death, comparing initiators of the target drug with initiators of drugs within the same Anatomical Therapeutic Chemical classification system level 1 group. Inverse probability of treatment weighting was used to adjust for potential confounders.RESULTSThe study included 14,289 individuals with PD (mean age 72 at diagnosis, 59% male) and identified 23 drugs associated with reduced mortality risk at 8 years. These drugs included ranitidine (histamine-2 blocker); pantoprazole and esomeprazole (proton pump inhibitors); losartan (angiotensin receptor blocker); atorvastatin (for high cholesterol); tadalafil (for erectile dysfunction); levothyroxine sodium (thyroid hormone); phenoxymethylpenicillin, erythromycin, and azithromycin (antibiotics); 4 nonsteroidal anti-inflammatory drugs; combined codeine/paracetamol and tramadol (opioid analgesics); zopiclone and melatonin (sleep aids); mianserin (antidepressant); mometasone (nasal corticosteroid); 2 opium-derived cough medicines; and dexamethasone (ophthalmologic corticosteroid).DISCUSSIONOur study identified several drugs with potential disease-modifying properties that could be candidates for future clinical trials. It highlights the potential of repurposing existing medications to advance drug development. While these findings are exploratory and, therefore, insufficient to justify immediate clinical application, they warrant further investigation and potential inclusion in clinical trials.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"36 1","pages":"e213783"},"PeriodicalIF":9.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Staging of H3 G34-Mutant Diffuse Hemispheric Glioma.","authors":"Kevin Akeret,Luis Padevit,Guido Reifenberger,Andreas von Deimling,Michael Weller,Emilie Le Rhun, ","doi":"10.1212/wnl.0000000000213861","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213861","url":null,"abstract":"OBJECTIVESH3 G34-mutant diffuse hemispheric gliomas are rare, aggressive primary brain tumors predominantly affecting young patients. We investigated the prognostic value of anatomic staging (AS)-a system previously validated in adult-type diffuse gliomas-in this molecularly distinct tumor type.METHODSPatients from an international cohort with H3 G34-mutant gliomas underwent AS based on pretreatment imaging, performed independently by 2 raters blinded to clinical outcomes. Inter-rater reliability was evaluated using Cohen kappa. Kaplan-Meier curves and Cox proportional hazards models-unadjusted and adjusted for sex, extent of resection, and O6-methylguanine DNA-methyltransferase (MGMT) status-were used to analyze overall survival across stages.RESULTSThirty-seven patients were included (median age 22 years; 54% female). Inter-rater reliability was high (weighted κ = 0.93, 95% CI 0.85-1.0). Median overall survival was 36 months for stage 1 (95% CI 16-67 months), 25 months for stage 2 (95% CI 8-41), and 9 months for stage 3 (95% CI 3-26). After adjustment for sex, extent of resection, and MGMT status, survival differences persisted (hazard ratio [HR]Stage 2 adjusted 2.25, 95% CI 0.67-7.5, p = 0.19; HRStage 3 adjusted 4.37, 95% CI 1.39-13.7, p = 0.01).DISCUSSIONAS is reproducible and prognostically relevant for H3 G34-mutant gliomas, providing insights into tumor spread. It may inform treatment decisions, but larger studies are needed to confirm its clinical utility.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"59 1","pages":"e213861"},"PeriodicalIF":9.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}