Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.90
C. Capper-Loup, M. Orth
{"title":"F47 The European huntington’s disease network (EHDN) scientific support","authors":"C. Capper-Loup, M. Orth","doi":"10.1136/jnnp-2021-ehdn.90","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.90","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121355275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.84
R. Reilmann, A. Rosser, S. Kostyk, M. Geva, A. McGarry, Yael Cohen, Noga Gershoni-Emek, M. Mehra, C. Olanow, K. Kieburtz, M. Hayden, A. Feigin
{"title":"F41 The proof-hd phase 3 study: pridopidine’s outcome on function in huntington disease (PROOF)","authors":"R. Reilmann, A. Rosser, S. Kostyk, M. Geva, A. McGarry, Yael Cohen, Noga Gershoni-Emek, M. Mehra, C. Olanow, K. Kieburtz, M. Hayden, A. Feigin","doi":"10.1136/jnnp-2021-ehdn.84","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.84","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125721030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.66
D. McLauchlan, D. Linden, A. Rosser
Background Impulsive and irritable behaviour have been reported in HD from the earliest clinical descriptions of the condition, and abnormalities on various measures of impulsive behaviour have been demonstrated. However these studies had small sample sizes, and did not account for potential confounding effects in the HD population such as IQ and medication. Furthermore, the links between impulsive and irritable behaviour in HD remain unclear. Aims Determine which cognitive mechanisms contribute to irritable behaviour in HD Determine which aspects of impulsive behaviour are seen in HD Methods/Techniques We recruited HD patients and familial controls from the South Wales HD Service and performed a battery of established and novel cognitive tasks, including questionnaire measures of impulsive behavour and irritability (UPPSP, Barrett Impulsivity Scale, PBAs and Snaith), motor inhibition (stop signal task), delay discounting (Kirby instrument) and cognitive impulsivity (Iowa Gambling task). We also performed tasks of provocation (a previously reported task, and a novel task) to determine the relative contributions of impaired inhibition and excessive response to provocation in mediating irritability in HD. Results We recruited 51 HD patients and 26 controls. We found differences in response to provocation and also impaired motor inhibition on the stop signal task in the HD population, even after correcting for relevant confounders such as IQ, medication, motor impairment and psychiatric comorbidity. However, only the response to provocation was associated with irritability in HD. The tasks of delay discounting, and cognitive impulsivity did not demonstrate any differences between HD patients and controls after controlling for relevant confounders. Conclusions Irritability in HD is mediated by excessive response to provocation rather than the known impairments in motor inhibition. Other aspects of impulsivity to contribute to impulsive behaviour in HD.
{"title":"F23 Impulsivity and irritability in huntington’s disease: a common foundation?","authors":"D. McLauchlan, D. Linden, A. Rosser","doi":"10.1136/jnnp-2021-ehdn.66","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.66","url":null,"abstract":"Background Impulsive and irritable behaviour have been reported in HD from the earliest clinical descriptions of the condition, and abnormalities on various measures of impulsive behaviour have been demonstrated. However these studies had small sample sizes, and did not account for potential confounding effects in the HD population such as IQ and medication. Furthermore, the links between impulsive and irritable behaviour in HD remain unclear. Aims Determine which cognitive mechanisms contribute to irritable behaviour in HD Determine which aspects of impulsive behaviour are seen in HD Methods/Techniques We recruited HD patients and familial controls from the South Wales HD Service and performed a battery of established and novel cognitive tasks, including questionnaire measures of impulsive behavour and irritability (UPPSP, Barrett Impulsivity Scale, PBAs and Snaith), motor inhibition (stop signal task), delay discounting (Kirby instrument) and cognitive impulsivity (Iowa Gambling task). We also performed tasks of provocation (a previously reported task, and a novel task) to determine the relative contributions of impaired inhibition and excessive response to provocation in mediating irritability in HD. Results We recruited 51 HD patients and 26 controls. We found differences in response to provocation and also impaired motor inhibition on the stop signal task in the HD population, even after correcting for relevant confounders such as IQ, medication, motor impairment and psychiatric comorbidity. However, only the response to provocation was associated with irritability in HD. The tasks of delay discounting, and cognitive impulsivity did not demonstrate any differences between HD patients and controls after controlling for relevant confounders. Conclusions Irritability in HD is mediated by excessive response to provocation rather than the known impairments in motor inhibition. Other aspects of impulsivity to contribute to impulsive behaviour in HD.","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131861517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.56
Yara Y. Hassan, Filipe Brogueira Rodrigues, Paul Zeun, L. Byrne, C. Estevez Fraga, R. Tortelli, R. Scahill, E. Wild, S. Tabrizi
{"title":"F13 Safety and tolerability of lumbar punctures (LP) procedure in patients with huntington’s disease","authors":"Yara Y. Hassan, Filipe Brogueira Rodrigues, Paul Zeun, L. Byrne, C. Estevez Fraga, R. Tortelli, R. Scahill, E. Wild, S. Tabrizi","doi":"10.1136/jnnp-2021-ehdn.56","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.56","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123050912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.89
J. Townhill, T. McLean, Jamie Levey, A. Rosser, P. Weydt, M. Orth, C. Capper-Loup, Ehdn Central Coordination
{"title":"F46 The European huntington’s disease network","authors":"J. Townhill, T. McLean, Jamie Levey, A. Rosser, P. Weydt, M. Orth, C. Capper-Loup, Ehdn Central Coordination","doi":"10.1136/jnnp-2021-ehdn.89","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.89","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121353997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.81
E. Burnip, Kristin Gozdzikowska, Esther Guiu-Hernandez, Paige Thomas, M. Jury, Katharina Winiker, Maggie-Lee Huckabee
{"title":"F38 Skill-based dysphagia training as an intervention for individuals with huntington’s disease","authors":"E. Burnip, Kristin Gozdzikowska, Esther Guiu-Hernandez, Paige Thomas, M. Jury, Katharina Winiker, Maggie-Lee Huckabee","doi":"10.1136/jnnp-2021-ehdn.81","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.81","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114591342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-EHDN.88
Chiara Pane, Cinzia Valeria Russo, Ilaria Celano, Federica Coscetta, Assunta Trinchillo, Giovanna De Michele, Elena Salvatore, Luigi Di Maio, Chiara Colella, Natascia De Lucia, Rosa De Anna, F. Saccà
If Huntington disease (HD) may represent a risk factor for Covid-19 is debated. The aim of our work was to assess the impact of Covid-19 pandemic on HD disease progression, to evaluate patients vulnerability to Covid-19 infection and the incidence of severe manifestations compared to the general population. Methods After obtaining oral informed consent, we conducted a telephone interview directed to patients or care-givers, using an ad hoc developed semi-structured questionnaire. The questionnaire was composed of two sections and is shown in table 1. Section one: telephone interview to HD patients Section two: telephone interview to HD patients who tested positive for COVID19 Results We interviewed a total of 112 HD patients. Since the beginning of the pandemic, 72.3% of patients experienced a progression of the basal clinical condition (figure 1). Thirty-one-percent of patients changed their pre-existing psychiatric therapy or started a new one. Interestingly, 50% described the onset of a new sleep disorder. Analysis of the standards of care showed that 78% of the patients missed their scheduled medical visit and 64.7% stopped physiotherapy. Within the observed cohort 10.8% of patients tested positive for Covid-19 infection, 6 experienced symptoms and 5 of them had comorbidities. Despite resolution of the infection 3 patients underwent a rapid progressive and generalized clinical worsening. Conclusion Our study was among one of the first to investigate the impact of the Covid-19 pandemic on HD patients. Our results shown that most patients experienced a global clinical worsening since the beginning of the pandemic. Despite the more severe confinement measure adopted by HD patients, the incidence, and the morbidity of Covid-19 infection seemed to be higher than the general population (Buder, et al., 2021). Whether HD represents per se a risk factor for COVID-19 is unclear. However, a negative impact of HD on the immune system has been described, and difficulties in swallowing and clearing secretions may have negatively impacted the disease course.
{"title":"F45 Impact of COVID-19 pandemic in patients with huntington diesease","authors":"Chiara Pane, Cinzia Valeria Russo, Ilaria Celano, Federica Coscetta, Assunta Trinchillo, Giovanna De Michele, Elena Salvatore, Luigi Di Maio, Chiara Colella, Natascia De Lucia, Rosa De Anna, F. Saccà","doi":"10.1136/jnnp-2021-EHDN.88","DOIUrl":"https://doi.org/10.1136/jnnp-2021-EHDN.88","url":null,"abstract":"If Huntington disease (HD) may represent a risk factor for Covid-19 is debated. The aim of our work was to assess the impact of Covid-19 pandemic on HD disease progression, to evaluate patients vulnerability to Covid-19 infection and the incidence of severe manifestations compared to the general population. Methods After obtaining oral informed consent, we conducted a telephone interview directed to patients or care-givers, using an ad hoc developed semi-structured questionnaire. The questionnaire was composed of two sections and is shown in table 1. Section one: telephone interview to HD patients Section two: telephone interview to HD patients who tested positive for COVID19 Results We interviewed a total of 112 HD patients. Since the beginning of the pandemic, 72.3% of patients experienced a progression of the basal clinical condition (figure 1). Thirty-one-percent of patients changed their pre-existing psychiatric therapy or started a new one. Interestingly, 50% described the onset of a new sleep disorder. Analysis of the standards of care showed that 78% of the patients missed their scheduled medical visit and 64.7% stopped physiotherapy. Within the observed cohort 10.8% of patients tested positive for Covid-19 infection, 6 experienced symptoms and 5 of them had comorbidities. Despite resolution of the infection 3 patients underwent a rapid progressive and generalized clinical worsening. Conclusion Our study was among one of the first to investigate the impact of the Covid-19 pandemic on HD patients. Our results shown that most patients experienced a global clinical worsening since the beginning of the pandemic. Despite the more severe confinement measure adopted by HD patients, the incidence, and the morbidity of Covid-19 infection seemed to be higher than the general population (Buder, et al., 2021). Whether HD represents per se a risk factor for COVID-19 is unclear. However, a negative impact of HD on the immune system has been described, and difficulties in swallowing and clearing secretions may have negatively impacted the disease course.","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127157226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.76
P. Morgan-Jones, Annabel Jones, L. Mills, P. Pallmann, C. Drew, A. Arnesen, M. Busse, Fiona Wood
{"title":"F33 Perceptions, motivators and barriers to the acceptance of wearable activity trackers in people with huntington’s disease","authors":"P. Morgan-Jones, Annabel Jones, L. Mills, P. Pallmann, C. Drew, A. Arnesen, M. Busse, Fiona Wood","doi":"10.1136/jnnp-2021-ehdn.76","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.76","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125397166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.67
A. D. Paepe, Alexia Giannoula, F. Sanz, L. Furlong, C. García-Gorro, S. Martínez-Horta, J. Pérez-Pérez, J. Kulisevsky, N. Rodríguez-Dechicha, I. Vaquer, S. Subirà, M. Calopa, Esteban Muñoz, P. Santacruz, Jesús Ruiz-Idiago, C. Mareca, R. D. Diego-Balaguer, E. Càmara
{"title":"F24 Unsupervised clustering reveals longitudinal psychiatric signatures in HD","authors":"A. D. Paepe, Alexia Giannoula, F. Sanz, L. Furlong, C. García-Gorro, S. Martínez-Horta, J. Pérez-Pérez, J. Kulisevsky, N. Rodríguez-Dechicha, I. Vaquer, S. Subirà, M. Calopa, Esteban Muñoz, P. Santacruz, Jesús Ruiz-Idiago, C. Mareca, R. D. Diego-Balaguer, E. Càmara","doi":"10.1136/jnnp-2021-ehdn.67","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.67","url":null,"abstract":"","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125627889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1136/jnnp-2021-ehdn.78
E. Doheny, Klavs Renerts, C. Baumann, P. Morgan-Jones, M. Busse, M. Lowery, H. Jung
Background Sleep is affected by Huntington’s disease (HD), and sleep quality is linked to neurodegeneration. Wearable devices, such as Fitbit, use inertial sensors and photoplethysmography to estimate sleep stages during sleep, providing a low-cost solution for home-based sleep monitoring. While Fitbit devices have been validated in healthy individuals against the gold standard, polysomnography (PSG), they have not yet been validated in HD. Aims To establish the accuracy of Fitbit sleep metrics against PSG, and to quantify sleep quality over 7 nights at home. Methods Participants wore a Fitbit Charge 4 during overnight PSG, followed by 7 nights at home. PSG sleep stages were scored by an expert sleep physiologist. Fitbit sleep data were extracted every 30 s. Time in bed (TIB), total sleep time (TST), wake time (TWT), time in REM sleep (REM), stage N3 (Deep) and stages N1 and N2 (Light), sleep onset latency (SOL) and wake after sleep onset (WASO) were examined on each night. Fitbit sensitivity and specificity to each sleep stage was examined. Home sleep metrics were compared to PSG. Results Data for 1 male with early-stage HD (UHDRS motor score 5) are reported. Using PSG, TIB was 474.5 min, TST was 373 min, TWT was 101.5 min, REM was 96 min, Deep was 100 min, Light was 177 min, SOL was 95 min, and WASO was 6.5 min. Compared to PSG, Fitbit overestimated TST by 23 mins, Light by 37.5 min, REM by 11.5 min, WASO by 38.5 min, and underestimated SOL by 67 min, TWT by 28.5 min, Deep by 12.5 min, TIB by 5.5 min. Fitbit sensitivity and specificity to wake was 98% and 54%, REM was 97% and 100%, and Deep sleep was 96% and 74%. PSG TST and sleep stage times were within the range observed at home, but PSG TWT was greater than observed at home. Conclusion Initial results in one participant indicate that Fitbit Charge 4 is suitable to monitor sleep stages in HD, particularly REM. Issues distinguishing wake and light sleep were observed in this case. Data collection is ongoing.
{"title":"F35 Sleep monitoring in huntington’s disease using fitbit compared to polysomnography","authors":"E. Doheny, Klavs Renerts, C. Baumann, P. Morgan-Jones, M. Busse, M. Lowery, H. Jung","doi":"10.1136/jnnp-2021-ehdn.78","DOIUrl":"https://doi.org/10.1136/jnnp-2021-ehdn.78","url":null,"abstract":"Background Sleep is affected by Huntington’s disease (HD), and sleep quality is linked to neurodegeneration. Wearable devices, such as Fitbit, use inertial sensors and photoplethysmography to estimate sleep stages during sleep, providing a low-cost solution for home-based sleep monitoring. While Fitbit devices have been validated in healthy individuals against the gold standard, polysomnography (PSG), they have not yet been validated in HD. Aims To establish the accuracy of Fitbit sleep metrics against PSG, and to quantify sleep quality over 7 nights at home. Methods Participants wore a Fitbit Charge 4 during overnight PSG, followed by 7 nights at home. PSG sleep stages were scored by an expert sleep physiologist. Fitbit sleep data were extracted every 30 s. Time in bed (TIB), total sleep time (TST), wake time (TWT), time in REM sleep (REM), stage N3 (Deep) and stages N1 and N2 (Light), sleep onset latency (SOL) and wake after sleep onset (WASO) were examined on each night. Fitbit sensitivity and specificity to each sleep stage was examined. Home sleep metrics were compared to PSG. Results Data for 1 male with early-stage HD (UHDRS motor score 5) are reported. Using PSG, TIB was 474.5 min, TST was 373 min, TWT was 101.5 min, REM was 96 min, Deep was 100 min, Light was 177 min, SOL was 95 min, and WASO was 6.5 min. Compared to PSG, Fitbit overestimated TST by 23 mins, Light by 37.5 min, REM by 11.5 min, WASO by 38.5 min, and underestimated SOL by 67 min, TWT by 28.5 min, Deep by 12.5 min, TIB by 5.5 min. Fitbit sensitivity and specificity to wake was 98% and 54%, REM was 97% and 100%, and Deep sleep was 96% and 74%. PSG TST and sleep stage times were within the range observed at home, but PSG TWT was greater than observed at home. Conclusion Initial results in one participant indicate that Fitbit Charge 4 is suitable to monitor sleep stages in HD, particularly REM. Issues distinguishing wake and light sleep were observed in this case. Data collection is ongoing.","PeriodicalId":277670,"journal":{"name":"F: Clinical studies: case reports, oberservational studies and trials","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127584502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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