{"title":"Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as predictors of MS severity: a retrospective cohort study","authors":"Sabah E. Fathy, Amany M. AbdAllah, Rania Y. Helal","doi":"10.1186/s41983-024-00802-2","DOIUrl":"https://doi.org/10.1186/s41983-024-00802-2","url":null,"abstract":"Multiple sclerosis (MS) is a disabling immune-mediated disease of the central nervous system. Ministry of Health and Population’s statistics show that MS comprise 1.4% of all neurological diseases, putting into consideration, current economic crisis; it is needed to predict disease severity with an acceptable cost-effective method. Complete blood count (CBC) parameters are supposed to be cheap, and simple markers for the systemic inflammatory state. This study aims at evaluating role of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in predicting the severity of MS. Therefore, this retrospective cohort study was done on 150 MS patients attending MS clinic during year 2022. All patients were subjected to complete medical history. Estimation of the disability was done through the extended disability status scale (EDSS) and analysis of different parameters of baseline CBC before starting therapy. A cutoff value of NLR ≥ 2.95 and PLR ≥ 201.5 could predict prognosis of MS. Risk factors of sever MS are high NLR, PLR, high body mass index and absence of disease-modifying therapy. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are cheap valid useful predictors of increased relapse rate and severity in MS. Highlighting the role of both ratios at time of first diagnosis helps physicians to predict prognosis of patients in context of severity. Paying special attention to those with higher ratios can lead to improve patient outcome and reducing disease burden.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006624","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}
Ghaydaa A. Shehata, Hassan M. Farweez, Anwar M. Ali, Huda S. Hassan, Amal M. Tohamy, Mohamed Mostafa, Mostafa A. Ibrahim, Khaled Tarek, Asmaa Ahmed Elrashedy, Ramy Abdelnaby, Mohamed Elsayed, Dina Elsayed Gaber
{"title":"Impact of Parkinsonism comorbid depression on cognitive functions","authors":"Ghaydaa A. Shehata, Hassan M. Farweez, Anwar M. Ali, Huda S. Hassan, Amal M. Tohamy, Mohamed Mostafa, Mostafa A. Ibrahim, Khaled Tarek, Asmaa Ahmed Elrashedy, Ramy Abdelnaby, Mohamed Elsayed, Dina Elsayed Gaber","doi":"10.1186/s41983-024-00813-z","DOIUrl":"https://doi.org/10.1186/s41983-024-00813-z","url":null,"abstract":"Parkinson's disease (PD) is a chronic progressive neurodegenerative disabling disease and involves about 1–3% of the worldwide population over the age of 60. A significant prevalence of psychopathological symptoms has been recorded as most patients with PD developed over their disease course neuropsychiatric symptoms such as depression, anxiety, sleep disorders, psychosis, and cognitive and behavioral abnormalities. These non-motor symptoms, which could appear decades before motor ones, become disturbing symptoms during the later phases of the disease. Hence, the current research aims to study depressive symptoms in Parkinson's disease patients. Thirty-six patients with Parkinson’s disease aged from 40 to 65 years (20 males and 16 females) and 36 age and sex-matched controls (19 males and 17 females) were included in the study. Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr scale, Schwab and England’s scale, Mini-Mental State Examination, Cognitive Ability Screening Instrument, and Hamilton Depression Rating Scale were applied to assess depression in both groups. Patients were 20 males and 16 females (mean age 52.44 ± 7.45), mean duration of Parkinsonism was 3.88 years. The mean value for Hoehn and Yahr scale was 1.97 ± 1.42, for UPDRS T was 42.41 ± 20.91 and Schwab England's scale was 74.77 ± 17.78. Concerning cognition, MMSE was significantly lower among patients 25.33 ± 3.63, than in the control group and CAS total was significantly lower in patients (16 ± 71.35) than in the control group 9.81 ± 84.62. Depressive symptoms are widespread in Parkinson's disease. Depression should be strictly determined and addressed, particularly in patients with more advanced cognitive impairment who are at a higher risk of developing or worsening depression.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006388","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}
Hany Mohamed El Deeb, Rasha Said Amr, Dina Elsayed Gaber
{"title":"Potential use of microRNA-590 biomarkers verses plasma calcitonin gene-related peptide for diagnosis of migraine","authors":"Hany Mohamed El Deeb, Rasha Said Amr, Dina Elsayed Gaber","doi":"10.1186/s41983-024-00815-x","DOIUrl":"https://doi.org/10.1186/s41983-024-00815-x","url":null,"abstract":"Many biomarkers have been investigated for migraine diagnosis, giving insights into the pathophysiology of migraine, treatment response, and for the development of new treatment strategies. Over the years, many substances, for example, neurotransmitters, neuropeptides, glio transmitters, and hormones, have been suggested as possible biomarkers for migraine. The literature demonstrates that miRNAs may play a role in migraine. The aim of this study was to compare serum mi RNA and calcitonin gene-related peptide in Migraineurs. 43 Migraineurs and 43 age and sex-matched controls were included in the study serum miRNA 590 of Migraineurs and controls were assessed by high content serum miRNA arrays. miRNA was compared to serum calcitonin gene-related peptide in both groups. Expression of miRNA-590 in serum is detected by real time PCR (q-PCR) Measurement of serum CGRP by ELISA (enzyme-linked immunosorbent assay) technique. 43 patients (86% females) mean age was 35.56 ± 9.45 and 43 controls (93% females) mean age was37.26 ± 9.15 which were age and sex matched with no statistically significant difference regarding age and sex (fisher extract) FE p = 0.483, p = 0.400, respectively. Regarding the level of miR-590-5p among patients and controls, Table 1 shows that miR-590-5p was significantly higher among cases (mean = 5.90 ± 21.22) than among controls mean = 3.32 ± 5.73 and *p = 0.027 reading the level of CGRP among patients and controls Table 2 shows that CGRP was significantly higher among cases (mean = 172 ± 110) than among controls mean = 66.43 ± 8.89 and *p ≤ 0.001. Regarding the relation between migraine type with miR-590-5p and CGRP among cases miR-590-5p had a higher mean among cases with episodic migraine mean = 11.58 ± 32.40 in comparison with chronic migraine mean = 1.81 ± 1.68 and this was statistically significant *p = 0.013. MicroRNA-590 can be used as a biomarker of migraine and has a comparable result to CGRP.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006623","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}
Daniel Encarnacion Santos, Ismail Bozkurt, Renat Nurmukhametov, Medet Dosanov, Alexander Volovish, Gennady Chmutin, Ariel Tapia Sierra, Brenda Eneliz, Edwin Bernard, Phon Nakry, Gianluca Scalia, Bipin Chaurasia
{"title":"The future of minimally invasive spine surgery in low-income Latin American countries","authors":"Daniel Encarnacion Santos, Ismail Bozkurt, Renat Nurmukhametov, Medet Dosanov, Alexander Volovish, Gennady Chmutin, Ariel Tapia Sierra, Brenda Eneliz, Edwin Bernard, Phon Nakry, Gianluca Scalia, Bipin Chaurasia","doi":"10.1186/s41983-024-00814-y","DOIUrl":"https://doi.org/10.1186/s41983-024-00814-y","url":null,"abstract":"Treatment of spinal disorders can be managed conservatively or surgically. With the trend toward minimalistic approaches, minimally invasive spinal surgery (MISS) has gained much more importance over the last decade. Its use along with the required training has tremendously increased in developed countries. However, the availability of MISS today is uneven in different regions due to the development and availability of technology, as well as the level of training and qualifications of surgeons who are able to perform such operations on the spine. The purpose of this article is to analyze the prospects for minimally invasive spine surgery in Latin America in comparison with higher income countries.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006626","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}
Hany Aref, Mohamed Maged, Tamer Roushdy, Hossam Shokri, Eman Hamid, Bernard P. H. Cho, Hugh S. Markus, Mai Fathy, Nevine El Nahas
{"title":"Whole exome sequencing in a sample of Egyptian patients with covert cerebral small vessel disease","authors":"Hany Aref, Mohamed Maged, Tamer Roushdy, Hossam Shokri, Eman Hamid, Bernard P. H. Cho, Hugh S. Markus, Mai Fathy, Nevine El Nahas","doi":"10.1186/s41983-024-00810-2","DOIUrl":"https://doi.org/10.1186/s41983-024-00810-2","url":null,"abstract":"Covert cerebral small vessel disease (cCSVD) is associated with many age-related morbidities with little available data regarding the pathophysiology and role of genetics in it. This study aims to investigate the genetic load in a sample of Egyptian patients with cCSVD. Thirty patients with cCSVD were recruited and underwent cognitive, gait, sphincter assessment, magnetic resonance imaging (MRI) brain, and blood sampling for whole exome sequencing. The mean age for the patients was 65.93 ± 8.8 with male patients representing 63.33% of the studied sample. The major risk factor was hypertension followed by diabetes mellitus, dyslipidaemia, and smoking. The main presenting symptom was cognitive impairment, found in 60% of the patients and the mean duration of symptoms was 2.1 ± 1.12 years. Two out of thirty patients were positive for a known pathogenic gene (NOTCH3 and COL4A1) despite the absence of family history in one representing 6.7% of the entire studied sample. Meanwhile, three patients had variant genes not previously linked to cCSVD. Whole exome sequencing and genetic studying of patients with cCSVD is of utmost importance as the genetic load is underestimated in the Egyptian population.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006622","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":"The diagnostic yield of a 2-h versus a 30-min electroencephalogram for patients with altered mental status in neurological intensive care unit","authors":"Nesma Mounir, Ehab Shaker Belal, Mahmoud Fathi Abozeina, Aliaa Ali Tawfeek","doi":"10.1186/s41983-024-00809-9","DOIUrl":"https://doi.org/10.1186/s41983-024-00809-9","url":null,"abstract":"The continuous electroencephalogram (cEEG) monitoring is recommended for critical ill patients with altered mental status, The cEEG detects seizure activity and nonconvulsive status epilepticus (NCSE) more efficiently than routine electroencephalogram (rEEG). Yet, cEEG is not widely available in many neurological intensive care units (NICU) in limited resource countries. Ideal study duration, and whether cEEG is useful and cost-effective in terms of patient outcome compared to (rEEG), is still questions under research. The main objective in our study was the relative diagnostic yield of the 2 h, prolonged EEG recording, compared to the 30-min rEEG recording in the NICU. There was no significant diagnostic yield for the 2-h electroencephalogram (EEG) over the 30-min EEG for patient with altered mental status in the NICU. Being with altered mental state in an NICU carries a poor outcome, we found that death occurred in 68.9% of patients. Acute ischemic stroke is the most common cause of altered mental status in NICU by about 53.3% of patients. Less than half of the patients (42.2%) were receiving anti-seizure medications (ASM). As long as the cEEG is not available in the NICU, the 30-min EEG has a good diagnostic yield and it is almost equivalent to the prolonged 2-h EEG, and if the EEG is recommended for a longer duration, we recommend a long-term EEG more than 2 h.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140006613","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}
I. A. Yassine, M. M. Hussein, A. O. Hosny, M. A. ElSamahy
{"title":"Association between acute stroke and COVID-19 infection among patients with acute stroke","authors":"I. A. Yassine, M. M. Hussein, A. O. Hosny, M. A. ElSamahy","doi":"10.1186/s41983-023-00784-7","DOIUrl":"https://doi.org/10.1186/s41983-023-00784-7","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS COV 2) infection is associated with multiple neurological complications. Cerebrovascular accidents are considered as one of the common neurological complications associated with corona virus (COVID-19). It may represent the first presentation of the patients of COVID-19 or may occur anytime during the course of the disease. This study included 381 patients after the diagnosis of cerebrovascular accident. The mean age of the participants was 57.1 ± 15 years. 53.5% of the participants were males and 46.5% were females. The participants had COVID-19 infection in past 3 months with mean duration was 35.5 ± 18 days. The mean NIHSS among the participants was 10.5 ± 6.2. Small artery stroke was higher among PCR negative patients and controls, while large artery stroke was higher among PCR positive patients. 26% of patients with stroke and confirmed COVID-19 infection developed stroke immediately after COVID-19 infection (within 1 week). Within 1 month from getting infection with COVID-19, 41.7% of patients developed stroke and 32.3% had developed stroke after 1 month of infection with COVID-19. Female gender, older age of the patients and presence of vascular risk factors were associated with increased severity of infection as evidenced by higher NIHSS and more ICU admission among COVID-19 positive patients. COVID-19 infection has been associated with both venous and arterial stroke, especially in elderly patients. COVID-19 infection was associated with increased stroke severity as evidenced by higher NIHSS and more ICU admission. Small vessel disease was higher among COVID-19 negative patients, while large artery stroke was higher among positive COVID-19 patients.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979594","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}
Mostafa M. Elkholy, Mohammed A. Osman, Ahmed S. Abd El Basset, Sameh K. El Maraghi, Hamdy M. Saber
{"title":"The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study","authors":"Mostafa M. Elkholy, Mohammed A. Osman, Ahmed S. Abd El Basset, Sameh K. El Maraghi, Hamdy M. Saber","doi":"10.1186/s41983-024-00808-w","DOIUrl":"https://doi.org/10.1186/s41983-024-00808-w","url":null,"abstract":"Critical illness myopathy (CIM) has negative impact on patient outcomes. We aimed to explore the diagnostic value of bedside ultrasonography for early identification of CIM in septic patients and its correlation with other diagnostic methods. This prospective observational study included 40 ICU patients diagnosed with sepsis on admission or within 48 h later according to the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). They were evaluated using muscle ultrasound, electrodiagnostic and clinical muscle assessment (Medical Research Council, MRC) at two time points, the first was between days 2 and 5 and the second was between days 10 and 15. There was significant deterioration of neuromuscular function between the two evaluation points demonstrated by decline in MRC, abnormal nerve conduction and electromyography (EMG) and increased muscle echogenicity on ultrasonography (P ≤ 0.001). Sepsis-Related Organ Failure Assessment (SOFA) score significantly correlated with different neuromuscular assessment tools. MRC had significant correlation with myopathic EMG (P ≤ 0.001, r = − 0.869) and increased muscle echogenicity (P ≤ 0.001, r = − 0.715). Abnormal ultrasonographic muscle architecture had sensitivity of 100%, specificity of 75% and positive likelihood ratio of 4 in detecting muscle dysfunction compared to myopathic EMG. Bedside peripheral muscle ultrasound echogenicity grade could be used as an additional screening test in ICU septic patients for early detection of CIM.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979980","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}
Nevine El Nahas, Mohamed Maged, Fatma Fathalla Kenawy
{"title":"Right-sided alien hand in acute parietal infarction: a case report","authors":"Nevine El Nahas, Mohamed Maged, Fatma Fathalla Kenawy","doi":"10.1186/s41983-024-00812-0","DOIUrl":"https://doi.org/10.1186/s41983-024-00812-0","url":null,"abstract":"Alien limb is an involuntary movement that is considered a diagnostic feature of corticobasal degeneration syndrome. Few reports describe this condition in acute stroke, and most of them result from right parietal infarction. This is a case of acute stroke presenting with a right-sided alien limb that was followed by right-sided weakness and aphasia. Effective management of the stroke was achieved through intravenous thrombolysis with the resolution of most symptoms except for a right-side sensory deficit. Magnetic resonance imaging of the brain showed acute parietal infarction involving the left sensory cortex. Although very rare, right-sided alien limb can occur due left parietal infarction.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979797","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}
Mohammed Youssef Elhamrawy, Wafik Said Bahnasy, Sabah Mohamed Elkady, Mohamed Taha Said
{"title":"Effect of functional electrical stimulation of interscapular muscles on trunk performance and balance in post-stroke elderly patients","authors":"Mohammed Youssef Elhamrawy, Wafik Said Bahnasy, Sabah Mohamed Elkady, Mohamed Taha Said","doi":"10.1186/s41983-024-00795-y","DOIUrl":"https://doi.org/10.1186/s41983-024-00795-y","url":null,"abstract":"Disability in the upper limb in post-stroke survivors may have a variety of effects, particularly in the elderly, that require planning therapeutic actions to restore function. Thirty-four patients were randomly assigned to the control group (CON) and the Functional Electrical Stimulation (FES) group. For 12 weeks, the CON group received core stabilization exercises (CSEs). The FES group received (FES) for the interscapular muscles with CSEs for the first six weeks and completed the following six weeks with only CSEs. Patients were assessed at baseline, 6 and 12 weeks post-intervention. The trunk impairment scale (TIS) and the Postural Assessment Scale for Stroke (PASS) were used to assess trunk performance. A palpation meter was used to measure the scapular horizontal position (SP). Balance was assessed by the Berg Balance Scale (BBS), and the Timed Up-and-Go test (TUG). Function was assessed with Barthel Index (BI). Both groups improved significantly (P < 0.001 for both groups, d = 1.1–3.7 for control group and d = 1.9–6.1 for FES group) post-treatment (at 6 and 12 weeks) in all outcomes except SP in the control group (P < 0.05 at both times, d = 0.6 at 6 weeks and 0.8 at 12 weeks). FES for interscapular muscles may have positive effects on trunk performance, scapular position, balance, and function in stroke patients. Also, additional improvements were observed post-intervention compared to baseline. FES is recommended to be part of the rehabilitation program of elderly post-stroke patients.","PeriodicalId":74995,"journal":{"name":"The Egyptian journal of neurology, psychiatry and neurosurgery","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139956416","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}