Stroke Research and Treatment最新文献

{"title":"The Severity of Intracranial Hemorrhages Measured by Free Hemoglobin in the Brain Depends on the Anticoagulant Class: Experimental Data.","authors":"Kyle M Ware,&nbsp;Douglas L Feinstein,&nbsp;Israel Rubinstein,&nbsp;Prudhvi Battula,&nbsp;Jose Otero,&nbsp;Lee Hebert,&nbsp;Tzu-Fei Wang,&nbsp;Alexandra Ivanova,&nbsp;Shweta Chaudhary,&nbsp;Jessica Hemminger,&nbsp;Sergey V Brodsky","doi":"10.1155/2017/6516401","DOIUrl":"https://doi.org/10.1155/2017/6516401","url":null,"abstract":"<p><p><i>Background and Purpose.</i> Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. <i>Methods.</i> Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor). Brain hemorrhages were assessed by the free hemoglobin concentration in the brain parenchyma. <i>Results.</i> Vitamin K antagonists (warfarin and brodifacoum) significantly increased free hemoglobin in the brain. Among direct oral anticoagulants, thrombin inhibitor dabigatran also significantly increased free hemoglobin in the brain, whereas treatment with factor Xa inhibitor rivaroxaban did not have significant effect on the free hemoglobin concentration. <i>Conclusions</i>. Our data indicates that the severity of brain hemorrhages depends on the anticoagulant class and it is more pronounced with vitamin K antagonists.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"6516401"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/6516401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35412945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Uric Acid Is Associated with Poor Outcome in Black Africans in the Acute Phase of Stroke.","authors":"Yacouba N Mapoure,&nbsp;Chia Mark Ayeah,&nbsp;M S Doualla,&nbsp;H Ba,&nbsp;Hugo B Mbatchou Ngahane,&nbsp;Salomon Mbahe,&nbsp;Henry N Luma","doi":"10.1155/2017/1935136","DOIUrl":"https://doi.org/10.1155/2017/1935136","url":null,"abstract":"<p><strong>Background: </strong>Prognostic significance of serum uric acid (SUA) in acute stroke still remains controversial.</p><p><strong>Objectives: </strong>To determine the prevalence of hyperuricemia and its association with outcome of stroke patients in the Douala General Hospital (DGH).</p><p><strong>Methods: </strong>This was a hospital based prospective cohort study which included acute stroke patients with baseline SUA levels and 3-month poststroke follow-up data. Associations between high SUA levels and stroke outcomes were analyzed using multiple logistic regression and survival analysis (Cox regression and Kaplan-Meier).</p><p><strong>Results: </strong>A total of 701 acute stroke patients were included and the prevalence of hyperuricemia was 46.6% with a mean SUA level of 68.625 ± 24 mg/l. Elevated SUA after stroke was associated with death (OR = 2.067; 95% CI: 1.449-2.950; <i>p</i> < 0.001) but did not predict this issue. However, an independent association between increasing SUA concentration and mortality was noted in a Cox proportional hazards regression model (adjusted HR = 1.740; 95% CI: 1.305-2.320; <i>p</i> < 0.001). Furthermore, hyperuricemia was an independent predictor of poor functional outcome within 3 months after stroke (OR = 2.482; 95% CI: 1.399-4.404; <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The prevalence of hyperuricemia in black African stroke patients is quite high and still remains a predictor of poor outcome.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"1935136"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1935136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35556925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequence Analysis of Long-Term Readmissions among High-Impact Users of Cerebrovascular Patients.","authors":"Ahsan Rao,&nbsp;Alex Bottle,&nbsp;Ara Darzi,&nbsp;Paul Aylin","doi":"10.1155/2017/7062146","DOIUrl":"https://doi.org/10.1155/2017/7062146","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the chronological order of the causes of readmissions may help us assess any repeated chain of events among high-impact users, those with high readmission rate. We aim to perform sequence analysis of administrative data to identify distinct sequences of emergency readmissions among the high-impact users.</p><p><strong>Methods: </strong>A retrospective cohort of all cerebrovascular patients identified through national administrative data and followed for 4 years.</p><p><strong>Results: </strong>Common discriminating subsequences in chronic high-impact users (<i>n</i> = 2863) of ischaemic stroke (<i>n</i> = 34208) were \"urological conditions-chest infection,\" \"chest infection-urological conditions,\" \"injury-urological conditions,\" \"chest infection-ambulatory condition,\" and \"ambulatory condition-chest infection\" (<i>p</i> < 0.01). Among TIA patients (<i>n</i> = 20549), common discriminating (<i>p</i> < 0.01) subsequences among chronic high-impact users were \"injury-urological conditions,\" \"urological conditions-chest infection,\" \"urological conditions-injury,\" \"ambulatory condition-urological conditions,\" and \"ambulatory condition-chest infection.\" Among the chronic high-impact group of intracranial haemorrhage (<i>n</i> = 2605) common discriminating subsequences (<i>p</i> < 0.01) were \"dementia-injury,\" \"chest infection-dementia,\" \"dementia-dementia-injury,\" \"dementia-urine infection,\" and \"injury-urine infection.\" <i>Conclusion</i>. Although common causes of readmission are the same in different subgroups, the high-impact users had a higher proportion of patients with distinct common sequences of multiple readmissions as identified by the sequence analysis. Most of these causes are potentially preventable and can be avoided in the community.</p><p><strong>Conclusion: </strong>Although common causes of readmission are the same in different subgroups, the high-impact users had a higher proportion of patients with distinct common sequences of multiple readmissions as identified by the sequence analysis. Most of these causes are potentially preventable and can be avoided in the community.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"7062146"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/7062146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35070491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack.","authors":"Philip M Bath, Jane May, Katie Flaherty, Lisa J Woodhouse, Natalia Dovlatova, Sue C Fox, Timothy J England, Kailash Krishnan, Thompson G Robinson, Nikola Sprigg, Stan Heptinstall","doi":"10.1155/2017/7365684","DOIUrl":"10.1155/2017/7365684","url":null,"abstract":"<p><strong>Background: </strong>The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation.</p><p><strong>Methods: </strong>Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values.</p><p><strong>Results: </strong>The aspirin P-selectin test demonstrated that platelet expression was lower in 494 patients taking aspirin than in 162 patients not: mean 210 (SD 188) versus 570 (435), difference 360.3 (95% CI 312.2-408.4) (2<i>p</i> < 0.001). Aspirin did not suppress P-selectin levels below 500 units in 23 (4.7%) patients. The clopidogrel test showed that platelet reactivity was lower in 97 patients taking clopidogrel than in 585 patients not: 655 (296) versus 969 (315), difference 314.5 (95% CI 247.3-381.7) (2<i>p</i> < 0.001). Clopidogrel did not suppress P-selectin level below 860 units in 24 (24.7%) patients.</p><p><strong>Conclusions: </strong>Aspirin and clopidogrel suppress stimulated platelet P-selectin, although one-quarter of patients on clopidogrel have high on-treatment platelet reactivity. Platelet function testing may be performed remotely in the context of a large multicentre trial. Trial registration ISRCTN47823388.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"7365684"},"PeriodicalIF":1.8,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35102380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Use or Not to Use Metformin in Cerebral Ischemia: A Review of the Application of Metformin in Stroke Rodents.","authors":"Isaac Arbeláez-Quintero, Mauricio Palacios","doi":"10.1155/2017/9756429","DOIUrl":"10.1155/2017/9756429","url":null,"abstract":"<p><p>Ischemic strokes are major causes of death and disability. Searching for potential therapeutic strategies to prevent and treat stroke is necessary, given the increase in overall life expectancy. Epidemiological reports indicate that metformin is an oral antidiabetic medication that can reduce the incidence of ischemic events in patients with diabetes <i>mellitus</i>. Its mechanism of action has not been elucidated, but metformin pleiotropic effects involve actions in addition to glycemic control. AMPK activation has been described as one of the pharmacological mechanisms that explain the action of metformin and that lead to neuroprotective effects. Most experiments done in the cerebral ischemia model, via middle cerebral artery occlusion in rodents (MCAO), had positive results favoring metformin's neuroprotective role and involve several cellular pathways like oxidative stress, endothelial nitric oxide synthase activation, activation of angiogenesis and neurogenesis, autophagia, and apoptosis. We will review the pharmacological properties of metformin and its possible mechanisms that lead to neuroprotection in cerebral ischemia.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"9756429"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/9756429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35106854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Management of Atrial Fibrillation and Stroke: Review of Data from Four European Countries.","authors":"Andreea D Ceornodolea, Roland Bal, Johan L Severens","doi":"10.1155/2017/8593207","DOIUrl":"10.1155/2017/8593207","url":null,"abstract":"<p><p>In Europe, 1-3% of the population suffers from atrial fibrillation (AF) and has increased stroke risk. By 2060 a doubling in number of cases and great burden in managing this medical condition are expected. This paper offers an overview of data on epidemiology and management of AF and stroke in four European countries as well as the interconnection between these dimensions. A search index was developed to access multiple scientific and \"grey\" literatures. Information was prioritised based on strength of evidence and date. Information on country reports was double-checked with national experts. The overall prevalence of AF is consistent across countries. France has the lowest stroke incidence and mortality, followed by Netherland and UK, while Romania has higher rates. GPs or medical specialists are responsible for AF treatment; exception are the special thrombosis services in the Netherlands. Prevention measurements are only present in UK through screening programs. Although international and national guidelines are available, undertreatment is present in all countries. Despite differences in healthcare systems and management of AF, epidemiology is comparable between three of the countries. Romania is an outlier, by being limited in data accessibility. This knowledge can contribute to improved AF care in Europe.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"8593207"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35106853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation.","authors":"Stephen N Housley,&nbsp;David Wu,&nbsp;Kimberly Richards,&nbsp;Samir Belagaje,&nbsp;Maysam Ghovanloo,&nbsp;Andrew J Butler","doi":"10.1155/2017/3603860","DOIUrl":"https://doi.org/10.1155/2017/3603860","url":null,"abstract":"<p><p>Stroke is a leading cause of long-term disability around the world. Many survivors experience upper extremity (UE) impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM) that uses a Tongue Drive System (TDS) to control a UE robotic device (Hand Mentor: HM) while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"3603860"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/3603860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35796661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiovisual Biofeedback-Based Trunk Stabilization Training Using a Pressure Biofeedback System in Stroke Patients: A Randomized, Single-Blinded Study.","authors":"Sangwoo Jung,&nbsp;Kyeongjin Lee,&nbsp;Myungjoon Kim,&nbsp;Changho Song","doi":"10.1155/2017/6190593","DOIUrl":"https://doi.org/10.1155/2017/6190593","url":null,"abstract":"<p><p>The purpose of this study was to assess the effects of audiovisual biofeedback-based trunk stabilization training using a pressure biofeedback system (PBS) in stroke patients. Forty-three chronic stroke patients, who had experienced a stroke more than 6 months ago and were able to sit and walk independently, participated in this study. The subjects were randomly allocated to an experimental group (<i>n</i> = 21) or a control group (<i>n</i> = 22). The experimental group participated in audiovisual biofeedback-based trunk stabilization training for 50 minutes/day, 5 days/week, for 6 weeks. The control group underwent trunk stabilization training without any biofeedback. The primary outcome of this study was the thickness of the trunk muscles. The secondary outcomes included static sitting balance ability and dynamic sitting balance ability. The thickness of the trunk muscles, static sitting balance ability, and dynamic sitting balance ability were significantly improved in the experimental group compared to the control group (<i>p</i> < 0.05). The present study showed that trunk stabilization training using a PBS had a positive effect on the contracted ratio of trunk muscles and balance ability. By providing audiovisual feedback, the PBS enables accurate and effective training of the trunk muscles, and it is an effective method for trunk stabilization.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"6190593"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/6190593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35812342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial.","authors":"Ilko L Maier,&nbsp;Katharina Schregel,&nbsp;André Karch,&nbsp;Mark Weber-Krueger,&nbsp;Rafael T Mikolajczyk,&nbsp;Raoul Stahrenberg,&nbsp;Klaus Gröschel,&nbsp;Mathias Bähr,&nbsp;Michael Knauth,&nbsp;Marios-Nikos Psychogios,&nbsp;Rolf Wachter,&nbsp;Jan Liman","doi":"10.1155/2017/1391843","DOIUrl":"https://doi.org/10.1155/2017/1391843","url":null,"abstract":"<p><p><i>Background</i>. Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. <i>Methods</i>. Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained. Embolic stroke patterns in CT- or MR-imaging were correlated with the diagnosis of ESUS as well as the short- (on baseline ECG and during 7-day Holter) and long-term (12-month follow-up) diagnosis of AF. <i>Results</i>. From 281 patients included in the Find-AF study, 127 (45.2%) patients with ischemic lesions detected in CT or MRI were included. 26 (20.5%) of these patients had ESUS. At least one embolic stroke pattern was detected in 67 (52.7%) patients. Embolic stroke patterns were not associated with ESUS (OR 1.57, 0.65-3.79, <i>p</i> = 0.317), the short-term (OR 0.64, 0.26-1.58, <i>p</i> = 0.327) or long-term diagnosis of AF (OR 0.72, 0.31-1.68, <i>p</i> = 0.448). <i>Conclusions</i>. This secondary data analysis of the Find-AF study could not provide evidence for an association between embolic stroke patterns, ESUS, and the new diagnosis of AF.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"1391843"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1391843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapists' Perspective on Virtual Reality Training in Patients after Stroke: A Qualitative Study Reporting Focus Group Results from Three Hospitals","authors":"L. Schmid, A. Glässel, C. Schuster-Amft","doi":"10.1155/2016/6210508","DOIUrl":"https://doi.org/10.1155/2016/6210508","url":null,"abstract":"Background. During the past decade, virtual reality (VR) has become a new component in the treatment of patients after stroke. Therefore aims of the study were (a) to get an insight into experiences and expectations of physiotherapists and occupational therapists in using a VR training system and (b) to investigate relevant facilitators, barriers, and risks for implementing VR training in clinical practice. Methods. Three focus groups were conducted with occupational therapists and physiotherapists, specialised in rehabilitation of patients after stroke. All data were audio-recorded and transcribed verbatim. The study was analysed based on a phenomenological approach using qualitative content analysis. Results. After code refinements, a total number of 1289 codes emerged out of 1626 statements. Intercoder reliability increased from 53% to 91% until the last focus group. The final coding scheme included categories on a four-level hierarchy: first-level categories are (a) therapists and VR, (b) VR device, (c) patients and VR, and (d) future prospects and potential of VR developments. Conclusions. Results indicate that interprofessional collaboration is needed to develop future VR technology and to devise VR implementation strategies in clinical practice. In principal, VR technology devices were seen as supportive for a general health service model.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"91 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2016-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81478561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}