Neurorehabilitation and neural repair最新文献

{"title":"Effect of <i>COMT</i> Val158Met Polymorphism on Stroke Functional Outcome and Recovery.","authors":"Jiabin Liang, Mingzhu Xu, Xiaodong Wang, Hua Li, Xun Luo, Andrea Christoforou, Qing Mei Wang","doi":"10.1177/15459683251340926","DOIUrl":"https://doi.org/10.1177/15459683251340926","url":null,"abstract":"<p><p><i>Background</i>. A single nucleotide polymorphism (SNP) in the catechol-o-methyltransferase (<i>COMT</i>) gene, Val158Met (rs4680), influences cognition in the general population. However, its role in stroke recovery is unclear. In this study, we evaluated the association of Val158Met SNP with stroke functional outcome and recovery. <i>Methods</i>. This is a retrospective study. The MGB Biobank was queried for 570 individuals with stroke and available genomics data. A subset of 164 was curated based on their admission to Spaulding Rehabilitation Hospital (SRH) for inpatient rehabilitation, meeting inclusion/exclusion criteria and receiving a rehabilitation program tailored to their individual needs and goals. Functional independent measures (FIM) were assessed upon admission to SRH and discharge. Multiple tests were performed to identify related clinic characteristics associated with functional outcome, recovery, and independence dichotomization. Logistic and linear regression models adjusted for covariate variables were used to evaluate the association between <i>COMT</i> Val58Met and functional outcome and recovery. <i>Results</i>. Genotype analysis confirmed that <i>COMT</i> Met/Met frequency was higher compared to Val allele frequency in high cognitive functional outcome. Furthermore, after adjusting for covariate variables, <i>COMT</i> Met/Met led to positive cognitive outcome (<i>P</i> = 0.029; OR = 2.43 [0.19-4.56)] in comprehension (<i>P</i> = 0.013, OR = 0.62 [0.15-1.08]) and expression (<i>P</i> = 0.007, OR = 0.74 [0.19-1.25]). In independence dichotomization analysis, high cognitive outcomes (<i>P</i> = 0.04, OR = 0.81 [1.04-4.82]) were found in the sub-domains of comprehension (<i>P</i> = 0.002, OR = 1.21 [1.56-7.17]), expression (<i>P</i> = 0.03, OR = 0.83 [1.08-4.83]), problem solving (<i>P</i> = 0.02, OR = 0.88 [1.15-5.06]), and memory (<i>P</i> = 0.039, OR = 0.78 [1.04-4.58]). <i>Conclusion</i>. Stroke patients with <i>COMT</i> Met/Met were associated with improved cognition, comprehension, and expression functional outcomes..</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251340926"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176374","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":"Gait Responses in People with Parkinson Disease During Autonomous Closed-loop Rhythmic Auditory Stimulation: An Exploratory Analysis.","authors":"James T Cavanaugh, Franchino Porciuncula, Jenna A Zajac, Teresa Baker, Nicholas Wendel, Louis N Awad, Terry D Ellis","doi":"10.1177/15459683251340910","DOIUrl":"https://doi.org/10.1177/15459683251340910","url":null,"abstract":"<p><p><i>Background.</i> Closed-loop rhythmic auditory stimulation (RAS) systems show promise for improving gait quality in people with Parkinson disease (PD). <i>Objective</i>: To examine auditory-motor entrainment and spatiotemporal gait responses to system-controlled rhythm tempo increase before and after a community-based RAS walking intervention. <i>Methods.</i> Thirteen persons with PD used an autonomous closed-loop RAS system during 30 walking sessions. Baseline (BL) and post-intervention (POST) gait responses to tempo increase were assessed as participants walked with the system in a clinic hallway. Rhythm tempo, entrainment, cadence, stride length, gait speed, and stride time variability (STV) were measured during the first minute (tempo at preferred walking cadence, prior to increase) and fifth minute (tempo above preferred cadence, following increase) of each assessment. Within- and between-assessment responses of entrainment and spatiotemporal variables to tempo increase were evaluated. <i>Results.</i> During each assessment, participants entrained to rhythmic cues while significantly increasing their cadence and stride length in response to tempo increase. Gait speed increased significantly only during the POST assessment. Nearly 70% of participants had significantly lower mean STV at the POST assessment compared to BL, indicating increased gait rhythmicity. The between-assessment decrease in STV was associated with increased stride length. <i>Conclusions.</i> Study findings supported the potential of an autonomous closed-loop RAS system to induce entrainment and meaningful gait responses to system-controlled tempo increase in persons with PD. The system appeared to promote implicit motor learning processes during use. Associated post-intervention improvements in rhythmicity and stride length in a subset of participants were suggestive of fall prevention effects.<b>Trial registration:</b> Prospectively registered at ClinicalTrials.gov (NCT05421624).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251340910"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176375","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 Specific Forces Applied During Robotic Training That Optimize Recovery of Locomotion in a Rat Model of Spinal Cord Injury.","authors":"Nathan D Neckel","doi":"10.1177/15459683251339809","DOIUrl":"https://doi.org/10.1177/15459683251339809","url":null,"abstract":"<p><p><i>Background</i>. Conventional physical therapy following neurological injury is an arduous task met with minimal returns and quickly plateauing recovery. Unconventional therapies, such as robotic assisted gait training (RAGT) have not produced the robust clinical gains that we all had hoped. Rodent RAGT is a nascent field, but it works on the same principles as the clinical counterpart. <i>Objective</i>. We have previously investigated the ability of RAGT to enhance the recovery of rats following a cervical spinal cord injury and found that training in a resistive field is detrimental, and training in a negative viscosity field is better than actively guiding the limbs through a healthy stepping pattern. Unfortunately, none of these treatments are particularly good at restoring unassisted overground locomotion. Previously we grouped animals based on the RAGT treatment they received. Upon further reflection, these groups are not based on what the animals actually experienced, but how the robot was programmed. <i>Methods</i>. In the work presented here we regrouped and reanalyzed our existing data bi-directionally (does level of overground recovery predict RAGT force profile experienced? does force profile predict recovery?). <i>Results</i>. This method allowed us to uncover a training force profile that optimized overground recovery, specifically, low overall forces (<±6 N), positive <i>Fy</i> and negative <i>Fx</i> during swing, and minimal forces during stance (<±2 N). <i>Conclusions</i>. This work provides new insights into the importance of the specific forces used in rehabilitation, a major shift in current clinical RAGT techniques, and could lead to improvements in patients' lives.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251339809"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145385","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":"Corrigendum to: Murakami et al. (2023).","authors":"","doi":"10.1177/15459683251341565","DOIUrl":"https://doi.org/10.1177/15459683251341565","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251341565"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129829","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":"Task Practice With and Without Aerobic Exercise Improves Health-related Quality of Life and Social Participation Post-stroke: A Randomized Clinical Trial.","authors":"Susan M Linder, Andrea Bischof-Bockbrader, Ozlenen Eylul Ince Hocaoglu, Francois Bethoux, Sara Davidson, Donayja Harris, Yadi Li, Brittany Lapin, Jay L Alberts","doi":"10.1177/15459683251338784","DOIUrl":"https://doi.org/10.1177/15459683251338784","url":null,"abstract":"<p><strong>Background: </strong>Physical, cognitive, and psychosocial impairments experienced by individuals post-stroke detrimentally impact health-related quality of life (HRQoL). Rehabilitation interventions targeting the recovery of motor function aim to improve community reintegration and HRQoL. Aerobic exercise has also been shown to have global effects in individuals post-stroke, positively affecting motor and mood-related outcomes.</p><p><strong>Objective: </strong>To determine the effects of forced-rate aerobic exercise (FE) coupled with upper extremity repetitive task practice (RTP) on HRQoL and mood in individuals post-stroke.</p><p><strong>Methods: </strong>A rater blinded randomized clinical trial was conducted. Individuals ≥6 months post-stroke received 90-minute sessions of FE+RTP or time-matched RTP alone, 3×/week for 8 weeks. The Stroke Impact Scale (SIS), Patient-Reported Outcomes Measurement Information System (PROMIS-29), and Centers For Epidemiology Studies-Depression Scale (CES-D) were administered at baseline, end of treatment (EOT), EOT+6 months, and EOT+12 months.</p><p><strong>Results: </strong>Sixty participants enrolled in the study and 57 completed the self-reported questionnaires (FE + RTP, N = 29; RTP alone, N = 28). Both groups improved significantly at each time point in the following SIS domains: physical problems, feelings, activities of daily living, mobility, hand use, meaningful activities, and overall recovery; and in the participation domain of PROMIS-29. Depressive symptomology as measured by CES-D improved from baseline to EOT+6. There were no significant group differences in any of the outcomes.</p><p><strong>Conclusions: </strong>Both interventions were comparably effective in improving HRQoL despite the FE+RTP group receiving only half the dose of RTP compared to the control group (RTP only). Improvements were maintained up to 1 year post-intervention.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251338784"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121761","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":"Speed-Biased Training Temporarily Improves Motor Performance of the Paretic Arm Compared to Accuracy-Biased Training in Chronic Stroke Survivors: The Phase 1 FAST Randomized Clinical Trial.","authors":"Yannick Darmon, Shailesh Kantak, Hannah Cone, Niko Fullmer, Debra Ouellette, Carolee Winstein, Emily R Rosario, Nicolas Schweighofer","doi":"10.1177/15459683251331582","DOIUrl":"https://doi.org/10.1177/15459683251331582","url":null,"abstract":"<p><p>BackgroundDespite the prevalence of upper extremity (UE) limitations after stroke, few training interventions prioritize fast movement speeds during rehabilitation.ObjectivesTo compare the effects of an equivalent dose (in the number of trials) of speed versus accuracy training in chronic stroke with mild-to-moderate impairments who have no direct cerebellar damage.Patients and MethodsIn this Phase-1 randomized controlled trial, we randomized 42 participants to either a speed or an accuracy arm-movement training condition. Participants moved their paretic hands through complex tracks, with 2080 trials in 4 sessions within a week. Speed and accuracy were manipulated by displaying 5 cm-wide or 1.25 cm-wide tracks or providing feedback based on average speed and accuracy in the Speed and Accuracy groups, respectively. We measured changes in kinematics in a 3-target test, in the speed-accuracy trade-off in a modified Fitts' test of the paretic arm during goal-directed reaching, and clinical outcomes (ie, UE Fugl-Meyer, Action Research Arm Test, and Box and Block Test) at 3 days and 1-month post-training.ResultsSpeed training led to significantly faster and smoother movements with more symmetric reach velocity profiles at the 3-day post-test, consistent with better feedforward control. Speed training temporarily improved the speed-accuracy tradeoff. At 1 month, however, most gains in the 3-target test and in the modified Fitts' test were lost.ConclusionSpeed training led to greater gains in kinematics of goal-directed actions than accuracy training, notably in a 3-day post-test. Our results suggest that training programs with high repetitions of fast movements may improve paretic arm reaching performance. The trial is registered at ClinicalTrials.gov under ID NCT05013762.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251331582"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015523","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 Power of Placebo to Restore Neurological Function After Spinal Cord Injury: Implications for Neuromodulation.","authors":"Jessica McDougall, Jacquelyn J Cragg, Robert M Brownstone, John L K Kramer","doi":"10.1177/15459683251335331","DOIUrl":"https://doi.org/10.1177/15459683251335331","url":null,"abstract":"<p><strong>Background: </strong>Emerging trials demonstrate that neuromodulation, especially spinal cord stimulation, improves function for those with chronic spinal cord injury. Their design - uncontrolled and unblinded - is justified by the claim that sham conditions are unethical and/or impossible. In the absence of controlled trials, the functional benefits of spinal cord stimulation cannot be distinguished from the effects of placebo.</p><p><strong>Objectives: </strong>To discuss the validity of the claim that placebo control conditions are infeasible in spinal cord stimulation research, and to propose feasible solutions for including sham conditions that would account for placebo effects.</p><p><strong>Results: </strong>Placebo effects are likely to occur in spinal cord stimulation studies, given the high levels of participant expectations of an effect, natural fluctuations in symptoms associated with spinal cord injury, regression towards the mean, the Hawthorne effect, presence of concurrent interventions, and the absence of blinding in existing studies. Options for placebo control conditions could include adding an \"untreated\" control group, using \"placebo-resistant\" outcomes, adding an active comparator group or sham stimulation, or investing in parasthesia-free stimulation. Additionally, wherever feasible, blinding of both participants and assessors should be pursued.</p><p><strong>Conclusions: </strong>The current evidence base for spinal cord stimulation is undermined by the lack of rigorous sham controls, and the argument that such controls are unethical or unfeasible do not withstand scrutiny. We propose strategies for the inclusion of placebo controls in future trials and encourage investigators to prioritize these approaches to ensure the true benefit of spinal cord stimulation can be determined.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251335331"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047527","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":"Discordance Between Balance Ability and Perception and Its Relation to Falls in Parkinson's Disease: A Replication Analysis.","authors":"Jason K Longhurst, Andrew Hooyman, Franziska Albrecht, Erika Franzén, Daniel S Peterson","doi":"10.1177/15459683251335316","DOIUrl":"https://doi.org/10.1177/15459683251335316","url":null,"abstract":"<p><strong>Background: </strong>Falls are a common challenge for people with Parkinson's disease (PwPD), driven by balance impairments and misaligned perceptions of balance abilities.</p><p><strong>Objective: </strong>This study investigated the replicability and generalizability of the relationship between balance ability and perception discordance and fall risk.</p><p><strong>Methods: </strong>Using baseline data from 2 clinical trials involving 171 PwPD, discordance was calculated using the Activities Specific Balance Confidence Scale and Timed Up and Go (TUG) or the Mini Balance Evaluation System's Test (MiniBEST).</p><p><strong>Results: </strong>Findings supported the replicability of discordance as a predictor of fall risk, with results consistent across measures. While TUG-derived discordance was statistically significant, MiniBEST-derived discordance showed generalizability without statistical inferiority.</p><p><strong>Conclusion: </strong>These results emphasize the relevance of balance perception and its misalignment with ability as fall risk predictors.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251335316"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035185","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":"Sleep Following a Stroke: Multimodal Evaluation of Sleep Health and Disruptions and Impact on Recovery During Acute Inpatient Rehabilitation.","authors":"Jacob Sindorf, Silvia Campagnini, Megan K O'Brien, Aashna Sunderrajan, Kristen L Knutson, Phyllis C Zee, Lisa Wolfe, Vineet M Arora, Arun Jayaraman","doi":"10.1177/15459683251335332","DOIUrl":"https://doi.org/10.1177/15459683251335332","url":null,"abstract":"<p><p>BackgroundOur understanding of sleep during early stroke care and its impact on rehabilitation outcomes remains limited. The objectives of this work were to (1) evaluate multidimensional sleep health and disruptions during acute inpatient rehabilitation for individuals with stroke, and (2) explore the relationship between sleep health/disruptions and functional recovery.MethodsData from 103 individuals with stroke were analyzed during acute inpatient rehabilitation. Sleep health/disruptions were assessed via patient reports, actigraphy, and biometric sensors. Functional outcomes were measured at admission and discharge. Generalized Linear Models (GLMs) were used to describe changes in sleep health over time, and multivariate regressions analyzed sleep disruptions and sleep-related predictors of functional recovery.ResultsOver inpatient stays, sleep improved with a 23% reduction in wake after sleep onset and 15% fewer multiple overnight disruptions. GLMs revealed that improved sleep quality was associated with reduced overnight activity and increased heart rate over time. Poor initial sleep quality and cognitive status were associated with more overnight disruptions. Lastly, minimal associations were found between sleep health and functional recovery.ConclusionsSleep health during inpatient stroke rehabilitation is generally poor, though improves over time. Sleep is affected by neurological recovery and hospital environment. Overnight activity and autonomic biomarkers were associated with perceived sleep health, and both physiological and environmental factors triggered disruptions. The association between functional recovery and indirect indicators of sleep health requires further investigation. These findings reveal new insights about inpatient sleep which can inform early, targeted sleep interventions to optimize post-stroke outcomes.SIESTA, ClinicalTrials.gov (NCT04254484).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251335332"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035186","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":"Correlates of Processing Speed Change With Combined Cognitive Rehabilitation and Exercise in Progressive MS: Secondary Analysis of the CogEx Trial.","authors":"Brian M Sandroff, Robert W Motl, Roberto S Hernandez, Maria Pia Amato, Giampaolo Brichetto, Jeremy Chataway, Nancy D Chiaravalloti, Gary R Cutter, Ulrik Dalgas, John DeLuca, Rachel Farrell, Peter Feys, Massimo Filippi, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Maria A Rocca, Amber Salter, Anthony Feinstein","doi":"10.1177/15459683251331586","DOIUrl":"https://doi.org/10.1177/15459683251331586","url":null,"abstract":"<p><p>BackgroundCognitive rehabilitation and exercise training are promising approaches for improving cognition in persons with progressive multiple sclerosis (MS). Identifying heterogeneity of change and factors that influence the effects of cognitive rehabilitation and/or exercise training on cognitive outcomes at the individual level have direct relevance for developing tailored and optimized rehabilitation interventions for improving cognition in progressive MS.ObjectiveThis study involved a secondary data analysis from the CogEx trial in progressive MS. This study first described heterogeneity of change in cognitive processing speed (CPS) across the intervention conditions and then identified possible adherence/compliance, baseline performance, and demographic/clinical variables as correlates of rehabilitation-related CPS changes.MethodsA total of 311 persons with progressive MS who were pre-screened for impaired CPS completed 12 weeks of combined cognitive rehabilitation (or sham) and exercise training (or sham). CPS was measured before and after the 12-week period. As potential correlates of CPS changes, we measured adherence/compliance (ie, treatment exposure), performance outcomes at baseline, as well as demographic and clinical characteristics at baseline.ResultsThere was heterogeneity of change in CPS across the 4 intervention conditions. We further identified baseline learning and memory impairment and premorbid intelligence quotient (IQ), but not adherence/compliance, other baseline performance outcomes, or demographic/clinical characteristics as significant correlates of CPS changes across the 4 intervention conditions.ConclusionsThe overall pattern of results suggests that future trials in this area might account for impaired learning and memory and/or premorbid IQ as potential covariates, or more carefully consider the role of reserve within rehabilitation interventions in progressive MS.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251331586"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048803","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}