Minerva Urology and Nephrology最新文献

{"title":"Future study: when a trial could be confusing.","authors":"Andrea Braga, Montserrat Espuña-Pons, Maurizio Serati","doi":"10.23736/S2724-6051.25.06532-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06532-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785916","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":"First-in-human transcontinental telesurgery collaboration for high intensity-focused ultrasound: a new era in globalizing focal treatment for prostate cancer.","authors":"Ruben Olivares, Jihad Kaouk, Nicolas A Soputro, Christopher J Weight, Georges-Pascal Haber, Waleed Hassan","doi":"10.23736/S2724-6051.25.06506-1","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06506-1","url":null,"abstract":"<p><p>The advent of telesurgery has opened a new frontier within minimally invasive surgery, allowing surgeons to complete procedures from a remote location and providing new opportunities for the delivery of care. Herein, we present the first clinical experience of telesurgery using high intensity-focused ultrasound (HIFU) for focal treatment of prostate cancer. The procedure was performed using the Focal One^® device (Focal One, Austin, TX, USA) on a 72-year-old with an ISUP Grade Group 2 prostate cancer from a single biopsy core that corresponds to a PIRADS 4 lesion in the left mid-apical region. A secure remote connection was established using the Software-Defined Wide Area Network (SD-WAN) infrastructure between the purpose-built virtual desktop for the console surgeon in Cleveland (OH, USA) and the operating room in Abu Dhabi (United Arab Emirates), spanning a total distance of 11,412 km (7091 miles). A total volume of 26.4 cm³ was ablated within 50 minutes of ablation time. Intraoperative blood loss was minimal, and there was no evidence of perioperative complications. With the total round-trip latency of 115 milliseconds, there remained no perceptible disruptions that were noted during the procedure. Notably, this collaborative effort marked a significant milestone that underscored the safety and feasibility of HIFU telesurgery for the management of localized, clinically significant prostate cancer. This remote surgery model using an already established network infrastructure, offers significant promise for expanding access to specialized, high-quality medical care, particularly in underserved regions.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"561-565"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978155","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":"Erectile dysfunction and obstructive sleep apnea syndrome: a post-hoc evaluation of Italian survey results.","authors":"Francesco DI Bello, Gianluigi Califano, Claudia Collà Ruvolo, Simone Morra, Agostino Fraia, Edoardo Mocini, Benedetta Muzii, Luigi Napolitano, Massimiliano Creta, Giovanni Salzano, Luigi A Vaira, Francesco Mangiapia, Nelson M Maldonato, Elena Cantone, Nicola Longo","doi":"10.23736/S2724-6051.24.05925-1","DOIUrl":"10.23736/S2724-6051.24.05925-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of the current study was to identify predictors of erectile dysfunction (ED) and obstructive sleep apnea syndrome (OSAS) in male participants at Italian web-survey.</p><p><strong>Methods: </strong>A cross-sectional web-based survey was administered via Google Forms between July 17 and October 31, 2022, among Italian participants. The erectile function and the excessive daytime sleepiness were measured through the International Index of Erectile Function - 5 (IIEF5) and Epworth Sleepiness Scale (ESS), respectively. Two separate and independent multivariable logistic regression models (mLRMs) were fitted to predict ED and OSAS, respectively, in men answering to the survey.</p><p><strong>Results: </strong>A total of 238 patients were identified. Of those, 58 (24%) reported to be affected by OSAS disease. Higher proportion of mild (21 vs. 6%), mild-to-moderate (9 vs. 5%), and severe (16 vs. 7%) ED were recorded in OSAS vs. non-OSAS patients (P<0.001). In mLRMs predicting ED (IIEF5≤7), age (OR: 1.04, 95% confidence interval [CI]: 1.01-1.06; P=0.002), and IPSS total score (OR:1.08, 95% CI: 1.02-1.15; P=0.006) were independent predictors. In mLRMs predicting OSAS, age (OR: 1.08, 95% CI: 1.05-1.12; P<0.001), Body Mass Index (BMI; OR: 1.12, 95% CI: 1.05-1.21; P<0.001), and ESS score (OR:1.14, 95% CI: 1.05-1.24; P=0.001) were independent predictors. In the subgroup analyses predicting severe ED, ESS and age or BMI or IPSS resulted as independent predictors (OR from 0.7 to 0.8; all P<0.05).</p><p><strong>Conclusions: </strong>The ESS score independently predicted severe ED in males. As a result, the OSAS disease should be explored in patients who harbored severe ED to address those patients for a prompt ear, nose and throat evaluation.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"538-545"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190311","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":"Awareness and use of generative AI-powered tools: results of one-year follow-up prospective cross-sectional global survey.","authors":"Francesco Cei, Conner Ganjavi, Ethan Layne, Tesniem Hussari, Rafael R Gevorkyan, Michael Eppler, Pietro Piazza, Severin Rodler, Enrico Checcucci, Juan Gomez Rivas, Karl F Kowalewski, Ines Rivero Belenchón, Stefano Puliatti, Mark Taratkin, Alessandro Veccia, Loïc Baekelandt, Pieter DE Backer, Jeremy Teoh, Bhaskar Somani, Marcelo Wroclawski, Andre DE Castro Abreu, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Francesco Porpiglia, Declan Murphy, David Canes, Inderbir Gill, Giovanni E Cacciamani","doi":"10.23736/S2724-6051.25.06133-6","DOIUrl":"10.23736/S2724-6051.25.06133-6","url":null,"abstract":"<p><strong>Background: </strong>Generative AI (GenAI) frameworks, such as generative pre-trained transformer (GPTs) and large language models (LLMs), promise to transform clinical and research practices. Informed human opinion is key to guiding appropriate technological development and task refinement. Detailed data on how GPTs/LLMs powered-Chatbots usage, perceived risks and benefits among physicians has evolved over time and their impact on clinical and academic activities remain unclear. The aim of this study is to assess how the use of GPTs/LLMs chatbots by professionals working in urology has changed over time in the setting of academic and clinical activities.</p><p><strong>Methods: </strong>A one-year follow-up prospective cross-sectional survey was conducted among urology professionals. Results were reported highlighting the differences in baseline characteristics of participants and their responses between the initial release (April 20^th, 2023 and May 5^th, 2023) and re-deployment of the survey 12 months after chi square and t-test were used to compare categorical and continuous variables.</p><p><strong>Results: </strong>A total of 129 participants completed the second survey. Eighty-six percent of participants reported having used any GPTs/LLMs chatbot for academic tasks, a significant increase from the previous survey (52.4%; P<0.001). When asked if they were using GPTs/LLMs chatbots more in academic settings compared to one year prior, 70.1% of participants answered affirmatively. Participants, when asked about the use of GPT/LLMs in particular clinical tasks after one year, reported less frequent use for deciding treatment options (18.6% vs. 31.0%; P=0.03) and patient follow-up care (10.1% vs. 21.4%; P=0.02). When participants were asked if they were using LLM chatbots more in clinical settings compared to one year before, 35.6% answered affirmatively.</p><p><strong>Conclusions: </strong>GPTs/LLMs have a consolidated role in academic tasks, with increasing usage, while some resistance to their use in clinical practice remains. These results are relevant for driving the human-centered development of GenAI technology.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"528-537"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063265","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":"Preventing and treating kidney stones: an umbrella review of meta-analyses of non-surgical randomized controlled trials.","authors":"Nicola Veronese, Stefano Ciriminna, Chiara M Errera, Maria C Garlisi, Ottavia Tulone, Vitalba Sapienza, Maria E Ciuppa, Rossella Capitummino, Chiara Giannettino, Ottavia G Plano, Salvatore F Contarino, Giuseppe Guagenti, Calogero Cottone, Federica Cardillo, Manuel Gilante, Lucia Campo, Gabriele Tulone, Alchiede Simonato, Mario Barbagallo, Nicola Pavan","doi":"10.23736/S2724-6051.25.06296-2","DOIUrl":"10.23736/S2724-6051.25.06296-2","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney stones represent a significant health burden due to their high prevalence, recurrence, and associated healthcare costs. Medical interventions are crucial for preventing and treating kidney stones, especially for patients at high risk or those undergoing extracorporeal shock wave lithotripsy (SWL). This umbrella review aims to synthesize evidence from systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the efficacy of non-surgical medical treatments in preventing and managing kidney stones.</p><p><strong>Evidence acquisition: </strong>A comprehensive search was conducted across Medline, Embase, and Web of Science until February 2024. Systematic reviews with meta-analyses of RCTs focusing on non-surgical medical interventions for kidney stone prevention and treatment were included. The GRADE framework evaluated the certainty of evidence.</p><p><strong>Evidence synthesis: </strong>Among 2481 records initially considered, nine systematic reviews comprising 88 RCTs and 27,286 participants were included. Supported by a high level of evidence according to the GRADE, tamsulosin, compared to placebo, demonstrated improved stone clearance post-SWL, while vitamin D and calcium supplementation were ineffective for primary prevention. In 571 patients affected by recurrent kidney calculi, the use of thiazides, compared to placebo, was associated with a statistically significant decrease in renal stones of 66% (GRADE: high level of evidence). The use of potassium citrate was able to prevent the risk of nephrolithiasis recurrence of 79%, supported by a high level of evidence.</p><p><strong>Conclusions: </strong>Several medical interventions for kidney stone management are supported by high-certainty evidence, particularly post-SWL α-blocker therapy and potassium citrate for recurrence prevention.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"472-478"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978204","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":"The current role of photodynamic diagnosis (PDD) in the management of non-muscle invasive bladder cancer: the Italian Society of Urology (SIU) Position Paper.","authors":"Francesco Soria, Andrea Mari, Marco Moschini, Richard Naspro, Rodolfo Hurle, Eugenio Miglioranza, Alberto Lapini, Alessandro Antonelli, Andrea Tubaro, Alessandro Volpe, Riccardo Bartoletti, Paolo Gontero, Giuseppe Carrieri, Vincenzo Ficarra","doi":"10.23736/S2724-6051.25.06361-X","DOIUrl":"10.23736/S2724-6051.25.06361-X","url":null,"abstract":"<p><p>Photodynamic diagnosis (PDD) significantly enhances the detection of bladder cancer (BCa) and is able to reduce the risk of disease recurrence, although it may not affect disease progression and mortality rates. Despite its advantages, widespread adoption of PDD is limited by cost considerations and the absence of unified guidelines on its application, highlighting the need for continued evaluation of its cost-effectiveness across different healthcare settings. To date, no specific recommendations for PDD in non-muscle invasive bladder cancer (NMIBC) management have been provided by the Italian Society of Urology (Società Italiana di Urologia, SIU). Therefore, the aim of this paper is to report on the position of SIU on the role of PDD in NMIBC. According to available evidence and international guidelines (i.e., European Association of Urology, American Association of Urology, National Comprehensive Cancer Network and other national guidelines) on BCa, a Panel of twelve Italian urologists with long and renowned experience in treating BCa defined current indications for PDD in the management of NMIBC. The final document was ultimately reviewed and approved by the expert Panel prior to publication. The consensus highlighted the role of PDD during the initial transurethral resection of the bladder (TURB) to detect carcinoma in situ (CIS) and small papillary lesions that might otherwise be missed, leading to disease persistence. Additionally, in clinical scenarios such as positive urine cytology with negative cystoscopy, PDD-guided biopsies can significantly increase the detection of CIS. For cases involving larger or multifocal tumors, or atypical macroscopic features during cystoscopy, PDD is valuable for identifying subtle high-grade disease elements, thereby facilitating more precise risk stratification and targeted treatment planning. In the setting of re-TURB, aiming to detect the presence and extent of concomitant CIS and to gain all possible additional information, PDD may be used in all procedures if not already performed during initial resection. Finally, PDD may be used for disease recurrence in patients with a history of HG NMIBC and to evaluate the response of CIS to Bacillus Calmette-Guérin (BCG). This position paper of the SIU highlights the current recommendation for the use of PDD in the management of NMIBC, from initial TURB, to re-TURB and follow-up.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"443-450"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978315","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":"Impact of minimally invasive surgical therapies on sexual function in benign prostatic hyperplasia: a systematic review.","authors":"Burak Akgul, Abdüllatif Aydin, Omer O Cakir, Atınc Tozsin, Onika Noel, Mehmet Balasar, Tevfik Aktoz, Lütfi Tunc, Cristian Fiori, Jens Rassweiler, Selcuk Guven, Kamran Ahmed","doi":"10.23736/S2724-6051.25.06374-8","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06374-8","url":null,"abstract":"<p><strong>Introduction: </strong>Technological advancements in minimally invasive surgical therapies(MIST) have altered the management of benign prostatic hyperplasia (BPH), offering reduced morbidity and better preservation of sexual functions compared to traditional surgical methods. The study aimed to systematically evaluate the effects of MISTs on erectile and ejaculatory functions in patients with BPH.</p><p><strong>Evidence acquisition: </strong>A systematic literature search was performed in Medline(PubMed), Embase (Ovid), and Cochrane Library (up to December 2024) following PRISMA guidelines (PROSPEROCRD42024541279). Retrospective and prospective studies were included, focusing on changes in the International Index of Erectile Function (IIEF-5) and the Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD; Function and/or Bother) scales, alongside the incidence of erectile (ED) and ejaculatory dysfunction (EjD) following MISTs.</p><p><strong>Evidence synthesis: </strong>Out of 743 studies, 79 met the inclusion criteria. EjD was reported for water vapor thermal therapy (WVTT) as 3.2% and 10.8% at 6- and 12-month follow-ups, respectively. For Aquablation, the rates were 15% at 6 months, 7% at 5 years, and at 3 years, 9.7% in younger and 12% in older patients. For Prostatic Artery Embolization(PAE), EjD was reported as 13.3% at 1 year and 56% at 2 years. ED rates were 6.8% at 10 years for Transurethral Needle Ablation(TUNA) and 1% at 5 years for transurethral microwave therapy (TUMT). Erectile function was largely preserved except for radiology-based techniques.</p><p><strong>Conclusions: </strong>This review underscores the superiority of MISTs in preserving erectile and ejaculatory functions compared to conventional treatments, particularly with PUL, Temporarily implantable nitinol device (iTIND), and the optilume BPH catheter system. While ED is largely preserved except for radiology-based techniques, EjD remains a potential risk.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"459-471"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978201","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":"Robotic retrohepatic inferior vena cava thrombectomy using the caudate lobectomy technique: indications and initial outcomes.","authors":"Cheng Peng, Jialong Song, Guodong Zhao, Liangyou Gu, Kan Liu, Zhuo Jia, Qilong Jiao, Ben Cao, Yibo Chen, Zhi Li, Xinran Chen, Qingjiang Xu, Liang Xu, Changwei Shi, Baojun Wang, Xu Zhang, Xin Ma, Qingbo Huang","doi":"10.23736/S2724-6051.25.06427-4","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06427-4","url":null,"abstract":"<p><strong>Background: </strong>Liver mobilization is essential for exposing the retrohepatic inferior vena cava (IVC) during level II-III robot-assisted IVC thrombectomy (RA-IVCT), but complex cases present significant challenges with a high risk of severe complications. This study aimed to evaluate the safety and feasibility of caudate lobectomy in facilitating retrohepatic IVC exposure in these complex cases.</p><p><strong>Methods: </strong>Sixteen patients with complex level II-III IVC tumor thrombus (IVC-TT) underwent RA-IVCT with caudate lobectomy in our institution from January 2021 to November 2023. Thirty-two baseline-matched patients who underwent RA-IVCT without caudate lobectomy by equivalent experienced surgeons were included as controls. In cases requiring caudate lobectomy, the hepatic parenchyma was transected between the paracaval portion and the Spiegel's lobe to improve exposure and control of the cephalic IVC using tourniquets.</p><p><strong>Results: </strong>All procedures were successfully completed. Five patients in the control group required conversion to open surgery compared to one patient in the caudate lobectomy group due to liver congestion. The caudate lobectomy group demonstrated significantly shorter liver mobilization times (138 vs. 188 minutes, P=0.044), reduced blood loss (1100 vs. 1900 mL, P=0.021), lower transfusion requirements (600 vs. 940 mL, P=0.033), and alleviated postoperative complications (P=0.035). Liver and kidney function, as well as short-term survival, were comparable between groups. Caudate lobectomy was shown to enhance exposure and control of the retrohepatic IVC during RA-IVCT.</p><p><strong>Conclusions: </strong>Caudate lobectomy facilitates retrohepatic IVC exposure and control in complex level II-III IVC-TT, potentially simplifying surgery and improving perioperative outcomes.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"490-499"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978293","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":"From launch to legacy: 10 years of The European Association of Urology Guidelines on social media.","authors":"Claudia Mercader, Jeremy Y Teoh, Nikita R Bhatt, Vito Cucchiara, Esther García Rojo, Vineet Gauhar, Julie Darraugh, Carla Bezuidenhout, Marc VAN Gurp, Evelynn Woods, Elisabeth Hesston, Jarka Bloemberg, Stacy Loeb, Morgan Roupret, Inge M VAN Oort, Hendrik Borgmann, Stefan W Czarniecki, Francesco Esperto, Benjamin Pradere, James N'dow, Maria J Ribal, Gianluca Giannarini","doi":"10.23736/S2724-6051.25.06474-2","DOIUrl":"10.23736/S2724-6051.25.06474-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"451-454"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555712","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":"New prospective of omitting pelvic lymph node dissection during radical prostatectomy for prostate cancer patients with negative preoperative PSMA PET.","authors":"Giuseppe Reitano, Giacomo Novara, Fabrizio Dal Moro, Fabio Zattoni","doi":"10.23736/S2724-6051.25.06640-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06640-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 4","pages":"455-458"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978194","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}