Epilepsy and Behavior Reports最新文献

{"title":"Exercise in patients with epilepsy and neurostimulation devices - physical activity levels, barriers, and beliefs","authors":"Sarah Mauney ,&nbsp;Papul Chalia ,&nbsp;Justine Julien ,&nbsp;Tiffany Fisher","doi":"10.1016/j.ebr.2024.100699","DOIUrl":"10.1016/j.ebr.2024.100699","url":null,"abstract":"<div><p>Exercise improves many comorbidities associated with epilepsy in addition to seizure control. Despite the ILAE consensus statement noting the positive effects of exercise in patients with epilepsy (PWE) and individual assessment of risks pertaining to these activities, many healthcare professionals, including neurologists, are unfamiliar with these guidelines. Neurostimulation is an increasingly prevalent treatment option for refractory epilepsy. To date, no literature exists regarding how PWE treated with neurostimulation devices view and participate in exercise. We surveyed 36 adult PWE treated with neurostimulation (11 VNS, 21 RNS, 3 DBS, 1 VNS+RNS) on their barriers, beliefs, activity levels, and interests in exercise. Forty-three percent of patients reported meeting AHA guidelines for physical activity. Ninety percent of participants noted at least one barrier to exercise with transportation being most common. Fear of embarrassment of a seizure during exercise was reported by 44% with 39% endorsing prior seizure while exercising. Device-specific barriers included fear of device damage or avoidance of specific exercises. There was a statistically significant effect on activity level and prior seizure while exercising. Only 8% of participants reported knowledge of exercise guidelines for PWE. This data provides insight into the views of PWE treated with neurostimulation devices on exercise.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100699"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258998642400056X/pdfft?md5=ff2e88cb3f92936b0ece25f2ba250a33&pid=1-s2.0-S258998642400056X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961558","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":"Clinician Understanding, Acceptance and utilization of Ketogenic diet therapy for epilepsy in Australia and New Zealand: An online survey","authors":"Tania E. Farrar ,&nbsp;Arlene D’Silva ,&nbsp;Michael Cardamone ,&nbsp;Melissa L. Bartley ,&nbsp;Chong H. Wong ,&nbsp;Michelle A. Farrar","doi":"10.1016/j.ebr.2024.100711","DOIUrl":"10.1016/j.ebr.2024.100711","url":null,"abstract":"<div><div>Ketogenic diet therapy (KDT) is an established treatment for people with epilepsy. As increasing evidence demonstrates effectiveness and safety of KDT on seizure reduction, cognition and behaviour, it is essential to evaluate factors hindering and supporting neurologists in prescribing KDT to strengthen quality, evidence-based, appropriate and equitable care. A study of Australian and New Zealand (ANZ) neurologists was undertaken via an online survey. Demographics, clinical role characteristics, perceptions of knowledge, use and experiences of KDT for epilepsy treatment were assessed. Responses were analysed using the Capability, Opportunity, Motivation and Behaviour (COM-B) model. 114 neurologists participated (18 % response rate). All were aware of KDT for epilepsy treatment, most (90 %) perceived it as acceptable and 85 % identified suitable patients in their practice. Poor knowledge of the KDT referral processes was a barrier for 64 %. Clinical role characteristics were significantly associated with perceived level of knowledge and use of KDT in practice, being more likely among paediatric neurologists), epileptologists and those in urban practices (p &lt; 0.00001). Most neurologists (90 %) endorsed adoption of a KDT guideline to facilitate use of KDT in epilepsy management. This study established that KDT is accepted as a suitable treatment for epilepsy in ANZ. There is high variability in perceived knowledge and skills related to KDT, which impacts on utilization in clinical practice. Further education and resources for clinicians, allied health and community support agencies are needed to optimise the use of this valuable therapy. Additionally, a clear referral pathway would improve patient access.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100711"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427177","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":"Anxiety and school avoidance in an 8-year-old child with epilepsy","authors":"Jay Salpekar,&nbsp;D. Dilara Ertenu","doi":"10.1016/j.ebr.2024.100659","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100659","url":null,"abstract":"<div><p>Anxiety is ubiquitous in school age children. Co-occurring medical illness adds to the complexity of identifying pathologic anxiety as opposed to that of typical development such as with social interactions or academic pressures. Anxiety may also occur in the context of cognitive difficulties or inattention, both of which may be exacerbated by epilepsy or by anti-seizure medicines themselves. Treatment strategies may require patience and long-term observations to account for the typical range of stressors that may be expected with disease progression or with development through childhood. This section illustrates the challenge of diagnosis and management of anxiety in the context of epilepsy in a school aged child and addresses nuances that neurology clinicians need to consider. Practical strategies for management including stepwise options for pharmacologic treatment will be emphasized.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"26 ","pages":"Article 100659"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000169/pdfft?md5=5586e5cceb58b2ca134e5aa4d52b6ad1&pid=1-s2.0-S2589986424000169-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159937","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":"Stroke-related epilepsy in the rehabilitation setting: Insights from the inpatient post-stroke rehabilitation study – RIPS","authors":"Maenia Scarpino ,&nbsp;Antonello Grippo ,&nbsp;Silvia Campagnini ,&nbsp;Bahia Hakiki ,&nbsp;Antonio Maiorelli ,&nbsp;Alessandro Sodero ,&nbsp;Erika Guolo ,&nbsp;Andrea Mannini ,&nbsp;Claudio Macchi ,&nbsp;Francesca Cecchi","doi":"10.1016/j.ebr.2024.100713","DOIUrl":"10.1016/j.ebr.2024.100713","url":null,"abstract":"<div><div>In stroke survivors, persistent seizure activity could be associated with poor functional outcomes. At the same time, antiepileptic over-treatment could hamper post-stroke recovery. We systematically investigated the occurrence of seizures, the prevalence of epileptic discharges, and delta slow waves on electroencephalogram (EEG) and anti-seizure medication (ASM) management in relation to clinical manifestations and EEG abnormalities. This was a multi-centre prospective study involving two intensive rehabilitation units (IRUs). Clinical and EEG data were acquired at admission to the IRU, discharge (T1), and six-month follow-up (T2). A total of 163 patients underwent EEG recording upon admission to the IRU, while 149 were available for analysis at discharge from the IRU. Eighteen patients were treated with ASMs upon IRU admission despite only five of these patients having early seizures. Among the 145 patients not treated upon admission to the IRU, eight had late seizures, of which six were during the IRU stay, while two were after discharge from the IRU. During IRU stay, ASMs were generally discontinued in patients with no early seizures reported and were started in patients with late seizures. Among the 18 patients treated with ASMs at admission to the IRU, only six maintained the therapy also at T2. Our results suggest that post-acute inpatient rehabilitation is a proper setting to observe patients treated with ASMs after stroke and provide personalized post-stroke epilepsy management.</div></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"28 ","pages":"Article 100713"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427116","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":"The Epileptic Heart Syndrome: Epidemiology, pathophysiology and clinical detection","authors":"Richard L. Verrier ,&nbsp;Steven C. Schachter","doi":"10.1016/j.ebr.2024.100696","DOIUrl":"10.1016/j.ebr.2024.100696","url":null,"abstract":"<div><p>Population studies report elevated incidence of cardiovascular events in patients with chronic epilepsy. Multiple pathophysiologic processes have been implicated, including accelerated atherosclerosis, myocardial infarction, altered autonomic tone, heart failure, atrial and ventricular arrhythmias, and hyperlipidemia. These deleterious influences on the cardiovascular system have been attributed to seizure-induced surges in catecholamines and hypoxemic damage to the heart and coronary vasculature. Certain antiseizure medications can accelerate heart disease through enzyme-inducing increases in plasma lipids and/or increasing risk for life-threatening ventricular arrhythmias as a result of sodium channel blockade. In this review, we propose that this suite of pathophysiologic processes constitutes “The Epileptic Heart Syndrome.” We further propose that this condition can be diagnosed using standard electrocardiography, echocardiography, and lipid panels. The ultimate goal of this syndromic approach is to evaluate cardiac risk in patients with chronic epilepsy and to promote improved diagnostic strategies to reduce premature cardiac death.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100696"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000534/pdfft?md5=a232a999e329d38e24e30d2c19f587ce&pid=1-s2.0-S2589986424000534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851018","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":"Comparison of induction agents for rapid sequence intubation in refractory status epilepticus: A single-center retrospective analysis","authors":"Matthew R. Woodward ,&nbsp;Adam Kardon ,&nbsp;Jody Manners ,&nbsp;Samantha Schleicher ,&nbsp;Melissa B. Pergakis ,&nbsp;Prajwal Ciryam ,&nbsp;Jamie Podell ,&nbsp;William Denney Zimmerman ,&nbsp;Samuel M. Galvagno Jr ,&nbsp;Bilal Butt ,&nbsp;Jennifer Pritchard ,&nbsp;Gunjan Y. Parikh ,&nbsp;Emily J. Gilmore ,&nbsp;Neeraj Badjatia ,&nbsp;Nicholas A. Morris","doi":"10.1016/j.ebr.2024.100645","DOIUrl":"10.1016/j.ebr.2024.100645","url":null,"abstract":"<div><p>Endotracheal intubation, frequently required during management of refractory status epilepticus (RSE), can be facilitated by anesthetic medications; however, their effectiveness for RSE control is unknown. We performed a single-center retrospective review of patients admitted to a neurocritical care unit (NCCU) who underwent in-hospital intubation during RSE management. Patients intubated with propofol, ketamine, or benzodiazepines, termed anti-seizure induction (ASI), were compared to patients who received etomidate induction (EI). The primary endpoint was clinical or electrographic seizures within 12 h post-intubation. We estimated the association of ASI on post-intubation seizure using logistic regression. A sub-group of patients undergoing electroencephalography during intubation was identified to evaluate the immediate effect of ASI on RSE. We screened 697 patients admitted to the NCCU for RSE and identified 148 intubated in-hospital (n = 90 ASI, n = 58 EI). There was no difference in post-intubation seizure (26 % (n = 23) ASI, 29 % (n = 17) EI) in the cohort, however, there was increased RSE resolution with ASI in 24 patients with electrographic RSE during intubation (ASI: 61 % (n = 11/18) vs EI: 0 % (n = 0/6), p =.016). While anti-seizure induction did not appear to affect post-intubation seizure occurrence overall, a sub-group of patients undergoing electroencephalography during intubation had a higher incidence of seizure cessation, suggesting potential benefit in an enriched population.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"25 ","pages":"Article 100645"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000029/pdfft?md5=7e4754d742333879a389e54631afec05&pid=1-s2.0-S2589986424000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139454541","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":"Comorbidity of attention deficit hyperactivity disorder in a patient with epilepsy: Staring down the challenge of inattention versus nonconvulsive seizures","authors":"Derryl J. Miller ,&nbsp;Hannah Komanapalli ,&nbsp;David W. Dunn","doi":"10.1016/j.ebr.2024.100651","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100651","url":null,"abstract":"<div><p>Epilepsy is a heterogeneous disorder of recurrent seizures which often is comorbid with anxiety, depression, attention deficit hyperactivity disorder (ADHD), intellectual disability (ID), and other psychiatric manifestations. Treating both epilepsy and behavioral symptoms from psychiatric disorders can result in polypharmacy with interactions of medications leading to both worsened efficacy of antiseizure medications due to psychotropic effects and worsening of psychiatric symptoms due to antiseizure medication side effects. We aim to suggest pragmatic strategies for the neurologist in the diagnosis and management of comorbid ADHD in patients with epilepsy based on the International League Against Epilepsy (ILAE) Pediatric Commission guidelines and additional literature review. The screening tool of choice for the symptoms of ADHD is validated in the country of practice and written in the language of the family, though various screening tools and advantages and disadvantages of each will be discussed. Once ADHD is diagnosed, recent safety data suggest that Methylphenidate, Amphetamine, and Atomoxetine are generally safe for patients with epilepsy. We present a case of a child with epilepsy and ADHD and discuss the clinical signs, symptoms, and strategies for treatment as well as when to refer to child psychiatry.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"25 ","pages":"Article 100651"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258998642400008X/pdfft?md5=f3caa0493e971bd47fc83cb957024837&pid=1-s2.0-S258998642400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709156","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":"The dual effect of vagus nerve stimulation in pediatric patients with drug-resistant epilepsy: Is there more than seizure control?","authors":"Mohamed Ashraf Mahmoud ,&nbsp;Omnia El Rashidi ,&nbsp;George Halim ,&nbsp;Mohamed Amgad Elkholy ,&nbsp;Osama Aglan ,&nbsp;Abdel Rahman El Sabbagh ,&nbsp;Ahmed Kamel Basha ,&nbsp;Hussein Hamdi ,&nbsp;Ahmed M. El Sayed ,&nbsp;Dina Amin Saleh ,&nbsp;R.H. Shatla ,&nbsp;Walid Abdel Ghany","doi":"10.1016/j.ebr.2024.100653","DOIUrl":"10.1016/j.ebr.2024.100653","url":null,"abstract":"<div><p>This is a retrospective and comparative pilot study to investigate the role of vagus nerve stimulation (VNS) in improving cognitive functions in the pediatric age group with drug resistant epilepsy (DRE). It was conducted from January 2018 to February 2023. Children between the ages of 4 and 18 years were divided into two groups, the “VNS group” and the “best medical treatment (BMT) group”. Follow up period was 12 months. Demographic, clinical, etiological and investigational data were recorded. Cognitive assessment using the Modified Mini-Mental State Examination for children (MMSE) was recorded at baseline and 12 months later for each group. 76.4 % of patients were classified as epilepsy secondary to cerebral palsy. 75 % of patients showed ≥ 50 % seizure frequency reduction among the VNS group as compared to 12.5 % in the BMT group. None of both groups achieved seizure freedom. At 12 months, both BMT and VNS groups showed statistically significantly improved overall cognitive score from baseline records (p = 0.027) and (p = 0.012), respectively, with a significantly higher improvement in VNS group. Also, statistical sub-analysis of cognitive subscales in cerebral palsy patients in both groups was conducted and revealed a significant improvement (p = 0.02) in the VNS group. We concluded that there is a potential role of VNS in improving cognitive functions which was shown by using a cost-effective screening tool. A significant effect was observed specially in cerebral palsy patients. This is very beneficial in limited-resources countries since VNS has good safety profile, high seizure control, and added value to cognitive functions.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100653"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000108/pdfft?md5=9d8b25ff151ad72fe219903e5e566077&pid=1-s2.0-S2589986424000108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139812046","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":"The epileptic blip syndrome","authors":"Edgar Matringe ,&nbsp;Juan R. Vidal ,&nbsp;Marcela Perrone-Bertolotti ,&nbsp;Laurent Vercueil","doi":"10.1016/j.ebr.2024.100691","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100691","url":null,"abstract":"<div><p>We report on the case of an adolescent with juvenile myoclonic epilepsy exhibiting compulsory sporadic voluntary movement. These movements entailed the deliberate act of touching her forehead with her hand and were triggered by a short and indefinable cephalic sensation. Upon inquiry regarding the nature of this movement, the patient reported a sudden perception of a peculiar event localized “inside her head”. In the course of a prolonged video-electroencephalographic recording, it appeared that the movements consistently followed the occurrence of diffuse Generalized Spike-and-Wave Bursts (GSWBs), lasting one to three seconds. This observation suggests that the impact of the GSWBs on the patient’s stream of consciousness could be detected by the patient herself, who attributed it to an internal sensation, like a “blip on a screen”. This clinical observation echoes the “blip syndrome”, as described by the neurologist James W. Lance thirty years ago. These findings give some support that “blips” could be of an epileptic origin and lend weight to the notion that some patients could perceive their own EEG discharges. Moreover, this observation should be added to the perennial debate on the cognitive impact of intercritical discharges.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100691"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000480/pdfft?md5=4446a3969dd192f5b6bee9a7fee526cd&pid=1-s2.0-S2589986424000480-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540087","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":"Refractory inflammatory hydrocephalus: A case report of a rare and complicated delayed sequelae following cerebral hemispherectomy surgery for epilepsy","authors":"Akshay Sharma ,&nbsp;Efstathios Kondylis ,&nbsp;Shaarada Srivatsa ,&nbsp;Nehaw Sarmey ,&nbsp;Deepak Lachhwani ,&nbsp;Laura Nedorezov ,&nbsp;William Bingaman","doi":"10.1016/j.ebr.2024.100694","DOIUrl":"https://doi.org/10.1016/j.ebr.2024.100694","url":null,"abstract":"<div><p>Hydrocephalus is a known complication following surgical resection of a cerebral hemisphere for refractory epilepsy, yet the pathological mechanism remains poorly understood. We present a case of refractory aseptic inflammatory hydrocephalus following cerebral hemispherectomy surgery for refractory epilepsy treated with a combination of cerebral spinal fluid (CSF) diversion and immunosuppression via IL-1 receptor agonist, Anakinra. At 6 month follow up, the patient had returned to neurologic baseline, with improvement in school and physical therapy performance. Further investigation into the beneficial role of immunosuppressive therapy is needed to better understand the relationship between neuro-inflammation and improving outcomes following epilepsy surgery.</p></div>","PeriodicalId":36558,"journal":{"name":"Epilepsy and Behavior Reports","volume":"27 ","pages":"Article 100694"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589986424000510/pdfft?md5=4039a2c825764ca223233eb7fc0729a3&pid=1-s2.0-S2589986424000510-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141593717","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}