César Valle , Armando Malanda , Oscar Garnés-Camarena , Daniel.W. Stashuk , Gurutzi Azkona , Javier Rodríguez-Falces , Javier Navallas
{"title":"Peaks or threshold-crossing: A comparative analysis of neuromuscular jitter measurement methods","authors":"César Valle , Armando Malanda , Oscar Garnés-Camarena , Daniel.W. Stashuk , Gurutzi Azkona , Javier Rodríguez-Falces , Javier Navallas","doi":"10.1016/j.jelekin.2025.103065","DOIUrl":"10.1016/j.jelekin.2025.103065","url":null,"abstract":"<div><h3>Introduction</h3><div>Commercial electromyographic recording systems usually include two different methods for jitter measurement, based on peaks or threshold-crossing. There is reported evidence that the measurements obtained with both methods from discharges recorded with concentric needle electrodes offer comparable results, but this evidence is scarce. This study aimed to replicate such studies and extract conclusions related to the use of the two methods.</div></div><div><h3>Methods</h3><div>129 EMG recordings were obtained from 12 patients using concentric needle electrodes (0.02 mm<sup>2</sup>), filtered at 1000 Hz and oversampled to 200 kHz. The recordings were aligned using either peak or threshold-crossing methods. Jitter was measured using both methods and obtained as mean consecutive differences (MCD). Statistical analyses included Anderson-Darling, Wilcoxon, and linear regression tests.</div></div><div><h3>Results</h3><div>Of the 129 recordings, 49 (38 %) were excluded for presenting contaminated waveforms. MCD values were similar in the two methods, with a median difference of −0.92 µs. The Wilcoxon test confirmed this difference (p = 0.0002). The regression yielded a high coefficient of determination (R<sup>2</sup> = 0.994) and a slope of 0.989.</div></div><div><h3>Conclusion</h3><div>No significant differences were found between the two jitter measurement methods. Variations were only a few µs, not enough to affect pathological jitter diagnosis. Both methods are valid for clinical use.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"85 ","pages":"Article 103065"},"PeriodicalIF":2.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of muscle activity between isokinetic and iso-inertial exercise","authors":"Timothy H.T. Phillips , Ransi S.S. Subasinghe Arachchige , Roy T.H. Cheung","doi":"10.1016/j.jelekin.2025.103052","DOIUrl":"10.1016/j.jelekin.2025.103052","url":null,"abstract":"<div><h3>Background</h3><div>Resistance training plays a crucial role in musculoskeletal rehabilitation and athletic performance. Traditional resistance training often underloads the eccentric phase, as muscles generate more force while lengthening. Isokinetic and iso-inertial exercises have been used to overcome this limitation, with both showing greater muscle activity compared to traditional methods, potentially leading to enhanced strength and hypertrophy. However, limited research compares the two modalities.</div></div><div><h3>Methods</h3><div>This randomised crossover study involved healthy adults between the ages of 18–45 years who performed isokinetic knee extensions and iso-inertial squats at fast and slow speeds. Electromyographic activity of the quadriceps was recorded, and the eccentric-to-concentric root-mean-square (RMS) ratio was calculated.</div></div><div><h3>Results</h3><div>Results showed that iso-inertial exercise at fast speeds led to a significantly greater eccentric-to-concentric RMS ratio in the rectus femoris (95 % CI 0.11 to 0.74; Cohen’s d = 0.89) and vastus lateralis (95 % CI 0.07 to 0.55, Cohen’s d = 0.75) compared to isokinetic exercise, with no difference in vastus medialis or at slow speeds.</div></div><div><h3>Conclusion</h3><div>Conclusion: These findings indicate that iso-inertial exercise induces greater eccentric muscle activity in key quadriceps muscles at fast speeds, suggesting its potential for enhancing eccentric overload and muscle strength gains.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"85 ","pages":"Article 103052"},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shoulder muscle activity magnitude and timing in individuals with specific scapular movement patterns","authors":"Gaura Saini , Madeline Goodson , Paula M. Ludewig","doi":"10.1016/j.jelekin.2025.103054","DOIUrl":"10.1016/j.jelekin.2025.103054","url":null,"abstract":"<div><div>Relationships between specific muscle activity alterations and specific scapular motion patterns have not been well established. The purpose of this study was to identify muscle activation magnitude and timing in two specific scapular movement groups (excessive scapular anterior tilt, scapular lateralization). Surface electromyography (EMG) was captured simultaneously with biplane video radiography and optical motion capture during two repetitions each of shoulder flexion, abduction, and unrestricted overhead reaching in 45 adults with shoulder pain. The following muscle activation magnitudes measured with EMG were assessed individually and in ratios: lower trapezius (LT), serratus anterior (SA), upper trapezius (UT), anterior deltoid (AD), and middle deltoid (MD). The timing of each muscle’s initiation was calculated as a percent of humerothoracic range of motion. For EMG magnitude, significant interactions including group were found for AD, LT/SA, and LT/AD. Findings suggest a relative reduction of SA in both groups in the constrained motions compared to the self-selected motion and a reduction in LT in the lateralization group in early motion. For EMG timing, no group effects were significant, however findings suggest delays in SA and LT activation in both groups. The findings provide evidence that individuals with different scapular movement patterns may have distinct muscle activity patterns which can inform patient-specific rehabilitation interventions.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"85 ","pages":"Article 103054"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Carlos dos Santos Albarello , Hélio V. Cabral , Francesco Negro , Liliam Fernandes de Oliveira
{"title":"Greater distal excitation of the biceps femoris long head reflects proximodistal differences in motor unit action potential properties","authors":"José Carlos dos Santos Albarello , Hélio V. Cabral , Francesco Negro , Liliam Fernandes de Oliveira","doi":"10.1016/j.jelekin.2025.103053","DOIUrl":"10.1016/j.jelekin.2025.103053","url":null,"abstract":"<div><div>Evidence on regional muscle excitation within hamstrings remains controversial, primarily because information derived solely from surface electromyograms (sEMG) amplitude does not necessarily provide an accurate estimate of neural drive to the muscle. To address this limitation, this study investigated whether there are proximodistal differences in motor unit properties of the biceps femoris long head during isometric hip extension and knee flexion tasks. Seventeen resistance-trained males performed isometric knee flexion and hip extension tasks at 20 % and 40 % of maximal voluntary contraction. High-density sEMG were recorded from proximal and distal regions of the biceps femoris long head and decomposed into individual motor units. Central motor unit and action potential properties were analyzed. Bipolar sEMG amplitude was also calculated for each region to simulate traditional sEMG measurements. Bipolar sEMG amplitude, motor unit action potential amplitude and conduction velocity were significantly greater in the distal region during both tasks. In contrast, no proximodistal differences were observed in central motor unit properties. These findings suggest that increased bipolar sEMG amplitude in the distal region of the biceps femoris long head is driven by motor unit action potential properties rather than differences in central modulation, likely influenced by intra-muscular variations in muscle mechanics and geometry.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"85 ","pages":"Article 103053"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cameron D. Ley , Eduardo Martinez Valdes , Conall F. Murtagh , Jonathan Power , Barry Drust
{"title":"Shear wave elastography provides reliable assessments of stiffness in the skin, fascia, and both superficial and deep muscle tissues","authors":"Cameron D. Ley , Eduardo Martinez Valdes , Conall F. Murtagh , Jonathan Power , Barry Drust","doi":"10.1016/j.jelekin.2025.103050","DOIUrl":"10.1016/j.jelekin.2025.103050","url":null,"abstract":"<div><div>Shear wave elastography (SWE) is a reliable method of estimating stiffness of superficial rectus femoris (RF) muscle at various muscle lengths. Its reliability has not been assessed in deeper muscle regions or its overlying fascia and skin tissue. 20 healthy participants completed two visits in which RF shear wave velocity (SWV) was measured twice, separated by 30mins, at four depths (skin–SKIN, fascia–FAS, superficial muscle–SUP, and deep muscle–DEEP) in three positions (relaxed–REL, neutral–NEU, and stretched–STR). Relative reliability was determined by intraclass correlation coefficients and absolute reliability was assessed by standard error and bias of measurements. SWE reported poor to good relative intra-day reliability (ICC, 0.33–0.82) but good to excellent absolute intra-day reliability (SEM, 0.14–0.25 m/s; bias, −0.12–0.07). Relative SWE inter-day reliability was moderate to excellent (ICC, 0.54–0.91) and absolute reliability was good to excellent (SEM, 0.12–0.21 m/s; bias, −0.05–0.06). Reliability was highest in the order of STR, NEU, REL with regards to position, with SKIN and FAS reliability greater than in muscle. SUP measurements reported greater reliability than DEEP. Therefore, SWE is a reliable method of estimating SKIN, FAS, SUP and DEEP RF tissue stiffness. To optimise repeatability, measurements should be taken from stretched superficial tissue.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103050"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moein Koohestani , David A. Sherman , Justin L. Rush , Ava L. Schwartz , Grant E. Norte
{"title":"Hamstrings corticomotor and neuromechanical function in individuals with anterior cruciate ligament reconstruction","authors":"Moein Koohestani , David A. Sherman , Justin L. Rush , Ava L. Schwartz , Grant E. Norte","doi":"10.1016/j.jelekin.2025.103048","DOIUrl":"10.1016/j.jelekin.2025.103048","url":null,"abstract":"<div><div>Hamstrings neuromuscular alterations are common after anterior cruciate ligament (ACL) reconstruction; however, their neural origins remain unclear. While quadriceps corticospinal function after ACL reconstruction (ACLR) is well studied, similar data for hamstrings are lacking. We aimed to assess hamstrings corticomotor and neuromechanical function and their associations in individuals with ACLR. Twenty-three adults with primary, unilateral ACLR via hamstrings tendon autograft were assessed (time from surgery = 46.9 ± 26.3). Corticomotor function was quantified via active motor threshold (AMT), motor evoked potential (MEP), short-interval intracortical inhibition, intracortical facilitation (ICF), and cortical silent period (CSP) in semitendinosus. Neuromechanical function was quantified via maximal voluntary isometric contraction (MVIC) torque, early and late-phase rate of torque development (RTD<sub>100</sub>, RTD<sub>200</sub>), and semitendinosus electromyographic amplitude.<!--> <!-->Paired-samples t-tests or Wilcoxon signed-rank tests compared outcomes between limbs. Associations between involved limb outcomes were analyzed using correlation coefficients. Involved limbs exhibited shorter CSP (<em>p</em> = 0.005), lower MVIC torque (<em>p</em> = 0.002), and lower RTD<sub>200</sub> (<em>p</em> = 0.002) than uninvolved limbs. Lower AMT (<em>r</em> = 0.462, <em>p</em> = 0.026) and ICF (<em>r</em> = 0.510, <em>p</em> = 0.013) associated with lower RTD<sub>200</sub>, and lower MEP associated with lower MVIC torque (<em>r</em> = 0.448, <em>p</em> = 0.032). Hamstrings neural adaptation following ACLR, characterized by lower corticospinal inhibition (semitendinosus) and torque deficits, highlights the need for rehabilitation approaches targeting both neural and peripheral impairments.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103048"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estimating maximum acceptable duty cycles (MADC) for overhead exertions","authors":"Michael W.B. Watterworth, Nicholas J. La Delfa","doi":"10.1016/j.jelekin.2025.103049","DOIUrl":"10.1016/j.jelekin.2025.103049","url":null,"abstract":"<div><div>Overhead work poses a significant risk for shoulder musculoskeletal disorders due to elevated arm postures and sustained loading, yet current ergonomics tools provide limited guidance on the acceptable percentage of time such tasks can be performed. This concept, referred to as the Maximum Acceptable Duty Cycle (MADC), represents the proportion of time within a work cycle that an exertion can be sustained at a psychophysically acceptable level. This study addresses that gap by reconfiguring an existing ergonomics assessment tool for overhead work to estimate MADC, rather than maximum acceptable forces. MADC values across the overhead workspace were mapped using computational modeling of over 800,000 overhead hand positions under three superior-directed load conditions (5, 10, and 20 N). MADC varied substantially with hand position and force demand: at 5 N, values ranged from 0–40 %, while at 20 N, MADC never exceeded 14 %. A consistent ergonomic ‘sweet spot’ was identified slightly above and forward of the shoulder, where MADC is maximized, providing the largest design space for allowable task duty cycles. The reconfigured tool offers actionable, evidence-based guidance for overhead task design by informing duty cycle limits in industrial settings, where current one-size-fits-all thresholds lack empirical justification.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103049"},"PeriodicalIF":2.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco Dalton-Alves , Taisa Menezes de Andrade , Francisco Kássio Menezes da Silva , Carla Bianca Tabosa Oliveira , Alex Soares Marreiros Ferraz
{"title":"Acute effects of different muscle fatigue conditions during strength training on localized muscle bioimpedance in women","authors":"Francisco Dalton-Alves , Taisa Menezes de Andrade , Francisco Kássio Menezes da Silva , Carla Bianca Tabosa Oliveira , Alex Soares Marreiros Ferraz","doi":"10.1016/j.jelekin.2025.103051","DOIUrl":"10.1016/j.jelekin.2025.103051","url":null,"abstract":"<div><div>This study aims to compare the localized muscle bioimpedance (ML-BIA) responses under different muscle fatigue conditions during strength training (ST). Twelve women participated in the study, which followed a crossover, counterbalanced, and randomized design. The experimental sessions were conducted using a 45° leg press machine, consisting of two conditions: a session until muscle failure (MF) and a session with no muscle failure (NMF). ML-BIA was assessed before the sessions, immediately after all sets were completed, and 20 and 30 min post-sessions. The ML-BIA measures of resistance (R), reactance (XC), and phase angle (PA) of the quadriceps were obtained. The countermovement Jump (CMJ) was assessed before and after both conditions. Repeated measures analysis of variance was used to compare conditions, with a significance level set at p < 0.05. In the CMJ test, significant reductions in jump height and power were observed only in the MF condition (p < 0.001). PA showed significant reductions compared to rest only in the MF condition (p < 0.001), with reductions maintained up to 30 min after the session. Our data showed that ML-BIA parameters respond differently under varying fatigue conditions, with PA decreasing only in the higher fatigue condition.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103051"},"PeriodicalIF":2.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Vinti , Mathias Blandeau , Hélène Pillet , Wafa Skalli , Philippe Decq , Andrea Merlo , Jean-Michel Gracies , Nicolas Bayle , Mouna Ghédira , Emilie Hutin
{"title":"Does hemiparetic dorsiflexion in swing phase depend on spasticity?","authors":"Maria Vinti , Mathias Blandeau , Hélène Pillet , Wafa Skalli , Philippe Decq , Andrea Merlo , Jean-Michel Gracies , Nicolas Bayle , Mouna Ghédira , Emilie Hutin","doi":"10.1016/j.jelekin.2025.103047","DOIUrl":"10.1016/j.jelekin.2025.103047","url":null,"abstract":"<div><h3>Objective</h3><div>This study quantified dorsiflexor and plantar flexor (PF) spasticity, and agonist and antagonist recruitment (cocontractions) during the swing phase of gait in individuals with hemiparesis with and without prior tibial neurotomy, investigating the role of spastic cocontraction versus spasticity in limiting dorsiflexion (DF).</div></div><div><h3>Methods</h3><div>Eleven hemiparetic subjects and 11 controls walking at comfortable and slow velocities underwent kinematic and electromyographic (EMG) analysis of PF and DF muscles. Five of the hemiparetic subjects had undergone tibial nerve neurotomy, which eliminates PF spasticity. Key metrics included ankle dorsiflexion, tibialis anterior recruitment, and coefficients of antagonist activation of gastrocnemius medialis and soleus during swing. Spasticity was assessed using the Tardieu scale.</div></div><div><h3>Results</h3><div>Controls walking at slow speed showed similar velocity as hemiparetic subjects. Hemiparetic subjects showed reduced ankle dorsiflexion despite higher tibialis anterior recruitment, increased plantar flexor cocontraction before any dorsiflexion, even in neurotomy patients without spasticity.</div></div><div><h3>Conclusions</h3><div>Increased PF cocontraction persists even in the absence of spasticity, limiting dorsiflexion during swing. Spastic cocontraction, not spasticity, is a primary factor impairing active DF.</div></div><div><h3>Significance</h3><div>These findings emphasize that targeting spastic cocontraction of plantar flexors may be crucial for improving dorsiflexion and gait rehabilitation in hemiparetic patients, instead of addressing spasticity.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103047"},"PeriodicalIF":2.3,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zoe M. Moore , Grace Wood , Jake Elliott , Julianna C. Simon , Meghan E. Vidt
{"title":"Tendon overuse models have different effects on tissue mechanical properties in ex vivo bovine tendons","authors":"Zoe M. Moore , Grace Wood , Jake Elliott , Julianna C. Simon , Meghan E. Vidt","doi":"10.1016/j.jelekin.2025.103043","DOIUrl":"10.1016/j.jelekin.2025.103043","url":null,"abstract":"<div><div>Tendinopathy is an overuse injury that occurs in high load bearing tendons, causing decreased function and increased pain. Current tendinopathy treatments produce inconsistent outcomes, creating a need for novel treatments. It is unclear whether current tendinopathy models used to develop new treatments replicate the mechanical effects of the injury. We aim to compare the mechanical properties of 2 established tendinopathy models – collagenase injection and mechanical overload − in <em>ex vivo</em> bovine tendons. Eighteen bovine tendons were split into 3 groups, including: uninjured, collagenase injection (0.5 mL collagenase and 0.5 mL fibrin gel), and mechanical overload (5 cycles of tensile loading/unloading). Mechanical testing of samples was performed. Stiffness, maximum force at failure, and ultimate tensile stress (UTS) were computed, then compared across groups using 1-way ANOVA with significance set at p < 0.05. Results showed maximum force and UTS were reduced for the mechanical overload group (402.1 ± 232.3 N; 9.1 ± 5.3 MPa) versus uninjured (1222.9 ± 270.8 N; 28.9 ± 4.6 MPa) and collagenase injection groups (1309.0 ± 242.1 N; 25.0 ± 8.2 MPa) (all p < 0.001). Stiffness was not different across groups (all p > 0.33). Findings suggest that <em>ex vivo</em> mechanical overload better represents the mechanical properties of tendinopathy than collagenase injection.</div></div>","PeriodicalId":56123,"journal":{"name":"Journal of Electromyography and Kinesiology","volume":"84 ","pages":"Article 103043"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}