Journal of Voice最新文献

{"title":"Developing Interdisciplinary Competency in Voice Performance: A Phenomenological Study of Higher Education in China.","authors":"He Jiang, Ku Wing Cheong, Henghua Wang, Wenbo Wu, Yuqi Wang","doi":"10.1016/j.jvoice.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.09.006","url":null,"abstract":"<p><p>This phenomenological study investigates the experiences and perceptions of interdisciplinary competencies for voice performance in higher education in China through semistructured interviews with four vocal education experts. Participants were selected via selective sampling based on their teaching experience, theoretical research, location, and professional development contributions. Coding and thematic analyses identify key interdisciplinary domains crucial for voice performers. Physiological and anatomical principles, informed by life sciences, are fundamental for vocal health and technique. Incorporating historical and cultural knowledge enriches performers' interpretive depth and emotional expression. Digital technologies further modernize vocal training and prepare students for contemporary performance environments. The findings illuminate that Chinese interdisciplinary competency in vocal performance has unique characteristics, emphasizing cultural literacy and the fusion of Italian bel canto with Chinese Indigenous vocalization methods, but it has its limitations. This study contributes to the global discourse on higher education voice performance studies by presenting the lived experiences of Chinese voice professors in higher education, which can inspire and inform educational initiatives worldwide.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coactivation of the Laryngeal Muscles in Pigs Without External Neural Control Indicates Existence of an Intrinsic Neuronal Network.","authors":"Rareş-Vasile Tracicaru, Lars Bräuer, Michael Döllinger, Bogdan Ionel Tamba, Andrei Szilagyi, Caratasu Cezar Catalin, Delia Hînganu, Friedrich Paulsen, Marius Valeriu Hînganu","doi":"10.1016/j.jvoice.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.09.004","url":null,"abstract":"<p><p>Electrophysiological studies of the larynx expose the mechanisms by which voice production is controlled. Previous studies have revealed certain phenomena during laryngeal oscillations that suggest a complex control mechanism. Starting from the principle of agonist-antagonist muscular pairing, the aim of this study was to gain a deeper insight into the function of the cricothyroid (CT) and thyroarytenoid (TA) muscles, both central to voice production. Electromyographic recordings were used to determine the response of the two muscles to different stimulation situations in an ex vivo animal model of the denervated larynx of pigs (n=26). Using a set of different experiments, it was shown that when one muscle (CT or TA muscle) was electrically stimulated, a response was observed in the other muscle, which in the otherwise-denervated larynx, was caused only by the applied stimulation and exhibited the characteristics of compound action potentials. This response was reproducible in all larynxes examined and was present bidirectionally. No response was registered in the absence of stimulation. The results show the existence of coactivation of the CT and TA muscles in the absence of external innervation hinting at the presence of a localized neuronal network of the larynx that has not been described previously. Further morphological investigation is needed to determine the presence of this internal laryngeal neuronal network.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Recommendations for Tablet Recordings From the Bridge2AI-Voice Acoustic Experiments.","authors":"Shaheen N Awan, Ruth Bahr, Stephanie Watts, Micah Boyer, Robert Budinsky, Yael Bensoussan","doi":"10.1016/j.jvoice.2024.08.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.029","url":null,"abstract":"<p><strong>Background: </strong>As part of a larger goal to create best practices for voice data collection to fuel voice artificial intelligence (AI) research, the objective of this study was to investigate the ability of readily available iOS and Android tablets with and without low-cost headset microphones to produce recordings and subsequent acoustic measures of voice comparable to \"research quality\" instrumentation.</p><p><strong>Methods: </strong>Recordings of 24 sustained vowel samples representing a wide range of typical and disordered voices were played via a head-and-torso model and recorded using a research quality standard microphone/preamplifier/audio interface. Acoustic measurements from the standard were compared with two popular tablets using their built-in microphones and with low-cost headset microphones at different distances from the mouth.</p><p><strong>Results: </strong>Voice measurements obtained via tablets + headset microphones close to the mouth (2.5 and 5 cm) strongly correlated (r's > 0.90) with the research standard and resulted in no significant differences for measures of vocal frequency and perturbation. In contrast, voice measurements obtained using the tablets' built-in microphones at typical reading distances (30 and 45 cm) tended to show substantial variability in measurement, greater mean differences in voice measurements, and relatively poorer correlations vs the standard.</p><p><strong>Conclusion: </strong>Findings from this study support preliminary recommendations from the Bridge2AI-Voice Consortium recommending the use of smartphones paired with low-cost headset microphones as adequate methods of recording for large-scale voice data collection from a variety of clinical and nonclinical settings. Compared with recording using a tablet direct, a headset microphone controls for recording distance and reduces the effects of background noise, resulting in decreased variability in recording quality.</p><p><strong>Data availability: </strong>Data supporting the results reported in this article may be obtained upon request from the contact author.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Patient Factors on Attendance at Remote Telehealth Voice Therapy.","authors":"Preetha Velu, Audrey Tran, Rohith Kariveda, Daniel Buckley, Pratima Agarwal, Lauren F Tracy","doi":"10.1016/j.jvoice.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.09.005","url":null,"abstract":"<p><strong>Objective: </strong>Although voice therapy is a highly effective treatment for voice disorders, benefits are diminished by poor adherence to appointments. Remote telehealth delivery of therapy may address this problem by improving access. This study investigates attendance at remote telehealth voice therapy and evaluates potential correlation with patient demographics and socioeconomic status.</p><p><strong>Methods: </strong>Retrospective review of all adult patients referred for telehealth voice therapy between April 2020-November 2021. Evaluated patient demographics including referral diagnosis, health insurance status and interpreter use, were obtained from medical records. Area Deprivation Index scores served as proxy for socioeconomic status. Multivariate analysis examined relationships between patient factors and attendance.</p><p><strong>Results: </strong>Of 423 patients referred for telehealth voice therapy, 220 (52%) attended more than one therapy session, 98 (23%) attended one, and 105 (25%) never attended therapy. Multivariate analysis did not identify significant correlations between telehealth attendance and sociodemographic factors including interpreter use, insurance status, and socioeconomic status, even after adjusting for ethnicity and primary language.</p><p><strong>Conclusion: </strong>Over half of patients referred to telehealth voice therapy participated in multiple sessions and 75% attended at least one session. Telehealth voice therapy attendance was not negatively impacted by public health insurance and patient race and socioeconomic status did not impact attendance. Telehealth voice therapy may minimize potential barriers to care in susceptible populations.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Speaker Head Posture on Auditory Perception of Vocal Masculinity.","authors":"Claire E Howerton, Daniel P Buckley, Kimberly L Dahl, Cara E Stepp","doi":"10.1016/j.jvoice.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.001","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the impact of head position on listeners' perception of vocal masculinity.</p><p><strong>Methods: </strong>Twelve cisgender women were recorded reciting two voiced sentences with varying head positions: baseline, flexed, and extended. Voice samples were cropped and fundamental frequency (f_o) was resynthesized to control for any changes in f_o across conditions. Twelve cisgender adults were recruited as listeners. Listeners were presented with 144 paired comparisons of speaker samples and were prompted to select the sample that sounded more masculine in each presented pairing. Ratings of masculinity were analyzed using Thurstone's law of comparative judgment. A repeated measures analysis of variance (ANOVA) assessed the effects of head positioning, followed by Dunnett's posthoc tests.</p><p><strong>Results: </strong>The ANOVA showed a statistically significant effect of head position on listener perceptions of masculinity: speech in the flexed position was perceived as statistically more masculine than that in the baseline condition.</p><p><strong>Conclusions: </strong>The results of this study support the use of head posture manipulation to achieve increased vocal masculinity, which adds to the limited research related to voice masculinization strategies for those seeking gender-affirming voice care.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Impact of Vocal Demand, Likelihood of Dysphonia, and Performance Aspects in Amateur Protestant Singers.","authors":"João Ricardo Ferreira Santos, Gabriel Trevizani Depolli, Elma Heitmann Mares Azevedo, Felipe Moreti, Michelle Ferreira Guimarães","doi":"10.1016/j.jvoice.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.010","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the immediate impact of vocal demand, probability of dysphonia, and performance aspects in amateur protestant singers.</p><p><strong>Methods: </strong>Cross-sectional, analytical study, with 76 amateur singers from a protestant church, 60 women and 16 men. All participants responded to a sociodemographic and performance questionnaire, the Evaluation of the Ability to Sing Easily for Brazil (EASE-BR), and the Dysphonia Screening Tool (DST-Br). The data were analyzed descriptively and inferentially, considering a significance level of 5%.</p><p><strong>Results: </strong>The singers reported good voice status after a performance, with the possibility of singing again if necessary. Most individuals had a low probability of dysphonia, showing a lower mean score compared to those with a moderate probability. There was an association between \"trying to sing louder than others\" and \"vocal self-assessment\" with the immediate impact of vocal demand and dysphonia screening. Implementing vocal rest was significantly associated with EASE-BR, and trying to sing louder than the instruments and being able to hear yourself well while singing and water intake were associated with the total DST-Br score.</p><p><strong>Conclusions: </strong>The immediate impact of vocal demand after performance on this population did not compromise their ability to sing easily. Most singers had a low probability of dysphonia. \"Trying to sing louder than the instruments\" and \"ability to hear oneself well while singing and water intake\" were associated with dysphonia screening.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Item Hierarchy of Vocal Fatigue Index (VFI) in School Teachers-A Study from South India.","authors":"Sreya Srinivas, R Poovaraghavan, Prakash Boominathan, Shenbagavalli Mahalingam","doi":"10.1016/j.jvoice.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.008","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to identify the item hierarchy of the Vocal Fatigue Index (VFI) in school teachers using Mokken Scaling Analysis (MSA).</p><p><strong>Method: </strong>A total of 362 school teachers from five zones in Chennai city, southern part of India, participated in the study. All subjects completed a subject-information form that had details such as age, sex, duration of vocal demand per day, number of classes taken, grades taught, and years of experience and VFI. Based on the VFI factor-I scores, teachers were segregated into three groups, viz, No Fatigue (<11), Low Fatigue (11-24), and High Fatigue (>24). Percentage analysis, Mann-Whitney U, and Pearson's chi square was done for finding the association of variables (listed above) with vocal fatigue and MSA.</p><p><strong>Results: </strong>Two-hundred and seventy-five teachers (75.5%) identified themselves with vocal fatigue, and 87 (24%) others reported no vocal fatigue. The highest percentage of fatigue (63.18%) was documented in factor II, followed by factor III (48.90%) and factor I (40.38%). Mann-Whitney U test revealed a significant difference in vocal fatigue experience between males and females (P = 0.01). Pearson chi square showed a positive association between factor I and years of experience in teachers (P = 0.02). No significant correlation was observed between other variables and factors of VFI. MSA divided the VFI scale into two, scale 1 (factors I and II) and scale 2 (factor III). On segregation, several reliable scales were obtained, however, all the scales had a low Loevinger's coefficient.</p><p><strong>Discussion/conclusion: </strong>VFI, though a reliable tool, did not capture the underlying trait of vocal fatigue completely in school teachers as a population. This study ascertains the need to develop a tool that is specific to occupation/profession, geographic, sociocultural, and ethnic group. Mere adaptations and translations of tools may not necessarily suffice for clinical utility and application.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Voice-Focused Speech-Language Pathologists' Usage of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V).","authors":"Kathleen F Nagle, Gail B Kempster, Nancy Pearl Solomon","doi":"10.1016/j.jvoice.2024.08.032","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.032","url":null,"abstract":"<p><strong>Purpose: </strong>As part of the process of developing specific recommendations for modifying certain elements of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) to promote end-user fidelity, the authors sought input from voice clinicians who regularly use the CAPE-V to assess voice quality.</p><p><strong>Method: </strong>At an academic meeting focusing on voice disorders, we presented a poster briefly reviewing the CAPE-V protocol and describing several sources of variability that have been reported in its current use. Interested viewers were directed to a QR code linking to a brief, anonymous survey on how individuals currently use the CAPE-V and how they might improve it. A link to the survey was also distributed on the conference discussion board.</p><p><strong>Results: </strong>Fifty-nine participants responded to the survey: 49 completed it. The median respondent reported 8years of experience conducting voice evaluations, with 50% of their current practice in voice, and about eight voice evaluations per week. Key findings from this survey were that fewer than half of respondents reported audio recording any components of in-person or virtual voice evaluations, and that most respondents reported changing some aspect of the CAPE-V tasks and stimuli in practice.</p><p><strong>Conclusion: </strong>This exploratory study revealed a wide range of idiosyncratic practices by clinicians when administering and scoring the CAPE-V. The findings support planned revisions to the CAPE-V protocol and form involving the tasks, stimuli, and rating procedures.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temperament and Voice Quality in Patients With Vocal Fold Nodules.","authors":"Emine Metin, Kemal Uygur, Erdoğan Okur, Bilge Metin, Bülent Gündüz","doi":"10.1016/j.jvoice.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.005","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vocal fold nodules are most common in women and patients with vocal fold nodules represent the largest group in voice clinics. The prevalence of vocal fold nodules is particularly high in professions where the voice is used on a regular basis. The quality of the voice is influenced by a number of factors, including temperament, stress, and emotional state. These factors can influence the physiological conditions of phonation. The objective of this study was to assess the acoustic parameters of voice in patients with vocal nodules in comparison to healthy controls, and to determine whether voice quality is influenced by emotional state and coping with stress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 32 patients admitted to the ENT Department of the University Medical School with voice disorders between March and June 2007 constituted the study group. All patients were found to have a vocal nodule on physical and stroboscopic examination. The control group consisted of 30 healthy individuals who did not report any voice disorders. All subjects underwent voice recordings in the voice laboratory. Following the completion of the voice evaluation form, an aerodynamic assessment (a, s, and s/z-time), an index of vocal impairment, the Rosenbaum's Learned Resourcefulness Scale, and the Temperament and Characteristics Inventory (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire), all subjects underwent further assessment. Acoustic analysis was conducted using the CSL program in Multidimensional voice program analysis and the Vocal Assessment component of Dr. Speech.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The decrease in maximum phonation time in the study group was statistically significant. There were statistically significant differences in the parameters Mean Fundamental Frequence, Jitter, Relative Avarage Perturbation, Pitch Perturbation Quotient, Shimmer in dB, Shimmer, Amplitude Perturbation Quotient, Noise Hormonic Ratio, Soft Phonation Index from the Multidimensional voice program analysis, Jitter, Shimmer% from the voice assessment, and the perceptual rating (H, R, and B) from Dr. Speech's voice assessment analysis. The differences in the dimensions of anxious temperament and the examination of stress problem-solving strategies were significant between the study group and the control subjects. Differences in aerodynamic and acoustic parameters were found between disordered and healthy groups, as well as between individuals with different personalities. Overall, those with nodules were less likely to manage stress well than those without nodules.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study group and the control subjects showed significant differences in anxious temperament dimensions and stress problem-solving strategies. There were also differences in aerodynamic and acoustic parameters between the disordered and healthy groups, as well as between the groups with and without personality tempera","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure Distributions in Glottal Geometries With Multichannel Airflows.","authors":"Ingo R Titze, Lynn Maxfield, Brian Manternach, Anil Palaparthi, Ronald Scherer, Xiaojian Wang, Xudong Zheng, Qian Xue","doi":"10.1016/j.jvoice.2024.08.019","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.08.019","url":null,"abstract":"<p><strong>Objectives: </strong>Computer simulation of self-sustained oscillation of the vocal folds has been successful with application of simple Bernoulli-like driving pressures. As voice simulation is now applied to asymmetric vibration with complex mode structures that yield partial vocal fold contact, the driving pressures need refinement.</p><p><strong>Study design and methodology: </strong>Two independent approaches were used to obtain pressure distributions. The first was a high-fidelity immersed-boundary method computation and the second was a series of pressure tap measurements on scaled-up physical models. Glottal geometries were based on normal surface modes of vibration. Samples are chosen from a large inventory of measured and calculated profiles.</p><p><strong>Results: </strong>Pressure distributions show the complexity that can exist in the driving forces on vocal fold surfaces. Qualitative similarity between computation and measurement was established for a variety of contact patterns, showing diverse pressure gradients in multiple directions.</p><p><strong>Conclusions: </strong>Simplified Bernoulli approaches to glottal pressure distributions are defensible when a single flow channel is preserved in vocal fold oscillation. However, when there are contact islands that produce confluence or difluence of multiple airflow channels, the pressure gradients vary profoundly. Small quantitative differences were observed between measurement and calculation, primarily due to spatial sampling.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}