Stroke最新文献

{"title":"Early Recanalization After Tenecteplase or Alteplase in Distal and Medium Vessel Occlusion Strokes: An Observational Cohort Study.","authors":"Nicolas Chausson, Joseph Benzakoun, Sofia Vargas-Ibarra, Yann L'Hermitte, Wagih Ben Hassen, Didier Smadja, Guillaume Turc","doi":"10.1161/STROKEAHA.125.054734","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.054734","url":null,"abstract":"<p><strong>Background: </strong>Intravenous thrombolysis remains the standard treatment for distal and medium vessel occlusion (DMVO) strokes. However, unlike large vessel occlusions, whether tenecteplase achieves higher early successful recanalization rates than alteplase in DMVO strokes remains uncertain.</p><p><strong>Methods: </strong>This single-center observational cohort study included consecutive patients with magnetic resonance imaging (MRI)-confirmed DMVO stroke treated at Centre Hospitalier Sud-Francilien, France, according to an institutional thrombolysis protocol specifying alteplase (0.9 mg/kg, 2016-2018) or tenecteplase (0.25 mg/kg, 2018-2023), with follow-up MRI 1 to 2 hours after intravenous thrombolysis. Patients intended for endovascular thrombectomy or without diagnostic-quality follow-up MRI were excluded. Recanalization was blindly assessed using a modified Arterial Occlusion Lesion scale designed for MRI and DMVO. Early successful recanalization was defined as ≥50% recanalization on early follow-up MRI (grade ≥2b), and substantial early infarct growth, assessed using a semiautomatic segmentation technique, was defined as a ≥0.5 mL and ≥20% increase in lesion volume. Propensity-score weighting accounted for baseline imbalances, including age, sex, vascular risk factors, baseline National Institutes of Health Stroke Scale score, occlusion site, and time period (2020-2023 versus 2016-2019).</p><p><strong>Results: </strong>Of the 319 included patients, 159 were treated with tenecteplase and 160 with alteplase. Median baseline National Institutes of Health Stroke Scale was 3 (1-7) in the tenecteplase group versus 4 (1-7.5) in the alteplase group, while M2 occlusions accounted for 54.1% versus 43.8% of cases. Early successful recanalization, assessed at a median postintravenous thrombolysis time of 80 (70-94) minutes, occurred in 72 (45.3%) and 53 (33.1%) patients treated with tenecteplase and alteplase, respectively (propensity-score weighting-odds ratio, 1.59 [95% CI, 1.15-2.20]; <i>P</i>=0.005). Substantial early infarct growth was observed in 42 (26.8%) and 64 (40.5%) patients, respectively (propensity-score weighting-odds ratio, 0.49 [95% CI, 0.35-0.69]; <i>P</i><0.0001).</p><p><strong>Conclusions: </strong>Compared with alteplase, tenecteplase-treated patients with DMVO had higher early successful recanalization and a lower risk of substantial early infarct growth, supporting its preferential use in this setting.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT05635786.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":11.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921106","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":"Arterial Spin Labeling Hemodynamic Indices Relate to Cognitive and Small Vessel Disease Trajectories Over 11 Years.","authors":"W Hudson Robb, Ava M Santner, Panpan Zhang, Darcie S Kim, T Bryan Jackson, Niranjana Shashikumar, Kimberly R Pechman, Yukti Vyas, Dandan Liu, L Taylor Davis, Timothy J Hohman, Angela L Jefferson","doi":"10.1161/STROKEAHA.125.054879","DOIUrl":"10.1161/STROKEAHA.125.054879","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamic insufficiency may contribute to the development of neuroimaging signs of cerebral small vessel disease (SVD). The arterial spin labeling (ASL) spatial coefficient of variation (ASL-sCoV) is a proxy marker of arterial transit time and may better capture SVD-related hemodynamic disturbances compared with ASL-derived cerebral blood flow. We investigated ASL-derived hemodynamic indices in relation to cognition and neuroimaging markers of SVD over an 11-year follow-up period.</p><p><strong>Methods: </strong>Participants without dementia or stroke were enrolled in the Vanderbilt Memory and Aging Project, a longitudinal observational cohort study in Nashville, TN. Participants underwent serial multimodal 3T brain magnetic resonance imaging to quantify SVD burden and neuropsychological assessment from 2012 to 2024 (4.9±3.5 years mean follow-up). Pseudo-continuous ASL assessed cerebral blood flow and ASL-sCoV in total gray matter. Baseline ASL-sCoV and cerebral blood flow were individually related to the cross-sectional burden and longitudinal trajectory of each SVD neuroimaging marker (white matter hyperintensities, enlarged perivascular spaces, cerebral microbleeds, and lacunar infarcts) and cognitive performances using linear and linear mixed-effects regression models. Models were adjusted for demographics, cognitive status, Framingham Stroke Risk Profile (minus age), <i>apolipoprotein E</i>-ε4 status, intracranial volume (for SVD outcomes), and follow-up time (for longitudinal models).</p><p><strong>Results: </strong>Among participants (n=667, 68±9 years, 18% mild cognitive impairment, 51% female), higher ASL-sCoV was cross-sectionally associated with SVD markers, including white matter hyperintensities and enlarged perivascular spaces (<i>p</i>_FDR-values<0.006). Higher baseline ASL-sCoV was associated with a faster longitudinal increase in the burden of white matter hyperintensities (<i>p</i>_FDR=0.03) and accelerated decline in executive function, information processing, language, and visuospatial performances (<i>P</i><0.05). Gray matter cerebral blood flow was not associated with SVD burden or cognition cross-sectionally (<i>p</i>_FDR-values>0.05) or longitudinally (<i>p</i>_FDR-values>0.06).</p><p><strong>Conclusions: </strong>ASL-sCoV may serve as an important hemodynamic measure for identifying perfusion deficits tied to SVD burden and progression. Readily derived from existing ASL data sets, ASL-sCoV could provide substantial insight into the longitudinal clinical consequences of SVD.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":11.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility-Weighted Analysis of the Modified Rankin Scale: An Updated Review of Methods, Challenges, and Future Directions.","authors":"Paul M Wechsler, Joseph P Broderick, Jeffrey L Saver, Eva A Mistry","doi":"10.1161/STROKEAHA.126.056638","DOIUrl":"https://doi.org/10.1161/STROKEAHA.126.056638","url":null,"abstract":"<p><p>The utility-weighted approach to analyzing the modified Rankin Scale (mRS) is increasingly being utilized in acute stroke clinical trials. This analytic approach assigns a patient-centered utility weight-the desirability or value of a health state to patients-to each level of the mRS. The utility-weighted-mRS analysis converts the mRS from a scale reflecting only the rank order of functional outcome after stroke into one that quantifies the value of each poststroke mRS health state from patients' perspectives. The ability of the utility-weighted-mRS analysis to capture the unequal difference in patient health-related quality of life between each level of the mRS makes it an appealing patient-centered end point for acute stroke clinical trials. However, several concerns have historically raised skepticism regarding its value as a trial end point. Unfamiliarity with how utility weights are derived and used poses challenges to its use for shared decision-making between patients and clinicians. There are valid concerns that social, geographic, and demographic factors that differ between countries influence the mRS utility weights, so that use of uniform weights across all settings mildly reduces the precision of utility quantification, particularly in multinational stroke clinical trials. This narrative review aims to provide the clinical and research stroke community with a practical overview of key methodology in the utility-weighted-mRS analysis to aid in its interpretation, considers the advantages and challenges of using the utility-weighted-mRS analysis, and suggests future areas of study.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":11.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892349","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":"Social Determinants of Health in Early to Mid-Adulthood and Risk of Early-Onset Stroke.","authors":"Nathaniel Fleming, Christina Dintica, Alexander Arynchyn, Donald M Lloyd-Jones, Daniel Lackland, Kristine Yaffe","doi":"10.1161/STROKEAHA.126.055839","DOIUrl":"10.1161/STROKEAHA.126.055839","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing incidence of stroke among younger adults, the associations of social determinants of health (SDOH) and stroke among younger adults are not well known. This study investigates the associations between SDOH from early adulthood and stroke in a prospective longitudinal cohort.</p><p><strong>Methods: </strong>We studied participants enrolled in the CARDIA study (Coronary Artery Risk Development in Young Adults). Participants aged 18 to 30 years were enrolled in 1985 and followed through 2022. We investigated longitudinal, time-varying measures of SDOH classified into 5 distinct domains: economic (6 measures), education (1 measure), healthcare (4 measures), neighborhood (2 measures), and social/community (5 measures). The outcome was incident stroke or transient ischemic attack. We evaluated associations between individual SDOH and stroke using unadjusted Cox models. We then evaluated whether a greater cumulative number of adverse SDOH domains (each represented by 1 exposure selected by empirical techniques) was associated with stroke risk after adjustment for demographics.</p><p><strong>Results: </strong>Among the 5114 participants (54.5% were female; baseline age, 25 years; and median follow-up, 37.9 years), 146 individuals experienced stroke or transient ischemic attack, all of which occurred <65 years. Household income (hazard ratio [HR], 1.24 per $10 000 lower [95% CI, 1.11-1.39]), education (HR, 0.93 per greater year [95% CI, 0.87-0.99]), neighborhood deprivation (HR, 1.21 [95% CI, 1.02-1.43]), and lacking health insurance (HR, 1.49 [95% CI, 1.05-2.11]) were associated with stroke risk. Those experiencing 2 adverse SDOH domains (HR, 1.65 [95% CI, 0.91-2.97]) or <u>≥</u>3 adverse domains (HR, 2.00 [95% CI, 1.09-3.66]) had progressively higher stroke risk (<i>P</i>_trend=0.005). In interaction analyses, the association between income and stroke appeared stronger in Black participants (<i>P</i>_interaction=0.02) and women (<i>P</i>_interaction=0.02).</p><p><strong>Conclusions: </strong>In this young cohort followed through midlife, SDOH spanning several domains were associated with stroke risk. We also observed a dose-dependent response with the number of adverse SDOH domains experienced. Our results suggest that SDOH experienced throughout adulthood are relevant to future stroke risk.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":11.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892433","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":"Brain Perivascular Space Morphometry Reflects Shared Familial Microvascular Architecture and Neuropsychiatric Influences.","authors":"Alexandra Morozova, Maria Del C Valdés Hernández, Roberto Duarte Coello, Heather C Whalley, Andrew McIntosh, Anca-Larisa Sandu Giuraniuc, Gordon D Waiter, Christopher J McNeil, J Douglas Steele, Jennifer A Macfarlane, Alison D Murray, Joanna M Wardlaw","doi":"10.1161/STROKEAHA.126.055378","DOIUrl":"10.1161/STROKEAHA.126.055378","url":null,"abstract":"<p><strong>Background: </strong>Brain perivascular spaces (PVS) are emerging magnetic resonance imaging markers of microvascular function and waste metabolite clearance. Although PVS enlargement has been linked to aging and vascular risk, it remains unclear whether PVS morphometry reflects shared familial microvascular characteristics and how these are shaped by individual vascular, physiological, and neuropsychiatric factors. We investigated whether PVS morphometry captures these familial characteristics in addition to individual determinants.</p><p><strong>Methods: </strong>We analyzed 1183 participants from the Stratifying Depression and Resilience Longitudinally family-based cohort, including 324 individuals with first-degree relatives. Automated magnetic resonance imaging segmentation quantified PVS volume, count, density, and median length in the centrum semiovale and basal ganglia. Linear mixed-effects models assessed associations with age, hypertension, hair cortisol, depressive symptom scores, and hand grip strength while accounting for familial clustering.</p><p><strong>Results: </strong>In 1050 individuals (59.5% female; mean age, 59.3±10.1 years), PVS burden increased with age (PVSvolume%ROI, β=0.18 [95% CI, 0.11-0.26]; <i>P</i><0.0001), current depressive symptoms across both regions (PVS density: centrum semiovale, β=0.092 [0.023-0.16]; <i>P</i>=0.009; BG, β=0.11 [0.043-0.18]; <i>P</i>=0.002; largely robust to false discovery rate correction), and with higher hair cortisol (PVS count β=0.08 [0.003-0.15]; <i>P</i>=0.041; borderline after false discovery rate correction) and weaker grip strength (PVSvolume%ROI β=-0.09 [-0.16 to -0.02]; <i>P</i>=0.013), in the centrum semiovale. Familial clustering was significant for PVS volume (β=0.22 [0.096-0.52]; <i>P</i>=0.013) and median length (β=0.28 [0.16-0.49]; <i>P</i>=0.0003), independent of other factors.</p><p><strong>Conclusions: </strong>PVS morphometry reflects shared familial microvascular phenotypes and neuropsychiatric influences beyond hypertension, highlighting both familial and individual determinants of PVS burden and morphology. These findings support PVS morphometry as a neuroimaging marker of cerebral microvascular health.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2768-2779"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion MRI Identifies a Prolonged Pre-WMH Phase in Cerebral Small Vessel Disease.","authors":"Prashanthi Vemuri, Mingzhao Hu, Emily S Lundt, Michael G Kamykowski, Robert I Reid, Terry M Therneau, Sheelakumari Raghavan, Petrice M Cogswell, Michael E Griswold, B Gwen Windham, Clifford R Jack, Ronald C Petersen, Jonathan Graff-Radford","doi":"10.1161/STROKEAHA.126.055797","DOIUrl":"10.1161/STROKEAHA.126.055797","url":null,"abstract":"<p><strong>Background: </strong>White matter hyperintensities (WMH) are widely used to assess cerebral small vessel disease but reflect late-stage injury. Diffusion magnetic resonance imaging (MRI) biomarkers have been proposed to capture earlier small vessel disease-related microstructural damage but their temporal progression relative to WMH and risk factors associated with progression remain unexplored.</p><p><strong>Methods: </strong>We identified 2077 participants from the population-based cohort study of the Mayo Clinic Study of Aging in Olmsted County, Minnesota (aged 50-101 years) collected between 05/2005 and 09/2024 with longitudinal neuroimaging. Using multioutput nonlinear mixed-effects models in those with at least 2 fluid-attenuated inversion recovery-MRI and diffusion MRI scans, we characterized the temporal progression of WMH and 4 diffusion MRI biomarkers: fractional anisotropy of the genu of the corpus callosum, peak width of skeletonized mean diffusivity, free water, and Arteriolosclerosis-score, which were automatically estimated. Models incorporated participant-specific time shifts, correlations between biomarkers, and effects of risk factors (sex, education, <i>APOE ε4</i> status, cardiometabolic conditions).</p><p><strong>Results: </strong>The study population had a mean age of 78 years, 47% were women, 28% were <i>APOE ε4</i> allele carriers, and 80% were cognitively unimpaired, with an average follow-up of 5.2 years (SD, 4.3 years) for fluid-attenuated inversion recovery-MRI and 4.3 years (SD, 3.9 years) for diffusion MRI. Arteriolosclerosis-score, fractional anisotropy of the genu of the corpus callosum, free water, and peak width of skeletonized mean diffusivity became abnormal in 50% of the study population 16, 12, 10, and 7 years before WMH become abnormal (half-width of CI <1 year), respectively. Global markers (Arteriolosclerosis-score, free water, peak width of skeletonized mean diffusivity, and WMH) were correlated, indicating shared substrates of widespread white matter injury. Fractional anisotropy of the genu of the corpus callosum, a vascular risk microstructural injury biomarker, was weakly coupled with WMH and had an earlier but more linear worsening across adulthood. Cardiometabolic conditions predicted earlier worsening of all biomarkers. Female participants showed earlier WMH, fractional anisotropy of the genu of the corpus callosum, and Arteriolosclerosis-score abnormalities, whereas male participants exhibited earlier peak width of skeletonized mean diffusivity and free water abnormalities.</p><p><strong>Conclusions: </strong>Diffusion MRI biomarkers were abnormal at least a decade before WMH become abnormal in the population, revealing a prolonged phase of early small vessel disease and highlighting their potential for small vessel disease prevention.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2789-2800"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Stroke 2026: Health Policy and Health Services Delivery.","authors":"Dominique A Cadilhac, Janet Prvu Bettger","doi":"10.1161/STROKEAHA.126.054531","DOIUrl":"https://doi.org/10.1161/STROKEAHA.126.054531","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"57 9","pages":"2909-2912"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814081","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":"Balloon Angioplasty by Prior Stroke History in Intracranial Artery Stenosis: A Post Hoc Analysis of the BASIS Trial.","authors":"Fangguang Chen, Ming Yang, Dapeng Sun, Longhui Zhang, Yiyang Sun, Yuesong Pan, Hongyi Yan, Ziqian Xu, Feng Gao, Ning Ma, Dapeng Mo, Yilong Wang, Zhongrong Miao, Xuan Sun","doi":"10.1161/STROKEAHA.126.055945","DOIUrl":"https://doi.org/10.1161/STROKEAHA.126.055945","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"57 9","pages":"e468-e470"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814099","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":"Response to Request for Modification of the 2026 AHA/ASA Acute Ischemic Stroke Guidelines: Endovascular Thrombectomy Imaging Selection in the 6- to 24-Hour Window.","authors":"Nestor R Gonzalez, Shyam Prabhakaran, Kori S Zachrison, Enrique C Leira, Mona N Bahouth, Joseph P Broderick","doi":"10.1161/STROKEAHA.126.056726","DOIUrl":"10.1161/STROKEAHA.126.056726","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2939-2948"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable Low-Field MRI Across the Stroke Continuum: From Hyperacute Care to Brain Health.","authors":"W Taylor Kimberly, Kevin N Sheth","doi":"10.1161/STROKEAHA.126.056840","DOIUrl":"https://doi.org/10.1161/STROKEAHA.126.056840","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"57 9","pages":"2574-2576"},"PeriodicalIF":11.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814071","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}