Muscle & Nerve最新文献

{"title":"Efficacy of Neuromuscular Electrical Stimulation in Mitigating Muscle Mass Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Yang Jiang, Yemei Gao, Renxian Wang, Bowen Liu","doi":"10.1002/mus.70396","DOIUrl":"https://doi.org/10.1002/mus.70396","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Evidence for the stand-alone effect of neuromuscular electrical stimulation (NMES) on muscle mass in adults with sarcopenia or secondary muscle loss remains fragmented. This systematic review and meta-analysis aimed to quantify this effect and explore whether population, stimulation parameters, and assessment methods modified treatment effects.</p><p><strong>Methods: </strong>Six electronic databases, including PubMed, Embase, and the Cochrane Library, were systematically searched for randomized controlled trials (RCTs) published between January 2000 and June 2025. Pooled effect sizes (standardized mean difference, SMD) were calculated using random-effects models (PROSPERO: CRD420251114043).</p><p><strong>Results: </strong>Eighteen RCTs involving 676 participants yielded 19 independent effect estimates. NMES improved muscle mass compared with control conditions (SMD = 0.66, 95% CI = 0.30-1.02), with substantial heterogeneity. Leave-one-out sensitivity analyses did not alter the direction of effect. Subgroup analyses suggested differences by population and assessment method: community-dwelling older adults showed the most consistent benefit, whereas hemodialysis patients showed no clear improvement. CT/DXA-based measures yielded larger estimates than ultrasound-based regional measures or indirect methods. Meta-regression suggested a potential positive association between pulse width and effect size, whereas stimulation site and intervention duration were not clearly associated with treatment effects.</p><p><strong>Discussion: </strong>Low-certainty evidence suggests that NMES may improve muscle mass in selected adults with sarcopenia or secondary muscle loss. Future trials should use standardized NMES protocols, reliable muscle-mass assessments, and clinically meaningful outcomes.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Neurofilament Light Chain and GFAP in Amyotrophic Lateral Sclerosis on a Commercial ECLIA Platform.","authors":"Nicholas S Streicher","doi":"10.1002/mus.70397","DOIUrl":"https://doi.org/10.1002/mus.70397","url":null,"abstract":"<p><strong>Introduction/aims: </strong>In amyotrophic lateral sclerosis (ALS), SIMOA-based studies show that baseline serum neurofilament light chain (NfL) predicts the revised ALS Functional Rating Scale (ALSFRS-R) decline rate and survival. The Roche Elecsys electrochemiluminescence immunoassay (ECLIA) reports values approximately six-fold lower; cross-platform comparison confirms comparable performance, but serial clinical-practice data remain limited. We assessed whether ECLIA NfL correlates with the ALSFRS-R decline rate under the sampling conditions of clinical practice, and whether GFAP or S-100B adds prognostic or disease-specific information.</p><p><strong>Methods: </strong>We retrospectively analyzed 58 patients with medical-record-confirmed ALS at an academic center (2022-2026). Serum NfL, GFAP, and S-100B were measured on the Roche Elecsys ECLIA. The NfL-ALSFRS-R correlation was assessed within matching windows; serial NfL was examined in patients with repeat draws.</p><p><strong>Results: </strong>First-per-patient NfL median was 7.06 pg/mL (IQR 4.06-17.30). NfL correlated strongly with the ALSFRS-R decline rate (Spearman r = 0.704, n = 31; r = 0.809 within 90 days, n = 17; both p < 0.0001). Fast progressors had 3.7-fold higher mean NfL than slow progressors (17.10 vs. 4.64 pg/mL). NfL showed no correlation with King's clinical stage (r = 0.00). GFAP correlated with age but not with progression rate or disease duration; S-100B showed no association with progression.</p><p><strong>Discussion: </strong>Serum NfL on a commercial ECLIA platform retained its strong correlation with progression rate despite unstructured sampling, replicating SIMOA-based findings at platform-specific values. NfL tracked the rate of decline rather than the accumulated disease state; GFAP and S-100B added no prognostic or disease-specific information.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Exercise-Associated Muscle Cramps: A Systematic Review With Meta-Analysis.","authors":"Lucas Dos Santos Costa, Vinicius A F Correa, Vitor F de Oliveira, Ana Julia S Jahn, Gabriela B Aliano, Guilherme S Nunes","doi":"10.1002/mus.70389","DOIUrl":"https://doi.org/10.1002/mus.70389","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Exercise-associated muscle cramps (EAMC) are common in athletic populations and are frequently cited as a factor limiting performance. Despite extensive investigation, uncertainty remains regarding the risk factors associated with EAMC. Therefore, the aim of this systematic review was to identify and synthesize the available evidence on potential risk factors for EAMC.</p><p><strong>Methods: </strong>A systematic search was conducted in MEDLINE, EMBASE, Web of Science, SPORTDiscus, and CINAHL from inception to April 2026. Longitudinal studies that followed participants over any period to assess the occurrence of EAMC were included.</p><p><strong>Results: </strong>Of 14,181 records, nine studies were included (n = 11,274 participants). Across 36 meta-analyses, only three variables demonstrated statistically significant associations with EAMC. A prior history of EAMC was associated with subsequent episodes, conferring approximately 4.4-fold higher odds of EAMC occurrence (strong evidence). Higher post-race serum potassium (moderate evidence) and magnesium (limited evidence) concentrations were also observed in individuals with EAMC. Strong evidence indicated no associations between EAMC and age, body mass, or height. No other consistent results were identified across anthropometric, demographic, hydration, metabolic, performance, practice, routine, or training domains.</p><p><strong>Discussion: </strong>The association with prior EAMC history supports the concept of a recurrent phenomenon. This suggests that EAMC may be driven primarily by individual history rather than by commonly investigated physiological or training-related factors. The uncertainties regarding hydration status, electrolyte balance, training load, and performance challenge traditional preventive paradigms. However, given that most findings were supported by limited or very limited evidence, further high-quality research is warranted.</p><p><strong>Trial registration: </strong>PROSPERO: CRD420251061240.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Challenges in Electrodiagnostic Medicine Education-We Can Do Better.","authors":"Chilvana Patel, Nortina Shahrizaila, Devon I Rubin","doi":"10.1002/mus.70347","DOIUrl":"10.1002/mus.70347","url":null,"abstract":"<p><p>Training in electrodiagnostic (EDX) medicine is highly variable globally, with trainees receiving widely different levels of didactic education, skills training, and hands-on experience. Global standardization of EDX training has the potential to improve diagnostic accuracy, promote equitable care, and strengthen international collaboration. Major barriers include limited resources, faculty shortages, and a lack of standardized curricula. To address these disparities, opportunities and strategies for international collaboration are proposed, including developing a uniform content curriculum, competency-based evaluation frameworks, and integration of online and simulation-based learning tools.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"553-558"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471908","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":"At-Home Versus in-Clinic Vital Capacity Measurement: Insights From the HEALEY ALS Platform Trial.","authors":"Eric A Macklin, James D Berry, Brittney A Harkey, Lindsay Heyd, Marianne Chase, Hong Yu, Alexander V Sherman, Derek Dagostino, Gale Kittle, Meghan Hall, Mariah R Connolly, Kristin Drake, Elisa Giacomelli, Erica Scirocco, Saloni Sharma, Suma Babu, Michael Benatar, Zachary Simmons, Eufrosina Young, Merit E Cudkowicz, Jeremy Shefner, Sabrina Paganoni","doi":"10.1002/mus.70322","DOIUrl":"10.1002/mus.70322","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Respiratory weakness, typically monitored as vital capacity (VC), is a central feature of amyotrophic lateral sclerosis (ALS). VC is increasingly measured remotely in participants' homes, although in-clinic assessment remains the standard. We tested concordance between at-home and in-clinic VC to determine trial eligibility, track progression, and predict survival in a large ALS trial.</p><p><strong>Methods: </strong>At-home and in-clinic VC were assessed at baseline and approximately every 8 weeks for a year in the first four regimens of the HEALEY ALS Platform Trial. At-home assessments were coached via live videoconference and centrally reviewed. VC measurements, expressed as percent of predicted normal (%PN), were compared cross-sectionally, longitudinally, and for predicting survival time. Data from 233 participants with 3-8 paired at-home and in-clinic VC assessments completed < 14 days apart were analyzed.</p><p><strong>Results: </strong>At-home and in-clinic VC were well correlated (Lin's r _c  = 0.82) with no systematic bias. At-home VC ≥ 60%PN predicted in-clinic VC ≥ 60%PN with a positive predictive value of 91% and a negative predictive value of 65%. VC slopes were moderately correlated (r _c  = 0.68). At-home VC progressed 28% faster than in-clinic VC with proportionately less variance (at-home [SE] = -1.882 [0.153] %PN/month, in-clinic = -1.476 [0.131] %PN/month). Slopes of at-home and in-clinic VC explained 15% and 17% of variation in future survival time, respectively.</p><p><strong>Discussion: </strong>At-home and in-clinic VC were well correlated cross-sectionally. At-home VC performed well tracking longitudinal change and predicting survival. The reduced participant burden of assessment and concordance with in-clinic measurement support use of at-home monitoring of VC.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"702-708"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346001","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":"Development and Validation of a Novel, Disease-Specific, Caregiver-Reported Outcome Measure: The Duchenne Muscular Dystrophy Caregiver Reported-Health Index (DMDCR-HI).","authors":"Charlotte Engebrecht, Spencer Rosero, Jennifer Weinstein, Jamison Seabury, Anika Varma, Christine Zizzi, John Heatwole, Nuran Dilek, Aaron Kaat, Debra Guntrum, Emma Ciafaloni, Chad Heatwole","doi":"10.1002/mus.70327","DOIUrl":"10.1002/mus.70327","url":null,"abstract":"<p><strong>Aim: </strong>Regulatory-grade outcome measures are essential for supporting future therapeutic trials. The goal of our study was to develop and validate a multifactorial, disease-specific, caregiver-reported outcome (CRO) measure for Duchenne muscular dystrophy (DMD).</p><p><strong>Methods: </strong>We conducted qualitative interviews and a cross-sectional study with caregivers of individuals with DMD to determine the most prevalent and impactful symptoms to individuals with DMD. Symptom items were selected for the Duchenne Muscular Dystrophy Caregiver Reported-Health Index (DMDCR-HI) based on their prevalence and impact to a national sample cohort of caregivers, along with their potential ability to respond to therapeutics. Subsequently, we conducted cognitive beta interviews, test-retest reliability assessments, and internal consistency analyses to evaluate and optimize the DMDCR-HI. Using known group analysis, we assessed the ability of the DMDCR-HI to differentiate between patients with differing levels of disease burden.</p><p><strong>Results: </strong>The DMDCR-HI is a regulatory-grade CRO that comprehensively measures 16 subscales in DMD. The instrument has a high internal consistency, strong test-retest reliability (intraclass correlation coefficient (ICC) = 0.96), and was identified by caregivers as easy to use, relevant, and comprehensive. Through known group analysis, DMDCR-HI scores demonstrated an ability to differentiate between subgroups with varying levels of symptomatic burden.</p><p><strong>Discussion: </strong>The DMDCR-HI is a valid and reliable CRO designed to sensitively and reliably capture how individuals with DMD feel and function from the perspective of the caregiver. The DMDCR-HI offers a robust mechanism to longitudinally track changes in disease burden in individuals with DMD, regardless of age, cognitive ability, or ambulation status.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"623-635"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412492","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":"Exploring the Content Validity of Patient-Reported Outcome Measures to Capture the Patient Experience of Becker Muscular Dystrophy.","authors":"Abby Bronson, Katie Mellor, Nicole Kilburn, Ryan Fischer, Natalie Aldhouse, Chris Marshall, Tamara Al-Zubeidi","doi":"10.1002/mus.70302","DOIUrl":"10.1002/mus.70302","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The patient experience of Becker muscular dystrophy (BMD) is not well understood, making it difficult to evaluate the conceptual relevance of proposed patient-reported outcome (PRO) measures. This study aimed to conceptualize the patient experience of BMD and evaluate content validity and perceptions of meaningful changes of PRO measures in this population.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with ambulatory adult and adolescent US-based participants with BMD. Transcripts were analyzed using content and framework analysis. Participant quotes were coded to identify concepts and themes, illustrated in a conceptual model of BMD experience. Cognitive debriefing methods assessed patient understanding of the brief pain inventory-short form (BPI-SF), quality of life in neurological disorders (Neuro-QoL), and three patient-reported outcomes measurement information system (PROMIS-57) domains: Physical Function, Fatigue, and Pain Interference.</p><p><strong>Results: </strong>Twenty-nine patients (mean age: 27.0 years; mean age at BMD diagnosis: 15.1 years) and two caregivers described a wide range of signs, symptoms, and impacts. Physical fatigue, pain, weakness, and impacts on physical mobility and emotional wellbeing were considered most bothersome. The BPI-SF Item 3 and PROMIS-57 domains were well understood and relevant; however, the Neuro-QoL Upper Extremity questionnaire demonstrated low conceptual relevance.</p><p><strong>Discussion: </strong>The conceptual model illustrated the burden of living with BMD. The BPI-SF Item 3 and evaluated PROMIS-57 domains are considered content-valid PRO measures in BMD, with most participants associating score improvements with meaningful changes to their health-related quality of life.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"559-569"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271614","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":"Determinants of the Maximal Nerve Cross-Sectional Area and Its Role in the Separation of Entrapment and Compression Ulnar Neuropathies at the Elbow.","authors":"Simon Podnar","doi":"10.1002/mus.70324","DOIUrl":"10.1002/mus.70324","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Nerve cross-sectional area (CSA) is the most robust and sensitive ultrasonographic indicator of nerve pathology. The study aimed to identify predictors of maximal CSA (CSA_max) in ulnar neuropathy at the elbow (UNE) and to assess its utility in elucidating the mechanism of UNE, which is potentially important for patient referral to a surgeon.</p><p><strong>Methods: </strong>In a group of prospectively recruited UNE patients, 11 demographic, clinical, and electrodiagnostic features were recorded. CSA_max in the elbow segment was measured ultrasonographically. Explanatory variables for CSA_max were determined using a backward stepwise method of multiple linear regression analysis. To determine the CSA_max threshold with the best differentiation of retrocondylar compression and cubital tunnel entrapment (i.e., the UNE mechanism), a ROC curve was constructed.</p><p><strong>Results: </strong>We studied 130 patients (94 men), aged 27-88 years (median 62 years). The only significant predictor of CSA_max was the mechanism of UNE (CSA_max = 7.49 + 6.89 UNE mechanism, SE 1.04, (adjusted) R ² = 0.25, p < 0.0001). The best differentiation between UNE mechanisms was obtained at the CSA_max of 16 mm² (sensitivity 0.80, positive predictive value 0.71).</p><p><strong>Discussion: </strong>In UNE, the main determinant of CSA_max was the mechanism of neuropathy. In the UNE of unclear mechanism, CSA_max larger than 16 mm² is more in favor of a cubital tunnel entrapment. These findings suggest that US is more sensitive in the diagnosis of entrapment compared with compression neuropathies.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"600-604"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295592","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":"The Emotional Experiences of Healthcare Professionals Working in Amyotrophic Lateral Sclerosis: A Systematic Review.","authors":"Young Chan, Sarah Creer, Jess Mere, Alys Wyn Griffiths, Charlotte Wright, Esther V Hobson, Christopher J McDermott, Emily J Mayberry","doi":"10.1002/mus.70309","DOIUrl":"10.1002/mus.70309","url":null,"abstract":"<p><p>Healthcare professionals (HCPs) working with people living with amyotrophic lateral sclerosis (ALS) are often exposed to emotive circumstances including end of life care, trauma, loss, and death. Existing reviews have explored the emotional experiences of people living with ALS and their carers but have largely ignored healthcare staff and the impact of this work on them. This systematic review of qualitative research aims to explore the emotional experiences of and impact on HCPs working with people living with ALS using thematic synthesis (PROSPERO reference: CRD42025631749). Electronic databases were searched for journal articles and gray literature (Medline, Scopus, PsycINFO, Google Scholar, King's Fund Library Database, ProQuest Dissertations, Theses Global) for qualitative or mixed-methods studies exploring the emotional impact on HCPs working in ALS. Twelve studies were included, critically appraised, and analyzed. Four themes were identified. The emotional intensity due to the nature of ALS created challenges for HCPs, while they were also faced with absorbing the emotions of others. HCPs learned to balance their emotional involvement, and HCPs also described positive experiences and coping mechanisms. HCPs working in ALS experience multi-faceted emotional challenges, and they do describe positive emotional experiences within their roles. However, HCPs describe having few coping mechanisms and limited formal support systems in place to process the intense emotions or to guide their emotional involvement. The lack of support for staff may ultimately negatively affect patient care. There is an unmet demand for debriefing, supervision, and further training on how to deal with intense, distressing emotions.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"517-529"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278007","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":"NMES-Facilitated Mandibular Rehabilitation for Spasticity-Related Trismus in ALS.","authors":"Kelly Salmon, Hristelina Ilieva, Daniel Kelly","doi":"10.1002/mus.70332","DOIUrl":"10.1002/mus.70332","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"747-750"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369445","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}