Multiple Sclerosis International最新文献

{"title":"Real-World Results of Ocrelizumab Treatment for Primary Progressive Multiple Sclerosis.","authors":"K Daniels,&nbsp;P B van der Nat,&nbsp;S T F M Frequin,&nbsp;P J van der Wees,&nbsp;D H Biesma,&nbsp;E L J Hoogervorst,&nbsp;E M W van de Garde","doi":"10.1155/2020/5463451","DOIUrl":"https://doi.org/10.1155/2020/5463451","url":null,"abstract":"<p><strong>Background: </strong>Recently, ocrelizumab (Ocrevus®) was approved for the treatment of primary progressive multiple sclerosis (PPMS) based on data from the ORATORIO clinical trial. Real-world data about the clinical effectiveness of ocrelizumab has yet to be gathered.</p><p><strong>Objective: </strong>The aim of this study was to provide data about the clinical effectiveness of ocrelizumab for patients diagnosed with PPMS in a real-world setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients with PPMS who started ocrelizumab treatment (<i>n</i> = 21) in St. Antonius Hospital (Utrecht/Nieuwegein, the Netherlands) between April 2018 and December 31, 2018. Primary outcome was pre- versus post-ocrelizumab disability worsening rate (from 96 weeks prior to first ocrelizumab administration up to 24 weeks post first ocrelizumab administration).</p><p><strong>Results: </strong>Disability worsening rate while on treatment significantly differed (lower) from disability worsening rate in pre-treatment period (<i>Z</i> = -2.81, <i>p</i> ≤ .01). Three out of 17 patients showed a clinically relevant improvement in disability status after treatment start.</p><p><strong>Conclusion: </strong>Ocrelizumab can stabilize disability progression in patients with PPMS. Some patients even showed a clinically relevant improvement in disability status. Further research should help to identify which patients benefit most from ocrelizumab.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2020 ","pages":"5463451"},"PeriodicalIF":2.5,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5463451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38109787","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":"Neuromyelitis Optica Spectrum Disorder Attack Triggered by Herpes Zoster Infection.","authors":"Emanuela Claudia Turco,&nbsp;Erica Curti,&nbsp;Valentina Maffini,&nbsp;Francesco Pisani,&nbsp;Franco Granella","doi":"10.1155/2020/6151258","DOIUrl":"https://doi.org/10.1155/2020/6151258","url":null,"abstract":"<p><p>Neuromyelitis optica spectrum disorder is a severe autoimmune disease of the central nervous system characterized by recurrent inflammatory events primarily involving the optic nerves and spinal cord. Recently, a triggering role of infectious events in the development of NMOSD has been suggested. Varicella zoster virus is the most common viral infection involved, though the linkage with anti-aquaporin-4 antibodies is so far unknown. We report, to the best of our knowledge, the first pediatric case report about NMOSD relapse triggered by herpes zoster infection. The strict temporal relationship between VZV infection and NMO attacks seems to be more than simply due to chance; however, further reports are needed to be confirmed.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2020 ","pages":"6151258"},"PeriodicalIF":2.5,"publicationDate":"2020-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6151258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37905278","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":"Integrating Caregiver Support into Multiple Sclerosis Care","authors":"J. Martindale-Adams, Jeffrey K Zuber, Michael C Levin, R. Burns, M. Graney, L. Nichols","doi":"10.1155/2020/3436726","DOIUrl":"https://doi.org/10.1155/2020/3436726","url":null,"abstract":"With loss of mobility in Multiple Sclerosis (MS) comes increase in caregiver assistance, burden, stress, and depression. This 6-month feasibility study used a pre-post design to test integration of a validated, behavioral, caregiving intervention into an ongoing MS clinic. Because the program focused on caregivers, there were no additional services provided to the persons living with MS other than usual medical care. Twenty-five MS caregivers received REACH VA (Resources for Enhancing All Caregivers’ Health in the VA), a six-session behavior-focused intervention during two to three months designed to increase caregiver skills in managing their own stress and burden and MS related issues and concerns, with a focus on mobility. Caregivers were assessed at baseline, three, and six months. Caregivers’ expectations of the program were to receive education on MS, caregiving and stress management skills, and support. The major benefits caregivers reported were understanding their loved one’s condition and how to better provide care. At six months, caregivers reported statistically and clinically significant improvements in depressive symptoms and bother with challenging MS behaviors. Persons with MS reported benefit for their caregivers and for themselves; 71% reported that their caregivers had helped them with mobility and function. Study results suggest that the addition of the brief REACH caregiver intervention into an MS clinic would benefit both caregivers and persons with MS. Although the intervention was six sessions over three months, benefit persisted at six months, suggesting durability of effects. This trial is registered with ClinicalTrials.gov NCT02835677 .","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2020 1","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2020-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3436726","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45031979","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}

{"title":"Biofeedback Based Home Balance Training can Improve Balance but Not Gait in People with Multiple Sclerosis.","authors":"Klara Novotna,&nbsp;Marketa Janatova,&nbsp;Karel Hana,&nbsp;Olga Svestkova,&nbsp;Jana Preiningerova Lizrova,&nbsp;Eva Kubala Havrdova","doi":"10.1155/2019/2854130","DOIUrl":"https://doi.org/10.1155/2019/2854130","url":null,"abstract":"<p><strong>Background: </strong>Impaired balance is common in people with multiple sclerosis (MS) and can be present even in those with a mild disability level. With increasing disability, gait, and balance impairment progress, and lead to increased risk of falls. In some recent studies, interactive commercial video games were used for improving balance, but their limitation is their lack of individual training parameter settings needed for rehabilitation purposes. The aim of this study was to evaluate the feasibility and effect of balance exercise in the home setting using the rehabilitation Homebalance® system.</p><p><strong>Methods: </strong>A single-centre, controlled, single blind study with allocation to intervention group or to control group was utilised. Participants were assessed at baseline, after four weeks of home-based balance training, and follow-up after four weeks. The primary outcomes were the Berg Balance Test (BBT). The secondary outcome measures included the Mini-BESTest, Timed Up, and Go Test (part of Mini-BESTest), and spatio-temporal gait parameter evaluation using the GAITRite instrument. The patient reported outcomes (PRO) included the 12-Item MS Walking Scale, Activities-specific Balance Confidence Scale, and the Falls Efficacy Scale.</p><p><strong>Results: </strong>A total of 39 people with Multiple Sclerosis (10 men) were enrolled into the study. The mean age of participants was 40.69 ± 10.2 years, with a mean disease duration 14.76 ± 9.1 years and mean disability level 3.8 ± 1.9 EDSS (EDSS range 1.5-7). Statistically significant improvements within the home exercise group were present for the BBT and the Mini-BESTest. This improvement was more significant in the subgroup with moderate and higher disability (EDSS 4.5-7). All other gait parameters and PRO did not show any improvement. Follow-up assessment after four weeks showed that the reached improvement persisted for a short time period after finishing the regular training regimen.</p><p><strong>Conclusion: </strong>In comparison with no intervention, a short-term programme of home-based balance training using Homebalance® improved balance but not gait performance in a group of people with MS. It seems that home-based balance training tailored according to individual needs by a physiotherapist may be a future approach to consider for telerehabilitation of people with MS.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"2854130"},"PeriodicalIF":2.5,"publicationDate":"2019-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2854130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37540618","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":"Multiple Sclerosis in the Emirati Population: Onset Disease Characterization by MR Imaging.","authors":"Manzoor Ahmed, Ruqqiya Mir, Mustafa Shakra, Safana Al Fardan","doi":"10.1155/2019/7460213","DOIUrl":"10.1155/2019/7460213","url":null,"abstract":"<p><strong>Background and objectives: </strong>Multiple Sclerosis (MS) epidemiology is on the path of globalization mainly due to changing environmental factors. The prevalence of MS is on the rise in the Middle East and Persian Gulf region. Our observations has led us to hypothesize a heavy MRI lesion load at the onset of disease in a relatively younger native population. We aimed to estimate and characterize the onset disease on MRI using McDonald's criteria while applying its terms of \"Dissemination in Space (DIS) and Dissemination in Time (DIT)\".</p><p><strong>Materials and methods: </strong>Retrospective review of onset MRI studies of 181 Emirati (native) individuals. Basic demographics were captured. Only 47 patients with Clinically Definite MS (CDMS) were included who had onset diagnostic MRI available. Lesion load was quantified using the specific zones of involvement designated for DIS: (1) Periventricular (PVZ) (I), (2) Juxta-cortical (II) (3) Infra-tentorial (III) and, (4) Spinal cord (IV). PVZ was sub-classified and lesions were quantified. A single enhancing lesion was required for DIT.</p><p><strong>Results: </strong>Average age of onset was about 26 years with female dominance of about 2 : 1. About 50% had all 4 zones and about 85% had at least 3 zones involved at the onset. Involvement of only 1 zone was rare. Dissemination in time (DIT) in brain and/or cord was present in approximately 50%. Each of the 4 zones were involved in at least 70% of cases. PVZ was not spared in any case with at least 3 lesions present in approx. 95% and ≥12 lesions in approx. half of the patients. Spinal cord specifically cervical cord was involved in up to 80% with typical patchy lesions.</p><p><strong>Conclusion: </strong>Onset disease characterization using MRI in a young Emirati cohort showed a heavy lesion load in the brain and spinal cord at the onset, signifying cumulative disease before presentation. Disseminated disease also facilitated early diagnosis of MS. The findings have significant potential ramifications for local environmental and cultural factors, as well as disease course and disability progression.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"7460213"},"PeriodicalIF":2.2,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499226","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":"Is There Any Relationship between Upper and Lower Limb Impairments in People with Multiple Sclerosis? A Kinematic Quantitative Analysis","authors":"G. Coghe, F. Corona, Giuseppina Pilloni, M. Porta, J. Frau, L. Lorefice, G. Fenu, E. Cocco, M. Pau","doi":"10.1155/2019/9149201","DOIUrl":"https://doi.org/10.1155/2019/9149201","url":null,"abstract":"Background In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman's rank correlation coefficients. Results The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p < 0.05). Conclusions Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9149201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44756377","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}

{"title":"A Pilot Study to Assess At-Home Speed of Processing Training for Individuals with Multiple Sclerosis.","authors":"Lindsay Barker,&nbsp;Brian C Healy,&nbsp;Emily Chan,&nbsp;Kaitlynne Leclaire,&nbsp;Bonnie I Glanz","doi":"10.1155/2019/3584259","DOIUrl":"https://doi.org/10.1155/2019/3584259","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is a common symptom of multiple sclerosis (MS), yet treatment is currently limited. The primary goal of this pilot study was to assess the feasibility and acceptability of an at-home, five-week computerized speed of processing (SOP) training intervention for MS patients. In addition, we examined the utility of the intervention to improve speed of information processing, memory, executive function, and health-related quality of life (HRQOL).</p><p><strong>Method: </strong>Fifteen subjects were assigned five weeks of SOP training, two times per week, for a total of ten sessions. Subjects were trained on five computerized SOP tasks that required processing of increasingly complex visual stimuli in successively shorter presentation times. Subjects were given a neuropsychological test battery that included measures of speed of information processing, verbal memory, visual spatial memory, and executive function. Subjects were also administered patient-reported outcome (PRO) measures to assess HRQOL, depression, and work productivity. Neuropsychological and PRO batteries were completed at baseline and after five weeks.</p><p><strong>Results: </strong>Eighty percent of subjects completed the five-week intervention (n = 12). Significant improvements were observed on some, but not all, measures of speed of information processing, verbal memory, and executive function. There were no significant changes in HRQOL.</p><p><strong>Conclusion: </strong>This pilot study supports the feasibility of an at-home SOP training intervention for individuals with MS. SOP training was associated with improvements in several cognitive domains. Larger, randomized controlled trials are warranted.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"3584259"},"PeriodicalIF":2.5,"publicationDate":"2019-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3584259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37392524","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":"Repeated Working Memory Training Improves Task Performance and Neural Efficiency in Multiple Sclerosis Patients and Healthy Controls.","authors":"Naiara Aguirre, Álvaro Javier Cruz-Gómez, Anna Miró-Padilla, Elisenda Bueichekú, Ricardo Broseta Torres, César Ávila, Carla Sanchis-Segura, Cristina Forn","doi":"10.1155/2019/2657902","DOIUrl":"10.1155/2019/2657902","url":null,"abstract":"<p><strong>Background/objective: </strong>To explore the effectiveness of a specific working memory (WM) training program in MS patients and healthy controls (HC).</p><p><strong>Method: </strong>29 MS patients and 29 matched HC were enrolled in the study. MS and HC were randomly split into two groups: nontraining groups (15HC/14 MS) and training groups (14 HC/15 MS). Training groups underwent adaptive n-back training (60 min/day; 4 days). Functional magnetic resonance imaging (fMRI) was used to monitor brain activity during n-back performance (conditions: 0-back, 2-back, and 3-back) at 3 time points: (1) baseline, (2) post-training (+7days), and (3) follow-up (+35days).</p><p><strong>Results: </strong>In post-training and follow-up fMRI sessions, trained groups (HC and MS patients) exhibited significant reaction time (RT) reductions and increases in Correct Responses (CRs) during 2-back and 3-back performance. This improvement of task performance was accompanied by a decrease in brain activation in the WM frontoparietal network. The two effects were significantly correlated.</p><p><strong>Conclusions: </strong>After WM training, both cognitively preserved MS patients and HC participants showed task performance improvement made possible by neuroplastic processes that enhanced neural efficiency.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"2657902"},"PeriodicalIF":2.2,"publicationDate":"2019-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37281004","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":"Occupational Therapy in Fatigue Management in Multiple Sclerosis: An Umbrella Review.","authors":"Angela Salomè,&nbsp;Tullia Sasso D'Elia,&nbsp;Giorgia Franchini,&nbsp;Valter Santilli,&nbsp;Teresa Paolucci","doi":"10.1155/2019/2027947","DOIUrl":"https://doi.org/10.1155/2019/2027947","url":null,"abstract":"<p><p><i>Background.</i> Fatigue is one of the most invalidant symptoms of Multiple Sclerosis (MS) that negatively affects occupational and work performance and social participation. Occupational therapy (OT) assessment and treatment of impairments related to fatigue can have a significant and positive impact on the quality of life. <i>Methods.</i> An umbrella review has been carried out to provide rehabilitative decision makers in healthcare with insight into the role of OT in fatigue management in Multiple Sclerosis. The question is, what type of treatment provided by occupational therapist is more effective in reducing fatigue in Multiple Sclerosis? A search of literature published until June 2018 was undertaken by three independent reviewers using PubMed, PEDro, and Cochrane Library database including systematic reviews and meta-analyses of the last 10 years. <i>Results</i>. 10 studies were selected (5 systematic reviews, 1 meta-analysis, 3 reviews, and 1 guideline). <i>Conclusions.</i> Fatigue management programs have moderate evidence; other strategies such as OT strategies and telerehabilitation show low evidence.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"2027947"},"PeriodicalIF":2.5,"publicationDate":"2019-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2027947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37178816","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":"Real-Life Outcome in Multiple Sclerosis in the Czech Republic.","authors":"Gisela Kobelt,&nbsp;Linus Jönsson,&nbsp;Miluse Pavelcova,&nbsp;Eva Kubala Havrdová","doi":"10.1155/2019/7290285","DOIUrl":"https://doi.org/10.1155/2019/7290285","url":null,"abstract":"<p><strong>Background: </strong>Cohort studies and registries provide opportunities to estimate long-term outcome in multiple sclerosis.</p><p><strong>Objectives: </strong>To describe changes in disability (EDSS), relapse activity, and health care consumption over the period 2008-2015 by combining two Czech cost-of-illness studies with disease data from the MS Center in Prague.</p><p><strong>Methods: </strong>The combined dataset included 426 patients with a mean observation time of 8.3 years. A Cox proportional hazards model with time-varying covariates for treatment, disease course, and EDSS was applied to estimate the effect of treatment on the risk of progression to EDSS 4 and the risk of relapses. The use of health care resources (hospitalization, consultation, and tests) was compared between the two cross-sectional studies.</p><p><strong>Results: </strong>Total health care costs appeared stable between 2008 and 2015, despite more intense use of disease-modifying treatments in 2015 (52% of patients versus 31% in 2008). 39% of patients starting treatment at EDSS 0-3 in 2008 progressed to EDSS 4 or higher by 2015, while 65% of patients starting at EDSS 0-2 remained stable. The number of relapses was associated with a higher risk of progression. In a marginal structural Cox model of the relapse risk, treatment with natalizumab or fingolimod was associated with a lower risk of relapse (hazard ratio 0.68, p<0.01). Treatment with natalizumab or fingolimod was associated with a lower risk of progression to EDSS 4.</p><p><strong>Conclusion: </strong>Our results link relapses to progression and indicate that the newer treatments have a better effectiveness, despite difficulties caused by small a sample size, administrative rules guiding treatment, and absence of a random comparator group.</p>","PeriodicalId":46096,"journal":{"name":"Multiple Sclerosis International","volume":"2019 ","pages":"7290285"},"PeriodicalIF":2.5,"publicationDate":"2019-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7290285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37089527","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}