Audiology Research最新文献

{"title":"Vestibular Assessment in Infants with Congenital or Early Onset Sensorineural Hearing Loss: Is Neonatal Vestibular Screening Required? A Scoping Review.","authors":"Lauren Farquhar, Amr El Refaie","doi":"10.3390/audiolres15020023","DOIUrl":"10.3390/audiolres15020023","url":null,"abstract":"<p><strong>Background/objectives: </strong>Children with congenital or early onset sensorineural hearing loss (SNHL) are at a greater risk of vestibular dysfunction (VD), hypothesized to occur from the close embryological relationship between the cochlear and vestibular systems. Even with increasing focus on early detection and rehabilitation through Universal Newborn Hearing Screening (UNHS) programmes in many countries, few studies have focused on the prevalence and feasibility of vestibular assessment in infant populations. The objectives of this review are to 1. identify the prevalence of VD infants with congenital or early onset (<12 months old) SNHL, 2. identify which vestibular assessment tests/protocols are conducted on this population, 3. report sensitivity and specificity values for identified vestibular assessment tests/protocols.</p><p><strong>Methods: </strong>Studies that included infants aged 0-12 months, with congenital or early onset SNHL of any laterality, degree, or configuration, and who underwent any method of vestibular assessment were included. The review adhered to the Joanna Briggs Institute (JBI) guidance and the PRISMA-ScR extension statement.</p><p><strong>Results: </strong>A total of 18 studies were included in the review. All articles reported that infants with congenital or early onset SNHL are at a greater risk of VD, particularly those with bilateral severe-profound SNHL. The cervical vestibular-evoked myogenic potentials (cVEMP) test was the most frequently identified vestibular assessment tool for this age demographic.</p><p><strong>Conclusions: </strong>Results from the included articles coincide with results from literature assessing older paediatric populations. cVEMPs have been reported to be a feasible, sensitive, and specific screening tool in infants with congenital or early onset SNHL. The prevalence of VD in infants with congenital or early onset SNHL justify further investigation on the feasibility of establishing a pathway for vestibular assessment for all infants referred by UNHS programmes.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693825","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":"Strategies to Mitigate Cisplatin-Induced Ototoxicity: A Literature Review of Protective Agents, Mechanisms, and Clinical Gaps.","authors":"Alexandru Orasan, Mihaela-Cristina Negru, Anda Ioana Morgovan, Razvan Claudiu Fleser, Daniela Sandu, Adrian Mihail Sitaru, Alexandru-Catalin Motofelea, Nicolae Constantin Balica","doi":"10.3390/audiolres15020022","DOIUrl":"10.3390/audiolres15020022","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin, a widely used chemotherapeutic agent, is associated with significant ototoxicity, leading to progressive and irreversible sensorineural hearing loss in up to 93% of patients. Cisplatin generates reactive oxygen species (ROS) in the cochlea, activating apoptotic and necroptotic pathways that result in hair cell death. Inflammatory processes and nitrative stress also contribute to cochlear damage.</p><p><strong>Methods: </strong>This literature review was conducted to explore the mechanisms underlying cisplatin-induced ototoxicity and evaluate protective strategies, including both current and emerging approaches. A structured search was performed in multiple scientific databases, including PubMed and ScienceDirect, for articles published up to November 2024.</p><p><strong>Results: </strong>Current otoprotective strategies include systemic interventions such as antioxidants, anti-inflammatory agents, and apoptosis inhibitors, as well as localized delivery methods like intratympanic injection and nanoparticle-based systems. However, these approaches have limitations, including potential interference with cisplatin's antitumor efficacy and systemic side effects. Emerging strategies focus on genetic and biomarker-based risk stratification, novel otoprotective agents targeting alternative pathways, and combination therapies. Repurposed drugs like pravastatin also show promise in reducing cisplatin-induced ototoxicity.</p><p><strong>Conclusions: </strong>Despite these advancements, significant research gaps remain in translating preclinical findings to clinical applications and developing selective otoprotective agents that do not compromise cisplatin's efficacy. This review examines the mechanisms of cisplatin-induced ototoxicity, current otoprotective strategies, and emerging approaches to mitigate this adverse effect.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693805","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":"Bilateral Vestibulopathy: What Can the Video Head Impulse Test Tell Us?","authors":"Sofia Waissbluth, Macarena Viñuela, Emilia Escobedo, Antonia Pastore, Ivan Novoa","doi":"10.3390/audiolres15020020","DOIUrl":"10.3390/audiolres15020020","url":null,"abstract":"<p><p>Bilateral vestibulopathy (BV) is a known cause of chronic vestibular syndrome. With the video head impulse test (VHIT), we can now evaluate all six semicircular canals independently and establish BV subgroups based on canal gain patterns. <b>Background/objectives</b>: To assess canal gain patterns for BV with VHIT, and evaluate subgroups with regard to sex, age, and hearing loss. <b>Methods</b>: A retrospective chart review was performed of all patients who underwent a VHIT between January 2021 and July 2024. Patients with decreased lateral canal gains, bilaterally, were included. Results of canal gains, VHIT patterns, audiometry, and videonystagmography (VNG) results were reviewed. <b>Results</b>: 101 cases were included. Patients were 75.5 ± 13.1 years old and 64.4% were women. Various VHIT patterns were observed; the most frequent being decreased canal gains across all six canals (44.6%), followed by a mix of canals with decreased gains with no clear pattern (34.7%). Decreased gains limited to the lateral canals were rare. We did not observe any significant difference between subgroups with regard to gender or age. Concomitant hearing loss was common (89.6%). A trend was noted, suggesting that severity of hearing loss increased with the number of affected canals. An abnormal VNG test was common (73.3%). <b>Conclusions</b>: Various patterns of canal gains were observed for patients with BV. Audiometry and VNG should be considered as part of BV studies since abnormalities are commonly found. Further research is needed to understand VHIT patterns in BV.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693778","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":"Vestibulo-Oculomotor Reflex Dysfunction in Children with Cerebral Palsy Correlates with Gross Motor Function Classification System.","authors":"Laura Casagrande Conti, Nicola Ferri, Leonardo Manzari, Tommaso Lelli, Maria Mangeruga, Margherita Dal Piaz, Andrea Manzotti, Luca Verrecchia, Marco Tramontano","doi":"10.3390/audiolres15020021","DOIUrl":"10.3390/audiolres15020021","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to evaluate the feasibility of the angular vestibulo-ocular reflex (aVOR) function assessment in children with cerebral palsy (CP) using the video Head Impulse Test (vHIT) and to investigate how vestibular impairments correlate with functional motor ability.</p><p><strong>Methods: </strong>This cross-sectional study included children diagnosed with CP who attempted a vestibular function assessment with the vHIT. Descriptive statistics and a subgroup analysis based on clinical expression were performed. Finally, the correlation between aVOR gain and functional motor ability was investigated.</p><p><strong>Results: </strong>Thirteen children underwent assessments of the horizontal semicircular canals. Six out of thirteen children presented at least one dysfunctional canal; overall, eight out of twenty-six horizontal semicircular canals were dysfunctional in the HIMP paradigm. A subgroup analysis revealed a dysfunctional aVOR gain in all the children presenting ataxia. The correlation analysis demonstrated a strong negative association between aVOR gain and the Gross Motor Function Classification System (-0.73 and -0.68 for the left and right horizontal canal, respectively; <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Vestibular dysfunctions are prevalent in children with CP and strongly correlate with motor function. An instrumental vestibular assessment in children with cognitive-motor disability seems feasible, in particular for horizontal canals and the HIMP paradigm. This could be important for better framing a child's function and enhancing the management of balance and motor impairments with more specific strategies for children with CP.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693835","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":"Long-Term Outcomes Following Cochlear Implantation: Device \"Aging\" and Hearing Performance.","authors":"Davide Soloperto, Gennaro Confuorto, Virginia Dallari, Luca Sacchetto, Marco Carner, Daniele Monzani, Riccardo Nocini","doi":"10.3390/audiolres15020019","DOIUrl":"10.3390/audiolres15020019","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the clinical and audiological outcomes in long-term cochlear implant (CI) users, focusing on hearing performance and device failures.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients who underwent CI surgery, with a minimum follow-up of 10 years. Device survival was analyzed using Kaplan-Meier curves, and failure rates were classified as device failure explants or medical-related explants. The time to revision and causes of reimplantation were assessed. Statistical analyses included Pearson correlation for audiological outcomes, Student's <i>t</i>-test for group comparisons, and the log-rank test for survival comparisons among implant brands.</p><p><strong>Results: </strong>In this study, data from a total of 211 CIs were collected. Fourteen major postoperative complications were reported in this series, resulting in a global major complication rate of 6.6%: 5.2% due to hard failure and 1.4% due to medical problems and soft failure. The revision rate was 4.1% for the children's group and 10% for the adult group. The overall device survival rates were more than 96% at 10 years and 91% at 20 years. The median postoperative follow-up was 16.3 years. Moreover, a highly significant correlation was observed (r = 0.669, <i>p</i> < 0.0001) between pure tone average (PTA) thresholds at implant activation and those at the last follow-up, as analyzed using Pearson's correlation coefficient.</p><p><strong>Conclusions: </strong>The CI is a lifelong device; however, the technology is constantly evolving. Therefore, careful patient counseling (or counseling of parents in the case of pediatric patients) is necessary. The device may wear out over time, requiring revision surgery. These data are essential for audiologists and ENT specialists when selecting patients and determining surgical indications.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693802","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":"Inadvertent Dural Puncture Causing Low Pressure Headache and Peripheral Vestibular Bilateral Damage.","authors":"N S Longridge, A I Mallinson, R G Robinson","doi":"10.3390/audiolres15020018","DOIUrl":"10.3390/audiolres15020018","url":null,"abstract":"<p><strong>Introduction: </strong>This edition of the <i>Audiology Research</i> journal is dedicated to Dr. John Epley. For this reason, we would like to present a very unusual case involving the development of a bilateral abnormality of the otolith organs. The otoliths are the structures from which calcium particles detach to induce benign paroxysmal positional vertigo, the disorder for which Dr. Epley is famous for managing.</p><p><strong>Case report: </strong>This case report outlines an unusual presentation of vestibular pathology involving the otoliths.</p><p><strong>Discussion: </strong>We suggest that the atypical presentation may be related to a bilaterally asymmetrical insult to the otoliths.</p><p><strong>Conclusions: </strong>The central insult suffered by this patient resulted in bilateral peripheral otolithic pathology.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693800","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":"Gain Analysis of Self-Fitting Over-the-Counter Hearing Aids: A Comparative and Longitudinal Analysis.","authors":"Megan Knoetze, Vinaya Manchaiah, Kayla Cormier, Carly Schimmel, Anu Sharma, De Wet Swanepoel","doi":"10.3390/audiolres15010017","DOIUrl":"10.3390/audiolres15010017","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the gain provided by self-fitting over-the-counter (SF-OTC) hearing aids compared to clinical NAL-NL2 targets, the differences between various FDA-approved SF-OTC devices, and potential changes in gain over time.</p><p><strong>Methods: </strong>Two experiments were conducted: (1) a cross-sectional comparison of six SF-OTC hearing aids (n = 43) and (2) a longitudinal evaluation of gain within five days of self-fitting and four additional time points (n = 15). Real-ear measurements (REMs) were used to measure gain.</p><p><strong>Results: </strong>SF-OTC hearing aid gain corresponded with 10 dB SPL but not 5 dB SPL criteria from NAL-NL2 targets. Differences between NAL-NL2 targets and gain did not differ significantly between devices. There were no significant changes in gain over time for any input level.</p><p><strong>Conclusions: </strong>SF-OTC hearing aids generally provide user-selected gain levels lower than clinical targets, particularly at higher frequencies. The gain remains stable over time, indicating limited user adjustment after initial fitting. OTC hearing aid manufacturers should consider implementing fitting algorithms that allow for gradual user acclimatization.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494037","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":"Teenagers and Young Adults with Cochlear Implants: A Multidisciplinary Follow-Up Study Approach and Baseline Characteristics.","authors":"Ulrika Löfkvist, Malin Dahlby-Skoog, Anna Persson, Filip Asp, Luca Verrecchia, Susanne Gripenberg, Niki Karpeta, Martin Eklöf, Eva Karltorp","doi":"10.3390/audiolres15010016","DOIUrl":"10.3390/audiolres15010016","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Early pediatric cochlear implantation positively impacts early language outcomes. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation and factors influencing variability among cochlear implant (CI) users. This article outlines participants' background, early language outcomes, and multidisciplinary study protocol. <b>Methods and Materials</b>: Individuals aged 12-22 received CIs before 30 months of age, followed-up at the same hearing implant center, and adhered to a standard school curriculum were invited to participate. Out of 109 eligible CI users, 50 participated; 46 agreed to undergo clinical assessments, while four completed questionnaires only. <b>Results</b>: The mean age at the first CI was 15.63 months (SD = 6.0). All but one communicated with spoken language(s). Participants attended mainstream schools and had highly educated parents. Over half (56%) had received Auditory Verbal Therapy in early childhood. Earlier implantation correlated with better language understanding one year post-CI. <b>Conclusions</b>: Earlier implantation was associated with better early language outcomes, with parental education level and early family-centered intervention likely contributing. Future sub-studies will investigate multidisciplinary long-term effects of pediatric cochlear implantation in adolescents.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494151","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":"Vestibular Agnosia: Toward a Better Understanding of Its Mechanisms.","authors":"Assan Mary Cedras, Jonathan Dion, Arnaud Saj, François Champoux, Maxime Maheu","doi":"10.3390/audiolres15010015","DOIUrl":"10.3390/audiolres15010015","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Vestibular agnosia is characterized by a reduced or absent self-motion perception while demonstrating the presence of normal peripheral vestibular function following stimulation. This condition has previously been reported by previous authors in different populations and more recently in traumatic brain injury patients. However, the underlying mechanisms responsible for vestibular agnosia remain a matter of debate. The objective of this manuscript is to review and compare the behavioral and neuroanatomical findings in populations where vestibular agnosia has been demonstrated to better understand the underlying mechanism. <b>Methods</b>: A review of the literature was conducted using four databases: Medline, Embase, Google Scholar, and PubMed. A normal vestibulo-ocular reflex function with an impaired self-motion perception following vestibular stimulation represented the inclusion criteria used. <b>Results</b>: Behavioral data reviewed in the studies revealed a clear association with postural instability. However, no consensus can be drawn from neuroanatomical data due to variability in brain impairments in those populations even though impairments in the parietal cortex are often reported. <b>Conclusions</b>: In general, behavioral data and neuroanatomical data regarding vestibular agnosia have been poorly documented throughout the literature. However, vestibular agnosia can be observed in different populations and is present in concomitant postural control deficits, an important predictor of falls. Finally, even though the parietal cortex has been associated with vestibular agnosia, future studies are required to adequately identify the underlying mechanism. Indeed, the parietal cortex could be part of a larger network mediating vestibular agnosia. This review proposes various methods that future studies should use to overcome the present limitations.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494154","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":"Impaired Prosodic Processing but Not Hearing Function Is Associated with an Age-Related Reduction in AI Speech Recognition.","authors":"Björn Herrmann, Mo Eric Cui","doi":"10.3390/audiolres15010014","DOIUrl":"10.3390/audiolres15010014","url":null,"abstract":"<p><strong>Background/objectives: </strong>Voice artificial intelligence (AI) technology is becoming increasingly common. Recent work indicates that middle-aged to older adults are less able to identify modern AI speech compared to younger adults, but the underlying causes are unclear.</p><p><strong>Methods: </strong>The current study with younger and middle-aged to older adults investigated factors that could explain the age-related reduction in AI speech identification. Experiment 1 investigated whether high-frequency information in speech-to which middle-aged to older adults often have less access due sensitivity loss at high frequencies-contributes to age-group differences. Experiment 2 investigated whether an age-related reduction in the ability to process prosodic information in speech predicts the reduction in AI speech identification.</p><p><strong>Results: </strong>Results for Experiment 1 show that middle-aged to older adults are less able to identify AI speech for both full-bandwidth speech and speech for which information above 4 kHz is removed, making the contribution of high-frequency hearing loss unlikely. Experiment 2 shows that the ability to identify AI speech is greater in individuals who also show a greater ability to identify emotions from prosodic speech information, after accounting for hearing function and self-rated experience with voice-AI systems.</p><p><strong>Conclusions: </strong>The current results suggest that the ability to identify AI speech is related to the accurate processing of prosodic information.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494149","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}