BMC Neurology最新文献

{"title":"Association between hyperglycemia and unfavorable outcome in patients with successful thrombectomy for acute ischemic stroke: a single-center study.","authors":"Ao Qian, Longyi Zheng, Shuang Tang, Wenli Xing","doi":"10.1186/s12883-025-04357-4","DOIUrl":"10.1186/s12883-025-04357-4","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the associations between hyperglycemia, dynamics of glucose levels and unfavorable outcome in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>A retrospective study was conducted in our center. Blood glucose levels were measured at admission, immediately following MT procedure, and under fasting condition the next morning. Two patterns of blood glucose increase (BGI) were defined: postoperative BGI as higher postoperative blood glucose level than the value at admission, and fasting BGI as fasting blood glucose level exceeding the value at admission. Hyperglycemia was classified as any blood glucose measurements ≥ 8 mmol/L. Unfavorable outcome was defined as a modified Rankin Scale (mRS) score > 2 at 90 days after onset. Multivariable logistic regression was performed to assess the associations of blood glucose levels at three time points (admission, postoperative, and the next-morning fasting), BGI, and unfavorable outcome. Lastly, mediation analysis was conducted to assess the potential mediating role of systemic inflammatory response in the association between hyperglycemia and unfavorable outcome.</p><p><strong>Results: </strong>A total of 395 patients were enrolled, and 224 (56.7%) experienced unfavorable outcome. After multivariable adjustment, admission (adjusted odds ratio [aOR] 4.030, 95% CI 2.200-7.382), postoperative (aOR 2.462, 95% CI 1.354-4.476), and fasting hyperglycemia (aOR 4.309, 95% CI 2.271-8.176) were independently associated with unfavorable outcome. Moreover, fasting BGI was also found as a significant risk factor for unfavorable outcome (aOR 2.077, 95% CI 1.167-3.696). The relationships of admission and fasting hyperglycemia with unfavorable outcome were mediated by systemic inflammation markers, with mediation proportions ranging from 10.4 to 21.8% (all p < 0.05).</p><p><strong>Conclusion: </strong>Our findings support hyperglycemia and fasting BGI indicating elevated risk of unfavorable outcome in AIS patients undergoing MT, with systemic inflammation partially mediating these association.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"333"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on delay factors and time to hospital arrival after acute stroke in patients at Shahid Rajaei hospital, Tonekabon (2022-2023).","authors":"Mohadeseh Farokhfar, Mohamad Saleh Pezeshki Almani","doi":"10.1186/s12883-025-04361-8","DOIUrl":"10.1186/s12883-025-04361-8","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a sudden focal neurological deficit caused by vascular damage to the central nervous system. Globally, stroke is a leading cause of death and disability, with a particularly significant burden in low- and middle-income countries. In Iran, the incidence of acute stroke is increasing, and the age of onset is lower compared to developed countries. This study examines factors causing pre-hospital delays in acute stroke patients at Shahid Rajaei Hospital, Tonekabon, North of Iran (2022-2023). Timely intervention is critical for improving outcomes, as delays significantly affect treatment effectiveness. This study aims to identify the primary causes of pre-hospital delays in acute stroke patients and provide actionable insights to enhance timely intervention strategies, ultimately improving patient outcomes.</p><p><strong>Methods: </strong>A retrospective descriptive-analytical study was conducted on 150 acute stroke patients using census sampling. Data included demographics, symptoms, and time intervals from onset to hospital arrival. Analysis was performed with SPSS using chi-square, T-tests, and ANOVA.</p><p><strong>Results: </strong>Of the 150 patients, 81.3% arrived over 4.5 hours after symptom onset, missing the thrombolytic treatment window. Statistical analysis revealed significant associations between some demographic and clinical factors: shorter distances to the hospital and faster arrival (p = 0.037), presence of a witness (p = 0.041), and stroke onset during the daytime (p = 0.002) were linked to reduced delays. Marital status also influenced arrival times significantly (p = 0.007). Other delay factors included unawareness of stroke symptoms (46%), being alone (14.7%), and symptoms occurring during sleep (8.6%).</p><p><strong>Conclusions: </strong>The study highlights the need for public education on stroke symptoms and improved emergency systems to reduce delays. Addressing these gaps can enhance patient outcomes, especially in areas with limited awareness and resources.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"340"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incomplete penetrance and variable phenotypes of a novel NPRL2 frameshift variant: from familial focal epilepsy with variable foci 2 to neurodevelopmental disorders.","authors":"Hui Zhu, Qiyan Wang, Wenxin Deng, Shuyao Zhu, Lan Zeng, Ai Chen, Ying Pang, Fu Xiong","doi":"10.1186/s12883-025-04339-6","DOIUrl":"10.1186/s12883-025-04339-6","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"331"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first case of sick sinus syndrome with an adult Sanfilippo A syndrome: a case report with review of literature.","authors":"Yuming Wang, Wenjing Zhou, Changqing Du, Yimin Tang, Kefu Zhu","doi":"10.1186/s12883-025-04354-7","DOIUrl":"10.1186/s12883-025-04354-7","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"330"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine and neuroinflammation: correlation of adipokines and cytokines with clinical features.","authors":"Can Ulutaş, Buse Rahime Hasırcı Bayır, Yılmaz Çetinkaya, Eray Metin Güler, Dilek Ağırcan, Beyza Nur Özkan","doi":"10.1186/s12883-025-04319-w","DOIUrl":"10.1186/s12883-025-04319-w","url":null,"abstract":"<p><strong>Objective: </strong>Migraine is one of the most disabling conditions affecting the quality of life in society. The pathophysiology of migraine is not yet fully understood, but neuroinflammation is thought to play an important role. The aim of our study is to investigate the potential biomarker properties of adipokines and cytokines in migraine and to assess their relationship with clinical features, including headache frequency, severity, disability scores.</p><p><strong>Materials and methods: </strong>The study included a total of 90 participants: 30 with episodic migraines (EM), 30 with chronic migraines(CM), and 30 healthy volunteers, all aged between 18 and 50 years. Data were collected on patients age, sex, migraine characteristics (pain location, type), attack frequency over the past 3 months, duration of the disease, attack severity, and body mass index. During the interictal period, blood levels of high molecular weight (HMW) adiponectin, leptin, resistin, IL-6, TNF-α, and IL-1β were measured using ELISA kits.</p><p><strong>Results: </strong>The age, sex, and body mass index between the patient and control groups were similar. Levels of HMW-adiponectin, resistin, IL-6, TNF-α, and IL-1β were significantly higher in the patient group compared to the control group (p < 0.001 for each). HMW-adiponectin and IL-6 levels were significantly higher in CM patients compared to the EM group (p = 0.004 and p < 0.001, respectively). Additionally, adiponectin and IL-6 levels were positively correlated with the number of painful days, and IL-6 and leptin levels correlated with MIDAS scores.</p><p><strong>Conclusions: </strong>The higher levels of cytokines and adipokines, in migraine patients compared to the control group suggest a potential role of neuroinflammation in migraine pathophysiology. The elevated levels of HMW-adiponectin and IL-6 in CM patients indicate that these molecules may be associated with the mechanisms involved in the chronification of migraine and pain burden.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"338"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nurse-led nomogram for predicting the risk of myasthenic crisis in patients with myasthenia gravis and bulbar weakness.","authors":"Huimin Dong, Mengna Li, Mei Ma, Guoyan Qi","doi":"10.1186/s12883-025-04370-7","DOIUrl":"10.1186/s12883-025-04370-7","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to develop and validate a nurse-led clinical prediction model for assessing the risk of myasthenic crisis (MC) in myasthenia gravis (MG) patients with bulbar weakness.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on MG patients meeting the inclusion criteria from January 2022 to June 2024. The training group included 308 patients (January 2022-January 2024), and the validation group included 77 patients (February 2024-June 2024). The primary outcome was MC occurrence. A binary logistic regression model was constructed and presented as a nomogram. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) values, calibration curves, and decision curve analysis (DCA). Internal validation was performed by bootstrap resampling, while external validation was conducted using a validation cohort.</p><p><strong>Results: </strong>The study included 385 MG patients. Logistic regression analysis identified Myasthenia Gravis Foundation of America classification, presence of thymoma, body position, partial pressure of carbon dioxide, oxygenation index, and oropharyngeal secretions as the independent predictors of MC. The nomogram showed good discrimination, with AUC values of 0.806 (sensitivity: 76.0%, specificity: 71.7%) in the training group and 0.832 (sensitivity: 60.0%, specificity: 95.2%) in the validation group. The model also exhibited good calibration, and the results of DCA confirmed the clinical utility of the model across a range of risk thresholds.</p><p><strong>Conclusion: </strong>This nomogram can serve as an effective tool for nurses to identify MG patients at a high risk of developing MC. Because this study was a single-center retrospective study, future multicenter validation studies are required to further verify and expand the clinical applicability of this model.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"332"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromyelitis optica spectrum disorders with recurrent syncope due to area postrema syndrome: a case report and literature review.","authors":"Hexiang Yin, Yingjie Wang, Yan Xu","doi":"10.1186/s12883-025-04215-3","DOIUrl":"10.1186/s12883-025-04215-3","url":null,"abstract":"<p><strong>Background: </strong>Area postrema syndrome is one of the core clinical features of neuromyelitis optica spectrum disorders (NMOSD), characterized by intractable hiccups, nausea, and vomiting. Brain MRI often reveals lesions in the dorsal medulla oblongata. However, recurrent syncope has rarely been described in NMOSD. In a few reported cases, patients have been diagnosed with bradycardia or orthostatic hypotension due to medullary lesions, often requiring pacemaker implantation or cardioneuroablation.</p><p><strong>Case presentation: </strong>We reported a case of a 70-year-old female who presented with intractable nausea for 3 weeks and recurrent syncope for 2 days, while no remarkable lesions were found on brain MRI. A 24-h electrocardiogram (ECG) confirmed sick sinus syndrome, revealing multiple sinus pauses longer than 8 s. Meanwhile, high titer anti-aquaporin-4 immunoglobulin G was detected in her serum, leading to a diagnosis of NMOSD. Following treatment with one course of an intravenous methylprednisolone pulse and four courses of eculizumab, her symptoms of nausea and syncope resolved completely, her ECG normalized to sinus rhythm, and pacemaker implantation was successfully averted.</p><p><strong>Conclusions: </strong>NMOSD should be considered a differential diagnosis in patients with recurrent syncope accompanied by intractable hiccups, nausea, and vomiting. Prompt immunotherapy may be sufficient for rhythm recovery, potentially eliminating the need for invasive procedures.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"339"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent ischemic strokes caused by hereditary protein S deficiency from a novel PROS1 mutation: a case report.","authors":"Mei-Ying Huang, Ning Su, Ya-Ping Liu, Yi-Cheng Zhu","doi":"10.1186/s12883-025-04355-6","DOIUrl":"10.1186/s12883-025-04355-6","url":null,"abstract":"<p><strong>Background: </strong>Protein S deficiency (PSD) is an inherited thrombophilia caused by functional defects in protein S encoded by the PROS1 gene. Mainly manifesting as venous thromboembolism, PSD is not considered as a definitive cause of arterial thrombosis. However, there are several cases reporting ischemic stroke in patients with PSD, and anticoagulants were given as treatment.</p><p><strong>Case presentation: </strong>We present a patient with four ischemic strokes during the past 11 years, which recurred despite secondary prevention. Brain magnetic resonance imaging showed ischemic lesions in bilateral basal ganglia and paraventricular regions, as well as the left pons. After thrombophilia screening, the patient was diagnosed with hereditary PSD with a heterozygous PROS1 c.1961 C > A (p.A654D) mutation. He was treated effectively with clopidogrel and rivaroxaban.</p><p><strong>Conclusions: </strong>Hereditary PSD should be suspected in patients with recurrent ischemic strokes and a family history of thrombotic events. Anticoagulation treatment is warranted if evidence strongly suggests a contribution of PSD to ischemic strokes.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"335"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial aneurysm location: potential influencing factor in ruptures with internal carotid artery occlusion.","authors":"Pengran Liu, Limei Mao, Bangyue Wang, Jing Guo, Hui Dai, Yan Zhao, Hao Yin, Xihai Zhu, Wentao Dong, Shujie Liu, Xinyu Yang, Xiaojun Zhang","doi":"10.1186/s12883-025-04362-7","DOIUrl":"10.1186/s12883-025-04362-7","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intracranial aneurysms combined with spontaneous internal carotid artery occlusion (ICAO) are a rare and serious vascular disorder. Currently, there is only limited information available on the clinical characteristics of these patients and the risk factors for aneurysm rupture. Our objective is to describe the clinical features of these patients and predict the risk factors for the rupture of unruptured intracranial aneurysms (UIAs) combined with ICAO.</p><p><strong>Methods: </strong>We retrospectively analyzed cases of intracranial aneurysms with concurrent spontaneous ICAO from the Chinese Multicenter Aneurysm Database(CMAD). We collected population demographic characteristics and clinical data using a standardized case questionnaire from CMAD. Binary logistic regression analysis was used to identify risk factors for rupture of UIA associated with combined ICAO.</p><p><strong>Results: </strong>We identified 93 patients with intracranial aneurysms combined with ICAO, including 38 females and 55 males, with an average age of 60.7 ± 9.5 years (ranging from 32 to 79 years old). Among those with ICAO, 52 had ruptured intracranial aneurysms (RIAs) and 41 had UIAs. Specifically, there were 81 cases of unilateral ICAO, with 16 aneurysms located on the same side as the ICAO, 22 in the midline (AcomA, Basilar tip), and 43 on the opposite side of the ICAO; 12 cases were bilateral ICAO. Binary logistic regression analysis indicated that risk factors associated with the rupture of UIAs with ICAO included bilateral internal carotid artery occlusion and aneurysms in the posterior circulation. Furthermore, multivariate analysis showed that posterior circulation aneurysms are an independent risk factor for the rupture of UIAs with ICAO.</p><p><strong>Conclusion: </strong>We have described and analyzed the clinical characteristics and risk factors influencing the rupture of intracranial aneurysms in patients with ICAO. The study found that the location of the aneurysm is an important risk factor for the rupture of UIAs combined with ICAO.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"337"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of disease-modifying therapies for highly active relapsing-remitting multiple sclerosis despite previous treatment - a systematic review and network meta-analysis.","authors":"Michael Köhler, Friedemann Paul, Kirsten Janke, Sibylle Sturtz, Daniela Preukschat, Sabine Ostlender, Michaela Florina Kerekes, Thomas Kaiser","doi":"10.1186/s12883-025-04338-7","DOIUrl":"10.1186/s12883-025-04338-7","url":null,"abstract":"<p><strong>Background: </strong>Comparative assessments of all available disease-modifying therapies (DMTs) in patients with highly active relapsing-remitting multiple sclerosis (RRMS) are lacking, even though some of these DMTs are restricted to this MS subpopulation. We therefore aimed to compare DMTs in patients with highly active RRMS using re-analyses of individual patient data (IPD) provided by study sponsors.</p><p><strong>Methods: </strong>We searched for randomised controlled trials (RCTs) that included adult patients with RRMS and directly compared alemtuzumab, cladribine, dimethyl fumarate, fingolimod, natalizumab, ocrelizumab, ofatumumab, ozanimod, ponesimod and teriflunomide, or compared these DMTs with other drugs or placebo. Re-analyses of IPD for subpopulations of patients with high disease activity despite previous DMT were included in network meta-analyses (NMAs). As there is no widely accepted definition of high disease activity in RRMS, criteria were chosen to cover as wide a range of definitions as possible, while being sufficiently similar across studies.</p><p><strong>Results: </strong>We identified 14 relevant RCTs, including only 3 head-to-head comparisons of DMTs, and no relevant studies on natalizumab. All studies were pivotal studies for approval. The available re-analyses of IPD did not allow comprehensive NMAs. The main reasons for this were the overall paucity of RCTs, especially head-to-head comparisons, and a high risk of bias. In addition, data on patient-relevant outcomes and long-term follow-up (> 2 years) were lacking.</p><p><strong>Conclusion: </strong>Based on the largest possible evidence base, including previously unpublished data, our systematic review shows substantial evidence gaps for DMTs in highly active RRMS. This indicates a need for further research beyond regulatory requirements.</p><p><strong>Trial registration: </strong>Clinical trial number: not applicable.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"328"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}