Journal of Speech Language and Hearing Research最新文献

{"title":"Race Identification in American English.","authors":"Yolanda Feimster Holt, Tessa Bent, Melissa Baese-Berk, Kathrin Rothermich","doi":"10.1044/2024_JSLHR-24-00228","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-24-00228","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the race identification of Southern American English speakers from two geographically distant regions in North Carolina. The purpose of this work is to explore how talkers' self-identified race, talker dialect region, and acoustic speech variables contribute to listener categorization of talker races.</p><p><strong>Method: </strong>Two groups of listeners heard a series of /h/-vowel-/d/ (/hVd/) words produced by Black and White talkers from East and West North Carolina, respectively.</p><p><strong>Results: </strong>Both Southern (North Carolina) and Midland (Indiana) listeners accurately categorized the race of all speakers with greater-than-chance accuracy; however, Western North Carolina Black talkers were categorized with the lowest accuracy, just above chance.</p><p><strong>Conclusions: </strong>The results suggest that similarities in the speech production patterns of West North Carolina Black and White talkers affect the racial categorization of Black, but not White talkers. The results are discussed with respect to the acoustic spectral features of the voices present in the sample population.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689498","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":"Microbiome and Communication Disorders: A Tutorial for Clinicians.","authors":"Anumitha Venkatraman, Ruth Davis, Wen-Hsuan Tseng, Susan L Thibeault","doi":"10.1044/2024_JSLHR-24-00436","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-24-00436","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging research in the field of microbiology has indicated that host-microbiota interactions play a significant role in regulating health and disease. Whereas the gut microbiome has received the most attention, distinct microbiota in other organs (mouth, larynx, and trachea) may undergo microbial shifts that impact disease states. A comprehensive understanding of microbial mechanisms and their role in communication and swallowing deficits may have downstream diagnostic and therapeutic implications.</p><p><strong>Method: </strong>A literature review was completed to provide a broad overview of the microbiome, including differentiation of commensal versus pathogenic bacteria; cellular mechanisms by which bacteria interact with human cells; site-specific microbial compositional shifts in certain organs; and available reports of oral, laryngeal, and tracheal microbial dysbiosis in conditions that are associated with communication and swallowing deficits.</p><p><strong>Results/conclusions: </strong>This review article is a valuable tutorial for clinicians, specifically introducing them to the concept of dysbiosis, with potential contributions to communication and swallowing deficits. Future research should delineate the role of specific pathogenic bacteria in disease pathogenesis to identify therapeutic targets.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689496","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":"Accurately Identifying Language Disorder in School-Age Children Using Dynamic Assessment of Narrative Language.","authors":"Douglas B Petersen, Alisa Konishi-Therkildsen, Kallie Dawn Clark, Anahi Kamila DeRobles, Ashley Elizabeth Frahm, Kristi Jones, Camryn Lettich, Trina D Spencer","doi":"10.1044/2024_JSLHR-23-00594","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-23-00594","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies have demonstrated that dynamic assessment can be a less biased, valid approach for the identification of language disorder among diverse school-age children. However, all prior studies have included a relatively small number of participants, which is generally not adequate for psychometric research. This is the first large-scale study to (a) examine whether a dynamic assessment of narrative language yields indifferent outcomes regardless of several demographic variables including age, race/ethnicity, multilingualism, or gender; (b) examine the sensitivity and specificity of the dynamic assessment of language among a large sample of students with and without language disorder; and (c) identify specific cut-points by grade to provide clinically useful data.</p><p><strong>Method: </strong>Participants included 634 diverse first- through fifth-grade students with and without language learning disorder. Students were confirmed as having a language disorder using a triangulation technique involving several sources of data. A dynamic assessment of narrative language, which took approximately 10 min, was administered to all students.</p><p><strong>Results: </strong>Results indicated that the dynamic assessment had excellent (> 90%) sensitivity and specificity and that modifiability scores were not meaningfully different across any of the demographic variables.</p><p><strong>Conclusions: </strong>The dynamic assessment of narrative language accurately identified language disorder across all student demographic groups. These findings suggest that dynamic assessment may provide less biased classification than traditional, static forms of assessment.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689495","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":"Cochlear Implant Sound Quality.","authors":"Michael F Dorman, Sarah C Natale, Nadine Buczak, Josh Stohl, Francesco Acciai, Andreas Büchner","doi":"10.1044/2024_JSLHR-23-00678","DOIUrl":"10.1044/2024_JSLHR-23-00678","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this exploratory study were (a) to assess common terms used to describe cochlear implant (CI) sound quality by patients fit with conventional CIs and (b) to compare those descriptors to previously obtained acoustic matches to CI sound quality created by single-sided deaf (SSD) patients for their normal-hearing ear.</p><p><strong>Method: </strong>CI patients fit with Advanced Bionics (AB; <i>n</i> = 89), Cochlear Corporation (<i>n</i> = 86), and MED-EL (<i>n</i> = 80) implants were the participants. The patients filled out a questionnaire about CI sound quality for two time points: For the time near activation (T1) from memory and at the time of filling out the questionnaire (T2). The mean CI experience at T2 for the three groups ranged from 4 to 8 years. The questionnaire was composed of 25 adjectives describing sound quality.</p><p><strong>Results: </strong>For T1, the most commonly used descriptors were Computer-like, Treble-y, Metallic, and Mickey Mouse-like. A superordinate category of HiPitched (High Pitched) gathered significantly more responses from patients with shorter electrode arrays (AB and Cochlear) than patients with longer arrays (MED-EL). At T2, the most common descriptor was Clear and was chosen by approximately two thirds of the patients. The between-group differences in responses to items in the HiPitched category, present at T1, were absent at T2.</p><p><strong>Conclusions: </strong>The questionnaire data from conventional CI patients differs from previous sound matching data collected from SSD-CI patients. Alterations to the spectral composition of the signal are less salient to experienced conventional patients than to experienced SSD-CI patients. This is likely due to the absence, for conventional patients, of an exemplar in an NH ear against which to judge CI sound quality.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670003","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 Methodological Review of Stimuli Used for Classroom Speech-in-Noise Tests.","authors":"Kiri Mealings, Kelly Miles, Joerg M Buchholz","doi":"10.1044/2024_JSLHR-24-00261","DOIUrl":"10.1044/2024_JSLHR-24-00261","url":null,"abstract":"<p><strong>Purpose: </strong>Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening.</p><p><strong>Method: </strong>A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was <i>classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children</i> in the article title, abstract, and key word fields<i>.</i></p><p><strong>Results: </strong>A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies.</p><p><strong>Conclusion: </strong>This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27659619.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670002","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":"Aerodynamic Threshold Measures for Reflecting Glottal Closure in Voice Disorders.","authors":"Roger W Chan, Sally Chien Hsin Liu, Li-Chun Hsieh, Chia-Hsin Wu, Xia Wu, Zhenyu Xie","doi":"10.1044/2024_JSLHR-24-00336","DOIUrl":"10.1044/2024_JSLHR-24-00336","url":null,"abstract":"<p><strong>Purpose: </strong>Previous work suggested that phonation threshold pressure (PTP), phonation threshold flow (PTF), and phonation threshold power (PTW) could be effective aerodynamic measures for quantifying glottal incompetence. This study examined how these measures could reflect varying extent of incomplete glottal closure in individuals with voice disorders.</p><p><strong>Method: </strong>Thirty individuals formally diagnosed with glottal incompetence, including 10 with hypofunctional disorders (hypo group) and 20 with hyperfunctional disorders (hyper group), and 30 individuals with normal voice (control group) participated in the study. PTP was measured indirectly by intra-oral pressure during production of bilabial stop consonant-vowel syllables, PTF was measured during the sustained vowel /a/, and PTW was obtained as the product of PTP and PTF. The extent of incomplete glottal closure was quantified by normalized glottal gap (NGG) and normalized glottal gap area (NGGA) based on image analysis of videostroboscopic recordings of sustained /i/.</p><p><strong>Results: </strong>Significant differences in all threshold measures (<i>p</i> < .05) were found among three participant groups with medium-to-large effect sizes (η_p² = .128-.220), with significantly higher values for the hypo group than the control group and no significant differences between the hyper and control groups. Receiver operating characteristic (ROC) analysis showed the highest diagnostic or classification accuracy contrasting between the hypo and control groups (area under the ROC curve = .717-.757), with the highest classification accuracy for PTW. There were significant, moderate-to-strong positive correlations with NGG and NGGA for the disorders group (Pearson's <i>r</i> = .4244-.6226) and the hypo group (<i>r</i> = .5689-.8949).</p><p><strong>Conclusions: </strong>These measures could be effective for identifying glottal incompetence, especially for hypofunctional disorders. PTW could be more sensitive than PTP and PTF in reflecting the extent of incomplete glottal closure, consistent with theoretical predictions. Their relative sensitivities for quantifying distinct incomplete glottal closures specific to different voice disorders should be evaluated in future studies.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649000","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":"Characterizing Physiologic Swallowing Impairment Profiles: A Large-Scale Exploratory Study of Head and Neck Cancer, Stroke, Chronic Obstructive Pulmonary Disease, Dementia, and Parkinson's Disease.","authors":"Alex E Clain, Noelle Samia, Kate Davidson, Bonnie Martin-Harris","doi":"10.1044/2024_JSLHR-24-00091","DOIUrl":"10.1044/2024_JSLHR-24-00091","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the present study was to use a large swallowing database to explore and compare the swallow-physiology impairment profiles of five dysphagia-associated diagnoses: chronic obstructive pulmonary disease (COPD), dementia, head and neck cancer (HNC), Parkinson's disease (PD), and stroke.</p><p><strong>Method: </strong>A total of 8,190 patients across five diagnoses were extracted from a de-identified swallowing database, that is, the Modified Barium Swallow Impairment Profile Swallowing Data Registry, for the present exploratory cross-sectional analysis. To identify the impairment profiles of the five diagnoses, we fit 18 partial proportional odds models, one for each of the 17 Modified Barium Swallow Impairment Profile components and the Penetration-Aspiration Scale, with impairment score as the dependent variable and diagnoses, age, sex, and race as the independent variables with interactions between age and diagnoses and between PD and dementia (in effect creating a PD with dementia [PDwDem] group). For components with > 5% missingness, we applied inverse probability weighting to correct for bias.</p><p><strong>Results: </strong>PD and COPD did not significantly differ on 13 of the 18 outcome variables (all <i>p</i>s > .02). Dementia, stroke, and PDwDem all showed worse impairments than COPD or PD on five of six oral components (all <i>p</i>s < .007). HNC had worse impairment than all diagnoses except PDwDem for nine of 10 pharyngeal components (all <i>p</i>s < .006). Stroke and HNC had worse penetration/aspiration than all other diagnoses (all <i>p</i>s < .003).</p><p><strong>Conclusions: </strong>The present results show that there are both common and differing impairment profiles among these five diagnoses. These commonalities and differences in profiles provide a basis for the generation of hypotheses about the nature and severity of dysphagia in these populations. These results are also likely highly generalizable given the size and representativeness of the data set.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27478245.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-25"},"PeriodicalIF":2.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649114","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":"Linguistic Markers of Subtle Cognitive Impairment in Connected Speech: A Systematic Review.","authors":"Amélie B Richard, Manon Lelandais, Karen T Reilly, Sophie Jacquin-Courtois","doi":"10.1044/2024_JSLHR-24-00274","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-24-00274","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review covers the current stage of research on subtle cognitive impairment with connected speech. It aims at surveying the linguistic features in use to single out those that can best identify patients with mild neurocognitive disorders (mNCDs), whose cognitive changes remain underdiagnosed.</p><p><strong>Method: </strong>We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and proposed a full definition of features for the analysis of speech features. Fifty-one studies met the inclusion criteria. Most of them focused on age-related progressive diseases and included fewer than 30 subjects.</p><p><strong>Results: </strong>A total of 384 features labeled with 335 different names was retrieved, yielding various results in discriminating individuals with mNCDs from controls.</p><p><strong>Conclusions: </strong>This finding highlights the need for harmonized labels to further investigate mNCDs with linguistic markers. We suggest two different ways of assessing a feature's reliability. We also point out potential methodological issues that remain to be resolved, along with recommendations for reproducible research in the field.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640322","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":"Progression of Motor Speech Function in Speakers With Primary Progressive Apraxia of Speech.","authors":"Gabriela Meade, Nha Trang Thu Pham, Heather M Clark, Joseph R Duffy, Jennifer L Whitwell, Keith A Josephs, Rene L Utianski","doi":"10.1044/2024_JSLHR-24-00283","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-24-00283","url":null,"abstract":"<p><strong>Purpose: </strong>Speakers with primary progressive apraxia of speech (PPAOS) have an insidious onset of motor speech planning/programming difficulties. As the disease progresses, the apraxia of speech (AOS) becomes more severe and a co-occurring dysarthria often emerges. Here, longitudinal data from speakers with phonetic- and prosodic-predominant PPAOS are used to characterize the progression of their motor speech impairment, including the development of dysarthria and mutism.</p><p><strong>Method: </strong>Data are presented from 52 speakers who had PPAOS at enrollment (i.e., progressive AOS in the absence of aphasia, cognitive, or other neurologic symptoms). Twenty-one had predominantly phonetic features, whereas 31 had primarily prosodic features. All participants underwent a comprehensive motor speech evaluation at their enrollment visit and each annual return visit, with a median of three visits per participant.</p><p><strong>Results: </strong>Almost 25% of the speakers with PPAOS presented with dysarthria at their enrollment visit (median disease duration of 3.65 years), whereas more than 70% of them had developed dysarthria by their last visit (median disease duration of 6.85 years). Neither the likelihood to develop dysarthria nor the disease duration at which it was detected differed significantly between the phonetic and prosodic groups. However, muteness emerged sooner for speakers with phonetic-predominant PPAOS; the median disease duration at which they became mute was 1.5 years shorter than for their prosodic counterparts.</p><p><strong>Conclusions: </strong>Clinically, these results facilitate more accurate prognostication of motor speech symptoms in speakers with PPAOS, allowing for timely introduction of alternative means of communication. The results also support the differentiation between progressive AOS and dysarthria as distinct motor speech disorders that often co-occur in these individuals.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640324","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":"Influence of Voice Focus on Auditory Feedback Control of Speech Using Long-Term Average Spectrum, Phon Spectrum, and Accelerometry.","authors":"Shao-Hsuan Lee, Guo-She Lee","doi":"10.1044/2024_JSLHR-24-00051","DOIUrl":"https://doi.org/10.1044/2024_JSLHR-24-00051","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the effect of voice-focus adjustments on oronasal balance and auditory feedback control of speech via analyzing spectral distribution, perceived loudness, and nasal vibrations during sustained phonation and passage reading.</p><p><strong>Method: </strong>Twenty-five speech-language pathologists sustained /a/ and read passages with forward, backward, and natural voice focuses in quiet and noisy conditions. The low-frequency power (LFP) below 3 Hz of vocal fundamental frequency was analyzed to access audio-vocal feedback control. Long-term average spectra of speech were converted to phon spectra based on equal-loudness contours ISO 226:2003 to estimate perceived loudness of self-voice across different conditions. Nasal vibrations were also recorded using a digital accelerometer to measure oronasal coupling.</p><p><strong>Results: </strong>Forward-focused voice enhanced the nasal acceleration and reduced LFP, suggesting that increasing the degree of oronasal coupling can improve audio-vocal feedback control compared to natural and backward-focused voices. Voice-focus adjustments were most related to average power and phon values in the 0.2- to 0.3-kHz band. In noise, perceived loudness in the 0.5- to 2.3-kHz band effectively predicted LFP, outperforming the average spectral power of the same band.</p><p><strong>Conclusions: </strong>Voice-focus adjustments significantly impact both the acoustic transfer function of the vocal tract and the spontaneous fine-tuning of audio-vocal integration. This influence becomes particularly pronounced when sound intensity or perceived loudness is changed within the frequency range of 0.2-2.3 kHz, depending on the voice focus selected by the speakers.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27183483.</p>","PeriodicalId":51254,"journal":{"name":"Journal of Speech Language and Hearing Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632316","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}