Journal of Speech Language and Hearing Research最新文献

{"title":"Disease-Specific Speech Movement Characteristics of the Tongue and Jaw.","authors":"Claudia Raines, Antje Mefferd","doi":"10.1044/2024_JSLHR-24-00351","DOIUrl":"10.1044/2024_JSLHR-24-00351","url":null,"abstract":"<p><strong>Purpose: </strong>To advance our understanding of disease-specific articulatory impairment patterns in speakers with dysarthria, this study investigated the articulatory performance of the tongue and jaw in speakers with differing neurological diseases (Parkinson's disease [PD], amyotrophic lateral sclerosis, multiple sclerosis, and Huntington's disease).</p><p><strong>Method: </strong>Fifty-seven speakers with dysarthria and 30 controls produced the sentence \"Buy Kaia a kite\" five times. A three-dimensional electromagnetic articulography was used to record the articulatory movements of the posterior tongue and jaw. Sentence-length kinematic measures (e.g., duration, tongue range of motion [ROM], jaw ROM, tongue speed, jaw speed) were extracted.</p><p><strong>Results: </strong>Results revealed significant group effects for the duration, jaw ROM, and tongue speed but not for tongue ROM. Post hoc pairwise comparisons revealed more significant between-groups differences for duration and jaw ROM than for tongue speed. Statistically significant findings between clinical groups were predominantly driven by the difference between speakers with PD and speakers of other clinical groups.</p><p><strong>Conclusions: </strong>Reduced jaw ROM and trends toward reduced tongue ROM confirm hypokinesia as a distinguishing motor feature of speakers with PD. However, deviancies in speed or movement duration did not emerge as a distinguishing motor feature for any of the four studied clinical groups. Nevertheless, movement duration, but not movement speed, may be useful to index dysarthria severity.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3544-3557"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflicting Evidence for a Motor Timing Theory of Stuttering: Choral Speech Changes the Rhythm of Both Neurotypical and Stuttering Talkers, but in Opposite Directions.","authors":"Sophie Meekings, Lotte Eijk, Stefany Stankova, Santosh Maruthy, Sophie Kerttu Scott","doi":"10.1044/2024_JSLHR-24-00405","DOIUrl":"10.1044/2024_JSLHR-24-00405","url":null,"abstract":"<p><strong>Purpose: </strong>Talking in unison with a partner, otherwise known as choral speech, reliably induces fluency in people who stutter (PWS). This effect may arise because choral speech addresses a hypothesized motor timing deficit by giving PWS an external rhythm to align with and scaffold their utterances onto. This study tested this theory by comparing the choral speech rhythm of people who do and do not stutter to assess whether both groups change their rhythm in similar ways when talking chorally.</p><p><strong>Method: </strong>Twenty adults who stutter and 20 neurotypical controls read a passage on their own and then a second passage chorally with a neurotypical partner. Their speech rhythm was evaluated using Envelope Modulation Spectrum (EMS) analysis to derive peak frequency, a measure of the dominant rate of modulation in the sound envelope, as well as peak amplitude (the amplitude of the peak frequency), across several octave bands associated with different features of speech.</p><p><strong>Results: </strong>The two groups displayed opposing patterns of rhythmic change during choral reading. People with a stutter increased their EMS peak frequency when they read chorally, while neurotypical talkers' choral speech was characterized by reduced peak frequency compared to solo reading.</p><p><strong>Conclusions: </strong>Our findings show that the choral speech rhythm of PWS differs from that of neurotypical talkers. This indicates limited support for the hypothesis that choral speech addresses a motor timing deficit by giving PWS a rhythmic cue with which to align.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3558-3567"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Investigation on the Relationship Between Infant Vocal Characteristics at 12 Months and Speech Motor Impairment at 4-5 Years.","authors":"Helen L Long, Sydney Jensen, Katherine C Hustad","doi":"10.1044/2025_JSLHR-24-00340","DOIUrl":"10.1044/2025_JSLHR-24-00340","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this pilot study was to investigate the relationship between infant vocal characteristics and later speech motor impairment in children at risk for cerebral palsy (CP) to inform the early prediction of speech motor impairment.</p><p><strong>Method: </strong>Vocal complexity, volubility, and consonant inventories of 13 infants at risk of CP were examined at approximately 12 months. We examined their association with later levels of speech motor impairment as measured by the Viking Speech Scale (VSS).</p><p><strong>Results: </strong>Children in our sample with greater speech motor impairment at age 4 years produced lower rates of developmentally complex vocalizations in infancy but showed no significant differences in vocal stage attainment, volubility, or consonant diversity.</p><p><strong>Conclusions: </strong>Our results are in line with trends found in prior literature examining vocal characteristics of infants at risk for speech motor involvement. These results can inform data-driven hypotheses in future studies aimed at the early prediction of speech motor impairment through the study of infant vocal production.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3646-3658"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistency of Order Effects in Higher Effort Speaking Styles Between Sessions.","authors":"Mehran Ghasemi, Adam M Fullenkamp, Jason A Whitfield","doi":"10.1044/2025_JSLHR-24-00350","DOIUrl":"10.1044/2025_JSLHR-24-00350","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this investigation was to determine the extent to which instruction order impacts the clear and loud speech response and to examine the consistency of the clear and loud speech response across two sessions.</p><p><strong>Method: </strong>Acoustic and kinematic data from sentences produced in habitual, loud, and clear speech styles were collected from participants assigned in two groups: a Clear-Loud group (order: habitual, clear, loud) and a Loud-Clear group (order: habitual, loud, clear styles). Participants performed the same protocol order during two sessions scheduled 1 week apart.</p><p><strong>Results: </strong>Analyses revealed that there were no significant differences between groups for speech intensity, lip aperture range, and speech rate in the habitual style. In both sessions, talkers in the Clear-Loud group exhibited a modest increase in speech intensity between the habitual and clear style and a larger increase between the clear and loud style. Alternatively, talkers in the Loud-Clear group exhibited no differences in speech intensity between the loud and clear styles, retaining the increases associated with the loud style during clear speech. Additionally, talkers in the Loud-Clear group exhibited a more graded change in lip aperture range and speech rate between the habitual, loud, and clear speech styles. In contrast, those in the Clear-Loud group retained the changes in lip aperture range and speech rate that were observed in the clear style when performing the loud style.</p><p><strong>Conclusion: </strong>Despite some between-participant variation in the observed trends, these data suggest that most talkers retained characteristics of the previously performed higher effort style in subsequent style.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3627-3645"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress Toward Estimating the Minimal Clinically Important Difference of Intelligibility: A Crowdsourced Perceptual Experiment.","authors":"Kaila L Stipancic, Frits van Brenk, Mengyang Qiu, Kris Tjaden","doi":"10.1044/2024_JSLHR-24-00354","DOIUrl":"10.1044/2024_JSLHR-24-00354","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the current study was to estimate the minimal clinically important difference (MCID) of sentence intelligibility in control speakers and in speakers with dysarthria due to multiple sclerosis (MS) and Parkinson's disease (PD).</p><p><strong>Method: </strong>Sixteen control speakers, 16 speakers with MS, and 16 speakers with PD were audio-recorded reading aloud sentences in habitual, clear, fast, loud, and slow speaking conditions. Two hundred forty nonexpert crowdsourced listeners heard paired conditions of the same sentence content from a speaker and indicated if one condition was more understandable than another. Listeners then used the Global Ratings of Change (GROC) Scale to indicate <i>how much more understandable</i> that condition was than the other. Listener ratings were compared with objective intelligibility scores obtained previously via orthographic transcriptions from nonexpert listeners. Receiver operating characteristic (ROC) curves and average magnitude of intelligibility difference per level of the GROC Scale were evaluated to determine the sensitivity, specificity, and accuracy of potential cutoff scores in intelligibility for establishing thresholds of important change.</p><p><strong>Results: </strong>MCIDs derived from the ROC curves were invalid. However, the average magnitude of intelligibility difference derived valid and useful thresholds. The MCID of intelligibility was determined to be about 7% for a small amount of difference and about 15% for a large amount of difference.</p><p><strong>Conclusions: </strong>This work demonstrates the feasibility of the novel experimental paradigm for collecting crowdsourced perceptual data to estimate MCIDs. Results provide empirical evidence that clinical tools for the perception of intelligibility by nonexpert listeners could consist of three categories, which emerged from the data (\"no difference,\" \"a little bit of difference,\" \"a lot of difference\"). The current work is a critical step toward development of a universal language with which to evaluate changes in intelligibility as a result of neurological injury, disease progression, and speech-language therapy.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3480-3494"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Benefits of Robustness in Measures of Spatiotemporal Stability: An Investigation in Childhood Apraxia of Speech.","authors":"Alan Wisler, Janet Vuolo, Annalise Fletcher","doi":"10.1044/2024_JSLHR-24-00360","DOIUrl":"10.1044/2024_JSLHR-24-00360","url":null,"abstract":"<p><strong>Purpose: </strong>When using the spatiotemporal index (STI) to measure variability across repetitions of the same stimulus, researchers will typically screen and remove productions that contain errors or disfluencies. However, this screening process is highly subjective, reduces the amount of data available, and may generate samples that are less representative of true speech difficulties. In this study, we quantify the degree to which the STI is skewed by the inclusion of highly deviating productions and whether alternative calculations could better facilitate their inclusion.</p><p><strong>Method: </strong>First, we conducted a controlled simulation to quantify how highly deviating productions skew STI values. The traditional STI calculation was compared to three robust alternative measures proposed to reduce the influence of outlying productions. Next, using audio recordings from typically developing (TD) children and children with childhood apraxia of speech (CAS), we investigated how effectively each STI measure differentiated the two groups.</p><p><strong>Results: </strong>Simulation findings demonstrated that the STI can be heavily skewed (more than doubling in value) by the inclusion of a single outlying production. In contrast, the robust alternative measures were all able to incorporate multiple outlying productions before their value was significantly altered. The proposed best-5 STI measure produced larger group differences between TD children and children with CAS compared to the traditional STI in both \"Mom pets the puppy\" and \"Buy Bobby a puppy\" stimuli.</p><p><strong>Conclusions: </strong>The STI is highly sensitive to outlying productions and requires careful consideration of the repetitions included in its calculation. However, conservative approaches to data removal may be problematic when studying populations that are prone to fluency errors. In these scenarios, more robust alternatives to the STI, such as the best-5 STI measure, may provide a more practical approach to measuring speech variability.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27973236.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3495-3506"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Predictors of Perception and Adaption to Dysarthric Speech in Older Adults.","authors":"Kaitlin L Lansford, Micah E Hirsch, Tyson S Barrett, Stephanie A Borrie","doi":"10.1044/2024_JSLHR-24-00345","DOIUrl":"10.1044/2024_JSLHR-24-00345","url":null,"abstract":"<p><strong>Purpose: </strong>In effortful listening conditions, speech perception and adaptation abilities are constrained by aging and often linked to age-related hearing loss and cognitive decline. Given that older adults are frequent communication partners of individuals with dysarthria, the current study examines cognitive-linguistic and hearing predictors of dysarthric speech perception and adaptation in older listeners.</p><p><strong>Method: </strong>Fifty-eight older adult listeners (aged 55-80 years) completed a battery of hearing and cognitive tasks administered via the National Institutes of Health Toolbox. Participants also completed a three-phase familiarization task (pretest, training, and posttest) with one of two speakers with dysarthria. Elastic net regression models of initial intelligibility (pretest) and intelligibility improvement (posttest) were constructed for each speaker with dysarthria to identify important cognitive and hearing predictors.</p><p><strong>Results: </strong>Overall, the regression models indicated that intelligibility outcomes were optimized for older listeners with better words-in-noise thresholds, vocabulary knowledge, working memory capacity, and cognitive flexibility. Despite some convergence across models, unique constellations of cognitive-linguistic and hearing parameters and their two-way interactions predicted speech perception and adaptation outcomes for the two speakers with dysarthria, who varied in terms of their severity and perceptual characteristics.</p><p><strong>Conclusion: </strong>Here, we add to an extensive body of work in related disciplines by demonstrating age-related declines in speech perception and adaptation to dysarthric speech can be traced back to specific hearing and cognitive-linguistic factors.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3507-3524"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Fundamental Frequency Variation in Speakers With Parkinson's Disease: Effects of Tracking Errors.","authors":"Alena Portnova, Annalise Fletcher, Alan Wisler, Stephanie A Borrie","doi":"10.1044/2024_JSLHR-24-00381","DOIUrl":"10.1044/2024_JSLHR-24-00381","url":null,"abstract":"<p><strong>Purpose: </strong>Automatic measurements of fundamental frequency (<i>F</i>0) typically contain tracking errors that can be challenging to accurately correct. This study assessed to what degree these errors change <i>F</i>0 summary statistics in speakers with Parkinson's disease (PD) and neurotypical adults. In addition, we include a case study examining how the removal of tracking errors influenced our ability to predict a perceptual outcome measure, speech expressiveness, associated with dysarthria and PD. Several different statistical approaches for characterizing <i>F</i>0 variability were used to demonstrate the influence of tracking errors.</p><p><strong>Method: </strong>Eight speakers with PD and eight neurotypical speakers were recorded reading The Caterpillar passage. <i>F</i>0 measurements were extracted in Praat and tracking errors were manually identified. The effect of tracking errors on <i>F</i>0 mean and standard deviation was statistically analyzed. Twenty listeners rated speech expressiveness across 80 sentences. The relationship between listener ratings and <i>F</i>0 variability was examined using different statistical approaches for characterizing <i>F</i>0 variability (with and without tracking errors).</p><p><strong>Results: </strong>Measurements of <i>F</i>0 standard deviation, but not <i>F</i>0 mean, were significantly affected by tracking errors. Relationships between measurements of <i>F</i>0 variability and expressiveness were strengthened when tracking errors were removed from data analysis.</p><p><strong>Conclusions: </strong>Tracking errors significantly alter <i>F</i>0 standard deviation values for both speakers with PD and neurotypical adults. Case study evidence also suggests that tracking errors can reduce the strength of relationships between <i>F</i>0 variability and perceptual outcome measures, such as speech expressiveness.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3568-3582"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Does Prosodic Prominence Impact Articulatory Movement Parameters and Movement Variability in Adults Who Stutter?","authors":"Hailey C Kopera, Maria I Grigos","doi":"10.1044/2024_JSLHR-24-00358","DOIUrl":"10.1044/2024_JSLHR-24-00358","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined how focus-induced changes in degree of prosodic prominence impact articulatory movement parameters and movement variability in adults who stutter (AWS) and adults who do not stutter (AWNS). AWS were predicted to display greater across-trial variability in closing and opening duration, displacement, and velocity compared to AWNS as prosodic demands (i.e., addition of pitch accent, degree of prosodic strengthening) increased.</p><p><strong>Method: </strong>Sixteen AWS and 15 AWNS participated in this study. A question-answer paradigm was used to manipulate the prosodic structure of spoken sentences through changes in semantic focus, and articulatory movement data were collected via a motion capture system. Kinematic analyses included oral closing and opening duration, displacement, and peak velocity, as well as the variability of these measures across repeated productions.</p><p><strong>Results: </strong>AWS and AWNS demonstrated prosodic strengthening of closing and opening gestures, contributing to the differentiation of non-focused and focused words, as well as different focus types (e.g., broad vs. narrow/contrastive). AWS demonstrated greater variability in closing displacement and velocity for unaccented, non-focused forms compared to other focus types and compared to AWNS, which was not in line with predictions.</p><p><strong>Conclusions: </strong>This work demonstrates a complex relationship between degree of prosodic prominence and articulatory movement variability. Based on patterns observed in AWS, but not AWNS, it is plausible that processes involved in suppressing default nuclear accents could act as linguistic stressors on the speech motor systems of AWS. Further research is needed to advance our understanding of the role of prosody within a multifactorial view of stuttering.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3602-3626"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Kinematics and Perioral Muscle Activity Are Influenced by Stroop Effects.","authors":"Zoe Kriegel, Adam M Fullenkamp, Jason A Whitfield","doi":"10.1044/2024_JSLHR-24-00311","DOIUrl":"10.1044/2024_JSLHR-24-00311","url":null,"abstract":"<p><strong>Purpose: </strong>The current project aimed to examine the effects of two experimental cognitive-linguistic paradigms, the Stroop task and a primed Stroop task, on speech kinematics and perioral muscle activation.</p><p><strong>Method: </strong>Acoustic, kinematic, and surface electromyographic data were collected from the verbal responses of 30 young adult healthy control participants in choice response, classic Stroop, and primed Stroop tasks. The classic and primed Stroop tasks included congruent and incongruent trials. Across all three tasks, the set of possible responses was limited to the same three possible color words (red, green, and black) to facilitate performance comparisons between tasks.</p><p><strong>Results: </strong>Trials with ink-word incongruence in the Stroop tasks resulted in significantly higher muscle activation in the upper lip during response selection. In addition, a prime word within the Stroop task resulted in more spatial variation in lip + jaw movements for the spoken responses. These results were accompanied by the expected longer response times for incongruent trials in both classic and primed Stroop tasks.</p><p><strong>Conclusions: </strong>These findings may suggest that more central cognitive-linguistic interference processes may lead to inefficiencies in more peripheral speech motor control. Future research should investigate the pattern of these effects in older adults with and without motor speech disorders for research and clinical applications.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"3525-3543"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}