Lung最新文献

{"title":"Inhalable Dry Powders of Antimicrobial Agents in Respiratory Diseases.","authors":"Hasham Shafi, David Encinas-Basurto, Y Peter Di, Heidi M Mansour","doi":"10.1007/s00408-026-00931-w","DOIUrl":"10.1007/s00408-026-00931-w","url":null,"abstract":"<p><strong>Background: </strong>Respiratory infections remain a major global health burden despite advances in systemic antimicrobial therapy. Antimicrobial dry powder inhalers (DPIs) have emerged as precision-engineered pulmonary delivery platforms capable of achieving high local drug concentrations while minimizing systemic toxicity.</p><p><strong>Objective: </strong>This review examines the historical evolution, pharmacological landscape, particle engineering technologies, translational challenges, and clinical progress of antibacterial, antiviral, and antifungal DPIs.</p><p><strong>Content: </strong>We trace the evolution of antimicrobial DPIs from early aerosolized therapies to contemporary engineered systems, integratingdisease targets, pharmacological agents, particle and formulation engineering, inhaler technologies, patents, clinical development andregulatory milestones. Particular emphasis is placed on formulations supported by in vivo efficacy, clinical investigation or regulatoryapproval, highlighting advances in tuberculosis, chronic bacterial infections, viral respiratory diseases and pulmonary fungal infections.</p><p><strong>Conclusions: </strong>Antimicrobial DPIs are evolving toward precision pulmonary therapies, highlighting their expanding role in chronic infections, pandemic preparedness, and next-generation pulmonary anti-infective therapy. Overcoming dose, deposition, stability, andtranslational barriers will be critical for broader clinical adoption.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea in Individuals with Alpha-1 Antitrypsin Deficiency: A Single Center Experience.","authors":"Leela Krishna Teja Boppana, Xueya Cai, Michael Schweitzer, Michael Yurcheshen","doi":"10.1007/s00408-026-00935-6","DOIUrl":"10.1007/s00408-026-00935-6","url":null,"abstract":"","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Literature Review of Digital Measures and Patient-Reported Outcomes for Refractory/Unexplained Chronic Cough: Assessment of Clinical Trials and Real-World Clinical Practice.","authors":"Elizabeth P Skinner, Rafael Alfonso-Cristancho, Atish De, Brian Leinwand, Elizabeth A Duncan","doi":"10.1007/s00408-026-00928-5","DOIUrl":"10.1007/s00408-026-00928-5","url":null,"abstract":"<p><strong>Purpose: </strong>Refractory/unexplained chronic cough (RCC/UCC) is a disease associated with substantial clinical and humanistic burden. A variety of endpoints have been used in RCC/UCC research to measure cough outcomes and impact on patients' quality of life (QoL), including clinical measures of cough using digital devices, or digital measures, and patient-reported outcomes (PROs). The aim of this review was to determine which endpoints are currently used in studies of RCC/UCC, and to explore the recent evolution of new digital measures used across research and clinical settings.</p><p><strong>Methods: </strong>We conducted a scoping literature review (January 1, 2019-October 31, 2024), assessing studies of adults diagnosed with chronic cough (refractory/unexplained or newly diagnosed). Clinical trials and observational/real-world studies were included that evaluated objective and PRO measures of cough frequency, severity, symptoms, other cough characterization, and QoL.</p><p><strong>Results: </strong>Overall, 70 studies (29 manuscripts, 35 clinicaltrials.gov entries, 6 posters/abstracts) were included: 36 clinical trials (Phase 2, 3, or 4), 34 observational/real-world studies. Objective cough frequency was the primary endpoint in 24/36 clinical trials. In contrast, objective cough frequency was reported in 10/34 observational/real-world studies. Observational/real-world studies had a greater variety of endpoints for cough outcomes and PROs compared with clinical trials.</p><p><strong>Conclusions: </strong>Clinical trials and observational/real-world studies of chronic cough and RCC use a wide range of outcome measures, including objective measures of cough frequency using digital devices (digital endpoints) and subjective PROs. New approaches to digital endpoints and PROs are being developed as the study and treatment of cough evolves.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cough Hypersensitivity in Gastroesophageal Reflux-Induced Chronic Cough: Insights from Reflux Monitoring and High-Resolution Manometry.","authors":"Yaxing Zhou, Siwan Wen, Yunfeng Zhang, Tongyangzi Zhang, Shengyuan Wang, Jiaying Yuan, Bingxian Sha, Haodong Bai, Yanan Wu, Li Yu, Xianghuai Xu","doi":"10.1007/s00408-026-00933-8","DOIUrl":"10.1007/s00408-026-00933-8","url":null,"abstract":"<p><strong>Background: </strong>Cough hypersensitivity contributes to the heterogeneity of gastroesophageal reflux-induced chronic cough (GERC), but its associated factors remain unclear. This study aimed to investigate factors associated with cough hypersensitivity and evaluate the relative contributions of reflux characteristics and esophageal motility across reflux phenotypes.</p><p><strong>Methods: </strong>This retrospective study included 195 patients with GERC who underwent 24-hour multichannel intraluminal impedance-pH monitoring and high-resolution esophageal manometry. Cough hypersensitivity was assessed using the Hull Airway Reflux Questionnaire (HARQ). Multivariable regression assessed independent associations with continuous HARQ scores, whereas random forest and SHAP analyses ranked the relative contributions of reflux-related and esophageal motility variables to HARQ score prediction.</p><p><strong>Results: </strong>Patients with higher cough hypersensitivity exhibited increased capsaicin cough sensitivity, poorer quality of life, lower response rates to standard anti-reflux therapy (all P < 0.05), and a higher prevalence of ineffective esophageal motility (62.1% vs. 32.6%, P < 0.001). In correlation analyses, both reflux burden and esophageal motility were associated with cough hypersensitivity; however, after stratification by reflux phenotype, only esophageal motility remained associated. Multivariable regression showed an independent inverse association between DCI and HARQ scores, while machine-learning analyses ranked DCI as the leading contributor, with both analyses suggesting a more prominent relationship in non-acid GERC.</p><p><strong>Conclusions: </strong>GERC patients with heightened cough hypersensitivity had greater cough-related burden and poorer response to standard anti-reflux therapy. Esophageal motility abnormalities appear to be more closely associated with cough hypersensitivity than reflux burden, particularly in non-acid reflux phenotypes, highlighting a potential role for motility-targeted therapeutic strategies.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the Utilization of GLP-1 and GLP-1/GIP in Adults with Cystic Fibrosis.","authors":"Morgan C Jones, Abagail Opsal, Ashley Buige","doi":"10.1007/s00408-026-00929-4","DOIUrl":"10.1007/s00408-026-00929-4","url":null,"abstract":"","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Inhaled Corticosteroid Prescribing in COPD: Evaluating the Impact of Eosinophil Testing on Clinical Outcomes.","authors":"Jared Hester, David Whipkey, James Ferrell","doi":"10.1007/s00408-026-00930-x","DOIUrl":"10.1007/s00408-026-00930-x","url":null,"abstract":"<p><strong>Purpose: </strong>Inhaled corticosteroids (ICS) are recommended for select patients with chronic obstructive pulmonary disease (COPD) based on exacerbation history and blood eosinophil counts. Prior studies suggest that ICS are frequently prescribed outside of guideline-based criteria, and eosinophil testing is inconsistently performed in clinical practice. This study evaluated adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) eosinophil criteria for ICS prescribing and associated clinical outcomes.</p><p><strong>Methods: </strong>This retrospective observational cohort study included adults with COPD receiving care within Cleveland Clinic outpatient practices in Ohio who were newly initiated on an ICS-containing regimen between January 1, 2021, and July 31, 2023. Patients were classified based on whether ICS prescribing aligned with GOLD eosinophil criteria. Outcomes included adherence to GOLD eosinophil recommendations for ICS use, pneumonia incidence, ICS de-escalation, and predictors of prescribing outside guideline-based criteria.</p><p><strong>Results: </strong>A total of 688 patients were included. Most patients received ICS outside of GOLD eosinophil criteria (589/688, 86%). Baseline eosinophil testing was performed in 102 patients (15%). Pneumonia incidence was similar among patients prescribed ICS outside versus within guideline-based criteria (15% vs. 16%, p = 0.686). ICS de-escalation was uncommon overall (7%) and occurred at similar rates between groups. A history of prior exacerbations was associated with prescribing within guideline-based indications.</p><p><strong>Conclusion: </strong>ICS prescribing frequently occurred outside of GOLD eosinophil criteria, with limited utilization of eosinophil testing in clinical practice. Clinical outcomes were similar regardless of guideline alignment, and ICS de-escalation was infrequent. These findings highlight opportunities to improve integration of eosinophil-guided decision-making into COPD management.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update 2026: Management of Small Cell Lung Cancer.","authors":"Mumtu Lalla, Puneet Dhillon, Buse Eglenen Polat, Haiying Cheng","doi":"10.1007/s00408-026-00927-6","DOIUrl":"https://doi.org/10.1007/s00408-026-00927-6","url":null,"abstract":"<p><p>Small cell lung cancer (SCLC) remains a biologically aggressive neuroendocrine carcinoma characterized by early metastatic spread, frequent relapse, and poor long-term survival. After several decades of limited progress, recent therapeutic advances have begun to reshape management across disease stages. In limited-stage SCLC, concurrent platinum-etoposide chemoradiotherapy remains the backbone of curative-intent treatment, while consolidation durvalumab after chemoradiotherapy has established a new standard for patients without disease progression. In extensive-stage SCLC, platinum-etoposide plus a PD-L1 inhibitor remains the preferred first-line approach. For selected patients, maintenance lurbinectedin plus atezolizumab and second-line tarlatamab have expanded treatment options beyond conventional cytotoxic chemotherapy. Intracranial management is also evolving, with greater emphasis on baseline brain magnetic resonance imaging, longitudinal surveillance, selective use of prophylactic cranial irradiation, stereotactic radiosurgery in appropriate patients, and neuroprotective strategies during whole-brain radiotherapy. Biologically, SCLC is increasingly recognized as a heterogeneous disease. Transcriptional subtypes, DLL3, B7-H3, SEZ6, SLFN11, and circulating tumor DNA are informing clinical trial design and may help refine future treatment selection. This review provides a clinically oriented overview of current standards and emerging therapeutic strategies in SCLC, with attention to evidence quality, toxicity, sequencing, and clinical applicability. It also discusses key unresolved questions that must be addressed before biomarker-directed and subtype-informed treatment can be integrated into routine practice.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Relevance of Serum Inducible and Endothelial Nitric Oxide Synthase Ratio for Pulmonary Hypertension in Acute Exacerbated Chronic Obstructive Pulmonary Disease.","authors":"Yating Zhang, Dongrui Zhang, Wei Jia, Yi Li","doi":"10.1007/s00408-026-00922-x","DOIUrl":"10.1007/s00408-026-00922-x","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a common complication of acute exacerbated chronic obstructive pulmonary disease (AECOPD) and is associated with poor prognosis. Nitric oxide synthase (NOS) imbalance may contribute to pulmonary vascular dysfunction, but the clinical value of serum inducible NOS (iNOS), endothelial NOS (eNOS), and the eNOS/iNOS ratio in AECOPD with PH remains unclear.</p><p><strong>Methods: </strong>This study included 260 hospitalized AECOPD patients, including 122 without PH and 138 with PH diagnosed by Doppler echocardiography. Clinical characteristics, pulmonary function, and arterial blood gas parameters were collected. Serum iNOS and eNOS levels were measured by ELISA, and the eNOS/iNOS ratio was calculated. The TAPSE/PASP ratio was calculated in patients with PH as an index of right ventricular-pulmonary arterial (RV-PA) coupling. ROC analysis, multivariate logistic regression, and correlation analysis were performed.</p><p><strong>Results: </strong>Compared with patients without PH, those with PH had significantly higher serum iNOS levels and significantly lower eNOS levels and eNOS/iNOS ratio (all P < 0.001). Similar trends were observed in patients with GOLD grade III-IV versus I-II. The eNOS/iNOS ratio showed the best diagnostic performance for PH, with an AUC of 0.86, sensitivity of 83.33%, and specificity of 74.59%. Multivariate logistic regression identified smoking, GOLD grade III-IV, hypertension, and elevated iNOS as independent risk factors, whereas higher FEV1%pred, PaO₂, eNOS, and eNOS/iNOS ratio were protective factors. In PH patients, iNOS was positively correlated with pulmonary artery systolic pressure, while eNOS and eNOS/iNOS ratio were negatively correlated. Additional analysis showed that iNOS was negatively correlated with TAPSE/PASP, whereas eNOS and the eNOS/iNOS ratio were positively correlated; the ratio showed the strongest association (r = 0.53, P < 0.001).</p><p><strong>Conclusion: </strong>Serum NOS imbalance is closely associated with PH in AECOPD. Its association with TAPSE/PASP further suggests relevance to impaired RV-PA coupling. The eNOS/iNOS ratio may serve as a promising noninvasive biomarker for identifying COPD-related PH.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Pleural Fluid IL-9 as a Diagnostic Biomarker for Differentiating Tuberculous from Lung Adenocarcinoma-Associated Malignant Pleural Effusions.","authors":"Huili Zhou, Shaobing Wang, Qunshan Huang, Tiantian Liu, Guomei Su, Yiyun Zhang, Yusheng Zhang, Jielin Duan, Tianwen Lai","doi":"10.1007/s00408-026-00925-8","DOIUrl":"10.1007/s00408-026-00925-8","url":null,"abstract":"<p><strong>Background: </strong>The differential diagnosis of tuberculous pleural effusion (TPE) and lung adenocarcinoma-associated malignant pleural effusion (LA-MPE) remains challenging. This study aimed to measure interleukin‑9 (IL‑9) levels in pleural fluid and evaluate its diagnostic utility in distinguishing between these two conditions.</p><p><strong>Methods: </strong>The study enrolled 105 patients with PE (51 TPE and 54 LA-MPE). IL-9 levels in pleural fluid were measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve analysis was employed to identify the optimal cutoff value and assess diagnostic performance, including area under the curve (AUC), sensitivity, and specificity, with adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) as comparators. Internal cross-validation was conducted to examine model robustness, and decision curve analysis was used to evaluate the clinical net benefit of IL-9 alone and in combination with ADA and CEA.</p><p><strong>Results: </strong>IL-9 levels were significantly elevated in TPE compared with LA-MPE (2828.13 vs. 310.55 ng/L, P < 0.001). At a cutoff of 748.47 ng/L, IL-9 distinguished TPE from LA-MPE with a sensitivity of 98.0% and specificity of 92.59%, and an AUC of 0.987 (P < 0.001), exceeding both ADA and CEA. Decision curve analysis showed that, within a threshold probability range of 0.10-0.40, the IL‑9‑based model consistently yielded greater net clinical benefit than conventional markers. Cross-validation further confirmed the robustness of IL-9 for distinguishing TPE from LA-MPE.</p><p><strong>Conclusion: </strong>IL-9 demonstrates promising diagnostic performance in differentiating TPE from LA-MPE, with favorable accuracy relative to ADA. It merits further investigation as a potential adjunctive diagnostic tool for pleural effusion.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue, Muscular Performance, and Quadriceps Fiber Type Profile in Lymphangioleiomyomatosis and Healthy Matched Controls.","authors":"Mary Beth Brown, Claire E Child, Paul Kim, Morgan L Kelly, Sophia Arons, Haotian D Cai, Kevin J McQuade, Ylinne T Lynch, Lawrence A Ho, Luis F Gonzalez-Cuyar","doi":"10.1007/s00408-026-00916-9","DOIUrl":"10.1007/s00408-026-00916-9","url":null,"abstract":"<p><strong>Purpose: </strong>Fatigue is a common symptom in lymphangioleiomyomatosis (LAM) and is associated with reduced physical activity and quality of life. Coexistent skeletal muscle dysfunction has been reported for other chronic lung diseases but has not been investigated in LAM.</p><p><strong>Methods: </strong>Fifteen patients with LAM and 15 matched individuals without LAM (NL) underwent computerized lower extremity dynamometry, standardized functional tests, and fatigue surveys. Immunohistochemistry to detect LAM+ cells and to characterize fiber-type distribution was performed on vastus lateralis (VL) samples of LAM and NL. Maximal cardiopulmonary exercise test (CPET) and six-minute walk test (6MWT) were additionally conducted for LAM. Welch's t-testing compared measures between LAM and NL. Pearson correlation tested relationships between variables. Data are mean ± SD.</p><p><strong>Results: </strong>LAM exhibited lower (p < 0.05) muscular force (by 220 ± 89 N), power (by 312 ± 129 W), and endurance (by 4674 ± 1974 N*sec) in dynamometry and functional tests (by 119 ± 45s in wall squat test), and worse fatigue survey scores (p = 0.02 to 0.0004). Poorer muscular endurance in LAM was associated with less distance achieved in 6MWT (r = 0.68), lower VO₂max (r = 0.58), and worse fatigue (r = 0.56). LAM with worse fatigue also exhibited lower relative fat utilization in CPET (r = 0.75, p = 0.005). No LAM+ cells were detected in VL samples, nor between-group differences in fiber type distribution.</p><p><strong>Conclusion: </strong>Muscular endurance and strength is lower in LAM, coincident with greater self-reported fatigue. Fiber type shift reported for skeletal muscle in other chronic lung disease is not observed in LAM. Further work is needed to elucidate peripheral muscle mechanisms for fatigue and exercise intolerance in LAM.</p>","PeriodicalId":18163,"journal":{"name":"Lung","volume":"204 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}