Journal of intensive medicine最新文献

{"title":"Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future?","authors":"Guillaume Carteaux ,&nbsp;Anne-Fleur Haudebourg","doi":"10.1016/j.jointm.2025.01.001","DOIUrl":"10.1016/j.jointm.2025.01.001","url":null,"abstract":"<div><div><em>De novo</em> acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical objective in this population. Noninvasive ventilation (NIV) has been proposed as a potential alternative to invasive ventilation in AHRF. However, no clear clinical benefit has been consistently demonstrated to date. The lack of definitive evidence has left experts unable to provide recommendations for the use of NIV in AHRF. Several factors may account for the inconsistencies in the literature and merit further investigation. Identifying early predictive criteria for NIV failure could be essential in determining which patients are most likely to benefit from this intervention. In addition, the approach to NIV settings may require reconsideration, particularly regarding the level of assistance. Efforts to reduce tidal volume, while aiming to minimize ventilator-induced lung injury, may have inadvertently resulted in insufficient support, amplifying the harmful effects of excessive inspiratory effort. The choice of interface may also significantly influence the physiological effects and outcomes and warrants further exploration. Finally, the frugal nature of noninvasive techniques makes them well-suited for the universal management of AHRF, regardless of constraints. This highlights the need for future developments aimed at optimizing oxygen and energy efficiency, enhancing the ease of use and robustness of NIV devices, and evaluating the effectiveness of NIV under high-constraint conditions, such as in low- and middle-income countries. This review addresses these critical questions.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 237-245"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of fluid balance with traumatic brain injury outcomes: A systematic review","authors":"Antonis Kalakoutas ,&nbsp;Ashley Thomas ,&nbsp;Thomas Fisher ,&nbsp;Bethany Lane","doi":"10.1016/j.jointm.2025.01.002","DOIUrl":"10.1016/j.jointm.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Fluid balance management is critical in moderate and severe traumatic brain injury (TBI) due to impaired cerebrovascular autoregulation. This study systematically reviews the association of fluid volume management with outcomes in moderate to severe TBI.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature search on MEDLINE, EMBASE, CINAHL, The Cochrane Database, and bibliographies of included articles. Studies assessing fluid volume management and outcomes in moderate/severe TBI patients were included. Risk of bias, publication bias, and heterogeneity were comprehensively assessed. Primary outcomes were short/long-term mortality and neurological outcomes. Secondary outcomes included the effect on intracranial pressure, development of acute kidney injury (AKI), refractory intracranial hypertension (RIH), pulmonary edema/acute respiratory distress syndrome, length of stay, and length of mechanical ventilation. Fluid balance groups were categorized into restrictive, euvolemic, and liberal.</div></div><div><h3>Results</h3><div>Out of 2668 studies identified, 12 studies (seven observational and five randomized controlled trials [RCTs]) involving 9184 TBI patients were included. Euvolemic fluid balance was associated with lower odds of mortality compared to restrictive (odds ratio [OR] = 0.39, 95% confidence interval [CI]: 0.27 to 0.57, <em>P</em> &lt;0.00001) and liberal groups (OR=0.47, 95% CI: 0.31 to 0.70, <em>P</em>=0.0003), and improved odds of favorable neurological outcomes compared to restrictive (OR=2.51, 95% CI: 1.72 to 3.66, <em>P</em> &lt;0.00001) and liberal groups (OR=1.86, 95% CI: 1.18 to 2.92, <em>P</em>=0.007). Euvolemic balance also reduced the odds of AKI and RIH, and shortened the mean length of mechanical ventilation compared to liberal fluid balance groups but not the restrictive ones.</div></div><div><h3>Conclusions</h3><div>Euvolemic fluid balance may improve key outcomes in TBI patients, including reduced mortality and better neurological outcomes. These findings underscore the need for RCTs to further assess euvolemic fluid management protocols in neurocritical care and their potential to inform clinical guidelines.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 276-287"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning integration of chest computed tomography and plasma proteomics to identify novel aspects of severe COVID-19 pneumonia","authors":"Yucai Hong ,&nbsp;Lin Chen ,&nbsp;Yang Yu ,&nbsp;Ziyue Zhao ,&nbsp;Ronghua Wu ,&nbsp;Rui Gong ,&nbsp;Yandong Cheng ,&nbsp;Lingmin Yuan ,&nbsp;Shaojun Zheng ,&nbsp;Cheng Zheng ,&nbsp;Ronghai Lin ,&nbsp;Jianping Chen ,&nbsp;Kangwei Sun ,&nbsp;Ping Xu ,&nbsp;Li Ye ,&nbsp;Chaoting Han ,&nbsp;Xihao Zhou ,&nbsp;Yaqing Liu ,&nbsp;Jianhua Yu ,&nbsp;Yaqin Zheng ,&nbsp;Zhongheng Zhang","doi":"10.1016/j.jointm.2024.11.001","DOIUrl":"10.1016/j.jointm.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Heterogeneity is a critical characteristic of severe coronavirus disease 2019 (COVID-19) pneumonia. Integrating chest computed tomography (CT) imaging and plasma proteomics holds the potential to elucidate Image-Expression Axes (IEAs) that can effectively address this disease heterogeneity.</div></div><div><h3>Methods</h3><div>A cohort of subjects diagnosed with severe COVID-19 pneumonia at 12 participating hospitals between December 2022 and March 2023 was prospectively screened for eligibility. Context-aware self-supervised representation learning (CSRL) was employed to extract intricate features from CT images. Quantification of plasma proteins was achieved using the Olink® inflammation panel. A deep learning model was meticulously trained, with CSRL features serving as input and the proteomic data as the target. This trained model facilitated the construction of IEAs, offering a representation of the underlying disease heterogeneity. The potential of these IEAs for prognostic and predictive enrichment was subsequently explored via conventional regression models.</div></div><div><h3>Results</h3><div>The study cohort comprised 1979 eligible patients, who were stratified into a training set of 630 individuals and a testing set of 1349 individuals. Three distinct IEAs were identified: IEA1 was correlated with shock conditions, IEA2 was associated with the systemic inflammatory response syndrome (SIRS), and IEA3 was reflective of the coagulation profile. Notably, IEA1 (odds ratio [OR]= 0.52, 95 % confidence interval [CI]: 0.40 to 0.67, <em>P</em> &lt; 0.001) and IEA2 (OR=0.74, 95 % CI: 0.62 to 0.90, <em>P</em>=0.002) exhibited significant associations with the risk of mortality. Intriguingly, patients characterized by lower IEA1 values (&lt;-2, indicative of more severe shock) demonstrated a reduced mortality risk when administered with steroids. Conversely, patients with higher IEA2 values seemed to benefit from a judicious approach to fluid infusion.</div></div><div><h3>Conclusions</h3><div>Our comprehensive approach, seamlessly integrating advanced deep learning techniques, proteomic profiling, and clinical data, has unraveled intricate interdependencies between IEAs, protein abundance patterns, therapeutic interventions, and ultimate patient outcomes in the context of severe COVID-19 pneumonia. These discoveries make a significant contribution to the rapidly advancing field of precision medicine, paving the way for tailored therapeutic strategies that can significantly impact patient care.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 252-261"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemia as a potent marker of in-hospital mortality in patients admitted to the cardiac intensive care unit: Data from the Critical Care Cardiology Trials Network (CCCTN) Registry","authors":"Christine Chow ,&nbsp;Rasheed Durowoju ,&nbsp;Carlos Alviar ,&nbsp;Gregory W Barsness ,&nbsp;Howard A Cooper ,&nbsp;Lori B Daniels ,&nbsp;Xuan Ding ,&nbsp;Shahab Ghafghazi ,&nbsp;Umesh Gidwani ,&nbsp;Michael Goldfarb ,&nbsp;Dustin Hillerson ,&nbsp;Jason N Katz ,&nbsp;Paul Marano ,&nbsp;Jeong-Gun Park ,&nbsp;Matthew Pierce ,&nbsp;Scott W Rose ,&nbsp;Robert O Roswell ,&nbsp;Sean van Diepen ,&nbsp;Anjali Wagle ,&nbsp;Erin A Bohula ,&nbsp;Younghoon Kwon","doi":"10.1016/j.jointm.2024.12.006","DOIUrl":"10.1016/j.jointm.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is common in critically ill patients and is associated with poor outcomes. We investigated the prevalence of anemia and its association with in-hospital outcomes among patients admitted to cardiac intensive care units (CICUs) and subgroups within this population.</div></div><div><h3>Methods</h3><div>The Critical Care Cardiology Trials Network (CCCTN) is a multicenter network of tertiary CICUs in North America. CICU admissions with available baseline hemoglobin (Hgb) between 2017 and 2023 were included in this analysis. Patients were stratified by Hgb levels (Hgb &lt;8 g/dL, 8 g/dL ≤ Hgb &lt;10 g/dL, 10 g/dL ≤ Hgb &lt;12 g/dL, 12 g/dL ≤ Hgb &lt;14 g/dL, and ≥14 g/dL). The ≥14 g/dL group was used for reference. The association of Hgb level and in-hospital mortality was examined by multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among 28,585 patient admissions (median age 67 years, 36.7 % female), the median Hgb was 12.1 g/dL (interquartile range: 10.1–13.9), with 48.3 % of patients who meet criteria for anemia (Hgb &lt;12 g/dL). The adjusted relative odds of in-hospital mortality was highest for patients with Hgb &lt;8 g/dL (1.60, 95 % confidence interval [CI]: 1.35 to 1.89, <em>P</em> &lt; 0.0001), followed by patients with 8 g/dL≤ Hgb &lt;10 g/dL (adjusted relative odds =1.51, 95 % CI: 1.32 to 1.73, <em>P</em> &lt; 0.0001), and patients with Hgb 10 g/dL≤ Hgb&lt;12 g/dL (adjusted relative odds=1.24, 95 % CI: 1.09 to 1.41, <em>P</em>=0.0012). This association was present among those with non-acute coronary syndrome (ACS) cardiogenic shock (<em>n</em>=4255) and those with non-cardiogenic shock ACS (<em>n</em>=7194).</div></div><div><h3>Conclusions</h3><div>Anemia was present in nearly half of patients admitted to CICUs. Lower admission Hgb is independently associated with higher in-hospital mortality in a graded relationship among patients with cardiac critical illness.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 262-268"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The glyoxalase system: A new target for inflammatory diseases","authors":"Yingyi Yang ,&nbsp;Rui Kang ,&nbsp;Huiting Zhou ,&nbsp;Daolin Tang","doi":"10.1016/j.jointm.2025.03.002","DOIUrl":"10.1016/j.jointm.2025.03.002","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 216-218"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHA2DS2-VASc scores to predict left atrial/left atrial appendage abnormalities in patients with sepsis-induced atrial fibrillation: A preliminary investigation","authors":"Vincent Labbé ,&nbsp;Stephane Ederhy ,&nbsp;David Legouis ,&nbsp;Jérémie Joffre ,&nbsp;Keyvan Razazi ,&nbsp;Oumar Sy ,&nbsp;Frank Chemouni ,&nbsp;Armand Mekontso Dessap ,&nbsp;Muriel Fartoukh ,&nbsp;Ariel Cohen ,&nbsp;FAST Study Group","doi":"10.1016/j.jointm.2024.12.007","DOIUrl":"10.1016/j.jointm.2024.12.007","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 288-291"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page","authors":"","doi":"10.1016/S2667-100X(25)00007-6","DOIUrl":"10.1016/S2667-100X(25)00007-6","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 2","pages":"Pages i-ii"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724783","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":"Predicting multiple organ dysfunction syndrome in trauma-induced sepsis: Nomogram and machine learning approaches","authors":"Jinyu Peng ,&nbsp;Yun Li ,&nbsp;Chao Liu ,&nbsp;Zhi Mao ,&nbsp;Hongjun Kang ,&nbsp;Feihu Zhou","doi":"10.1016/j.jointm.2024.12.008","DOIUrl":"10.1016/j.jointm.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Multiple organ dysfunction syndrome (MODS) is a critical complication in trauma-induced sepsis patients and is associated with a high mortality rate. This study aimed to develop and validate predictive models for MODS in this patient population using a nomogram and machine learning approaches.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care-IV 2.2 database, focusing on trauma patients diagnosed with sepsis within the first day of intensive care unit (ICU) admission. Predictive variables were extracted from the initial 24 h of ICU data. The dataset (2008–2019) was divided into a training set (2008–2016) and a temporal validation set (2017–2019). Feature selection was conducted using the Boruta algorithm. Predictive models were developed and validated using a nomogram and various machine learning techniques. Model performance was evaluated based on discrimination, calibration, and decision curve analysis.</div></div><div><h3>Results</h3><div>Among 1295 trauma patients with sepsis, 349 (26.95%) developed MODS. The 28-day mortality rates were 11.21% for non-MODS patients and 23.82% for MODS patients. Key predictors of MODS included the simplified acute physiology score II score, use of mechanical ventilation, and vasopressor administration. In temporal validation, all models significantly outperformed traditional scoring systems (all <em>P</em> &lt;0.05). The nomogram achieved an area under the curve (AUC) of 0.757 (95% confidence interval [CI]: 0.700 to 0.814), while the random forest model demonstrated the highest performance with an AUC of 0.769 (95% CI: 0.712 to 0.826). Calibration plots showed excellent agreement between predicted and observed probabilities, and decision curve analysis indicated a consistently higher net benefit for the newly developed models.</div></div><div><h3>Conclusion</h3><div>The nomogram and machine learning models provide enhanced predictive accuracy for MODS in trauma-induced sepsis patients compared to traditional scoring systems. These tools, accessible via web-based applications, have the potential to improve early risk stratification and guide clinical decision-making, ultimately enhancing outcomes for trauma patients. Further external validation is recommended to confirm their generalizability.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 2","pages":"Pages 193-201"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724780","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":"Causes of fulminant tropical probable myocarditis: A retrospective cohort study in the French West Indies","authors":"Laurent Camous ,&nbsp;Nicolas Paulo ,&nbsp;Frederic Martino ,&nbsp;Sylvaine Bastian ,&nbsp;Marc Valette ,&nbsp;Jean-David Pommier","doi":"10.1016/j.jointm.2024.07.001","DOIUrl":"10.1016/j.jointm.2024.07.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 1","pages":"Pages 111-112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054388","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":"A modified screening protocol for ARDS in patients with respiratory support based on SpO2 and FiO2: A single-center prospective, observational study","authors":"Yan Xia ,&nbsp;Qiancheng Xu ,&nbsp;Zhiyuan Guo ,&nbsp;Huijuan Zhang ,&nbsp;Yingya Cao ,&nbsp;Yupeng Qi ,&nbsp;Qun Chen ,&nbsp;Weihua Lu","doi":"10.1016/j.jointm.2024.06.002","DOIUrl":"10.1016/j.jointm.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>The purpose is to formulate a modified screening protocol for acute respiratory distress syndrome (ARDS) in patients with respiratory support based on saturation of pulse oximetry (SpO₂) and inspired oxygen concentration (FiO₂).</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted from August to October 2020 at the Department of Critical Care Medicine of Yijishan Hospital Affiliated with Wannan Medical College. All patients admitted during the study period and required arterial blood gas analysis and electrocardiogram monitoring were included in this study. Patients with contraindications to arterial puncture, methemoglobinemia, carbon monoxide poisoning, and other factors that could affect data collection were excluded. The demographic and clinical data, immediate percutaneous SpO₂, FiO₂, arterial oxygen partial pressure (PaO₂), and respiratory rate were recorded; and the SpO₂/FiO₂ ratio (SFR) and PaO₂/FiO₂ ratio (PFR) values were calculated according to the above information. The patients were divided into two cohorts by random number table: the establishment cohort and the verification cohort. In the established part, data were divided into group H and group N according to whether SpO₂ &gt;97 %. For group H (SpO₂ ≤97 %), the regression equation was established between SFR and PFR. For group N (SpO₂ &gt;97 %), the correlation between each observation data and PFR was analyzed. Then, a new diagnostic process was established, and the reliability was verified with the Berlin definition set as the gold standard for diagnosis and classification.</div></div><div><h3>Results</h3><div>There were 341 patients were included. Among them, 161 patients were used to establish the model, and 180 patients were used to verify the validity of the model. In this new diagnosis progress, when SpO₂ ≤97 %, if SFR ≤352, ARDS may exist; when SpO₂ &gt;97 %, if FiO_2min &gt;39 %, there may be ARDS. The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of the new diagnosis progress for ARDS were 91.1 %, 76.7 %, 89.6 %, 79.6 %, and 83.9 %, respectively.</div></div><div><h3>Conclusion</h3><div>The SpO₂/FiO₂ ratio demonstrates notable sensitivity and specificity in diagnosing ARDS, presenting as a credible alternative to PFR.</div><div><strong>Trail Registration</strong> Chinese Clinical Trial Registry Identifier: ChiCTR2000029217</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 1","pages":"Pages 51-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054384","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}