Annals of Biomedical Engineering最新文献

{"title":"Predicting Steady-State Metabolic Power in Cerebral Palsy, Stroke, and the Elderly During Walking With and Without Assistive Devices.","authors":"Karl Harshe, Benjamin C Conner, Zachary F Lerner","doi":"10.1007/s10439-024-03614-w","DOIUrl":"https://doi.org/10.1007/s10439-024-03614-w","url":null,"abstract":"<p><strong>Purpose: </strong>Individuals with walking impairment, such as those with cerebral palsy, often face challenges in leading physically active lives due to the high energy cost of movement. Assistive devices like powered exoskeletons aim to alleviate this burden and improve mobility. Traditionally, optimizing the effectiveness of such devices has relied on time-consuming laboratory-based measurements of energy expenditure, which may not be feasible for some patient populations. To address this, our study aimed to enhance the state-of-the-art predictive model for estimating steady-state metabolic rate from 2-min walking trials to include individuals with and without walking disabilities and for a variety of terrains and wearable device conditions.</p><p><strong>Methods: </strong>Using over 200 walking trials collected from eight prior exoskeleton-related studies, we trained a simple linear machine learning model to predict metabolic power at steady state based on condition-specific factors, such as whether the trial was conducted on a treadmill (level or incline) or outdoors, as well as demographic information, such as the participant's weight or presence of walking impairment, and 2 minutes of metabolic data.</p><p><strong>Results: </strong>We demonstrated the ability to predict steady-state metabolic rate to within an accuracy of 4.71 ± 2.7% on average across all walking conditions and patient populations, including with assistive devices and on different terrains.</p><p><strong>Conclusion: </strong>This work seeks to unlock the use of in-the-loop optimization of wearable assistive devices in individuals with limited walking capacity. A freely available MATLAB application allows other researchers to easily apply our model.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Tooth Crack Image Analysis with Multiple Deep Learning Approaches.","authors":"Zheng Li, Zhongqiang Li, Ya Zhang, Huaizhi Wang, Xin Li, Jian Zhang, Waleed Zaid, Shaomian Yao, Jian Xu","doi":"10.1007/s10439-024-03615-9","DOIUrl":"https://doi.org/10.1007/s10439-024-03615-9","url":null,"abstract":"<p><p>Tooth cracks, one of the most common dental diseases, can result in the tooth falling apart without prompt treatment; dentists also have difficulty locating cracks, even with X-ray imaging. Indocyanine green (ICG) assisted near-infrared fluorescence (NIRF) dental imaging technique can solve this problem due to the deep penetration of NIR light and the excellent fluorescence characteristics of ICG. This study extracted 593 human cracked tooth images and 601 non-cracked tooth images from NIR imaging videos. Multiple imaging analysis methods such as classification, object detection, and super-resolution were applied to the dataset for cracked image analysis. Our results showed that machine learning methods could help analyze tooth crack efficiently: the tooth images with cracks and without cracks could be well classified with the pre-trained residual network and squeezenet1_1 models, with a classification accuracy of 88.2% and 94.25%, respectively; the single shot multi-box detector (SSD) was able to recognize cracks, even if the input image was at a different size from the original cracked image; the super-resolution (SR) model, SR-generative adversarial network demonstrated enhanced resolution of crack images using high-resolution concrete crack images as the training dataset. Overall, deep learning model-assisted human crack analysis improves crack identification; the combination of our NIR dental imaging system and deep learning models has the potential to assist dentists in crack diagnosis.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Deformation of the Human Basilar Artery.","authors":"Jaemin Kim, Kaiyu Zhang, Gador Canton, Niranjan Balu, Kenneth Meyer, Reza Saber, David Paydarfar, Chun Yuan, Michael S Sacks","doi":"10.1007/s10439-024-03605-x","DOIUrl":"https://doi.org/10.1007/s10439-024-03605-x","url":null,"abstract":"<p><p>An estimated 6.8 million people in the United States have an unruptured intracranial aneurysms, with approximately 30,000 people suffering from intracranial aneurysms rupture each year. Despite the development of population-based scores to evaluate the risk of rupture, retrospective analyses have suggested the limited usage of these scores in guiding clinical decision-making. With recent advancements in imaging technologies, artery wall motion has emerged as a promising biomarker for the general study of neurovascular mechanics and in assessing the risk of intracranial aneurysms. However, measuring arterial wall deformations in vivo itself poses several challenges, including how to image local wall motion and deriving the anisotropic wall strains over the cardiac cycle. To overcome these difficulties, we first developed a novel in vivo MRI-based imaging method to acquire cardiac gated images of the human basilar artery (BA) over the cardiac cycle. Next, complete BA endoluminal surfaces from each frame were segmented, producing high-resolution point clouds of the endoluminal surfaces. From these point clouds we developed a novel B-spline-based surface representation, then exploited the local support nature of B-splines to determine the local endoluminal surface strains. Results indicated distinct regional and temporal variations in BA wall deformation, highlighting the heterogeneous nature BA function. These included large circumferential strains (up to <math><mo>∼</mo></math> 20 <math><mo>%</mo></math> ), and small longitudinal strains, which were often contractile and out of phase with the circumferential strains patterns. Of particular interest was the temporal phase lag in the maximum circumferential perimeter length, which indicated that the BA deforms asynchronously over the cardiac cycle. In summary, the proposed method enabled local deformation analysis, allowing for the successful reproduction of local features of the BA, such as regional principal stretches, areal changes, and pulsatile motion. Integrating the proposed method into existing population-based scores has the potential to improve our understanding of mechanical properties of human BA and enhance clinical decision-making.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanded Combined Loading Injury Criterion for the Human Lumbar Spine Under Dynamic Compression","authors":"Maria Ortiz-Paparoni,&nbsp;Joost Op ‘t Eynde,&nbsp;Christopher Eckersley,&nbsp;Concetta Morino,&nbsp;Mitchell Abrams,&nbsp;Derek Pang,&nbsp;Jason Kait,&nbsp;Frank Pintar,&nbsp;Narayan Yoganandan,&nbsp;Jason Moore,&nbsp;David Barnes,&nbsp;Kathryn Loftis,&nbsp;Cameron R. Bass","doi":"10.1007/s10439-024-03570-5","DOIUrl":"10.1007/s10439-024-03570-5","url":null,"abstract":"<div><p>Contemporary injury tolerance of the lumbar spine for under-body blast references axial compression and bending moments in a limited range. Since injuries often occur in a wider range of flexion and extension with increased moment contribution, this study expands a previously proposed combined loading injury criterion for the lumbar spine. Fifteen cadaveric lumbar spine failure tests with greater magnitudes of eccentric loading were incorporated into an existing injury criterion to augment its applicability and a combined loading injury risk model was proposed by means of survival analysis. A loglogistic distribution was the most representative of injury risk, resulting in optimized critical values of <i>F</i>_{<i>r</i>,crit} = 6011 N, and <i>M</i>_y,crit = 904 Nm for the proposed combined loading metric. The 50% probability of injury resulted in a combined loading metric value of 1, with 0.59 and 1.7 corresponding to 5 and 95% injury risk, respectively. The inclusion of eccentric loaded specimens resulted in an increased contribution of the bending moment relative to the previously investigated flexion/extension range (previous <i>M</i>_{<i>y</i>,crit} = 1155 Nm), with the contribution of the resultant sagittal force reduced by nearly 200 N (previous <i>F</i>_{<i>r</i>,crit} = 5824 N). The new critical values reflect an expanded flexion/extension range of applicability of the previously proposed combined loading injury criterion for the human lumbar spine during dynamic compression.</p></div>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":"52 11","pages":"3067 - 3077"},"PeriodicalIF":3.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10439-024-03570-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Probe Pressure Affects Aortic Wall Stiffness: A Patient-Specific Computational Study in Abdominal Aortic Aneurysms.","authors":"Marta Irene Bracco, Ali Akbar Karkhaneh Yousefi, Laurence Rouet, Stéphane Avril","doi":"10.1007/s10439-024-03608-8","DOIUrl":"https://doi.org/10.1007/s10439-024-03608-8","url":null,"abstract":"<p><strong>Purpose: </strong>Ultrasound imaging is key in the management of patients with an abdominal aortic aneurysm (AAA). It was recently shown that the cyclic diameter variations between diastole and systole, which can be quantified with US imaging, increase significantly with the strength of the applied probe pressure on the patient's abdomen. The goal of this study is to investigate this effect more thoroughly.</p><p><strong>Methods: </strong>With finite-element modeling, pulsatile blood pressure and probe pressure are simulated in three patient-specific geometries. Two distinct models for the aortic wall were simulated: a nonlinear hyperelastic and a linear elastic model. In addition, varying stiffness was considered for the surrounding tissues. The effect of light, moderate, and firm probe pressure was quantified on the stresses and strains in the aortic wall, and on two in vivo stiffness measures. In addition, the Elasticity Loss Index was proposed to quantify the change in stiffness due to probe pressure.</p><p><strong>Results: </strong>Firm probe pressure decreased the measured aortic stiffness, and material stiffness was affected only when the wall was modeled as nonlinear, suggesting a shift in the stress-strain curve. In addition, stiffer surrounding tissues and a more elongated aneurysm sac decreased the responsiveness to the probe pressure.</p><p><strong>Conclusion: </strong>The effect of probe pressure on the AAA wall stiffness was clarified. In particular, the AAA wall nonlinear behavior was found to be of primary importance in determining the probe pressure response. Thus, further work will intend to make use of this novel finding in a clinical context.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Fluid–Structure Interaction Mechanisms for a Native Aortic Valve, Patient-Specific Ozaki Procedure, and a Bioprosthetic Valve","authors":"Tom Fringand,&nbsp;Loic Mace,&nbsp;Isabelle Cheylan,&nbsp;Marien Lenoir,&nbsp;Julien Favier","doi":"10.1007/s10439-024-03566-1","DOIUrl":"10.1007/s10439-024-03566-1","url":null,"abstract":"<div><p>The Ozaki procedure is a surgical technique which avoids to implant foreign aortic valve prostheses in human heart, using the patient’s own pericardium. Although this approach has well-identified benefits, it is still a topic of debate in the cardiac surgical community, which prevents its larger use to treat valve pathologies. This is linked to the actual lack of knowledge regarding the dynamics of tissue deformations and surrounding blood flow for this autograft pericardial valve. So far, there is no numerical study examining the coupling between the blood flow characteristics and the Ozaki leaflets dynamics. To fill this gap, we propose here a comprehensive comparison of various performance criteria between a healthy native valve, its pericardium-based counterpart, and a bioprosthetic solution, this is done using a three-dimensional fluid–structure interaction solver. Our findings reveal similar physiological dynamics between the valves but with the emergence of fluttering for the Ozaki leaflets and higher velocity and wall shear stress for the bioprosthetic heart valve.</p></div>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":"52 11","pages":"3021 - 3036"},"PeriodicalIF":3.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Super-Resolving and Denoising 4D flow MRI of Neurofluids Using Physics-Guided Neural Networks.","authors":"Neal M Patel, Emily R Bartusiak, Sean M Rothenberger, A J Schwichtenberg, Edward J Delp, Vitaliy L Rayz","doi":"10.1007/s10439-024-03606-w","DOIUrl":"https://doi.org/10.1007/s10439-024-03606-w","url":null,"abstract":"<p><strong>Purpose: </strong>To obtain high-resolution velocity fields of cerebrospinal fluid (CSF) and cerebral blood flow by applying a physics-guided neural network (div-mDCSRN-Flow) to 4D flow MRI.</p><p><strong>Methods: </strong>The div-mDCSRN-Flow network was developed to improve spatial resolution and denoise 4D flow MRI. The network was trained with patches of paired high-resolution and low-resolution synthetic 4D flow MRI data derived from computational fluid dynamic simulations of CSF flow within the cerebral ventricles of five healthy cases and five Alzheimer's disease cases. The loss function combined mean squared error with a binary cross-entropy term for segmentation and a divergence-based regularization term for the conservation of mass. Performance was assessed using synthetic 4D flow MRI in one healthy and one Alzheimer' disease cases, an in vitro study of healthy cerebral ventricles, and in vivo 4D flow imaging of CSF as well as flow in arterial and venous blood vessels. Comparison was performed to trilinear interpolation, divergence-free radial basis functions, divergence-free wavelets, 4DFlowNet, and our network without divergence constraints.</p><p><strong>Results: </strong>The proposed network div-mDCSRN-Flow outperformed other methods in reconstructing high-resolution velocity fields from synthetic 4D flow MRI in healthy and AD cases. The div-mDCSRN-Flow network reduced error by 22.5% relative to linear interpolation for in vitro core voxels and by 49.5% in edge voxels.</p><p><strong>Conclusion: </strong>The results demonstrate generalizability of our 4D flow MRI super-resolution and denoising approach due to network training using flow patches and physics-based constraints. The mDCSRN-Flow network can facilitate MRI studies involving CSF flow measurements in cerebral ventricles and association of MRI-based flow metrics with cerebrovascular health.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an Injectable Hydrogel for Histotripsy Ablation Toward Future Glioblastoma Therapy Applications","authors":"Zerin Mahzabin Khan,&nbsp;Junru Zhang,&nbsp;Jessica Gannon,&nbsp;Blake N. Johnson,&nbsp;Scott S. Verbridge,&nbsp;Eli Vlaisavljevich","doi":"10.1007/s10439-024-03601-1","DOIUrl":"10.1007/s10439-024-03601-1","url":null,"abstract":"<div><p>Glioblastoma (GBM) is the most common and malignant type of primary brain tumor. Even after surgery and chemoradiotherapy, residual GBM cells can infiltrate the healthy brain parenchyma to form secondary tumors. To mitigate GBM recurrence, we recently developed an injectable hydrogel that can be crosslinked in the resection cavity to attract, collect, and ablate residual GBM cells. We previously optimized a thiol-Michael addition hydrogel for physical, chemical, and biological compatibility with the GBM microenvironment and demonstrated CXCL12-mediated chemotaxis can attract and entrap GBM cells into this hydrogel. In this study, we synthesize hydrogels under conditions mimicking GBM resection cavities and assess feasibility of histotripsy to ablate hydrogel-encapsulated cells. The results showed the hydrogel synthesis was bio-orthogonal, not shear-thinning, and can be scaled up for injection into GBM resection mimics <i>in</i> <i>vitro</i>. Experiments also demonstrated ultrasound imaging can distinguish the synthetic hydrogel from healthy porcine brain tissue. Finally, a 500 kHz transducer applied focused ultrasound treatment to the synthetic hydrogels, with results demonstrating precise histotripsy bubble clouds could be sustained in order to uniformly ablate red blood cells encapsulated by the hydrogel for homogeneous, mechanical fractionation of the entrapped cells. Overall, this hydrogel is a promising platform for biomaterials-based GBM treatment.</p></div>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":"52 12","pages":"3157 - 3171"},"PeriodicalIF":3.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s10439-024-03601-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Instrumented Hammer to Detect the Rupture of the Pterygoid Plates.","authors":"Manon Bas Dit Nugues, Leo Lamassoure, Giuseppe Rosi, Charles Henri Flouzat-Lachaniette, Roman Hossein Khonsari, Guillaume Haiat","doi":"10.1007/s10439-024-03596-9","DOIUrl":"https://doi.org/10.1007/s10439-024-03596-9","url":null,"abstract":"<p><strong>Purpose: </strong>Craniofacial osteotomies involving pterygomaxillary disjunction are common procedures in maxillofacial surgery. Surgeons still rely on their proprioception to determine when to stop impacting the osteotome, which is important to avoid complications such as dental damage and bleeding. Our group has developed a technique consisting in using an instrumented hammer that can provide information on the mechanical properties of the tissue located around the osteotome tip. The aim of this study is to determine whether a mallet instrumented with a force sensor can be used to predict the crossing of the osteotome through the pterygoid plates.</p><p><strong>Methods: </strong>31 osteotomies were carried out in 16 lamb skulls. For each impact, the force signal obtained was analysed using a dedicated signal processing technique. A prediction algorithm based on an SVM classifier and a cost matrix was applied to the database.</p><p><strong>Results: </strong>We showed that the device could always detect the crossing of the osteotome, sometimes before its occurrence. The prediction accuracy of the device was 94.7%. The method seemed to be sensitive to the thickness of the plate and to crack apparition and propagation.</p><p><strong>Conclusion: </strong>These results pave the way for the development of a per-operative decision support system in maxillofacial surgery.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate and Transient Perturbances in EEG Within Seconds Following Controlled Soccer Head Impact","authors":"Ahmad Rezaei,&nbsp;Timothy Wang,&nbsp;Cyrus Titina,&nbsp;Lyndia Wu","doi":"10.1007/s10439-024-03602-0","DOIUrl":"10.1007/s10439-024-03602-0","url":null,"abstract":"<div><p>Athletes in contact and collision sports can sustain frequent subconcussive head impacts. Although most impacts exhibit low kinematics around or below 10 g of head linear acceleration, there is growing concern regarding the cumulative effects of repetitive sports head impacts. Even mild impacts can lead to brain deformations as shown through neuroimaging and finite element modeling, and thus may result in mild and transient effects on the brain, prompting further investigations of the biomechanical dose—brain response relationship. Here we report findings from a novel laboratory study with continuous monitoring of brain activity through electroencephalography (EEG) during controlled soccer head impacts. Eight healthy participants performed simulated soccer headers at 2 mild levels (6 g, 4 rad/s and 10 g, 8 rad/s) and three directions (frontal, oblique left, oblique right). Participants were instrumented with an inertial measurement unit (IMU) bite bar and EEG electrodes for synchronized head kinematics and brain activity measurements throughout the experiment. After an impact, EEG exhibited statistically significant elevation of relative and absolute delta power that recovered within two seconds from the impact moment. These changes were statistically significantly higher for 10 g impacts compared with 6 g impacts in some topographical regions, and oblique impacts resulted in contralateral delta power increases. Post-session resting state measurements did not indicate any cumulative effects. Our findings suggest that even mild soccer head impacts could lead to immediate, transient neurophysiological changes. This study paves the way for further dose-response studies to investigate the cumulative effects of mild sports head impacts, with implications for long-term athlete brain health.</p></div>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":"52 10","pages":"2897 - 2910"},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}