Journal of anesthesia and translational medicine最新文献

{"title":"The incidence of postoperative sleep disturbance and its influencing factors in cancer patients.","authors":"Zihan Wang, Xi Zhang, Shan Gao, Yingying Zhang, Dongxue Liu, Jian Peng","doi":"10.1016/j.jatmed.2025.12.001","DOIUrl":"10.1016/j.jatmed.2025.12.001","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are a risk factor for poor prognosis, which is significantly related to postoperative recovery in cancer patients. In this cross-sectional study, we investigated the incidence of sleep disturbance in cancer patients after surgery and the associated risk factors.</p><p><strong>Methods: </strong>380 cancer patients who underwent elective surgery in the First Affiliated Hospital of Wenzhou Medical University from October 2021 to June 2023 were selected. According to the Pittsburgh Sleep Quality Index (PSQI) score, the patients were divided into a sleep disturbance group (PSQI ≥ 6 points) and a no sleep disturbance group (PSQI < 6 points). Univariate analysis was performed on the general data of patients, surgery-related complications, and factors related to the hospital environment. Based on clinical practice and univariate analysis, variables associated with sleep disturbance were selected for inclusion in a multivariable logistic regression model to identify independent risk factors and to develop a predictive model, which was evaluated in terms of discrimination and calibration.</p><p><strong>Results: </strong>The incidence of postoperative sleep disturbance in cancer patients was 65.2 % (n = 193). Independent risk factors included preoperative sleep disturbance (OR [95 % CI]: 36.09 [15.59-83.53], <i>P</i> < 0.001), postoperative moderate to severe pain (OR [95 % CI]: 2.95 [1.19-7.30], <i>P</i> = 0.019), ward noise (OR [95 % CI]: 3.03 [1.41-6.52], <i>P</i> = 0.004), and postoperative anxiety (OR [95 % CI]: 9.07 [1.33-61.69], <i>P</i> = 0.024). Patients undergoing thoracic surgery had a lower risk of postoperative sleep disturbance compared to those undergoing thyroid or breast surgery (OR [95 % CI]: 0.27 [0.09-0.85], <i>P</i> = 0.024). Patients with high school education or above also had a lower incidence (OR [95 % CI]: 0.19 [0.08-0.50], <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The incidence of sleep disturbance in cancer patients after surgery was 65.2 %. Moderate to severe postoperative pain, postoperative anxiety, preoperative sleep disturbance, and ward noise are independent factors associated with postoperative sleep disturbance in cancer patients.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"277-285"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative anemia and postoperative delirium in elderly patients undergoing total hip arthroplasty with combined spinal-epidural anesthesia: A retrospective cohort study.","authors":"Xianting Ke, Yi Liu, Xingyin Chen, Qiuyue Jiang, Hongrui Zhu, Qing Li","doi":"10.1016/j.jatmed.2025.11.002","DOIUrl":"10.1016/j.jatmed.2025.11.002","url":null,"abstract":"<p><strong>Background: </strong>The effect of preoperative anemia on postoperative delirium (POD) risk in elderly patients undergoing total hip arthroplasty (THA) with spinal-epidural anesthesia remains unclear. This study aimed to evaluate the association of preoperative anemia and its severity on POD occurrence in this population.</p><p><strong>Methods: </strong>This retrospective cohort study included 609 patients aged ≥ 65 years who underwent their first elective total THA with CSE between January 1, 2020, and December 31, 2024. Patients were stratified by preoperative anemia status using WHO criteria as hemoglobin < 13 g/dL males and < 12 g/dL females. Anemia severity was further stratified into mild or moderate-to-severe categories using a hemoglobin cutoff of 11 g/dL. Inverse probability of treatment weighting (IPTW) was employed to adjust for potential confounders. The primary outcome was the incidence of postoperative delirium. The secondary outcomes included in-hospital deep vein thrombosis, pulmonary infection, surgical site infection, and length of hospital stay (LOS).</p><p><strong>Results: </strong>The overall POD incidence was 4.5 % (24/538). Moderate-to -severe anemia was significantly associated with increased POD risk (odds ratio [OR] 3.29; 95 % confidence interval [CI], 1.21-8.96; <i>P</i> = 0.02). No statistically significant differences were observed for secondary outcomes between groups.</p><p><strong>Conclusions: </strong>Moderate-to-severe preoperative anemia was significantly associated with an increased risk of postoperative delirium in elderly patients undergoing THA with combined spinal-epidural anesthesia. Further prospective studies are warranted to evaluate the efficacy of specific interventions aimed at correcting preoperative anemia in this patient population.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"234-240"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective mechanisms of dexmedetomidine in perioperative neurocognitive disorders: From molecular pathways to clinical translation.","authors":"Zhi Shang, Yuyang Wu, Chen Gu, Ju Gao, Cunjin Wang","doi":"10.1016/j.jatmed.2025.11.001","DOIUrl":"10.1016/j.jatmed.2025.11.001","url":null,"abstract":"<p><p>Perioperative neurocognitive disorders (PNDs) are common severe complications observed in elderly patients following surgery, primarily characterized by a decline in postoperative cognitive function and memory. Dexmedetomidine, a highly selective α₂-adrenergic receptor agonist, has garnered increasing attention due to its notable neuroprotective properties. This article comprehensively reviews the multifaceted neuroprotective mechanisms of dexmedetomidine in the prevention and management of PNDs, encompassing inhibition of neuroinflammation, mitigation of oxidative stress, reduction of cellular apoptosis, preservation of the blood-brain barrier, and regulation of metabolic reprogramming. Furthermore, this review delves into the clinical translational applications and future research directions of dexmedetomidine, offering a theoretical foundation for the development of more efficacious strategies in the prevention and treatment of PNDs.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"220-230"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive implant removal: Case report and the role of an ultrasound-trained anesthesiologist in perioperative localization and regional anesthesia.","authors":"Austin T Nguyen, Matthew W Swisher","doi":"10.1016/j.jatmed.2025.11.003","DOIUrl":"10.1016/j.jatmed.2025.11.003","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive implants offer a long-term reversible option for contraception. While palpable implants can be removed under local anesthesia in an office setting, nonpalpable implants can present greater safety challenges and may increase the overall complication rate of removal.</p><p><strong>Case presentation: </strong>We present the case of a 28 year-old female who presented for an elective upper extremity contraceptive implant removal. The implant could not be palpated, and imaging confirmed subfascial placement of the implant in muscle. Preoperatively, her implant was identified on ultrasound within the biceps brachii muscle and mapped to guide the dissection. An ultrasound-guided nerve block of the intercostobrachial and medial brachial cutaneous nerves was performed with subfascial deposition of local anesthetic. The implant was then successfully removed without any additional local anesthesia or analgesia.</p><p><strong>Conclusions: </strong>This case report highlights the role of anesthesiologist-directed localization and ultrasound-guided nerve blocks.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"231-233"},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative predictors of complications in open abdominal aortic surgery: A retrospective analysis under a structured perioperative goal-directed therapy protocol.","authors":"Rosanna Carmela De Rosa, Antonio Romanelli","doi":"10.1016/j.jatmed.2025.10.002","DOIUrl":"10.1016/j.jatmed.2025.10.002","url":null,"abstract":"<p><strong>Background: </strong>Perioperative goal-directed therapy (PGDT) optimizes hemodynamics in high-risk vascular surgery. However, data on postoperative risk factors and temporal hemodynamic and arterial blood gas (ABG) data patterns within PGDT-managed patients undergoing open elective abdominal aortic surgery (OEAAS) are limited.</p><p><strong>Methods: </strong>We conducted an explorative retrospective cohort study of patients undergoing sub-renal OEAAS managed with a structured PGDT protocol from the induction of anesthesia to six hours postoperatively. We collected clinical, hemodynamic, and ABG data at predefined perioperative time points. Patients were stratified by the occurrence of postoperative complications. Differences between groups were evaluated with appropriate tests. Univariate and bivariate Firth logistic regression analyses identified complication predictors, calculating odds ratio (OR) and 95 % confidence interval (95 % CI). Hemodynamic and ABG trends were assessed using the Aligned Rank Transform (ART) test. A p-value < 0.05 was significant.</p><p><strong>Results: </strong>Among 101 patients, postoperative complications occurred in 9.9 %, and the 30-day mortality rate was 4.0 %. Bivariate analysis identified longer surgery time (OR 1.01, 95 % CI 1.00-1.02, p = 0.034), higher postoperative fluid input (OR 1.67, 95 % CI 1.10-3.52, p = 0.016), and more positive fluid balance (OR 4.10, 95 % CI 1.53-16.76, p = 0.002) as associated with complications. ART indicated that patients with complications showed different trends in ScvO₂ (p = 0.031) and lactate (p < 0.001).</p><p><strong>Conclusions: </strong>In patients managed with PGDT, postoperative complications were associated with surgical complexity, positive fluid balance, and markers of impaired oxygen delivery. Monitoring dynamic trends of ScvO₂ and lactate may help identify high-risk patients and guide individualized hemodynamic management.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"197-206"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in non-cardiac surgical patients and associations with adverse outcomes: A systematic review and meta-analysis.","authors":"Jonathan Chung, Joshua Andrusiak, Sam Ali, Ellene Yan, Aparna Saripella, Frances Chung","doi":"10.1016/j.jatmed.2025.10.001","DOIUrl":"10.1016/j.jatmed.2025.10.001","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders such as anxiety and depression are associated with advanced disease at presentation, reduced treatment uptake, and worse postoperative outcomes. Despite this, preoperative screening remains underutilized. This systematic review and meta-analysis aimed to characterize the prevalence of preoperative anxiety and depression in non-cardiac surgery patients and assess their associations with adverse postoperative outcomes.</p><p><strong>Methods: </strong>The protocol was registered with PROSPERO (CRD42024578357) and followed PRISMA guidelines. MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and CENTRAL were searched. All studies included were prospective cohorts that enrolled a minimum of 100 adults undergoing non-cardiac surgery, used validated preoperative mental health screening tools, and reported postoperative outcomes. Studies involving cardiac, neurosurgical, or bariatric procedures were excluded. Random-effects meta-analysis generated pooled prevalence, mean difference (MD), and odds ratios (OR) with 95 % confidence intervals (CI) and 95 % prediction intervals (PI).</p><p><strong>Results: </strong>Forty-six studies (n = 23,628; mean age 58.5 ± 19.2 years; 61 % female) met inclusion criteria. Pooled prevalence of anxiety was 26 % (95 % CI, 21 %-31 %; 95 % PI, 20 %-33 %; I² = 95 %) while depression was 23 % (95 % CI, 14 %-31 %; 95 % PI, 14 %-36 %; I² = 100 %). The prevalence of anxiety ranged from 19 % in orthopedic to 29 % in cancer surgery. It was associated with a greater hospital length of stay (MD 0.55 days; 95 % CI, 0.29-0.82; 95 % PI, -0.04-1.14; I² = 0 %). The prevalence of depression ranged from 17 % in orthopedic to 30 % in cancer surgery and 24 % in mixed surgery. Preoperative depression was associated with increased odds of postoperative delirium (OR 2.33; 95 % CI, 1.74-3.11; 95 % PI, 1.5-3.5; I² = 0 %).</p><p><strong>Conclusions: </strong>Anxiety and depression affect one-fifth of non-cardiac surgical patients, with highest prevalence in cancer surgery. Preoperative anxiety was associated with a greater hospital length of stay, while preoperative depression was associated with twofold risk of postoperative delirium. Therefore, routine preoperative mental health screening could identify high-risk patients and enable targeted perioperative interventions to reduce adverse outcomes.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 4","pages":"207-219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural mechanisms of pain susceptibility and resilience: Insights from a socially transferred allodynia mouse model.","authors":"Yi Han, Lin Ai, Xin Yang, Hongxing Zhang","doi":"10.1016/j.jatmed.2025.09.002","DOIUrl":"10.1016/j.jatmed.2025.09.002","url":null,"abstract":"","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 3","pages":"193-195"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice advisory on the management of the perioperative period of scoliosis correction surgery.","authors":"Tiangang Lou, Lu Chen, Guihua Xiang, Wei Yan, Xin Pi, Kun Wang","doi":"10.1016/j.jatmed.2025.09.003","DOIUrl":"10.1016/j.jatmed.2025.09.003","url":null,"abstract":"<p><p>Scoliosis correction surgery is a complex procedure aimed at rectifying the spinal lateral curvature and rotation. Perioperative anesthetic management is a critical determinant of both surgical success and patient safety. As surgical and anesthetic techniques continue to advance, scoliosis correction has become increasingly established in clinical practice. However, there remains a paucity of standardized guidelines specifically addressing anesthetic practices in this procedure. This article aims to review several frequently encountered challenges during the perioperative phase of scoliosis correction surgery, with a particular emphasis on anesthetic considerations.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 3","pages":"186-192"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guidelines for postoperative pain management in adults (2024 edition).","authors":"Xiangdong Chen, Qinjun Chu, Yunshui Peng, Yaolong Chen, Alan D Kaye, Henry Liu, Jianjun Yang, Tianlong Wang, Weifeng Yu","doi":"10.1016/j.jatmed.2025.09.001","DOIUrl":"10.1016/j.jatmed.2025.09.001","url":null,"abstract":"<p><p>Acute pain differs in many aspects from chronic pain states and can arise from various etiologies. Recent years have seen advancements in postoperative acute pain management, which is a critical component of perioperative care. These strategies play a key role in enhancing recovery after surgery (ERAS) with goals of reducing postoperative opioid consumption and shortening hospital stay durations. To further standardize postoperative pain management for adult patients in China，the Guidelines Working Group has developed the Clinical Practice Guideline for Postoperative Pain Management in Adults (2024 Edition). These guidelines were formulated in accordance with World Health Organization handbook for guideline development and the Guidance Principles for Developing/Revising Clinical Guidelines in China (2022 Edition). These guidelines consist of 33 evidence-based recommendations for 17 clinical questions on postoperative pain management. We provide recommendations pertaining to preoperative education, risk assessment, selection of analgesic modalities, and management of adverse effects. We also provide some principles of analgesia strategy including: using preemptive or multimodal analgesia; foundation; regional blocks; patient-controlled intravenous analgesia; and opioid sparing. By enhancing the scientific rigor of postoperative pain management， the guidelines aim to provide healthcare professionals with a clear decision-making framework, ultimately improving patient outcomes.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 3","pages":"161-185"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open lung ventilation with low tidal volumes, staircase recruitment maneuvers, high PEEP and decremental PEEP titration vs ARDSNet in ARDS: A systematic review and meta-analysis.","authors":"Siyao Zeng, Zhipeng Yao, Chunming Guan, Shanpeng Cui, Zhen Quan, Yue Li, Junbo Zheng, Hongliang Wang","doi":"10.1016/j.jatmed.2025.08.001","DOIUrl":"10.1016/j.jatmed.2025.08.001","url":null,"abstract":"<p><p>The impact of open lung ventilation (OLV) with low tidal volumes (TV), staircase recruitment maneuvers (SRMs), high positive end-expiratory pressure (PEEP), and decremental PEEP titration on acute respiratory distress syndrome (ARDS) patients is still uncertain. We aim to assess the impact of this OLV versus ARDS Network (ARDSNet) on patients with ARDS. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science, Embase, and Cochrane were searched from inception through August 11, 2025. Statistical analysis used risk ratios (RR), weighted mean differences (WMD), and 95 % confidence intervals (95 % CI). Based on seven RCTs involving 1545 participants, it was found that for ARDS patients whose lung recruitability has not been assessed, compared to ARDSNet, OLV does not reduce hospital mortality (RR: 1.03; 95 % CI: 0.94 to 1.13; <i>P</i> = 0.51), ICU mortality (RR: 1.04; 95 % CI: 0.94 to 1.15; <i>P</i> = 0.41), mortality at day 28 (RR: 1.08; 95 % CI: 0.97 to 1.21; <i>P</i> = 0.18), mortality at day 60 (RR: 0.86; 95 % CI: 0.62 to 1.19; <i>P</i> = 0.36), or mortality at 6 months (RR: 1.07; 95 % CI: 0.98 to 1.18; <i>P</i> = 0.14). No significant differences were found in hospital length of stay, length of ventilation, ventilator-free days to day 28, incidence of barotrauma or rates requiring prone position. However, compared to ARDSNet, OLV improves the oxygenation index (OI) at days 1, 3, and 7, while also increasing the incidence of some adverse events such as pneumothorax requiring drainage within 7 days, hypotension within 1 h, arrhythmia, and desaturation. In ARDS patients whose lung recruitability has not been assessed, the routine application of OLV with low TV, SRMs, high PEEP, and decremental PEEP titration does not improve clinical outcomes and may result in certain adverse events.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"4 3","pages":"148-160"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}