Clinical Neurology and Neurosurgery最新文献

{"title":"Hematoma expansion in intracerebral hemorrhage retrospective chart review: Who are the super-expanders?","authors":"Sebastian Koch ,&nbsp;Tiffany Eatz ,&nbsp;Berje H. Shammassian ,&nbsp;Lili Zhou ,&nbsp;Nicole Sur ,&nbsp;Gillian Gordon Perue ,&nbsp;Amedeo Merenda ,&nbsp;Ayham Alkhachroum","doi":"10.1016/j.clineuro.2025.109256","DOIUrl":"10.1016/j.clineuro.2025.109256","url":null,"abstract":"<div><h3>Background</h3><div>Hematoma expansion in intracerebral hemorrhage (ICH) is a predictor of poor outcome and remains an important therapeutic target. Little is known about the incidence and clinical characteristics of patients with severe hematoma expansion, who we hereafter label as super-expanders.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed baseline clinical and radiological features in consecutive ICH patients admitted over a three-year period to a comprehensive stroke center. Hematoma expansion was defined conventionally as a &gt; 33 % increase in hematoma volume or a &gt; 6 ml increase in absolute hematoma volume between the baseline and 24-hour follow-up brain CT. Severe hematoma expansion was defined as a &gt; 50 % increase in ICH volume associated with a decrease in the Glasgow Coma Scale of at least four points. We used Random Forest (RF) to generate importance plots searching for the determinants of super-expanders in ICH. In addition, a multivariable logistic regression model was done to examine independent factors associated with super-expanders.</div></div><div><h3>Results</h3><div>We analyzed 417 cases. Hematoma expansion, defined conventionally, occurred in 97/417 (23 %) patients of which 15/417 (4 %) were super-expanders. In the univariate analysis, super-expanders were more likely to have a lobar hemorrhage, spot sign, and increased in-hospital mortality. Using the RF analysis, age, platelet count, and presence of a spot sign emerged as important determinants of super-expansion. In a multivariable model, only spot sign was an independent predictor for super-expansion [Age (OR = 1.43, 95 % CI=0.61–3.37), spot sign (OR = 6.25, 95 % CI=2.30–17.00), lobar location (OR = 4.63, 95 % CI= 0.92–23.42)].</div></div><div><h3>Conclusion</h3><div>We describe a low incidence of 4 % of severe hematoma expansion in ICH. There were no definitive clinical or radiological characteristics that differentiated super-expanders. Identifying such characteristics may allow for patient risk stratification. We encourage further investigations into the early identification of super-expanders, who arguably have the most to benefit from aggressive interventions.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"261 ","pages":"Article 109256"},"PeriodicalIF":1.6,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617485","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":"Increased cortical activation in dizziness: Neural compensation or maladaptive load?","authors":"Gül Yücel ,&nbsp;Nur Yücel Ekici","doi":"10.1016/j.clineuro.2025.109246","DOIUrl":"10.1016/j.clineuro.2025.109246","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109246"},"PeriodicalIF":1.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534418","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":"Challenges in antiseizure medication discontinuation decisions: A qualitative study of clinicians who see patients with epilepsy","authors":"Samuel W. Terman ,&nbsp;Navya Kalia ,&nbsp;Micaela Dugan ,&nbsp;Jordan M. Silva ,&nbsp;Charlotte van Asch ,&nbsp;James F. Burke ,&nbsp;Shawna N. Smith ,&nbsp;Susanna S. O’Kula ,&nbsp;Chloe E. Hill","doi":"10.1016/j.clineuro.2025.109242","DOIUrl":"10.1016/j.clineuro.2025.109242","url":null,"abstract":"<div><h3>Background</h3><div>Antiseizure medication (ASM) withdrawal can be considered after a period of seizure-freedom for patients with epilepsy. We interviewed clinicians who treat patients with epilepsy about challenges and existing information gaps regarding ASM withdrawal decisions.</div></div><div><h3>Methods</h3><div>We conducted six focus groups of 3–5 clinicians each (N = 25). We used purposive sampling to reach key informants with diversity of geography, specialty, and credentialing, focusing on epilepsy specialists who may have the greatest experience with these scenarios but also seeking non-specialist neurology input. We asked respondents to describe their greatest challenges when discussing ASM withdrawal with patients and making treatment decisions. We then performed thematic qualitative analysis.</div></div><div><h3>Results</h3><div>Twenty (80 %) participants were epileptologists or clinical neurophysiologists, and three (12 %) were physician extenders. Respondents identified many challenges when discussing ASM withdrawal with patients. Estimating an individual patient’s seizure risk was one of the greatest challenges, due to heterogeneity in etiologies, electroclinical syndromes, and other patient characteristics. Additional challenges included weighing the net benefit versus harm of ASM discontinuation, dealing with uncertainty even if one could accurately estimate the chance of another seizure, and questions about optimal use of EEG. Respondents also noted challenges when patient preferences are not aligned with physician recommendations and the feeling of personal responsibility should the patient have a seizure after withdrawal.</div></div><div><h3>Conclusions</h3><div>Many challenges remain in ASM discontinuation decisions after a period of seizure-freedom. Our results encourage future efforts to improve individualized seizure risk prediction and to develop prediction models into seizure risk calculators.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109242"},"PeriodicalIF":1.6,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548306","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":"Letter to the editor: Cognitive impairment in calcified neurocysticercosis – Mechanistic and clinical considerations","authors":"Nathkapach K. Rattanapitoon,&nbsp;Patpicha Arunsan,&nbsp;Chutharat Thanchonnang,&nbsp;Schawanya K. Rattanapitoon","doi":"10.1016/j.clineuro.2025.109243","DOIUrl":"10.1016/j.clineuro.2025.109243","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109243"},"PeriodicalIF":1.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519293","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":"Response to Komiotis et al. “Genetic perspectives on transient global amnesia: A narrative review”","authors":"Andrew J. Larner","doi":"10.1016/j.clineuro.2025.109241","DOIUrl":"10.1016/j.clineuro.2025.109241","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109241"},"PeriodicalIF":1.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519292","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":"The lateral orbitotomy approach: Technical nuances and video-illustration","authors":"Hussam Abou-Al-Shaar ,&nbsp;Tarek Y. El Ahmadieh ,&nbsp;Maximiliano Nuñez ,&nbsp;Vera Vigo ,&nbsp;Ju Hyung Moon ,&nbsp;Juan C. Fernandez-Miranda ,&nbsp;Aaron A. Cohen-Gadol","doi":"10.1016/j.clineuro.2025.109235","DOIUrl":"10.1016/j.clineuro.2025.109235","url":null,"abstract":"<div><div>The lateral orbitotomy approach is a minimally-invasive transorbital technique that was originally developed to address orbital pathologies. With the increased understanding of orbital anatomy and multidisciplinary collaboration between neurosurgeons and oculoplastic surgeons, the approach has been expanded to address various pathologies of the anterior and middle cranial fossae, and intrinsic brain pathologies. Clipping select aneurysms and resecting both intrinsic and extra-axial brain tumors were made possible through a small skin incision around the eye. The lateral orbitotomy offers optimal visualization to pathologies located inferior to the anterior clinoid process, anterior to Meckel’s cave, lateral to the optic nerve, and medial to foramen ovale. In this report, the authors delineate the indications, advantages, and limitations of the lateral orbitotomy approach and discuss related technical nuances and common pitfalls. This report aims to provide a practical educational resource for neurosurgery trainees and junior neurosurgeons through high-quality dissections and 3D 4 K video presentations.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109235"},"PeriodicalIF":1.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548353","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":"Mid-long term efficacy of dihydroergotoxine mesylate in treatment of sialorrhea in Parkinson's disease","authors":"Huihui Jin ,&nbsp;Ting Huang ,&nbsp;Jing Wu ,&nbsp;Yanan Zhu ,&nbsp;Qing Gao ,&nbsp;Youyong Tian","doi":"10.1016/j.clineuro.2025.109239","DOIUrl":"10.1016/j.clineuro.2025.109239","url":null,"abstract":"<div><h3>Purpose</h3><div>To further assess the mid-long term effects of dihydroergotoxine mesylate (DHM) on salivation in patients with Parkinson’s disease (PD).</div></div><div><h3>Methods</h3><div>Thirty-nine participants were enrolled in a 24-week, open, self-controlled study. After baseline assessments of salivation, swallowing, and motor and cognitive function, the participants were given DHM. The primary outcome was the difference in the Sialorrhea Clinical Scale for Parkinson’s disease (SCS-PD) scores of salivation before and after treatment. The secondary outcomes included ≥ 30 % improvement in the SCS-PD score at each posttreatment visit and changes in the scores from other scales.</div></div><div><h3>Results</h3><div>A total of 39 participants were included in this study, and 4 participants dropped out. Finally, 35 patients completed all the visits. Salivation: After treatment for 1 week, the primary outcome, namely, the median SCS-PD score, decreased from 9.0 (IQR 5.0–12.0) at baseline to 7.0 (IQR 4.7–10.0) (<em>P</em> = 0.03). This effect persisted at 24 weeks, and the median score at 24 weeks was 5.0 (IQR 2.0–8.0) (<em>P</em> &lt; 0.001 compared with baseline). For the Drooling Severity and Frequency Scale (DSFS) scale, the median baseline score was 6.0 (IQR 5.0–7.0). After two weeks of treatment, the median score decreased from baseline to 5.0 (IQR 4.0–6.0) (<em>P</em> &lt; 0.001), and the median score at the final visit was 4.0 (IQR 3.7–6.0) (<em>P</em> &lt; 0.001). The second term of the second part of the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS-2.2) showed a trend that was consistent with that of the DSFS scale, and significant differences started to emerge at 2 weeks after treatment was initiated. Within one week of treatment, 25.64 % of the patients had improved SCS-PD scores, reaching improvements of 30 % or more. At 2–12 weeks, the proportion of patients with improved SCS-PD scores exceeded 50 %, and this proportion reached 64.10 % at 24 weeks. Swallowing function: The Eating Assessment Tool-10 (EAT-10) revealed that the median scores at 4–24 weeks were 1.0 (IQR 0–3.0), 1.0 (IQR 0–2.2) and 1.0 (IQR 0–3.0), which were significantly different from the baseline score of 2.0 (IQR 0.7–4.0) (<em>P</em> &lt; 0.05). After 2 weeks of treatment, the median score of the Swallowing Disturbance Questionnaire for Parkinson’s Disease (SDQ-PD) decreased from 22.0 (IQR 18.0–27.0) at baseline to 19.0 (IQR 17.0–23.2) (<em>P</em> = 0.001). However, motor and cognitive function did not significantly change in this study. Moreover, only 7.69 % of patients experienced mild and transient adverse effects.</div></div><div><h3>Conclusion</h3><div>DHM can significantly ameliorate salivation in PD patients over 24 weeks, with fewer adverse effects.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109239"},"PeriodicalIF":1.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519289","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":"Identifying poor prognostic factors in patients with spontaneous spinal epidural hematoma: Insights from 47 cases at a single institution","authors":"Michiru Katayama ,&nbsp;Yasufumi Ohtake ,&nbsp;Masaaki Mikamoto ,&nbsp;Makoto Senoo ,&nbsp;Hirohiko Nakamura","doi":"10.1016/j.clineuro.2025.109238","DOIUrl":"10.1016/j.clineuro.2025.109238","url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinical and perioperative factors associated with poor neurological outcomes in spontaneous spinal epidural hematoma (SSEH).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 47 consecutive SSEH patients treated from 1995 to 2024 at two centers. Neurological status was graded using the ASIA Impairment Scale (AIS). Good outcome was defined as AIS D/E at final follow-up; poor outcome as AIS A–C. Demographic characteristics, comorbidities, symptoms, imaging findings, treatment, and perioperative variables were statistically compared between outcome groups.</div></div><div><h3>Results</h3><div>The cohort comprised 20 men and 27 women (median age 69 years). Twenty-six patients underwent surgery and 21 were managed conservatively. All conservatively managed patients and 22/26 surgically treated patients achieved good outcomes. In the surgical group, perioperative hypotension requiring continuous catecholamines and a history of cardiovascular disease (CVD) were significantly associated with poor outcome (p = 0.00154 and p = 0.0278, respectively). Age, sex, lifestyle comorbidities, admission severity, hematoma extent, and canal occupancy ratio were not significantly associated. Time to surgery trended longer in the poor-outcome subgroup.</div></div><div><h3>Conclusion</h3><div>In SSEH, perioperative hypotension and CVD comorbidity are associated with worse neurological recovery. Vigilant hemodynamic management—especially around anesthetic induction—may help preserve spinal cord perfusion and improve outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109238"},"PeriodicalIF":1.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511869","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":"Stroke in pregnancy and postpartum: Etiology, incidence, and risk factors in a tertiary care cohort","authors":"Adalet Göçmen ,&nbsp;Murat Çekiç ,&nbsp;Mehmet İncebıyık ,&nbsp;Dilek Ağırcan ,&nbsp;Tülin Gesoğlu Demir ,&nbsp;Özlem Öz ,&nbsp;Özlem Ethemoğlu","doi":"10.1016/j.clineuro.2025.109237","DOIUrl":"10.1016/j.clineuro.2025.109237","url":null,"abstract":"<div><h3>Background</h3><div>Stroke during pregnancy and the puerperium is rare but potentially devastating, contributing substantially to maternal morbidity, mortality, and adverse fetal outcomes. Data on incidence, etiology, and modifiable risk factors in low- and middle-income countries remain limited.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed medical records of women ≥ 18 years admitted with ischemic stroke (arterial or cerebral venous thrombosis) or hemorrhagic stroke during pregnancy or up to 12 weeks postpartum at Harran University Hospital between January 2013 and October 2024. Clinical features, neuroimaging findings, laboratory parameters, thrombophilia/genetic testing, and obstetric complications were analyzed. A control group comprised age-matched pregnant/postpartum women hospitalized for obstetric indications without stroke. Risk factors were compared between groups, and center-based incidence was calculated per 100,000 deliveries.</div></div><div><h3>Results</h3><div>Eighty-three women were included (25 pregnant, 58 postpartum). Ischemic stroke predominated over hemorrhagic events. Cerebral venous thrombosis was the most frequent subtype, particularly postpartum and within 6 weeks of delivery. Preeclampsia/eclampsia and anemia were significantly more common in cases than controls (p &lt; 0.01). Laboratory abnormalities included higher urea, creatinine, glucose, low-density lipoprotein cholesterol, C-reactive protein, erythrocyte sedimentation rate, red cell distribution width, and platelet counts, with lower hemoglobin, ferritin, albumin, thyroid-stimulating hormone, and mean corpuscular volume. Thrombophilia testing revealed higher frequencies of methylenetetrahydrofolate reductase C677T/A1298C, prothrombin G20210A, and Factor V Leiden variants among cerebral venous thrombosis patients. The incidence of pregnancy-associated stroke at our center was 57.8 per 100,000 deliveries.</div></div><div><h3>Conclusions</h3><div>Pregnancy-associated stroke, especially postpartum CVT, remains an important cause of maternal morbidity. Hypertensive disorders and anemia emerged as key modifiable correlates. Early postpartum surveillance, blood pressure control, treatment of anaemia, and risk-tailored thromboprophylaxis may reduce the burden of maternal stroke.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109237"},"PeriodicalIF":1.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511981","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":"Short-term outcomes and hospitalization cost associated with flow diversion versus coil embolization for unruptured aneurysms: A national assessment","authors":"Jonathan Dallas ,&nbsp;Michelle Lin ,&nbsp;David J. Cote ,&nbsp;Anadjeet S. Khahera ,&nbsp;Li Ding ,&nbsp;Frank J. Attenello ,&nbsp;William J. Mack","doi":"10.1016/j.clineuro.2025.109236","DOIUrl":"10.1016/j.clineuro.2025.109236","url":null,"abstract":"<div><h3>Objective</h3><div>The use of flow diversion (FD) has rapidly increased over the last decade, particularly for treatment of complex aneurysms not amenable to conventional coil embolization (CE). We aimed to compare national outcomes and healthcare utilization associated with FD and CE of unruptured aneurysms.</div></div><div><h3>Methods</h3><div>The National Inpatient Sample (2019–2022) was used to identify patients with unruptured intracranial aneurysms who underwent CE or FD (patients undergoing both FD+CE were classified as FD). Pediatric patients, non-elective admissions, and patients with subarachnoid hemorrhage were excluded. Variables included sociodemographics (e.g., age, race, gender), hospital factors (e.g., size, ownership, teaching status, location), and basic clinical variables in bivariate and multivariable regression. Outcomes included in-hospital mortality, stroke, discharge disposition (favorable/unfavorable), length of stay, and total cost of hospitalization.</div></div><div><h3>Results</h3><div>7370 patients were identified, of which 4280 were CE and 3090 were FD. Given the elective nature of intervention, rates of mortality (0.19 %), unfavorable discharge disposition (2.77 %), and stroke (0.83 %) were low. On multivariable analysis, use of flow diversion was not associated with unfavorable discharge (OR 0.80, P = 0.211) or stroke (OR 0.91, P = 0.753). FD trended toward, but did not reach, statistical significance for elevated length of stay (IRR 1.04, P = 0.150); however, it did lead to a significantly higher overall cost (ß=$1260.98, P = 0.049)</div></div><div><h3>Conclusion</h3><div>Nationally, short-term outcomes are similar between FD and CE, although use of FD does imbue a mildly higher hospitalization cost. Further work is needed to characterize large-scale, long-term outcome differences, particularly as FD use increases for more complex aneurysms not amenable to CE.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"260 ","pages":"Article 109236"},"PeriodicalIF":1.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145479113","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}