Ideggyogyaszati Szemle-Clinical Neuroscience最新文献

{"title":"Validation studies on a noninvasive neuromonitoring method, rheoencephalography - A review.","authors":"Jason J Chang, Ryan Gensler, Rocco A Armonda, Michael Bodo","doi":"10.18071/isz.78.0151","DOIUrl":"10.18071/isz.78.0151","url":null,"abstract":"<p><p>The loss of cerebral blood flow autoregulation is experienced after severe neurological injuries. Its impairment leads to a cascade of secondary neurological injuries that often follow the primary neurological insult. However, although its maintenance is important, cerebral autoregulation monitoring remains and does not follow consistent clinical standards. The traditional neurocritical monitoring method is invasive intracranial pressure monitoring. Several methods have also been tested for noninvasive neuromonitoring. Rheoencephalography is a form of non-invasive monitoring based on bioimpedance measurement; however, it is not used in routine clinical practice today. This review presents selected results of in-vitro and in-vivo studies evaluating the rheoencephalogram pulse waveform quantification during cerebral blood flow alterations, correlations with the intracranial pressure and other cerebral blood flow measuring modalities, and calculation of the rheoencephalogram-based autoregulation index. A total number of 1027 human and 638 animal measurements were involved. An in-vitro study documented the correlation between Doppler ultrasound flow and bioimpedance. In-vivo animal and human studies established a correlation with other modalities such as laser Doppler flow, carotid flow, near-infrared spectroscopy, and intracranial pressure as well as invasive and noninvasive cerebral blood flow autoregulation indexes. Studies documented that rheoencephalogram reflects cerebral volume change, cerebrovascular reactivity, intracranial pressure, and cerebral blood flow autoregulation. Human measurements documented that rheoencephalogram pulse wave morphology changes (peak 2) and that cerebral blood flow autoregulation's active/ passive status and peak 2 increases during the Trendelenburg position. These studies support the idea that rheoencephalography can be considered as a future non-invasive neuromonitoring modality.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 5-6","pages":"151-161"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235820","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":"[Unexpected changes in long-term follow-up of pharmacoresistant epilepsies. Case reports].","authors":"Péter Rajna","doi":"10.18071/isz.78.0189","DOIUrl":"10.18071/isz.78.0189","url":null,"abstract":"<p><strong>Background and purpose: </strong>There is few naturalistic evaluation on the spontaneous plasticity in the long-term follow-up of pharmacoresistant epilepsies. The author aims to answer the following questions: What are the trends and characteristics in spontaneous clinical development (amelioration or worsening) of these patients? Which external circumstances can influence the outcome - with special concern to seizure precipitating/ provoking factors?</p><p><strong>Methods: </strong>The author summarizes the history of 4 patients from the 14 ones with pharmacoresistant epilepsy presented consecutively between 1th January to 30th June 2024 at his out-patient clinic in whom he observed meaningful 'spontaneous' improvement in the follow-up without any modification of pharmacotherapy, and that of further 3 patients in whom unwanted seizure occurred after a long lasting seizure freedom. In their short case-reports he pointed the presence of some actual life events of physical, mental or emotional nature which possibly acted on the outcome.</p><p><strong>Results: </strong>During the long-term follow-up of pharmacoresistant epilepsies the author found that i./ The clinical course can show 'spontaneous' improvement concerning both in the frequency and intensity of seizures. ii./ In the majority of patients it shows close relation to the changes in life circumstances and to the presence of transient life events. iii./ The increased risk for relapse has been still remaining after a seizure-free life period lasting longer than that of established for the cured state.</p><p><strong>Conclusion: </strong>Occurrence of habitual seizures can be in closer connection with precipitating factors even is pharmacoresistant epilepsies. So, decrease or lack of some of them can lead to spontaneous recovery. The applied pills did not play significant role. On the other hand, the pharmacoresistant epilepsies can temporarily fulfill the conditions of 'cured epilepsy' but the risk of recurrence still remains higher. Based on these observations, a more detailed evaluation of precipitating and provoking factors of seizure is recommended in pharmacoresistant patients for achieving their optimal care. This may also include some new concepts in the definition of pharmacoresistant epilepsy.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 5-6","pages":"189-198"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235798","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":"Mechanical thrombectomy for acute ischemic stroke with simultaneous aorto-iliac occlusion due to cardiac myxoma dislodgement - Case report with review of the literature.","authors":"Lazar Lazovic, Petar Bosnjakovic, Yousef A I Abousedu, Diana Khedr, Lamya Alsarraf, Dragan Savic, Maryam Al Murshed, Doaa Hamdy Elkholy, Ibrahim Hanbal, Ghada Hamden","doi":"10.18071/isz.78.0199","DOIUrl":"10.18071/isz.78.0199","url":null,"abstract":"<p><p>Introduction - Cardiac myxomas are the most common cardiac tumors that can present with a spectrum of clinical manifestations. They are an uncommon cause of cerebral stroke, and simultaneous involvement of the aorto-iliac vessels is extremely rare with 8 cases reported in the literature over the past 10 years. We provide a pictorial illustration of the radiological, surgical, and histopathological findings, which differentiates our case from others in the literature. Case presentation - A 41-year-old female was admitted with right side weakness and aphasia (NIHSS score of 15). CT and CT-angiography revealed hyperacute brain ischemia with occlusion of left M1-segment of MiddleCerebral-Artery. The patient was shifted to a thrombectomy-capable center, where the left femoral pulse was found to be absence and the right femoral artery had weak pulsations. Mechanical thrombectomy of left MCA was done. Angiography showed occlusions of the distal abdominal aorta, the bilateral common iliac arteries, the left external iliac artery and the left common femoral artery. Surgical embolectomy of peripheral vessels was done. Pathohistology of clots taken out from the cerebral as well as peripheral vessels revealed cardiac myxoma. Patient had complete recovery of the stroke as well as the lower limb ischemia. Conclusion - Atrial myxoma is a rare cause of cerebral stroke requiring a thorough investigation to reach a diagnosis. Mechanical thrombectomy is a safe and effective method for treatment of such strokes. Important to emphasize the need for a multi-disciplinary team in the management of distal embolization in these cases. Data in the literature with regards to its treatment is limited.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 5-6","pages":"199-206"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235818","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":"Antibodies against SARS-CoV-2 in cerebrospinal fluid: Clinical features and laboratory findings of hospitalized patients with neurologic symptoms in the pandemic era.","authors":"Sezin Alpaydin Baslo, Burcu Yuksel, Isil Baytekin, Araz Ceren Incesoy, Eda Salihoglu Kara, Mesrure Koseoglu, Serap Teker, Begum Cengizler, Fatma Betul Oktelik, Aysu Sen, Dilek Atakli, Gunnur Deniz, Aysun Soysal","doi":"10.18071/isz.77.0136","DOIUrl":"10.18071/isz.77.0136","url":null,"abstract":"<p><strong>Background and purpose: </strong>High titers of anti-SARS-CoV-2 immunoglobulin G (IgG) have been reported in cerebrospinal fluid (CSF) samples of patients with COVID-19, but the data are limited. Our purpose is to report the clinical features and CSF findings of patients with neurologic symptoms in the pandemic era, and to discuss the origin and importance of anti-SARS-CoV-2 IgG in CSF.</p><p><strong>Methods: </strong>The data of 100 patients hospitalized in neurology inpatient clinics and tested for anti-SARS-CoV-2 IgG antibodies in CSF samples, between May 2021 and March 2022, were evaluated in a retrospective manner. Demographic features, presence of coronavirus disease 2019 (COVID-19) and/or COVID-19 history, vaccination, vaccine type, and neurologic diagnoses were noted. CSF and serum anti-SARS-CoV-2 antibody ratio (AR) were assessed using a Euroimmun ELISA assay. CSF cytology, CSF protein level, oligoclonal band, IgG index, and albumin quotient (QAlb) were analyzed and compared between CSF AR positive and negative groups.</p><p><strong>Results: </strong>QAlb and CSF protein levels were higher in the CSF anti-SARS-CoV-2 AR-positive group compared with CSF anti-SARS-CoV-2 AR-negative group (p.</p><p><strong>Conclusion: </strong>Anti-SARS-CoV-2 antibodies in CSF seem to be related to a past immunization or a pre-existing cross reactive immunity and passive diffusion through a disrupted blood-brain-barrier, but not to an intrathecal antibody synthesis.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"136-144"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755883","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":"[Management of migraine without aura in adolescents: The experience of flunarizine use in a Turkish cohort].","authors":"Faik Ilik, Devrimsel Harika Ertem, M Kemal Ilik","doi":"10.18071/isz.77.0122","DOIUrl":"10.18071/isz.77.0122","url":null,"abstract":"<p><strong>Background and purpose: </strong>Flunarizine is a specific calcium antagonist and is frequently used in adults for the prophylactic treatment of migraine. The use of flunarizine may lead to somnolence and weight gain, depression, and rarely extrapyramidal symptoms in adults. However, studies detecting the efficacy and safety of flunarizine use in adolescents are limited. In the current study, the effectiveness of flunarizine for the management of migraine without aura in Turkish adolescents was evaluated.</p><p><strong>Methods: </strong>Forty-six patients with migraine without aura, receiving flunarizine 5mg per day were included. In this retrospective study, the medical records of the cases were examined. Visual Analog Scale (VAS) and MIDAS scores were compared to assess the efficacy of the 3 months treatment.</p><p><strong>Results: </strong>The mean age was 14.37±1.83 years. There was a significant improvement in the VAS and MIDAS scores of the patients at the end of the third month (p.</p><p><strong>Conclusion: </strong>Although the advancement of migraine research and treatment is inevitable, our findings support that flunarizine should still be considered as an effective and tolerable treatment option in adolescent migraineurs.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"122-126"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755881","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":"Management of pediatric Sylvian arachnoid cysts. A retrospective study.","authors":"Murat Zaimoglu, Umit Eroglu, Melih Bozkurt, Baran Can Alpergin, Savas Hasimoglu, Onur Ozgural, Gokmen Kahilogullari, Mustafa Agahan Unlu","doi":"10.18071/isz.78.0127","DOIUrl":"10.18071/isz.78.0127","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neurosurgical approaches in Sylvian arachnoid cysts include microsurgery, endoscopy, and shunting. Yet, their relative safety and efficacy is still under debate. This retrospective study evaluated 36 pediatric patients with Sylvian arachnoid cysts and treated with different surgical types to contribute to global data.</p><p><strong>Methods: </strong>The study included 24, 8, and 4 patients receiving endoscopic, microsurgical, and shunt surgeries, respectively. Preoperative and postoperative assessments included the patients' demographics and symptoms, cyst size and type, psychomotor status, length of hospital stay, and complications with a mean follow-up of 37.3 months.</p><p><strong>Results: </strong>All types of surgeries alleviated headaches and seizures in most of the patients. Shunt operations led to the highest reduction in cyst size in the early postoperative period and relieved cranial palsy in all patients. Microsurgery achieved greater healing regarding hemiparesis and seizures, and reduced cyst size more effectively in the early postoperative period than endoscopy. Complication rates were similar between the endoscopy and microsurgery groups.</p><p><strong>Conclusion: </strong>Arachnoid cyst surgery is efficient and relatively safe. The higher efficacy of microsurgery may be associated with the lesser chronic presence of cysts in this group rather than its technical superiority. Endoscopic surgery is challenging, yet it may be advocated to avoid craniotomy and shunt complications. Surgical-type decisions for arachnoid cysts should be patient-tailored based on careful preoperative clinical and radiological examinations.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"127-135"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755886","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":"Application of computerised interactive devices for stroke patients with hemispatial neglect.","authors":"Ibolya Tavaszi, Gábor Szabó, Petra Erdősi, Benjamin Shenker, Gábor Fazekas","doi":"10.18071/isz.77.0107","DOIUrl":"10.18071/isz.77.0107","url":null,"abstract":"<p><strong>Background and purpose: </strong>Computerised interactive devices provide various treatment options for post-stroke rehabilitation, and may be applicable to treat neuropsychological deficits. This study aimed to identify a single rehabilitation task capable of improving both motor and cognitive functions in stroke patients.</p><p><strong>Methods: </strong>This prospective randomised controlled trial involved post-stroke patients with hemispatial neglect who were divided into four groups. All groups received conventional treatment. Besides this, the control group made sorter exercises, while the three experimental groups engaged in the following additional activities: exercises with a gravity-supporting exoskeleton; exercises with an upper limb device with sensors on the patient; exercises with an upper limb device with sensors on a touchscreen. All groups used the unaffected side, except the exoskeleton group. Following measures were assessed pre- and post-test: upper limb subsection of the Fugl-Meyer scale (FM-UL), functional independence measure (FIM), line bisection test (LBT), Bells test.</p><p><strong>Results: </strong>The programme (four weeks, 15 sessions) was completed by 59 post-stroke patients (less than 6 months after stroke). Significant associations were observed between time since stroke onset and improvements in FM-UL (p = .039), and motor (p = .021) and total FIM (p = .034). The motion abilities of the affected upper limb improved regardless of the treated side (p FM-UL = 0.45; p FIM = 0.416; p motor FIM = 0.395; p Bells test = 0.347; p LBT = 0.887). Bells test and LBT showed a strong correlation (-0.593). The effectiveness of the computerised interactive rehabilitation exercises in treating hemispatial neglect was comparable to conventional exercises, improving motor abilities of patients, as well as reducing hemispatial neglect in post-stroke patients.</p><p><strong>Conclusion: </strong>This form of therapy is effective for both motor and certain cognitive deficits.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"107-121"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755884","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":"[Automated audio analysis and depression: A systematic umbrella review].","authors":"Bálint Hajduska-Dér, Lajos Simon, János Réthelyi, Edit Haluska-Vass","doi":"10.18071/isz.77.0087","DOIUrl":"10.18071/isz.77.0087","url":null,"abstract":"<p><strong>Background and purpose: </strong>The early and accurate diagnosis of depression is essential for the timely initiation of appropriate treatment. However, the use of traditional diagnostic methods is often subjective, labour-intensive, and time-consuming. Automated voice analysis offers promising solution to overcome these challenges by enabling the objective measurement of voice-based biometric features. The aim of this study is to review the research practice and findings of voice analysis methods supported by machine learning, to uncover inconsistencies, and to formulate constructive suggestions for future research.</p><p><strong>Methods: </strong>This paper presents the results of a so-called umbrella review, which integrates the findings of already published systematic literature reviews and meta-analyses. For the identification of publications, we used the PubMed, Scopus, and ProQuest databases, following the PRISMA guidelines. The search interval covered the last 5 years. The search was conducted using predefined search terms and selection criteria, with the involvement of independent reviewers. Prior to detailed analysis, the methodological quality of the publications was assessed using the AMSTAR2 evaluation system.</p><p><strong>Results: </strong>Through the systematic literature search, we identified a total of 162 unique records. Based on the inclusion and exclusion criteria, 6 publications were selected for detailed analysis. The results highlight the background factors limiting the applicability of the developed models and also emphasize the importance of acoustic characteristics that can be identified as biomarkers of depression despite methodological inconsistencies. This review supports the importance of machine learning and voice analysis in advancing the diagnostics of depression. However, to translate research outcomes into practice, beyond the application of standardized methods, validation across diverse test groups is necessary, among other things.</p><p><strong>Conclusion: </strong>The application of machine learning in depression detection promises numerous advantages, such as objective diagnosis or early detection. This technology could offer cost-effective solution in the long run while providing greater access to mental health services. Nevertheless, the field is still evolving, and further research is needed to enhance the reliability of these methods.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"87-99"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755880","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":"Difficult clinical decisions regarding carotid artery revascularization in patients with contralateral carotid occlusion.","authors":"Robin Roy Mathews, László Oláh, László Csiba","doi":"10.18071/isz.77.0100","DOIUrl":"10.18071/isz.77.0100","url":null,"abstract":"<p><p>Background and purpose - Carotid revascularization through carotid endarterectomy (CEA) and carotid artery stenting (CAS) are well established secondary preventive measures after ischemic stroke in unilateral carotid artery stenosis, but in the presence of contralateral carotid occlusion (CCO) the evidence regarding the optimal management of the stenotic carotid is not as clear even though the risk of ischemic stroke is high. The purpose of our review is to summarize recent findings and suggest its future implications. Methods - We conducted a systematic literature review using PubMed and ScienceDirect databases supplemented with studies found from Google Scholar. Results - Recent guidelines recommend CAS over CEA in patients with CCO, but in contrast some studies favor CEA over CAS after analysis of the complications and clinical outcome. Discussion - The decision between CEA and CAS depends upon a variety of factors such as neurological status, surgical risk factors, medical comorbidities, age, and imaging findings (presence of silent infarcts, plaque characteristics and the state of collateral circulation). Due to the contradictory observations the authors suggest further multicenter studies to establish the optimal management of patients with carotid stenosis and CCO and also summarize their personal opinion.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"100-106"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755885","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":"[Prognostic significance of smoldering disease in multiple sclerosis, monitoring progression by imaging].","authors":"Lilla Rácz, Tünde Csépány","doi":"10.18071/isz.77.0079","DOIUrl":"10.18071/isz.77.0079","url":null,"abstract":"<p><p>Disability progression can occur in all phenotypes of multiple sclerosis (MS) from the early stages of the disease, which may be due to incomplete recovery from clinical relapses and/or more insidious deterioration of neurological functions independent of relapses. Progression independent of relapse is more common in patients with progressive MS than in patients with relapsing-remitting MS. Its main background may be the activation of innate immune cells and the development of chronic active lesions, referred to as smoldering disease. Their identification may help in the early recognition of aggressive forms. Finding effective therapies targeting progressive mechanisms is a major need. A better understanding of the mechanisms underlying the progression of MS, the identification and validation of biomarkers and new therapeutic targets could lead to further success of therapies. In this communication, we summarize the theoretical background of smoldering disease and potential imaging modalities for its detection.</p>","PeriodicalId":50394,"journal":{"name":"Ideggyogyaszati Szemle-Clinical Neuroscience","volume":"78 3-04","pages":"79-85"},"PeriodicalIF":0.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755882","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}