{"id":"https://openalex.org/W7204157273","doi":"https://doi.org/10.64898/2026.08.21.26360905","title":"Patient-Specific Adaptations in ERAS for High-Altitude Laparoscopic Cholecystectomy: The PAERS Hypothesis","display_name":"Patient-Specific Adaptations in ERAS for High-Altitude Laparoscopic Cholecystectomy: The PAERS Hypothesis","publication_year":2026,"publication_date":"2026-08-25","ids":{"openalex":"https://openalex.org/W7204157273","doi":"https://doi.org/10.64898/2026.08.21.26360905"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.21.26360905","doi":"https://doi.org/10.64898/2026.08.21.26360905","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.21.26360905","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/25/2026.08.21.26360905.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/25/2026.08.21.26360905.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5108855484","display_name":"Zhongfeng Dang","orcid":"https://orcid.org/0009-0007-2196-8183","observed_orcids":["https://orcid.org/0009-0007-2196-8183"]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Zhongfeng Dang","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":"https://orcid.org/0009-0007-2196-8183","affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5146004502","display_name":"Jianduojie Dan","orcid":"https://orcid.org/0009-0003-2154-5480","observed_orcids":["https://orcid.org/0009-0003-2154-5480"]},"institutions":[{"id":"https://openalex.org/I220289513","display_name":"American University of Central Asia","ror":"https://ror.org/03vvzk644","country_code":"KG","type":"education","lineage":["https://openalex.org/I220289513"]}],"countries":["KG"],"is_corresponding":false,"raw_author_name":"Jianduojie Dan","raw_affiliation_strings":["Department of Software Engineering, American University of Central Asia, Bishkek 720060, Kyrgyzstan"],"raw_orcid":"https://orcid.org/0009-0003-2154-5480","affiliations":[{"raw_affiliation_string":"Department of Software Engineering, American University of Central Asia, Bishkek 720060, Kyrgyzstan","institution_ids":["https://openalex.org/I220289513"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030440758","display_name":"Wei Su","orcid":"https://orcid.org/0000-0003-1289-4403","observed_orcids":["https://orcid.org/0000-0003-1289-4403"]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Wei Su","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5146018062","display_name":"Guoliang Ren","orcid":"https://orcid.org/0009-0008-5770-5542","observed_orcids":["https://orcid.org/0009-0008-5770-5542"]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Guoliang Ren","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5146010132","display_name":"Zhiqiang Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhiqiang Wang","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5145938806","display_name":"Yabing Ma","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146711","display_name":"Sun Yat-sen University Cancer Center","ror":"https://ror.org/0400g8r85","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210146711"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yabing Ma","raw_affiliation_strings":["Ultrasound and ECG Center, Gansu Hospital of Sun Yat-sen University Cancer Center, Lanzhou, Gansu 730050, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ultrasound and ECG Center, Gansu Hospital of Sun Yat-sen University Cancer Center, Lanzhou, Gansu 730050, China","institution_ids":["https://openalex.org/I4210146711"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5024922711","display_name":"Shengmei Li","orcid":"https://orcid.org/0000-0002-8597-8627","observed_orcids":["https://orcid.org/0000-0002-8597-8627"]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Shengmei Li","raw_affiliation_strings":["Department of Laboratory Medicine, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Laboratory Medicine, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5146066965","display_name":"Dongde Ji","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Dongde Ji","raw_affiliation_strings":["Department of Gastroenterology, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5145954962","display_name":"Liansheng Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Liansheng Li","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5021791616","display_name":"Junlin Gao","orcid":"https://orcid.org/0009-0007-4103-2649","observed_orcids":["https://orcid.org/0009-0007-4103-2649"]},"institutions":[{"id":"https://openalex.org/I4210113043","display_name":"Qinghai Red Cross Hospital","ror":"https://ror.org/023xep540","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210113043"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Junlin Gao","raw_affiliation_strings":["Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China"],"raw_orcid":"https://orcid.org/0009-0007-4103-2649","affiliations":[{"raw_affiliation_string":"Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China","institution_ids":["https://openalex.org/I4210113043"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5108855484"],"corresponding_institution_ids":["https://openalex.org/I4210113043"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12020","display_name":"Enhanced Recovery After Surgery","score":0.9901999831199646,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12020","display_name":"Enhanced Recovery After Surgery","score":0.9901999831199646,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11968","display_name":"High Altitude and Hypoxia","score":0.00430000014603138,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11930","display_name":"Cardiac, Anesthesia and Surgical Outcomes","score":0.0010000000474974513,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/enhanced-recovery-after-surgery","display_name":"enhanced recovery after surgery","score":0.9739999771118164},{"id":"https://openalex.org/keywords/high-altitude","display_name":"high altitude","score":0.949999988079071},{"id":"https://openalex.org/keywords/laparoscopic-cholecystectomy","display_name":"laparoscopic cholecystectomy","score":0.9639999866485596},{"id":"https://openalex.org/keywords/chronic-hypoxia","display_name":"chronic hypoxia","score":0.8069999814033508},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.7419999837875366},{"id":"https://openalex.org/keywords/body-mass-index","display_name":"body mass index","score":0.6830000281333923},{"id":"https://openalex.org/keywords/hemoglobin","display_name":"hemoglobin","score":0.7160000205039978},{"id":"https://openalex.org/keywords/oxygen-saturation","display_name":"oxygen saturation","score":0.9160000085830688},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.7760000228881836},{"id":"https://openalex.org/keywords/postoperative-complications","display_name":"postoperative complications","score":0.8730000257492065},{"id":"https://openalex.org/keywords/epas1","display_name":"EPAS1","score":0.9340000152587891},{"id":"https://openalex.org/keywords/genetic-adaptation","display_name":"genetic adaptation","score":0.7680000066757202},{"id":"https://openalex.org/keywords/surgeon-variation","display_name":"surgeon variation","score":0.5379999876022339}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6021999716758728},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.4975999891757965},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4271000027656555},{"id":"https://openalex.org/C3020404979","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk stratification","level":2,"score":0.39739999175071716},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.39649999141693115},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.3912999927997589},{"id":"https://openalex.org/C2780221984","wikidata":"https://www.wikidata.org/wiki/Q131191","display_name":"Body mass index","level":2,"score":0.39079999923706055},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.3871999979019165},{"id":"https://openalex.org/C2776868573","wikidata":"https://www.wikidata.org/wiki/Q46855","display_name":"Sprint","level":2,"score":0.3546999990940094},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3508000075817108},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.34610000252723694},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.30379998683929443},{"id":"https://openalex.org/C2992519594","wikidata":"https://www.wikidata.org/wiki/Q870433","display_name":"Genetic model","level":3,"score":0.30300000309944153},{"id":"https://openalex.org/C2987287001","wikidata":"https://www.wikidata.org/wiki/Q638774","display_name":"Laparoscopic cholecystectomy","level":2,"score":0.29350000619888306},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.27489998936653137},{"id":"https://openalex.org/C2776641081","wikidata":"https://www.wikidata.org/wiki/Q638774","display_name":"Cholecystectomy","level":2,"score":0.27469998598098755},{"id":"https://openalex.org/C2780047204","wikidata":"https://www.wikidata.org/wiki/Q675754","display_name":"Laparoscopy","level":2,"score":0.2689000070095062},{"id":"https://openalex.org/C48921125","wikidata":"https://www.wikidata.org/wiki/Q10861030","display_name":"Linear regression","level":2,"score":0.265500009059906},{"id":"https://openalex.org/C186413461","wikidata":"https://www.wikidata.org/wiki/Q744727","display_name":"Genetic association","level":5,"score":0.26499998569488525},{"id":"https://openalex.org/C83546350","wikidata":"https://www.wikidata.org/wiki/Q1139051","display_name":"Regression","level":2,"score":0.2644999921321869},{"id":"https://openalex.org/C6350597","wikidata":"https://www.wikidata.org/wiki/Q339495","display_name":"Altitude (triangle)","level":2,"score":0.25940001010894775},{"id":"https://openalex.org/C68873052","wikidata":"https://www.wikidata.org/wiki/Q349856","display_name":"Genetic variation","level":3,"score":0.2522999942302704}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.08.21.26360905","doi":"https://doi.org/10.64898/2026.08.21.26360905","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.21.26360905","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/25/2026.08.21.26360905.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.08.21.26360905","doi":"https://doi.org/10.64898/2026.08.21.26360905","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.21.26360905","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/25/2026.08.21.26360905.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204157273.pdf","grobid_xml":"https://content.openalex.org/works/W7204157273.grobid-xml"},"referenced_works_count":23,"referenced_works":["https://openalex.org/W1994809630","https://openalex.org/W2063505665","https://openalex.org/W2100482242","https://openalex.org/W2133809942","https://openalex.org/W2147575903","https://openalex.org/W2159645225","https://openalex.org/W2512086803","https://openalex.org/W2519479277","https://openalex.org/W2550622978","https://openalex.org/W2573978544","https://openalex.org/W2575997663","https://openalex.org/W2599076725","https://openalex.org/W2608402327","https://openalex.org/W2735301415","https://openalex.org/W2989427582","https://openalex.org/W4206747940","https://openalex.org/W4385367174","https://openalex.org/W4399773903","https://openalex.org/W4402775481","https://openalex.org/W7201858936","https://openalex.org/W7203683825","https://openalex.org/W7203692330","https://openalex.org/W7204076052"],"related_works":["https://openalex.org/W7204076052","https://openalex.org/W6961052184","https://openalex.org/W4407365845","https://openalex.org/W4412493042","https://openalex.org/W7124915014","https://openalex.org/W4408206870","https://openalex.org/W2169794275","https://openalex.org/W7169675957","https://openalex.org/W4205638906","https://openalex.org/W2469736074"],"abstract_inverted_index":{"ABSTRACT":[0],"Background":[1],"ERAS":[2,40,63,252],"protocols":[3],"reduce":[4],"hospital":[5],"stay":[6],"by":[7,12],"1.88":[8],"days":[9],"and":[10,29,125,131,146,261],"complications":[11],"29%":[13],"globally,":[14],"but":[15],"their":[16],"\u201cone-size-fits-all\u201d":[17,275],"paradigm\u2014validated":[18],"at":[19,23,44,101],"sea":[20],"level\u2014may":[21],"fail":[22],"high":[24,45],"altitude":[25,46],"where":[26],"chronic":[27],"hypoxia":[28],"population-specific":[30],"genetic":[31,74,135,262],"adaptations":[32],"remodel":[33],"baseline":[34,238],"physiology.":[35],"No":[36],"study":[37],"has":[38],"quantified":[39],"effect":[41,211,256],"weight":[42,67,257],"shifts":[43],"or":[47],"proposed":[48],"a":[49,237],"theoretical":[50],"model":[51,86],"to":[52,88,276],"explain":[53],"the":[54,78],"gap.":[55],"Objectives":[56],"To":[57],"evaluate":[58],"three":[59,254],"dimensions":[60],"of":[61,93],"plateau":[62],"remodeling\u2014(i)":[64],"risk":[65,84,115,163,271],"factor":[66,116,164],"shift,":[68],"(ii)":[69],"traditional":[70],"marker":[71],"failure,":[72,260],"(iii)":[73],"background":[75,263],"modification\u2014and":[76],"propose":[77],"PAERS":[79,266],"(Plateau":[80],"Adaptation\u2013ERAS":[81],"Remodeling":[82,156],"Syndrome)":[83],"stratification":[85,272],"tailored":[87],"altitude.":[89],"Methods":[90],"Retrospective":[91],"cohort":[92],"612":[94],"adults":[95],"undergoing":[96],"elective":[97],"laparoscopic":[98],"cholecystectomy":[99],"(2018\u20132023)":[100],"Qinghai":[102],"Red":[103],"Cross":[104],"Hospital":[105],"(2260":[106],"m).":[107],"Three":[108,245],"analytical":[109],"tiers:":[110],"(1)":[111,154],"multivariable":[112],"regression":[113],"comparing":[114],"coefficients":[117],"against":[118],"plain-altitude":[119],"benchmarks;":[120],"(2)":[121,190],"restricted":[122],"cubic":[123],"spline":[124],"interaction":[126,203],"modeling":[127],"for":[128],"Hb,":[129],"SpO\u2082,":[130],"LOS;":[132],"(3)":[133,219],"inferential":[134],"modifier":[136,239],"analysis":[137],"using":[138],"population-level":[139],"EPAS1":[140,226],"carrier":[141,227],"rates.":[142],"Primary":[143],"outcomes:":[144],"LOS":[145,199],"complication":[147],"rate.":[148],"Results":[149],"Three-dimensional":[150],"shift":[151],"was":[152],"observed:":[153],"Weight":[155],":":[157,193,224],"BMI":[158],"replaced":[159],"sex":[160],"as":[161],"primary":[162],"(OR":[165],"=":[166,175,205,208],"1.86,":[167],"P":[168,187,207],"<":[169,188],".001),":[170],"surgeon":[171],"variability":[172],"amplified":[173],"(F":[174],"6.33":[176],"vs":[177],"plain":[178],"benchmark":[179],"2\u20134,":[180],"an":[181,269],"\u223c58%":[182],"increase":[183],"in":[184],"F-statistic":[185],"ratio,":[186],".001);":[189],"Marker":[191],"Failure":[192],"Hb":[194],"showed":[195],"J-type":[196],"relationship":[197],"with":[198,210],"(Hb":[200],"\u00d7":[201],"SpO\u2082":[202,214],"\u03b2":[204],"\u22120.0095,":[206],".009),":[209],"reversal":[212],"across":[213,231],"strata":[215],"(\u201dPlateau":[216],"Hemoglobin":[217],"Paradox\u201d);":[218],"Genetic":[220],"Modification":[221],"(population-level":[222],"inference)":[223],"\u223c70%":[225],"rate":[228],"(range":[229],"57\u201385%":[230],"studies)":[232],"suggests":[233],"HIF-2\u03b1":[234],"pathway":[235],"is":[236],"that":[240],"must":[241],"be":[242],"accounted":[243],"for.":[244],"falsifiable":[246],"predictions":[247],"were":[248],"proposed.":[249],"Conclusions":[250],"High-altitude":[251],"faces":[253],"challenges:":[255],"remodeling,":[258],"biomarker":[259],"calibration.":[264],"The":[265],"hypothesis":[267],"proposes":[268],"integrated":[270],"model\u2014shifting":[273],"from":[274],"altitude-aware,":[277],"patient-specific":[278],"protocols.":[279]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-08-26T00:00:00"}
