BMJ Neurology Open最新文献

{"title":"Visual outcome measures in clinical trials of remyelinating drugs","authors":"Gioia Riboni-Verri, Benson S Chen, Christopher E McMurran, Gregory J Halliwell, J William L Brown, Alasdair J Coles, Nick G Cunniffe","doi":"10.1136/bmjno-2023-000560","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000560","url":null,"abstract":"One of the most promising approaches to delay, prevent or reverse disability progression in multiple sclerosis (MS) is to enhance endogenous remyelination and limit axonal degeneration. In clinical trials of remyelinating drugs, there is a need for reliable, sensitive and clinically relevant outcome measures. The visual pathway, which is frequently affected by MS, provides a unique model system to evaluate remyelination of acute and chronic MS lesions in vivo and non-invasively. In this review, we discuss the different measures that have been used and scrutinise visual outcome measure selection in current and future remyelination trials.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"97 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139917642","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":"Cognitive impairment and liver fibrosis in non-alcoholic fatty liver disease.","authors":"Neal S Parikh, Farah Wahbeh, Christopher Tapia, Mallory Ianelli, Vanessa Liao, Abhishek Jaywant, Hooman Kamel, Sonal Kumar, Costantino Iadecola","doi":"10.1136/bmjno-2023-000543","DOIUrl":"10.1136/bmjno-2023-000543","url":null,"abstract":"<p><strong>Background: </strong>Data regarding the prevalence and phenotype of cognitive impairment in non-alcoholic fatty liver disease (NAFLD) are limited.</p><p><strong>Objective: </strong>We assessed the prevalence and nature of cognitive deficits in people with NAFLD and assessed whether liver fibrosis, an important determinant of outcomes in NAFLD, is associated with worse cognitive performance.</p><p><strong>Methods: </strong>We performed a prospective cross-sectional study. Patients with NAFLD underwent liver fibrosis assessment with transient elastography and the following assessments: Cognitive Change Index, Eight-Item Informant Interview to Differentiate Aging and Dementia Questionnaire (AD8), Montreal Cognitive Assessment (MoCA), EncephalApp minimal hepatic encephalopathy test and a limited National Institutes of Health Toolbox battery (Flanker Inhibitory Control and Attention Test, Pattern Comparison Test and Auditory Verbal Learning Test). We used multiple linear regression models to examine the association between liver fibrosis and cognitive measures while adjusting for relevant covariates.</p><p><strong>Results: </strong>We included 69 participants with mean age 50.4 years (SD 14.4); 62% were women. The median liver stiffness was 5.0 kilopascals (IQR 4.0-6.9), and 25% had liver fibrosis (≥7.0 kilopascals). Cognitive deficits were common in people with NAFLD; 41% had subjective cognitive impairment, 13% had an AD8 >2, 32% had MoCA <26 and 12% had encephalopathy detected on the EncephalApp test. In adjusted models, people with liver fibrosis had modestly worse performance only on the Flanker Inhibitory Control and Attention Task (β=-0.3; 95% CI -0.6 to -0.1).</p><p><strong>Conclusion: </strong>Cognitive deficits are common in people with NAFLD, among whom liver fibrosis was modestly associated with worse inhibitory control and attention.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"6 1","pages":"e000543"},"PeriodicalIF":2.1,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10806883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547638","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":"Subthalamic stimulation has acute psychotropic effects and improves neuropsychiatric fluctuations in Parkinson’s disease","authors":"Andreia D Magalhães, Deborah Amstutz, Katrin Petermann, Ines Debove, Mário Sousa, Marie E Maradan-Gachet, Martin Lenard Lachenmayer, Julia Waskönig, Sandra Murcia-Carretero, Andreas Antonios Diamantaras, Gerd Tinkhauser, Andreas Nowacki, Claudio Pollo, Carmen Rodriguez-Blazquez, Pablo Martinez-Martin, Paul Krack","doi":"10.1136/bmjno-2023-000524","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000524","url":null,"abstract":"Background Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for motor complications in Parkinson’s disease (PD). However, its effects on neuropsychiatric symptoms remain disputed. The aim of this study was to evaluate the effects of STN-DBS on neuropsychiatric symptoms in PD. Methods We retrospectively assessed 26 patients with PD who underwent a preoperative levodopa challenge and postoperative levodopa and stimulation challenges 1 year after STN-DBS. Based on the Neuropsychiatric Fluctuations Scale, Neuropsychiatric State Scores and Neuropsychiatric Fluctuation Indices (NFIs) were calculated. Mixed-effects models with random effects for intercept were used to examine the association of Neuropsychiatric State Score and NFI with the different assessment conditions. Results In acute challenge conditions, there was an estimated increase of 15.9 points in the Neuropsychiatric State Score in stimulation ON conditions (95% CI 11.4 to 20.6, p<0.001) and 7.6 points in medication ON conditions (95% CI 3.3 to 11.9, p<0.001). Neuropsychiatric fluctuations induced by levodopa, quantified with NFI, decreased by 35.54% (95% CI 49.3 to 21.8, p<0.001) 1 year after STN-DBS. Conclusions Bilateral STN-DBS at therapeutic parameters has acute psychotropic effects similar to levodopa and can modulate and decrease levodopa-induced neuropsychiatric fluctuations. Data are available upon reasonable request.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374603","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":"Levodopa use in Australia: an analysis of Pharmaceutical Benefits Scheme 10% data","authors":"Andrew Evans, Benjamin J Waterhouse","doi":"10.1136/bmjno-2023-000484","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000484","url":null,"abstract":"Background Levodopa remains the mainstay of treatment of Parkinson’s disease, however, over time motor fluctuations and levodopa-induced dyskinesia develop, requiring add-on therapies to control emerging symptoms. To date, however, there is no clear consensus in Australia, or elsewhere, at which dose of levodopa that add-on therapies should be considered. Objectives The purpose of this study was to examine the treatment patterns of patients with Parkinson’s disease in Australia, with particular focus on levodopa doses at the time of first add-on. Methods This was a retrospective, observational, non-interventional study of patients with Parkinson’s disease within the Australian Department of Human Services Pharmaceutical Benefits Scheme (PBS) 10% sample. Data on all reimbursed prescriptions (both general and concession), prescriber type and item code were extracted for patients who were dispensed at least three PBS reimbursed prescriptions for levodopa in the previous 12 months prescription from 1 January 2007 to 31 December 2021. Results 154 850 unique patients were included, of whom 42 330 (27%) commenced add-on therapy during the period. In the 12 months prior to add-on therapy, levodopa doses ranged from 100 mg/day to 1000 mg/day. The majority of patients were prescribed add-on therapy by a neurologist and approximately 40% of patients were prescribed levodopa doses of 600 mg/day or more prior to the first add-on therapy being initiated. Conclusions A large proportion of patients in Australia are managed with levodopa monotherapy doses that are considered high and many of these patients may benefit from the addition of add-on therapy to their regimen. Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from Services Australia. Restrictions apply to the availability of these data, which were used under license for this study. Data are available at <https://www.servicesaustralia.gov.au/organisations/about-us/reports-and-statistics/statistical-information-and-data%23request> with the permission of Services Australia’s External Request Evaluation Committee.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"10 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139496475","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":"Is there a temporal relationship between atrial fibrillation and stroke? A review","authors":"Jessica Dlima, Rooj Kitisarn, Han Lim, Vincent Thijs","doi":"10.1136/bmjno-2023-000512","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000512","url":null,"abstract":"Importance Atrial fibrillation (AF) is an established risk factor for ischaemic stroke. The introduction of continuous cardiac rhythm monitoring devices has enabled detection of brief and asymptomatic episodes of AF. Observations The search yielded 727 studies, 11 of which met the inclusion criteria. Four studies suggested a strong temporal association between episodes of AF and stroke, while seven indicated a weak relationship. The conflicting nature of the studies may be attributed to inconsistencies in ischaemic stroke verification (n=5/11), event rate and power (n=6/11) and lack of controlling for anticoagulation (n=10/11), mitigating the relationship between AF episodes and stroke. Conclusions and relevance The temporal relationship between AF and stroke still remains unclear due to varying study methodology, lack of control for anticoagulation and inconsistent stroke subtyping. Our review identifies limitations to the current literature and makes recommendations for future studies assessing the temporal relationship between AF episodes and cardioembolic stroke. No data are available.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"210 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139558754","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":"Cytotoxic lesions of the corpus callosum (CLOCCs) with a flow gap in straight sinus on magnetic resonance venography","authors":"Seung-Cheol Jeong, Seokwon Han, Jihye Hwang","doi":"10.1136/bmjno-2023-000579","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000579","url":null,"abstract":"Cytotoxic lesions of the corpus callosum (CLOCCs) are cytotoxic lesions observed in the splenium of the corpus callosum and are also called mild encephalitis or encephalopathy with reversible splenial lesions or reversible splenial lesion syndrome. It was first reported in patients with epilepsy and since then has been observed in a wide variety of diseases, including infections, trauma, metabolic disorders (hyperglycaemia, hypernatraemia and hyponatraemia), mountain sickness and cerebral venous sinus thrombosis. Here, we present a patient with CLOCCs accompanied by a flow gap in the straight sinus on magnetic resonance venography without any evidence of cerebral venous sinus thrombosis and discuss the possible clinical implications. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"29 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139463635","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":"Batoclimab as induction and maintenance therapy in patients with myasthenia gravis: rationale and study design of a phase 3 clinical trial","authors":"Michael Benatar, Heinz Wiendl, Richard Nowak, Yan Zheng, William Macias","doi":"10.1136/bmjno-2023-000536","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000536","url":null,"abstract":"Introduction Batoclimab, a fully human monoclonal antibody that inhibits the neonatal fragment crystallisable receptor, has shown promising phase 2 clinical trial results in patients with generalised myasthenia gravis (gMG). Methods and analysis In this phase 3, randomised, quadruple-blind, placebo-controlled study, adults with gMG will be randomised 1:1:1 to induction therapy with batoclimab 680 mg, batoclimab 340 mg, or placebo, administered once weekly (QW) for 12 weeks as a subcutaneous injection. The primary endpoint is the change from baseline to week 12 on the Myasthenia Gravis Activities of Daily Living (MG-ADL) score. Batoclimab-treated patients achieving a ≥2-point improvement from baseline on MG-ADL at week 10 or week 12 will be re-randomised to maintenance treatment with batoclimab 340 mg QW, batoclimab 340 mg every other week (Q2W), or placebo for 12 weeks; batoclimab-treated patients with a <2-point improvement at week 10 and week 12 will be switched to placebo for the maintenance period and discontinued thereafter. Placebo-treated patients from the induction period will be re-randomised to batoclimab 340 mg QW or Q2W in the maintenance period. All patients who complete the maintenance period and achieve a ≥2-point improvement from baseline in MG-ADL during ≥1 of the final 2 visits of the induction and/or maintenance periods will continue their current batoclimab dose (or switch to batoclimab 340 mg QW for those on placebo) for a 52-week long-term extension (LTE-1). Patients who complete LTE-1 may enter a second, optional 52-week LTE (LTE-2). Ethics and dissemination This trial is being conducted in accordance with the International Council for Harmonisation Guideline for Good Clinical Practice, the Declaration of Helsinki, and each site’s Institutional Review Board/Independent Ethics Committee. All patients must provide written informed consent. Results from this study will be published in peer-reviewed journals and presented at national and global conferences. Trial registration number [NCT05403541][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05403541&atom=%2Fbmjno%2F6%2F1%2Fe000536.atom","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"26 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423182","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":"Peculiar aetiology for orbital apex syndrome: Wyburn-Mason syndrome as orbital apex lesion","authors":"Lívio Leite Barros, Pedro Lucas Grangeiro de Sá Barreto Lima, Pedro Helder de Oliveira Júnior, Daniel Aguiar Dias, Carolina de Figueiredo Santos, Pedro Braga-Neto, Paulo Ribeiro Nóbrega","doi":"10.1136/bmjno-2023-000559","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000559","url":null,"abstract":"Background Wyburn-Mason syndrome is a rare, non-hereditary congenital disease, belonging to the group of neurocutaneous syndromes with fewer than 100 cases reported since its first description in 1937. Case report A young adult man was initially evaluated at the age of 2 years for proptosis and progressive visual impairment of the right eye, followed by impairment in ocular abduction, adduction and elevation as well as amaurosis. MRI revealed an expansive formation centred in the right orbit compromising conal spaces with distortion of eye muscles and optic nerve. The lesion extended through the superior orbital fissure into the right cavernous sinus and to the contralateral orbit. Despite embolisation, proptosis and oedema of the periorbital tissue continued to worsen. The combination of facial, ocular and intracranial vascular malformations and the exclusion of alternative aetiologies led to a diagnosis of cerebrofacial arteriovenous metameric syndrome (CAMS) 1 (Wyburn-Mason syndrome). Discussion Important differential diagnoses are other CAMS, such as Sturge-Weber syndrome, as well as other conditions such as retinal cavernous haemangioma and vasoproliferative tumours. The optimal treatment regimen for severe cases of this syndrome is still unclear. Wyburn-Mason syndrome should be considered in patients presenting multiple arteriovenous malformations with orbital apex lesions. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"557 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139496430","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":"Twelve-month efficacy of CGRP monoclonal antibodies and predictive value of short-term response: results of an Australian multicentre study","authors":"Jason Charles Ray, Linda Dalic, Josephine Baker, Shuli Cheng, Elspeth Jane Hutton, Manjit Matharu","doi":"10.1136/bmjno-2023-000547","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000547","url":null,"abstract":"Introduction Clinical trials show that calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are effective preventative treatments for chronic migraine. Their efficacy over longer time periods and in cohorts originally excluded from trials remains uncertain. This study aims to explore the impact of CGRP mAbs in an Australian real-life setting. Methods A multicentre cohort study was performed in the tertiary headache clinics of the Alfred and Austin Hospitals, Melbourne, Australia. Patients were commenced on a CGRP mAb for chronic migraine and asked to keep a headache diary, recorded at 3 monthly appointments for 12 months. Primary outcome was a ≥50% reduction in monthly headache days (MHD). Results From a population of 105 patients, 90 patients commenced galcanezumab and 15 commenced fremanezumab. The ≥50% responder rate of the cohort was 52.4% after 3 months. Over 12 months follow-up, 25.7% of the cohort ceased due to a lack of efficacy and 16.2% ceased due to an adverse event. There was no difference in response or cessation between medications. There was poor agreement in 3-month and 12-month response rates (Cohen’s κ=0.130; p=0.171). On subgroup analysis, continuous headache at baseline and number of trialled preventative treatments were the only factors associated with efficacy. Conclusion CGRP mAbs were associated with sustained reductions in MHD over 12-month follow-up in patients with resistant migraine in Australia. Further studies are required to determine treatment options for patients with continuous headache. Poor agreement between outcomes at 3 and 12 months highlights the need to assess some patients at later timepoints. Data are available on reasonable request. Data is available on reasonable request.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"29 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423219","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":"Poor haemorrhagic stroke outcomes during the COVID-19 pandemic are driven by socioeconomic disparities: analysis of nationally representative data","authors":"Abdulaziz T Bako, Thomas Potter, Alan P Pan, Karim A Borei, Taya Prince, Gavin W Britz, Farhaan S Vahidy","doi":"10.1136/bmjno-2023-000511","DOIUrl":"https://doi.org/10.1136/bmjno-2023-000511","url":null,"abstract":"Background Nationally representative studies evaluating the impact of the COVID-19 pandemic on haemorrhagic stroke outcomes are lacking. Methods In this pooled cross-sectional analysis, we identified adults (≥18 years) with primary intracerebral haemorrhage (ICH) or subarachnoid haemorrhage (SAH) from the National Inpatient Sample (2016–2020). We evaluated differences in rates of in-hospital outcomes between the prepandemic (January 2016–February 2020) and pandemic (March–December 2020) periods using segmented logistic regression models. We used multivariable logistic regression to evaluate differences in mortality between patients admitted from April to December 2020, with and without COVID-19, and those admitted from April to December 2019. Stratified analyses were conducted among patients residing in low-income and high-income zip codes, as well as among patients with extreme loss of function (E-LoF) and those with minor to major loss of function (MM-LoF). Results Overall, 309 965 patients with ICH (47% female, 56% low income) and 112 210 patients with SAH (62% female, 55% low income) were analysed. Prepandemic, ICH mortality decreased by ~1% per month (adjusted OR, 95% CI: 0.99 (0.99 to 1.00); p<0.001). However, during the pandemic, the overall ICH mortality rate increased, relative to prepandemic, by ~2% per month (1.02 (1.00 to 1.04), p<0.05) and ~4% per month (1.04 (1.01 to 1.07), p<0.001) among low-income patients. There was no significant change in trend among high-income patients with ICH (1.00 (0.97 to 1.03)). Patients with comorbid COVID-19 in 2020 had higher odds of mortality (versus 2019 cohort) only among patients with MM-LoF (ICH, 2.15 (1.12 to 4.16), and SAH, 5.77 (1.57 to 21.17)), but not among patients with E-LoF. Conclusion Sustained efforts are needed to address socioeconomic disparities in healthcare access, quality and outcomes during public health emergencies.","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"64 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139465205","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}