Neurologist最新文献

{"title":"Validation of an Artificial Intelligence-Powered Virtual Assistant for Emergency Triage in Neurology.","authors":"Lucas Alessandro, Santiago Crema, Juan I Castiglione, Daiana Dossi, Federico Eberbach, Alejandro Kohler, Alfredo Laffue, Abril Marone, Vanesa Nagel, José M Pastor Rueda, Francisco Varela, Diego Fernandez Slezak, Sofía Rodríguez Murúa, Carlos Debasa, Pensa Claudio, Mauricio F Farez","doi":"10.1097/NRL.0000000000000594","DOIUrl":"10.1097/NRL.0000000000000594","url":null,"abstract":"<p><strong>Objectives: </strong>Neurological emergencies pose significant challenges in medical care in resource-limited countries. Artificial intelligence (AI), particularly health chatbots, offers a promising solution. Rigorous validation is required to ensure safety and accuracy. Our objective is to evaluate the diagnostic safety and effectiveness of an AI-powered virtual assistant (VA) designed for the triage of neurological pathologies.</p><p><strong>Methods: </strong>The performance of an AI-powered VA for emergency neurological triage was tested. Ten patients over 18 years old with urgent neurological pathologies were selected. In the first stage, 9 neurologists assessed the safety of the VA using their clinical records. In the second stage, the assistant's accuracy when used by patients was evaluated. Finally, VA performance was compared with ChatGPT 3.5 and 4.</p><p><strong>Results: </strong>In stage 1, neurologists agreed with the VA in 98.5% of the cases for syndromic diagnosis, and in all cases, the definitive diagnosis was among the top 5 differentials. In stage 2, neurologists agreed with all diagnostic parameters and recommendations suggested by the assistant to patients. The average use time was 5.5 minutes (average of 16.5 questions). VA showed superiority over both versions of ChatGPT in all evaluated diagnostic and safety aspects ( P <0.0001). In 57.8% of the evaluations, neurologists rated the VA as \"excellent\" (suggesting adequate utility).</p><p><strong>Conclusions: </strong>In this study, the VA showcased promising diagnostic accuracy and user satisfaction, bolstering confidence in further development. These outcomes encourage proceeding to a comprehensive phase 1/2 trial with 100 patients to thoroughly assess its \"real-time\" application in emergency neurological triage.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"155-163"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Mortality and Neurological Complications in a Large Cohort of Patients With COVID-19: A Retrospective Single-Center Cohort Study.","authors":"Parastoo Moradi Choghakabodi, Mofid Hosseinzadeh, Neda Yakhchali Dehkordi, Mandana Pouladzadeh, Davood Shalilahmadi","doi":"10.1097/NRL.0000000000000593","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000593","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between the baseline clinical and laboratory characteristics of patients with COVID-19 and their risk of subsequent development of neurological complications and mortality.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included patients with COVID-19 who presented to the Emergency Department of Razi Hospital. Patients' charts were reviewed to collect baseline clinical and laboratory data.</p><p><strong>Results: </strong>Of 2205 patients with COVID-19, 1473 (66.8%) developed various neurological complications in addition to other symptoms. Among the 168 patients who died, 66.66%, 43.5%, and 25% had a history of neurological disorders, encephalopathy, and stroke, respectively. Disease severity was significantly associated with comorbidities, hypoxemia, hypoalbuminemia, hypophosphatemia, elevated ESR, hypomagnesemia, stroke, and encephalopathy (P<0.05). The risk of death remained strongly linked to older age, comorbidities, severe infection, ICU admission, and extended hospitalization (P<0.05), even after adjustments, indicating they are potential confounders for other variables. More importantly, in non-critically ill patients, there was no significant association between the risk of death and hypoxemia, anemia, thrombocytopenia, hypomagnesemia, stroke, and encephalopathy (P>0.05). Moreover, the association between encephalopathy and other factors was greatly influenced by disease severity. Nonetheless, older age, comorbidities, and anemia remained significant predictors of stroke even after adjusting for confounders (P<0.05).</p><p><strong>Conclusions: </strong>The high rates of neurological disorders among deceased patients with COVID-19 underscores the need for early prediction and management of these complications. Moreover, neurological disorders were linked to an increased risk of death because they tend to be present in critically ill patients admitted to the ICU with extended hospitalization.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 3","pages":"123-131"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-powered Virtual Assistant for Emergency Triage in Neurology.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/NRL.0000000000000621","DOIUrl":"10.1097/NRL.0000000000000621","url":null,"abstract":"","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"190"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombolytic Imaging-to-Needle Time as a Metric for Comparing Telemedicine versus In-Person Evaluation in Acute Ischemic Stroke.","authors":"Andrea Loggini, Faddi G Saleh Velez, Jessie Henson, Julie Wesler, Jonatan Hornik, Amber Schwertnam, Karam Dallow, Joaquin Grimaldi, Alejandro Hornik","doi":"10.1097/NRL.0000000000000618","DOIUrl":"10.1097/NRL.0000000000000618","url":null,"abstract":"<p><strong>Objectives: </strong>Door-to-needle time (DTN) is standard for measuring the efficiency of thrombolytic administration in acute ischemic stroke, with guidelines recommending DTN <60 minutes. DTN can be divided into door-to-imaging time (DIT) and imaging-to-needle time (ITN), separated by arrival at the CT scanner. We hypothesize that ITN is more accurate for comparing the mode of evaluation for stroke patients treated with thrombolytics.</p><p><strong>Methods: </strong>This is a retrospective cohort study of stroke patients treated with thrombolytics at Southern Illinois Health care. Data on demographics, clinical presentation, stroke metrics, thrombolytic complications, and mRS at 1-month were reviewed. Multivariate logistic regression models were applied to evaluate predictors of DTN, ITN, and DIT, with OR and 95% CI. P -value was set at 0.05.</p><p><strong>Results: </strong>Out of 287 patients, 170 were evaluated by telemedicine, 117 in-person. The 2 groups were comparable in demographics and stroke severity. Telemedicine had longer median DTN, in minutes [55 (43 to 70) vs. 42 (34 to 62), P <0.01], and median ITN, in minutes [43 (35-58) vs. 32 (25-48), P <0.01]. There was no statistical difference in DIT between the 2 groups. Adjusted for stroke severity and age, telemedicine was associated with lower odds of DTN <60 minutes (OR: 0.553, 95% CI: 0.328-0.931, P =0.026) and ITN <35 minutes (OR: 0.265, 95% CI: 0.159-0.441, P <0.01). However, telemedicine was not independently associated with DIT <25 minutes, which was instead inversely correlated with age (OR: 0.974, 95% CI: 0.951-0.997, P =0.03).</p><p><strong>Conclusions: </strong>ITN represents a more accurate metric for comparing telemedicine and in-person evaluations than DTN, as it excludes stroke-specific processes of care and patient-specific factors that are intrinsic to DTN and unrelated to the modality of evaluation.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"170-174"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke-Related Factors Influencing Thrombolysis Eligibility and Outcomes.","authors":"Maurizio Giorelli, Maria Stella Aniello, Daniele Liuzzi, Alfredo De Liso, Donatella Accavone, Francesco Negri","doi":"10.1097/NRL.0000000000000609","DOIUrl":"10.1097/NRL.0000000000000609","url":null,"abstract":"<p><strong>Objective: </strong>Intravenous thrombolysis (IVT) improves outcomes of acute ischemic stroke (AIS) when timely administered. The aim of this study was to collect and analyze data of stroke-related factors which may influence the performance of stroke-related rescue chains, the use of IVT, and patients' outcomes.</p><p><strong>Methods: </strong>This study enrolled patients with AIS admitted to our Stroke Unit (SU) between January 1, 2023, and December 31, 2023. We investigated whether age, occurrence of baseline disabling deficits, stroke severity, or stroke location influenced the median Onset-to-Door Time (ODT), the chance of receiving IVT, or the outcomes of AIS in our facility.</p><p><strong>Results: </strong>A total of 208 patients were enrolled. Patients who received IVT had higher baseline National Institute of Health Stroke Scale (NIHSS) scores (12.26±1.2) than those who did not (6.77±0.51) ( P <0.0001). Patients with IVT further showed a greater strength deficit, less ataxia, and lower median ODT (108±20 min) than patients with NO IVT (720±67) ( P <0.0001). Weakness of the lower limbs and higher total NIHSS predicted ODT≤ 3.5 hours and the use of IVT. Ataxia and Posterior Circulation Stroke slowed the rescue chain and were negatively correlated with the use of IVT.</p><p><strong>Conclusions: </strong>Stroke-related factors may slow the rescue chain and affect the application of IVT for AIS. New evaluation strategies are warranted to overcome the detrimental effects of these factors and to allow clinicians to effectively manage strokes of any severity and location.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"164-169"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortened NIHSS for Rapid Stroke Assessment in Emergency Care Settings.","authors":"Sama Rahnemayan, Alireza Ala, Nasrin Taghizadeh, Elyar Sadeghi-Hokmabadi, Ipak Entezari, Samad Shams Vahdati","doi":"10.1097/NRL.0000000000000608","DOIUrl":"10.1097/NRL.0000000000000608","url":null,"abstract":"<p><strong>Objectives: </strong>The National Institutes of Health Stroke Scale (NIHSS) is widely used to assess ischemic stroke severity, but its full 11-item version can be time-consuming. This study evaluates the NIHSS-8, a shortened version, for its efficacy compared with NIHSS-11 in an emergency department setting.</p><p><strong>Methods: </strong>A cohort study was conducted from May 2018 to May 2019 at Imam Reza Hospital, Tabriz, Iran. Patients with suspected acute stroke were assessed using both NIHSS-11 and NIHSS-8. The modified Rankin Scale (mRS) was used to evaluate patient outcomes at discharge. Correlations between NIHSS-8, NIHSS-11, and mRS were analyzed, and diagnostic performance metrics were calculated.</p><p><strong>Results: </strong>The study included 292 patients with a mean age of 70.40 years. Approximately 68.5% of patients were categorized as having moderate stroke severity using NIHSS-11, with a similar 67.1% using NIHSS-8. The correlation between NIHSS-11 and NIHSS-8 scores was high (intraclass correlation coefficient of 0.970). Both scales showed strong relationships with mRS at discharge but were not significantly correlated with long-term outcomes. NIHSS-8 demonstrated a sensitivity of 97.5% and specificity of 96.9%, while NIHSS-11 showed 100% sensitivity and 96.9% specificity.</p><p><strong>Conclusions: </strong>NIHSS-8 is a reliable and efficient alternative to NIHSS-11 for assessing stroke severity in emergency departments. It provides high sensitivity and specificity while being less time-consuming, making it suitable for rapid stroke assessment and triage.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"150-154"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enoxaparin Failure in Patient With Cerebral Venous Sinus Thrombosis and Prothrombin G20210A Mutation: Case Report.","authors":"Adithya Polavarapu, Anita Bhushan, Walter Duarte-Celada, Thomas Windisch, Bharat Bhushan","doi":"10.1097/NRL.0000000000000591","DOIUrl":"10.1097/NRL.0000000000000591","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral venous sinus thrombosis (CVST) is a rare, serious, and complex cerebrovascular disease. The prothrombin G20210A mutation is the second most common inherited thrombophilia and is considered to be one of the etiologies of CVST. The optimal heparinoid medication for treatment remains a topic of debate.</p><p><strong>Case report: </strong>This case report describes a young woman with CVST who did not respond to low-molecular-weight heparin (LMWH). The patient was initially treated with LMWH; however, her symptoms and clot burden in the sagittal sinus worsened, and coagulation studies showed no evidence of therapeutic anticoagulation despite good compliance. Unfractionated heparin was then initiated, and the patient's symptoms improved dramatically within 24 hours, along with the recanalization of the cerebral venous sinuses. Genetic testing revealed a heterozygous mutation in the prothrombin gene (G20210A). This mutation is a known risk factor for CVST. However, it is unclear why the patient did not respond to LMWH but responded appropriately to unfractionated heparin.</p><p><strong>Conclusion: </strong>This case report highlights the potential for LMWH resistance in patients with CVST and prothrombin gene mutations. These findings also emphasize the importance of close monitoring of coagulation parameters and clinical response in patients with CVST receiving LMWH.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"175-181"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Naples Prognostic Score and All-Cause and Cardiovascular Mortality in Stroke Patients.","authors":"Lirong Chen, Yongming Liu","doi":"10.1097/NRL.0000000000000617","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000617","url":null,"abstract":"<p><strong>Objectives: </strong>Stroke is a primary public health challenge worldwide, with its prognosis profoundly related to inflammation and nutritional status. Naples prognostic score (NPS) is an integrated indicator of combined inflammation and nutrition. The study aimed to elucidate the link between NPS and all-cause and cardiovascular (CVD) deaths in stroke patients.</p><p><strong>Methods: </strong>NHANES (2001 to 2018) data set was used. Multivariate corrected Cox models, Kaplan-Meier, and restricted cubic spline analysis were adopted to explore the link between NPS, all-cause, and CVD mortality in stroke patients. Subgroup analyses based on age, sex, BMI, education, alcohol consumption, smoking, hypertension, and diabetes were performed to further explore associations.</p><p><strong>Results: </strong>Totally, 1247 stroke patients were enrolled. High NPS levels were notably linked with a heightened risk of all-cause mortality (HR: 1.320, 95% CI: 1.180-1.470, P<0.001) and CVD death (HR: 1.390, 95% CI: 1.120-1.730, P=0.003) in stroke patients after adjusting for relevant factors. Compared with group 0 (NPS=0), group 2 (NPS=3-4) had a high hazard ratio for all-cause mortality (HR: 2.920, 95% CI: 1.820-4.670, P<0.001) and CVD mortality (HR: 2.610, 95% CI: 1.140-5.970, P=0.023). The RCS suggested a linear link between NPS and both all-cause (P for nonlinear=0.2202) and CVD deaths (P for nonlinear=0.9841) in stroke patients. These links were mostly consistent in subgroups. There was no pronounced interaction between status and NPS scores for each subgroup (all P<0.05).</p><p><strong>Conclusions: </strong>High NPS scores are connected with an augmented risk of all-cause mortality and CVD death in stroke patients. NPS is possibly connected with prognosis in stroke patients.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Seizure Risks in Cerebral Venous Sinus Thrombosis Based on Thrombosis Site.","authors":"Ali Amini Harandi, Helia Jafari Khaljiri, Nafiseh Jahangiri Zarkani, Hossein Pakdaman, Nika Khalili","doi":"10.1097/NRL.0000000000000625","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000625","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebral venous sinus thrombosis (CVST) often leads to seizures, potentially worsening prognosis. This study aimed to assess the relationship between specific occlusion sites and seizure occurrence.</p><p><strong>Methods: </strong>We retrospectively analyzed 154 patients diagnosed with CVST in 3 major hospitals in Tehran. Medical records detailing sinus involvement, seizure occurrence, and baseline characteristics were reviewed. Statistical analyses included the χ2 or the Fisher exact tests, followed by binomial logistic regression to identify independent predictors. Model performance was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>The study included 102 women (66.2%) and 52 men (33.8%), with a mean age of 36.4±10.8 years. A total of 35 patients (22.7%) experienced seizures, predominantly generalized tonic-clonic (85.7%). Superior sagittal sinus (SSS) involvement was strongly associated with seizures (odds ratio=3.056, P=0.006), while left transverse sinus involvement showed a marginally significant inverse relationship in univariate analysis (P=0.027), which became nonsignificant in the multivariate model (P=0.056). Trolard vein thrombosis was rare but associated with a high seizure rate (3/4 cases). The ROC for the final model showed moderate predictive ability (AUC=0.676).</p><p><strong>Conclusion: </strong>SSS thrombosis significantly predicted seizures in Iranian CVST patients. Although rare, trolard vein involvement may carry a substantial seizure risk. These findings underscore the importance of precise imaging and individualized treatment plans for high-risk CVST patients. By illuminating the role of SSS and trolard vein, this study highlights the need for prospective trials to refine clinical decision-making.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Counterpulsation Therapy Enhances Neurological Outcomes in Patients Experiencing Acute Ischemic Stroke.","authors":"Jiaxuan Li, Xinhui Jia, Xinyi Chen, Jie Hu, Xun He, Yueyu Zhang, Yi Tang, Juncang Wu","doi":"10.1097/NRL.0000000000000616","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000616","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the effects of extracorporeal counterpulsation therapy (ECP) on the short-term outcomes of patients with acute ischemic stroke in the mid-stroke phase.</p><p><strong>Methods: </strong>A total of 171 patients with acute ischemic stroke from the Department of Neurology at our hospital were selected and randomly assigned to 2 groups: 84 patients in the ECP group and 87 patients in the control group. Both groups received standard medication and rehabilitation. In addition, extracorporeal counterpulsation was incorporated into the treatment for the ECP group. At the conclusion of the treatment and after 90 days, both groups were evaluated based on the NIHSS and MRS scores.</p><p><strong>Results: </strong>No statistically significant differences were detected between the NIHSS and MRS scores of the 2 groups before and following treatment (P>0.05). However, on the 90th day, the NIHSS and MRS scores of the ECP group were significantly lower than those of the comparison group (P<0.05). The difference in the proportion of patients with NIHSS scores ≤1 between the 2 groups was 20.8%, whereas the absolute difference in MRS scores was 14.1%.</p><p><strong>Conclusion: </strong>Extracorporeal counter therapy effectively enhances neurological function in patients with ischemic stroke, thereby improving their ability to perform activities of daily living and overall prognosis.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}