Audiology Research最新文献

{"title":"Electrode Impedance Subcomponent Analysis in Cochlear Implant Patients with Rising or Fluctuating Electrode Impedances.","authors":"Aniket A Saoji, Madison K Graham, Melissa D DeJong, Joscelyn R K Martin, Joerg Pesch, Filiep J Vanpoucke","doi":"10.3390/audiolres15020041","DOIUrl":"https://doi.org/10.3390/audiolres15020041","url":null,"abstract":"<p><strong>Background/objectives: </strong>Electrode impedance is crucial for optimizing cochlear implant (CI) stimulation and hearing outcomes. While typically stable, some patients experience unexplained impedance fluctuations. This study used electrode impedance subcomponent analysis to identify the subcomponents contributing to these impedance fluctuations.</p><p><strong>Methods: </strong>This study analyzed clinical electrode impedances and transimpedance matrix (TIM) measurements in 10 CI patients with Nucleus devices (CI422, CI522, or CI622 electrode arrays) who exhibited fluctuating or rising electrode impedances. TIM measurements used a cathodic-leading biphasic pulse (110 CLs, 75 µs/phase, 7 µs interphase interval). Electrode impedances were determined at 6, 12, 18, 24, and 75 µs, and subcomponents (access resistance [near-field/far-field] and polarization impedance [Warburg capacitance/Faraday resistance]) were calculated.</p><p><strong>Results: </strong>Both access resistance and polarization impedance changes contributed to impedance fluctuations. Large changes in near-field resistance compared to far-field resistance were associated with increased resistance to current flow closer to the surface of the electrode. The decreased double-layer capacitance and slightly increased Faraday resistance further suggested increased resistance to charge transfer at the electrode-electrolyte interface.</p><p><strong>Conclusions: </strong>Electrode impedance subcomponent analysis reveals changes in the electrochemical reaction at the electrode surface that cause fluctuating or rising CI electrode impedances.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ontology-Based Expert System Approach for Hearing Aid Fitting in a Chaotic Environment.","authors":"Guy Merlin Ngounou, Anne Marie Chana, Bernabé Batchakui, Kevina Anne Nguen, Jean Valentin Fokouo Fogha","doi":"10.3390/audiolres15020039","DOIUrl":"https://doi.org/10.3390/audiolres15020039","url":null,"abstract":"<p><strong>Background/objectives: </strong>Hearing aid fitting is critical for hearing loss rehabilitation but involves complex, interdependent parameters, while AI-based technologies offer promise, their reliance on large datasets and cloud infrastructure limits their use in low-resource settings. In such cases, expert knowledge, manufacturer guidelines, and research findings become the primary sources of information. This study introduces DHAFES (Dynamic Hearing Aid Fitting Expert System), a personalized, ontology-based system for hearing aid fitting.</p><p><strong>Methods: </strong>A dataset of common patient complaints was analyzed to identify typical auditory issues. A multilingual self-assessment questionnaire was developed to efficiently collect user-reported complaints. With expert input, complaints were categorized and mapped to corresponding hearing aid solutions. An ontology, the Hearing Aid Fitting Ontology (HAFO), was developed using OWL 2. DHAFES, a decision support system, was then implemented to process inputs and generate fitting recommendations.</p><p><strong>Results: </strong>DHAFES supports 33 core complaint classes and ensures transparency and traceability. It operates offline and remotely, improving accessibility in resource-limited environments.</p><p><strong>Conclusions: </strong>DHAFES is a scalable, explainable, and clinically relevant solution for hearing aid fitting. Its ontology-based design enables adaptation to diverse clinical contexts and provides a foundation for future AI integration.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Beliefs, and Treatment Practices for Otitis Media in Malawi: A Community-Based Assessment.","authors":"Enittah Chikuse, Derek Jacobs, Angella Banda, Julia Toman, Jenna Vallario, Danielle Curtis, J Zachary Porterfield","doi":"10.3390/audiolres15020038","DOIUrl":"https://doi.org/10.3390/audiolres15020038","url":null,"abstract":"<p><strong>Background: </strong>Hearing-related disease is a significant cause of disability worldwide. In resource-limited settings, prevention and early detection are critical for preventing severe disease. Understanding what a population knows and believes with regards to hearing health can be critical in identifying knowledge gaps and developing targeted interventions.</p><p><strong>Objective: </strong>To assess community awareness of hearing health and otitis media (OM) treatment, both modern and traditional, to inform educational programs.</p><p><strong>Methods: </strong>A retrospective review of clinical records from 52 patients (aged 1-79 years) diagnosed with OM during a 3-day hearing health clinic in Kasungu district, Malawi was conducted. Patients diagnosed with OM during the clinic were invited to provide additional details about their hearing health. Surveys contained open-ended questions to assess knowledge and beliefs regarding the cause of their infection and therapies they had previously used for treatment, including home remedies and prescribed medications from allopathic providers or traditional healers. A WHO adapted survey on hearing knowledge was also administered.</p><p><strong>Results: </strong>Hearing loss was identified in 60% of participants. Otoscopy revealed either bilateral or unilateral drainage in 69% of participants and perforation in 73%. Confidence in understanding the causes and treatments of OM was voiced by 60% of participants and 54% had used home remedies as treatment. Of the 11 home remedies used, none aligned with modern medical practice, and only two were recommended by local herbalists.</p><p><strong>Conclusions: </strong>Hearing-related disease contributes significantly to global disability, particularly in resource-limited settings. Educational campaigns to improve hearing health knowledge offer low-cost yet impactful solutions and implementation via partnerships with community leaders and traditional healers can be critical to addressing hearing health challenges. The use of nonantibiotic antimicrobials should be explored further, as these are low-cost and readily available. However, therapeutic alliance between patients and healthcare providers remains crucial.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Outcomes in Children with Unilateral Hearing Loss. The Benefits of Rehabilitative Strategies: Preliminary Results.","authors":"Rita Malesci, Carla Laria, Giovanni Freda, Valeria Del Vecchio, Antonietta Mallardo, Nicola Serra, Gennaro Auletta, Anna Rita Fetoni","doi":"10.3390/audiolres15020037","DOIUrl":"https://doi.org/10.3390/audiolres15020037","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Unilateral hearing loss (UHL) is a relatively common disability condition comprising around 20-50% of all congenital hearing loss (HL). The adverse effects of UHL affect the typical development of auditory function with implications for communication, speech and language acquisition, academic development and quality of life. Current literature suggests an early intervention treatment in order to avoid developmental delays, but there is a lack of evidence about the effectiveness and use of hearing devices. The purpose of the present study was to evaluate the benefits of rehabilitative strategies such as hearing aid (HA) and cochlear implant (CI) in UHL children by exploring audiological and parent-reported outcomes. <b>Methods</b>: A total of 18 UHL children, between the ages of 3 and 17, were enrolled in the study designed as a prospective longitudinal study from July 2023 to July 2024. All children were evaluated for speech perception in quiet and noise and subjective benefits before and after rehabilitative treatment with HA in 15 (83.3%) children and with CI in 3 (16.7%) children. <b>Results</b>: The evaluation of audiological outcomes in children with UHL, based on assessment of aided sound field thresholds and speech perception scores assessment versus unaided, shows improvements in audiometric thresholds and how the hearing devices adequately support listening and spoken language. Scores with hearing devices were significantly higher than baseline-only scores when averaging both SSQ and CHILD questionnaires, pointing to an overall rehabilitative benefit. <b>Conclusions</b>: Rehabilitative interventions, particularly HA and CI, offer notable benefits when introduced early, but achieving optimal outcomes requires a multidisciplinary and individualized approach.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Assessment of Cochlear Nerve Function During Cochlear Implantation Using the Auditory Nerve Test Stimulator.","authors":"Karin Hallin, Nadine Schart-Morén","doi":"10.3390/audiolres15020036","DOIUrl":"https://doi.org/10.3390/audiolres15020036","url":null,"abstract":"<p><strong>Background/objectives: </strong>A crucial factor for a successful cochlear implant (CI) outcome is an intact auditory nerve (AN). The integrity of the AN can be tested during implantation by measuring electrical auditory brainstem responses (eABR) via the CI. A method that does not require a CI is the use of the auditory nerve test stimulator (ANTS) from MED-EL (Innsbruck, Austria). The aim of the current study was to investigate the cases tested with the ANTS at our clinic and to describe the hearing results following CI for the cases who were implanted with a CI.</p><p><strong>Methods: </strong>All patients underwent preoperative magnetic resonance imaging (MRI) and high-resolution computed tomography (HRCT) to rule out cochlear malformation or retrocochlear pathology. In this study, we described all cases from when we began using the ANTS in 2011.</p><p><strong>Results: </strong>Five patients were tested intraoperatively: three adults with long-term deafness prior to CI and two children with no detectable AN. Three of the five patients were implanted with a CI. All implanted patients in this study could hear with their CIs, even though the speech perception results were limited.</p><p><strong>Conclusions: </strong>The ANTS can be used as a method to assess cochlear nerve function during implantation. The eABR results from the ANTS and the implanted CI were comparable for all cases in our study. Minor changes in waveform latencies were found between ANTS and CI stimulation and may be explained by the insertion depth of the electrode used for stimulation.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Machine Learning for Analysis of Wideband Acoustic Immittance and Assessment of Middle Ear Function in Infants.","authors":"Shan Peng, Yukun Zhao, Xinyi Yao, Huilin Yin, Bei Ma, Ke Liu, Gang Li, Yang Cao","doi":"10.3390/audiolres15020035","DOIUrl":"https://doi.org/10.3390/audiolres15020035","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluating middle ear function is essential for interpreting screening results and prioritizing diagnostic referrals for infants with hearing impairments. Wideband Acoustic Immittance (WAI) technology offers a comprehensive approach by utilizing sound stimuli across various frequencies, providing a deeper understanding of ear physiology. However, current clinical practices often restrict WAI data analysis to peak information at specific frequencies, limiting its comprehensiveness.</p><p><strong>Design: </strong>In this study, we developed five machine learning models-feedforward neural network, convolutional neural network, kernel density estimation, random forest, and support vector machine-to extract features from wideband acoustic immittance data collected from newborns aged 2-6 months. These models were trained to predict and assess the normalcy of middle ear function in the samples.</p><p><strong>Results: </strong>The integrated machine learning models achieved an average accuracy exceeding 90% in the test set, with various classification performance metrics (accuracy, precision, recall, F1 score, MCC) surpassing 0.8. Furthermore, we developed a program based on ML models with an interactive GUI interface. The software is available for free download.</p><p><strong>Conclusions: </strong>This study showcases the capability to automatically diagnose middle ear function in infants based on WAI data. While not intended for diagnosing specific pathologies, the approach provides valuable insights to guide follow-up testing and clinical decision-making, supporting the early identification and management of auditory conditions in newborns.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of Newborn Hearing Screening Programs in Saudi Arabia: A Systematic Review.","authors":"Ahmad A Alanazi, Nannette Nicholson","doi":"10.3390/audiolres15020034","DOIUrl":"https://doi.org/10.3390/audiolres15020034","url":null,"abstract":"<p><strong>Background/objectives: </strong>Although newborn hearing screening (NHS) programs have been successfully implemented in many countries worldwide, challenges to these programs have been reported in the literature, such as a lack of awareness among families and healthcare professionals and limited funding. Challenges to the NHS programs in Saudi Arabia have not been systematically reported. This study aimed to assess the level and quality of evidence supporting the existing challenges of the NHS programs in Saudi Arabia.</p><p><strong>Methods: </strong>A systematic review of all peer-reviewed literature on Saudi NHS programs published between 2016 and 2024 was conducted according to the PRISMA guidelines. Search strategies were executed in seven databases. Data were collected from studies that met the inclusion criteria.</p><p><strong>Results: </strong>A total of 37 records were reviewed, and 13 peer-reviewed publications met the inclusion criteria. Characteristics of included studies were classified by study language, study sample, sample size, location of the study sample, study purpose, and study method via evidence tables. Each study was critically appraised according to the quality. Results revealed that cross-sectional prospective description was the main research design with low strength of evidence. Six main challenges were identified and described: lack of awareness and gaps in knowledge, lost to follow-up, inadequate data entry, management, and tracking system, limited or absence of services in some residential areas, insufficient training and frequent changes of NHS personnel, and absence of a standardized NHS protocol.</p><p><strong>Conclusions: </strong>This review may assist in overcoming these challenges and improving the NHS programs in Saudi Arabia. There is a need to establish national education campaigns about the NHS programs, improve documentation by using database management and tracking systems, and expand the early hearing detection and intervention (EHDI) services for children in all Saudi regions.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nystagmus and Vertigo During Aural Toilet Using Microsuction.","authors":"Chang-Hee Kim, Minho Jang, Taehee Kim, JiAh Kim, ChanEui Hong, Dong-Han Lee, Jung Eun Shin","doi":"10.3390/audiolres15020033","DOIUrl":"10.3390/audiolres15020033","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Aural toilet using microsuction is a common procedure in ENT clinics, and vertigo is a frequent complaint during this procedure. This study aimed to investigate the characteristics and incidence of microsuction-induced nystagmus and vertigo based on the appearance of the tympanic membrane (TM). <b>Methods</b>: In 85 patients with various TM appearances, microsuction-induced vertigo and nystagmus were assessed. <b>Results</b>: Microsuction elicited nystagmus in 95% (81 of 85) of patients and vertigo in 36% (31 of 85). The nystagmus direction was towards the ipsilateral ear in a bowing position and towards the contralateral ear in a leaning position. The proportion of patients who complained of rotatory vertigo was significantly higher in those with TM perforation, open cavity mastoidectomy, and adhesive otitis media (74%, 26 of 35) compared to those without TM perforation (10%, 5 of 50) (<i>p</i> < 0.001, X² test). <b>Conclusions</b>: Aural toilet using microsuction commonly induces vertigo due to convection in the lateral semicircular canal endolymph caused by the cooling effect. While microsuction-induced nystagmus was observed in most patients, the incidence of vertigo varied depending on the TM condition. Clinicians should closely monitor patients for vertigo during the procedure, and methods to prevent microsuction-induced vertigo should be explored.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Potential Pathomechanisms Behind an Impaired Canal Function at the Video-Head Impulse Test in Canal Dehiscence. Reply to Ionescu et al. Comment on \"Castellucci et al. Impaired Vestibulo-Ocular Reflex on Video Head Impulse Test in Superior Canal Dehiscence: \"Spontaneous Plugging\" or Endolymphatic Flow Dissipation? <i>Audiol. Res.</i> 2023, <i>13</i>, 802-820\".","authors":"Pasquale Malara, Salvatore Martellucci, Andrea Castellucci","doi":"10.3390/audiolres15020032","DOIUrl":"10.3390/audiolres15020032","url":null,"abstract":"<p><p>We read with great interest the comment on our articles of Dr [...].</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Carotid and Vertebral Doppler Ultrasonography and Brain MRI Abnormalities on Hearing Levels, Tinnitus Intensities and Frequencies.","authors":"András Molnár, Viktória Molnár, Panayiota Mavrogeni, Stefani Maihoub","doi":"10.3390/audiolres15020029","DOIUrl":"10.3390/audiolres15020029","url":null,"abstract":"<p><p><b>Objectives</b>: This study aimed to analyse the potential influence of abnormalities detected through carotid-vertebral ultrasonography and brain MRI on pure-tone averages (PTAs) and the frequency and intensity of tinnitus. <b>Methods</b>: 423 participants with subjective tinnitus were enrolled in this investigation. All patients underwent carotid- vertebral ultrasonography, brain MRI, and pure-tone audiometry, including tinnitus matching. <b>Results</b>: The median values for tinnitus onset indicated chronic tinnitus in most cases. Regarding tinnitus location, left-sided symptoms (32%) and bilateral symptoms (44%) were the most prevalent. In analysing the effects of abnormalities detected by carotid-vertebral ultrasonography on PTAs, a statistically significant difference was found between the groups (<i>p</i> = 0.0037). Specifically, individuals with intimal hyperplasia had significantly higher PTAs (<i>p</i> = 0.02), as did those with carotid artery plaques (<i>p</i> = 0.005). However, no significant differences in PTAs were noted in relation to carotid artery stenosis (<i>p</i> = 0.07). Similar trends emerged regarding tinnitus intensity (<i>p</i> = 0.013), with significantly higher values observed in the presence of any carotid-vertebral ultrasonography abnormalities. In contrast, tinnitus frequencies were not significantly affected (<i>p</i> = 0.401). Regarding brain MRI findings, Fazekas scores of 2 (<i>p</i> = 0.02) and 3 (<i>p</i> = 0.0052) significantly influenced PTAs. For tinnitus intensity, Fazekas scores of 2 (<i>p</i> = 0.0027) and 3 (<i>p</i> = 0.0005), and the presence of acoustic neuromas <i>(p</i> = 0.019), significantly impacted the intensity values. However, tinnitus frequencies were not significantly (<i>p</i> = 0.36) influenced by brain MRI abnormalities. <b>Conclusions</b>: The findings of this study show that carotid-vertebral ultrasonography and brain MRI abnormalities significantly influence PTAs and tinnitus intensities.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"15 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}