Alzheimer Disease & Associated Disorders最新文献

{"title":"A Longitudinal Evaluation of the Pattern of Social Cognition Impairment in Brazilians With Alzheimer's Disease.","authors":"Tatiana Teresa Belfort Almeida Dos Santos, Marcela Moreira Lima Nogueira, Isabel Barbeito Lacerda, Michelle Brandt, Aline Tavares de Lucena, Rogeria Rangel, Julia Gaigher, Felipe Oliveira, Marcia Cristina Nascimento Dourado","doi":"10.1097/WAD.0000000000000588","DOIUrl":"10.1097/WAD.0000000000000588","url":null,"abstract":"<p><strong>Background: </strong>Social cognition (SC) impairments contribute to the dependence of people with Alzheimer disease (AD), influencing their functional disability and the burden on family members and caregivers. Our objective was to longitudinally investigate the relationship between SC and cognitive and clinical variables in persons with AD and their caregivers. We also evaluated the different SC predictors from 3 perspectives: people with AD, caregivers of people with AD, and discrepancy analysis.</p><p><strong>Methods: </strong>In all, 137 dyads (people with AD and their caregivers) underwent 2 assessments: at baseline (M1) and after 1 year (M2). During follow-up, 58 dyads were excluded, and the study was thus concluded with 79.</p><p><strong>Results: </strong>Longitudinal analysis of the people with AD showed that while some cognitive functions declined (which is consistent with disease progression), SC impairments showed a more stable pattern. Another interesting result was related to SC predictors. For people with AD, SC was associated with cognition at both time points. For caregivers, besides cognition, other predictors included reduced functional abilities and quality of life in people with AD. These results are consistent with the discrepancy predictors.</p><p><strong>Conclusion: </strong>The stable pattern in SC functioning over 12 months in AD suggests that this neurocognitive domain may be influenced more by emotional processing than by cognitive impairment. In addition, the SC predictors showed that the investigation of different points of view enables a more global understanding, contributing to better and more targeted treatment for the patient.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"363-369"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419821","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":"Novel APOE Mutation in a Moroccan Subject Suffering from Alzheimer Disease: A Case Study and Exploration of Pathogenic Implication.","authors":"Youssef Razouqi, Ihssane El Bouchikhi, Hassan El-Abid, Soukayna Baammi, Ayoub Nedbour, Ahmed Omar Touhami Ahami, Achraf El Allali, Laila Bouguenouch","doi":"10.1097/WAD.0000000000000590","DOIUrl":"10.1097/WAD.0000000000000590","url":null,"abstract":"<p><p>Alzheimer disease (AD) is a major public health concern worldwide. It is a severe neurodegenerative disease that primarily affects the elderly and causes significant brain cell death. According to the most complete scientific research, the APOE gene, which encodes the APOE protein, maybe the key to identifying the likely cause of delayed AD. The development of plaques and tangles, as well as increased amyloid (amyloid-β) levels and deposition, have been linked to APOE4. Pathogenic mutations in this gene can impact how beta-amyloid deposits and how they are cleared from the body. In this study, we report a novel pathogenic mutation, Arg160Leu, in APOE that was identified in a Moroccan patient. The magnetic resonance imaging of this 67-year-old woman revealed hippocampal shrinkage, and the results of her cognition testing revealed that she is suffering from severe AD. The current study may increase awareness of the genetic risk factors for AD caused by APOE4 mutations.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":"37 4","pages":"370-372"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138443567","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":"Proteomic Analysis Reveals Potential Exosomal Biomarkers in Patients With Sporadic Alzheimer Disease.","authors":"Konstanze Plaschke, Jürgen Kopitz, Johannes Gebert, Nadine D Wolf, Robert Christian Wolf","doi":"10.1097/WAD.0000000000000589","DOIUrl":"10.1097/WAD.0000000000000589","url":null,"abstract":"<p><strong>Background: </strong>Despite substantial progress made in the past decades, the pathogenesis of sporadic Alzheimer disease (sAD) and related biological markers of the disease are still controversially discussed. Cerebrospinal fluid and functional brain imaging markers have been established to support the clinical diagnosis of sAD. Yet, due to the invasiveness of such diagnostics, less burdensome markers have been increasingly investigated in the past years. Among such markers, extracellular vesicles may yield promise in (early) diagnostics and treatment monitoring in sAD.</p><p><strong>Materials and methods: </strong>In this pilot study, we collected the blood plasma of 18 patients with sAD and compared the proteome of extracted extracellular vesicles with the proteome of 11 age-matched healthy controls. The resulting proteomes were characterized by Gene Ontology terms and between-group statistics.</p><p><strong>Results: </strong>Ten distinct proteins were found to significantly differ between sAD patients and controls (P<0.05, False Discovery Rate, corrected). These proteins included distinct immunoglobulins, fibronectin, and apolipoproteins.</p><p><strong>Conclusions: </strong>These findings lend further support for exosomal changes in neurodegenerative disorders, and particularly in sAD. Further proteomic research could decisively advance our knowledge of sAD pathophysiology as much as it could foster the development of clinically meaningful biomarkers.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":"37 4","pages":"315-321"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138443568","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":"Regional White Matter Hyperintensities Relate to Specific Cognitive Abilities in Older Adults Without Dementia.","authors":"Rachel Membreno, Kelsey R Thomas, Amanda T Calcetas, Lauren Edwards, Maria Bordyug, Maya Showell, Morgan Stanfill, Einat K Brenner, Kayla S Walker, Lindsay J Rotblatt, Adam M Brickman, Emily C Edmonds, Katherine J Bangen","doi":"10.1097/WAD.0000000000000585","DOIUrl":"10.1097/WAD.0000000000000585","url":null,"abstract":"<p><strong>Introduction: </strong>White matter hyperintensities (WMHs) are magnetic resonance imaging markers of small vessel cerebrovascular disease that are associated with cognitive decline and clinical Alzheimer disease. Previous studies have often focused on global or total WMH; less is known about associations of regional WMHs and cognitive abilities among older adults without dementia.</p><p><strong>Methods: </strong>A total of 610 older adults with normal cognition (n=302) or mild cognitive impairment (n=308) from the Alzheimer's Disease Neuroimaging Initiative underwent neuropsychological testing and magnetic resonance imaging. Linear regression models examined associations between regional WMH volumes and cognition, adjusting for age, sex, education, apolipoprotein E ε4 allele frequency, and pulse pressure.</p><p><strong>Results: </strong>Among all participants, greater regional WMH volume in all lobes was associated with poorer performance on memory and speed/executive functioning. Among participants with normal cognition, greater temporal and occipital WMH volumes were associated with poorer memory, whereas no regional WMH volumes were associated with speed/executive function.</p><p><strong>Discussion: </strong>Results show that greater regional WMH volume relates to poorer cognitive functioning-even among those with normal cognition. Together with results from previous studies, our findings raise the possibility that WMH may be a useful therapeutic target and/or important effect modifier in treatment or prevention dementia trials.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":"37 4","pages":"303-309"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138443569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Visual Analog Scale for Self-Reported Quality of Life: A Comparison of VAS and QoL-AD in Older Adults.","authors":"Elizabeth Redford, Sabine Heuer","doi":"10.1097/WAD.0000000000000581","DOIUrl":"10.1097/WAD.0000000000000581","url":null,"abstract":"<p><strong>Purpose: </strong>People with dementia (PWD) are one of the fastest-growing clinical populations for speech-language pathologists. Self-reported quality of life (QoL) assessments are critical patient-reported outcome measures that align with person-centered care principles. However, proxy-reporting is most often used due to assumptions that PWD cannot provide reliable self-report. Visual analog scales (VASs) have been successfully used with people with expressive and cognitive deficits to measure subjective constructs such as QoL, mood, and pain. The purpose of this project is to evaluate the feasibility and reliability of a VAS QoL assessment tool.</p><p><strong>Methods: </strong>Twenty older adults free of cognitive impairment were assessed using the quality of life in Alzheimer's disease (QoL-AD) and the QoL-AD in combination with a VAS (VAS QoL-AD). The construct validity, internal consistency, and test-retest reliability of the VAS QoL-AD were assessed by performing both assessments twice, 4 weeks apart.</p><p><strong>Results: </strong>Significant correlations between the overall VAS QoL-AD and the QoL-AD scale ratings, between most of the QoL-AD and VAS QoL-AD subtests, and between the first and second assessment scores were observed.</p><p><strong>Conclusions: </strong>Results indicated strong construct validity, internal consistency, and test-retest reliability of the VAS QoL-AD in people without dementia. These results warrant further research into the development of a dementia-specific, self-reported VAS QoL scale for PWD.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"343-348"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41119190","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":"Anticipated Psychological or Behavioral Reactions to Learning Alzheimer Biomarker Results: Associations With Contextual Factors.","authors":"Lindsay R Clark, Claire M Erickson, Nathaniel A Chin, Kristin E Basche, Erin M Jonaitis, Fred B Ketchum, Carey E Gleason","doi":"10.1097/WAD.0000000000000586","DOIUrl":"10.1097/WAD.0000000000000586","url":null,"abstract":"<p><strong>Background: </strong>As Alzheimer disease (AD) biomarker testing becomes more widely available, adults may opt to learn results. Considering potential reactions to learning biomarker results can guide prebiomarker and postbiomarker testing education and counseling programs.</p><p><strong>Methods: </strong>Cognitively healthy adults enrolled in observational Alzheimer research responded to a telephone survey about learning AD risk information (n=334; 44% Black or African American; mean age=64.9±7.0). Multiple linear regression models tested if contextual factors predicted anticipated psychological impact (distress, stigma, and cognitive symptoms) or behavior change (planning and risk-reduction). Secondary analyses tested for differences in relationships by racial identity.</p><p><strong>Results: </strong>Internal health locus of control, concern about AD, self-identified sex, education, family dementia history, and belief in AD modifiability predicted anticipated psychological impact. Concern about AD, age, racial identity, belief in AD modifiability, research attitudes, and exposure to brain health-related social norms predicted anticipated behavior change. For Black respondents, there were no sex differences in anticipated distress, whereas there were stronger relationships between health locus of control, brain health social norms, and education on outcomes compared with White respondents.</p><p><strong>Conclusions: </strong>Results may inform personalized and culturally tailored biomarker testing education and counseling to minimize psychological impacts and increase behavior change related to learning AD risk information.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"282-289"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41188499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Cognitive Change in Parkinson Disease: A 2-year Follow-up Study.","authors":"Carmen Gasca-Salas, Sarah Duff-Canning, Eric McArthur, Melissa J Armstrong, Susan Fox, Christopher A Meaney, David F Tang-Wai, David Gill, Paul J Eslinger, Cindy Zadikoff, Fred J Marshall, Mark Mapstone, Kelvin L Chou, Carol Persad, Irene Litvan, Benjamin T Mast, Adam T Gerstenecker, Sandra Weintraub, Connie Marras","doi":"10.1097/WAD.0000000000000576","DOIUrl":"10.1097/WAD.0000000000000576","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment is common in Parkinson disease (PD-MCI). However, instability in this clinical diagnosis and variability in rates of progression to dementia raises questions regarding its utility for longitudinal tracking and prediction of cognitive change in PD. We examined baseline neuropsychological test and cognitive diagnosis predictors of cognitive change in PD.</p><p><strong>Methods: </strong>Persons with PD, without dementia PD (N=138) underwent comprehensive neuropsychological assessment at baseline and were followed up to 2 years. Level II Movement Disorder Society criteria for PD-MCI and PD dementia (PDD) were applied annually. Composite global and domain cognitive z -scores were calculated based on a 10-test neuropsychological battery.</p><p><strong>Results: </strong>Baseline diagnosis of PD-MCI was not associated with a change in global cognitive z -scores. Lower baseline attention and higher executive domain z -scores were associated with greater global cognitive z -score worsening regardless of cognitive diagnosis. Worse baseline domain z -scores in the attention and language domains were associated with progression to MCI or PDD, whereas higher baseline scores in all cognitive domains except executive function were associated with clinical and psychometric reversion to \"normal\" cognition.</p><p><strong>Conclusions: </strong>Lower scores on cognitive tests of attention were predictive of worse global cognition over 2 years of follow-up in PD, and lower baseline attention and language scores were associated with progression to MCI or PDD. However, PD-MCI diagnosis per se was not predictive of cognitive decline over 2 years. The association between higher executive domain z -scores and greater global cognitive worsening is probably a spurious result.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"335-342"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10116472","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":"Mild Cognitive Impairment Subtype Performance in Comparison to Healthy Older Controls on the NIH Toolbox and Cogstate.","authors":"Sarah Garcia, Robert L Askew, Voyko Kavcic, Sarah Shair, Arijit K Bhaumik, Edna Rose, Stephen Campbell, Nicolas May, Benjamin M Hampstead, Hiroko H Dodge, Judith L Heidebrink, Henry L Paulson, Bruno Giordani","doi":"10.1097/WAD.0000000000000587","DOIUrl":"10.1097/WAD.0000000000000587","url":null,"abstract":"<p><strong>Background: </strong>Early detection is necessary for the treatment of dementia. Computerized testing has become more widely used in clinical trials; however, it is unclear how sensitive these measures are to early signs of neurodegeneration. We investigated the use of the NIH Toolbox-Cognition (NIHTB-CB) and Cogstate-Brief computerized neuropsychological batteries in the identification of mild cognitive impairment (MCI) versus healthy older adults [healthy control (HC)] and amnestic (aMCI) versus nonamnestic MCI (naMCI). Exploratory analyses include investigating potential racial differences.</p><p><strong>Methods: </strong>Two hundred six older adults were diagnosed as aMCI (n = 58), naMCI (n = 15), or cognitively healthy (HC; n = 133).</p><p><strong>Results: </strong>The NIH Toolbox-CB subtests of Flanker, Picture Sequence Memory, and Picture Vocabulary significantly differentiated MCI from HC. Further, subtests from both computerized batteries differentiated patients with aMCI from those with naMCI. Although the main effect of race differences was noted on tests and in diagnostic groups was significant, there were no significant race-by-test interactions.</p><p><strong>Conclusions: </strong>Computer-based subtests vary in their ability to help distinguish MCI subtypes, though these tests provide less expensive and easier-to-administer clinical screeners to help identify patients early who may qualify for more comprehensive evaluations. Further work is needed, however, to refine computerized tests to achieve better precision in distinguishing impairment subtypes.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"328-334"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balance and Gait: Associations With Cognitive Impairment and Dementia in Individuals With Down Syndrome.","authors":"Aline S G G Conceição, Lívea F G Sant Ana, Guilherme P Mattar, Maria de Fátima R Silva, Andressa R Ramos, Alexandra M Oliveira, Claudia L Carvalho, Octavio R Gonçalves, Bruna L R Varotto, Luana D Martinez, Vinícius Leduc, Luciana M Fonseca, Orestes V Forlenza","doi":"10.1097/WAD.0000000000000580","DOIUrl":"10.1097/WAD.0000000000000580","url":null,"abstract":"<p><strong>Background: </strong>Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS.</p><p><strong>Methods: </strong>We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities.</p><p><strong>Results: </strong>The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia ( P <0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score ( P <0.05).</p><p><strong>Conclusion: </strong>A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"349-356"},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41095048","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":"Utility of amyloid PET Imaging in a Memory Clinic.","authors":"Alexandra Pletnikova, Hamid R Okhravi, Nimra Jamil, Mackenzie Kirby, Constantine G Lyketsos, Esther S Oh","doi":"10.1097/WAD.0000000000000575","DOIUrl":"10.1097/WAD.0000000000000575","url":null,"abstract":"<p><p>There is greater interest in amyloid biomarker for the diagnosis of Alzheimer disease (AD) with the recent Food and Drug Administration approval of amyloid-targeted therapy. The goal of this study was to assess the clinical utility of amyloid positron emission tomography (PET) in clinically ambiguous cases of cognitive impairment by examining outcomes of patients enrolled in the Imaging Dementia-Evidence of Amyloid Scanning study at 2 academic institutions. Of the 112 patients in the study, 66.1% (n=74) of patients had a positive amyloid PET scan, and 33.96% (n=38) had a negative amyloid PET scan. Lower cognitive test scores were predictive of positive amyloid PET scan ( P =0.001). Eighty-two percent (92/112) of the patients were seen for follow-up. Of the 30 patients with negative amyloid PET scan results, 90% had a diagnosis of non-AD etiology after receiving the negative results, suggesting a negative amyloid scan can be used to rule out AD diagnosis.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"270-273"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10783798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}