Journal of Diabetes Science and Technology最新文献

{"title":"Multicenter Comparison of Computerized Insulin Sensitivity Coefficient and Paper-Based Intravenous Insulin Protocols.","authors":"Amy K Janowski, Nandini Patel, Lydia R Ware, Kevin M Dube, Mary P Kovacevic, Kenneth E Lupi, Andrew Tom, Russel J Roberts, Anne Bane, Paul M Szumita, Nadine E Palermo, Jeremy R DeGrado","doi":"10.1177/19322968261462502","DOIUrl":"10.1177/19322968261462502","url":null,"abstract":"<p><strong>Introduction: </strong>Computerized intravenous (IV) insulin infusion calculators may offer a safe and efficacious means of achieving glycemic control. Historically, our health system utilized various paper-based IV insulin infusion protocols but transitioned to a computerized insulin infusion calculator protocol based on the insulin sensitivity coefficient (ISC) in 2024. The objective of this study was to compare the safety and efficacy of the computerized ISC-based insulin infusion calculator protocol with previous protocols.</p><p><strong>Methods: </strong>This was a pre-post intervention analysis of critically ill adult patients initiated on a paper-based insulin infusion across 13 institutions from March 2023 to May 2023 for pre-analysis and patients on a computerized, ISC-based insulin infusion from November 2024 to December 2024 for post-analysis. The primary outcome was the percentage of blood glucose levels within target range (80-180 mg/dL). Secondary outcomes included rates of hyperglycemia (>200 mg/dL), severe hyperglycemia (>250 mg/dL), hypoglycemia (<70 mg/dL), and severe hypoglycemia (<54 mg/dL).</p><p><strong>Results: </strong>In total, 207 and 237 patients were included in the pre- and post-intervention groups, respectively. For the primary outcome, 4610 of 6313 (73%) and 6163 of 7870 (78.3%) of blood glucose values were in range in the pre- and post-intervention groups, respectively (<i>P</i> < .01). There was no difference in severe hypoglycemia (0.2% vs 0.1%, <i>P</i> = .24), but rates of hyperglycemia (16.6% vs 12.6%, <i>P</i> < .01), severe hyperglycemia (5.7% vs 4.0%, <i>P</i> < .01), and hypoglycemia (0.7% vs 0.2%, <i>P</i> < .01) were higher in the pre-intervention group.</p><p><strong>Conclusions: </strong>A computerized ISC-based insulin infusion protocol resulted in more blood glucose values in target range and lower rates of hypoglycemia compared with paper-based protocols.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261462502"},"PeriodicalIF":4.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective Sleep and Circadian Metrics in Adolescents With Type 1 Diabetes Mellitus: A Systematic Review.","authors":"Ayesha Juhi, Rashmi Kumari, Himel Mondal, Pritam Kumar Choudhary, Shreya Sharma","doi":"10.1177/19322968261463558","DOIUrl":"10.1177/19322968261463558","url":null,"abstract":"<p><strong>Purpose: </strong>This review synthesizes evidence on objectively measured sleep and circadian parameters in adolescents with type 1 diabetes mellitus (T1DM) and associations with glycaemic outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered with PROSPERO (CRD420251164605). Five electronic databases were searched for studies reporting objective sleep or circadian measures in adolescents aged 10 to 19 years with T1DM. Eligible designs included cross-sectional, cohort, longitudinal, and randomized controlled trials. Risk of bias was assessed using the JBI checklist, Newcastle-Ottawa Scale, and Cochrane RoB 2. Narrative synthesis was conducted per Synthesis Without Meta-analysis guidelines.</p><p><strong>Results: </strong>Ten studies met inclusion criteria. Adolescents with T1DM consistently demonstrated suboptimal sleep duration (mean total sleep time 6.8-7.6 h/night), high night-to-night variability, impaired continuity, and circadian misalignment. Associations between sleep duration and HbA1c were inconsistent; however, sleep efficiency, fragmentation, variability, and circadian timing showed more consistent associations with higher HbA1c and increased glucose variability. Only 1 study included a healthy control group; most were single-cohort observational designs, limiting causal inference. Risk of bias was moderate in cross-sectional and low to moderate in cohort studies. Randomized evidence comprised 2 trials; neither demonstrated sustained improvements in objective sleep outcomes or glycaemic control with closed-loop therapy versus standard care.</p><p><strong>Conclusions: </strong>In adolescents with T1DM, disturbed sleep involves insufficient duration, fragmentation, variability, and circadian misalignment. Sleep efficiency and regularity showed more consistent associations with glycaemic outcomes than duration alone, positioning sleep assessment as a potential research target in adolescent diabetes care. Future research should integrate standardized actigraphy with continuous glucose monitoring to establish causal pathways.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261463558"},"PeriodicalIF":4.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Active Insulin Time and Glycemic Targets on Automatic Correction Bolus Delivery.","authors":"Giuseppe Papa, Rossella Cannarella, Carmelo Gusmano, Concetta Finocchiaro, Massimiliano Anzaldi, Gianfranco Gruttadauria, Luca Patti, Donatella Lo Presti, Salvatore Scirè Calabrisotto, Rosita A Condorelli, Sandro La Vignera, Aldo E Calogero","doi":"10.1177/19322968261465689","DOIUrl":"10.1177/19322968261465689","url":null,"abstract":"<p><strong>Background: </strong>This study examined how automatic correction boluses (ABs) vary according to active insulin time (AIT) and glucose target settings, and how these parameters impact glycemic control in individuals with type 1 diabetes.</p><p><strong>Methods: </strong>Retrospective data from 287 individuals with type 1 diabetes using the MiniMed 780G system in auto-mode for at least 80% of the time over a minimum period of 6 months were analyzed. The AB delivery was evaluated in relation to different AIT and glucose target settings. Glycemic outcomes, including time in range (TIR 70-180 mg/dL), were assessed.</p><p><strong>Results: </strong>Automatic correction boluses accounted for 33.1% of bolus insulin and 18.3% of the total daily insulin dose (TDD). Active insulin time settings significantly influenced AB delivery: individuals using a 2-hour AIT showed higher percentages of ABs relative to both TDD and bolus insulin, as well as higher AB doses expressed in IU/kg/day. Shorter AIT settings were also associated with improved TIR. In contrast, glucose target settings ranging from 100 to 120 mg/dL did not significantly affect AB delivery or TIR.</p><p><strong>Conclusion: </strong>Active insulin time is a key modifiable parameter influencing AB delivery and glycemic outcomes. Shorter AIT settings were associated with increased AB administration and improved TIR, whereas glucose target settings had no significant impact on these outcomes.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261465689"},"PeriodicalIF":4.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Changes in Continuous Glucose Monitoring Profiles in Health Care Workers Participating in a Digitally Delivered Metabolic Wellness Program.","authors":"Bariq S Firmansyah, Ronesh Sinha, Ashutosh Sabharwal, Cheryl D Stults, Joseph Wilcox, Katie Gillespie, Rekha Viswanathan, Richard Chapman, Susan McClendon, David Kerr","doi":"10.1177/19322968261463562","DOIUrl":"10.1177/19322968261463562","url":null,"abstract":"<p><strong>Background: </strong>Health care workers face elevated cardiometabolic risks due to irregular hours and chronic stress, yet targeted interventions are limited. This study evaluated an 8-week digital Metabolic Wellness Program (MWP), combining lifestyle education with real-time continuous glucose monitoring (CGM).</p><p><strong>Methods: </strong>One hundred health care workers and dependents within a California health care system completed the MWP and were stratified by baseline time in tight range (TITR) 70 to 140 mg/dL. Continuous glucose monitoring (CGM)-derived metrics (average glucose [AG], glycemia risk index [GRI], time in range [TIR] 70-180 mg/dL, TITR, coefficient of variation [CV]) were evaluated via static pre-post comparison. These were supplemented by novel temporal change metrics: mean change index (MCI, average daily change relative to baseline) and improvement consistency index (ICI, % days with improvement). Engagement and behavioral changes were also assessed.</p><p><strong>Results: </strong>Static pre-post comparisons of CGM-derived metrics showed no significant glycemic changes cohort-wide or within TITR strata. However, temporal change metrics revealed improvements across participants. The low TITR (<70%) Group showed comprehensive improvements: AG (MCI -17.2 mg/dL), GRI (MCI -15.3), CV (MCI -3.2%), TIR (MCI 8.5%), and TITR (MCI 8.8%), with consistent improvements in GRI (ICI 72.1%), TIR (ICI 70.5%), and CV (ICI 73.3%), all <i>P</i> < .05. The high TITR (≥90%) group improved CV (MCI -1.6%, ICI 69.5%, <i>P</i> < .001). Metabolic Wellness Program engagement was associated with positive behavioral changes (<i>P</i> < .001), which were correlated with improved temporal change metrics (eg, TIR MCI: <i>r</i> = 0.31, <i>P</i> < .05).</p><p><strong>Conclusions: </strong>While static CGM metrics remained unchanged, MWP participation was associated with significant behavioral and temporal glycemic improvements, particularly among those with lower baseline TITR. Long-term sustainability warrants further investigation.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261463562"},"PeriodicalIF":4.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Fine-Tuned Commercial Artificial Intelligence Model to Assess Nutrients from Photographs of Japanese Meals.","authors":"Daniel R Lane, Yuexiang Ji, Naoto Otaki, Maiko Kitagawa, Kenji Obayashi, Keigo Saeki, Toshimasa Yamauchi, Masaomi Nangaku, Kayo Waki","doi":"10.1177/19322968261462556","DOIUrl":"10.1177/19322968261462556","url":null,"abstract":"<p><p>To reduce meal logging burden in diet interventions, we fine-tuned OpenAI's GPT-4o on 1269 Japanese meal photographs (train/val/eval: 912/252/105) to estimate nutrients, using weighed food records or dietitian estimates as ground truth, and compared it with 27 non-fine-tuned models and a human dietitian. Non-fine-tuned models did poorly for fiber. Most models did well for carbohydrates, protein, and energy, while performance for salt and fat varied by model. GPT-5.1 (minimal reasoning) and non-fine-tuned GPT-4o models both provided strong accuracy, though not universally better than dietitian performance. The fine-tuned GPT-4o model's accuracy exceeded that of the dietitian for all nutrients, with the intra-class correlation coefficient for fiber of 0.79 (95% CI 0.782-0.797) greatly exceeded the dietitian performance of 0.68, validating the accuracy of the model.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261462556"},"PeriodicalIF":4.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity of Daily Glycemic Phenotypes Is Independently Associated With HbA1c: A Time-Resolved CGM Clustering Analysis.","authors":"Saeko Osawa, Emi Kuroiwa, Naohiko Ito","doi":"10.1177/19322968261436429","DOIUrl":"10.1177/19322968261436429","url":null,"abstract":"<p><strong>Background: </strong>Although continuous glucose monitoring (CGM)-derived summary metrics are widely used, they may obscure the intraday temporal organization and potentially overlook clinically relevant differences in daily glucose patterning across time. We aimed to identify distinct daily glycemic phenotypes using time-resolved clustering and to examine whether the diversity of these patterns is independently associated with glycated hemoglobin (HbA1c).</p><p><strong>Methods: </strong>We analyzed 5902 days of CGM data from 103 participants with type 1 (n = 19) and type 2 (n = 84) diabetes. Daily waveforms were clustered using <i>k</i>-means with dynamic time warping (DTW) to capture temporal features independent of phase shifts. A \"Phenotype Diversity Score\" (Shannon entropy of each individual's cluster-label distribution) quantified the variety of phenotypes expressed per participant. Multivariable regression assessed its association with HbA1c, adjusting for established variability metrics, insulin use, and estimated glomerular filtration rate (eGFR).</p><p><strong>Results: </strong>Eight distinct daily glycemic phenotypes were identified. The Phenotype Diversity Score strongly correlated with HbA1c (<i>r</i> = 0.600, <i>P</i> < .0001). In a fully adjusted model, including mean of daily differences, coefficient of variation, insulin use, and eGFR, the Phenotype Diversity Score remained independently associated with HbA1c (β = 0.322, <i>P</i> = .004).</p><p><strong>Conclusions: </strong>Time-resolved CGM clustering reveals clinically meaningful daily glycemic phenotypes and demonstrates that phenotype diversity is independently associated with HbA1c. This pattern-based perspective complements conventional summary metrics and may help explain glycemic heterogeneity among individuals with similar average glucose levels.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"19322968261436429"},"PeriodicalIF":4.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Diabetic Retinopathy After Initiation of Automated Insulin Delivery System in Adults With Type 1 Diabetes.","authors":"Kagan E Karakus, Halis K Akturk, Janet K Snell-Bergeon, Viral N Shah","doi":"10.1177/19322968251318740","DOIUrl":"10.1177/19322968251318740","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the progression of diabetic retinopathy (DR) after the initiation of automated insulin delivery (AID) systems in adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>In this longitudinal study with 152 adults, retinal exams and clinical variables were collected before and after AID initiation up to 2.7 years. The DR worsening was defined as an increase in Early Treatment of Diabetic Retinopathy Study (ETDRS) scores or qualitative retinal exam.</p><p><strong>Results: </strong>A total of 152 adults with mean age of 42 years (57% female), 26 years of T1D duration, and mean baseline HbA_1c of 7.6% (60 mmol/mol) were included in this analysis. Of 152 adults with T1D, 42 (28%) adults had DR worsening after AID initiation. After adjusting for age, diabetes duration, and sex, baseline HbA_1c (odds ratio [OR] = 2.1 [1.34-3.04]) and low-density lipoprotein cholesterol (LDL-C) >100 mg/dL with HbA_1c >8% (OR = 3.33 [1.12-9.91]) were associated with two- and three-fold increased risk for DR worsening, respectively. The decline of HbA_1c with AID initiation between DR worsening and no-DR worsening groups was not significant (-0.38 ± 1.2% vs -0.47 ± 0.9%; <i>P</i> = .6).</p><p><strong>Conclusions: </strong>Higher baseline HbA_1c with LDL-C >100 mg/dL may be associated with DR worsening after initiation of AID systems in T1D. Those with elevated HbA_1c should get periodic ophthalmic examination after AID initiation to detect progression of DR. Prompt diagnosis may result in timely treatment.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1159-1163"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of High-Dose Ascorbic Acid on HS 312 Continuous Glucose Monitoring Accuracy: A Two-Phase Pilot Study in Taiwan.","authors":"Mary Wen Reng Ho, Yi Ting Ho, Chia Yin Chen, Mei Yueh Lee","doi":"10.1177/19322968261442924","DOIUrl":"10.1177/19322968261442924","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1491-1492"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Impossible' Insulin to C-Peptide Ratios are Common in Insulin-Free Pre-term NICU Infants: Antibodies Act as a Storage Medium.","authors":"J Geoffrey Chase, Helen D Shannon","doi":"10.1177/19322968261439151","DOIUrl":"10.1177/19322968261439151","url":null,"abstract":"","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1489-1490"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Virtual Consultations on Quality of Care for Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis.","authors":"Reham Aldakhil, Geva Greenfield, Elena Lammila-Escalera, Liliana Laranjo, Benedict W J Hayhoe, Azeem Majeed, Ana Luísa Neves","doi":"10.1177/19322968251316585","DOIUrl":"10.1177/19322968251316585","url":null,"abstract":"<p><p>BackgroundVirtual consultations (VC) have transformed healthcare delivery, offering a convenient and effective way to manage chronic conditions such as Type 2 Diabetes (T2D). This systematic review and meta-analysis evaluated the impact of VC on the quality of care provided to patients with T2D, mapping it across the six domains of the US National Academy of Medicine (NAM) quality-of-care framework (ie, effectiveness, efficiency, patient-centeredness, timeliness, safety, and equity).MethodsA systematic search was conducted in PubMed/MEDLINE, Cochrane, Embase, CINAHL, and Web of Science for the period between January 2010 and December 2024. Eligible studies involved adult T2D patients, evaluated synchronous VCs, and reported outcomes relevant to NAM quality domains. Two independent reviewers performed screening, and studies were assessed using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted for each quality domain, and a meta-analysis of HbA1c levels was performed using random-effects models.ResultsIn total, 15 studies involving 821 014 participants were included. VCs were comparable with face-to-face care in effectiveness, efficiency, patient-centeredness, and timeliness, with improvements in accessibility and patient satisfaction. Mixed results were found for safety due to limitations in physical assessments, and for equity, with older adults and those with lower digital literacy facing more challenges. The meta-analysis showed no significant difference in HbA1c reduction between VCs and face-to-face (standardized mean difference [SMD] = -0.31, 95% confidence interval [CI]: -0.71 to 0.09, <i>P</i> = 0.12).ConclusionVCs offer a promising alternative to in-person care, but addressing digital disparities and improving access for older adults are essential for maximizing VC potential.</p>","PeriodicalId":15475,"journal":{"name":"Journal of Diabetes Science and Technology","volume":" ","pages":"1435-1449"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}