Jaro-Journal of the Association for Research in Otolaryngology最新文献

{"title":"A Structural Equation Approach to Characterizing Growth and Nonlinearity Underlying Distortion Product Otoacoustic Emissions.","authors":"Shawn S Goodman, M Ehsan Khalili, Julia H Roemen, Ishan Bhatt, Skyler G Jennings, Jeffery T Lichtenhan, Sumitrajit Dhar","doi":"10.1007/s10162-026-01057-9","DOIUrl":"10.1007/s10162-026-01057-9","url":null,"abstract":"<p><strong>Purpose: </strong>Distortion product otoacoustic emission (DPOAE) magnitudes measured in the ear canal in response to a range of primary stimulus levels as growth functions (GFs) may be useful for assessing cochlear non-linearity, predicting behavioral audiometric thresholds, estimating loudness perception, and differentiating types of cochlear pathology. A variety of stimulation schemes have been proposed, and GF shapes differ depending on the stimulation scheme used. A clearer understanding of the relationships between stimuli, GFs, cochlear non-linearities, and cochlear health is important for maximizing the diagnostic potential of DPOAEs.</p><p><strong>Methods: </strong>Latent growth modeling, a technique within the structural equation modeling framework, can provide insight into the relationships between observed (e.g., GFs) and unobserved latent variables (e.g., cochlear non-linearities). We describe a latent growth model for characterizing GFs with a generalized logistic function representing the latent non-linearity, coupled with a generalized linear regression model appropriate for fitting GFs with varying signal-to-noise ratios (SNRs). The model was applied to GF data from twelve young adult ears (9 female, 3 male). The resulting fits inferred the shape of the underlying non-linearity and also quantified standard GF characteristics such as slope, threshold, and inflection points.</p><p><strong>Results: </strong>Data from participants, along with Monte Carlo simulations, demonstrate that this fitting method performs well under low SNR conditions and accurately predicts DPOAE magnitudes at low stimulus levels.</p><p><strong>Conclusion: </strong>This report establishes a robust method for characterizing GFs, supporting the long-term goal of applying the method in future studies of the relationships between acoustic stimuli, GFs, cochlear non-linearities, and cochlear health.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"683-703"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interphase Gap Effect in Cochlear Implant Users: Biological Basis, Parameter Selection, Analytical Methods, and Quantitative Scales.","authors":"Shuman He, Zi Gao, Jacob J Oleson, Ian C Bruce","doi":"10.1007/s10162-026-01041-3","DOIUrl":"10.1007/s10162-026-01041-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed (1) to determine the biological basis of the interphase gap (IPG) effect and (2) to identify the most informative parameters, analytical methods, and quantitative scales for evaluating the IPG effect in human cochlear implant (CI) users.</p><p><strong>Methods: </strong>The IPG effect was quantified using multiple parameters, analytical methods, and quantitative scales (three combinations using linear or logarithmic scales for the input and output variables) across three pediatric CI groups with differing cochlear nerve (CN) anatomy: children with cochlear nerve deficiency (CND), GJB2 mutations, and idiopathic sensorineural hearing loss (SNHL). All participants in the GJB2 and idiopathic SNHL groups had normal-sized CNs (NSCNs) in the test ear. Neural synchrony, a property depending on neural health, was assessed using phase locking value (PLV) and compared between children with CND and those with GJB2 mutations.</p><p><strong>Results: </strong>The PLV did not differ significantly between the CND and GJB2 groups, nor did it correlate with the IPG effect in GJB2 cases, regardless of parameter, analytical method, or quantitative scale. In contrast, consistent group differences in IPG effects on stimulation level offset and maximum slope of the eCAP input/output function were observed across all analytical methods and quantitative scales. The sensitivity of other eCAP measures-threshold, maximum amplitude, and overall linear slope-to group differences varied by quantitative scale.</p><p><strong>Conclusions: </strong>The IPG effect primarily reflects the number of active CN fibers rather than their health. Stimulation level offset and the IPG effect on maximum slope are robust indicators of CN fiber counts in CI users and are unaffected by the choice of quantitative scale.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"465-490"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Characterization of Middle-Ear Muscle Reflexes Using Swept Elicitors.","authors":"M Ehsan Khalili, Julia H Roemen, Jeffery T Lichtenhan, Shawn S Goodman","doi":"10.1007/s10162-026-01037-z","DOIUrl":"10.1007/s10162-026-01037-z","url":null,"abstract":"<p><strong>Purpose: </strong>We describe a novel paradigm for evoking and measuring middle ear muscle reflex (MEMR), in which a train of broadband clicks act as probes, while a broadband noise elicitor is continuously swept in both ascending and descending sound levels. A new measure, total change, incorporates both magnitude and phase to quantify MEMR in a way that promotes meaningful averaging across a wide range of sound levels and frequencies. The aims of the study were to assess the retest reliability of the new swept-elicitor MEMR paradigm, to compare results with those obtained using traditional discrete-elicitor stimuli, and to preliminarily examine correlations with speech-in-noise performance.</p><p><strong>Methods: </strong>MEMR was measured in 38 young, normal-hearing participants (24 female, 14 male) using both the novel swept paradigm and a more conventional paradigm with elicitor noises that were discretely varied in level. Key measures of MEMR dynamics were obtained from the swept elicitor paradigm, including maximum total change, onset and offset thresholds, hysteresis, and reflex delay. Intraclass correlation coefficients (ICCs) were used to assess repeatability, and robust linear regression was used to examine correlations with QuickSIN performance.</p><p><strong>Results: </strong>The swept MEMR paradigm demonstrated excellent repeatability, with ICC values exceeding 0.90 for all extracted measures. MEMR thresholds from the swept elicitor correlated moderately with speech-in-noise performance.</p><p><strong>Conclusions: </strong>Our new MEMR paradigm provides fast, repeatable measurements. Several measures of MEMR dynamics can be obtained, improving upon traditional measurement approaches. Results suggest a possible link between MEMR dynamics and speech-in-noise performance.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"427-445"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The UmboMic: Characterization and Testing of a Middle Ear Microphone.","authors":"Emma F Wawrzynek, John Z Zhang, Ioannis Kymissis, Elizabeth S Olson, Jeffrey H Lang, Hideko Heidi Nakajima","doi":"10.1007/s10162-026-01039-x","DOIUrl":"10.1007/s10162-026-01039-x","url":null,"abstract":"<p><strong>Purpose: </strong>We report developments on the \"UmboMic,\" a piezoelectric microphone for fully implanted cochlear implants. Internal implantation of the microphone for fully implantable cochlear implants is the goal of future technology, as it has the potential to significantly improve the device performance and user experience.</p><p><strong>Methods: </strong>The UmboMic is designed for implantation in the middle ear cavity, where it detects the motion of the umbo via the piezoelectric effect. The UmboMic sensor is made from two layers of the piezoelectric material called polyvinylidene difluoride (PVDF). Steps towards biocompatibility necessitated material changes to the device structure, including the conducting and glue layers. Seven individual UmboMic sensors are characterized on the bench and implanted in five human cadaveric ears (1 female and 4 male).</p><p><strong>Results: </strong>Extensive UmboMic testing and characterization demonstrates high sensitivity across frequencies, low noisefloor, shielding from electromagnetic interference, and good linearity. The UmboMic's performance is comparable to a Knowles external hearing-aid microphones, with an equivalent input noise of 32.4 dB SPL from 100 Hz to 7 kHz. Less than a 6 dB difference between UmboMic sensor sensitivity indicates fabrication repeatability. Studies on UmboMic sensor positioning demonstrate the design's resilience to implantation variations.</p><p><strong>Conclusion: </strong>This UmboMic design represents a promising advancement towards a viable microphone for fully implanted cochlear implants. With very good microphone performances on the bench and in cadaveric human ears, research can turn towards complete device biocompatibility, fixation hardware, and testing for long-term implantation.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"411-425"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Genes Affecting Endocochlear Potential.","authors":"Darcey A Kirwin, Morag A Lewis, Karen P Steel","doi":"10.1007/s10162-026-01046-y","DOIUrl":"10.1007/s10162-026-01046-y","url":null,"abstract":"<p><strong>Purpose: </strong>Hearing loss is highly heterogeneous. Any one of hundreds of genes and dozens of cell types can be involved in the pathological processes in the auditory system. One class of hearing loss results from a reduction of the endocochlear potential (EP), a voltage maintained in the endolymph that bathes the upper surface of the sensory hair cells in the cochlea. Understanding the landscape of genes involved in reduced EP will be useful in developing targeted therapies for this type of hearing loss. Here we review these genes.</p><p><strong>Methods: </strong>Research articles that report genes impacting EP in mutant mice were collated using several different approaches. Cell type-specific expression and patterns in their biological function were investigated.</p><p><strong>Results: </strong>We report 55 genes associated with reduced EP as well as 43 genes shown to underlie deafness but with no change in EP. We show that of these 55 reduced EP genes, 27 are linked to deafness in humans and therefore these patient populations are candidates for having a reduced EP. We demonstrate that the expression of reduced EP genes is not clustered to a particular cell type within the stria vascularis or organ of Corti.</p><p><strong>Conclusion: </strong>This analysis highlights the broad range of expression patterns and functions of genes involved in generating and maintaining the mammalian EP. Furthermore, the lists presented here can inform the direction of translational research for different forms of human hearing loss.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"361-378"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Vestibular Deficits Following Moderate-Intensity Blast Overpressure in Rats.","authors":"Jena' N Mazique, Caroline Sit, Raven Riley, Zelma Iriarte Oporto, Ian Mcneill, Tianwen Chen, James Warren, David Huang, Youguo Xu, Austin Frisbie, Bradley Walters, Yi Pang, Wu Zhou, Hong Zhu","doi":"10.1007/s10162-026-01038-y","DOIUrl":"10.1007/s10162-026-01038-y","url":null,"abstract":"<p><strong>Purpose: </strong>Military personnel and veterans exposed to blast overpressure waves frequently report vestibular symptoms, including dizziness, vertigo, and imbalance. Although blast exposure is known to disrupt vestibular function, how vestibular deficits develop over time, particularly at the level of vestibular afferent signaling, remains unclear.</p><p><strong>Methods: </strong>In this study, we used an ear-blast model to investigate the early injury responses and progression of vestibular deficits following a single, moderate-intensity blast exposure (20 PSI) in male and female Long-Evans rats. Vestibular function was assessed using single-unit recordings from vestibular afferents and vestibulo-ocular reflex (VOR) testing.</p><p><strong>Results: </strong>Blast exposure produced progressive changes in vestibular afferent activity in both male and female rats. In males, spontaneous firing rates remained unchanged, whereas females showed a reduction at 1 day and 14 days post-blast. In both sexes, firing irregularity increased, and a greater proportion of afferents became less responsive to head rotation and translation. Although gains and phases of the remaining canal and otolith afferents were preserved, response distortion increased following blast exposure, indicating reduced precision of vestibular afferents' encoding of head movement. Despite the impairments in vestibular nerve activity, steady-state rotational and translational VOR gains remained largely unchanged, with only moderate phase changes up to 56 days post-blast. However, a subset of animals exhibited reduced step rotational VOR gains and earlier quick phase responses following blast exposure. Morphological analysis revealed stereocilia damage, significant loss of saccular hair cells, and astrocytic activation in the central vestibular nuclei.</p><p><strong>Conclusion: </strong>Together, these findings indicate that blast-induced vestibular injury involves both peripheral and central components, with progressive changes in vestibular afferent activity that could influence sensory inputs to the CNS.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"391-409"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cochlear Lateral Wall as a Biological Battery: the Mechanisms Underlying K⁺ Transport and Potential Generation.","authors":"Fumiaki Nin, Hiroshi Hibino","doi":"10.1007/s10162-026-01034-2","DOIUrl":"10.1007/s10162-026-01034-2","url":null,"abstract":"<p><p>The cochlea possesses an exceptional capacity for rapid sensory transduction, enabling sound perception of at frequencies exceeding 15 kHz. This extraordinary performance depends on a specialized electrochemical environment that maintains a high endocochlear potential (EP) and facilitates efficient K⁺ circulation. The cochlear lateral wall serves as a central component, functioning as a biological battery that generates and sustains the EP via intricate ion transport mechanisms. It consists of two epithelial-like layers-the marginal cell layer and the syncytial layer-which are electrically insulated by tight junctions and interconnected via gap junctions. K⁺ enters hair cells from the K⁺-rich endolymph to initiate sensory transduction and is subsequently recycled through the perilymph and reabsorbed by the lateral wall. Our combined electrophysiological and mathematical modeling studies elucidate that the EP primarily depends on K⁺ equilibrium potentials across the apical membranes of intermediate and marginal cells, primarily mediated by K_ir4.1 and IKs channels, respectively. Pharmacological experiments confirmed that Na⁺,K⁺-ATPase and NKCC are essential for maintaining the K⁺ gradient and EP. Furthermore, our computational model successfully reproduced dynamic changes in ion concentrations and membrane potentials under hypoxic conditions and acoustic stimulation. Genetic studies further reinforce the physiological importance of lateral wall components, as mutations in associated transporters, channels, and structural proteins commonly lead to sensorineural hearing loss. Collectively, these findings underscore the cochlear lateral wall as an integrated electrochemical organ and illustrate the utility of multiscale modeling in bridging molecular mechanisms with systems-level auditory function.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"343-359"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Calcium Signalling in the Developing Mammalian Cochlea.","authors":"Federico Ceriani, Walter Marcotti","doi":"10.1007/s10162-026-01035-1","DOIUrl":"10.1007/s10162-026-01035-1","url":null,"abstract":"<p><p>In mammals, the accurate and high-fidelity representation of sound largely depends on the cochlea, the sensory organ specialized for transducing acoustic signals into neural activity with remarkable temporal precision. Prior to hearing onset, which occurs around postnatal day 12 in most altricial rodents, the immature cochlea plays an active role in the refinement of neural circuits along the auditory pathway. To accomplish this function, sensory hair cells and glia-like supporting cells in the immature cochlea generate distinct patterns of spontaneous Ca²⁺ signals. Synchronized Ca²⁺-dependent activity across multiple hair cells is conveyed to the ascending auditory neurons, where it contributes to the emergence of tonotopic maps that enable frequency discrimination. Within the cochlea itself, this spontaneous Ca²⁺ activity serves to promote cellular and synaptic refinement. In this review, we summarize the current insights into the cellular and molecular mechanisms responsible for generating and modulating these spontaneous Ca²⁺ signals in the developing cochlea, and how they regulate the activation of auditory afferent fibres.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"315-330"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury-Induced Remodeling of Junctional Actin Bands in the Vestibular Maculae of Mice and Chicks: Implications for Sensory Regeneration.","authors":"Mark E Warchol","doi":"10.1007/s10162-026-01040-4","DOIUrl":"10.1007/s10162-026-01040-4","url":null,"abstract":"<p><p>The vestibular organs of birds are capable of regenerating sensory hair cells after ototoxic injury, but the regenerative ability of the mammalian vestibular organs is much more limited. The factors that inhibit regeneration in the mammalian inner ear are not known, but it has been proposed that the structure of filamentous actin cables at cell-cell junctions may be an important regulatory influence. Junctional actin cables in the chick utricle are relatively thin, while those in the mouse utricle are much thicker. These differences result in differing mechanical properties of the avian vs. mammalian inner ear, which may affect the potential for regenerative proliferation. In the present study, I characterized injury-evoked changes in junctional actin cables and supporting cell surface areas in the utricles of mice and chicks of either sex. I found that the thickness of junctional cables in the chick utricle was not affected by ototoxic injury, but that injury to the mouse utricle resulted in the formation of numerous new junctional actin bands whose thickness was comparable to those in the chick utricle. Thicker actin bands also persisted after injury, but were not necessarily associated with cellular junctions. I further found that moderate hair cell injury caused supporting cells in the chick utricle to expand their lumenal surfaces by about 50%, while comparable injury to the mouse utricle caused supporting cells to expand by only ~ 30%. I speculate that this difference may impact the injury-induced activation of Hippo/YAP signaling.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"379-390"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efferent Inhibition of Hair Cells: Past, Present and Future.","authors":"Paul Albert Fuchs","doi":"10.1007/s10162-026-01045-z","DOIUrl":"10.1007/s10162-026-01045-z","url":null,"abstract":"<p><p>Efferent modulation of vertebrate auditory organs has been known since the early twentieth century, mediated by cholinergic brainstem neurons. In mammals, medial olivocochlear neurons release acetylcholine (ACh) to inhibit outer hair cells to reduce cochlear sensitivity and tuning through an unusual mechanism of nicotinic inhibition, employing unique α9α10-containing AChRs (nAChRs). This synaptic mechanism and orthologous nAChRs, are conserved among vertebrate hair cells. Genetic modification of α9α10-containing nAChRs has cemented the role of efferent feedback in protection against noise-induced hearing loss in mice. Virally-mediated introduction of gain-of-function nAChRs reduces the impact of acoustic trauma in wildtype mice, encouraging development of cholinergic gene therapy for clinical application.</p>","PeriodicalId":56283,"journal":{"name":"Jaro-Journal of the Association for Research in Otolaryngology","volume":" ","pages":"331-342"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}