Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Implementation and Sustainability of Exercise Interventions in Persons With Spinal Cord Injury: Research Recommendations and Future Directions.","authors":"Matteo Ponzano, Jennifer R Tomasone","doi":"10.46292/sci25-00109","DOIUrl":"https://doi.org/10.46292/sci25-00109","url":null,"abstract":"<p><p>Exercise participation among persons living with a spinal cord injury (PwSCI) typically declines after the end of rehabilitation programs or exercise studies. The limited exercise implementation research involving PwSCI challenges the implementation and sustainability of exercise in the real world. The Physical Activity Special Interest Group of the International Spinal Cord Society developed consensus-based recommendations to improve the methodological quality of exercise intervention research involving PwSCI. Some of the recommendations pertain to intervention delivery fidelity and to exercise sustainability after the end of research studies. This article outlines actionable strategies to utilize such recommendations and provides more in-depth guidance to advance the impact of exercise implementation research involving PwSCI. We suggest research teams follow these strategies, as their adoption and proper reporting will maximize fidelity and exercise sustainability and thus advance SCI exercise implementation research.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"66-75"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057553","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":"Dignified Moving and Handling in Spinal Cord Injury Rehabilitation: A Global Call for Practice Transformation.","authors":"Ishmeet Singh","doi":"10.46292/sci25-00079","DOIUrl":"10.46292/sci25-00079","url":null,"abstract":"<p><p>Safe and dignified moving and handling practices are essential components of spinal cord injury (SCI) rehabilitation. While many high-income health systems integrate mechanical aids and evidence-based protocols to ensure patient and staff safety, moving and handling practices in low- and middle-income countries (LMICs) often continue to involve manually handling patients during transfers. This outdated approach compromises patient safety, increases the risk of pressure injuries, and adversely affects patients' sense of dignity and engagement in rehabilitation. Despite centers being equipped with technological advancements in neurorehabilitation such as robotics, exoskeletons, and virtual reality-based rehabilitation systems, moving and handling remains an under-addressed issue globally. A review of literature shows that most research in this area has focused on caregiver biomechanics and injury prevention, with limited exploration of patient-reported outcomes and dignity-related concerns. There is a critical need for globally harmonized moving and handling standards that uphold patient-centered care principles. By aligning practice with existing evidence on complication prevention and quality of life, healthcare systems can mitigate long-term costs while enhancing rehabilitation outcomes. This article calls for increased research on patient experiences, cross-context collaboration, and policy reform to prioritize dignity, safety, and evidence-based moving and handling practices as core elements of SCI rehabilitation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"132-134"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057535","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":"Individually Tailored Endurance Training During Early Rehabilitation in Individuals with Traumatic Spinal Cord Injury: A Feasibility Study.","authors":"Claudio Perret, Anneke Hertig-Godeschalk, Anna Jegier, Anke Scheel-Sailer, Sylwia Kowalczyk-Jurigel","doi":"10.46292/sci25-00071","DOIUrl":"10.46292/sci25-00071","url":null,"abstract":"<p><strong>Background: </strong>Endurance training after the onset of spinal cord injury (SCI) can support the recovery of function and mobility and should be implemented into the daily routine as early as possible.</p><p><strong>Objectives: </strong>To investigate the feasibility and effects of a new, progressive, individually tailored, mixed-effort endurance training program during early rehabilitation of individuals with traumatic SCI.</p><p><strong>Methods: </strong>Participants performed 3 training sessions of 30- to 45-minute duration every week for 8 weeks, consisting of a mix of moderate endurance, vigorous endurance, and high-intensity interval sessions. Before and after the intervention phase, peak oxygen uptake (VO_2peak) and peak power output (PO_peak) were determined. Additionally, functioning (Spinal Cord Independence Measure [SCIM]) and well-being (12-item Short Form Survey [SF-12]) were assessed.</p><p><strong>Results: </strong>Thirteen (9 M/4 F) individuals with paraplegia (median [Q1-Q3] age 42 [24-50] years) started the training intervention 14 (12-17) weeks after the onset of traumatic SCI. Training compliance was 92%. Participants trained at an average of 78% (75-81) of peak heart rate. VO_2peak and PO_peak significantly increased by 8.8% (1.9-32.4) (<i>P</i> = .003) and 20% (16-29) (<i>P</i> < .001), respectively. Total SCIM score [+24% (6-33), <i>P</i> = .002] and the physical component of the SF-12 [+14% (8-21), <i>P</i> = .001] also improved.</p><p><strong>Conclusion: </strong>The newly developed individually tailored endurance training program improved endurance capacity and performance in individuals with traumatic paraplegia during early rehabilitation. The implementation of such a structured endurance training program can support individuals with SCI to achieve optimal functioning, mobility, independence, and well-being at the end of the early rehabilitation process.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"146-157"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057562","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":"Factors That Influence the Clinical Outcome After Tendon Transfer Surgery to Restore Grip Function in Individuals With Tetraplegia.","authors":"Therese Ramström, Johanna Wangdell, Jennifer Dunn, Carina Reinholdt, Lina Bunketorp Käll","doi":"10.46292/sci24-00084","DOIUrl":"10.46292/sci24-00084","url":null,"abstract":"<p><strong>Background: </strong>Approximately 50% of spinal cord injuries (SCI) occur at the cervical level, resulting in significant loss of arm and hand function. Restoration of upper limb function is a high priority, and many opt for upper limb reconstructive surgeries to improve daily activities and psychological well-being.</p><p><strong>Objectives: </strong>This retrospective multicenter study investigates whether demographic data (sex and age) and clinical characteristics (type of SCI and years since injury) are related to the outcome of upper limb reconstructive surgery.</p><p><strong>Methods: </strong>Data were extracted from medical records of individuals with an SCI who underwent surgery in Sweden and New Zealand. Muscle strength (pinch, grip) and grasp ability were measured before surgery and at 6 or 12 months after surgery using standard methods. Statistical analyses included univariable and multivariable linear regression to assess the association between outcomes and predictors. Outcomes were available for 183 arms at follow-up, assessed through at least one of the response variables: grip strength, pinch strength, or grasp ability.</p><p><strong>Results: </strong>The analyses demonstrated that by using regression models, we could explain 24% to 31% of the variation in pinch strength, grip strength, and grasp ability. The variables of sex, age, and level and severity of injury did explain a small but statistically significant proportion of the variance in pinch strength, grip strength, and grasp ability. Years after injury had no influence on the variation in outcome scores.</p><p><strong>Conclusion: </strong>The findings suggest that demographic and injury-related factors partially explain the variation in functional outcomes after surgery, providing valuable insights for clinical decision-making and managing patient expectations.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"1-11"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285452","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":"AI in the Wild: A Pilot Deployment of an AI-Enhanced Robot-Assisted Feeding System at a Rehab Hospital.","authors":"Jacob Miller, Claire Foley, Gina Kubec, Ian Burkhart, Nicholas Zingale, Eric Schearer","doi":"10.46292/sci26-00005","DOIUrl":"10.46292/sci26-00005","url":null,"abstract":"<p><strong>Background: </strong>Assistive robots have the potential to mitigate the caregiver shortage crisis and increase independence for individuals with spinal cord injury (SCI). Advances in artificial intelligence (AI) have improved the capabilities of assistive robots, however they still lack evaluation outside of controlled laboratory settings.</p><p><strong>Objectives: </strong>To evaluate the technical performance, usability, and workload of an AI-enhanced robot-assisted feeding (RAF) system deployed in an inpatient SCI rehabilitation unit.</p><p><strong>Methods: </strong>RAF-HI, a system incorporating AI-based food detection, natural language communication, and mouth tracking, was integrated into a rehabilitation hospital. Two participants with SCI used the system to eat 8 modified hospital meals in their private rooms. System performance metrics (bite acquisition and transfer rates), usability (System Usability Scale [SUS]), workload (NASA Task Load Index [NASA-TLX]), and researcher interventions were recorded.</p><p><strong>Results: </strong>Across the meals, the system had an acquisition rate of 88.4% and a transfer rate of 87.4%, similar to state-of-the-art benchmarks. However, usability and workload scores among participants were poor (NASA-TLX 42.9, SUS 47.5), and frequent researcher interventions were required to keep the system operating (36 total, 4.5 per meal). Participants cited low adaptability and complex setup requirements as obstacles to usability and demonstrated responsibility over their comfort within the interaction.</p><p><strong>Conclusion: </strong>Our use of AI tools successfully achieved technical benchmarks in a hospital environment but fell short of achieving a truly independent meal. We argue advancing RAF systems toward human-inspired, situationally aware intelligence is necessary to translate technical capability into real-world clinical utility.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"28-38"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714248","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 ASIA Data Science Challenge: Predicting Functional and Neurological Recovery from Acute ISNCSCI Scores.","authors":"J Villines, R Stirnimann, L P Lukas, O Taran, M Tuci, Y Li, C R Jutzeler, J L K Kramer, F H Geisler, D Bourbeau, R James Cotton, S C Brüningk","doi":"10.46292/sci25-00137","DOIUrl":"10.46292/sci25-00137","url":null,"abstract":"<p><strong>Background: </strong>Recovery after spinal cord injury (SCI) is driven by a variety of factors, making SCI recovery prediction particularly suitable for data-driven modelling. The American Spinal Injury Association (ASIA) Engineering and Data Science Committee launched the first open SCI data science challenge focused on recovery prediction.</p><p><strong>Objectives: </strong>Hosted on Kaggle in 2025, the challenge addressed 2 tasks using data from the Sygen clinical trial (<i>N</i> = 797): (1) predicting motor status as assessed by the International Standards for Neurological Classification of SCI (ISNCSCI; score: RMSE [root mean square error] between true and predicted motor scores), and (2) predicting walking function on the 8-point modified Benzel scale (score: Spearman's ρ).</p><p><strong>Method: </strong>Eight teams participated in the motor status track and 14 in the walking function track. The winning solution (RMSE = 1.0) in the motor status track applied an ensemble of boosting models with multiple imputation and Bayesian hyperparameter optimization, whereas the winning solution in the walking function track (Spearman's ρ = 0.85) harnessed TabPFN, a pretrained transformer for tabular data, combined with feature engineering from early ISNCSCI assessments and auxiliary predictions of future motor scores.</p><p><strong>Results: </strong>Both approaches demonstrated competitive performance for SCI recovery prediction from acute phase assessments, despite modest dataset size and missing data. Both winning solutions further conducted an interpretability analysis, identifying key predictors consistent with clinical understanding of SCI recovery.</p><p><strong>Conclusion: </strong>This challenge highlights the value of publicly accessible formats, which encourage broader engagement of diverse audiences, for developing robust predictive models and provides a proof of concept for future initiatives leveraging larger, multicenter, multimodal datasets to improve personalized prognostication in SCI rehabilitation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"12-23"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714008","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":"AI-Supported Practice in ASIA Education: A Conservative, Scalable Model.","authors":"Cristina Sadowsky, Megan Torrance","doi":"10.46292/sci26-00006","DOIUrl":"10.46292/sci26-00006","url":null,"abstract":"<p><p>The recently (2024) launched American Spinal Injury Association (ASIA) e-learning module UroSTeP: Urology course is getting a modern upgrade with artificial intelligence (AI)-based clinical cases developed to refine and cement knowledge acquisition. AI-based learning is not only accepted but is also required nowadays, and the conservatism of medicine is traditionally not conducive to early adoption. Here, we try to explain why and how it can be done.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"24-27"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714265","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":"Feasibility and Acceptability of an App-Based Mindfulness Meditation Intervention for People with Spinal Cord Injury and Chronic Pain.","authors":"Radha Korupolu, Chelsea G Ratcliff, Shrasti Lohiya, Heather B Taylor, Ruosha Li, Susan Robinson-Whelen","doi":"10.46292/sci25-00038","DOIUrl":"10.46292/sci25-00038","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the feasibility and acceptability of an app-guided mindfulness meditation (MM) intervention compared to a health education (HE) control for individuals with spinal cord injury (SCI) and chronic pain.</p><p><strong>Methods: </strong>A pilot randomized controlled trial recruited 60 individuals with SCI and chronic pain from local SCI outpatient clinics, national registries, and community outreach. Participants were randomly assigned to MM or HE conditions. The intervention involved listening to either guided meditations or health-related talks on a mobile app for 10 minutes/day, 6 days/week, for 6 weeks. Feasibility was determined via benchmarks for recruitment (≥80% consent rate), adherence (≥70% use app ≥60 minutes/week for 6 weeks), and retention (≥70% complete follow-up assessments). Acceptability was determined if ≥70% of participants reported a score of ≥20 on a satisfaction questionnaire. Participants also completed ratings of pain intensity, interference, depression, and anxiety at baseline (T1), immediately post intervention (T2), and 6 weeks post intervention (T3).</p><p><strong>Results: </strong>A total of 93% of eligible participants consented, 76% completed T2, and 86% completed T3 assessments. Adherence rates fell below the benchmark for MM (63%) and HE (62%) but exceeded the benchmark when considering only participants who used the app at least once (MM, 71%; HE, 80%). Eighty-two percent of MM and 84% of HE scored ≥20 on the satisfaction questionnaire.</p><p><strong>Conclusion: </strong>A 6-week MM intervention using a no-cost, publicly available app is feasible and acceptable among people with SCI and chronic pain. Future research examining the efficacy of the MM intervention on pain and mood in this population is warranted.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"78-93"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714033","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":"Prevalence of Neurogenic Bowel and Lower Urinary Tract Dysfunctions in Brazilians With Traumatic and Nontraumatic Spinal Cord Injury.","authors":"Eliz Ferreira, Geyslane Albuquerque, Luís M M Sousa, Filipe Lopes, Ana Paula S Champs, Fabiana Faleiros","doi":"10.46292/sci26-00030","DOIUrl":"10.46292/sci26-00030","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bowel dysfunction and neurogenic lower urinary tract dysfunction are often associated with spinal cord injury (SCI). In Brazil, studies and statistical data on these dysfunctions are scarce.</p><p><strong>Objectives: </strong>To estimate the prevalence of neurogenic bowel dysfunction and neurogenic lower urinary tract dysfunction in Brazilians diagnosed with traumatic and nontraumatic SCI.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, a form was used to collect sociodemographic and clinical data from medical records. The Mann-Whitney statistical tests were used for 2 independent samples, Pearson's chi-square test for categorical variables, and the Kruskal-Wallis test for more than 2 independent samples for quantitative variables. A logistic regression model was used to understand the factors associated with neurogenic bowel dysfunction.</p><p><strong>Results: </strong>The sample comprised 1056 participants from all regions of Brazil. Of this sample, 60.90% had traumatic SCI, and 69.03% were male. The prevalence of neurogenic bowel dysfunction in the sample was 88%, and the prevalence of neurogenic lower urinary tract dysfunction was 90.6%. Participants with traumatic SCI are more affected by neurogenic bowel and lower urinary tract dysfunction than those with nontraumatic SCI.</p><p><strong>Conclusion: </strong>Most people with SCI have neurogenic lower urinary tract and bowel alterations, especially those with traumatic SCI. Further studies are needed, and bowel and bladder reeducation programs should be provided in rehabilitation centers.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"30-37"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481488","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":"Measuring Outcomes and Controlling Confounding Variables in Exercise Intervention Trials for Spinal Cord Injury.","authors":"Gary J Farkas, Guillermo Mederos Hernandez, Tom E Nightingale, Glen M Davis, Mark S Nash","doi":"10.46292/sci25-00086","DOIUrl":"https://doi.org/10.46292/sci25-00086","url":null,"abstract":"<p><strong>Background: </strong>Designing exercise intervention trials in individuals with spinal cord injury (SCI) requires purposeful outcome measure selection and control of confounding variables.</p><p><strong>Objectives: </strong>This article provides guidance to operationalize consensus recommendations from the International Spinal Cord Society (ISCoS) Physical Activity Special Interest Group.</p><p><strong>Methods: </strong>We outline strategies to align outcome measures with study aims, ensure validity and reliability, and adapt testing protocols to accommodate functional limitations. Key domains include cardiorespiratory fitness, anaerobic capacity, muscular strength, patient-centered outcomes (e.g., quality of life), and functional performance. We emphasize standardized assessment procedures, staff training, and participant safety, particularly for individuals with injuries experiencing autonomic instability. Confounding variables, including injury characteristics, comorbidities, medications, and behavioral or environmental factors, are identified and addressed through protocol design, measurement, and analysis strategies. These include fidelity to a prior protocol design, eligibility criteria, stratification, standardized testing conditions, covariate adjustment, and sensitivity analyses.</p><p><strong>Conclusion: </strong>Engaging individuals with SCI and rehabilitation professionals (when appropriate) in the process of outcome selection enhances study relevance and translational impact. By implementing these recommendations, researchers can improve the validity, reproducibility, and clinical applicability of SCI exercise trials. Future work should focus on harmonizing protocols to enable pooled analyses, thereby advancing evidence-based guidelines for exercise programs specific to SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"19-33"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057533","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}