POCUS journal最新文献

{"title":"Glow Up Pediatric Minor Trauma Care: Detecting Adrenal Bleeding with Contrast-Enhanced Ultrasound in Emergency Settings.","authors":"Yair Katzir, Yehuda Tzur","doi":"10.24908/pocusj.v10i02.19131","DOIUrl":"10.24908/pocusj.v10i02.19131","url":null,"abstract":"<p><p>Minor abdominal blunt trauma is a common pediatric emergency department presentation. Contrast-enhanced computed tomography (CECT) is the current gold standard imaging modality for identifying abdominal parenchymal injuries. Contrast-enhanced ultrasound (CEUS) has been suggested as a radiation-sparing alternative. Here we describe, for the first time, the use of pediatric emergency physician-performed CEUS in the evaluation of minor abdominal trauma in a child. The use of CEUS informed the decision-making process in this case and ultimately led to the diagnosis of an adrenal hemorrhage.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650305","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":"Bilateral Lung Points without Pneumothorax: Exploring \"Lung Point\" Mimics.","authors":"Michael Dong, Rebecca Davis, F Mae West, Gillian Naro, Arthur Au, Jonathan Foster, Jillian Cooper","doi":"10.24908/pocusj.v10i02.18500","DOIUrl":"10.24908/pocusj.v10i02.18500","url":null,"abstract":"<p><p>A \"lung point\" is the interface between present and absent lung sliding artifacts identified by point of care ultrasound (POCUS). This finding has long been considered highly specific for pneumothorax, with certain studies citing a specificity as high as 100%. More recently, multiple cases that mimic the lung point have been reported. Here, we present a patient case with bilateral lung points in the absence of pneumothorax. We reviewed lung point mimics and explored the conditions that caused this finding without pneumothorax.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"42-45"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662742","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":"Lung POCUS in a Pulmonary Outpatient Clinic: Balancing Utility and Feasibility.","authors":"Priyanka Sridhar, Paru Patrawalla, Boram Kim","doi":"10.24908/pocusj.v10i02.19661","DOIUrl":"10.24908/pocusj.v10i02.19661","url":null,"abstract":"<p><strong>Background: </strong>Despite abundant literature supporting the diagnostic utility of lung point of care ultrasound (POCUS) in inpatient settings, there is limited data on the feasibility and utility of lung POCUS in pulmonary outpatient clinics. Patients may first seek care for dyspnea in a pulmonary outpatient clinic. Existing data on in-hospital use suggests that integrating lung POCUS into clinic visits may lead to earlier diagnosis and limit the need for additional testing [1,2].</p><p><strong>Objective: </strong>The aim of this observational study was to evaluate the feasibility, clinical impact, indications, practices, and findings associated with lung POCUS in an urban-based pulmonary outpatient clinic.</p><p><strong>Methods: </strong>We reviewed 100 consecutive patients who underwent a lung POCUS exam during their pulmonary outpatient clinic visit. Lung POCUS was performed by trainees and faculty, stored in a cloud-based archival system, and reviewed by pulmonary attendings. Findings were categorized into three patterns: predominant A-line, predominant B-lines, and predominant A-lines with a B-line focus. Summary statistics were performed using the data.</p><p><strong>Results: </strong>The mean age of the included patients was 57+/- 17 years, and 64% were female. Residents performed 70% of the studies. The median time for a lung POCUS exam was 5 minutes. A normal lung POCUS with a predominant bilateral A-line pattern (71%) was most commonly associated with obstructive airway disease (31%). A bilateral B-line pattern (13%) was associated with either interstitial lung disease (7%) or heart failure (8%). Focal dense B-lines (10%) were seen with atelectasis (3%) or other abnormal computed tomography (CT) findings (3%). Lung POCUS demonstrated stability versus progression of pleural effusions in 18% of cases. Of the 49% of patients who had additional imaging ordered for them, there was 100% concordance between lung POCUS findings and chest X-ray (CXR). We explored the potential impact of lung POCUS on clinical management in five cases.</p><p><strong>Conclusions: </strong>Lung POCUS is feasible to perform in a pulmonary outpatient clinic without adding a significant amount of time to the patient encounter. There is strong concordance between a normal lung POCUS and CXR, which can supplant the need for CXRs in certain conditions. Areas of future research include evaluating providers' attitudes towards lung POCUS use in the clinic setting and integrating lung POCUS into clinic workflow.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650288","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":"Measurement of Systolic Blood Pressure Using POCUS With Color Doppler Compared to with an Intraarterial Line.","authors":"Henry Mayo-Malasky, Daniel Ying, Alekhya Bukkuri, Paul H Mayo","doi":"10.24908/pocusj.v10i02.19281","DOIUrl":"10.24908/pocusj.v10i02.19281","url":null,"abstract":"<p><strong>Background: </strong>In some clinical circumstances, it may be difficult to accurately measure systolic blood pressure (SBP) using direct auscultation technique or an automated oscillometric cuff pressure device. As an alternative method, this study compared the measurement of SBP using point of care ultrasound (POCUS) with color Doppler to the measurement of SBP using an intraarterial catheter.</p><p><strong>Methods: </strong>Study subjects were 50 patients in an intensive care unit who had an intraarterial catheter placed for monitoring blood pressure. The intraarterial catheter systolic pressure was recorded and compared to the contemporaneous measurement of SBP using POCUS with color power Doppler (CPD). The operator placed the Doppler sample volume over the brachial artery with ipsilateral inflation of a prepositioned upper arm blood pressure cuff that was inflated sufficiently to ablate blood flow in the target artery. The blood pressure cuff was then deflated until there was return of CPD signal in the brachial artery. At this moment, the corresponding blood pressure was noted on a sphygmomanometer attached to the blood pressure cuff. The values of the two methods were compared using standard statistical technique.</p><p><strong>Results: </strong>The intraarterial systolic pressures and CPD systolic pressures by POCUS were well correlated with a Pearsons correlation coefficient of 0.96. Bland-Altman analysis of bias and limits of agreement indicated that the POCUS with CPD measurement was sufficiently accurate to have clinical utility.</p><p><strong>Conclusions: </strong>The use of POCUS with CPD to measure SBP may have utility in situations where direct auscultation or automated oscillometeric cuff pressure measurements may be unreliable.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"30-33"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650372","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":"POCUS Diagnosis of Bacterial Lymphadenitis Later Determined to be Cat Scratch Disease: A Unique Presentation and Review.","authors":"Alec P Tolentino, Stanley Wojtas, Camille D Audette, Erin J Meyer, Zachary W Binder","doi":"10.24908/pocusj.v10i02.19399","DOIUrl":"10.24908/pocusj.v10i02.19399","url":null,"abstract":"<p><p>Acute lymphadenopathy has a wide range of possible etiologies, ranging from self-limiting viral infections to life-threatening malignancy. Point of care ultrasound (POCUS) can play a crucial role in identifying lymphadenopathy and ruling out other potential causes of soft tissue swelling, such as hernias, abscesses, and malignancies. Furthermore, POCUS enables the characterization of lymphadenopathy by evaluating the size, shape, echogenicity, and vascularity of the involved lymph nodes, thereby helping to identify the presence and extent of pathology. When performed at the time of initial presentation, POCUS can narrow the differential diagnosis and guide appropriate work-up and management. We present a case of a teenage male evaluated in the pediatric emergency department for acute bilateral inguinal swelling, in which POCUS identified lymphadenopathy and guided the evaluation of a presumed infectious process, ultimately determined to be caused by cat scratch disease.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650390","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":"Performance of POCUS for Pregnancy Evaluation using a Non-Piezoelectric Ultrasound Device in the Emergency Department.","authors":"Hae I Yun, Brandon M Wubben","doi":"10.24908/pocusj.v10i02.18473","DOIUrl":"10.24908/pocusj.v10i02.18473","url":null,"abstract":"<p><strong>Background: </strong>Confirmation of pregnancy location using point of care ultrasound (POCUS) is an essential component of emergency obstetric care. The accuracy of a non-piezoelectric portable ultrasound device compared to obstetric sonographer-performed ultrasonography remains uncertain.</p><p><strong>Objective: </strong>The objective of this study was to describe the practical utility of a non-piezoelectric POCUS system (Butterfly iQ+) in the emergency department, including characterizing the accuracy of findings relative to obstetric sonographer-performed ultrasound (OB-US) for obstetric and non-pregnant pelvis evaluations in the emergency department.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a Level 1 trauma center. Patients who underwent emergency physician-performed transabdominal obstetric or gynecologic POCUS examination using a non-piezoelectric transducer between November 2021 and November 2022 were included. Data from electronic medical records and ultrasound databases were abstracted. POCUS findings such as yolk sac presence, fetal heart motion, and gestational age were recorded alongside patient data including age, body mass index, human chorionic gonadotropin (hCG) levels, and ultrasound results. Descriptive statistics were analyzed using SPSS.</p><p><strong>Results: </strong>Seventy-two obstetric POCUS studies were included with an average maternal age of 29.6 ± 7.8 years. Common indications included positive pregnancy tests, abdominal/pelvic pain, and vaginal bleeding. All first-trimester intrauterine pregnancies (IUPs) diagnosed by POCUS and referred for OB-US were confirmed, with no false positives. POCUS had a sensitivity of 83.3% (95% CI 61.8-94.5) and specificity of 100% (95% CI 71.7-100) for confirmation of an IUP. The lowest hCG levels at which IUP was detected with POCUS were 6,488 without fetal heart motion and 7,098 with heart motion. The agreement between POCUS and OB-US for gestational age measurements was moderate (ICC = 0.83, 95% CI 0.0-0.99). In the second trimester, POCUS accurately detected fetal heart rate, with a strong agreement for gestational age (ICC = 0.96, 95% CI 0.43-0.99) compared to OB-US. Transabdominal POCUS also identified gynecologic conditions such as postpartum hemorrhage, and normal POCUS exams led to alternate diagnoses such as pelvic inflammatory disease and pyelonephritis.</p><p><strong>Conclusion: </strong>POCUS using a non-piezoelectric ultrasound device was able to accurately rule in first trimester IUP in the emergency department at relatively low hCG levels, with no false positive IUPs identified. During the second and third trimesters, POCUS consistently detected fetal heart motion and had good accuracy for gestational age measurements compared to OB-US. These findings suggest that POCUS using a non-piezoelectric ultrasound device is a useful tool for emergency department assessments, though further evaluation is needed.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"86-90"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650409","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":"Detecting a Canal of Nuck Hydrocoele in a Child with a Ventriculoperitoneal Shunt Using POCUS.","authors":"David J McCreary, Maria Munir, Milan Gopal","doi":"10.24908/pocusj.v10i02.19411","DOIUrl":"10.24908/pocusj.v10i02.19411","url":null,"abstract":"<p><p>In females, failure of the processus vaginalis to close properly can result in continued outpouching of the parietal peritoneum through the inguinal canal into the labia majora, forming a structure known as the Canal of Nuck. In rare cases, a Canal of Nuck hydrocoele can develop in association with the presence of a ventriculoperitoneal (VP) shunt, leading to symptoms of pain and discomfort in the inguinal region. We present the first reported case of a Canal of Nuck hydrocoele identified using POCUS in a child. This case highlights the role of POCUS as a safe, reliable, first-line imaging tool for identifying Canal of Nuck hydrocoeles in patients with VP shunts.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650231","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":"Assessment of the Association Between Lung POCUS Findings During Preoperative Assessment and Cardiopulmonary Outcomes in Patients Undergoing Major Abdominal Surgery: A Pilot Study Protocol.","authors":"Leonidas Palaiodimos, Sriram Sunil Kumar, Perminder Gulani, Maisha Maliha, Adam Mylonakis, Lori Lemberg, Mindaugas Pranevicius, Robert T Faillace, Ilias I Siembos, Benjamin Galen, Dimitrios Schizas","doi":"10.24908/pocusj.v10i02.18912","DOIUrl":"10.24908/pocusj.v10i02.18912","url":null,"abstract":"<p><p>Abdominal surgeries make up a significant portion of all surgical procedures performed worldwide. Despite advances in surgical techniques, there is significant morbidity and mortality associated with abdominal surgeries. Cardiopulmonary complications in the postoperative period play an important part in the elevated risk associated with these surgeries. Preoperative medical assessments have therefore become the standard of care to evaluate the risk of surgery, optimize a patient's medical conditions, and mitigate the perioperative risk. While there has been increasing utilization of lung point of care ultrasound (POCUS) in the immediate preoperative setting, the use of lung POCUS at the preoperative medical assessment clinic visit has not been studied. While using risk stratification tools is common in current practice, the role of adjunctive office-based techniques like lung POCUS have not been studied in this setting. We conducted an observational prospective pilot study to evaluate the association of lung POCUS findings in the preoperative visit on the risk of adverse cardiopulmonary outcomes in the 30-day postoperative period after major abdominal surgery. A standardized scoring system called integrated lung ultrasound score (iLUS) is used for objective assessment. Our study attempted to determine whether the addition of lung POCUS can be used to better stratify the risk for postoperative complications.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650186","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":"Agreement of IVC Diameter Measurements via Subcostal and Transhepatic POCUS Views.","authors":"Santiago Beltramino, Giuliano Gaudenzi, Jhon Mauricio Rojas, Agustín Manchado Bruno","doi":"10.24908/pocusj.v10i02.18823","DOIUrl":"10.24908/pocusj.v10i02.18823","url":null,"abstract":"<p><strong>Background: </strong>Inferior vena cava (IVC) point of care ultrasound (POCUS) is essential for hemodynamic evaluation, with the subcostal view (SCV) being the gold standard. However, in situations where this view is inaccessible, the transhepatic view (THV) is a viable alternative. This study evaluates the concordance between these two views in ventilated and non-ventilated patients, categorizing the IVC as small, intermediate, or large.</p><p><strong>Methods: </strong>This prospective observational study included 99 patients; healthy volunteers, ventilated patients, and non-ventilated patients. We measured end-expiratory IVC diameter, classified as small (<10 mm), intermediate (10-20 mm) or large (>20 mm), via SVC and THV. We then assessed agreement by categorical concordance, using Bland-Altman (mean bias ± 95% limits) and Pearson's correlation (r).</p><p><strong>Results: </strong>The overall concordance between both views was 83.8% (83/99; 95% CI: 76.4-90%). By IVC diameter category, concordance was 93.8% (15/16; 95% CI: 69.8-99.8) for small, 84% (42/50; 95% CI: 70-90 %) for intermediate, and 82% (27/33; 95% CI: 77-95%) for large. Concordance was unaffected by ventilation status (p = 0.83), but patients with Body Mass Index (BMI) ≥ 30 had lower concordance than those with BMI < 30 (73.9% vs. 89.5%; p = 0.086). The Bland-Altman analysis showed a mean bias of +0.22 mm with 95% limits of agreement from -6.99 to +7.43 mm. Pearson's correlation coefficient for the 99 paired measurements was r = 0.86 (p < 0.001), overall, and when stratified by category was r = 0.81 (small), r = 0.78 (intermediate) and r = 0.74 (large) (all p < 0.001). The sensitivity and specificity of THV for identifying \"responders\" (CI > 42%) were 28% and 93%, respectively.</p><p><strong>Conclusion: </strong>The THV is a reliable alternative for categorical evaluation of the IVC, particularly when the SCV is inaccessible. This method supports rapid and accurate clinical decision, especially for dichotomous POCUS decisions but should be used cautiously in patients with elevated BMI.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650216","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":"Can a POCUS Clinical Decision Rule Improve Reliability in the Diagnosis of Paediatric Transient Synovitis of the Hip? A Single Centre Pilot Study.","authors":"David J McCreary, Rashed Chowdhury, Cameron Hamilton","doi":"10.24908/pocusj.v10i02.18290","DOIUrl":"10.24908/pocusj.v10i02.18290","url":null,"abstract":"<p><strong>Objectives: </strong><i>Primary</i>: To determine if point of care ultrasound (POCUS) combined with a clinical decision rule (CDR) improves reliability in the diagnosis of transient synovitis of the hip (TS) in paediatric patients presenting with atraumatic limp. <i>Secondary</i>: To describe how POCUS improves diagnostic reliability and reduces the need for further investigations for the child with atraumatic limp.</p><p><strong>Methods: </strong>We retrospectively applied a POCUS CDR to patients presenting to our paediatric emergency department (PED) with atraumatic limp over a 5-year period. This consisted of the following: ages 1 to 10 years old, able to weight bear, no history of fever, symptom duration for 7 days or less, and no pallor, lymphadenopathy, or hepatosplenomegaly.</p><p><strong>Results: </strong>A total of 77 out of 178 patients presenting to the PED with a diagnosis of TS underwent a POCUS examination during their clinical assessment. Of these, 67 patients had hip effusion on POCUS. Our CDR could be applied to correctly rule-in TS in 63 out of 67 patients. Ten patients did not have hip effusion; five of which were diagnosed with another cause for their limp and five were categorized as being possible TS. When POCUS was not utilised as part of clinical assessment, three cases included a misdiagnosis for children presenting with atraumatic limp.</p><p><strong>Conclusion: </strong>Our POCUS CDR could be applied to correctly rule-in TS in a very high proportion of cases. The integration of POCUS into the clinical assessment of children with atraumatic limp can reduce the need for unnecessary investigations while maintaining diagnostic reliability. We recognise that a large prospective study evaluating the role of a POCUS CDR is needed to further evaluate its reliability.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 2","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650278","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}