Preterm infants, defined as those born before 37 weeks of gestation, often experience significant respiratory distress due to underdeveloped lungs that lack sufficient surfactant to keep alveoli open. Resuscitation protocols currently involve the use of continuous positive airway pressure (CPAP) or mechanical ventilation, which includes the application of PEEP to prevent alveolar collapse and enhance gas exchange. However, the precise level of PEEP that balances efficacy with safety remains uncertain, leading to variability in clinical practice and outcomes. The POLAR trial aims to systematically investigate this critical parameter.

Developed by a multidisciplinary team led by Dr. Douglas G. Tingay and colleagues, the POLAR study protocol is designed as a randomized controlled trial—considered the gold standard for clinical evidence generation. This design will enable researchers to directly compare different PEEP levels applied during the resuscitation process. By rigorously controlling and measuring these variables, the study seeks to identify an optimal PEEP strategy that maximizes respiratory support while minimizing potential lung injury, such as volutrauma or barotrauma.

The scientific premise underpinning the POLAR trial is grounded in detailed pulmonary physiology. Positive end-expiratory pressure maintains airway patency and prevents cyclical alveolar collapse during exhalation. However, excessively high PEEP may overdistend delicate lung tissue, encouraging inflammation and subsequent chronic lung disease, a frequent complication known as bronchopulmonary dysplasia in preterm infants. Conversely, insufficient PEEP can lead to atelectasis and poor oxygenation, placing infants at risk for acute respiratory failure. Striking this balance is essential yet has remained elusive due to heterogeneous patient conditions and limitations in existing research.

What sets the POLAR trial apart is its real-time integration of cutting-edge respiratory monitoring technologies alongside clinical parameters. Detailed lung function assessments—including dynamic compliance and functional residual capacity—will be performed using non-invasive tools to tailor PEEP application and evaluate its immediate physiological impact. This approach reflects a paradigm shift from one-size-fits-all protocols toward personalized neonatal respiratory care, potentially reducing morbidity and mortality rates associated with prematurity-related respiratory distress.

Furthermore, the study embraces the complexities of neonatal adaptation at birth, recognizing that the transition from fetal to neonatal life involves major cardiopulmonary changes. In the womb, lungs are fluid-filled and remain unexpanded; however, upon birth, rapid clearance of fluid and lung expansion are essential for effective gas exchange. Appropriate PEEP levels during resuscitation can facilitate this transition by promoting alveolar recruitment and sufficient lung volume, critical for establishing stable oxygenation and ventilation.

Ethical considerations are meticulously addressed within the study design. The involvement of preterm infants—a population vulnerable due to their fragility—demands strict oversight and parent engagement. Informed consent processes and safety monitoring committees ensure the utmost adherence to ethical research standards, balancing scientific rigor with compassionate care. This ethical framework underscores the commitment to advancing neonatal medicine responsibly.

Anticipated findings from the POLAR trial promise to substantially influence clinical guidelines and practice worldwide. Many neonatal intensive care units (NICUs) follow varied protocols for initial respiratory support, often reflecting local preferences or limited evidence. By generating high-quality data on PEEP titration, the study aims to reduce inconsistencies, optimize resuscitation protocols, and establish evidence-based standards for care immediately after birth.

In addition to its clinical relevance, the POLAR study addresses broader global health implications. Preterm birth accounts for approximately 10% of all live births globally and remains the leading cause of neonatal mortality. Improving resuscitation strategies has the potential to save countless lives, especially in resource-limited settings where advanced respiratory support modalities are less accessible. Establishing simple, effective PEEP guidelines could therefore represent a cost-effective intervention with vast public health benefits.

The results of this trial will also contribute to the growing body of knowledge surrounding neonatal lung mechanics and pathophysiology. Such insights may fuel subsequent innovations in ventilatory support technologies, including the development of advanced ventilators designed specifically for the unique physiology of preterm infants. Moreover, understanding the interplay between ventilation pressures and lung injury pathways could open new avenues for pharmacological adjuncts aimed at protecting fragile lung tissue during postnatal adaptation.

Intriguingly, the POLAR research methodology incorporates a thorough follow-up phase to assess long-term developmental outcomes related to the initial resuscitation strategies. This is crucial as early respiratory interventions can have lingering effects on neurodevelopment and lung health throughout childhood. By correlating PEEP levels with these long-term outcomes, the study will aid clinicians in balancing immediate respiratory needs with future health considerations.

Another dimension to the POLAR trial is the interdisciplinary collaboration between neonatologists, respiratory therapists, biomedical engineers, and statisticians, highlighting the importance of diverse expertise in tackling complex medical challenges. Such teamwork ensures robust study design, precise data interpretation, and pragmatic translation of findings into bedside clinical practice, bridging the gap between scientific discovery and patient care.

The timing of the POLAR publication is particularly relevant given the ongoing advances in neonatal care and the increasing survival rates of extremely preterm infants. Despite these gains, respiratory complications remain a significant hurdle, often leading to extended NICU stays and elevated healthcare costs. By elucidating optimal PEEP strategies, this research could streamline clinical pathways, promote faster stabilization, and reduce the burden on healthcare systems.

As anticipation builds around the findings to emerge from this landmark trial, the neonatal community watches with hope for a new era of resuscitation excellence. The innovative approach of the POLAR study exemplifies how targeted clinical research can directly impact vulnerable populations, fostering better outcomes through evidence-based interventions.

In conclusion, the POLAR trial represents a milestone in neonatal respiratory care through its rigorous exploration of positive end-expiratory pressure during resuscitation of preterm infants. This study not only promises to refine critical clinical interventions at birth but also embodies a broader vision of precision medicine in neonatology, where individualized treatments enhance survival and quality of life for the most fragile patients. As healthcare providers await the full results, the potential for POLAR to transform frontline neonatal resuscitation protocols heralds an exciting future for preterm infant care.

Subject of Research: Exploration of optimal positive end-expiratory pressure (PEEP) levels during resuscitation of preterm infants immediately after birth.

Article Title: Positive end-expiratory pressure levels during resuscitation of preterm infants at birth (POLAR): study protocol for a randomised controlled trial.

Article References: Tingay, D.G., Galletta, L., Owen, L.S. et al. Positive end-expiratory pressure levels during resuscitation of preterm infants at birth (POLAR): study protocol for a randomised controlled trial. Pediatr Res (2026). https://doi.org/10.1038/s41390-026-04942-4

Image Credits: AI Generated

DOI: 10.1038/s41390-026-04942-4

Keywords: Neonatal resuscitation, positive end-expiratory pressure, preterm infants, respiratory support, pulmonary physiology, randomized controlled trial, neonatal intensive care, lung mechanics, bronchopulmonary dysplasia, precision medicine in neonatology

Preterm birth, defined as delivery before 37 weeks of gestation, presents a significant challenge globally, contributing heavily to neonatal morbidity and mortality. Among the multisystemic complications affecting these infants, bone mineralization deficits and immune system immaturity are profound concerns, often resulting in lifelong health impairments. Vitamin D, renowned for its role in calcium absorption and bone health, has increasingly been implicated in immune regulation and neurodevelopment. This study rigorously synthesizes data across numerous clinical trials to parse out how supplementation impacts these domains in infants whose physiological systems are still under rapid maturation.

One of the central discoveries of the meta-analysis centers on the striking improvement in bone mineral content among preterm infants receiving vitamin D supplements. The researchers documented statistically significant enhancements in bone density markers, suggesting that corrected vitamin D levels may offset the typical bone fragility linked to early birth. This fortification of skeletal health during a critical window of postnatal development could curtail the incidence of conditions like rickets and osteopenia, which have historically plagued this group. Importantly, the timing and dosage of vitamin D supplementation emerged as critical moderators influencing these skeletal outcomes.

Moreover, the immunomodulatory properties of vitamin D unveiled by this review offer compelling evidence that supplementation may decrease susceptibility to infections during infancy. The enhanced expression of antimicrobial peptides and modulation of inflammatory responses appear to fortify the immature immune defenses of preterm neonates, reducing the frequency and severity of respiratory and systemic infections. This insight aligns with burgeoning research positing vitamin D as a crucial player in innate immunity, highlighting its potential as a low-cost, low-risk intervention to improve neonatal health resilience.

The study further explores nuanced neurological outcomes associated with early vitamin D status. Emerging data suggest that adequate levels may support brain development and cognitive function, possibly through its influence on neurotrophic factors and neurotransmitter synthesis. While direct causal pathways remain to be fully elucidated, the meta-analysis identifies promising correlations between vitamin D supplementation and improved neurodevelopmental scores in early childhood assessments. Such findings beckon a reevaluation of nutritional guidelines to consider neurodevelopment as a vital endpoint.

From a methodological perspective, the analysis employed rigorous inclusion criteria, encompassing randomized controlled trials and well-designed cohort studies, collectively representing thousands of preterm infants across diverse healthcare settings. Statistical techniques, including subgroup analyses and meta-regressions, were applied to distill the effects attributable specifically to vitamin D amidst heterogeneous clinical protocols. This methodological rigor enhances the reliability and generalizability of the conclusions, making a compelling case for standardized supplementation regimens.

The safety profile of vitamin D supplementation in preterm infants, often a concern due to the existing fragilities of this group, was reassuringly benign in the compiled data. Adverse events were rare and predominantly unrelated to supplementation, indicating that the benefits overwhelmingly outweigh the risks. This positions vitamin D as an accessible intervention with a high therapeutic index, facilitating its adoption in neonatal intensive care units worldwide without excessive monitoring burdens.

In terms of clinical application, the authors propose integrating vitamin D supplementation into existing neonatal nutrition programs, particularly emphasizing administration during the earliest postnatal weeks—a critical period for both skeletal ossification and immune system priming. They stress the importance of dosing strategies aligned with gestational age and initial serum vitamin D levels to avoid under- or overdosing and to maximize therapeutic outcomes. This tailored approach underscores the necessity for personalized medicine in neonatology.

Longitudinal data synthesized in the review reveal that the benefits of vitamin D extend beyond the immediate neonatal period, with implications for growth trajectories, bone health in childhood, and potentially even metabolic programming. These enduring effects advocate for sustained monitoring of vitamin D status and supplementation as part of post-discharge care in preterm infants. Attention to these long-term outcomes is vital, given the propensity for chronic health challenges in this population.

This analysis also highlights gaps in current knowledge, particularly regarding the interaction of vitamin D supplementation with other micronutrients and the influence of genetic polymorphisms affecting vitamin D metabolism. The research community is called to deepen investigations into these areas, fostering integrative nutritional strategies that holistically address the multifaceted needs of preterm infants.

The public health significance of this work cannot be overstated. Preterm birth rates are climbing globally, with disparities most acute in low-resource settings where vitamin D deficiency is prevalent. By affirming the tangible benefits of supplementation, this study advocates for policy-level interventions to ensure equitable access to vitamin D supplements, potentially mitigating health disparities and reducing the burden on healthcare systems.

Furthermore, the findings resonate beyond neonatology, reinforcing the central role of vitamin D throughout the lifespan and its impact on early development as a determinant of lifelong health. This convergence of evidence invigorates ongoing debates regarding optimal vitamin D thresholds, supplementation timing, and the definition of deficiency, steering future research agendas.

From a translational viewpoint, the synthesis of data presented here is a call to action for clinicians, researchers, and health policymakers alike. It galvanizes efforts to integrate evidence-based vitamin D supplementation into neonatal care pathways, refine clinical guidelines, and prioritize funding for large-scale intervention trials to solidify these preliminary yet promising outcomes.

In sum, this systematic review and meta-analysis conducted by Shin, Kim, and Heo represents a pivotal advancement in neonatal medicine, underscoring vitamin D supplementation as a potent enhancer of preterm infant health. By integrating comprehensive data from multiple studies, it delivers robust, actionable insights that may transform clinical practices and optimize outcomes for one of the most vulnerable patient populations.

Subject of Research: Effects of vitamin D supplementation on short-term and long-term health outcomes in preterm infants.

Article Title: Short-term and long-term effects of vitamin D supplementation for preterm infants: a systematic review and meta-analysis.

Article References:
Shin, S.H., Kim, H.J. & Heo, J.S. Short-term and long-term effects of vitamin D supplementation for preterm infants: a systematic review and meta-analysis. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02440-9

Image Credits: AI Generated

DOI: https://doi.org/10.1038/s41372-025-02440-9

Over the past decades, NEC has been recognized primarily for its acute morbidity and mortality predominantly in neonatal intensive care units. The focus has largely been on immediate surgical interventions, nutritional management, and preventing sepsis. However, long-term neurodevelopmental outcomes have emerged as a critical area of concern, especially considering that survival rates have improved, leaving a growing population of preterm children with potential hidden disabilities. By investigating somatosensory function years after NEC, researchers have begun to unravel subtle but profound disruptions in neurological processing, opening a new frontier in pediatric research and follow-up care.

Somatosensory function—a fundamental aspect of how the nervous system processes sensory input like touch, pain, temperature, and proprioception—is essential for interacting with the environment and developing coordinated motor skills. Damage or alteration in these pathways can have widespread implications, from chronic pain syndromes to motor impairment or cognitive deficits. The study conducted by ten Barge and colleagues employed a comprehensive and technically advanced battery of somatosensory assessments, integrating electrophysiological measurements with clinical examinations. Their approach allowed for an in-depth interrogation of sensory nerve function and cortical processing beyond mere clinical observation.

One of the striking revelations from this research was the persistence of altered somatosensory function long after the resolution of the initial intestinal pathology. The data demonstrated significant differences in nerve conduction velocity and sensory thresholds when comparing NEC survivors to preterm peers without NEC history, suggesting that the early-life inflammatory insult extends beyond the gut to impact peripheral and central nervous system integrity. These findings provide compelling evidence that NEC is not solely an intestinal disease but may act as a trigger for systemic inflammatory cascades with lasting neurological consequences.

The underlying mechanisms linking NEC to subsequent somatosensory dysfunction are multifaceted. Inflammation-induced neurotoxicity during critical windows of neurodevelopment likely plays a central role, with cytokines and other inflammatory mediators crossing immature barriers to affect developing neural circuits. Additionally, surgical interventions and prolonged critical illness associated with NEC may contribute to neural injury through hypoxia, stress, or altered microbiome-gut-brain axis interactions. This multiplicity of influences complicates therapeutic approaches but also highlights the necessity for integrated multidisciplinary strategies in neonatal follow-up programs.

Technological advancements have been pivotal in capturing these subtle neurosensory changes. High-resolution nerve conduction studies paired with quantitative sensory testing provide objective biomarkers that correlate with functional impairments. Moreover, neuroimaging modalities such as diffusion tensor imaging (DTI) and functional MRI (fMRI), though not directly reported in this study, represent promising adjuncts to localize and characterize connectivity disruptions implicated in NEC-related neurological sequelae. Researchers advocate for longitudinal imaging and electrophysiological monitoring to correlate structural changes with functional outcomes over childhood.

This research also spotlights a critical gap in neonatal care: the lack of standardized protocols to monitor and support somatosensory development post-NEC. While neurodevelopmental screening is routine in many centers for cognitive and motor domains, sensory function assessments are infrequently incorporated despite their demonstrated importance. A paradigm shift is urgently needed to embrace somatosensory evaluations as integral components of comprehensive follow-up, enabling early identification of dysfunction and timely rehabilitation interventions such as sensory integration therapy or physiotherapy tailored to sensory deficits.

The implications of these findings transcend the sphere of pediatric neurology and neonatology. They invite reevaluation of how neonatal systemic inflammation interfaces with developing neural systems and raise broader questions about subtle neurodevelopmental disorders that may go unnoticed due to lack of targeted assessments. Furthermore, the study underlines the necessity for exploring anti-inflammatory and neuroprotective therapeutic avenues during the neonatal period to mitigate long-term consequences of NEC. Discovery of biomarkers predictive of somatosensory outcome could revolutionize risk stratification and personalized treatment plans.

From a clinical perspective, the recognition of somatosensory impairment adds a new dimension to the challenges faced by families and healthcare providers managing children post-NEC. Sensory dysfunction may manifest as atypical pain responses, impaired fine motor skills, or altered balance and coordination, all of which influence quality of life and educational participation. Awareness and education around these potential issues are crucial for caregivers, pediatricians, educators, and therapists alike to optimize support systems and foster developmental potential in this vulnerable population.

The study’s methodological rigor and comprehensive analysis set new standards for research in neonatal brain-gut interactions. By focusing on the long-term trajectory of children who survived NEC rather than emphasizing the acute phase alone, ten Barge and colleagues have illuminated neglected aspects of pediatric neurodevelopmental research. Their work underscores the indispensable role of longitudinal studies designed to capture evolving clinical phenotypes that only emerge over years, necessitating sustained commitment from healthcare systems and researchers.

Future research inspired by these findings will likely focus on delineating the precise timelines and critical windows during which interventions might alter neurological outcomes. Investigations must also aim to disentangle the contributions of prematurity per se from those uniquely attributable to NEC. Multi-center collaborations and larger cohort studies will be essential to validate and expand upon these findings, integrating genetic, immunological, and neuroimaging data to develop holistic models of NEC’s lifelong impact.

In parallel, the development of novel neuroprotective strategies during the neonatal period could dramatically shift outcomes for preterm infants with NEC. Early modulation of inflammatory pathways, neuroregenerative therapies, and microbiome-targeted interventions represent promising realms of exploration that might reduce neural injury and improve somatosensory integration. Bridging preclinical and clinical research will be necessary to translate these concepts into effective treatments that can be implemented in neonatal intensive care settings.

Ultimately, the revelation that a gastrointestinal emergency in early life intricately shapes somatosensory function years later offers a profound lesson on the interconnectedness of organ systems and the vulnerability of the developing brain. It challenges clinicians and scientists to adopt a more integrative view of neonatal disease and recovery, emphasizing comprehensive lifelong care beyond survival. For families and children touched by NEC, this research provides hope grounded in deeper understanding and points the way toward more informed, targeted follow-up and rehabilitation strategies.

The findings published in this pivotal study mark a watershed moment in neonatal medicine and developmental neuroscience. By shining a light on somatosensory dysfunction as a significant and measurable consequence of NEC, ten Barge et al. call for renewed attention to the sensory dimensions of neurodevelopmental outcomes. In doing so, they pave the way for innovations in diagnosis, monitoring, and treatment, ultimately aiming to enhance life quality for one of medicine’s most vulnerable populations.

The journey to fully comprehend and mitigate NEC’s long-term neurological imprint is just beginning, but this research represents a critical milestone. As awareness grows that systemic neonatal inflammation imprints on sensory pathways with lasting disruption, the field moves closer to unraveling the complex interplay of immune, neural, and environmental factors shaping early human development. This integrated understanding is the cornerstone for addressing the enduring challenges faced by preterm-born children worldwide.

Subject of Research: Long-term impact of necrotizing enterocolitis on somatosensory function in preterm-born children

Article Title: Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children

Article References:
ten Barge, J.A., Vermeulen, M.J., Keyzer-Dekker, C.M.G. et al. Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04348-8

Image Credits: AI Generated

DOI: https://doi.org/10.1038/s41390-025-04348-8

Preterm infants, particularly those born extremely prematurely, often suffer from respiratory distress syndrome (RDS), which stems from immature lungs lacking sufficient surfactant. Traditional ventilation strategies, while life-saving, can impose risks of lung injury due to volutrauma or barotrauma. Conventional imaging methods like chest X-rays provide limited snapshots in time and expose infants to radiation, leaving clinicians with insufficient data to finely tune ventilation settings. Herein lies the promise of EIT, a real-time bedside imaging modality that leverages small electrical currents to construct dynamic lung maps, without incurring radiation exposure.

High-frequency oscillatory ventilation is an advanced mode of mechanical ventilation that delivers very small tidal volumes at rapid frequencies. Its advantage lies in minimizing lung injury by avoiding overexpansion of fragile alveoli. Nevertheless, optimizing HFOV requires precise guidance on lung recruitment – a process whereby collapsed lung regions are reopened to enhance oxygen exchange. Without accurate monitoring, recruitment efforts risk being either insufficient or excessive, both endangering the delicate lungs of preterm neonates. The integration of EIT into HFOV management represents a pivotal step in addressing this critical clinical balancing act.

Werther and colleagues embarked on a meticulous investigation involving preterm infants receiving HFOV therapy. Utilizing EIT, they were able to observe the spatial distribution of ventilation throughout the lungs during recruitment maneuvers. Their approach enabled the detection of heterogeneous lung inflation patterns, giving immediate feedback on the effectiveness of recruitment strategies in real time. This dynamic feedback is crucial since static measures of lung function often fail to reveal underlying regional disparities, which contribute to ventilator-induced lung injury and prolonged morbidity.

The principle behind electrical impedance tomography centers on the differential electrical conductivity of lung tissues during the breathing cycle. As air fills the alveoli, impedance changes predictably, allowing EIT to generate cross-sectional images reflecting regional ventilation. Unlike computed tomography or magnetic resonance imaging, EIT devices are compact, portable, and safe for continuous monitoring in neonatal intensive care settings. This portability facilitates its use in dynamic physiological monitoring and adjusting ventilator parameters on-the-fly, tailored individually to the infant’s lung mechanics.

Within their clinical protocol, the research team employed EIT to guide incremental lung recruitment steps during HFOV. By incrementally increasing airway pressure while observing EIT images, clinicians could optimize pressure levels to maximize alveolar recruitment while minimizing overdistension. Notably, the study highlighted significant inter-individual variability; what constitutes an optimal recruitment pressure varied considerably between infants. This finding underscores the central tenet of personalized medicine – even in the neonatal intensive care unit – to improve outcomes by customizing therapy to patient-specific physiology.

Moreover, the study’s longitudinal observations revealed that EIT-driven recruitment maneuvers correlated with improved oxygenation and more homogeneous ventilation distribution. These physiological improvements hold promise for reducing long-term pulmonary complications, such as bronchopulmonary dysplasia, which remains a major cause of morbidity in preterm survivors. As lung injury prevention becomes a cornerstone of neonatal care, real-time imaging tools like EIT are poised to become indispensable in the ventilator management arsenal.

However, while the potentials of EIT are compelling, the authors also candidly discuss limitations and practical challenges. Signal artifacts caused by electrodes or movement, as well as the current resolution constraints of EIT, require ongoing technological refinement. Furthermore, training clinicians to interpret and integrate EIT data into clinical decision-making is critical for widespread adoption. Yet, these hurdles are surmountable, and advances in artificial intelligence and machine learning could soon automate portions of image interpretation, enhancing usability and precision.

From a broader perspective, this study represents a significant leap in neonatal respiratory care by bridging technology and physiology in an elegant feedback loop. The concept of “lung-protective ventilation” is no longer theoretical but achievable in real time. By embracing continuous regional lung monitoring, the neonatal community can foresee a future where ventilator-induced injury rates decline steadily and tailored treatments become the norm rather than the exception.

The implications extend beyond the neonatal population. Insights gained from EIT monitoring during HFOV can inform adult critical care, where compromised lung mechanics demand nuanced ventilation strategies. The translational potential underscores the relevance of the research, positioning EIT at the forefront of precision ventilation monitoring across age groups and clinical contexts.

As the study illuminates, early intervention guided by accurate physiological insights delivers a dual benefit: preserving lung health while supporting survival. It captures a paradigmatic shift from reactive to proactive respiratory management. In this evolving landscape, technological innovations such as electrical impedance tomography will not only refine clinical protocols but also inspire novel therapeutic paradigms within neonatology and beyond.

Looking ahead, the researchers advocate for larger, multicenter trials to validate and expand on their promising findings. Such studies could solidify EIT’s place in evidence-based neonatal guidelines and foster widespread integration into clinical practice. Concurrent development of user-friendly interfaces and robust analytics will catalyze this transition, ultimately enhancing care quality and life quality for countless vulnerable infants worldwide.

In conclusion, the pioneering work by Werther et al. exemplifies how advanced imaging techniques can revolutionize neonatal ventilation management. By harnessing the power of electrical impedance tomography during high-frequency oscillatory ventilation, clinicians can achieve unprecedented precision in lung recruitment, safeguarding the futures of preterm infants. This research heralds a new era where bedside imaging translates directly to improved respiratory outcomes, bridging the divide between innovative technology and compassionate care.

Subject of Research: Respiratory management in preterm infants using high-frequency oscillatory ventilation guided by electrical impedance tomography.

Article Title: Preterm infants on high-frequency oscillatory ventilation: electrical impedance tomography during lung recruitment.

Article References:
Werther, T., Küng, E., Aichhorn, L. et al. Preterm infants on high-frequency oscillatory ventilation: electrical impedance tomography during lung recruitment. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04173-z

Image Credits: AI Generated

DOI: https://doi.org/10.1038/s41390-025-04173-z