{"title":"Design Parametrization of Central Venous Catheters for Pediatric Dialysis: Supporting the Quest for the Most Influential Features.","authors":"Claudia Bruno, Rukshana Shroff, Silvia Schievano, Claudio Capelli","doi":"10.1097/MAT.0000000000002547","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002547","url":null,"abstract":"<p><p>Pediatric hemodialysis is a life-saving treatment for children with chronic kidney diseases. Central venous catheters (CVCs) are the most commonly used vascular access, despite being commonly subject to complications leading to inadequate hemodialysis and catheter replacement. The available CVCs feature various design elements reflecting ongoing efforts to achieve optimal performance. Computational fluid dynamics (CFD) can contribute to analyze the flow dynamics within the CVCs. The aim of this study is to investigate the design parameters that most influence the flow performance of CVCs. A design of experiment (DOE) was set up to assess the CFD of two CVC models of 6.5F and 8F size. Blood flow rates, shear stress, residence time, and platelet lysis index were evaluated. The results showed how the proximal side holes were the most influential geometrical features, influencing both the flow rates (r > 0.64) and the shear stress of the CVCs (|r| > 0.5). At increased flow rate, the side holes were found to be competing with the tip in terms, especially, of residence time inside the CVC. The findings of this DOE show how CFD can contribute to understand the influence of design parameters and potentially guide the development of optimized pediatric-specific CVC models.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-05DOI: 10.1097/MAT.0000000000002531
Ari R Joffe, Lauren Ryan, Laurance Lequier, Charlene M T Robertson
{"title":"Over 30 Years of Neonatal Respiratory Extracorporeal Membrane Oxygenation From a Regional Program.","authors":"Ari R Joffe, Lauren Ryan, Laurance Lequier, Charlene M T Robertson","doi":"10.1097/MAT.0000000000002531","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002531","url":null,"abstract":"<p><p>This referral center's prospective inception-cohort study from 1989 to 2000 (Era 1) and 2000 to 2022 (Era 2) included 232 consecutive children having neonatal respiratory extracorporeal membrane oxygenation (ECMO). Kindergarten-age outcomes determined in 137/139 (95.8%) survivors were Wechsler Preschool and Primary Scales of Intelligence, Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), and sensorimotor disability, with optimal outcome defined as scores greater than or equal to 80 and without disability. In Era 2, there were fewer patients/year, fewer neonates with meconium aspiration syndrome, and more with sepsis, lethal disease, or \"other\" diagnoses. Era 2 also had higher rates of venoarterial cannulation, cannulation after the first week of life, and extracorporeal cardiopulmonary resuscitation. In survivors, there was a shift in Full-Scale Intelligence Quotient (FSIQ), Verbal IQ, Performance IQ, and VMI to the left of population norms, with scores less than 70 in 16-40% (expected in 2.27% of the normative population), disability in 53%, and optimal outcome in 38%. Era was not independently associated with mortality, optimal outcome, or FSIQ outcomes. Congenital Diaphragmatic Hernia (CDH) was independently associated with lower optimal outcome and FSIQ. Sensorineural hearing loss (bilateral, predominantly high-frequency, often progressive, and of delayed onset) was eliminated from Era 2, despite a concerning incidence of 40% in Era 1. Survival and neurocognitive outcomes after neonatal respiratory ECMO have not changed over 34 years.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-03DOI: 10.1097/MAT.0000000000002544
Luca Baldetti, Guglielmo Gallone, Lorenzo Cianfanelli, Simone Frea, Wim Rietdijk, Gaetano Maria De Ferrari, Silvia Ajello, David A Baran, Corstiaan A den Uil, Anna Mara Scandroglio
{"title":"Intra-Aortic Balloon Pump in Heart Failure-Related Cardiogenic Shock: A Meta-Analysis of Randomized Clinical Trials.","authors":"Luca Baldetti, Guglielmo Gallone, Lorenzo Cianfanelli, Simone Frea, Wim Rietdijk, Gaetano Maria De Ferrari, Silvia Ajello, David A Baran, Corstiaan A den Uil, Anna Mara Scandroglio","doi":"10.1097/MAT.0000000000002544","DOIUrl":"10.1097/MAT.0000000000002544","url":null,"abstract":"<p><p>Pathophysiologic assumptions and clinical data frame a promising role for intra-aortic balloon pump (IABP) in heart failure-related cardiogenic shock (HF-CS). Currently, two randomized clinical trials (RCT) exploring this hypothesis have been published, yielding inconclusive results. We thus designed this meta-analysis to assess the efficacy of IABP in HF-CS. Randomized clinical trials comparing IABP to standard of care (SoC) in patients with HF-CS were included. The study endpoint was survival or successful bridge to heart replacement therapies (HRT) at 60 days. Meta-analytic results are presented as risk difference (RD) and odds ratio (OR). Two RCTs were included (IABP group: 69 patients; SoC group: 64 patients). Patients were in Society for Cardiovascular Angiography & Interventions (SCAI) CS stage B in 21.1% and in stages C/D in 78.9%. Intra-aortic balloon pump use was associated with a nonsignificant trend for better 60 day survival or successful bridge to HRT with moderate heterogeneity between studies (RD: 0.12; 95% confidence interval [CI]:-0.02 to 0.27; p = 0.096; I2 = 49%; OR: 1.94; 95% CI: 0.87-4.32). Subgroup testing demonstrated a significantly improved 60 day survival or successful bridge to HRT with IABP in the SCAI C/D cohort with low heterogeneity (RD: 0.17; 95% CI: 0.01-0.34; p = 0.040; I2 = 14%; OR: 2.52; 95% CI: 1.02-6.23), but not in the SCAI B cohort (RD: 0.06; 95% CI: -0.36 to 0.24; p = 0.712; I2 = 0%; OR: 0.72; 95% CI: 0.13-4.01). This meta-analysis of RCTs supports the clinical utility of IABP in patients with HF-CS with SCAI C/D CS stages. These findings highlight the need for future randomized trials, designed with enrollment criteria based on clinical and hemodynamic features associated with potential responsiveness to IABP support.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-01Epub Date: 2025-06-26DOI: 10.1097/MAT.0000000000002491
Ryota Sato, Natsumi T Hamahata, Daisuke Hasegawa, Erick Itoman
{"title":"Age and In-Hospital Mortality in Patients With Acute Respiratory Distress Syndrome Undergoing Venovenous Extracorporeal Membrane Oxygenation.","authors":"Ryota Sato, Natsumi T Hamahata, Daisuke Hasegawa, Erick Itoman","doi":"10.1097/MAT.0000000000002491","DOIUrl":"10.1097/MAT.0000000000002491","url":null,"abstract":"<p><p>Age is a known risk factor for mortality in acute respiratory distress syndrome (ARDS) patients receiving venovenous extracorporeal membrane oxygenation (VV ECMO), but an optimal age cutoff for patient selection remains unclear. This study evaluates the association between age and in-hospital mortality in ARDS patients undergoing VV ECMO using the National Inpatient Sample from 2019 to 2022. We included adults with ARDS treated with VV ECMO and applied logistic regression to assess mortality risk while adjusting for demographics, comorbidities, hospital settings, and socioeconomic factors. Among an estimated 510,175 ARDS hospitalizations, 13,150 patients received VV ECMO, with an in-hospital mortality rate of 43.4%. The predicted mortality increased linearly with age. Compared with patients aged 18-25 years, the odds ratios (ORs) for mortality were 1.01 (26-35 years), 1.47 (36-45 years), 1.96 (46-55 years), 2.79 (56-65 years), 3.72 (66-75 years), and 4.27 (≥76 years), with statistical significance for older groups. Our findings confirm age as a strong predictor of mortality in this population. However, the absence of a clear threshold suggests that strict age cutoffs may not be justified. Instead, ECMO candidacy should be individualized, emphasizing overall clinical status rather than age alone.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"760-766"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High-Concentration Hydrogen Delivery During Dialysis Using an Innovative Direct Dissolution Technique: In Vivo Kinetics in a Canine Model.","authors":"Masaki Shibuya, Masafumi Fujinaka, Mako Yonezawa, Natsumi Nishimura, Hitoshi Uchinoumi, Kenji Tani, Yukihiro Hitaka, Kimihiko Nakamura, Naohito Isoyama, Zenzo Fujii, Motoaki Sano","doi":"10.1097/MAT.0000000000002508","DOIUrl":"10.1097/MAT.0000000000002508","url":null,"abstract":"<p><p>Hydrogen gas (H₂) shows broad therapeutic potential. Hemodialysis, using large dialysate volumes in contact with blood, presents a promising H₂ delivery method. We developed an innovative system generating hydrogen-enriched dialysate, differing from conventional electrolysis. This system directly dissolves H₂ gas into tap water to produce saturated water, which then undergoes reverse osmosis (RO) for dialysate preparation. Using this system in a canine hemodialysis model with a single dog, we measured H₂ concentrations. High H₂ levels were consistently maintained (approximately 1,600 ppb in RO water; stable approximately 230 ppb in final dialysate). H₂ efficiently diffused into the extracorporeal blood circuit, with outlet concentrations reaching 54.0-67.7% of the dialysate level. However, low systemic arterial concentrations (pulmonary, carotid) indicated significant pulmonary clearance, suggesting H₂ primarily acts locally within the circuit and dialyzer. Compared with traditional electrolyzed water methods, this direct dissolution system delivers substantially higher and more stable H₂ concentrations. Its simpler design and potentially lower installation costs suggest feasibility for widespread clinical adoption. Future studies should explore hemodiafiltration (HDF) to potentially enhance systemic H₂ delivery and evaluate long-term clinical benefits.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"767-774"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636024","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}
ASAIO JournalPub Date : 2025-09-01Epub Date: 2025-07-17DOI: 10.1097/MAT.0000000000002512
Patrick M Wieruszewski, Hannah M Brinkman, Jamel P Ortoleva, Juan G Ripoll, Sarah E Pieterick, Katharine E Damico, Subhasis Chatterjee, Erica D Wittwer, Danielle J Gerberi, Jacopo D'Andria Ursoleo, Erin D Wieruszewski, Troy G Seelhammer
{"title":"Dosing Reliability of Direct Thrombin Inhibitors in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis.","authors":"Patrick M Wieruszewski, Hannah M Brinkman, Jamel P Ortoleva, Juan G Ripoll, Sarah E Pieterick, Katharine E Damico, Subhasis Chatterjee, Erica D Wittwer, Danielle J Gerberi, Jacopo D'Andria Ursoleo, Erin D Wieruszewski, Troy G Seelhammer","doi":"10.1097/MAT.0000000000002512","DOIUrl":"10.1097/MAT.0000000000002512","url":null,"abstract":"<p><p>Empirical evidence suggests direct thrombin inhibitors (DTIs) produce more favorable hemostatic outcomes than heparin in patients supported by extracorporeal membrane oxygenation (ECMO), yet the exact mechanisms responsible are unknown. We systematically searched databases and registers for studies comparing DTIs to heparin in humans receiving ECMO. A total of 28 studies were identified, most of which (n = 25) used bivalirudin, while the rest (n = 3) used argatroban. In random-effects meta-analysis, DTIs achieved the therapeutic anticoagulation range faster (mean difference = -6.96 hours, 95% confidence interval [CI] = -11.98 to -1.95, p = 0.006) and maintained the therapeutic range for a greater proportion of time (mean difference = 18.6%, 95% CI = 8.78-28.42, p < 0.001) than heparin. Subgroup analysis revealed these effects were similarly significant in adult patients and when bivalirudin was the DTI; however, they were not significant in pediatric patients or when argatroban was the DTI. Sensitivity analysis confirmed robustness of the primary findings in only low-risk of bias studies and in only studies published as full papers. In summary, DTIs-specifically bivalirudin-were associated with faster time to therapeutic anticoagulation and maintained the goal range for a greater percentage of time than heparin during ECMO support.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"691-700"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HeartMate III Autonomy Assistant in a Hemiplegic Left Ventricular Assist Device Patient: A Case Report.","authors":"Manuel Iafrate, Lorraine Aviolat, Filipa Monis Vieira Marques, Valentin Soumille, Matthias Kirsch","doi":"10.1097/MAT.0000000000002342","DOIUrl":"10.1097/MAT.0000000000002342","url":null,"abstract":"<p><p>Terminal heart failure presents challenges, requiring cardiac transplantation, or mechanical circulatory support. Limited donor organ availability has made mechanical support crucial. Advances in centrifugal-flow systems, compared to axial-flow, have improved patient outcomes by reducing adverse events. Rehabilitation is vital for patient independence postimplantation. We developed a tool to aid hemiplegic patients in managing power sources. A 44 year old male with tritroncular ischemic heart disease and a 15% ejection fraction. He underwent a double bypass and left ventricular assist device (LVAD) implantation while awaiting a transplant. Postsurgery, the patient suffered a stroke, leading to left motor impairments. To assist in managing LVAD power sources, an autonomous tool with a Woodcast support base and antislip surface was developed. The tool improves autonomy and quality of life for motor-impaired patients. It is designed to be portable, adaptable, supporting various mobility levels. Real-world evidence shows it reduces time and alarms for battery changes, proving effective in home settings. The tool significantly enhances hemiparetic patients' self-care and independence, showing promise for motor-impaired individuals. Further research is needed to evaluate long-term benefits and challenges.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e130-e131"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-01Epub Date: 2025-05-23DOI: 10.1097/MAT.0000000000002463
Toghrul Javadov, Semra Unal, Asli Katmis, Mustafa Sakar, Dilek Akakin, Elif Kervancioglu Demirci, Mustafa Ibrahim Ziyal
{"title":"Polylactic Acid/Polyvinylpyrrolidone Scaffolds With Adipose Tissue-Derived Mesenchymal Stem Cells Enhance Nerve Regeneration in Rats.","authors":"Toghrul Javadov, Semra Unal, Asli Katmis, Mustafa Sakar, Dilek Akakin, Elif Kervancioglu Demirci, Mustafa Ibrahim Ziyal","doi":"10.1097/MAT.0000000000002463","DOIUrl":"10.1097/MAT.0000000000002463","url":null,"abstract":"<p><p>The aim of this study was to investigate the treatment effect of an artificial nerve graft produced with polylactic acid (PLA) and polyvinylpyrrolidone (PVP) by electrospinning method, in combination with rat allogeneic adipose tissue-derived mesenchymal stem cells (rAT-MSCs), on axonal regeneration in a rat sciatic nerve injury. A 10 mm long gap in the right sciatic nerve was created in rats which were divided into three groups and the gap was repaired with autologous nerve graft (autograft group), PLA/PVP conduit alone (PLA/PVP group), and PLA/PVP conduit with rAT-MSCs inside (PLA/PVP with rAT-MSC group). At the end of the eighth week, the results were evaluated functionally, electrophysiologically, and histologically. In functional evaluation, sciatic functional index (SFI) was used and all groups showed improvement over time. The results were seen in the autograft and PLA/PVP with rAT-MSC groups, with no statistically significant difference between them. In electrophysiological evaluation, action potential was seen in all three groups, with the best results seen in the PLA/PVP with rAT-MSC group with statistical significance. Histological evaluation showed axonal regeneration in all three groups. These results show that PLA/PVP conduit contributes to regeneration even when used alone, and increases regeneration when used together with rAT-MSCs.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"775-783"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-01Epub Date: 2025-01-16DOI: 10.1097/MAT.0000000000002381
Kaspar F Bachmann, David Berger
{"title":"Estimation of Cardiac Output Under Venovenous Extracorporeal Membrane Oxygenation: Comparing Thermodilution Methods to 3D Echocardiography.","authors":"Kaspar F Bachmann, David Berger","doi":"10.1097/MAT.0000000000002381","DOIUrl":"10.1097/MAT.0000000000002381","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e132"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ASAIO JournalPub Date : 2025-09-01Epub Date: 2025-03-17DOI: 10.1097/MAT.0000000000002415
Jenny P Garzón Ruiz, Estefanía Giraldo Bejarano, Mario A Mercado Díaz, Rodrigo Pardo Turriago
{"title":"Anticoagulation in ECMO: Target Values to Reduce Hemorrhagic Complications in Adults. A Retrospective Cohort Study.","authors":"Jenny P Garzón Ruiz, Estefanía Giraldo Bejarano, Mario A Mercado Díaz, Rodrigo Pardo Turriago","doi":"10.1097/MAT.0000000000002415","DOIUrl":"10.1097/MAT.0000000000002415","url":null,"abstract":"<p><p>The 2021 Adult and Pediatric Anticoagulation Guidelines for patients on extracorporeal membrane oxygenation (ECMO) recommend a target partial thromboplastin time (PTT) between 60 and 85 seconds when unfractionated heparin (UFH) is administered as an anticoagulant. However, institutions may develop their own protocols in the absence of solid evidence regarding patient anticoagulation during ECMO support. We aimed to determine the association between maintenance anticoagulation with different PTT ranges among patients receiving UFH or no anticoagulation therapy and the occurrence of hemorrhagic complications in adults receiving ECMO support. We conducted a prospective cohort study that included 277 adults on ECMO support. Kaplan-Meier curves were used to compare the time-dependent risk of hemorrhagic events. The association was estimated using the hazard ratio, and the risk was estimated using the multivariate Cox proportional hazards model adjusted for covariates. The time-dependent risk of hemorrhagic events during ECMO support was 2.97-fold higher in patients with a PTT greater than 70 than in patients under no UFH therapy (95% confidence interval [CI]: 1.53-5.77; p = 0.001). An association was observed between target PTT and hemorrhagic complications, with the risk of hemorrhagic complications being higher when maintaining PTT values greater than 70 seconds during ECMO support.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"744-751"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647068","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}