Journal of Sexual Medicine最新文献

{"title":"Editorial comment on \"Association between surgeon procedure volume and reoperation rates for penile prosthesis implantation\".","authors":"Edward Karpman","doi":"10.1093/jsxmed/qdaf066","DOIUrl":"10.1093/jsxmed/qdaf066","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"665"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773964","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":"Knowledge and attitudes toward genderism, transphobia, and persons of the LGBT+ community of urologists and andrologists.","authors":"Bac Hoai Nguyen, Quan Minh Pham, Eric Hahn, Tam Thi Minh Ta, Kerem Böge, Solveig Kemna, Emmanuele A Jannini, Vu Bui Duy Nguyen","doi":"10.1093/jsxmed/qdaf038","DOIUrl":"10.1093/jsxmed/qdaf038","url":null,"abstract":"<p><strong>Background: </strong>Despite social transitions in attitude toward the LGBT+ community, homonegativity, genderism, or transphobia persist, even found in healthcare providers (HCPs), which can hamper the goal of equality and equity in general health and that of gender minorities. The lack of knowledge about the community is also a problem, especially in developing countries.</p><p><strong>Aim: </strong>To investigate the influences of attitudes toward and knowledge about the LGBT+ community of HCPs who are not LGBT+ on how they practice in clinical settings.</p><p><strong>Methods: </strong>A survey was conducted on HCPs, mainly working in urology, nephrology, and andrology, who attended the annual congress on Urology and Nephrology in August 2023. The survey evaluated homophobia, genderism/transphobia, and knowledge about LGBT+ using the Attitude Toward Lesbians and Gay Men Scale-Short Version (ATLG-S), Genderism and Transphobia Scale-Revised-Short Form (GTS-R-SF), and Knowledge About Homosexuality Questionnaire (KAHQ). The behaviors of HCPs toward LGBT+ were also investigated.</p><p><strong>Outcome: </strong>HCPs' attitudes toward and knowledge about LGBT+ were affected by individual-related factors and modulated behaviors toward LGBT+ patients in clinical settings.</p><p><strong>Results: </strong>Among 362 qualified respondents, levels of negative attitudes toward lesbians, gay men, and transgender people are mild at 5.5%, 13.0%, and 11.1%, respectively. Most respondents (93.4%) have a low to moderate level of knowledge, as measured by the KAHQ, about the LGBT+ community. Respondents having LGBT+ friends have more positive attitudes toward LGBT+ people and higher levels of knowledge about the community than others. Findings from the structural equation model indicate that improving knowledge is the key factor to change the attitudes and practices of Vietnamese HCPs while in contact with LGBT+ clients.</p><p><strong>Clinical implications: </strong>Developing official and thoughtful curricula on the diversities of gender identities and sexual orientations for medical staff is crucial to reducing gender and sexual orientation discrimination.</p><p><strong>Strengths and limitations: </strong>This study used validated questionnaires with the ability to exclude unintended respondents, improving the analyses' accuracy. Since the sample did not represent all HCPs and other specialties, further studies are required.</p><p><strong>Conclusion: </strong>This study indicates the existence of mild levels of homophobia, genderism, and transphobia among HCPs. Improving the knowledge of HCPs about LGBT+ people plays a critical role in improving attitudes toward the community and ensuring equality and equity in providing health services for all patients regardless of their gender identity and sexual orientation.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"755-766"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588076","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":"A critical assessment of online patient education materials for gender-affirming surgery: a systematic review and meta-analysis.","authors":"Antoinette T Nguyen, Rena A Li, Robert D Galiano","doi":"10.1093/jsxmed/qdaf075","DOIUrl":"10.1093/jsxmed/qdaf075","url":null,"abstract":"<p><strong>Introduction: </strong>Gender-affirming surgeries significantly improve the well-being of transgender and gender-diverse individuals. However, patients often rely on online patient education materials (OPEMs) to navigate surgical options, making readability, quality, and accessibility critical factors in informed decision-making.</p><p><strong>Objective: </strong>The objective of this study is to evaluate the readability, quality, and accessibility of online patient education materials related to gender-affirming surgeries.</p><p><strong>Methods: </strong>This systematic review analyzed nine studies evaluating 898 OPEMs related to gender-affirming surgeries and transgender voice care. Readability was assessed using Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease Score (FRES), while quality was evaluated using DISCERN and the Patient Education Materials Assessment Tool. A meta-analysis synthesized readability scores, and qualitative trends were examined to assess readability-quality trade-offs.</p><p><strong>Results: </strong>OPEMs consistently exceeded the recommended 6th-grade reading level, with a pooled FKGL mean of 12.49 (95% CI: 12.41-12.57), indicating high school to university-level complexity. SMOG scores averaged 11.89 (95% CI: 11.79-11.99), suggesting materials required at least some college education. FRES scores (mean: 37.49, 95% CI: 37.17-37.80) classified most materials as \"difficult\" to \"very difficult\" to read. Healthcare-affiliated websites had significantly higher FKGL scores than non-healthcare sources (P < 0.01). DISCERN scores were highly variable, with 68.33% of facial feminization materials rated poor or very poor. Physician-created TikTok content scored higher in reliability (P < 0.001) but had lower engagement than non-physician videos. Spanish-language materials were slightly more readable (SMOG 11.7 vs. 14.2 in English) but less available.</p><p><strong>Conclusions: </strong>Most OPEMs for gender-affirming care fail to meet health literacy guidelines, limiting accessibility. To improve patient comprehension, materials should be simplified without sacrificing accuracy, incorporate multimedia tools, and undergo usability testing. Standardized, trans-affirming, and linguistically inclusive resources are essential for equitable access and informed decision-making.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"951-960"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025707","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":"Treatment of hypoactive sexual desire disorder in women: why is the pipeline different for postmenopausal women?","authors":"Rachel Pope, Anna Myers","doi":"10.1093/jsxmed/qdaf002","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf002","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 4","pages":"556-558"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059038","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":"Phalloplasty: which technique should I choose?","authors":"Wai Gin Lee, Nim Christopher, David Ralph","doi":"10.1093/jsxmed/qdae187","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae187","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 4","pages":"554-555"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995110","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":"Chemsex and compulsive sexual behavior among sexual minority men.","authors":"Todd L Jennings, Neil Gleason, Frankie Nieblas, Nicholas C Borgogna, Shane W Kraus","doi":"10.1093/jsxmed/qdaf021","DOIUrl":"10.1093/jsxmed/qdaf021","url":null,"abstract":"<p><strong>Introduction: </strong>Chemsex, or the use of specific psychoactive substances to enhance or prolong sexual encounters, is increasingly prevalent among sexual minority men and is linked to adverse health outcomes.</p><p><strong>Aim: </strong>This study examines the co-occurrence of chemsex and compulsive sexual behavior disorder (CSBD) among sexual minority men and whether this co-occurrence is connected to mental and sexual health concerns.</p><p><strong>Methods: </strong>A sample of 289 sexual minority men (223 gay men and 66 bisexual men), recruited primarily through the dating/hookup application Grindr, completed measures of chemsex participation, CSBD, substance use disorder symptoms, and health outcomes. CSBD was measured with the Compulsive Sexual Behavior Disorder Scale-7 (CSBD-7), which uses a psychometrically validated cut-off for identifying individuals who are at high risk of experiencing CSBD.</p><p><strong>Results: </strong>Chemsex participation (15.2%) and falling above the CSBD-7 cut-off (34.3%) were prevalent, with 9.3% of participants endorsing both. Chemsex, compared to alcohol and marijuana use during sex, was more strongly associated with sexual and mental health outcomes. Individuals reporting chemsex and/or falling above the CSBD-7 cut-off, experienced greater depression and anxiety compared to those without these concerns. However, only individuals reporting the co-occurrence of chemsex and CSBD endorsed greater sexual health concerns, such as condomless anal sex and HIV infection. Participants only endorsing chemsex were not included in the analyses due to low frequency.</p><p><strong>Discussion: </strong>This study suggests that chemsex and CSBD co-occur and are connected to negative health outcomes, such as depression and condomless anal sex. Notably, differences in sexual health concerns (i.e., condomless anal sex, HIV infection, and the use of poppers and erectile dysfunction medications during sex) were only identified when participants endorsing chemsex were included in analyses, suggesting that CSBD's connection to sexual risk may arise from a subset of individuals struggling with chemsex. Lastly, chemsex, popper use, and erectile dysfunction medication use during sex appear more strongly connected to CSBD than marijuana or alcohol use during sex. Future research is needed using larger samples, longitudinal approaches, and more refined measures of chemsex.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"658-662"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460559","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":"Phase 2 randomized study of abobotulinumtoxinA in patients with provoked vestibulodynia: dose-finding results.","authors":"Andrew Goldstein, Rachel Rubin, Melissa Dahir, Irwin Goldstein, Brooke M Faught, Nina Bohm-Starke, Jill Krapf, Peter Caetano, Magali Volteau, Robert Silva","doi":"10.1093/jsxmed/qdaf022","DOIUrl":"10.1093/jsxmed/qdaf022","url":null,"abstract":"<p><strong>Background: </strong>Hypertonicity of the pelvic floor muscles is commonly associated with provoked vestibulodynia (PVD); therefore, patients may benefit from treatments that relax the pelvic floor.</p><p><strong>Aim: </strong>To define optimal (safe and efficacious) doses of abobotulinumtoxinA (aboBoNT-A) for the treatment of PVD associated with hypertonic pelvic floor muscle dysfunction and to explore use of a novel endpoint for pain assessment for PVD.</p><p><strong>Methods: </strong>This phase 2, randomized, placebo-controlled study comprised two steps: dose escalation (Stage 1) and dose expansion (Stage 2). Stage 1 included up to four treatment cycles; Cycle 1 was double blind, Cycles 2-4 open label. Patients were assessed for retreatment every 6 weeks. Stage 2 was not conducted because of early study termination by the sponsor, unrelated to observed safety signals. Enrolled patients-premenopausal women with PVD with associated pelvic-floor hypertonia-were randomized (n = 60) 4:1 to receive aboBoNT-A (doses: 100, 300, 400, or 500 units [U]) or placebo.</p><p><strong>Outcomes: </strong>The primary endpoint was safety. Additionally, a novel composite endpoint, dilator maximum tested size was evaluated. This endpoint combined assessment of vaginal-dilator tolerability with patient-reported pain assessment on an 11-point numeric rating scale, used as a surrogate measure of sexual activity in this study.</p><p><strong>Results: </strong>All treatment-emergent adverse events (AEs) were mild or moderate in intensity, with no serious AEs or AEs leading to withdrawal reported in the double-blind period. AEs of special interest (urinary incontinence, anal sphincter atonia) were observed at low incidence and predominantly with higher aboBoNT-A doses. The dilator test composite score might be a useful endpoint for pain assessment, with a greater reduction in pain score noted for the 300 U dose group compared with other dose groups and placebo.</p><p><strong>Clinical implications: </strong>aboBoNT-A was well tolerated in patients with PVD and a novel method for assessing dilator-induced pain was introduced.</p><p><strong>Strengths and limitations: </strong>The study provided valuable data on use of aboBoNT-A in women with primary or secondary PVD and introduced a novel composite endpoint for assessing dilator-induced pain. Study limitations included the small sample size, limiting formal statistical analysis.</p><p><strong>Conclusion: </strong>aboBoNT-A was well tolerated in patients with PVD with no safety signals reported. Further studies are warranted to demonstrate clinically meaningful benefits with repeated treatment.</p><p><strong>Clinical trial registration number: </strong>NCT03598777.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"588-596"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426570","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":"Photobiomodulation therapy for the treatment of vulvar pain among those with provoked vestibulodynia: a randomized controlled trial.","authors":"Flavia I Antonio, Caroline Pukall, Linda McLean","doi":"10.1093/jsxmed/qdaf011","DOIUrl":"10.1093/jsxmed/qdaf011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Provoked vestibulodynia (PVD) is characterized by recurring pain confined to the vulvar vestibule; histological studies show inflammatory mediators and neural proliferation in the vulvar tissues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine whether a 15-session photobiomodulation (PBM) intervention is more effective than sham-PBM for reducing vulvar pain. Secondary objectives were to evaluate the effect of the PBM intervention on broader domains of vulvar pain, psychological outcomes, sexual function, perceived improvement and satisfaction, as well as to describe adverse events and adherence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Randomized controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Participants with PVD were recruited from the local community.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Allocation: &lt;/strong&gt;Randomized allocation to real- or sham-PBM (1:1) was concealed from participants and all members of the research team until after data analysis was complete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Primary outcomes: pressure pain threshold (PPT), pain reported on the tampon test, and vulvar pain sensitivity reported on the Vulvar Pain Assessment Questionnaire (VPAQ). Secondary outcomes: pain-related domains reported on the VPAQ, sexual function, depression, anxiety and stress, pain catastrophizing, central sensitization to pain, Patient Global Perception of Improvement (PGPI), Perceived overall percent improvement (P%I), perceived satisfaction with treatment (%), adherence and adverse events. The primary end point was one week following the last PBM intervention session.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Fifteen sessions of a real- or sham-PBM intervention were delivered over an 8-week period, progressing through five stages of incremental exposure to light in the red and near-infrared spectra applied to the vulvar vestibule, the perineum, and the sacral region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty participants (16 real-PBM, 14 sham-PBM) enrolled and received their intended intervention; one (sham-PBM) was lost to follow-up. Vulvar pain was reduced more in the real- compared to the sham-PBM group; between group differences were 28.2-112.0 g/cm2 (d = 0.61) for PPT, 0.1-2.5 1(d = 0.60) for pain reported on the tampon test, and 0.1-0.9 (d = 0.87) for pain sensations reported on the VPAQ. Changes in other pain-related domains reported on the VPAQ, psychological outcomes and sexual function were not different between the real- and sham-PBM groups. Adherence to the intervention was nearly 100% among those who completed the study. Most participants in both groups were satisfied or very satisfied with the intervention (real-PBM = 80%; sham-PBM = 64%), with no group differences in satisfaction or perception of improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The PBM intervention resulted in greater reductions in vulvar pain than the sham intervention. However, patients did not perceive that the real-PBM was significantly better than the sham-PB","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"579-587"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411050","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":"Sexuality in people assigned female at birth with spinal cord injury: the challenges encountered.","authors":"Meenakshi Goel, Claire Mazzia, Sarah Daisy Kosa, Anne Harris, Anne Berndl","doi":"10.1093/jsxmed/qdaf024","DOIUrl":"10.1093/jsxmed/qdaf024","url":null,"abstract":"<p><strong>Background: </strong>Spinal Cord Injury (SCI) can impact sexual function negatively, and although most people continue to be sexually active post-injury, they often report decreased satisfaction in various aspects of sexual life.</p><p><strong>Aim: </strong>To gain insight into the sexual experience and functioning of people assigned female at birth (AFAB) with a SCI.</p><p><strong>Methods: </strong>This study is part of an international observational questionnaire examining the reproductive health outcomes of individuals AFAB with SCI. The questionnaire was distributed to SCI organizations and support groups in 33 countries in four languages between 2019 and 2021. A total of 557 individuals AFAB with SCI, between the ages of 18 and 50, who completed the sexual health questions were included in this analysis.</p><p><strong>Outcome: </strong>Scores of Female Sexual Function Index (FSFI-6) in relation to the severity of the SCI based on the American Spinal Injury Association (ASIA) impairment scale, level, and duration of SCI.</p><p><strong>Results: </strong>Nearly 65% (170/263) of the study population within 10 years of injury had sexual dysfunction (SD) (FSFI-6 score less than or equal to 19), and participants with ASIA A had the most dysfunction (Mean score 15.95 + 7.52). Interestingly, although half of the study population scores as experiencing SD, only one-third describe SD as a concern associated with SCI. Though most of the changes were of a physical nature (inability to orgasm, pain during penetration, spasticity, barriers related to bowel/bladder problems and episodes of autonomic dysreflexia), psychosocial factors like the presence of concomitant anxiety/depression and sexual violence from a partner affected their sexual lives adversely. We attempt to elucidate the strategies adopted to improve sexual satisfaction that can help professionals involved in the SCI rehabilitative process.</p><p><strong>Clinical implications: </strong>Our results provide insight into the degree of SD, factors impacting sexual satisfaction and areas which need to be emphasized during the rehabilitation process of people AFAB with SCI.</p><p><strong>Strength and limitations: </strong>This study is one of the largest of its kind, attempting to understand sexual functioning and factors impacting the sexual life of people AFAB post-SCI using a standardized tool, the FSFI score. As a voluntary survey, those who responded may not be fully representative of the population.</p><p><strong>Conclusion: </strong>Sexual health is an essential component of rehabilitation for individuals AFAB with SCI. Enhancing their sexual satisfaction requires a comprehensive approach that considers their physical, psychological and interpersonal circumstances.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"562-569"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477147","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":"Letter to the Editor on \"Unlocking the potential of noninvasive neuromodulation and integrated therapies: a new era for fertility and sexual function recovery in spinal cord injury?\"","authors":"Rocco Salvatore Calabrò","doi":"10.1093/jsxmed/qdaf023","DOIUrl":"10.1093/jsxmed/qdaf023","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"663-664"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460561","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}