Pub Date : 2025-09-10DOI: 10.1038/s41585-025-01072-0
Lexiaochuan Wen, Hiroko Miyagi, Philippe E. Spiess, Alice Yu, Cathy L. Mendelsohn, Wei Shen Tan, Sarah P. Psutka, Seth P. Lerner, Liang Cheng, Lars Dyrskjøt, Joshua J. Meeks, Shahrokh F. Shariat, Paolo Gontero, Benjamin Pradere, Gary D. Steinberg, Ashish M. Kamat, Roger Li
Low-grade non-muscle invasive bladder cancer is a specific category of bladder cancer with a favourable prognosis; however, its management presents several challenges. The risk of stage progression is very low, but approximately half of patients will experience recurrence within the first 5 years after diagnosis. This high propensity for recurrence, coupled with the threat of progression, mandates ongoing surveillance. However, the optimal frequency and duration of follow-up monitoring remain undefined. Current management strategies for low-grade non-muscle invasive bladder cancer rely heavily on routine office cystoscopy, with few advances in diagnostic and treatment options over the past 25 years. Our basic understanding of disease biology has substantially advanced. However, at present, considerable variations in clinical practice exist, with implications for increased financial and treatment burden for patients and health care systems. Molecular signatures and biomarker discoveries are crucial to understand disease behaviour and inform novel treatment strategies. Emerging therapies, such as advanced drug-delivery systems, immunomodulatory agents and targeted therapies, offer the potential to improve patient outcomes, streamline management and reduce the need for surveillance cystoscopies. Actionable avenues for future research in the field include prospective validation of novel biomarkers and therapies with the ultimate aim of optimizing patient care and reducing health care costs. In this Review, the authors summarize the biological features of low-grade non-muscle-invasive bladder cancer, clinical risk stratification and evidence supporting treatment strategies. They also highlight contemporary developments in monitoring and therapeutic technologies.
{"title":"Low-grade non-muscle-invasive bladder cancer: molecular landscape, treatment strategies and emerging therapies","authors":"Lexiaochuan Wen, Hiroko Miyagi, Philippe E. Spiess, Alice Yu, Cathy L. Mendelsohn, Wei Shen Tan, Sarah P. Psutka, Seth P. Lerner, Liang Cheng, Lars Dyrskjøt, Joshua J. Meeks, Shahrokh F. Shariat, Paolo Gontero, Benjamin Pradere, Gary D. Steinberg, Ashish M. Kamat, Roger Li","doi":"10.1038/s41585-025-01072-0","DOIUrl":"10.1038/s41585-025-01072-0","url":null,"abstract":"Low-grade non-muscle invasive bladder cancer is a specific category of bladder cancer with a favourable prognosis; however, its management presents several challenges. The risk of stage progression is very low, but approximately half of patients will experience recurrence within the first 5 years after diagnosis. This high propensity for recurrence, coupled with the threat of progression, mandates ongoing surveillance. However, the optimal frequency and duration of follow-up monitoring remain undefined. Current management strategies for low-grade non-muscle invasive bladder cancer rely heavily on routine office cystoscopy, with few advances in diagnostic and treatment options over the past 25 years. Our basic understanding of disease biology has substantially advanced. However, at present, considerable variations in clinical practice exist, with implications for increased financial and treatment burden for patients and health care systems. Molecular signatures and biomarker discoveries are crucial to understand disease behaviour and inform novel treatment strategies. Emerging therapies, such as advanced drug-delivery systems, immunomodulatory agents and targeted therapies, offer the potential to improve patient outcomes, streamline management and reduce the need for surveillance cystoscopies. Actionable avenues for future research in the field include prospective validation of novel biomarkers and therapies with the ultimate aim of optimizing patient care and reducing health care costs. In this Review, the authors summarize the biological features of low-grade non-muscle-invasive bladder cancer, clinical risk stratification and evidence supporting treatment strategies. They also highlight contemporary developments in monitoring and therapeutic technologies.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 12","pages":"846-861"},"PeriodicalIF":14.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-08DOI: 10.1038/s41585-025-01087-7
Siyu Huang, David C. Chen, David Hennes, Declan G. Murphy, Nathan Lawrentschuk, Marlon L. Perera
New evidence shows that NeuroSAFE, an intraoperative frozen section technique during radical prostatectomy, improves erectile function recovery. Traditional NeuroSAFE using frozen section analysis might not work for all centres, but new technologies for intraoperative margin assessment might facilitate more pragmatic alternatives during radical prostatectomy.
{"title":"New evidence and novel techniques for assessing intraoperative margins during radical prostatectomy","authors":"Siyu Huang, David C. Chen, David Hennes, Declan G. Murphy, Nathan Lawrentschuk, Marlon L. Perera","doi":"10.1038/s41585-025-01087-7","DOIUrl":"https://doi.org/10.1038/s41585-025-01087-7","url":null,"abstract":"New evidence shows that NeuroSAFE, an intraoperative frozen section technique during radical prostatectomy, improves erectile function recovery. Traditional NeuroSAFE using frozen section analysis might not work for all centres, but new technologies for intraoperative margin assessment might facilitate more pragmatic alternatives during radical prostatectomy.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"31 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-02DOI: 10.1038/s41585-025-01081-z
Arianna Biasatti, Nicolas A. Soputro, Francesco Porpiglia, Sisto Perdonà, Firas Abdollah, Ryan Nelson, Craig Rogers, Lee C. Zhao, Ahmed Ghazi, Ben Challacombe, Christopher Eden, Agostino Mattei, Christian D. Fankhauser, Alberto Breda, Bernardo Rocco, Francesco Montorsi, Alberto Briganti, Antony A. Pellegrino, Alexandre Mottrie, Ruben De Groote, Alexander Haese, Markus Graefen, Marcio C. Moschovas, Vipul Patel, Giuseppe Simone, Antonio Galfano, Silvia Secco, Riccardo Bertolo, Savio D. Pandolfo, Vito Pansadoro, Filipe L. F. Carvalho, Jean V. Joseph, Mohammad Ramadan, Jaschar Shakuri-Rad, Bertram Yuh, Jeffrey Nix, David I. Lee, Soroush Rais-Bahrami, Sij Hemal, Mohamed Eltemamy, Alp T. Beksac, Zeyad Schwen, Li-Ming Su, Maurizio Buscarini, Michael Palese, Ash Tewari, Peter Wiklund, Edward E. Cherullo, Srinivas Vourganti, Jennifer A. Linehan, Zhenjie Wu, Michael Stifelman, Mutahar Ahmed, Reza Mehrazin, Ketan Badani, Richard E. Link, Simone Crivellaro, Jihad Kaouk, Riccardo Autorino
The advent of the purpose-built da Vinci single-port robotic platform marks a pivotal advancement in minimally invasive urological surgery. Designed to overcome the ergonomic and technical limitations of prior single-site approaches, the single-port system enables complex procedures through a single incision, with enhanced dexterity, optimized use of confined spaces and improved cosmetic and peri-operative outcomes. The single-port system has been increasingly used across a wide range of urological indications, including robot-assisted radical prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive surgeries such as pyeloplasty and ureteral re-implantation. Innovative access strategies, such as the single-port transvesical and low anterior access approaches, have facilitated regionalized and multi-quadrant surgeries without the need for repositioning or robot re-docking. These advances have translated into reduced morbidity, faster recovery and increased feasibility of opioid-sparing, same-day discharge protocols. As surgical expertise deepens and technology evolves, the single-port robotic platform stands as a refinement of minimally invasive surgery, and also as a potential paradigm shift in urological practice. This Review provides an overview of the main applications of single-port robotic surgery in urology, presenting emerging outcomes and discussing the transformative potential of this approach.
{"title":"The current landscape of single-port robotic surgery in urology","authors":"Arianna Biasatti, Nicolas A. Soputro, Francesco Porpiglia, Sisto Perdonà, Firas Abdollah, Ryan Nelson, Craig Rogers, Lee C. Zhao, Ahmed Ghazi, Ben Challacombe, Christopher Eden, Agostino Mattei, Christian D. Fankhauser, Alberto Breda, Bernardo Rocco, Francesco Montorsi, Alberto Briganti, Antony A. Pellegrino, Alexandre Mottrie, Ruben De Groote, Alexander Haese, Markus Graefen, Marcio C. Moschovas, Vipul Patel, Giuseppe Simone, Antonio Galfano, Silvia Secco, Riccardo Bertolo, Savio D. Pandolfo, Vito Pansadoro, Filipe L. F. Carvalho, Jean V. Joseph, Mohammad Ramadan, Jaschar Shakuri-Rad, Bertram Yuh, Jeffrey Nix, David I. Lee, Soroush Rais-Bahrami, Sij Hemal, Mohamed Eltemamy, Alp T. Beksac, Zeyad Schwen, Li-Ming Su, Maurizio Buscarini, Michael Palese, Ash Tewari, Peter Wiklund, Edward E. Cherullo, Srinivas Vourganti, Jennifer A. Linehan, Zhenjie Wu, Michael Stifelman, Mutahar Ahmed, Reza Mehrazin, Ketan Badani, Richard E. Link, Simone Crivellaro, Jihad Kaouk, Riccardo Autorino","doi":"10.1038/s41585-025-01081-z","DOIUrl":"10.1038/s41585-025-01081-z","url":null,"abstract":"The advent of the purpose-built da Vinci single-port robotic platform marks a pivotal advancement in minimally invasive urological surgery. Designed to overcome the ergonomic and technical limitations of prior single-site approaches, the single-port system enables complex procedures through a single incision, with enhanced dexterity, optimized use of confined spaces and improved cosmetic and peri-operative outcomes. The single-port system has been increasingly used across a wide range of urological indications, including robot-assisted radical prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive surgeries such as pyeloplasty and ureteral re-implantation. Innovative access strategies, such as the single-port transvesical and low anterior access approaches, have facilitated regionalized and multi-quadrant surgeries without the need for repositioning or robot re-docking. These advances have translated into reduced morbidity, faster recovery and increased feasibility of opioid-sparing, same-day discharge protocols. As surgical expertise deepens and technology evolves, the single-port robotic platform stands as a refinement of minimally invasive surgery, and also as a potential paradigm shift in urological practice. This Review provides an overview of the main applications of single-port robotic surgery in urology, presenting emerging outcomes and discussing the transformative potential of this approach.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 3","pages":"156-173"},"PeriodicalIF":14.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-27DOI: 10.1038/s41585-025-01079-7
Evan Suzman, Ang Li, Gal Wald, Jim C. Hu
Urinary incontinence is a common sequela of robot-assisted radical prostatectomy and adversely affects quality of life. Advances in surgical technique preserve the pelvic anatomy to mitigate postoperative urinary incontinence. Pelvic-fascia-sparing techniques such as Retzius-sparing and hood with single-port or multi-port robotic approaches can improve outcomes.
{"title":"Pelvic-fascia-sparing techniques and outcomes with RARP","authors":"Evan Suzman, Ang Li, Gal Wald, Jim C. Hu","doi":"10.1038/s41585-025-01079-7","DOIUrl":"https://doi.org/10.1038/s41585-025-01079-7","url":null,"abstract":"Urinary incontinence is a common sequela of robot-assisted radical prostatectomy and adversely affects quality of life. Advances in surgical technique preserve the pelvic anatomy to mitigate postoperative urinary incontinence. Pelvic-fascia-sparing techniques such as Retzius-sparing and hood with single-port or multi-port robotic approaches can improve outcomes.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"24 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-20DOI: 10.1038/s41585-025-01083-x
Melissa L. Abel, Esther Mena, Liza Lindenberg, Fatima Karzai, Peter Choyke, Oliver Sartor, Ravi A. Madan
Understanding of metastatic prostate cancer is mainly defined by macroscopic findings, but prostate-specific membrane antigen (PSMA) PET has increased sensitivity. PSMA+ serosal-based findings on the surface of the liver and other organs might not have the same implications when seen on PSMA PET versus conventional imaging. Awareness of this phenomenon is important in assessing whether treatment escalation is truly required.
{"title":"Ominous-appearing serosal findings on PSMA imaging might belie indolent clinical course","authors":"Melissa L. Abel, Esther Mena, Liza Lindenberg, Fatima Karzai, Peter Choyke, Oliver Sartor, Ravi A. Madan","doi":"10.1038/s41585-025-01083-x","DOIUrl":"https://doi.org/10.1038/s41585-025-01083-x","url":null,"abstract":"Understanding of metastatic prostate cancer is mainly defined by macroscopic findings, but prostate-specific membrane antigen (PSMA) PET has increased sensitivity. PSMA+ serosal-based findings on the surface of the liver and other organs might not have the same implications when seen on PSMA PET versus conventional imaging. Awareness of this phenomenon is important in assessing whether treatment escalation is truly required.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"54 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-20DOI: 10.1038/s41585-025-01076-w
Yacov Reisman, Alexandra Dubinskaya, Anna Padoa
Female sexual dysfunction (FSD) is common and affects women of all ages. Between 30% and 50% of sexually active women will encounter some type of FSD at some point in their life, highlighting its importance as a public health issue. FSD goes undiagnosed and untreated in many women owing to the stigma associated with sexual health, insufficient awareness and restricted access to specialized medical care. Over the past few decades, considerable progress in understanding FSD has resulted in the development of pharmacological therapies; the treatment of FSD should be evaluated through a biopsychosocial approach to determine whether to use medication, therapy or a mix of both methods. A number of non-hormonal pharmacological treatments for FSD are available, specifically to treat hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders. Further work towards the development of future therapies will help to better support women with FSD. Despite affecting 30–50% of sexually active women, female sexual dysfunction (FSD) goes undiagnosed and untreated in many women owing to the stigma associated with sexual health, insufficient awareness and restricted access to specialized medical care. In this Review, experts in the field discuss the treatments currently available to treat FSD — including hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders — and consider the new approaches that are currently in development.
{"title":"Current and future pharmacotherapy for female sexual dysfunction","authors":"Yacov Reisman, Alexandra Dubinskaya, Anna Padoa","doi":"10.1038/s41585-025-01076-w","DOIUrl":"10.1038/s41585-025-01076-w","url":null,"abstract":"Female sexual dysfunction (FSD) is common and affects women of all ages. Between 30% and 50% of sexually active women will encounter some type of FSD at some point in their life, highlighting its importance as a public health issue. FSD goes undiagnosed and untreated in many women owing to the stigma associated with sexual health, insufficient awareness and restricted access to specialized medical care. Over the past few decades, considerable progress in understanding FSD has resulted in the development of pharmacological therapies; the treatment of FSD should be evaluated through a biopsychosocial approach to determine whether to use medication, therapy or a mix of both methods. A number of non-hormonal pharmacological treatments for FSD are available, specifically to treat hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders. Further work towards the development of future therapies will help to better support women with FSD. Despite affecting 30–50% of sexually active women, female sexual dysfunction (FSD) goes undiagnosed and untreated in many women owing to the stigma associated with sexual health, insufficient awareness and restricted access to specialized medical care. In this Review, experts in the field discuss the treatments currently available to treat FSD — including hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders — and consider the new approaches that are currently in development.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 2","pages":"133-147"},"PeriodicalIF":14.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-20DOI: 10.1038/s41585-025-01084-w
Cameron J. Britton, Brian D. Cortese, Ruchika Talwar
In April 2025, the US executive administration announced universal 10% tariffs on all imported products, in addition to reciprocal tariffs for select foreign nations. As trade negotiations evolve, it is essential to recognize and evaluate the profound implications these economic policies hold for healthcare systems.
{"title":"Economic impact of tariffs on healthcare costs in urology","authors":"Cameron J. Britton, Brian D. Cortese, Ruchika Talwar","doi":"10.1038/s41585-025-01084-w","DOIUrl":"https://doi.org/10.1038/s41585-025-01084-w","url":null,"abstract":"In April 2025, the US executive administration announced universal 10% tariffs on all imported products, in addition to reciprocal tariffs for select foreign nations. As trade negotiations evolve, it is essential to recognize and evaluate the profound implications these economic policies hold for healthcare systems.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"8 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1038/s41585-025-01077-9
Thorsten H. Ecke, Sarah Collen, Alex Filicevas, Theodoros Yfantis, Florence Le Calvez-Kelm, Bente Thoft Jensen, Hein van Poppel
Cancer is a crucial health priority of the current European Commission and a pillar of a strong European Health Union. However, policy measures targeting cancer in the EU do not approach all types of cancer equally. Bladder cancer is the fifth most common cancer in Europe. Although bladder cancer is associated with one of the highest lifetime costs of any cancer, research funding is among the lowest. This imbalance has led to an alarming stagnation in the availability of diagnostic tools, which negatively affected the prognosis and treatment options for bladder cancer, and resulted in complex pathways for patients. The lack of bladder-cancer awareness drastically hinders early detection. Furthermore, insufficient understanding of gender differences in bladder-cancer symptoms exacerbates the gender gap, leading to worse outcomes for women. After the European elections in 2024 and the learnings from Europe’s Beating Cancer Plan, additional effort is needed to inform the policymakers in Brussels and the Member-State capitals to consider an EU agenda with ambitious policy actions targeting neglected cancers, such as bladder cancer, and close the cancer-care gap by supporting awareness and education and by ensuring access to high-quality diagnostic tools, care and treatment. In this Expert Recommendation, a group of clinicians and scientists with high expertise in crucial areas of bladder cancer joined forces, together with members from patient groups and nurses’ associations, to write ten recommendations addressed to politicians and health care professionals in the EU to increase awareness of bladder cancer and improve targeted policy actions for this neglected cancer.
{"title":"Urinary bladder cancer needs more attention — recommendations for health care professionals and politicians in the European Union","authors":"Thorsten H. Ecke, Sarah Collen, Alex Filicevas, Theodoros Yfantis, Florence Le Calvez-Kelm, Bente Thoft Jensen, Hein van Poppel","doi":"10.1038/s41585-025-01077-9","DOIUrl":"10.1038/s41585-025-01077-9","url":null,"abstract":"Cancer is a crucial health priority of the current European Commission and a pillar of a strong European Health Union. However, policy measures targeting cancer in the EU do not approach all types of cancer equally. Bladder cancer is the fifth most common cancer in Europe. Although bladder cancer is associated with one of the highest lifetime costs of any cancer, research funding is among the lowest. This imbalance has led to an alarming stagnation in the availability of diagnostic tools, which negatively affected the prognosis and treatment options for bladder cancer, and resulted in complex pathways for patients. The lack of bladder-cancer awareness drastically hinders early detection. Furthermore, insufficient understanding of gender differences in bladder-cancer symptoms exacerbates the gender gap, leading to worse outcomes for women. After the European elections in 2024 and the learnings from Europe’s Beating Cancer Plan, additional effort is needed to inform the policymakers in Brussels and the Member-State capitals to consider an EU agenda with ambitious policy actions targeting neglected cancers, such as bladder cancer, and close the cancer-care gap by supporting awareness and education and by ensuring access to high-quality diagnostic tools, care and treatment. In this Expert Recommendation, a group of clinicians and scientists with high expertise in crucial areas of bladder cancer joined forces, together with members from patient groups and nurses’ associations, to write ten recommendations addressed to politicians and health care professionals in the EU to increase awareness of bladder cancer and improve targeted policy actions for this neglected cancer.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 1","pages":"40-49"},"PeriodicalIF":14.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}