{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:10:21Z","timestamp":1787026221055,"version":"build-2736575974"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Orthoses have shown potential in addressing upper limb spasticity in stroke survivors; however, their influence on motor recovery remains controversial. This study aimed to examine the effects of a wearable hand orthosis on spasticity, motor recovery of both upper and lower limbs, balance, and activities of daily living in stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Inpatient rehabilitation department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Fifty-one stroke survivors with hemiplegia were randomly assigned to either an experimental group (n = 26) or a control group (n = 25).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Both groups underwent a 4-week conventional rehabilitation program. Participants in the experimental group engaged in a self-directed training program utilizing a wearable hand orthosis for 5\u00a0h daily, whereas the control group followed the identical regimen without the use of the orthosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures<\/jats:title>\n                    <jats:p>Modified Ashworth Scale (MAS) for spasticity, Fugl-Meyer Assessment for upper and lower extremities (FMA-UE &amp;amp; FMA-LE), Berg Balance Scale (BBS) and Barthel Index (BI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The experimental group showed greater improvements in FMA-UE (difference = 4.37, P = 0.022), BBS (difference = 12.37, P &amp;lt; 0.001), and BI (difference = 17.65, P &amp;lt; 0.001) compared to the control group. No significant differences were found in MAS (P = 0.654) or FMA-LE (P = 0.495). A stepwise multiple linear regression analysis revealed that improvement in FMA-UE was a significant predictor of BBS recovery in the experimental group (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.207, P = 0.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of a wearable hand orthosis in self-directed training significantly improved upper limb motor recovery, balance, and ADL abilities in stroke survivors. The observed correlation between upper limb recovery and balance improvement indicates the potential of this orthosis to facilitate comprehensive rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2025.1600706","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T01:44:55Z","timestamp":1748569495000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of a wearable hand orthosis on upper and lower limb motor recovery in stroke patients: a randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Lijuan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yefan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazhakaiti","family":"Aizezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyu","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanzheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueming","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hewei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.4103\/0976-3147.83579","article-title":"Inpatient occupational therapists hand-splinting practice for clients with stroke: a cross-sectional survey from Ireland","volume":"2","author":"Adrienne","year":"2011","journal-title":"J. Neurosci. Rural. Pract."},{"key":"B2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1080\/10749357.2021.1878669","article-title":"Dynamic hand orthoses for the recovery of hand and arm function in adults after stroke: a systematic review and meta-analysis of randomised controlled trials","volume":"29","author":"Alexander","year":"2022","journal-title":"Top. stroke rehabilitation"},{"key":"B3","first-page":"575","article-title":"Features and predictors of activity limitations and participation restriction 2 years after intensive rehabilitation following first-ever stroke","volume":"51","author":"Andrenelli","year":"2015","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/767859","article-title":"Does the motor level of the paretic extremities affect balance in poststroke subjects?","volume":"2014","author":"Arya","year":"2014","journal-title":"Rehabilitation Res. Pract."},{"key":"B5","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1080\/09638280110112891","article-title":"The effects of botulinum toxin treatment on associated reactions of the upper limb on hemiplegic gait-a pilot study","volume":"24","author":"Bakheit","year":"2002","journal-title":"Disabil. rehabilitation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1310\/tsr1904-329","article-title":"Hand splinting for poststroke spasticity: a randomized controlled trial","volume":"19","author":"Basaran","year":"2012","journal-title":"Top. stroke rehabilitation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"559","DOI":"10.2522\/ptj.20070205","article-title":"Usefulness of the berg balance scale in stroke rehabilitation: a systematic review","volume":"88","author":"Blum","year":"2008","journal-title":"Phys. Ther."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.apmr.2008.02.015","article-title":"The effects of stretching in spasticity: a systematic review","volume":"89","author":"Bovend'Eerdt","year":"2008","journal-title":"Archives Phys. Med. Rehabilitation."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1016\/j.apmr.2010.08.025","article-title":"Balance, balance confidence, and health-related quality of life in persons with chronic stroke after body weight-supported treadmill training","volume":"91","author":"Combs","year":"2010","journal-title":"Archives. Phys. Med. rehabilitation."},{"key":"B10","first-page":"1","article-title":"Effect of modified bobath cuff on energy expenditure and fatigue during level surface waking among subjects with hemiplegic shoulder subluxation: a prospective study","volume":"8","author":"Dash","year":"2020","journal-title":"Int. Phys. Med. Rehabil. J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"CD009689","DOI":"10.1002\/14651858.CD009689.pub2","article-title":"Multidisciplinary rehabilitation following botulinum toxin and other f ocal intramuscular treatment for post-stroke spasticity","volume":"2013","author":"Demetrios","year":"2013","journal-title":"Cochrane database Syst. Rev."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1342545","DOI":"10.3389\/fneur.2024.1342545","article-title":"Efficacy of botulinum toxin a combined with extracorporeal shockwave t herapy in post-stroke spasticity: a systematic review","volume":"15","author":"Du","year":"2024","journal-title":"Front. neurology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1177\/154596802401105171","article-title":"The fugl-meyer assessment of motor recovery after stroke: a critical r eview of its measurement properties","volume":"16","author":"Gladstone","year":"2002","journal-title":"Neurorehabilitation neural repair"},{"key":"B14","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.gaitpost.2013.06.022","article-title":"Relationship between asymmetry of quiet standing balance control and walking post-stroke","volume":"39","author":"Hendrickson","year":"2014","journal-title":"Gait and posture"},{"key":"B15","doi-asserted-by":"publisher","first-page":"623","DOI":"10.2340\/16501977-1172","article-title":"A new orthosis for subluxed, flaccid shoulder after stroke facilitates gait symmetry: a preliminary study","volume":"45","author":"Hesse","year":"2013","journal-title":"J. rehabilitation Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"100136","DOI":"10.1016\/j.jnrt.2024.100136","article-title":"The 2023 yearbook of neurorestoratology","volume":"12","author":"Huang","year":"","journal-title":"J. Neurorestoratology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"100121","DOI":"10.1016\/j.jnrt.2024.100121","article-title":"Two sides of one coin: neurorestoratology and neurorehabilitation","volume":"12","author":"Huang","year":"","journal-title":"J. Neurorestoratology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1589\/jpts.27.35","article-title":"Immediate effects of an elastic arm sling on walking patterns of chronic stroke patients","volume":"27","author":"Hwang","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e928549","DOI":"10.12659\/msm.928549","article-title":"Effects of self-assisted shoulder elevation of the affected side combined with balance training on associated reactions of upper limb and walking function in chronic stroke patients: a randomized controlled trial","volume":"27","author":"Jiang","year":"2021","journal-title":"Med. Sci. Monit."},{"key":"B20","doi-asserted-by":"publisher","first-page":"53","DOI":"10.3233\/nre-2011-0677","article-title":"The effect of a stretching device on hand spasticity in chronic hemipa retic stroke patients","volume":"29","author":"Jung","year":"2011","journal-title":"NeuroRehabilitation"},{"key":"B21","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1097\/PHM.0000000000001551","article-title":"Upper limb associated reactions: the relationship between movement kinematics and muscle activity in seated versus walking testing","volume":"100","author":"Kahn","year":"2021","journal-title":"Am. J. Phys. Med. and Rehabilitation"},{"key":"B22","doi-asserted-by":"publisher","first-page":"7405205050p1","DOI":"10.5014\/ajot.2020.029454","article-title":"Stretching and splinting interventions for poststroke spasticity, hand function, and functional tasks: a systematic review","volume":"74","author":"Kerr","year":"2020","journal-title":"Am. J. Occup. Ther."},{"key":"B23","doi-asserted-by":"publisher","first-page":"437","DOI":"10.3233\/nre-162128","article-title":"Effect of task specific training and wrist-fingers extension splint on hand joints range of motion and function after stroke","volume":"41","author":"Khallaf","year":"2017","journal-title":"NeuroRehabilitation"},{"key":"B24","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.rehab.2017.10.001","article-title":"Non-pharmacological interventions for spasticity in adults: an overvie w of systematic reviews","volume":"62","author":"Khan","year":"2019","journal-title":"Ann. Phys. rehabilitation Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e1704","DOI":"10.1002\/pri.1704","article-title":"Training using a new multidirectional reach tool improves balance in i ndividuals with stroke","volume":"23","author":"Khumsapsiri","year":"2018","journal-title":"Physiother. Res. Int. J. Res. Clin. Phys. Ther."},{"key":"B26","doi-asserted-by":"publisher","first-page":"540","DOI":"10.4103\/jnrp.jnrp_464_16","article-title":"Effect of scapular stabilization exercise during standing on upper lim b function and gait ability of stroke patients","volume":"8","author":"Kim","year":"2017","journal-title":"J. Neurosci. rural Pract."},{"key":"B27","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/s1474-4422(09)70150-4","article-title":"Motor recovery after stroke: a systematic review","volume":"8","author":"Langhorne","year":"2009","journal-title":"Lancet. Neurology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1191\/0269215503cr682oa","article-title":"Is hand splinting effective for adults following stroke? A systematic review and methodologic critique of published research","volume":"17","author":"Lannin","year":"2003","journal-title":"Clin. Rehabil."},{"key":"B29","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1177\/0269215507079141","article-title":"A systematic review of upper extremity casting for children and adults with central nervous system motor disorders","volume":"21","author":"Lannin","year":"2007","journal-title":"Clin. Rehabil."},{"key":"B30","doi-asserted-by":"publisher","first-page":"8426","DOI":"10.1038\/s41598-023-35562-1","article-title":"Efficiency of botulinum toxin injection into the arm on postural balance and gait after stroke","volume":"13","author":"Lee","year":"2023","journal-title":"Sci. Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1093\/ageing\/afz159","article-title":"Effects of radial extracorporeal shockwave therapy on spasticity of upper-limb agonist\/antagonist muscles in patients affected by stroke: a randomized, single-blind clinical trial","volume":"49","author":"Li","year":"2020","journal-title":"Age Ageing"},{"key":"B32","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jbmt.2020.06.006","article-title":"Replacing canes with an elasticated orthotic-garment in chronic stroke patients - the influence on gait and balance. A series of n-of-1 trials","volume":"24","author":"Maguire","year":"2020","journal-title":"J. Bodyw. Mov. Ther."},{"key":"B33","doi-asserted-by":"publisher","first-page":"12455","DOI":"10.4081\/ejtm.2024.12455","article-title":"Stretching exercises in managing spasticity: effectiveness, risks, and adjunct therapies","volume":"34","author":"Mehraban Jahromi","year":"2024","journal-title":"Eur. J. Transl. myology"},{"key":"B34","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1080\/09593980802278959","article-title":"Interrater reliability of the modified modified ashworth scale (mmas) for patients with wrist flexor muscle spasticity","volume":"24","author":"Naghdi","year":"2008","journal-title":"Physiother. theory Pract."},{"key":"B35","doi-asserted-by":"publisher","first-page":"e069424","DOI":"10.1136\/bmjopen-2022-069424","article-title":"Preliminary effectiveness of 3d-printed orthoses in chronic hand conditions: study protocol for a non-randomised interventional feasibility study","volume":"13","author":"Oud","year":"2023","journal-title":"BMJ Open"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1080\/09638288.2023.2190168","article-title":"Effects of neurorehabilitation with and without dry needling technique on muscle thickness, reflex torque, spasticity and functional performance in chronic ischemic stroke patients with spastic upper extremity muscles: a blinded randomized sham-controlled clinical trial","volume":"46","author":"Panahi","year":"2024","journal-title":"Disabil. Rehabil."},{"key":"B37","doi-asserted-by":"publisher","first-page":"128","DOI":"10.3390\/healthcare8020128","article-title":"Changes in gait performance in stroke patients after taping with scapu lar setting exercise","volume":"8","author":"Park","year":"2020","journal-title":"Healthc."},{"key":"B38","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1177\/153944929001000605","article-title":"The effectiveness of inflatable pressure splints on motor function in stroke patients","volume":"10","author":"Poole","year":"1990","journal-title":"OTJR"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1161\/strokeaha.110.598540","article-title":"Barthel Index for stroke trials: development, properties, and application","volume":"42","author":"Quinn","year":"2011","journal-title":"Stroke Trials."},{"key":"B40","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.rehab.2018.11.004","article-title":"Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: systematic review with meta-analysis","volume":"62","author":"Salazar","year":"2019","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1572-0241.2005.41537.x","article-title":"Evidence-based medicine in practice: applying intention-to-treat analysis and perprotocol analysis","volume":"100","author":"Schoenfeld","year":"2005","journal-title":"Am. J. gastroenterology"},{"key":"B42","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"Consort 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ Clin. Res."},{"key":"B43","doi-asserted-by":"publisher","first-page":"717","DOI":"10.3390\/brainsci13050717","article-title":"A comprehensive review of physical therapy interventions for stroke rehabilitation: impairment-based approaches and functional goals","volume":"13","author":"Shahid","year":"2023","journal-title":"Brain Sci."},{"key":"B44","doi-asserted-by":"publisher","first-page":"98","DOI":"10.3390\/toxins16020098","article-title":"Best practice guidelines for the management of patients with post-stro ke spasticity: a modified scoping review","volume":"16","author":"Suputtitada","year":"2024","journal-title":"Toxins"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.1111\/ene.15319","article-title":"Determinants of disability at 6 months after stroke: the grecogvasc study","volume":"29","author":"Tasseel-Ponche","year":"2022","journal-title":"Eur. J. Neurol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1080\/09593985.2018.1458929","article-title":"Kinematic upper extremity performance in people with near or fully recovered sensorimotor function after stroke","volume":"35","author":"Thrane","year":"2019","journal-title":"Physiother. theory Pract."},{"key":"B47","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3233\/nre-2011-0629","article-title":"The effect of upper limb orthotics after stroke: a systematic review","volume":"28","author":"Tyson","year":"2011","journal-title":"NeuroRehabilitation"},{"key":"B48","doi-asserted-by":"publisher","first-page":"695","DOI":"10.23736\/s1973-9087.20.06332-7","article-title":"The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review","volume":"56","author":"Van Bladel","year":"2020","journal-title":"Eur. J. Phys. rehabilitation Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.concog.2013.02.006","article-title":"The effect of limb crossing and limb congruency on multisensory integration in peripersonal space for the upper and lower extremities","volume":"22","author":"van Elk","year":"2013","journal-title":"Conscious Cogn."},{"key":"B50","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1080\/01616412.2020.1723312","article-title":"Flexors activity of affected upper extremity in stroke patients during different standing conditions and their relationships with clinical scales: a cross-sectional study","volume":"42","author":"Wang","year":"2020","journal-title":"Neurol. Res."},{"key":"B51","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/phm.0000000000002413","article-title":"Evidence map of clinical practice guideline recommendations on stroke rehabilitation","volume":"104","author":"Wei","year":"2024","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"B52","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1016\/j.jht.2022.09.003","article-title":"Reduced pain and improved daily activities for individuals with hand osteoarthritis using a silicone wrist hand orthosis","volume":"36","author":"Windt","year":"2023","journal-title":"J. hand Ther. official J. Am. Soc. Hand Ther."},{"key":"B53","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1161\/str.0000000000000098","article-title":"Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the american heart association\/american stroke association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"B54","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s40814-023-01353-8","article-title":"Upper limb practice with a dynamic hand orthosis to improve arm and hand function in people after stroke: a feasibility study","volume":"9","author":"Wong","year":"2023","journal-title":"Pilot feasibility Stud."},{"key":"B55","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","year":"2013","journal-title":"Jama"},{"key":"B56","doi-asserted-by":"publisher","first-page":"182","DOI":"10.31083\/j.jin2310182","article-title":"Dynamic reorganization patterns of brain modules after stroke reflecting motor function","volume":"23","author":"Yu","year":"2024","journal-title":"J. Integr. Neurosci."},{"key":"B57","doi-asserted-by":"publisher","first-page":"160","DOI":"10.31083\/j.jin2308160","article-title":"Immediate effects of preconditioning intermittent theta burst stimulation on lower extremity motor cortex excitability in healthy participants","volume":"23","author":"Zhang","year":"2024","journal-title":"J. Integr. Neurosci."}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1600706\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T01:44:56Z","timestamp":1748569496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1600706\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":57,"alternative-id":["10.3389\/fbioe.2025.1600706"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2025.1600706","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"article-number":"1600706"}}