Journal of Telemedicine and Telecare最新文献

{"title":"Artificial intelligence: Augmenting telehealth with large language models.","authors":"Centaine L Snoswell, Aaron J Snoswell, Jaimon T Kelly, Liam J Caffery, Anthony C Smith","doi":"10.1177/1357633X231169055","DOIUrl":"10.1177/1357633X231169055","url":null,"abstract":"<p><p>This brief editorial describes an emerging area of machine learning technology called large language models (LLMs). LLMs, such as ChatGPT, are the technological disruptor of this decade. They are going to be integrated into search engines (Bing and Google) and into Microsoft products in the coming months. They will therefore fundamentally change the way patients and clinicians access and receive information. It is essential that telehealth clinicians are aware of LLMs and appreciate their capabilities and limitations.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"150-154"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9638411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between broadband capacity and telehealth utilization among Medicare Fee-for-service beneficiaries during the COVID-19 pandemic.","authors":"Ambrish A Pandit, Ruchira V Mahashabde, Clare C Brown, Mahip Acharya, Catherine C Shoults, Hari Eswaran, Corey J Hayes","doi":"10.1177/1357633X231166026","DOIUrl":"10.1177/1357633X231166026","url":null,"abstract":"<p><strong>Background: </strong>Telehealth is a rapidly growing modality for expanding healthcare access, especially in the post-COVID-19 era. However, telehealth requires high-quality broadband, thus making broadband a social determinant of health. The objective of this study was to evaluate the association between broadband access and telehealth utilization across the United States during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using a cross-sectional, ecological study design, we merged county-level data on broadband capacity (Microsoft's Rural Broadband Initiative), telehealth utilization among Medicare Fee-for-Service beneficiaries from January through September 2020 (CareJourney), and county-level socioeconomic characteristics (Area Health Resources Files). Multivariable linear regression was used to estimate the association between broadband capacity, county-level characteristics, and telehealth utilization.</p><p><strong>Results: </strong>Among the 3107 counties, those with the greatest broadband availability (quintile 5) had 47% higher telehealth utilization compared to counties with the least broadband availability (quintile 1). In the adjusted model, a 1 standard deviation (SD) increase in broadband access was associated with a 1.54 percentage point (pp) increase in telehealth utilization (P < 0.001). Rural county designation (-1.96 pp; P < 0.001) and 1 SD increases in average Medicare beneficiary age (-1.34 pp; P = 0.001), number of nursing home beds per 1000 individuals (-0.38 pp; P = 0.002), and proportion of Native Americans/Pacific Islanders (-0.59 pp; P < 0.001) were associated with decreased telehealth utilization.</p><p><strong>Conclusion: </strong>The association between broadband access and telehealth utilization and the decreased telehealth utilization in rural areas highlight the importance of broadband access for healthcare access and the need to continue investing in broadband infrastructure to promote equitable healthcare access across populations.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"41-48"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076155/pdf/10.1177_1357633X231166026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9270192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding how virtual care has shifted primary care interactions and patient experience: A qualitative analysis.","authors":"Kelly Wu, Marlena Dang Nguyen, Geneviève Rouleau, Rhea Azavedo, Diya Srinivasan, Laura Desveaux","doi":"10.1177/1357633X231167905","DOIUrl":"10.1177/1357633X231167905","url":null,"abstract":"<p><strong>Introduction: </strong>The widespread and rapid implementation of virtual care has introduced evolutionary changes in the context, process, and way primary care is delivered. The objectives of this study were to: (1) understand whether and how virtual care has shifted the therapeutic relationship; (2) describe the core components of compassionate care from the patient perspective and (3) identify how and in what circumstances compassionate care might be amplified.</p><p><strong>Methods: </strong>Participants living in Ontario, Canada were eligible if they had interacted with their primary care clinician following the rapid implementation of virtual care in March 2020, irrespective of virtual care use. One-on-one semi-structured interviews were conducted with all participants and data were analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Four themes emerged across 36 interviews: (1) Virtual care shifts communication patterns but the impact on the therapeutic relationship is unclear; (2) Rapid implementation of virtual care limited perceived quality and access among those who did not have the option to utilize it; (3) Patients perceive five key elements as central to compassion in a virtual context; and (4) Leveraging technology to fill gaps within and beyond the visit is a step towards improving experiences for all.</p><p><strong>Discussion: </strong>Virtual care has transformed the ways in which patient-clinician communication operates in primary care. Patients with access to virtual care described largely positive experiences, while those whose interactions were limited to phone visits experienced decreased quality and access to care. Attention must shift to identifying effective strategies to support the health workforce in building virtual compassion competencies.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"73-81"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9318366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-assessment of activities and participation in chronic phase of stroke: Is use valid and viable in a developing country?","authors":"Léia Cordeiro de Oliveira, Heyriane Martins Dos Santos, Mariana Acciarini da Silva, Bianca Stefany Lima de Oliveira, Taiane Silva de Lima, Gabriela Santos Pereira, Soraia Micaela Silva","doi":"10.1177/1357633X231166817","DOIUrl":"10.1177/1357633X231166817","url":null,"abstract":"<p><strong>Background: </strong>SATISPART-Stroke (SATIS-Stroke) is the most complete instrument for the assessment of activity and participation following a stroke. However, its use in a developing country has only been tested through in-person interviews.</p><p><strong>Objective: </strong>To determine the validity, reproducibility and viability of the SATIS-Stroke scale administered in two tele-assessment modalities: self-assessment of an electronic form versus videoconference.</p><p><strong>Methods: </strong>Methodological study with Brazilian chronic stroke survivors was conducted. Stage I comprised an in-person interview to apply the SATIS-Stroke and a self-assessment by completing an electronic form to respond to the SATIS-Stroke items. Step II occurred 6 to 8 months after Step I, during which SATIS-Stroke was administered again in-person and via videoconference. The order was randomized.</p><p><strong>Results: </strong>Ninety-five stroke survivors were recruited, but only 50 answered the electronic form (adherence: 52.6%). Mean scores were higher in the self-administration of electronic form compared to the in-person interview (mean difference = -0.36 ± 0.93; <i>P</i> = 0.009). Adequate reliability was found in the comparison of the in-person and self-assessment of electronic form (ICC_2,1 = 0.66; 95%CI: 0.40-0.81). Fifty stroke survivors participated in Step II, during which adequate reliability was found in the comparison of the in-person administration and videoconference (ICC_2,1 = 0.55; 95%CI: 0.21-0.74) and a moderate correlation was found between the assessment methods (<i>r</i> = 0.43; <i>P</i> = 0.02).</p><p><strong>Discussion: </strong>Adequate validity and reliability were found in the tele-assessment. Thus, this method is appropriate and viable for use in developing countries. Although reliable, the self-assessment did not have good adherence in the Brazilian population due to internet access problems, lack of familiarity with the digital form and lack of autonomy to answer the questions alone.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"82-89"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9364751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual hospitals: The future of the healthcare system? An expert consensus.","authors":"Chiara Bidoli, Veronica Pegoraro, Francesca Dal Mas, Carlo Bagnoli, Fabrizio Bert, Mauro Bonin, Giovanni Butturini, Lorenzo Cobianchi, Claudio Cordiano, Giulio Minto, Claudio Pilerci, Paolo Stocco, Maristella Zantedeschi, Stefano Campostrini","doi":"10.1177/1357633X231173006","DOIUrl":"10.1177/1357633X231173006","url":null,"abstract":"<p><p>Today, social and healthcare systems at a global level are facing constant challenges dictated by an increasing mismatch between the demand for care services and the supply of human and economic resources. Such a situation has been exacerbated in the past two years by the Covid-19 pandemic. This has led to an increase in the leverage of digitalisation, which has proved to be a crucial tool for the development and application of new organisational models at both hospital and territorial levels, thus addressing the various criticalities already present in the system. In this sense, the <i>Virtual Hospital</i> has emerged as a potential model for increasing effectiveness and efficiency in delivering sociomedical services. Starting from these premises, an EFTE (<i>estimate, feedback, talk, estimate</i>) approach was used to acquire an <i>expert consensus</i> within a multidisciplinary panel of academics and healthcare managers of the Veneto Region in Italy. This article reports the expert opinion on the possible application of the <i>Virtual Hospital</i> model in the national context, starting from the existing international evidence and good practices, highlighting the potential advantages and barriers to its implementation. Furthermore, the article analyses the most relevant areas of investment for the development of intangible assets and the acquisition of tangible assets necessary for its implementation.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"121-133"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence assisted telehealth for nursing: A scoping review.","authors":"Jeeyae Choi, Seoyoon Woo, Anastasiya Ferrell","doi":"10.1177/1357633X231167613","DOIUrl":"10.1177/1357633X231167613","url":null,"abstract":"<p><strong>Background: </strong>Due to the COVID-19 pandemic, telehealth resurfaced as a convenient efficient healthcare delivery method. Researchers indicate that Artificial Intelligence (AI) could further facilitate delivering quality care in telehealth. It is essential to find supporting evidence to use AI-assisted telehealth interventions in nursing.</p><p><strong>Objectives: </strong>This scoping review focuses on finding users' satisfaction and perception of AI-assisted telehealth intervention, performances of AI algorithms, and the types of AI technology used.</p><p><strong>Methods: </strong>A structured search was performed in six databases, PubMed, CINAHL, Web of Science, OVID, PsycINFO, and ProQuest, following the guidance of the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews. The quality of the final reviewed studies was assessed using the Medical Education Research Study Quality Instrument.</p><p><strong>Results: </strong>Eight of the 41 studies published between 2017 and 2022 were included in the final review. Six studies were conducted in the United States, one in Japan, and one in South Korea. Four studies collected data from participants (<i>n</i> = 3014). Two studies used image data (<i>n</i> = 1986), and two used sensor data from smart homes to detect patients' health events for nurses (<i>n</i> = 35). The quality of studies implied moderate to high-quality study (mean = 10.1, range = 7.7-13.7). Two studies reported high user satisfaction, three assessed user perception of AI in telehealth, and only one showed high AI acceptability. Two studies revealed the high performance of AI algorithms. Five studies used machine learning algorithms.</p><p><strong>Conclusions: </strong>AI-assisted telehealth interventions were efficient and promising and could be an effective care delivery method in nursing.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"140-149"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9323422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we need to rethink the determination of exercise-related energy expenditure in cardiac telerehabilitation interventions?","authors":"Toshiki Kaihara, Dominique Hansen, Supraja Sankaran, Martijn Scherrenberg, Maarten Falter, Linqi Xu, Karin Coninx, Paul Dendale","doi":"10.1177/1357633X231166159","DOIUrl":"10.1177/1357633X231166159","url":null,"abstract":"<p><p>The American College of Sports Medicine determined the energy consumption of daily activities and sports. Cardiac telerehabilitation (CTR) requires knowing how much energy people consume in daily life outside of cardiac rehabilitation activities. Therefore, we have investigated if the estimated values are valid in CTR. Data from two studies were incorporated. The first study measured ventilatory threshold (VT)1, VT2, and peak exercise on cardiopulmonary exercise testing (CPET) collected from 272 cardiac (risk) patients and compared them to the estimated oxygen consumption (VO₂) at low-to-moderate-intense exercise (3-6 metabolic equivalents [METs]). Next, a patient-tailored application was developed to support CTR using these estimated values, and the intervention (the second study) was conducted with 24 coronary artery disease patients using this application during a CTR intervention. In the first study, VO₂ at VT1, VT2 and peak exercise corresponded to 3.2 [2.8, 3.8], 4.3 [3.8, 5.3], and 5.4 [4.5, 6.2] METs, which are significantly different from the estimated VO₂ at low-to-moderate-intense exercise, especially lower in older, obese, female, and post-myocardial infarction/heart failure patients. These VO₂ varied considerably between patients. The telerehabilitation study did not show significant progress in peak VO₂, but using the application's estimated target, 97.2% of the patients achieved their weekly target, which is a significant overestimate. The estimated and observed exercise-related energy expenditures by CPET were significantly different, resulting in an overestimation of the exercise done by the patients at home. The results can have a significant impact on the quantification of exercise dose during (tele)rehabilitation programs.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"90-96"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9242758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telepresence for surgical assistance and training using eXtended reality during and after pandemic periods.","authors":"Eric L Wisotzky, Jean-Claude Rosenthal, Senna Meij, John van den Dobblesteen, Philipp Arens, Anna Hilsmann, Peter Eisert, Florian Cornelius Uecker, Armin Schneider","doi":"10.1177/1357633X231166226","DOIUrl":"10.1177/1357633X231166226","url":null,"abstract":"<p><p>Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called \"TeleSTAR\" using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear-Nose-Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"14-28"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9428337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of race and ethnicity on acute telestroke care: A multistate experience.","authors":"Mark McDonald, Theresa Sevilis, Michelle Boudreau, Hsiong Chen, Caitlyn Boyd, Amanda Avila, Mohammed Zaman, Gregory Heath, Lan Gao, Thomas Devlin","doi":"10.1177/1357633X231166028","DOIUrl":"10.1177/1357633X231166028","url":null,"abstract":"<p><strong>Introduction: </strong>Previous analyses suggest that ethnic and racial differences exist in acute stroke care including thrombolytic treatment rates. The current study evaluates ethnic or racial differences in acute stroke treatment within a multi-state telestroke program.</p><p><strong>Methods: </strong>Acute telestroke consultations seen in the Emergency Department in 203 facilities and 23 states were extracted from the Telecare by TeleSpecialists^TM database. Cases were reviewed for age, race, ethnicity, sex, last known normal time, arrival time, treatment with thrombolytic therapy, door-to-needle (DTN) time, and baseline National Institutes of Health Stroke Scale score. Race was defined as Black, White, or Other; ethnicity was defined as Hispanic or non-Hispanic.</p><p><strong>Results: </strong>The current study included 13,221 acute telestroke consultations consisting of 9890 White, 2048 Black, and 1283 patients classified as Other. A total of 934 patients were Hispanic and 12,287 patients were non-Hispanic. There were no statistically significant differences noted in thrombolytic treatment rates when comparing White (7.9%) patients with non-White patients (7.4%), <i>p</i> = 0.36, or comparing Black (8.1%) with non-Black patients (7.8%), <i>p</i> = 0.59. In addition, there were no statistically significant differences in treatment rates comparing Hispanic (6.3%) with non-Hispanic (7.9%) patients, <i>p</i> = 0.072. We noted no measurable differences in DTN times by race or ethnicity.</p><p><strong>Conclusions: </strong>Contrary to previous reports, we failed to detect any significant differences in thrombolytic treatment rates and DTN times by race or ethnicity among stroke patients in a multistate telestroke program. These findings support the hypothesis that telestroke may mitigate racial and ethnic disparities which may be attributable to local variability in stroke procedures or access to healthcare.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"49-54"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 telehealth in sepsis care: A systematic review.","authors":"Kevin J Tu, Cole Wymore, Nedelina Tchangalova, Brian M Fuller, Nicholas M Mohr","doi":"10.1177/1357633X231170038","DOIUrl":"10.1177/1357633X231170038","url":null,"abstract":"<p><strong>Objectives: </strong>Sepsis is associated with significant mortality. Telehealth may improve the quality of early sepsis care, but the use and impact of telehealth applications for sepsis remain unclear. We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes.</p><p><strong>Data sources: </strong>We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date.</p><p><strong>Study selection: </strong>Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included.</p><p><strong>Data extraction and synthesis: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. A random-effects subgroup analysis was conducted on patient survival treated with and without telehealth.</p><p><strong>Results: </strong>A total of 15 studies were included, involving 188,418 patients with sepsis. Thirteen studies used observational study designs, and the most common telehealth applications were provider-to-provider telehealth consultation and intensive care unit telehealth. Clinical and methodological heterogeneity was significantly high. Telehealth use was associated with higher survival, especially in settings with low control group survival. The effect of telehealth on other care processes and outcomes were more varied and likely dependent on hospital-level factors.</p><p><strong>Conclusions: </strong>Telehealth has been used in diverse applications for sepsis care, and it may improve patient outcomes in certain contexts. Additional interventional trials and cost-based analyses would clarify the causal role of telehealth in improving sepsis outcomes.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"3-13"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}