Brain & Development最新文献

{"title":"JSCN Best Paper Awards","authors":"","doi":"10.1016/j.braindev.2025.104372","DOIUrl":"10.1016/j.braindev.2025.104372","url":null,"abstract":"","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104372"},"PeriodicalIF":1.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071422","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":"Awareness and knowledge of pediatricians regarding genetic testing for Fragile X syndrome in Japan: A National Survey of Pediatricians Managing Developmental Delay/Intellectual disability","authors":"Tetsuya Okazaki ,&nbsp;Chisako Aoki ,&nbsp;Saki Shinzato ,&nbsp;Kaori Adachi ,&nbsp;Eiji Nanba","doi":"10.1016/j.braindev.2025.104367","DOIUrl":"10.1016/j.braindev.2025.104367","url":null,"abstract":"<div><h3>Background</h3><div>Fragile X syndrome (FXS) commonly cause developmental delay, intellectual disability, and autism spectrum disorder. Although genetic testing has been available and included in Japan's national health insurance since 2016, the number of cases diagnosed with FXS remains low. This study aimed to explore the levels of awareness and understanding of FXS among pediatricians managing developmental delay/ intellectual disability in Japan, particularly between pediatrician with and without clinical genetics certification (or clinical experience with FXS).</div></div><div><h3>Methods</h3><div>A survey involving 1217 certified pediatric neurologists from the Japanese Society of Pediatric Neurology and 367 members of the Japanese Society of Pediatric Genetics was conducted. Additional participants were recruited from an online mailing list of 1469 pediatric neurologists. The survey comprised questions on demographics, knowledge about FXS, and genetic testing practices. The responses were analyzed using Chi-square and Fisher's exact tests, and a <em>p</em>-value &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Out of 386 respondents, 326 had experience ordering some kind of genetic testing, including 78 certified clinical geneticists. Knowledge gaps were significant between clinical geneticists and non-genetic specialists. While 20 % of non-genetic specialists were unaware of insurance-covered FXS genetic testing, this percentage was lower among those with clinical experience in FXS cases. Many respondents, irrespective of certification, struggled to determine the indications for requesting FXS genetic testing. Furthermore, non-genetic specialists reported more difficulty providing genetic counseling owing to the psychological burden on mothers.</div></div><div><h3>Conclusion</h3><div>This study highlights the necessity for expanding education and training on FXS among pediatricians in Japan. Addressing these knowledge gaps may enhance FXS diagnostic rates and improve the management of affected individuals and families. Future efforts should focus on strengthening the collaboration between clinical geneticists and general pediatricians and establishing reliable genetic counseling support systems.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104367"},"PeriodicalIF":1.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932241","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":"The first case of Al-Raqad syndrome in Japan is associated with a homozygous DCPS exonic variant resulting in aberrant splicing","authors":"Haruka Nozaki ,&nbsp;Nana Sakakibara ,&nbsp;Hiroaki Hanafusa ,&nbsp;Yuta Inoki ,&nbsp;Yu Tanaka ,&nbsp;Hideaki Kitakado ,&nbsp;Chika Ueda ,&nbsp;China Nagano ,&nbsp;Tomoko Horinouchi ,&nbsp;Tomohiko Yamamura ,&nbsp;Shingo Ishimori ,&nbsp;Hiroshi Yamaguchi ,&nbsp;Kandai Nozu ,&nbsp;Naoya Morisada","doi":"10.1016/j.braindev.2025.104366","DOIUrl":"10.1016/j.braindev.2025.104366","url":null,"abstract":"<div><h3>Background</h3><div>Cases of unexplained neurodevelopmental disorder (NDD) are often accompanied by multiple congenital anomalies. With recent advances in genetic analysis technology, whole-exome sequencing (WES) has become a powerful diagnostic tool for unexplained NDD patients, but variants of unknown significance are sometimes detected in them.</div></div><div><h3>Methods</h3><div>WES identified a variant in a 2-year-old boy with NDD associated with multiple congenital anomalies who had no abnormal findings in G-banding and array comparative genomic hybridization (array CGH). mRNA analysis was performed on the variant using the patient's peripheral blood leukocytes following <em>in silico</em> analysis to confirm its effect on splicing.</div></div><div><h3>Results</h3><div>WES revealed a novel homozygous single base substituting variant of unknown significance (VUS), which was carried heterozygously by the patient's parents (<em>DCPS</em>, <span><span>NM_014026.6</span><svg><path></path></svg></span>: c.200A&gt;G, p.(Lys67Arg)). <em>In silico</em> analysis predicted that this variant may cause aberrant splicing, and mRNA analysis revealed a 48-bp deletion from the 3′ end of exon 1. Biallelic variants of <em>DCPS</em> are known to cause Al-Raqad syndrome, a quite rare disorder which presents NDD with multiple malformations. This disease has been reported in only eight individuals from five Middle Eastern or Caucasian families but never in the Japanese but the symptoms of the present case were similar to reported cases of this syndrome.</div></div><div><h3>Discussion</h3><div>We successfully diagnosed a case of unexplained NDD as Al-Raqad syndrome by WES along with mRNA analysis. Single base substitution with judged VUS can be pathogenic by causing aberrant splicing and, therefore, <em>in silico</em> analysis and subsequent RNA sequence are necessary to prove its pathogenicity.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104366"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924745","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":"Development of a manual for an upper extremity intensive rehabilitation program for pediatric hemiplegia in Japan and assessment of its effectiveness and usability","authors":"Sayaka Katori ,&nbsp;Yukihiro Kitai ,&nbsp;Ryo Tanabe ,&nbsp;Yusuke Kawahara ,&nbsp;Masaki Miura ,&nbsp;Etsushi Toyoda","doi":"10.1016/j.braindev.2025.104364","DOIUrl":"10.1016/j.braindev.2025.104364","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to develop a manual for an upper extremity intensive rehabilitation program for pediatric hemiplegia in Japan, and to clarify its effectiveness and usability.</div></div><div><h3>Methods</h3><div>The manual was created through discussions among nine experts with sufficient pediatric clinical experience in Japan. A total of 39 children with hemiplegia aged 2 to 16 years underwent 44 intensive therapy sessions using the manual. Each child's upper limb function was assessed pre-, post- and 6-month after the intervention using the Canadian Occupational Performance Measure (COPM), ABILHAND-Kids, the Quality of Upper Extremity Skills Test (QUEST), and Box and Block Test (BBT). Questionnaire assessments were also conducted to evaluate usability of the manual.</div></div><div><h3>Results</h3><div>All four indices showed statistically significant improvements from pre- to post-intervention; COPM improved by 4 points in both performance and satisfaction; the ABILHAND-Kids logit score improved by 0.78; the total QUEST score improved by 2.8 in total score; and BBT improved by 5 on the affected side and 6 on the non-affected side. These effects were maintained 6 months later. Most therapists responded that the manual is useful, and most children and their parents were satisfied with the rehabilitation.</div></div><div><h3>Conclusions</h3><div>An upper extremity intensive rehabilitation program for pediatric hemiplegia using our manual was clinically effective. The manual was useful for therapists, and the level of satisfaction among parents and children who received the therapy was high.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104364"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900331","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":"Volumetric and microstructural changes in the Hippocampus and cingulum in children with west syndrome","authors":"Özgür PALANCI ,&nbsp;Tülay KAMAŞAK ,&nbsp;Zeliha AYDIN KASAP ,&nbsp;İlker EYÜBOĞLU ,&nbsp;Beril DİLBER ,&nbsp;Ali CANSU","doi":"10.1016/j.braindev.2025.104365","DOIUrl":"10.1016/j.braindev.2025.104365","url":null,"abstract":"<div><h3>Purpose:</h3><div>We aimed to investigate structural changes in the hippocampus using automated segmentation techniques to evaluate the anatomy and function of the hippocampus in patients with West syndrome (WS).</div></div><div><h3>Methods:</h3><div>The study included 48 participants (24 with WS and 24 healthy controls) aged 0‐4 years. Automated segmentation methods were used to measure hippocampal volume and evaluate diffusion tensor imaging (DTI) parameters such as fractional anisotropy (FA) and mean diffusivity (MD). Bonferroni correction was applied for multiple comparisons, setting the adjusted significance threshold at <em>p</em> &lt; 0.0033.</div></div><div><h3>Results:</h3><div>Children with WS exhibited significantly reduced total hippocampal volume and diminished volumes in the CA2–CA3, CA4-dentate gyrus (CA4-DG), and SR-SL-SM regions compared to healthy controls (padj &lt;0.0033). After correction, no significant differences were found in the CA1 and subiculum regions (padj &gt;0.0033). Although initial comparisons between ongoing WS and seizure-controlled WS suggested increased volumes in several hippocampal regions in the seizure-controlled group, these differences did not remain significant after adjustment and must be interpreted with caution. Notably, patients with seizure-controlled WS displayed larger hippocampal volumes, higher FA, and lower MD values, indicating a possible link between seizure activity and structural alterations. Additionally, DTI analysis of the cingulum revealed lower FA and higher MD values in WS patients, suggesting compromised microstructural integrity.</div></div><div><h3>Conclusions:</h3><div>These findings emphasize the potential role of hippocampal alterations in the pathophysiology of WS and suggest that DTI parameters may serve as useful measures for monitoring disease progression and treatment response.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104365"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886608","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":"Challenges in genetic counseling for RYR1-related myopathies","authors":"Rina Shimomura ,&nbsp;Yuki Kihara ,&nbsp;Tomoe Yanagishita ,&nbsp;Kumiko Ishiguro ,&nbsp;Minobu Shichiji ,&nbsp;Takatoshi Sato ,&nbsp;Keiko Shimojima Yamamoto ,&nbsp;Yasuki Ishihara ,&nbsp;Miho Nagata ,&nbsp;Yohei Miyashita ,&nbsp;Yoshihiro Asano ,&nbsp;Keiko Ishigaki ,&nbsp;Satoru Nagata ,&nbsp;Toshiyuki Yamamoto","doi":"10.1016/j.braindev.2025.104363","DOIUrl":"10.1016/j.braindev.2025.104363","url":null,"abstract":"<div><h3>Background</h3><div>Ryanodine receptor 1 (<em>RYR1</em>)-related myopathy is inherited in an autosomal dominant (AD) or recessive (AR) manner. We experienced two sporadic cases of <em>RYR1</em>-related myopathy. One patient harbored a de novo missense variant, whereas the other harbored compound heterozygous variants inherited from each parent. The possibility of dual inheritance makes it challenging to distinguish between these two inheritance patterns based only on clinical information.</div></div><div><h3>Methods</h3><div>In this study, PubMed was used to perform literature review on genetic counseling for <em>RYR1</em>-related myopathy.</div></div><div><h3>Results</h3><div>Recently published manuscripts have emphasized the importance of comprehensive genomic analysis of all <em>RYR1</em> coding regions.</div></div><div><h3>Conclusion</h3><div><em>RYR1</em>-related myopathy without family history may be associated with de novo heterozygous AD variants and biallelic involvement in AR. In cases of AR traits, a prenatal diagnosis may be required from the parents. Therefore, precise genetic information is essential for genetic counseling. It would be impossible to assess the inheritance patterns from genotypes only if monoallelic missense variants were identified in patients with congenital myopathy. This review emphasizes the importance of comprehensively analyzing all coding regions using trio samples for better genetic counseling.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104363"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886606","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":"Brain dysfunction underlying visual snow syndrome: Insights into therapeutic implications","authors":"Mamoru Shibata","doi":"10.1016/j.braindev.2025.104362","DOIUrl":"10.1016/j.braindev.2025.104362","url":null,"abstract":"<div><div>Visual snow (VS) is defined as dynamic, continuous tiny dots across the entire visual field persisting for more than three months. VS is frequently associated with enhanced entoptic phenomenon, palinopsia, photophobia and night blindness. This constellation of symptoms is now referred to as visual snow syndrome (VSS). VSS is reported to affect approximately 2 % of the UK population. Neuroimaging has contributed to a better understanding of VSS disease mechanism. While the dysfunction of visual association area is likely to play a pivotal role in its pathophysiology, functional and microstructural abnormalities extend beyond the visual system. Nevertheless, no specific marker for VSS has been identified, which makes the diagnosis of VSS challenging. The treatment of VSS remains to be established. There has been only sporadic therapeutic success with lamotrigine and cognitive behavioral therapy. Given the complexity of its disease state, multidisciplinary therapeutic approaches appear to be required for more effective symptom management.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104362"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886607","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":"Japanese pediatric neurologist's decision regarding genetic testing for patients with developmental delay/intellectual disability: A nationwide survey","authors":"Tetsuya Okazaki ,&nbsp;Chisako Aoki ,&nbsp;Kaori Adachi ,&nbsp;Takashi Yorifuji ,&nbsp;Akira Hirasawa ,&nbsp;Eiji Nanba","doi":"10.1016/j.braindev.2025.104361","DOIUrl":"10.1016/j.braindev.2025.104361","url":null,"abstract":"<div><h3>Background</h3><div>Advances in genetic analysis technology are increasing the opportunities for developmental delay/intellectual disability (DD/ID) cases to reach genetic diagnosis. However, the decision to perform genetic testing depends on the physician's decision; furthermore, the accessibility of genetic testing varies by country or region.</div></div><div><h3>Methods</h3><div>Japanese certified pediatric neurologists participated in an online survey from February to March 2023 to assess their attitudes toward genetic testing for DD/ID.</div></div><div><h3>Results</h3><div>The study enrolled 266 pediatric neurologists, including 41 certified clinical geneticists. In Japan, G-banding emerged as the most common first-line genetic testing for DD/ID. For DD/ID without physical and behavioral abnormalities, 30 % of pediatric neurologists indicated that they would not perform genetic testing compared with 15 % of clinical geneticists. 75.6 % of certified clinical geneticists reported experience submitting chromosomal microarray analysis (CMA), while only 39.2 % of pediatric neurologists had experience submitting CMA.</div></div><div><h3>Conclusion</h3><div>Differences in the decision of indication for genetic testing for DD/ID cases were shown to be influenced by specialized genetic training. Improved education and access to genetic specialists may help standardize genetic diagnosis in Japan. On the other hand, a standardized testing policy, especially for non-genetic specialists, is needed to make genetic testing for DD/ID more widely available.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104361"},"PeriodicalIF":1.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869238","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":"Tryptophan metabolism in children with migraine: The role of kynurenine pathway","authors":"Şeyma Sönmez Şahin ,&nbsp;Esra Paydaş Hataysal ,&nbsp;Elif Yüksel Karatoprak ,&nbsp;Fadime Ovalı ,&nbsp;Ayşegül Özel ,&nbsp;Ferit Durankuş ,&nbsp;Hüsamettin Vatansev","doi":"10.1016/j.braindev.2025.104359","DOIUrl":"10.1016/j.braindev.2025.104359","url":null,"abstract":"<div><h3>Background</h3><div>Migraine is a common neurological disorder in children, significantly impacting quality of life and academic performance. The kynurenine pathway, a major metabolic route of tryptophan, plays a critical role in neuroinflammation and neurotransmission, yet its involvement in pediatric migraine remains unexplored. This study aims to investigate alterations in kynurenine pathway metabolites in children with migraine and assess their correlation with headache frequency and severity.</div></div><div><h3>Methods</h3><div>A case-control study was conducted including pediatric patients diagnosed with migraine (<em>n</em> = 45) and healthy controls (<em>n</em> = 48). Serum levels of tryptophan (TRP) and its kynurenine pathway metabolites—including kynurenine (KYN), kynurenic acid (KYNA), 3-hydroxykynurenine (3−HK), and 3-hydroxyanthranilic acid (3-HANA)—were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Pediatric Migraine Disability Assessment (PedMIDAS) scores were used to evaluate the functional impact of migraine. Statistical analyses included comparisons between groups and correlation assessments between metabolite levels and clinical parameters.</div></div><div><h3>Results</h3><div>KYN, KYNA, and the KYN/TRP ratio were significantly higher in the migraine group compared to controls (<em>p</em> &lt; 0.05). KYNA/3-HK ratios showed a negative correlation with headache frequency and PedMIDAS scores, whereas 3-HK levels were positively correlated with PedMIDAS scores. Receiver operating characteristic curve analysis identified KYN as a potential biomarker for distinguishing migraine patients from controls, with a sensitivity of 86.7 % and specificity of 45.8 % at a cutoff value of 1415.</div></div><div><h3>Conclusion</h3><div>This study is the first to evaluate kynurenine pathway metabolites in pediatric migraine. The findings suggest that alterations in the tryptophan-kynurenine pathway, particularly increased KYN and KYNA levels, may serve as compensatory mechanisms in migraine pathophysiology. Future studies should explore the therapeutic implications of targeting the kynurenine pathway in pediatric migraine treatment.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104359"},"PeriodicalIF":1.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845028","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":"Synaptic disturbance in neurodevelopmental disorders: Perspectives from fragile X and Rett syndromes","authors":"Ruixiang Li ,&nbsp;Mai Anzai ,&nbsp;Akiko Shibata ,&nbsp;Aya Ito-Ishida","doi":"10.1016/j.braindev.2025.104358","DOIUrl":"10.1016/j.braindev.2025.104358","url":null,"abstract":"<div><div>Neurodevelopmental disorders (NDDs) are often referred to as “synaptopathies” because many of their behavioral symptoms arise from impaired synaptic development and function. However, the mechanisms that connect synaptic dysfunction to neurological symptoms remain unclear, mainly due to the wide variety of genetic and environmental factors involved in these disorders. Fragile X syndrome and Rett syndrome, two extensively studied monogenic NDDs, provide a unique opportunity to explore these mechanisms at molecular, cellular, and synaptic levels. This review summarizes the current understanding of how synaptic alterations contribute to the neurological symptoms observed in fragile X and Rett syndromes. A comparison of findings from mouse models indicates that an imbalance in local and distal connectivity may serve as a common feature of both disorders.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 3","pages":"Article 104358"},"PeriodicalIF":1.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824002","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}