{"title":"Assisted reproductive technology in Japan: A summary report for 2022 by the Ethics Committee of the Japan Society of Obstetrics and Gynecology.","authors":"Yukiko Katagiri, Seung Chik Jwa, Akira Kuwahara, Takeshi Iwasa, Masanori Ono, Keiichi Kato, Hiroshi Kishi, Yoshimitsu Kuwabara, Fuminori Taniguchi, Miyuki Harada, Akira Iwase, Norihiro Sugino","doi":"10.1002/rmb2.12620","DOIUrl":"10.1002/rmb2.12620","url":null,"abstract":"<p><strong>Purpose: </strong>This descriptive analysis evaluated the 2022 assisted reproductive technology (ART) data collected by the Japan Society of Obstetrics and Gynecology registry.</p><p><strong>Methods and results: </strong>In 2022 (cutoff date 30 November 2023), 634 of 635 registered ART facilities participated; 602 implemented ART treatment, with 543 630 registered cycles and 77 206 neonates (9.1% and 10.6% increases from the previous year). For fresh cycles, freeze-all in vitro fertilization and intracytoplasmic sperm injection cycles increased, resulting in 2183 and 2822 neonates, respectively. In total, 275 296 cycles resulted in oocyte retrieval, with 158 247 (57.5%) freeze-all cycles. Total single embryo transfer (ET) and singleton pregnancy rates were 82.4% and 97.2%, respectively. The singleton live birth rate was 97.4%. The number of frozen-thawed ET (FET) cycles was 264 412, with 98 348 pregnancies and 72 201 neonates. The single ET rate was 85.3%. The rate of singleton pregnancies was 96.9%; that of singleton live births was 96.9%. Per registered cycle, women had a mean age of 37.6 (standard deviation: 4.8) years; 210 322 cycles (38.7%) were conducted for women aged ≥40 years.</p><p><strong>Conclusions: </strong>Significant growth in ART cycles and outcomes reflects the impact of recent expanded insurance coverage.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12620"},"PeriodicalIF":2.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829583","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}
Shashika D Kothalawala, Stefan Günther, Hans-Christian Schuppe, Adrian Pilatz, Florian Wagenlehner, Sabine Kliesch, Liza O'Donnell, Daniela Fietz
{"title":"Identification of differentially expressed genes in human testis biopsies with defective spermatogenesis.","authors":"Shashika D Kothalawala, Stefan Günther, Hans-Christian Schuppe, Adrian Pilatz, Florian Wagenlehner, Sabine Kliesch, Liza O'Donnell, Daniela Fietz","doi":"10.1002/rmb2.12616","DOIUrl":"10.1002/rmb2.12616","url":null,"abstract":"<p><strong>Purpose: </strong>Sperm morphology and motility are major contributors to male-factor infertility, with many genes predicted to be involved. This study aimed to elucidate differentially expressed transcripts in human testis tissues of normal and abnormal spermatogenesis that could reveal new genes that may regulate sperm morphology and function.</p><p><strong>Methods: </strong>Human testis biopsies were collected from men with well-characterized phenotypes of normal spermatogenesis, spermatid arrest, and Sertoli cell-only phenotype, and transcriptional differences were quantified by RNA-sequencing (RNA-Seq). Differentially expressed genes (DEGs) were filtered based on predominant expression in spermatids and gene functional annotations relevant to sperm morphology and motility. Selected 10 DEGs were validated by qRT-PCR and the localization of two proteins was determined in testis biopsies.</p><p><strong>Results: </strong>The analysis revealed 6 genes (<i>SPATA31E1</i>, <i>TEKT3</i>, <i>SLC9C1</i>, <i>PDE4A</i>, <i>CFAP47</i>, and <i>TNC</i>) that are excellent candidates for novel genes enriched in developing human sperm. The immunohistochemical localization of two proteins, ORAI1 and SPATA31E1, in testis biopsies, verified that both are expressed in developing human germ cells, with SPATA31E1 enriched in late spermatocytes and spermatids.</p><p><strong>Conclusion: </strong>This study identified human germ cell-enriched genes that could play functional roles in spermiogenesis and could thus be important in the development of morphologically normal, motile sperm.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12616"},"PeriodicalIF":2.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829598","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 relationship between controlled ovarian stimulation protocol, meiotic spindle visibility, position of the meiotic spindle relative to the polar body in the human oocyte, and clinical outcomes following ICSI.","authors":"Taketo Inoue, Yuki Matsuo, Sayumi Taguchi, Yoshiko Tsujimoto, Mikiko Uemura, Yoshiki Yamashita","doi":"10.1002/rmb2.12601","DOIUrl":"10.1002/rmb2.12601","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of different controlled ovarian stimulation (COS) protocols, including the progestin-primed ovarian stimulation (PPOS), long, short, and the gonadotropin-releasing hormone antagonist protocols, on meiotic spindle visibility and position within the oocyte and clinical outcomes following ICSI.</p><p><strong>Methods: </strong>Before ICSI, spindle position (<i>θ</i>) just below the polar body (PB) was defined as 0° and categorized as follows: <i>θ</i> = 0°, 0° < <i>θ</i> ≤ 30°, 30° < <i>θ</i> ≤ 60°, 60° < <i>θ</i> ≤ 90°, 90° < <i>θ</i> ≤ 180°, between the PB and the oolemma, and nonvisible. The clinical outcomes after ICSI were retrospectively analyzed.</p><p><strong>Results: </strong>The normal fertilization rate was significantly higher in oocytes with visible spindles than in oocytes with nonvisible spindles after each COS protocol, but did not differ based on spindle positioning (0° ≤ <i>θ</i> ≤ 180°). The rates of pregnancy, live birth/ongoing pregnancy, and miscarriage did not differ based on spindle visibility or positioning. In multinominal logistic regression analysis, female age was associated with spindle position, and the odds of a spindle located at 30° < <i>θ</i> ≤ 60°, at 60° < <i>θ</i> ≤ 90°, or at 90° < <i>θ</i> ≤ 180° were increased relative to <i>θ</i> = 0° in older women (odds ratio; 1.020, 1.030, and 1.060, respectively; <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Meiotic spindle positioning in the oocyte does not affect normal fertilization, blastulation, pregnancy, live birth/ongoing pregnancy, and miscarriage after ICSI, independent of the COS protocol used.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12601"},"PeriodicalIF":2.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829605","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":"Association between anti-Müllerian hormone levels and polycystic ovary syndrome in a general cohort of young women in Japan.","authors":"Natsuki Miyake, Satoko Osuka, Isao Ohsawa, Takashi Tonoike, Tomoko Uno, Kazuo Tsuzuki, Bayasula, Reina Sonehara, Ayako Muraoka, Tomoko Nakamura, Maki Goto, Akira Iwase, Hiroaki Kajiyama","doi":"10.1002/rmb2.12615","DOIUrl":"https://doi.org/10.1002/rmb2.12615","url":null,"abstract":"<p><strong>Purpose: </strong>Polycystic ovary syndrome (PCOS) significantly affects women. This study investigated the association between serum anti-Müllerian hormone (AMH) levels and menstrual cycle disorders, and AMH for PCOS in a general cohort of young Japanese women.</p><p><strong>Methods: </strong>We measured serum AMH levels in 528 healthy female students at two universities in Japan between 2014 and 2020. We investigated the association between serum AMH levels and hormone levels, menstrual cycle, and body mass index.</p><p><strong>Results: </strong>The mean (±standard deviation) AMH level was 4.78 ± 2.88 ng/mL. Correlations were observed between serum AMH and luteinizing hormone (LH) or LH/follicle-stimulating hormone (FSH) levels in women with irregular menstruation (LH: <i>r</i> = 0.542, <i>p</i> < 0.001; LH/FSH: <i>r</i> = 0.584, <i>p</i> < 0.001). The optimal serum AMH cutoff value that predicted LH ≥7.1 IU/L and LH/FSH ≥1.21 (PCOS diagnostic criteria revised by Japan Society of Obstetrics and Gynecology) in women with menstrual irregularities was 5.30 ng/mL (area under the curve: 0.815, sensitivity: 84.2%, specificity: 70.3%).</p><p><strong>Conclusions: </strong>Serum AMH can be measured during annual health checkups and may be a useful biomarker for early and arcuate diagnosis and intervention in women with PCOS.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12615"},"PeriodicalIF":2.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626978","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":"Ectopic expression of the mitochondrial protein COXFA4L3 in human sperm acrosome and its potential application in the selection of male infertility treatments.","authors":"Yusuke Fujisawa, Sayaka Kikuchi, Fujino Kuba, Kosei Oishi, Soushi Murayama, Tomoya Sugiyama, Reiji Tokito, Hiroe Ueno, Shin-Ichi Kashiwabara, Yasushi Yumura, Yasuyuki Kurihara","doi":"10.1002/rmb2.12602","DOIUrl":"10.1002/rmb2.12602","url":null,"abstract":"<p><strong>Purpose: </strong>Spermatogenesis requires a large amount of energy, which is primarily produced by the mitochondrial electron transfer chain. Mitochondrial dysfunction affects male infertility, suggesting a relationship between the electron transfer chain and male infertility. COXFA4L3 (C15ORF48) is an emerging subunit protein of cytochrome oxidase specifically expressed in germ cells during spermatogenesis, and it may be involved in male infertility. Therefore, to investigate whether COXFA4L3 could be a marker of mitochondrial dysfunction in the sperm, this study examined the protein expression and localization profile of COXFA4L3 in the sperm of male patients with infertility.</p><p><strong>Methods: </strong>Twenty-seven semen samples from a male infertility clinic at the Reproductive Center of Yokohama City University Medical Center were used to analyze sperm quality parameters and the expression and localization of energy production-related proteins. These data were compared with the outcomes of infertility treatment.</p><p><strong>Results: </strong>The expression levels of COXFA4L3 varied significantly between samples. Furthermore, COXFA4L3 was ectopically localized to the acrosome.</p><p><strong>Conclusions: </strong>Ectopic expression of COXFA4L3 and PNA-stained acrosomes may be useful parameters for fertility treatment selection. Assessing the acrosomal localization of COXFA4L3 will expedite pregnancy treatment planning.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12602"},"PeriodicalIF":2.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547127","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":"Molecular mechanisms of mammalian sperm capacitation, and its regulation by sodium-dependent secondary active transporters.","authors":"Gen L Takei","doi":"10.1002/rmb2.12614","DOIUrl":"https://doi.org/10.1002/rmb2.12614","url":null,"abstract":"<p><strong>Background: </strong>Mammalian spermatozoa have to be \"capacitated\" to be fertilization-competent. Capacitation is a collective term for the physiological and biochemical changes in spermatozoa that occur within the female body. However, the regulatory mechanisms underlying capacitation have not been fully elucidated.</p><p><strong>Methods: </strong>Previously published papers on capacitation, especially from the perspective of ions/channels/transporters, were extracted and summarized.</p><p><strong>Results: </strong>Capacitation can be divided into two processes: earlier events (membrane potential hyperpolarization, intracellular pH rise, intracellular Ca<sup>2+</sup> rise, etc.) and two major later events: hyperactivation and the acrosome reaction. Earlier events are closely interconnected with each other. Various channels/transporters are involved in the regulation of them, which ultimately lead to the later events. Manipulating the extracellular K<sup>+</sup> concentration based on the oviductal concentration modifies membrane potential; however, the later events and fertilization are not affected, suggesting the uninvolvement of membrane potential in capacitation. Hyperpolarization is a highly conserved phenomenon among mammalian species, indicating its importance in capacitation. Therefore, the physiological importance of hyperpolarization apart from membrane potential is suggested.</p><p><strong>Conclusion: </strong>The hypotheses are (1) hyperpolarizing Na<sup>+</sup> dynamics (decrease in intracellular Na<sup>+</sup>) and Na<sup>+</sup>-driven secondary active transporters play a vital role in capacitation and (2) the sperm-specific potassium channel Slo3 is involved in volume and/or morphological regulation.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12614"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473585","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":"Correction to \"A new clustering model based on the seminal plasma/serum ratios of multiple trace element concentrations in male patients with subfertility\".","authors":"","doi":"10.1002/rmb2.12613","DOIUrl":"https://doi.org/10.1002/rmb2.12613","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1002/rmb2.12584.].</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12613"},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392902","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}
Daiki Hashimoto, Kota Fujimoto, Masanori Nakata, Takuya Suzuki, Shinji Kumegawa, Yuko Ueda, Kentaro Suzuki, Shinichi Asamura, Gen Yamada
{"title":"Developmental and functional roles of androgen and interactive signals for external genitalia and erectile tissues.","authors":"Daiki Hashimoto, Kota Fujimoto, Masanori Nakata, Takuya Suzuki, Shinji Kumegawa, Yuko Ueda, Kentaro Suzuki, Shinichi Asamura, Gen Yamada","doi":"10.1002/rmb2.12611","DOIUrl":"10.1002/rmb2.12611","url":null,"abstract":"<p><strong>Background: </strong>Recent progress in molecular and signal analyses revealed essential functions of cellular signals including androgen and related growth factors such as Wnt regulators for external genitalia (ExG) development and its pathogenesis. Accumulated data showed their fundamental functions also for erectile tissue (corporal body) development and its abnormalities. The current review focuses on such signals from developmental and functional viewpoints.</p><p><strong>Methods: </strong>Experimental strategies including histological and molecular signal analyses with conditional mutant mice for androgen and Wnt signals have been extensively utilized.</p><p><strong>Main findings: </strong>Essential roles of androgen for the development of male-type ExG and urethral formation are shown. Wnt signals are associated with androgen for male-type ExG organogenesis. Androgen plays essential roles in the development of erectile tissue, the corporal body and it also regulates the duration time of erection. Wnt and other signals are essential for the regulation of mesenchymal cells of erectile tissue as shown by its conditional mutant mouse analyses. Stress signals, continuous erection, and the potential of lymphatic characteristics of the erectile vessels with sinusoids are also shown.</p><p><strong>Conclusion: </strong>Reiterated involvement of androgen, Wnt, and other regulatory factors is stated for the development and pathogenesis of ExG and erectile tissues.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12611"},"PeriodicalIF":2.7,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381555","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}
Yasunari Miyagi, Toshihiro Habara, Rei Hirata, Nobuyoshi Hayashi
{"title":"Predicting implantation by using dual AI system incorporating three-dimensional blastocyst image and conventional embryo evaluation parameters-A pilot study.","authors":"Yasunari Miyagi, Toshihiro Habara, Rei Hirata, Nobuyoshi Hayashi","doi":"10.1002/rmb2.12612","DOIUrl":"10.1002/rmb2.12612","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the usefulness of an original dual artificial intelligence (AI) system, in which the first AI system eliminates the background of sliced tomographic blastocyst images, then the second AI system predicts implantation success using three-dimensional (3D) reconstructed images of the sequential images and conventional embryo evaluation parameters (CEE) such as maternal age.</p><p><strong>Methods: </strong>Patients (from June 2022 to July 2023) could opt out and there was additional information on the Web site of the clinic. Implantation and non-implantation cases numbered 458 and 519, respectively. A total of 10 747 tomographic images of the blastocyst in a time-lapse incubator system with the CEE were obtained.</p><p><strong>Results: </strong>The statistic values by the dual AI system were 0.774 ± 0.033 (mean ± standard error) for area under the characteristic curve, 0.727 for sensitivity, 0.719 for specificity, 0.727 for predictive value of positive test, 0.719 predictive value of negative test, and 0.723 for accuracy, respectively.</p><p><strong>Conclusions: </strong>The usefulness of the dual AI system in predicting implantation of blastocyst in handling 3D data with conventional embryo evaluation information was demonstrated. This system may be a feasible option in clinical practice.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12612"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352883","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":"Recent progress in metabolomics for analyzing common infertility conditions that affect ovarian function.","authors":"Hiroshi Kobayashi, Shogo Imanaka","doi":"10.1002/rmb2.12609","DOIUrl":"10.1002/rmb2.12609","url":null,"abstract":"<p><strong>Background: </strong>Numerous efforts have been undertaken to identify biomarkers associated with embryo and oocyte quality to improve the success rate of in vitro fertilization. Metabolomics has gained traction for its ability to detect dynamic biological changes in real time and provide comprehensive metabolite profiles. This review synthesizes the most recent findings on metabolomic analysis of follicular fluid (FF) in clinical conditions leading to infertility, with a focus on the dynamics of energy metabolism and oocyte quality, and discusses future research directions.</p><p><strong>Methods: </strong>A literature search was conducted without time constraints.</p><p><strong>Main findings: </strong>The metabolites present in FF originate from five primary pathways: glycolysis, oxidative phosphorylation, lipid metabolism and β-oxidation, nucleic acid synthesis, and ketogenesis. Metabolomic profiling can broadly categorize infertile women into two groups: those with infertility due to aging and endometriosis, and those with infertility associated with polycystic ovarian syndrome and obesity. In the former group, glycolysis and lipid metabolism are upregulated to compensate for mitochondrial dysfunction, whereas the latter group exhibits the opposite trend. Assessing the levels of glucose, pyruvate, lactate, and plasmalogens in FF may be valuable for evaluating oocyte quality.</p><p><strong>Conclusion: </strong>Metabolomic analysis, particularly focusing on energy metabolism in FF, holds promise for predicting female reproductive outcomes.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12609"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352884","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}