Neurotrauma reports最新文献

{"title":"Recovery from Mild Traumatic Brain Injury in the Nonathletic Population: A Systematic Review.","authors":"Véronique Déry, Gabrielle Lafond, Rosemarie Picard, Pierre Langevin","doi":"10.1089/neur.2025.0006","DOIUrl":"10.1089/neur.2025.0006","url":null,"abstract":"<p><p>The objective of this study was to document the resolution rate of mild Traumatic Brain Injury (mTBI) symptoms at various time points in a nonathletic adult population and identify prognostic factors influencing recovery. Sixteen prospective cohort studies were included, focusing on participants aged 18-65 with acute mTBI, followed for a minimum of 1 month. The recovery criterion was the resolution of symptoms not attributable to pre-existing conditions. Risk of bias was assessed using the Quality in Prognostic Studies tool, with most studies rated as moderate risk, highlighting variability in methodological rigor. Symptom resolution was reported in 49.0% to 69.5% of patients at 1 month, 40.8% to 84.4% at 3 months, 38.3% to 72.2% at 6 months, and 58.1 to 68.3% at 12 months. These findings emphasize the first 6 months as a critical period for evaluating the risk of symptom chronicity. The most commonly reported prognostic factors was baseline symptom severity, including higher intensity of symptoms such as headaches, nausea, and dizziness, as well as elevated scores on validated symptom scales. Psychiatric history, such as pre-existing anxiety or depression, was also a significant predictor of prolonged symptoms. Biomarkers, including NSE and S-100B levels, and reduced blood-derived neurotrophic factors, were associated with poorer recovery at 6 months. Demographic factors, including age, gender, and education level, showed mixed results. While some studies associated female gender, older age, and lower education with poorer recovery, others found no significant correlations. These discrepancies highlight the complexity of mTBI prognosis. Overall, more than half of patients recover within 6 months, but persistent symptoms can have a profound impact on quality of life and functional status. Identifying patients at higher risk of prolonged recovery is crucial for targeted management strategies, emphasizing the importance of individualized, evidence-based care in mTBI populations.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"355-374"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692675","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":"Effects of Traumatic Brain Injury on the Orexin/Hypocretin System.","authors":"Rebecca T Somach, Miranda M Lim, Akiva S Cohen","doi":"10.1089/neur.2024.0111","DOIUrl":"https://doi.org/10.1089/neur.2024.0111","url":null,"abstract":"<p><p>Traumatic Brain Injuries (TBIs) are known to cause a myriad of symptoms in patients. One common symptom after injury is sleep disruptions. One neuropeptide system has been studied repeatedly as a potential cause of sleep disruptions after TBI- the orexin/hypocretin system. Orexin promotes wakefulness and arousal while disrupting the orexin system causes increased sleepiness and narcolepsy. Studies of TBI in human and animal subjects have shown that TBI affects the orexin system. This review serves as an overview of how TBI affects the orexin/hypocretin system, including structural and functional changes to the neurons after injury. This review is the first to include studies that examine how TBI affects orexin/hypocretin receptors. This review also examines how sex is accounted for in the studies of the orexin system after TBI.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"322-335"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000115","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":"IGF-1 as a Biomarker for Symptom Severity in Adult Traumatic Brain Injury: Evidence from an Observational Study.","authors":"Justin Weppner, Kimberly Rosenthal, Jennifer Bath, Tonja Locklear, Melissa Martinez","doi":"10.1089/neur.2025.0009","DOIUrl":"10.1089/neur.2025.0009","url":null,"abstract":"<p><p>Traumatic brain injury (TBI)-related growth hormone deficiency is often undertreated, despite documented physical, metabolic, and neuropsychiatric effects. Insulin-like growth factor (IGF-1), with neuroreceptors located in brain regions responsible for learning, memory, and mood, regulates cerebral blood flow, neurogenesis, and neuroplasticity. The aim of this study was to determine associations between IGF-1 levels and post-TBI symptom severity, anxiety, and depression. This retrospective observational study at an Academic Brain Injury Center included participants evaluated 3-12 months post-TBI with available IGF-1 values and complete Rivermead Post-Concussion Symptoms Questionnaire (RPQ-13), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) responses. Patients under 18 or over 65 and those with incomplete data were excluded. Participants were grouped by TBI severity: mild (Glasgow Coma Scale [GCS] 13-15) and moderate-to-severe (GCS < 13). IGF-1 <i>Z</i>-scores were standardized for age and gender. Significant negative correlations were found between IGF-1 levels and RPQ-13, GAD-7, and PHQ-9 scores across all TBI severity groups, with lower IGF-1 <i>Z</i>-scores correlating with higher symptoms of TBI, depression, and anxiety. The Generalized Linear Models showed that the IGF-1 <i>Z-</i>score is a significant predictor for GAD-7, PHQ-9, and RPQ-13. Specifically, a one-point increase in the IGF-1 <i>Z-</i>score is associated with a 29.85% decrease in anxiety symptoms on the GAD-7, a 16.30% reduction in depression severity on the PHQ-9, and a 39.23% decrease in post-TBI symptom severity on the RPQ-13. Findings suggest that decreased IGF-1 is associated with increased post-injury symptom severity, depression, and anxiety. Future studies should explore IGF-1 as a biomarker for TBI symptom severity.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"345-354"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692673","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":"Prognostic Factors and Initial Treatment Strategies for Patients with Head Trauma and Vital Signs of Shock.","authors":"Masaki Yasuda, Makoto Ohtake, Taisuke Akimoto, Masayuki Okano, Yuya Imanishi, Takafumi Kawasaki, Jun Suenaga, Katsumi Sakata, Ichiro Takeuchi, Tetsuya Yamamoto","doi":"10.1089/neur.2024.0167","DOIUrl":"10.1089/neur.2024.0167","url":null,"abstract":"<p><p>Head trauma accompanied by circulatory failure is a rare but severe condition, and few reports regarding its prognosis or initial treatment strategies have been published. We aimed to evaluate the prognostic factors and treatment strategies for patients with head trauma and vital signs of shock. We included 415 consecutive patients with head trauma (Abbreviated Injury Scale [AIS] score ≥3) who were transported to our institution from January 2017 to December 2023. These patients were divided into shock and non-shock groups. Data on their background, vital signs at presentation, trunk injury status, surgical intervention, and hematological findings were examined. A retrospective analysis was conducted with the modified Rankin Scale score after 3 months as the primary outcome. The patients' mean age was 53.9 ± 24.4 years, 304 (73.3%) were male, 265 (63.9%) experienced severe trauma (injury severity score ≥16), 124 (29.9%) had multiple trauma (AIS score ≥3 at two or more locations), and 59 (14.2%) had accompanying vital signs of shock (shock index >1). Multivariable analysis revealed that older age (<i>p</i> < 0.0001), a lower Glasgow Coma Scale (GCS) score (<i>p</i> < 0.0001), elevated D-dimer levels (<i>p</i> = 0.0077), and pupillary abnormalities (<i>p</i> = 0.038) were independently associated with a poor prognosis in the non-shock group. In the shock group, older age (<i>p</i> = 0.0037) and neurosurgical intervention (<i>p</i> = 0.012) were independent prognostic factors. In contrast to those in the non-shock group, the GCS score and D-dimer levels were not useful prognostic factors in the shock group. The optimal cut-off age for prognosis was 64 years (area under the receiver operating characteristic curve: 0.752; sensitivity: 0.670, specificity: 0.777). The prognosis was significantly worse in the shock group when neurosurgery was required, suggesting that developing a treatment strategy aimed at more rapidly reducing intracranial pressure is essential, especially for patients under 64 years old with circulatory failure.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"336-344"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692674","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":"Crossing the Valley of Death in Spinal Cord Injury: Learning from Successful Translators.","authors":"Vieri Failli, Stephen M Strittmatter, Martin E Schwab, Aileen J Anderson, Angela Ruban, Hassan Al-Ali, Armin Curt, Adrien Cohen, Jane T C Hsieh","doi":"10.1089/neur.2025.0029","DOIUrl":"10.1089/neur.2025.0029","url":null,"abstract":"<p><p>A straightforward path to successful scientific translation remains uncharted, particularly in a complex progressive condition such as spinal cord injury (SCI), which affects multiple body functions simultaneously. Evolving regulatory requirements add to the complexity and expense of attaining a treatment that is both safe and efficacious. Although rare, there are examples of SCI scientists who have successfully navigated the \"valley of death\" from discovery science to completed clinical trials. This article reflects the translational journey of five SCI scientists who have encountered similar and different scenarios while striving to launch or complete a clinical trial. Learning from these experiences has identified lessons learned and gaps, particularly with respect to funding and support for SCI translation.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"298-310"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063430","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":"Epidemiology of Spinal Cord Injury in British Columbia, Canada: 20 Years of Population-Based Administrative Data.","authors":"Michael Bond, Aidan Beresford, Vanessa Noonan, Naama Rotem-Kohavi, Marcel Dvorak, Brian Kwon, Guiping Liu, Jason M Sutherland","doi":"10.1089/neur.2025.0012","DOIUrl":"https://doi.org/10.1089/neur.2025.0012","url":null,"abstract":"<p><p>Traumatic spinal cord injury (TSCI) is a debilitating condition that can have significant effects on physical function and overall quality of life. Mechanisms of injury can vary from major trauma to low-energy falls. There has been a recent increase in the number of elderly patients with TSCI. A retrospective analysis of population-based hospital records linked with health care administrative datasets was conducted to measure age-standardized rates of TSCI over time. The study was conducted to describe the epidemiology and demographic characteristics of patients who experienced TSCI between 2001 and 2021 in the province of British Columbia, Canada. Demographic, clinical characteristics, and rates of TSCI were evaluated over time. Linear regression was used to assess changes over time. The study identified 3622 patients with TSCI. The average age at the time of injury was 51.1 (standard deviation [SD] 21.19) and 75.0% were males. The average annual age-standardized rate in this population was 35.4 per million. The overall rate remained stable throughout the study period. The mean age at injury increased from 41.9 to 57.5 over the study period of 2001-2021 (<i>p</i> < 0.001). The most frequent causes of injury were low-energy falls (49.9%) and motor vehicle injuries (36.6%). The proportion of injuries related to falls increased over the study period (<i>p</i> < 0.001). Motor and sensory complete TSCI were seen in higher rates among younger patients, and cervical spine injuries were most common among all age-groups. The rate of TCSI was consistent during the study period, though the demographic of patients and their injury mechanism changed considerably; elderly low-energy falls were an increasing proportion of cases. Continued vigilance in elderly fall prevention is needed to reduce the incidence of TCSI among the elderly.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"311-321"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055089","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":"Temporal Dynamics of Retinal Inflammation Following Blast Exposure in a Ferret Model.","authors":"Rex Jeya Rajkumar Samdavid Thanapaul, Chetan Pundkar, Gaurav Phuyal, Manoj Y Govindarajulu, Ashwathi Menon, Joseph B Long, Peethambaran Arun","doi":"10.1089/neur.2024.0127","DOIUrl":"https://doi.org/10.1089/neur.2024.0127","url":null,"abstract":"<p><p>Blast-induced traumatic ocular injury (bTOI) is a major cause of vision loss in military personnel involved in recent combat operations. However, its underlying mechanisms remain poorly understood, hindering the development of effective treatments. This study investigated the temporal expression patterns of key inflammatory markers in the retina after blast exposure using a ferret model. Ferrets (<i>n</i> = 40) were subjected to two tightly coupled blasts (20 psi) using an advanced blast simulator. Retinal tissues were collected at 4 h, 24 h, or 28 days post-blast. Differential mRNA expression of Toll-like receptors (<i>TLR</i>s: <i>1-9</i>), cytokines (<i>IL</i>: <i>1β, 6,</i> and <i>10</i>), and cyclooxygenase enzymes (<i>COX</i>: 1 and 2) was assessed using quantitative real-time polymerase chain reaction after blast exposure and compared with sham controls. Our results revealed a rapid and sustained upregulation of multiple <i>TLR</i>s (1, 2, 4, 5, 7, and 8) in the retina following blast exposure, indicating a robust inflammatory response. This was accompanied by a significant increase in pro- and anti-inflammatory cytokines (<i>IL-1β</i>, <i>IL-6 IL-10,</i> and <i>COX2</i>) at 4 h post-blast, suggesting their involvement in the acute pathogenesis of bTOI. Our findings emphasize the critical role of early innate immune responses and the potential for chronic inflammation in bTOI, highlighting the importance of timely therapeutic interventions. Targeting these inflammatory pathways may offer therapeutic avenues for mitigating retinal damage and improving ocular function.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"283-290"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060193","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":"Prevalence of Seizures in Hospitalizations with Traumatic Brain Injury: A U.S. Population-Based Study.","authors":"Alka Mithal, Maanek Sehgal, Christopher Newey, Derek Ems, Vince Florio, Gurkirpal Singh","doi":"10.1089/neur.2025.0001","DOIUrl":"https://doi.org/10.1089/neur.2025.0001","url":null,"abstract":"<p><p>In the United States, data on outcomes in adults hospitalized with traumatic brain injury (TBI) and concomitant seizures are limited. Here, we report on a feasibility analysis to understand the prevalence and consequences of concomitant seizures in patients with TBI. A retrospective database study was conducted using the National Inpatient Sample 2016-2020. Hospitalizations in patients (≥18 years of age) with TBI were assessed and stratified into groups either with or without concomitant seizures. All patient data were stratified by age, sex, ethnicity, and payer type. The primary outcome was the prevalence of seizures or epilepsy among hospitalizations for TBI. Other outcome variables recorded were mean charges, length of hospital stay, and case fatality. Overall, 1,591,575 hospitalizations with TBI were assessed over the study period. TBI prevalence remained relatively constant throughout the study period and was higher in men and those aged ≥65 years. Concomitant seizures were observed in 12.2% of all patients and were highest for men, the 45-64 years age group, and Black and Native Americans. Mean charges were significantly higher and length of hospital stay was significantly longer in TBI hospitalizations with seizures compared with those without seizures across all study years. No significant difference in case fatality between patients with seizures compared with those without seizures was observed. Data from this analysis showed differences in demographics and outcomes for TBI hospitalizations with versus without concomitant seizures, highlighting potential disparities in health care for patients experiencing seizures that warrant further research.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"291-297"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029995","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":"Feasibility and Acceptability of Telephone-Administered Traumatic Brain Injury Common Data Elements and the Rehabilitation Needs Survey in Community-Dwelling Adults Exposed to the United States Criminal Legal System.","authors":"Casey LaDuke, Kabrianna Tamura, Micaela Linder, Ronald Day, Kristen Dams-O'Connor","doi":"10.1089/neur.2024.0158","DOIUrl":"https://doi.org/10.1089/neur.2024.0158","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is common among legally-impacted adults and has also been linked to negative outcomes throughout the criminal legal system. Despite this, relatively limited TBI research has focused on or even included legally-impacted adults. Existing literature in this population has used heterogeneous TBI definitions, populations, and measures when studying outcomes. This study therefore investigates the feasibility and acceptability of telephone-administered TBI common data elements (CDEs) and the Rehabilitation Needs Survey (RNS) in 85 legally-impacted community-dwelling adults. Regarding feasibility, completion rates across measures were high (88-100%), and noncompletion was most commonly due to participants declining to continue. Regarding acceptability, data collectors were able to administer and code most measures with relative ease. Reported difficulties related to measures requiring detailed data collector training to administer and code, such as the Brain Injury Screening Questionnaire (BISQ) and Brief Test of Adult Cognition by Telephone, or challenges inherent to self-report tests in general. In addition, data collectors recommended adding specific questions to the BISQ to query head injuries experienced during or as a result of their exposure to the criminal legal system. Overall, results support the use of telephone-administered TBI CDEs and the RNS in legally-impacted adults, and underscore the need for culturally-responsive training and technical assistance for TBI researchers engaging with this population.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"274-282"},"PeriodicalIF":1.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036863","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":"Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content.","authors":"Adrienne K Ho","doi":"10.1089/neur.2025.0008","DOIUrl":"https://doi.org/10.1089/neur.2025.0008","url":null,"abstract":"<p><p>Previous studies on restrictive versus liberal blood hemoglobin transfusion triggers in critically ill or cardiac surgery patients had established a paradigm favoring restrictive triggers. In contrast, the hemoglobin transfusion threshold in traumatic brain injury optimization and transfusion strategy in patients with acute brain injury trials (2024) suggest that a liberal hemoglobin (90-100 g/L) transfusion trigger is associated with better neuro-outcomes than a restrictive (70 g/L) trigger in anemic patients with acute brain injury. Increased blood oxygen content is one obvious possible reason for the observed superior neuro-outcomes with more liberal red blood cell transfusion. In this author's opinion, another plausible reason is that in replacing extracranial blood loss, which most of the patients in both trials had, avoidance of blood alternatives that could worsen intracranial hypertension might also have benefitted the liberal transfusion cohorts.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"257-260"},"PeriodicalIF":1.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055403","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}