{"title":"Mechanisms of Decidual Dysfunction and Infertility in Endometriosis: Roles of Prostaglandins and SASP.","authors":"Kazuhiro Tamura, Mikihiro Yoshie, Kazuya Kusama, Atsuya Tsuru","doi":"10.1002/rmb2.12663","DOIUrl":"10.1002/rmb2.12663","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a challenging disease to treat and one of the leading causes of infertility. Impaired endometrial receptivity, and particularly inadequate decidualization of endometrial stromal cells (ESCs), is a crucial component. Multiple inflammatory factors disrupt decidualization.</p><p><strong>Methods: </strong>A comprehensive search of PubMed and Google Scholar (peer-reviewed journals only from 2000 to 2025) was performed in April 2025. The keyword \"decidualization\" was combined with \"endometriosis\", \"infertility\", and \"inflammation\". We summarize recent findings regarding the mechanisms of endometrial receptivity, focusing on the decidualization of ESCs, and discuss the impact of endometriosis, particularly in relation to PG metabolism and the senescence-associated secretory phenotype (SASP).</p><p><strong>Main findings: </strong>Endometriotic lesions demonstrate progesterone (P4) resistance and heightened inflammation due to elevated local estrogen levels and feedback loops involving PGE<sub>2</sub> and steroidogenic enzymes. Oxidative stress secondary to inflammation and menstrual blood in ectopic locations promotes lesion growth. Excessive numbers of senescent cells with SASP contribute to fibrosis in the lesions. Impaired decidualization also occurs in eutopic ESCs, which show epigenetic dysregulation and inflammation, and these have effects through P4 and PGE<sub>2</sub> signaling.</p><p><strong>Conclusion: </strong>Both endometriotic lesions and eutopic endometrium in endometriosis patients exhibit changes that contribute to infertility, with abnormal inflammation and epigenetic modifications leading to impaired decidualization.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12663"},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333747","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":"A Comparative Study of Intravenous Immunoglobulin and Lipid Emulsion in Patients With Reproductive Failures Associated With NK Cell Abnormalities.","authors":"Ayano Yamaya, Atsushi Fukui, Kiyotaka Kawai, Mizuho Yano, Haruka Honda, Kohei Nakagawa, Hidetake Kamei, Maya Omote, Yu Wakimoto, Seiji Mabuchi","doi":"10.1002/rmb2.12662","DOIUrl":"10.1002/rmb2.12662","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of intravenous immunoglobulin (IVIG) and lipid emulsion (LE) therapies on reproductive failure such as recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) associated with natural killer (NK) cell abnormalities.</p><p><strong>Methods: </strong>NK cell abnormalities were defined as peripheral blood NK (pNK) cell activity of 40% or higher and CD16<sup>+</sup>/CD56<sup>dim</sup> uterine NK (uNK) cells at 18% or higher. IVIG and LE were administered to RPL and RIF patients. In patients undergoing IVF-ET, treatment was initiated either before ET, on ET day, or after ET.</p><p><strong>Results: </strong>Implantation rates of 48.3% and 47.8% were revealed in the IVIG and LE groups, respectively, with no significant difference. For patients with RPL, live birth rates were 75.0% for the IVIG group and 72.5% for the LE group, with no significant difference. For timings of administration before ET, on ET day, or after ET, the clinical pregnancy rates were 47.6%, 0%, and 0%, respectively, in the IVIG group and 30.0%, 12.5%, and 0%, respectively, in the LE group. Higher clinical pregnancy rates were observed when each treatment was initiated before ET.</p><p><strong>Conclusions: </strong>Both treatments exhibited comparable therapeutic effects on reproductive disorders associated with NK cell abnormalities.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12662"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326772","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":"How do fertility facilities in Japan perceive disclosing institutional success rates for IVF? A nationwide survey of registered assisted reproductive technology facilities.","authors":"Seung Chik Jwa, Eri Maeda, Osamu Ishihara, Akira Tsujimura, Yukihiro Terada, Yutaka Osuga","doi":"10.1002/rmb2.12653","DOIUrl":"10.1002/rmb2.12653","url":null,"abstract":"<p><p>To evaluate the current perspectives on reporting success rates for assisted reproductive technology, the authors conducted a nationwide survey. Of the 327 facilities that responded (response rate: 53.5%), over half recognized potential benefits of reporting in vitro fertilization (IVF) success rates, such as aiding patients in selecting a clinic (68.5%) and enhancing the quality and efficiency of information provided to patients (62.1%). However, concerns regarding potential negative impacts, including patient selection bias, were also highlighted, albeit to a lesser extent (32.7%-52.3%). These findings underscore the need for further discussions to establish an unbiased reporting framework and improve patient education on assisted reproductive technology (ART) success rates.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12653"},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286353","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}
Olabimpe Caroline Badejogbin, Oyedayo Phillips Akano, Oluwafisayo Elizabeth Boluwatife Julius, Mary Olaoluwa Agunloye, Makinde Vincent Olubiyi, Ojichukwuka Ebere Chijioke-Agu, Matthew Agene Obekpa, Adesina Paul Arikawe, Kehinde Samuel Olaniyi
{"title":"Potential Role of CREM in Diabetes-Associated Testicular Dysfunction: Current Evidence and Future Perspectives.","authors":"Olabimpe Caroline Badejogbin, Oyedayo Phillips Akano, Oluwafisayo Elizabeth Boluwatife Julius, Mary Olaoluwa Agunloye, Makinde Vincent Olubiyi, Ojichukwuka Ebere Chijioke-Agu, Matthew Agene Obekpa, Adesina Paul Arikawe, Kehinde Samuel Olaniyi","doi":"10.1002/rmb2.12661","DOIUrl":"10.1002/rmb2.12661","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2D) is a growing metabolic disorder affecting all age groups and is linked to testiculopathy, a key contributor to male infertility. Testiculopathy disrupts spermatogenesis and the sperm microenvironment, with the cyclic adenosine monophosphate (cAMP) response element modulator (CREM) playing a pivotal role in testicular function. Understanding the interplay between T2D and CREM dysregulation is essential for developing targeted therapies for diabetic testicular dysfunction.</p><p><strong>Methods: </strong>A systematic review of PubMed, Web of Science, Scopus, and Google Scholar was conducted to identify peer-reviewed studies, both preclinical and clinical, that explored CREM's role in diabetes-induced testicular dysfunction. Extracted data focused on CREM expression, oxidative stress, apoptosis, and spermatogenic impairment in diabetic models.</p><p><strong>Main findings: </strong>Research from studies on diabetic patients and animal models highlights the detrimental effects of diabetes on the reproductive system, including hypothalamic-pituitary-testicular (HPT) axis dysregulation. CREM regulates spermatogenic gene expression, influenced by luteinizing hormone (LH), follicle-stimulating hormone (FSH), and cAMP signaling.</p><p><strong>Conclusion: </strong>CREM has a therapeutic role in maintaining testicular function, and its disruption may contribute to testiculopathy in T2D, highlighting its potential therapeutic target for preserving male fertility in diabetic patients. Further research is needed to explore its molecular mechanisms and therapeutic implications.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12661"},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234994","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":"KIF2C Deletion Causes Meiotic Abnormalities and Nonobstructive Azoospermia in Mice.","authors":"Hiroaki Kitakaze, Haruhiko Miyata, Yuki Oyama, Chen Pan, Yuma Kujime, Go Tsujimura, Takahiro Imanaka, Sohei Kuribayashi, Norichika Ueda, Kentaro Takezawa, Shinichiro Fukuhara, Norio Nonomura, Masahito Ikawa","doi":"10.1002/rmb2.12659","DOIUrl":"10.1002/rmb2.12659","url":null,"abstract":"<p><strong>Purpose: </strong>Kinesin Family Member 2C (KIF2C) is a key regulator of microtubule dynamics and chromosome segregation in mitosis. However, its role in spermatogenesis remains unclear. Recent transcriptomic analyses suggest a potential link between KIF2C and male infertility. This study aimed to clarify KIF2C's roles in spermatogenesis using <i>Kif2c</i> knockout (KO) mice.</p><p><strong>Methods: </strong>To overcome the preweaning lethality associated with <i>Kif2c</i> deletion, we generated <i>Kif2c</i> KO mice with a mixed genetic background of 129X1/SvJ and B6D2. We assessed male fertility, epididymal sperm counts, and testicular sections of <i>Kif2c</i> KO mice.</p><p><strong>Results: </strong>Global <i>Kif2c</i> KO mice were obtained and showed male infertility. Histological analyses and epididymal sperm count revealed that <i>Kif2c</i> KO mice exhibited severely impaired spermatogenesis and absence of mature spermatozoa. These findings are consistent with those observed in patients with nonobstructive azoospermia (NOA). Our classification of <i>Kif2c</i> KO seminiferous tubules indicated that most spermatogenic cells were arrested at the early stages, particularly during meiosis.</p><p><strong>Conclusions: </strong>This study provides in vivo evidence that KIF2C is essential for spermatogenesis and male fertility in mice. The successful generation of global <i>Kif2c</i> KO mice establishes an animal model for NOA, supporting research on germ cell development and reproductive health.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12659"},"PeriodicalIF":2.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161730","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}
Wanqi Chen, Qi Feng, Chan Zhang, Lu Yang, Jingyi Qi
{"title":"Exosomes From Human Umbilical Cord Mesenchymal Stem Cells Alleviate Oxidative Stress-Induced POI by Regulating Autophagic Homeostasis Through the AMPK Pathway.","authors":"Wanqi Chen, Qi Feng, Chan Zhang, Lu Yang, Jingyi Qi","doi":"10.1002/rmb2.12658","DOIUrl":"10.1002/rmb2.12658","url":null,"abstract":"<p><strong>Background: </strong>Increased oxidative stress is a key factor in developing premature ovarian insufficiency (POI). Exosome therapy emerges as a promising cell-free treatment. However, research into the molecular mechanisms of exosome repair in ovarian diseases is still in its infancy. By establishing models of oxidative stress in ovarian granulosa cells and POI in mice, we aim to explore whether human umbilical cord mesenchymal stem cell exosomes can repair oxidative damage in ovarian granulosa cells and mouse ovaries, as well as identify potential targets of action. Our goal is to provide new ideas and methods for the clinical application of exosomes and the early prevention and treatment of POI.</p><p><strong>Methods: </strong>Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) (200 μM, 2 h) and D-galactose (D-gal) (200 mg/kg, 56 days) were used to induce oxidative stress in ovarian granulosa cells and mice, respectively. Subsequently, exosomes were added to the injury model to validate the mechanism of exosome repair of oxidative damage. We evaluated senescence indicators, AMPK activation, and autophagy.</p><p><strong>Result: </strong>Through the execution of in vivo and in vitro experiments, it was observed that the activation of the AMP-activated protein kinase (AMPK) pathway is induced by exosome intervention, leading to a reduction in the accumulation of autophagic vesicles and the restoration of the patency of autophagic flow. This, in turn, results in the repair of oxidative stress-induced damage and the enhancement of the function of damaged cells and ovaries.</p><p><strong>Conclusion: </strong>Our findings indicate that exosomes derived from human umbilical cord stem cells have the beneficial effect of ameliorating oxidative stress-induced POI by activating AMPK and regulating autophagic homeostasis.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12658"},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161593","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":"Foundational basic animal experiments paved the way for the clinical development of uterus transplantation.","authors":"Iori Kisu, Makoto Mihara, Hisako Hara, Yojiro Kato, Yusuke Matoba, Yohei Yamada, Kentaro Matsubara, Hideaki Obara, Nobuhiko Suganuma, Kouji Banno","doi":"10.1002/rmb2.12656","DOIUrl":"10.1002/rmb2.12656","url":null,"abstract":"<p><p>Uterus transplantation (UTx) has emerged as a revolutionary treatment for absolute uterine factor infertility, made possible by extensive preclinical research. Animal studies have played a pivotal role in advancing UTx to clinical practice. We highlight Japan's contribution, including non-human primate research and regulatory progress, leading to its anticipated clinical implementation. The expansion of UTx in the Asia-Oceania region underscores its global impact. Further refinements in surgical techniques, optimization of immunosuppressive regimens, and establishment of clear patient eligibility criteria will be crucial for ensuring the long-term success and sustainability of UTx programs worldwide. This letter acknowledges the Swedish team's foundational efforts in establishing UTx as a viable reproductive technology.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12656"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120522","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":"Effect of aging on semen and embryonic developmental scores in assisted reproductive technology.","authors":"Taiyo Yamamoto, Katsuya Mine, Hisataka Iwata","doi":"10.1002/rmb2.12647","DOIUrl":"10.1002/rmb2.12647","url":null,"abstract":"<p><strong>Purpose: </strong>The effects of female aging on fertility have been extensively studied; however, this is not the case for aging males. Embryonic selection using time-lapse observations is helpful for successful embryo transfer; however, information on the effect of male aging on time-lapse is insufficient. We analyzed the impact of paternal aging on sperm characteristics, embryonic developmental kinetics, embryo evaluation score, and pregnancy outcomes.</p><p><strong>Methods: </strong>We used data from patients treated at our clinic between January 2020 and December 2022. We evaluated the effects of aging in men and women on semen data, in vitro fertilization (IVF) results, developmental kinetics, embryo evaluation scores, and embryo transfer outcomes using a retrospective approach.</p><p><strong>Results: </strong>Male aging adversely affected the semen characteristics. Although female aging had adverse effects on IVF, embryonic developmental kinetics, and embryo transfer outcomes, male aging did not have such a significant impact. Female aging decreased the iDAScore and Gardner criteria, whereas male aging did not affect the iDAScore.</p><p><strong>Conclusions: </strong>Aging in males had a negative effect on semen data. Contrary to the impact of aging on women, aging in men did not have a significant effect on embryo and gestation rates following embryo transfer.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12647"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120553","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":"Effect of embryo cryopreservation before surgery on clinical outcomes in IVF patients with endometrioma.","authors":"Nozomi Takahashi, Yuma Kawahara, Miyuki Harada, Tomoko Makabe, Gentaro Izumi, Osamu Wada-Hiraike, Yasushi Hirota, Yutaka Osuga","doi":"10.1002/rmb2.12654","DOIUrl":"10.1002/rmb2.12654","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated whether embryo cryopreservation before surgery (ECBS) improves clinical outcomes in in vitro fertilization (IVF) patients with endometrioma.</p><p><strong>Methods: </strong>This retrospective study included patients aged 28-42 years with endometrioma who underwent oocyte retrieval at our hospital from 2019 to 2022. Seventeen patients who underwent ECBS and 43 patients who underwent embryo transfer (ET) without surgery were included. Patient characteristics, reproductive outcomes, and obstetric outcomes were compared between the groups.</p><p><strong>Results: </strong>Maximum cyst size was significantly larger in the ECBS group than in the control group. The abortion rate per pregnancy was significantly lower (0% vs. 35.5%) in the ECBS group than in the control group. The ongoing pregnancy rate per case was significantly higher in the ECBS group than in the control group (88.2% vs. 58.1%), while the time to ongoing pregnancy was similar. Among patients in the ECBS group who experienced live births, 84.6% became pregnant following three or fewer ET attempts. Multivariate analysis revealed that ECBS was the only factor associated with ongoing pregnancy. The rates of perinatal complications are comparable between the groups.</p><p><strong>Conclusions: </strong>ECBS is an effective method to improve reproductive outcomes in IVF patients with endometrioma without prolonging the time to pregnancy.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12654"},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029189","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 quality of human eggs and its pre-IVF incubation.","authors":"Ri-Cheng Chian, Yi-Chun Guan, Xiao-Jin He, Jian Xu, Jin-Hui Shu, Jian-Hua Li","doi":"10.1002/rmb2.12652","DOIUrl":"10.1002/rmb2.12652","url":null,"abstract":"<p><strong>Background: </strong>Multi-factors influence the success rate of infertility treatments, and one of the important points is to obtain good quality eggs.</p><p><strong>Methods: </strong>Based on the literatures and unpublished data, the factors affecting egg quality were summarized.</p><p><strong>Main findings results: </strong>Egg quality is an important determinant in successful infertility treatment. In addition to maternal age, controlled ovarian hyperstimulation (COH) protocols also play a key role in affecting the quality of the egg. After egg retrieval, the insemination occurs 3-6 h after collection, with a pre-IVF incubation time by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) (39-42 h post-HCG injection). The pre-IVF incubation refers to the short period time of 3 to 6 h after oocyte retrieval and before the insemination by IVF or ICSI. The pre-IVF incubation of collected eggs in the designed culture medium improves egg quality in terms of maturation and early embryonic development.</p><p><strong>Conclusions: </strong>Pre-IVF incubation of the collected eggs contributes to the improvement of the quality of eggs; therefore, it may increase subsequent pregnancy and implantation rates following embryo transfer.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"24 1","pages":"e12652"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036624","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}