{"title":"A Review for automated classification of knee osteoarthritis using KL grading scheme for X-rays.","authors":"Tayyaba Tariq, Zobia Suhail, Zubair Nawaz","doi":"10.1007/s13534-024-00437-5","DOIUrl":"https://doi.org/10.1007/s13534-024-00437-5","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a musculoskeletal disorder that affects weight-bearing joints like the hip, knee, spine, feet, and fingers. It is a chronic disorder that causes joint stiffness and leads to functional impairment. Knee osteoarthritis (KOA) is a degenerative knee joint disease that is a significant disability for over 60 years old, with the most prevalent symptom of knee pain. Radiography is the gold standard for the evaluation of KOA. These radiographs are evaluated using different classification systems. Kellgren and Lawrence's (KL) classification system is used to classify X-rays into five classes (Normal = 0 to Severe = 4) based on osteoarthritis severity levels. In recent years, with the advent of artificial intelligence, machine learning, and deep learning, more emphasis has been given to automated medical diagnostic systems or decision support systems. Computer-aided diagnosis is needed for the improvement of health-related information systems. This survey aims to review the latest advances in automated radiographic classification and detection of KOA using the KL system. A total of 85 articles are reviewed as original research or survey articles. This survey will benefit researchers, practitioners, and medical experts interested in X-rays-based KOA diagnosis and prediction.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"1-35"},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956887","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":"Excessive propagation of right frontal beta oscillations in patients with a history of major depressive disorder.","authors":"Duho Sihn, Sung-Phil Kim","doi":"10.1007/s13534-024-00433-9","DOIUrl":"https://doi.org/10.1007/s13534-024-00433-9","url":null,"abstract":"<p><p>Patients suffering from various neurological disorders, including major depressive disorder (MDD), often exhibit abnormal brain connectivity. In particular, patients with MDD show atypical brain oscillations propagation. This study aims to investigate an association between abnormal brain connectivity and atypical oscillatory propagation of electroencephalogram (EEG) signals in patients with a history of MDD. Previous findings of functional hyperconnectivity in beta oscillations (15-25 Hz) lead us to hypothesize that patients would experience abnormal beta oscillation propagation. Using the local phase gradient (LPG) method, we analyze a publicly available EEG dataset recorded during a probabilistic learning task. Our findings indicate that, upon receiving positive feedback during the learning task, patients with a history of MDD show more pronounced propagation directions of beta oscillations observed in the right frontal region compared to healthy controls. This directional pattern may help differentiate patients with a history of MDD from healthy controls. The observed abnormalities in brain oscillation propagation suggest that cognitive deficits in patients with a history of MDD might stem from excessive and negatively biased information transmission between brain regions.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13534-024-00433-9.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"159-168"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956551","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":"Driver fatigue recognition using limited amount of individual electroencephalogram.","authors":"Pukyeong Seo, Hyun Kim, Kyung Hwan Kim","doi":"10.1007/s13534-024-00431-x","DOIUrl":"https://doi.org/10.1007/s13534-024-00431-x","url":null,"abstract":"<p><p>This study aims to create a fatigue recognition system that utilizes electroencephalogram (EEG) signals to assess a driver's physiological and mental state, with the goal of minimizing the risk of road accidents by detecting driver fatigue regardless of physical cues or vehicle attributes. A fatigue state recognition system was developed using transfer learning applied to partial ensemble averaged EEG power spectral density (PSD). The study utilized layer-wise relevance propagation (LRP) analysis to identify critical cortical regions and frequency bands for effective fatigue discrimination. A total of 21 participants were included in the study, and data augmentation techniques were used to enhance the system's classification accuracy. The results indicate a significant improvement in classification accuracy, particularly with the application of data augmentation. The classification accuracies were 99.2 ± 2.3% for the training data, 97.9 ± 3.1% for the validation data, and 96.9 ± 3.3% for the test data. This study advances the development of personalized EEG-based fatigue monitoring systems that have the potential to improve road safety and reduce accidents. The findings highlight the utility of EEG signals in detecting fatigue and the benefits of data augmentation in improving system performance. Further research is recommended to optimize data augmentation strategies and enhance the scalability and efficiency of the system.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13534-024-00431-x.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"143-157"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956873","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}
Seung Min Ryu, Keewon Shin, Chang Hyun Doh, Hui Ben, Ji Yeon Park, Kyoung-Hwan Koh, Hangsik Shin, In-Ho Jeon
{"title":"Orthopedic surgeon level joint angle assessment with artificial intelligence based on photography: a pilot study.","authors":"Seung Min Ryu, Keewon Shin, Chang Hyun Doh, Hui Ben, Ji Yeon Park, Kyoung-Hwan Koh, Hangsik Shin, In-Ho Jeon","doi":"10.1007/s13534-024-00432-w","DOIUrl":"https://doi.org/10.1007/s13534-024-00432-w","url":null,"abstract":"<p><p>Accurate assessment of shoulder range of motion (ROM) is crucial for evaluating patient progress. Traditional manual goniometry often lacks precision and is subject to inter-observer variability, especially in measuring shoulder internal rotation (IR). This study introduces an artificial intelligence (AI)-based approach that uses clinical photography to improve the accuracy of ROM quantification. We analyzed a total of 150 clinical photographs, including 100 shoulder and 50 elbow images, taken between January and April 2022. An MMPose model with an HR-NET backbone architecture, pre-trained on the COCO-WholeBody dataset, was used to detect 17 anatomical landmarks. A random forest classifier (PoseRF) then categorized poses, and ROM angles were calculated. Concurrently, two clinicians independently measured shoulder IR at the vertebral level, and inter-observer agreement was evaluated. Linear regression analyses were conducted to correlate the AI-derived measurements with the clinicians' assessments. The AI-based algorithm accurately detected anatomical landmarks in 96% of shoulder and 100% of elbow images. Pose detection achieved 95% accuracy overall, with 100% accuracy for specific shoulder (abduction, flexion, external rotation) and elbow (flexion, extension) poses. Intraclass correlation coefficients (ICCs) between the AI algorithm and human observers ranged from 0.965 to 0.997, indicating excellent inter-observer reliability. Kruskal-Wallis test showed no statistically significant differences in ROM measurements among the AI algorithm and two human observers across all joint angles (<i>p</i> > 0.05). The AI-based algorithm demonstrated performance comparable to that of human observers in quantifying shoulder and elbow ROM from clinical photographs. For shoulder internal rotation, the AI approach showed potential for improved consistency compared to traditional methods.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13534-024-00432-w.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"131-142"},"PeriodicalIF":3.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956509","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":"Gaussianmorph: deformable medical image registration with Gaussian noise constraints.","authors":"Ranran Zhang, Shunbo Hu, Wenyin Zhang, Yuwen Wang, Zunrui Hu, Yongfang Wang, Dezhuang Kong, Hongchao Zhou, Meng Li, Desley Munashe Gurure, Yingying Wen, Chengchao Wang, Shiyu Liu","doi":"10.1007/s13534-024-00428-6","DOIUrl":"https://doi.org/10.1007/s13534-024-00428-6","url":null,"abstract":"<p><p>Deep learning-based image registration methods offer advantages of time efficiency and registration outcomes by automatically extracting enough image features. Currently, more and more scholars choose to use cascaded networks to achieve coarse-to-fine registration. Although cascaded networks take a lot of time in the training and inference stages, they can improve registration performance. In this study, we utilize the advantage of high registration performance of cascaded networks. Two VoxelMorph convolutional neural networks are cascaded together. The first VoxelMorph network outputs the dense deformation field of registration. The second network outputs a noisy deformation field, which serves to boost the registration performance by minimizing the error in comparison with Gaussian noise. At the same time, the Enhancement Features-encoder (EF-encoder) block is introduced in the encoder and decoder part of the network to achieve enhancement features functions by attention mechanism. This paper conducted experiments on LPBA40 and HBN datasets. The experimental results show that the Dice similarity coefficient, Average Symmetric Surface Distance, Structural similarity and Pearson correlation coefficient of GaussianMorph are better than those of VM, VM × 2 and TST-Net. Experimental results show that GaussianMorph can improve the registration accuracy.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"105-115"},"PeriodicalIF":3.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956555","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}
HyunSub Kim, Chunghwan Kim, Chaeyoon Kim, HwyKuen Kwak, Chang-Hwan Im
{"title":"New user authentication method based on eye-writing patterns identified from electrooculography for virtual reality applications.","authors":"HyunSub Kim, Chunghwan Kim, Chaeyoon Kim, HwyKuen Kwak, Chang-Hwan Im","doi":"10.1007/s13534-024-00426-8","DOIUrl":"https://doi.org/10.1007/s13534-024-00426-8","url":null,"abstract":"<p><p>Demand for user authentication in virtual reality (VR) applications is increasing such as in-app payments, password manager, and access to private data. Traditionally, hand controllers have been widely used for the user authentication in VR environment, with which the users can typewrite a password or draw a pre-registered pattern; however, the conventional approaches are generally inconvenient and time-consuming. In this study, we proposed a new user authentication method based on eye-writing patterns identified using electrooculogram (EOG) recorded from four locations around the eyes in contact with the face-pad of a VR headset. EOG data acquired during eye-writing a specific pattern are converted into a ten-dimensional vector, named a similarity vector, by calculating similarity values between the EOG data for the current pattern and ten pre-defined template patterns using dynamic positional warping. If the specific pattern corresponds to password, the similarity vector will have shorter distance to a similarity vector of the pre-registered password than an individually pre-determined threshold value. Nineteen participants were instructed to eye-write ten template patterns and five designated patterns to evaluate the performance of the proposed method. A specific user's similarity vectors were computed using the other users' template EOG data, employing the leave-one-subject-out cross-validation scheme. The proposed method exhibited an average accuracy of 97.74%, with a false accept rate of 1.31% and a false reject rate of 3.50%. The proposed method would provide a new effective way to secure private data in practical VR applications with edge devices because it does not require heavy computational burden.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"95-104"},"PeriodicalIF":3.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956505","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}
Ana González-Suárez, Cian Kerrigan, Jason McNamara, Seán Kinsella, Maeve Duffy
{"title":"Computer modelling and vegetable bench test of a bipolar electrode array intended for use in high frequency irreversible electroporation treatment of skin cancer.","authors":"Ana González-Suárez, Cian Kerrigan, Jason McNamara, Seán Kinsella, Maeve Duffy","doi":"10.1007/s13534-024-00421-z","DOIUrl":"https://doi.org/10.1007/s13534-024-00421-z","url":null,"abstract":"<p><strong>Purpose: </strong>Pulsed electrical field (PEF) ablation is an energy-based technique used to treat a range of cancers by irreversible electroporation (IRE). Our objective was to use computational and plant-based models to characterize the electric field distribution and ablation zones induced with a commercial 8-needle array-based applicator intended for treatment of skin cancer when high-frequency IRE (H-FIRE) pulses are applied. Electric field characterisation of this device was not previously assessed.</p><p><strong>Methods: </strong>Vegetable experimental were conducted using parallel plate electrodes to obtain the lethal threshold for H-FIRE pulses. Then a 3D computational model of the applicator was built mimicking the experimental conditions. The computational ablation zones were validated with the experiments for different voltage levels ranging from 220 to 525 V.</p><p><strong>Results: </strong>A threshold of 453 V/cm was estimated for H-FIRE pulses, which was used to predict computationally the ablation zones. It was found that the model showed a low prediction error, ranging from 2% for the minor diameter to 4.5% for the depth compared with experiments. Voltages higher than 370 V created an ablation volume with a rectangular prism shape determined by the positions of the needles, whereas lower voltages provoked the appearance of untreated areas (gaps).</p><p><strong>Conclusions: </strong>Our computer model predicts reasonably well the ablation zone induced by H-FIRE pulses, suggesting that a sufficiently large voltage must be applied to avoid the appearance of gaps. The validated model with vegetable experiments could serve as the basis for future computer studies to predict the behaviour of this device on heterogeneous tissues.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"69-79"},"PeriodicalIF":3.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956872","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}
Lina Agyekumwaa Asante, Sung Bin Park, Seungkwan Cho, Jun Won Choi, Han Sung Kim
{"title":"Assessment of conductive textile-based electrocardiogram measurement for the development of a lonely death prevention system.","authors":"Lina Agyekumwaa Asante, Sung Bin Park, Seungkwan Cho, Jun Won Choi, Han Sung Kim","doi":"10.1007/s13534-024-00422-y","DOIUrl":"https://doi.org/10.1007/s13534-024-00422-y","url":null,"abstract":"<p><p>The rise in individuals living alone in ageing societies raises concerns about social isolation and associated health risks, notably lonely deaths among the elderly. Traditional electrocardiogram (ECG) monitoring systems, reliant on intrusive and potentially irritating electrodes, pose practical challenges. This study examines the efficacy of conductive textile electrodes (CTEs) vis-á-vis conventional electrodes (CEs) in ECG monitoring, along with the effect of electrode positioning. Twenty subjects without cardiovascular conditions, were monitored using a commercial ECG device (HiCardi+) with both CEs and CTEs. The CTEs were tested in two experiments: at the nape and left hand (position 1), and at the nape and legs (position 2). Each experiment placed one HiCardi + SmartPatch with CE at its standard position, while the other used CTEs. ECG signals were processed using the Pan-Tompkins algorithm, and heart rate variability (HRV) metrics were analysed. Significant improvements in signal-to-noise ratio (SNR) were observed after filtering. There were no significant differences (<i>p</i> > 0.05) in time-domain HRV metrics between CEs and CTEs, though CTEs showed superior R peak characteristics and reduced noise sensitivity. Additionally, no significant position effect (<i>p</i> > 0.05) was noted within the CTE group. Nonlinear analysis further confirmed the efficacy of the CTEs. Our findings suggest that CTEs offer a comfortable, non-intrusive alternative to conventional ECG electrodes, enhancing ECG monitoring and contributing to the development of a \"lonely death prevention system\".</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"15 1","pages":"57-67"},"PeriodicalIF":3.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956870","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}
Adrian Ryser, Tobias Reichlin, Jürgen Burger, Thomas Niederhauser, Andreas Haeberlin
{"title":"A rate-responsive duty-cycling protocol for leadless pacemaker synchronization.","authors":"Adrian Ryser, Tobias Reichlin, Jürgen Burger, Thomas Niederhauser, Andreas Haeberlin","doi":"10.1007/s13534-024-00413-z","DOIUrl":"10.1007/s13534-024-00413-z","url":null,"abstract":"<p><p>Dual-chamber leadless pacemakers (LLPMs) consist of two implants, one in the right atrium and one in the right ventricle. Inter-device communication, required for atrioventricular (AV) synchrony, however, reduces the projected longevity of commercial dual-chamber LLPMs by 35-45%. This work analyzes the power-saving potential and the resulting impact on AV-synchrony for a novel LLPM synchronization protocol. Relevant parameters of the proposed window scheduling algorithm were optimized with system-level simulations investigating the resulting trade-off between transceiver current consumption and AV-synchrony. The parameter set included the algorithm's setpoint for the target number of windows per cardiac cycle and the number of averaging cycles used in the window update calculation. The sensing inputs for the LLPM model were derived from human electrocardiogram recordings in the MIT-BIH Arrhythmia Database. Transceiver current consumption was estimated by combining the simulation results on the required communication resources with electrical measurements of a receiver microchip developed for LLPM synchronization in previous work. The performance ratio given by AV-synchrony divided by current consumption was maximized for a target of one window per cardiac cycle and three averaging cycles. Median transceiver current of both LLPMs combined was 166 nA (interquartile range: 152-183 nA) and median AV-synchrony was 92.5%. This corresponded to median reduction of 18.3% and 3.2% in current consumption and AV-synchrony, respectively, compared to a non-rate-responsive implementation of the same protocol, which prioritized maximum AV-synchrony. In conclusion, adopting a rate-responsive communication protocol may significantly increase device longevity of dual-chamber LLPMs without compromising AV-synchrony, potentially reducing the frequency of device replacements.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"14 6","pages":"1397-1407"},"PeriodicalIF":3.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510255","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":"Spiking neural networks for physiological and speech signals: a review.","authors":"Sung Soo Park, Young-Seok Choi","doi":"10.1007/s13534-024-00404-0","DOIUrl":"10.1007/s13534-024-00404-0","url":null,"abstract":"<p><p>The integration of Spiking Neural Networks (SNNs) into the analysis and interpretation of physiological and speech signals has emerged as a groundbreaking approach, offering enhanced performance and deeper insights into the underlying biological processes. This review aims to summarize key advances, methodologies, and applications of SNNs within these domains, highlighting their unique ability to mimic the temporal dynamics and efficiency of the human brain. We dive into the core principles of SNNs, their neurobiological underpinnings, and the computational advantages they bring to signal processing, particularly in handling the temporal and spatial complexities inherent in physiological and speech data. Comparative analyses with conventional neural network models are presented to underscore the superior efficiency, lower power consumption, and higher temporal resolution of SNNs. The review further explores challenges and future prospects, highlighting the potential of SNNs to revolutionize wearable healthcare monitoring systems, neuroprosthetic devices, and natural language processing technologies. By providing a comprehensive overview of current strategies, this review aims to inspire innovative approaches in the field, fostering advances in real-time and energy-efficient processing of complex biological signals.</p>","PeriodicalId":46898,"journal":{"name":"Biomedical Engineering Letters","volume":"14 5","pages":"943-954"},"PeriodicalIF":3.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113344","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}