British Journal of Neurosurgery最新文献

{"title":"Clinical predictions using artificial intelligence in neurosurgery and its subspecialties: a systematic review and meta-analysis.","authors":"Prajwal Ghimire, Aswin Chari, Jonathan Shapey, Keyoumars Ashkan","doi":"10.1080/02688697.2026.2759623","DOIUrl":"https://doi.org/10.1080/02688697.2026.2759623","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) models for clinical prediction are proliferating across neurosurgery, but their aggregate discriminative performance, distribution along the care pathway and methodological quality are unclear. We systematically reviewed and meta-analysed these studies in neurosurgery and its subspecialities along with their risk of bias appraisal.</p><p><strong>Methods: </strong>We performed a PRISMA search on PubMed and Ovid for peer-reviewed original studies (2015-2026) using AI to predict a clinical outcome in neurosurgical populations. Metrics (primary- AUC; secondary- accuracy, sensitivity, specificity, c-index) were pooled using random effects modelling, overall, by subspeciality and care-pathway stage. Each study was classified as diagnostic, prognostic or forecasting and was assigned an evidence level. Clinical prediction task sub-stratification analysis was performed. Risk-of-bias was assessed using PROBAST. PROSPERO registered: CRD420261436614.</p><p><strong>Results: </strong>1063 studies were included. Across 451 (42.2%) studies reporting AUC, pooled discrimination was 0.86 (95% CI: 0.849-0.862), ranging from 0.84 (spine) to 0.87 (neuro-oncology), with extreme heterogeneity (I² 98.6%, τ²=0.27; 95% prediction interval: 0.68-0.94). Performance varied by clinical pathway stage, highest for diagnosis, grading and molecular tasks and lowest for post-operative tasks; pre-diagnosis, pre-operative and intra-operative applications were sparse, and treatment models were confined to neuro-oncology. Only 51 studies (4.8%) were using prospective data with external validation, whereas 619 (58%) rested on internal validation alone or no validation. 89% studies were at high risk-of-bias, driven by the analysis domain. Pooled discrimination was unchanged (AUC: 0.86%) when restricted to externally validated or non-high-risk studies.</p><p><strong>Conclusion: </strong>AI models report high performance across all the neurosurgical subspecialities, concordant across AUC, accuracy, sensitivity and specificity and robust to risk-of-bias stratification. Performance is highest for imaging-anchored diagnostic tasks and lowest at decision-facing post-operative stage. However, the literature is dominated by optimism-prone, internally-validated and poorly calibrated models with extreme heterogeneity. External validation, calibration analysis and reporting guidelines adherence remain prerequisites for clinical adoption.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":0.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357168","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":"Hydrocephalus awareness month: a call for standardised outcome reporting and regional registries in Africa.","authors":"Abdulrahmon Moradeyo, Zainab Oluwatunmise Yusuf","doi":"10.1080/02688697.2026.2753129","DOIUrl":"https://doi.org/10.1080/02688697.2026.2753129","url":null,"abstract":"","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149318174","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":"Utilising wearable technology to enhance neurosurgical training: a systematic scoping review.","authors":"Honglin Zhu, James Booker, Sanchit Aapan, Udhay Cheema, Joachim Starup-Hansen, Chan Hee Koh, Evangelos Mazomenos, Manish K Tiwari, Hani J Marcus","doi":"10.1080/02688697.2026.2753136","DOIUrl":"https://doi.org/10.1080/02688697.2026.2753136","url":null,"abstract":"<p><strong>Purpose: </strong>Contemporary neurosurgical training faces challenges due to reduced operative exposure and the limited, inconsistent feedback provided to trainees. Wearable technologies may help address these issues by offering objective data and real-time support. This scoping review systematically evaluates the evidence of wearable technology in surgical training, analysing device types, their applications, and the supporting evidence for their effectiveness.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted in 10 pre-clinical and clinical databases from inception to May 2024, searching for keywords \"wearable technology\" AND \"surgery\" AND \"training\". The search yielded 25,806 results. After removing duplicates, papers were screened by title and abstract (n = 12,306), followed by full-text screening (n = 482).</p><p><strong>Results: </strong>Forty-one studies, including 985 participants, were included in the review. Head-mounted displays were predominantly used for augmented and mixed reality applications, while smart glasses facilitated telementoring and procedure recording. Other wearables enabled biomechanical analysis and ergonomic assessments. Reported outcomes varied widely, with clinician-centred metrics, such as procedural accuracy, error rates, completion times, and satisfaction, being the most frequently assessed. Devices including HTC VIVE and HoloLens were associated with improved surgical performance. Clinicians often reported enhanced visualisation and anatomical orientation, though barriers such as learning curves, technical issues, and discomfort were noted.</p><p><strong>Conclusions: </strong>This review provides a comprehensive evaluation of wearable technologies in surgical training, highlighting their potential to improve performance metrics and support a range of educational uses for neurosurgical trainees. However, key challenges must be addressed to enable broader adoption and integration into surgical education.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":0.8,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149318175","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":"Contralateral acute subdural hematoma following moyamoya bypass surgery: a rare complication.","authors":"Junichi Akiyama, Sukwoo Hong, Satoru Miyawaki, Hideaki Ono, Nobuhito Saito","doi":"10.1080/02688697.2026.2753131","DOIUrl":"https://doi.org/10.1080/02688697.2026.2753131","url":null,"abstract":"<p><strong>Background: </strong>Moyamoya disease (MMD) is a progressive cerebrovascular disorder characterized by compensatory development of collateral vessels in response to internal carotid artery occlusion. Superficial temporal artery to middle cerebral artery (STA-MCA) bypass combined with encephalomyosynangiosis is a standard surgical intervention, hemorrhagic complications following such procedures are rare, especially in pediatric patients. We present a rare case of contralateral acute subdural hematoma (ASDH) occurring immediately after revascularization surgery in a child with MMD.</p><p><strong>Case description: </strong>A 7-year-old girl with a history of left cerebral infarction due to MMD underwent left STA-MCA bypass with encephalomyosynangiosis. Although the bypass was technically successful and the patient showed no new neurological deficits postoperatively, routine computed tomography revealed a contralateral ASDH. The hematoma was promptly evacuated. Intraoperative findings included oozing from the dura near the sphenoid ridge, but no active bleeding source was identified. She recovered well without neurological deterioration. Notably, follow-up digital subtraction angiography at five months postoperatively revealed the formation of a spontaneous transdural anastomosis from the right middle meningeal artery, eliminating the need for further bypass surgery on the contralateral side.</p><p><strong>Conclusion: </strong>Cerebral atrophy, intraoperative cerebrospinal fluid drainage, and perioperative aspirin use may have contributed to the development of contralateral ASDH. Surgeons should be aware of this possibility. Prompt recognition and evacuation are essential.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149294785","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":"Can risk factors predict the development of subdural haematoma after shunt surgery?","authors":"Fatih Demir, Bilal Ertuğrul, Fatih Serhat Erol, Metin Kaplan, Bekir Akgün, Sait Öztürk","doi":"10.1080/02688697.2026.2743532","DOIUrl":"https://doi.org/10.1080/02688697.2026.2743532","url":null,"abstract":"<p><strong>Purpose: </strong>Subdural haematoma is a well-recognized complication following ventriculoperitoneal shunt surgery. However, limited data exist regarding which clinical and surgical factors may predict its development. This study aims to identify specific risk factors associated with subdural haematoma formation following ventriculoperitoneal shunt placement.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 499 patients who underwent ventriculoperitoneal shunt placement between June 2010 and June 2020. Patients with a history of trauma were excluded. Demographic characteristics, surgical details, and radiological data were recorded. The primary outcome was the incidence of postoperative subdural haematoma. Statistical analyses were performed to identify significant predictors.</p><p><strong>Results: </strong>Of the 499 patients included in the study, 79 (15%) developed subdural haematoma during follow-up. Univariate and multivariate analyses revealed that older age, male gender, preoperative Evans index >48%, acetylsalicylic acid use, and placement of the ventricular catheter through Kocher's point were significantly associated with increased risk of subdural haematoma development (<i>p</i> < 0.05). No significant association was found with other surgical variables.</p><p><strong>Conclusion: </strong>Subdural haematoma occurred in 15% of patients following ventriculoperitoneal shunt surgery. The presence of certain preoperative and perioperative factors (particularly age, sex, ventricular size, acetylsalicylic acid use, and catheter trajectory) may help identify high-risk patients. Risk-based follow-up and tailored surgical planning could potentially reduce the incidence of subdural haematoma after shunting procedures.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262944","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":"Endo-ACDF with a rigid bendable burr for lesions located at posterior vertebral body: a technical note.","authors":"Yuxin Meng, Shangju Gao, Ting Li, Fantao Meng, Zhaohui Li, Wenyi Li, Mengfei Li, Yanwang Niu, Jingchao Wei","doi":"10.1080/02688697.2026.2745204","DOIUrl":"https://doi.org/10.1080/02688697.2026.2745204","url":null,"abstract":"<p><p>Anterior cervical discectomy and fusion (ACDF), featuring a high fusion rate and favourable clinical outcomes, has always been the gold standard technique for treating cervical spondylosis.¹ With significant advancements in optical technology, surgical instruments, and imaging systems, a variety of new devices have been successively applied in ACDF to enhance its advantages. However, lesions located at posterior vertebral body remains a challenge for ACDF. To solve this problem, we have explored a technique that utilizes endoscope-assisted ACDF (Endo-ACDF) with a rigid bendable burr. During the surgery, a rigid bendable burr is used to perform bone resection on the upper and lower endplates of the target intervertebral space to expose the lesion, and then other instruments are used to complete the removal. The rigid bendable burr and the clear endoscopic field of view can help the surgeon achieve complete removal of lesions through a single-segment discectomy, while maintaining the advantages of traditional ACDF. Compared with the use of nonbendable burr, we speculate that this technique can achieve the removal of posterior vertebral lesions while preserving more vertebral bone mass. Therefore, in this article, we elaborated in detail on the technique of utilizing Endo-ACDF with a rigid bendable burr.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227364","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":"Ventriculostomy-associated infection rates and routine EVD replacement: a systematic review and meta-analysis.","authors":"Saleh Salah Safi, Menatalla Metwally Ramadan Said Elbadway, Mariah Mancha, Ibtihal Abdelgadir, Ian Pople, Khalid Al-Kharazi","doi":"10.1080/02688697.2026.2743512","DOIUrl":"https://doi.org/10.1080/02688697.2026.2743512","url":null,"abstract":"<p><strong>Background: </strong>External ventricular drainage (EVD) is associated with a significant risk of ventriculostomy-associated infection (VAI), which can lead to severe complications. The relationship between catheterization duration, routine catheter exchange, and infection risk remains debated. This meta-analysis aimed to estimate the contemporary pooled VAI rate and evaluate the effect of catheter type and management strategy on infection risk.</p><p><strong>Methods: </strong>PROSPERO-registered (CRD42025632997) systematic review and meta-analysis. MEDLINE, Cochrane, Embase, Scopus, and CINAHL were searched through February 2024. Studies reporting EVD infection counts with catheter-days were included. Random-effects (DerSimonian-Laird) meta-analysis pooled log-transformed infection rates. Subgroup analyses compared impregnated versus plain catheters and pre-/post-2010 era. Two RCTs were qualitatively synthesized. Risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane RoB2.</p><p><strong>Results: </strong>Nineteen cohort studies and two RCTs were included. Critically, neither RCT demonstrated benefit from routine replacement (Wong 2002: RR = 1.80, 95% CI 0.33-9.81, <i>p</i> = 0.50; Keong 2012: RR = 0.58, 95% CI 0.33-0.99, favouring silver-impregnated catheters over standard catheters rather than supporting exchange). All 19 observational cohort studies confirmed that routine fixed-interval EVD replacement was not practiced at any included institution, precluding direct observational comparison. Eight cohort studies contributed 167 infections across 22,839 catheter-days to quantitative synthesis. The pooled VAI rate was 7.87 per 1,000 catheter-days (95% CI 4.67-13.25; I²=91%, τ²=0.506). The 95% prediction interval was 1.78-34.85/1,000 catheter-days, reflecting wide variation across settings. Antimicrobial-impregnated catheters had a pooled rate of 4.85 versus 17.03/1,000 catheter-days for plain catheters.</p><p><strong>Conclusion: </strong>Routine fixed-interval EVD replacement is not supported by current evidence, independently confirming IDSA 2017 Recommendation 78. Antimicrobial-impregnated catheters and infection prevention bundles appear more effective at reducing VAI rates than scheduled catheter exchange alone. Further adequately powered RCTs are needed and research should standardize reporting of institutional replacement practices and evaluate broader-spectrum antimicrobial catheter technologies targeting both gram-positive and gram-negative organisms.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-14"},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179591","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":"Matched analysis of the LACE+ score for post-operative outcomes in patients with intradural spinal tumors.","authors":"Emily Xu, Jennifer Cirvello, Kristen H Park, Sumasri Kotha, Joshua L Golubovsky, Mackenzie Castellanos, Scott D McClintock, Anish Butala, Gabrielle W Peters, Alvand Hassankhani, Hayley M Knollman, James Schuster, Colbey W Freeman, Neil R Malhotra","doi":"10.1080/02688697.2026.2743510","DOIUrl":"https://doi.org/10.1080/02688697.2026.2743510","url":null,"abstract":"<p><strong>Objective: </strong>The management of intradural spinal tumors can be complex and associated with high resource utilization. The LACE+ index is a validated tool developed to predict post-operative readmission and mortality. This study evaluated the utility of LACE+ in patients undergoing surgery for intradural spinal tumors.</p><p><strong>Methods: </strong>Data on patients undergoing spinal oncology surgery for intradural tumors (<i>n</i> = 275) with LACE+ score was collected. Coarsened exact matching was used to control for confounding variables and assess the predictive value of LACE+. Patients with a LACE+ score in the top quartile (≥ 58, <i>n</i> = 18) were compared to matched patients in the bottom quartile (≤23, <i>n</i> = 18). A secondary analysis compared the top (> 44, <i>n</i> = 58) and bottom (≤ 44, <i>n</i> = 58) halves. Outcomes included 30- and 90-day ED visits, readmissions, reoperations, non-home discharges, and mortality.</p><p><strong>Results: </strong>After matching, patients in the top LACE+ quartile had greater odds of non-home discharge (OR 5.80, <i>p</i> = 0.02) and 90-day readmission (OR 5.52, <i>p</i> = 0.04). In the secondary analysis, patients in the top half had greater odds of non-home discharge (OR 2.5, <i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>Higher LACE+ scores were associated with non-home discharge and 90-day readmission after intradural spinal tumor surgery. Application of this tool may guide risk stratification and perioperative management of patients.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191437","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":"Advances in monitoring the injured brain.","authors":"Elham Rostami, Peter J Hutchinson, Bart Depreitere","doi":"10.1080/02688697.2026.2743496","DOIUrl":"https://doi.org/10.1080/02688697.2026.2743496","url":null,"abstract":"<p><p>Multimodal neuromonitoring has emerged as a cornerstone of modern neurocritical care for traumatic brain injury (TBI). Traditional monitoring approaches based on intracranial pressure (ICP) and clinical examination alone have proven insufficient to capture the complex, heterogeneous pathophysiology that drives secondary brain injury. Over the past decade, significant advances in monitoring technology, including brain tissue oxygenation, cerebral microdialysis, continuous electroencephalography, near‑infrared spectroscopy, cerebrovascular autoregulation assessment and non‑invasive techniques have enabled clinicians to individualize treatment strategies based on real‑time physiological data. Concurrently, artificial intelligence and machine learning are transforming data integration and prognostic modelling, and non‑invasive and wearable approaches are beginning to extend brain monitoring beyond high‑resource neuro‑ICUs. This review examines recent innovations in neuromonitoring for TBI, highlighting invasive and non‑invasive modalities, their integration into multimodal platforms, and emerging technologies that promise to make precision neurocritical care a clinical reality. As we move toward the future of neurosurgery, the challenge lies not only in developing advanced monitoring tools but in interpreting them in the context of host‑specific factors and translating complex physiological signals into timely, evidence‑based interventions that improve patient outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164850","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":"Impact of Hurricane Melissa on neurosurgery care in Jamaica: implications for disaster preparedness.","authors":"Matthew Myers, Shantall Hamilton, Shaneika Hazle, Lorenzo Blake, Lisanne Hylton, Stuart Holder, Scizar Samuels, Alistair Lawrence, Tariq Parker, Kevin Wade, Mark Morgan, Carl Bruce, Peyton Lawrence","doi":"10.1080/02688697.2026.2746369","DOIUrl":"https://doi.org/10.1080/02688697.2026.2746369","url":null,"abstract":"<p><strong>Background: </strong>Natural disasters, including hurricanes, are becoming increasingly severe as a result of climate change, and can have a devastating impact on healthcare systems. In October 2025, a category five hurricane struck Jamaica and caused extensive damage throughout the island. This study reports on the nationwide impact of the hurricane on neurosurgical services, to identify lessons learned and to support future disaster preparedness.</p><p><strong>Methods: </strong>A mixed-methods descriptive multi-centre case series including all acute neurosurgical units across Jamaica. The study includes all patients for whom neurosurgical care was impacted by the hurricane over a period of four weeks around the event.</p><p><strong>Results: </strong>Twenty-one patients across Jamaica received neurosurgical care that was impacted by the hurricane, of which eight required surgical intervention, presenting with a variety of traumatic injuries, commonly caused by spinal injury from falling trees (SIFT). Delayed presentations were common, and non-traumatic conditions and elective procedures were affected. Logistical and operational issues were also prevalent.</p><p><strong>Conclusions: </strong>This study highlights the clinical and logistical difficulties that could be expected for a neurosurgical unit affected by a hurricane. Disaster preparedness should include the stockpiling of essential equipment, clear staffing plans, and education of staff and the public regarding emergency plans and risk reduction.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147719","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}