Neuropediatrics最新文献

{"title":"End-of-Life Pathways and Limitation of Life-Sustaining Treatment in Children with Pre-existing Neurological Disorders: A 10-Year Retrospective Cohort Study.","authors":"Raquel Carvalho de Sousa, Mariana Sofia, Maria Filipa Torres, Cláudia Melo","doi":"10.1055/a-2987-4628","DOIUrl":"https://doi.org/10.1055/a-2987-4628","url":null,"abstract":"<p><strong>Background and objective: </strong>Limitation of life-sustaining treatment (LSTL) is an important component of pediatric end-of-life care, but its use in children with pre-existing neurologic disorders remains insufficiently described. We aimed to characterize end-of-life pathways, LSTL practices, and decision-making processes in this population.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study of children with pre-existing neurologic disorders who died in a tertiary pediatric hospital between 2015 and 2024. Clinical characteristics and end-of-life care were compared between children with and without LSTL preceding death.</p><p><strong>Results: </strong>Of 37 included children, LSTL preceded death in 24/37; 8/37 died after brain death and 5/37 after unsuccessful resuscitation. Compared with children without LSTL, those with LSTL were less often admitted for acute neurological conditions (2/24 vs. 6/13, p = 0.013) or receiving invasive mechanical ventilation at death (9/24 vs. 11/13, p = 0.014), and more often died on the pediatric ward (15/24 vs. 0/13, p < 0.001) or had received pediatric palliative care (7/24 vs. 0/13, p = 0.038). Among children with LSTL, most decisions were documented during clinical stability (15/24), involving a median of four physicians; a do-not-resuscitate order was documented in 16/24 cases.</p><p><strong>Conclusions: </strong>In this cohort, LSTL was the most frequent end-of-life pathway among children with pre-existing neurologic disorders. Decisions were often documented before terminal deterioration and were usually multidisciplinary. These findings suggest that earlier advance care planning, structured, individualized documentation, and closer integration between pediatric neurology and pediatric palliative care may contribute to improving the quality and consistency of end-of-life care.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245482","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":"Impact of etiology and lead time to treatment with first-line agents on outcome of infantile epileptic spasms syndrome-A retrospective cohort from LMIC.","authors":"Shravani Gk, Bidisha Banerjee, Ullas V Acharya, Mitesh Shetty","doi":"10.1055/a-2987-4550","DOIUrl":"https://doi.org/10.1055/a-2987-4550","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the etiological spectrum, safety and effectiveness of first-line agents and developmental outcomes of children with Infantile Epileptic Spasms Syndrome (IESS) managed at a tertiary-care hospital in South India, focusing on the influence of lead time to treatment.</p><p><strong>Methods: </strong>This retrospective cohort study included 65 children diagnosed with IESS between 2020 and 2025. Lead time to treatment was categorized as ≤1 week, 1-2, 3-8, and >8 weeks. First-line therapies included high-dose oral corticosteroids, vigabatrin, or sequential therapy. Treatment response was assessed at one and three months and developmental outcomes at follow-up.</p><p><strong>Results: </strong>The median age at onset of spasms was 6 months (IQR 5,8) and the median treatment lag 4 weeks (IQR 1,12) with only 26% treated within the first week. Structural-acquired etiologies predominated (36/65; 55.3%), commonly periventricular leukomalacia (24.6%) and neonatal hypoglycaemic brain injury (13.8%). Spasm cessation occurred in 62% at one month and was sustained in 55.4% at three months, with a relapse rate of 15.4%. High-dose oral corticosteroids achieved a significantly higher one-month response than vigabatrin or sequential therapy (p = 0.006). Earlier treatment showed numerically better responses without statistical significance. Adverse effects occurred in 48%, most commonly irritability (64.5%) and weight gain (22.5%). At a mean follow-up of 19.4 months, approximately one-third of children achieved normal or borderline developmental outcomes.</p><p><strong>Conclusion: </strong>Structural-acquired etiologies predominated, and lead time did not significantly influence treatment response. Our findings support that high-dose oral corticosteroids appear to be an effective, practical, and reasonably safe first-line therapy for IESS in resource-limited settings.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245546","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":"Consensus on the use of intrathecal gene therapy for spinal muscular atrophy.","authors":"Astrid Blaschek, Ulrike Schara-Schmidt, Susanne Petri, Maggie Christine Walter, Claudia Weiß, Katharina Vill, Matthias Baumann, Günther Bernert, Marina Flotats Bastardas, Maja Von Der Hagen, Jessika Johannsen, Cornelia Köhler, Georg M M Stettner, Janbernd Kirschner, Astrid Pechmann, Andreas Hahn, Markus Weiler, Tim Hagenacker, Andreas Ziegler","doi":"10.1055/a-2976-6524","DOIUrl":"https://doi.org/10.1055/a-2976-6524","url":null,"abstract":"<p><strong>Background: </strong>Intrathecal (IT) delivery of gene therapy is an emerging strategy for Spinal Muscular Atrophy (SMA), aiming to enhance central nervous system targeting while potentially reducing systemic exposure. The new administration route of Onasemnogene abeparvovec is associated with a distinct safety profile, including dorsal root ganglia toxicity, and requires structured monitoring beyond existing intravenous guidelines, including planning for long-term multidisciplinary follow-up in pediatric and adult care as well as structured transition protocols.</p><p><strong>Methods: </strong>We expanded the existing intravenous monitoring guideline by incorporating surveillance for potential dorsal root ganglia-related adverse effects. The protocol integrates clinical, laboratory, electrophysiological, imaging, and long-term follow-up recommendations.</p><p><strong>Results: </strong>The protocol defines pre-treatment assessment, peri-procedural management, and longitudinal follow-up in both pediatric and adult care settings, with emphasis on proactive evaluation of dorsal root ganglia function and structured transition of adolescents treated before adulthood to specialized multidisciplinary adult neurology services.</p><p><strong>Conclusions: </strong>A structured, multimodal monitoring approach-including dorsal root ganglia surveillance, multidisciplinary long-term follow-up, and coordinated transition from pediatric to adult care-is essential for the safe implementation of intrathecal Onasemnogene abeparvovec in SMA.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183496","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":"Sleep Quality among Family Caregivers of Children with Duchenne Muscular Dystrophy.","authors":"Muhammed Mustafa Uzan, Gamze Sarıkaya Uzan, Gizem Doğan, Yasemin Kılıç Öztürk","doi":"10.1055/a-2965-5652","DOIUrl":"10.1055/a-2965-5652","url":null,"abstract":"<p><strong>Background: </strong>Duchenne and Becker muscular dystrophies (DMD/BMD) are progressive neuromuscular disorders typically presenting in childhood. Caring for children with these conditions imposes a substantial emotional and physical burden on parents. This study aimed to compare sleep quality and daytime sleepiness between caregivers of children with DMD who were followed at a specialized pediatric neuromuscular center and caregivers of healthy peers.</p><p><strong>Methods: </strong>The study included mothers of patients diagnosed with DMD who had no known psychiatric or organic disorders. Participants were recruited from a single neuromuscular center between March and May 2025. Sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS).</p><p><strong>Results: </strong>Statistically significant differences were observed between mothers of children with DMD and the control group regarding ESS scores, subjective sleep quality, daytime functioning, and total PSQI scores. Interestingly, mothers of children with DMD had lower ESS scores (4.35 ± 3.903) compared with the control group (<i>p</i> = 0.034). A moderately significant positive correlation was identified between ESS scores and total PSQI scores (<i>r</i> = 0.491, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our findings revealed that the sleep quality of parents was better than anticipated. This suggests that specialized neuromuscular disease centers may positively impact the mental health and sleep hygiene of families. A multidisciplinary approach appears to support the psychological well-being and, indirectly, the sleep quality of parents managing chronic neuromuscular disorders.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025493","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":"Electrical Stimulation Therapy in Children with Obstetric Brachial Plexus Injury: A Systematic Review.","authors":"Lorin Valentijn Rompen, Alisa M Gschaidmeier, Céline N de Araujo, Miriam von Gunten, Sebastian Grunt","doi":"10.1055/a-2944-5525","DOIUrl":"https://doi.org/10.1055/a-2944-5525","url":null,"abstract":"<p><p>To provide an evidence-based review of the effects of electrical stimulation (ES) in children with obstetric brachial plexus injury (OBPI).A systematic literature search and review was performed using Medline, Embase, PEDro, and manual citation searching. Studies using ES applied to the skin resulting in muscle contraction in children (0-18 years) with OBPI were included. Quality assessment was performed using the Cochrane Collaboration Risk of Bias tool and the National Institute of Health Quality Assessment Tool. Outcomes were reported as range of motion, active movement scale, Mallet grading system, and side effects.Ten studies with a total of 388 participants were included: Five randomized controlled trials, three prospective interventional studies, and two retrospective studies. In most of them, ES was combined with conventional physiotherapy. No side effects were reported, and ES was well adhered. Improvements in at least one outcome measure were reported across the included studies following ES therapy. However, substantial heterogeneity existed regarding study design, ES application protocols, and reported outcomes.ES is well tolerated in children with OBPI. It may have a positive effect as part of a rehabilitation program, especially in combination with physiotherapy.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920296","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":"Deep Intronic NPC1 Variants in Niemann-Pick Disease Type C: A Pediatric Case Report and Systematic Review.","authors":"Ayca Burcu Kahraman, Ayberk Zengin, Kubra Yuksel-Bican, Bora Ergin, Murat Oktem, Yilmaz Yildiz, Goknur Haliloglu","doi":"10.1055/a-2903-9323","DOIUrl":"10.1055/a-2903-9323","url":null,"abstract":"<p><strong>Abstract: </strong>We report a 16-year-old girl with progressive ataxia, gaze palsy, and psychotic symptoms suggestive of Niemann-Pick disease type C (NPC). Despite strong clinical and biochemical evidence, including elevated <i>N</i>-palmitoyl-<i>O</i>-phosphocholine-serine (PPCS or lysosphingomyelin-509 [lyso-SM-509]), conventional genetic testing was inconclusive. RNA sequencing of fibroblasts revealed a homozygous <i>NPC1</i> intronic variant (c.3246-25A > G) causing aberrant splicing. Miglustat was initiated, leading to clinical stabilization. A systematic literature review identified 12 patients with intronic splice-altering variants located outside the canonical splice donor and acceptor regions, including variants situated more than 20 bp from exon-intron boundaries, predominantly affecting <i>NPC1.</i> Most patients presented with juvenile- or adult-onset disease and showed heterogeneous biomarker profiles. This case highlights the diagnostic utility of RNA sequencing in unsolved NPC cases and emphasizes its role in uncovering cryptic pathogenic variants, enabling timely diagnosis and treatment. Intronic variants should be considered in genetically elusive but clinically compatible NPC presentations.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":"293-299"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412383","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":"Prolonged Episodes of Paroxysmal Exertion-Induced Dystonia in Glut1 Deficiency Syndrome.","authors":"Joerg Klepper, Lucia Kiesel, Eva Runkel","doi":"10.1055/a-2883-4228","DOIUrl":"10.1055/a-2883-4228","url":null,"abstract":"<p><strong>Abstract: </strong>Glucose transporter type I (Glut1) deficiency syndrome (Glut1DS) is associated with paroxysmal exertion-induced dystonia (PED). Episodes are published as brief, lasting 20 to 30 minutes. Increasingly, Glut1DS patients report prolonged PED of more than 1 hour duration. In a cohort of 60 Glut1DS patients seen in our institution within a 4-year period, a total of 26/60 patients (43%) on ketogenic dietary therapy (KDT) experienced PED. In 18/26 patients (30%), episodes lasted less than 1 hour as previously described. In 8/26 patients (13%), prolonged episodes lasted more than 1 hour up to 1 day despite adequate dietary treatment. We conclude that PED is common in Glut1DS starting in late childhood despite adequate treatment with KDT. Prolonged PED in Glut1DS occurs in a subset of patients, also unresponsive to KDT, and represents a substantial burden to patients and families.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":"286-288"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Epileptic Spasms with Perampanel in a Patient with Menkes Disease Caused by a Novel Splice Variant in Intron of ATP7A.","authors":"Hiroaki Yoshida, Hidehito Kondo, Naoko Yano, Takeshi Yoshida","doi":"10.1055/a-2883-3021","DOIUrl":"10.1055/a-2883-3021","url":null,"abstract":"<p><strong>Abstract: </strong>Genetic variants in <i>ATP7A</i> are associated with a spectrum of X-linked copper metabolism disorders. Menkes disease (MD) is the most severe form of <i>ATP7A</i>-related disorders, characterized by severe central nervous system degeneration and connective tissue abnormalities. Intractable epilepsy is a hallmark of MD, typically progressing through epileptic spasms resistant to antiseizure drugs. Here, we report a severe case of MD with a novel splice variant (c.2782-3T > G) that was successfully treated with perampanel.</p><p><strong>Abstract: </strong>The patient developed epileptic spasms during early infancy and his initial electroencephalography revealed hypsarrhythmia. As his seizures were refractory to many antiseizure drugs and thyrotropin-releasing hormone therapy, he underwent adrenocorticotropic hormone therapy; however, this treatment was ineffective and caused various side effects. Eventually, perampanel was initiated, resulting in the cessation of seizures and improvement in electroencephalography findings.</p><p><strong>Abstract: </strong>This is the first reported case of MD successfully treated with perampanel, suggesting that perampanel may be a potential therapeutic option for intractable epilepsy with MD. Splice-site and intronic variants reportedly are more prevalent in milder forms of <i>ATP7A</i>-related disorders. The novel splice variant identified in the present case expands the understanding of intronic variation in <i>ATP7A</i>-related disorders.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":"289-292"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055993","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":"Gait Variability in Children with Periventricular Leukomalacia and Perinatal Stroke: A Comparison of Between-Subject Variability.","authors":"Nathalie Alexander, Melissa Köckemann, Christoph Tobias Kuenzle, Eugen Boltshauser, Stephan Waelti, Philip Julian Broser","doi":"10.1055/a-2877-3483","DOIUrl":"10.1055/a-2877-3483","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to (1) compare gait patterns between children with periventricular leukomalacia (PVL) and those with perinatal stroke and (2) assess between-subject gait variability within each group to quantify differences in the heterogeneity of gait patterns associated with distinct brain lesion types.</p><p><strong>Methods: </strong>A total of 43 children with cerebral palsy (CP) (32 PVL, 11 perinatal stroke) underwent three-dimensional gait analysis. Kinematic waveforms of the more affected leg and temporospatial gait parameters were compared between groups. Furthermore, between-subject gait variability in gait kinematics was evaluated. Differences in discrete kinematic parameters were assessed with Levene's tests. Dynamic time warping (DTW) quantified deviations from group mean trajectories, and principal component analysis (PCA) evaluated the number of components required to explain cumulative variance in gait patterns.</p><p><strong>Results: </strong>Children with PVL and stroke did not differ significantly in temporospatial gait parameters or overall kinematic profiles, except for greater hip adduction during mid-stance in PVL. However, gait variability was consistently higher in the PVL group across analytical methods. PVL was associated with greater variability in knee flexion at initial contact (<i>p</i> = 0.040) and a trend during swing (<i>p</i> = 0.069). DTW distances were larger for PVL in sagittal knee kinematics (<i>p</i> = 0.002), and PCA indicated that more components were needed to explain 90% of variance.</p><p><strong>Conclusion: </strong>Children with PVL exhibited greater between-subject gait variability than those with stroke, reflecting the diffuse nature of white matter injury. These findings highlight the importance of considering lesion type and gait variability when designing individualized rehabilitation strategies for children with CP.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":"249-257"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176267","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":"Primary Headache in Children: Clinical Characteristics and Impact on School Functioning in a Low-Resource Country.","authors":"Amal Abu Libdeh, Lara Alsubehat, Nada Tabbalat, Shahed Mraish, Noura Al-Nawaiseh, Nadine Arabiyat, Mustafa Elayyan, Mohammad Al-Daraghmeh, Hani Hussein, Mohammad Deameh, Lina Alshadfan, Amira Masri","doi":"10.1055/a-2886-4833","DOIUrl":"10.1055/a-2886-4833","url":null,"abstract":"<p><strong>Background: </strong>Primary headaches in children impair daily functioning, yet data from Jordan, particularly regarding their effect on school functioning, have not been systematically evaluated.</p><p><strong>Objective: </strong>The objective of this study is to assess the clinical characteristics of pediatric primary headaches in central Jordan and their association with school functioning.</p><p><strong>Methods: </strong>A cross-sectional study included children aged 5 to 18 years diagnosed with primary headaches at three public hospitals. Data were collected using a structured, culturally adapted questionnaire incorporating items from the validated Arabic PedsQL 4.0 school-functioning scale. Descriptive, univariable, and multivariable analyses were performed to identify factors associated with impaired school functioning.</p><p><strong>Results: </strong>A total of 147 children were included (51% male; 61.2% aged 10-14 years). Migraine was most common (60.5%), followed by tension-type headache (23.8%). Common triggers included stress, noise, and sleep disturbance. Unfavorable lifestyle factors-increased screen time, skipped meals, low hydration, and limited physical activity-were prevalent. More than 92% of participants had impairment in at least one school-functioning domain. Poor academic performance and lower parental education were significantly associated with lower scores. In multivariable analysis, poorer academic performance and lower paternal education remained independently associated with worse school-functioning scores, whereas headache type and frequency were not significant predictors. Most patients used simple analgesics (paracetamol in 93%), whereas migraine-specific rescue medications and preventive therapies were rarely used.</p><p><strong>Conclusion: </strong>Primary headaches in children are associated with substantial impairment in school functioning. Educational and family-related factors appear more influential than headache-specific variables. Addressing modifiable lifestyle and contextual factors may improve outcomes.</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":"280-285"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412361","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}