Journal of Clinical Monitoring and Computing最新文献

{"title":"Paired assessment of two electromyographic neuromuscular monitors: stimpod NMX450X versus Datex-Ohmeda E-NMT.","authors":"Manish Zambre, Ulrich Janssens, Wilfried Cools, Jarne De Mey, Domien Vanhonacker, Hugo Carvalho","doi":"10.1007/s10877-026-01411-5","DOIUrl":"10.1007/s10877-026-01411-5","url":null,"abstract":"<p><p>Quantitative neuromuscular monitoring (NMM) is widely recommended, yet its clinical adoption remains limited, partly due to usability issues. This study aimed to compare the clinical performance of two electromyography (EMG)-based NMM devices—the Datex-Ohmeda E-NMT module and the Stimpod NMS450X—under real-world operating room conditions. Twenty-four adult patients undergoing elective non-cardiac surgery were monitored simultaneously with both devices, applied contralaterally. Train-of-four (TOF) counts and TOF ratios were recorded at one-minute intervals. Agreement between devices was assessed using Bland–Altman analysis, repeatability coefficients, and the concordance correlation coefficient (CCC). The Datex-Ohmeda recorded an average of 121 TOF-count and 71 TOF-ratio values per patient, compared with 56 and 39, respectively, for the Stimpod. Inter-device correspondence was low, with numerous missing or physiologically implausible values on the Stimpod stream. The repeatability coefficient was 0.81 (95% CI: 0.80–0.83), indicating poor precision. The CCC was 0.662, consistent with weak agreement. In routine clinical use, the Stimpod NMS450X and Datex-Ohmeda E-NMT demonstrated poor concordance and high variability, likelyinfluenced by device-specific artifacts, connectivity limitations and electrode sensitivity.These findings highlight the need for device-specific validation of EMG NMM, both for clinical practice and for research purposes.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"757-765"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous autonomic system monitoring during neurosurgical procedures -proof of concept.","authors":"Julian Zipfel, Dimitar Stoyanov, Marek Czosnyka, Berthold Drexler, Martin U Schuhmann","doi":"10.1007/s10877-025-01386-9","DOIUrl":"10.1007/s10877-025-01386-9","url":null,"abstract":"<p><p>Vegetative reactions are common during neurosurgical procedures. Known effects are mainly cardiovascular, including tachy- and bradyarrhythmia, hyper- and hypotonia as well as cardiac arrest. Computer-assisted real-time analysis of heart rate variability (HRV), baroreflex-sensitivity (BRS) allows for continuous evaluation of the autonomic nervous system (ANS). We analyzed ANS parameters during intracranial neurosurgical procedures. In this pilot study, we aim to provide proof-of-concept that ANS monitoring during surgery is feasible and yields stable results.We included 129 consecutive patients undergoing neurosurgery for intracranial pathologies over a period of four months. Heart rate (HR) and mean arterial pressure (MAP) were continuously monitored during routine anesthesiology care. Data were recorded via ICM + software. HRV, BRS and other vegetative parameters were calculated continuously. Intraoperative events such as hypo-/hypertonia or brady-/tachycardia were monitored.Mean age was 47.2 ± 17.7 years. Of all patients, 54.3% were male (n = 70). For every patient, four intraoperative episodes were defined: start of anesthesia until incision - start of incision until craniotomy - craniotomy until end of resection or intracranial manipulation - end phase until skin closure. BRS continuously decreased during cranial surgery, indicating stabilized autonomic function. Furthermore, blood pressure variability was increased during semi-sitting surgery.Autonomic system monitoring during neurosurgical procedures is safe and feasible. Intraoperatively, an increasing sympathetic activity has been observed without clear disctinction between surgical or anesthesiological events as underlying cause. Monitoring results are reproducible and may be of importance for the detection and prevention of intraoperative cardiovascular events.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"611-620"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral intravenous waveform analysis for evaluating volume status in healthy volunteers and mechanically ventilated patients.","authors":"Aura Koistinaho, Sole Lindvåg Lie, Svein Aslak Landsverk, Harald Lenz, Marius Rehn, Jonny Hisdal, Lars Øivind Høiseth","doi":"10.1007/s10877-025-01408-6","DOIUrl":"10.1007/s10877-025-01408-6","url":null,"abstract":"<p><p>Timely diagnosis of blood loss and evaluation of intravascular volume status are pivotal tasks in clinical practice. Recent studies in animals and during lower body negative pressure (LBNP) in humans indicate that peripheral intravenous pressure waveform analysis (PIVA) may detect early stages of blood loss. As PIVA only requires a peripheral venous cannula, it may have value in emergency settings. However, its clinical relevance remains uncertain. This study examined how volume changes affect the PIVA-derived fundamental frequency (PIVAF1). Two cohorts were studied. The LBNP cohort comprised 15 healthy volunteers exposed to simulated blood loss in 10 mmHg increments of LBNP every two minutes from 0 to 80 mmHg, or until hemodynamic decompensation. The general anesthesia (GA)-cohort included 20 patients undergoing laparoscopic surgery who underwent preload increase with a head-down tilt. Peripheral intravenous pressure waveforms were continuously recorded from an antecubital vein and analyzed using short-time Fourier transform to extract the amplitude at the heart-rate frequency (PIVAF1). Changes in PIVAF1 were analyzed using linear regression. In the LBNP-cohort, data were log(e) – transformed and associated with a change per LBNP level of -0.11 (95% CI -0.14 to -0.09, P < 0.001). In the GA-cohort, PIVAF1 did not reliably predict a 10% change in stroke volume with head-down tilt [AUC 0.71 (95% CI 0.47 to 0.96; P = 0.11)]. We found statistically significant reductions in PIVAF1 during simulated blood loss but PIVAF1 did not predict increasing stroke volume during head-down tilt in general anesthesia. The clinical significance of PIVA remains to be elucidated.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"645-654"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory clinical trial on the acoustic variability index for predicting fluid responsiveness during hepatectomy.","authors":"Woo-Young Seo, Hye-Mee Kwon, Baehun Moon, Hyun-Seok Kim, Kyu-Min Kang, Chang-Hoe Heo, Gil-Chun Park, Ji-Jung Park, Sung-Hoon Kim, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang","doi":"10.1007/s10877-026-01427-x","DOIUrl":"10.1007/s10877-026-01427-x","url":null,"abstract":"<p><p>The acoustic variability index (AVI), derived from continuous phonocardiographic analysis of heart sounds via an esophageal stethoscope, is a novel minimally invasive method for intraoperative hemodynamic monitoring. We evaluated the ability of AVI to predict fluid responsiveness in patients undergoing hepatectomy and compared its performance with that of the conventional indices. Forty adult patients who underwent hepatectomy were enrolled in this prospective, single-center observational study. After major surgical resection and stabilization, a 500 mL crystalloid fluid challenge was administered. Hemodynamic parameters including AVI, central venous pressure (CVP), stroke volume variation (SVV), and pulse pressure variation (PPV) were recorded before and after volume expansion. Patients with ≥ 10% increase in cardiac output (CO) were defined as responders. Thirty-seven patients were included in the final analysis, of which 12 (32.4%) were classified as responders. After fluid loading, responders showed a significant decrease in AVI (11.4% ± 2.5% to 7.8% ± 2.9%, p = 0.004), while non-responders showed no significant change (7.1% ± 3.2% to 6.3% ± 3.0%, p = 0.356). AVI demonstrated predictive performance comparable to SVV and PPV, with an optimal cutoff of > 9.8% and an area under the receiver operating characteristic curve of 0.873 (95% CI: 0.743–0.967). Real-time intraoperative monitoring of the AVI shows potential as a predictor for fluid responsiveness in patients undergoing hepatectomy. AVI offers a promising, minimally invasive approach for guiding fluid therapy. Further research is warranted to validate its utility in broader surgical populations.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"663-671"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate variability as a marker of multiple organ dysfunction syndrome in deeply sedated, prepubescent patients: a secondary analysis.","authors":"Anne Wojtanowski, Côme Bureau, Mathieu Jeanne, Morgan Recher, Julien De Jonckheere","doi":"10.1007/s10877-026-01417-z","DOIUrl":"10.1007/s10877-026-01417-z","url":null,"abstract":"<p><p>Multiple organ dysfunction syndrome (MODS) is a frequent complication in critically ill patients. The objective of the present study in a pediatric intensive care unit was to determine the feasibility of using HRV to differentiate between deeply sedated patients with medium/high MODS and those with no/low MODS. This was a secondary analysis of data from the ANI EP clinical study (NCT04913038). Various HRV indices were computed in a 10-minute time window. A patient with a pediatric Sequential Organ Failure Assessment (pSOFA) score higher than 5 was classified into the medium/high MODS group. Forty-seven patients were selected for analysis. The Energy variable (equivalent to the standard deviation of normal-to-normal intervals) was significantly correlated with the pSOFA score (r²=-0.31, p = 0.03). HFnu values were higher in the medium/high MODS group than in the no/low MODS group (0.35 vs. 0.28, respectively; p = 0.019), and HFnu discriminated between the two groups of patients with an area under the receiver operating characteristic curve of 0.75 (sensitivity = 0.78, specificity = 0.74). Energy was slightly but not significantly lower in the medium/high MODS group (0.17, vs. 0.35 in the no/mild MODS group; p = 0.086). The results of our study in a PICU showed that HRV indices can differentiate between deeply sedated patients with MODS and those without. Further investigations are needed to confirm this finding and extend it to other populations.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"601-609"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodic limb movements during sedation and general anesthesia in elderly patients: a prospective observational study.","authors":"Katalin Arki, Johannes Harte, Fabienne Frickmann, Darren Hight, Sarah Saxena, Mia Gisselbaek, Anthony R Absalom, Joana Berger-Estilita, Friedrich Lersch","doi":"10.1007/s10877-026-01421-3","DOIUrl":"10.1007/s10877-026-01421-3","url":null,"abstract":"<p><p>Dexmedetomidine sedation in elderly patients is associated with cognitive benefits due to its biomimetic non-rapid eye movement (NREM) sleep–like state. However, this state may predispose patients to periodic limb movements (PLMs), which can cause unintended procedural risk during sedation. We aimed to determine the incidence of PLMs during dexmedetomidine-based multimodal sedation for transcatheter aortic valve implantation (TAVI) and explore associations with the need for conversion to general anesthesia. In this prospective observational study, 35 consecutive patients (mean age 81 ± 6 years; 17 female, 18 male) undergoing TAVI over a two-month period from October 2021 to the end of November 2021 were monitored using standard anesthesia monitoring, processed electroencephalography (pEEG) monitoring using Narcotrend 3-lead frontal EEGs (Narcotrend, Hannover, Germany), and bilateral ankle actimetry (SOMNOwatch™ plus). Sedation was administered according to our institutional protocol, beginning with a dexmedetomidine loading dose (0.5 µg kg⁻¹), followed by titration of the infusion between 0.2 and 1.5 µg kg⁻¹ h⁻¹. Additional propofol or fentanyl boluses were administered as clinically indicated by the responsible anesthesiologist. Actimetry, EEG patterns, and intraoperative events were analyzed. PLMs (2–6 movements/min; most commonly 3–5 movements/min) were observed in 20 of 35 patients (57%) and all conversions to general anesthesia (5/5, 100%) occurred in the PLM-positive group, highlighting a potential clinical impact on procedural stability. In the 19 patients with complete EEG datasets, Narcotrend indices during dexmedetomidine-only sedation averaged 96.6 ± 2.6, consistent with an awake–sedate EEG pattern. Following propofol administration, the index decreased to 39.3 ± 20.0, corresponding to a very large effect size (Cohen’s d = 2.85). Five conversions to general anesthesia were necessary in patients with PLMs, because of restlessness, although the severity of PLMs did not predict conversion. No patient had a known history of restless legs syndrome (RLS); prior neurological disease showed no consistent association with PLM occurrence. PLMs are common during dexmedetomidine sedation for TAVI in elderly patients and may need conversion to general anesthesia. While dexmedetomidine offers cognitive benefits, the potential for movement-related procedural risk warrants increased monitoring and consideration during patient selection and anesthetic planning. Further studies comparing sedation-induced and natural sleep PLMs are needed.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"589-600"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admixture of anesthetic drugs in the era of precision monitoring: a dangerous convenience.","authors":"Susana Vacas, Michele Introna, Francisco Lobo","doi":"10.1007/s10877-026-01435-x","DOIUrl":"10.1007/s10877-026-01435-x","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"585-588"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal doppler ultrasound: comparison of measurements sampled in different anatomical locations.","authors":"Rasmus Aagaard, Johan Lyngklip Hermansen, Simone Krogh Christensen, Peter Juhl-Olsen","doi":"10.1007/s10877-026-01413-3","DOIUrl":"10.1007/s10877-026-01413-3","url":null,"abstract":"<p><p>Renal Doppler ultrasound can be used to predict acute kidney injury and assess venous congestion. There is no consensus on which renal vessels should be used for Doppler sampling. This study compares renal Doppler ultrasound measurements obtained in renal hilar and interlobar arteries and veins in patients recovering from open-heart surgery.This secondary analysis included data from 99 patients who underwent cardiac surgery. Doppler ultrasound was performed on both hilar and interlobar vessels in each kidney and renal venous flow pattern, renal venous stasis index (RVSI), and renal arterial resistive index (RI) were assessed.For renal venous flow pattern Kappa was 84% for hilar vs. interlobar measurements, 63% for hilar measurements on either side, and 77% for interlobar measurements on either side. When comparing RVSI the biases ranged from 0.2% to 4.8%, limits of agreement were consistently wide, and percentage error ranged from 96% to 133%. The comparisons of RI showed biases from 0.1% to 0.4% with limits of agreement consistently narrow. Percentage error ranged from 9.9% to 12.3%In a population of postoperative open-heart cardiac surgery patients, comparable results can be expected when sampling renal venous flow pattern from hilar and interlobar veins. Overall low bias but also low precision can be expected when sampling RVSI in hilar and interlobar veins on either side. In regard to RI, low bias and high precision can be expected when sampling from hilar and interlobar arteries on either side.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"687-694"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early detection of postoperative infections using continuous temperature monitoring: A prospective clinical trial.","authors":"Lars Schäfer, Franziska Dickel, Karl Strohmayer, Werner Koele, Bettina Leber, Robert Sucher, Philipp Stiegler","doi":"10.1007/s10877-025-01383-y","DOIUrl":"10.1007/s10877-025-01383-y","url":null,"abstract":"<p><p>This study aimed to evaluate whether continuous axillary temperature monitoring using a wearable patch enables earlier detection of postoperative infections compared to conventional intermittent infrared thermometry. 103 surgical patients were included in this prospective, single-center study and monitored over an 11-month period. Continuous axillary temperature monitoring using the SteadyTemp^® patch was compared to routine infrared measurements performed as part of clinical routine. The primary outcome was fever detection rate (≥ 38.0 °C). Secondary outcomes included the correlation between fever detection and laboratory values as well as the frequency of clinical interventions. Out of 103 included patients, fever was detected in 33 cases. Continuous monitoring identified fever in 31 of these 33 patients (93.9%), whereas infrared thermometry detected fever in only 12 cases (36.4%). In 16 cases where antibiotic therapy was initiated or adjusted due to newly detected fever, the patch detected fever in 15 patients, compared to only 7 detections by infrared thermometry. Surgical interventions due to suspected infections were performed in 5 patients, and fever was detected by the patch in all cases, while infrared thermometry detected fever in only 2 of these patients. Due to the frequent failure of infrared thermometry to detect fever, a scoring system was developed to assess the clinical relevance of fever detection. Continuous temperature monitoring with the SteadyTemp^® patch demonstrated superior fever detection compared to infrared thermometry, leading to earlier identification of febrile events. This study suggests that continuous temperature monitoring may enhance infection surveillance in surgical patients, allowing for more timely clinical interventions.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"721-733"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral perfusion noninvasive monitoring technologies - a literature and patent review.","authors":"Irene Orellana Plaza, Jenny Dankelman, Jan Bakker","doi":"10.1007/s10877-026-01412-4","DOIUrl":"10.1007/s10877-026-01412-4","url":null,"abstract":"<p><p>Shock is a life-threatening condition marked by inadequate tissue perfusion and oxygen supply, leading to organ failure if not rapidly addressed. Clinical management of shock involves detecting and correcting altered macro hemodynamic parameters. However, these parameters may not accurately reflect microcirculatory alterations or abnormalities in oxygenation. A resuscitation strategy focused on peripheral perfusion, which can be non-invasively monitored, may allow for earlier shock detection and treatment, potentially reducing mortality. This literature review aims to study the available technologies found in literature and in patents to non-invasively monitor peripheral perfusion. PRISMA method was employed to systematically select or exclude articles and patents, resulting in 44 studies and 21 patents included in the review. The found technologies were classified based on the sensing principle in light (reflected, transmitted, or scattered), Doppler effect, temperature, and skin mottling. Combining the monitorization of microcirculatory with macrocirculatory parameters has the potential to have an accurate prognosis value for shock and other diseases. However, the various technologies that have been developed to monitor peripheral perfusion require further research and testing in diverse conditions.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"673-686"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}