Transfusion Medicine最新文献

{"title":"Challenges associated with recall and referral strategies for HIV-reactive blood donors in India: Insights from a nationwide online survey.","authors":"Aikaj Jindal, Aseem Kumar Tiwari, Ankit Mathur, Deepa Bhuyan, Rajesh B Sawant, Suvro Sankha Datta","doi":"10.1111/tme.70067","DOIUrl":"10.1111/tme.70067","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"411-413"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian patterns in transfusion-associated circulatory overload.","authors":"Krishna G Badami, Anna Y Zhou","doi":"10.1111/tme.70074","DOIUrl":"10.1111/tme.70074","url":null,"abstract":"<p><strong>Objectives: </strong>To examine if transfusion-associated circulatory overload (TACO) shows a circadian pattern.</p><p><strong>Background: </strong>Non-urgent transfusions often take place during the night-time. This interferes with patient rest and patient monitoring. Also, transfusion reactions like TACO may be more likely during the night for pathophysiologic reasons.</p><p><strong>Materials and methods: </strong>Using New Zealand haemovigilance and transfusion data for the three-year period between January 2022 and December 2024, we compared the daytime and night-time rates of TACO and two other transfusion reactions (allergic reactions and transfusion-associated hypotension, TAH).</p><p><strong>Results: </strong>A quarter of transfusion episodes happened during the night-time. The night-time TACO rate was twice the daytime rate (p = <0.0001). This was also seen in males alone (p = <0.0001), but not in females. With allergic reactions, the daytime and night-time rates were similar. With TAH, it appeared to be higher, but our TAH numbers are small.</p><p><strong>Conclusion: </strong>The night-time TACO rate was higher than the daytime rate. As with cardiogenic acute pulmonary edema and other cardio- and cerebro-vascular conditions which are more frequent at night, this may involve biological clocks, external stressors (e.g. recumbency and transfusion), and individual risk factors. This is yet another reason to avoid overnight transfusions unless urgently needed.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"401-405"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely geographic access to blood banking facilities: A pan-India modelling study.","authors":"Gaurav Urs, Aamir Miyajiwala, Ankit Raj, Siddhesh Zadey","doi":"10.1111/tme.70075","DOIUrl":"10.1111/tme.70075","url":null,"abstract":"<p><strong>Background: </strong>Efficient blood transfusion planning requires knowledge of the distribution and accessibility of blood banking facilities (BBFs). We mapped population-level, timely geographic access to BBFs across 735 districts across India.</p><p><strong>Study design and methods: </strong>We conducted a pan-India geospatial modelling study using 2024 data from e-RaktKosh, a centralised blood management system. As outcomes, we estimated BBFs per million people, travel time to the nearest BBF, and access population coverage (APC), defined as the proportion of the population with access to the nearest BBF by motorised transport (60 min) and walking (30 min).</p><p><strong>Results: </strong>In 2024, India had 5679 BBFs, averaging 4.13 facilities per million people. Median travel times to the nearest BBF were 35.25 min by motorised transport and 253.27 min by walking. For APCs, 93.86% of people were within 60 min of their nearest BBF by motorised transport, while 16.21% were within 30 min by walking. There were large differences in APCs across districts and states, with notable rural-urban disparities.</p><p><strong>Discussion: </strong>Access to blood banking facilities in India exhibits geographic disparities, with the northeastern states and island Union Territories having prolonged median travel times and low APC values. Rural areas are disproportionately adversely affected. Future efforts should focus on using timely geographic access data to inform strategic infrastructure planning and resource allocation, enhancing healthcare equity.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"360-369"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early cryoprecipitate transfusion through goal-directed bleeding management in a real world setting-How important it is to focus on the fibrinogen in major obstetric Haemorrhage.","authors":"Ganesh Mohan, Shamee Shastry, Prethika P A, Deepika Chenna, Bemma Paonam","doi":"10.1111/tme.70072","DOIUrl":"10.1111/tme.70072","url":null,"abstract":"<p><strong>Background: </strong>Postpartum haemorrhage (PPH) causes ~70 000 maternal deaths annually, making it one of the leading causes of preventable maternal mortality. This study evaluated the effectiveness of individualised goal-directed bleeding management (GDBM) in severe PPH in our centre with unique geographical challenges.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of severe PPH requiring massive transfusion over 1 years. Patients were classified into a fixed ratio (1:1:1) massive transfusion protocol (Group 1) and GDBM (Group 2). Study outcomes included blood utilisation, persistence of coagulopathy after resuscitation and mortality. The target was to keep a fibrinogen level of >200 mg/dL during the resuscitation. Thromboelastography was used to guide GDBM, and data were analysed using mean, median, percentage changes, chi-square test, student t test, and Mann-Whitney U-test.</p><p><strong>Results: </strong>Out of 96 patients (42 were in Group 1 and 54 in Group 2), GDBM led to increased cryoprecipitate utilisation (410 vs. 297 units) and a higher post-resuscitation fibrinogen value (252 [185.32-426.42] mg/dL vs. 204.6 [154.5-274.05] mg/dL, p = 0.02). The cryoprecipitate turnaround time was improved (41 vs. 73 min, p < 0.001) with GDBM ensuring timely administration. Increased fibrinolysis activity was observed in 24% of the patients in TEG. The persistence of coagulopathy after deactivation of MTP was lower in GDBM (7.4% vs. 26.19%). Out of the three patients who did not survive, two were in Group 1.</p><p><strong>Conclusion: </strong>Individualised GDBM optimises blood utilisation, reduces turnaround time and improves coagulopathy in PPH and needs to be prioritised.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"386-394"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic barriers to donation for African, Caribbean and Black communities: A qualitative key informant study.","authors":"Jennie Haw, Joyeuse Senga, Dzifa Dordunoo, Biba Tinga","doi":"10.1111/tme.70065","DOIUrl":"10.1111/tme.70065","url":null,"abstract":"<p><strong>Background and objective: </strong>For many blood collection agencies (BCAs), meeting the transfusion needs of people living with sickle cell disease, a genetic condition that causes sickling of red blood cells, is a priority but also a challenge because of a lack of diversity in the donor base. To help address this challenge, this study aimed to understand systemic barriers to donation from the perspectives of African, Caribbean, and Black (ACB) community leaders.</p><p><strong>Methods and materials: </strong>A qualitative study informed by a community-based participatory research approach was conducted with 10 ACB community leaders across Canada. Semi-structured interviews were conducted with key informants from February to March 2023. Topics explored included community involvement and priorities, perspectives on racism and discrimination, and perspectives on blood and other forms of donation including challenges to donation and recommendations for addressing challenges. Interviews were audio-recorded with participants' consent, transcribed, and uploaded to NVivo for analysis. Data analysis was guided by an interpretive descriptive and thematic analytic approach.</p><p><strong>Results: </strong>Our analysis demonstrates how differing sociocultural views on blood donation, mistrusting BCAs as an extension of healthcare systems, and experiences of deferral criteria as exclusionary are constructed as barriers to donation for some ACB people and communities.</p><p><strong>Conclusions: </strong>Easing deferral criteria was recommended by key informants as a necessary step towards addressing a significant barrier to donation; however, even with the removal of a permanent deferral, its legacy and impact on affected communities may remain. Recommendations include that BCAs collaborate with ACB community groups to address these barriers.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"326-334"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-time red blood cell transfusions in the emergency department: A deficiency in micronutrient testing.","authors":"Andrea Coetzee, Karryn Brown, Jessica Opie, Jody Rusch, Annemarie Kropman, Vernon Louw","doi":"10.1111/tme.70068","DOIUrl":"10.1111/tme.70068","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate laboratory investigations for micronutrient deficiencies as the cause of anaemia prior to first-time red blood cell transfusions in the medical emergency department (ED) of a large academic hospital.</p><p><strong>Background: </strong>The ED is often the first point of contact for acutely ill anaemic patients, yet patient blood management principles are underutilised. Because micronutrient deficiencies are common, treatable causes of anaemia, they should be screened for to guide targeted treatment and reduce unnecessary transfusions.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of 198 adult patients receiving first-time transfusions in the medical emergency unit at Groote Schuur Hospital, South Africa, between April and October 2023. Laboratory investigations for iron, vitamin B12, and folate deficiencies were analysed and stratified by pre-transfusion mean corpuscular volume (MCV). Iron deficiency was evaluated using three locally used criteria. Data about haematinic supplementation were also collected.</p><p><strong>Results: </strong>Only 29% of patients received a full micronutrient deficiency workup, while 39% had no testing. Iron deficiency was the most frequent abnormality, and up to 30% of these patients had normocytic indices. Iron supplementation rates were high, but many patients without iron deficiency also received iron.</p><p><strong>Conclusion: </strong>The ED encounter should be used as an opportunity to initiate basic micronutrient deficiency screening for anaemia, regardless of MCV.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"395-400"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining a safe pre-transfusion protocol for multiple myeloma patients on anti-CD38 treatment.","authors":"Amanda Nicolson, Jonathan Falconer","doi":"10.1111/tme.70046","DOIUrl":"10.1111/tme.70046","url":null,"abstract":"<p><strong>Background: </strong>Daratumumab is a monoclonal antibody therapy used to treat multiple myeloma. It has introduced challenges for blood transfusion laboratories to provide safe red cells for transfusion due to the cross-reactivity of daratumumab with red cell surface antigens on antibody screening cells, resulting in panreactivity and preventing the exclusion of alloantibodies. NHS Lothian transfusion protocol for patients on daratumumab involves pre-daratumumab extended patient phenotyping of significant RBC antigens and transfusion of RhD (CcEe) and K phenotype matched Red Cell Concentrate (RCC) without performing any pre-transfusion antibody screening.</p><p><strong>Methods: </strong>To determine alloimmunisation rates following the current protocol the laboratory information management system (LIMS) was interrogated to determine if patients previously on daratumumab had developed antibodies in response to transfused RCCs. Grifols sCD38 was used to neutralise daratumumab in transfused patients. sCD38 was used to (1) assess alloimmunisation rates in patients on treatment (2) assess how it could be applied in a routine pre transfusion testing protocol.</p><p><strong>Results: </strong>Since 2018, 185 patients started daratumumab therapy in Lothian. There was a record of RCC transfusion in 102 patients. From the LIMS, negative antibody screens were recorded in 21 patients post-daratumumab treatment. No alloimmunisation was detected from 34 transfused patients still on daratumumab.</p><p><strong>Conclusion: </strong>Low alloimmunisation suggests NHS Lothian protocol for transfusion of daratumumab patients is safe. Extended phenotyping of patients pre-treatment may be extensive and unnecessary due to the low alloimmunisation rate. Implementation of sCD38 reagent into pre-transfusion testing can reduce extensive pre-treatment testing and improve the safety of transfusion by exclusion of alloantibodies in daratumumab patients.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"354-359"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes toward perioperative patient blood management: A cross-sectional study among Anaesthesiology and Orthopaedic Surgery Departments at a university hospital.","authors":"Chayapa Luckanachanthachote, Wittawat Mingmongkolchaikul, Piyanut Jungkhananan, Mingkwan Wongyingsinn","doi":"10.1111/tme.70070","DOIUrl":"10.1111/tme.70070","url":null,"abstract":"<p><strong>Background: </strong>Perioperative patient blood management (PBM) is a crucial, multidisciplinary, evidence-based approach aimed at optimising patient outcomes by reducing unnecessary erythrocyte transfusions. This study assessed the knowledge and attitudes of healthcare professionals in two key surgical specialties toward PBM.</p><p><strong>Methods: </strong>This cross-sectional questionnaire-based survey involved personnel from the Department of Anaesthesiology and the Department of Orthopaedic Surgery at a university hospital. The questionnaire assessed knowledge (scored out of 100) and attitudes (specifically self-reported adherence, scored out of 100). The correct responses were based on the PBM guidelines and institutional protocols. Multivariable logistic regression was used to identify predictors of adherence.</p><p><strong>Results: </strong>The overall response rate was 86.2% (n = 250) from 163 Anaesthesiology and 87 Orthopaedic Surgery. The Orthopaedic Surgery group scored significantly lower on knowledge assessments than the Anaesthesiology group (median score 48 vs. 58, p < 0.001). However, the attitude scores were statistically similar (median score 77 vs. 76, p = 0.237), revealing a knowledge-attitude paradox. Multivariable logistic regression identified hierarchical position as the only significant independent predictor: staff physicians were 7.1 times more likely to report adherence compared to residents (adjusted odds ratios 7.1, 95% confidence interval 3.1-16.2, p < 0.001). Individual knowledge level was not a significant predictor.</p><p><strong>Conclusions: </strong>Our study demonstrates that hierarchical mandate, not individual knowledge or department affiliation, is the primary driver of PBM adherence. Implementation efforts must therefore leverage staff physician leadership to mandate PBM as the institutional standard of care, ensuring that positive attitudes translate into consistent practice.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"345-353"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune-mediated platelet refractoriness: Mechanisms, diagnostics, and therapeutic breakthroughs.","authors":"Lei Ma, Lina Wu, Jinhui Xie","doi":"10.1111/tme.70071","DOIUrl":"10.1111/tme.70071","url":null,"abstract":"<p><p>Platelets are increasingly recognised as key mediators of immunity, contributing to clinical challenges such as platelet transfusion refractoriness (PTR). While predominantly driven by non-immune factors, immune-mediated PTR-primarily due to alloimmunisation against human leukocyte antigens (HLA) and/or human platelet antigens (HPA)-presents distinct management difficulties. Current therapies are often suboptimal, and emerging strategies require validation. This review synthesises current knowledge on antibody pathogenesis, advanced detection methods, and novel therapies for immune-mediated PTR, aiming to inform clinical decision-making and future research. A comprehensive literature review was conducted, focusing on peer-reviewed articles addressing immune-mediated PTR, mechanisms of alloimmunisation, diagnostic techniques for HLA/HPA antibodies, and therapeutic innovations. Key studies and emerging data were analysed to evaluate current evidence and identify knowledge gaps. Immune-mediated PTR arises primarily from alloantibodies against HLA class I and/or HPA, leading to accelerated platelet clearance. Advanced detection methods, including multiplex bead arrays and genotyping platforms, have improved identification of incompatible donors. Current management relies on provision of antigen-negative or crossmatch-compatible platelets, with immunosuppressive therapy reserved for refractory cases. Novel strategies such as platelet genome editing, antibody inhibition, and nanoparticle-based immune modulation are under investigation, but robust clinical validation is lacking. This review highlights the central role of alloimmunisation in immune-mediated PTR and the importance of accurate antibody detection and antigen matching. While existing therapies remain suboptimal for some patients, emerging technologies hold potential but require further clinical evaluation. Improved understanding of pathogenesis and validation of novel approaches are essential to advance management and reduce the burden of PTR.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"311-325"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quasi-experimental study evaluating the efficacy of crossmatch-matched platelet transfusions in hemato-oncology patients with suspected alloimmune platelet refractoriness: A single-centre experience.","authors":"Daljit Kaur, Gita Negi, Vaidehi Prasanth, Joyisa Deb, Dixa Kumari, Gaurav Dhingra, Uttam Kumar Nath, Ashish Jain","doi":"10.1111/tme.70058","DOIUrl":"10.1111/tme.70058","url":null,"abstract":"<p><strong>Background: </strong>Platelet transfusion is essential in managing thrombocytopenia in hemato-oncology patients. This study aimed to determine the prevalence of platelet refractoriness (PR) and to evaluate the efficacy of crossmatch-compatible single-donor platelet (SDP) transfusions in patients with suspected platelet refractoriness.</p><p><strong>Materials and methods: </strong>A two-year quasi-experimental study comprised adult and paediatric hemato-oncology patients with two consecutive low corrected count increment (CCI) responses (<7500/μL) following SDP transfusions. Refractory patients with non-immune causes were tried to be excluded as far as possible. Platelet crossmatching was performed using solid-phase red cell adherence (SPRCA) technology. One-hour post-transfusion CCI and percentage platelet recovery (PPR) were evaluated between crossmatch-compatible and incompatible transfusions. Statistical analyses included descriptive statistics as mean ± standard deviation (SD), median with interquartile range (IQR), or frequencies (%). Multivariate regression analysis was used to identify predictors of transfusion response.</p><p><strong>Results: </strong>Among 272 SDP transfused patients, 142 (52.2%) were refractory and of them, 101 were eligible for platelet crossmatching. Of the 166 SDP transfusions, 63.4% were crossmatch incompatible. Crossmatch-compatible transfusions yielded significantly higher mean CCI (17 788 vs. 11 913, p = 0.001) and PPR (44.8% vs. 28.7%, p < 0.001). Crossmatching demonstrated high sensitivity (84.8%) and NPV (86.4%) for detecting inadequate responses. Multivariate analysis identified platelet compatibility and age as significant predictors of transfusion efficacy.</p><p><strong>Conclusion: </strong>Crossmatch-compatible platelet transfusions significantly improve post-transfusion CCI and PPR in alloimmunised hemato-oncology patients. Crossmatch compatibility and patient age were identified as two independent predictors of adequate early platelet transfusion response (1-h CCI, PPR and platelet increment).</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"377-385"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}