Thyroid Science最新文献

{"title":"Smartphone-enabled AI for diagnosing papillary thyroid carcinoma: A low-cost, high-security and high-accuracy approach using ultrasound imaging","authors":"Yoshihiro Takahashi ,&nbsp;Ryutaro Mori ,&nbsp;Sodai Kubota ,&nbsp;Saki Kubota ,&nbsp;Mayu Sakai ,&nbsp;Ken Takao ,&nbsp;Takehiro Kato ,&nbsp;Masami Mizuno ,&nbsp;Takuo Hirota ,&nbsp;Yukio Horikawa ,&nbsp;Shin Tsunekawa","doi":"10.1016/j.thscie.2026.100039","DOIUrl":"10.1016/j.thscie.2026.100039","url":null,"abstract":"<div><h3>Background</h3><div>Papillary thyroid cancer (PTC) accounts for approximately 90% of all thyroid malignancies, with ultrasound playing a critical role in diagnosis. Although artificial intelligence (AI)-assisted systems have shown promise in improving diagnostic accuracy, widespread adoption is hindered by concerns regarding cost and data security. To address these issues, we developed a smartphone-compatible AI diagnostic system targeting ultrasound images of PTC.</div></div><div><h3>Methods</h3><div>We used ultrasound images from 150 PTC and 200 benign thyroid lesions to train an AI server employing an object detection model for lesion identification. A smartphone application was developed to communicate with the AI server and display diagnostic predictions. For performance evaluation, we used 15 PTC and 15 benign images extracted from the training dataset. Sensitivity, specificity, and overall accuracy were calculated for both server-based and smartphone-based predictions.</div></div><div><h3>Results</h3><div>The AI server achieved a sensitivity of 100%, specificity of 96.7%, and overall accuracy of 97.8%. The smartphone-based system also showed high performance, with a sensitivity of 100%, specificity of 90.0%, and overall accuracy of 93.3%. One instance of misclassification occurred, where tracheal cartilage was incorrectly identified as a PTC.</div></div><div><h3>Conclusions</h3><div>The developed AI system enables highly accurate diagnosis of PTC from ultrasound images. The smartphone interface retains robust diagnostic performance, offering a low-cost, secure, and accessible tool for clinical use, particularly in resource-limited settings.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 2","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147386740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional variation in thyroid volume and iodine status among Japanese school-aged children: Modest effect of iodine intake on thyroid volume in a long-standing iodine-sufficient area","authors":"Yozen Fuse ,&nbsp;Yo Kunii ,&nbsp;Yoshiya Ito ,&nbsp;Sonja Y. Hess ,&nbsp;Michael B. Zimmermann ,&nbsp;Yoshimasa Shishiba","doi":"10.1016/j.thscie.2026.100043","DOIUrl":"10.1016/j.thscie.2026.100043","url":null,"abstract":"<div><h3>Context</h3><div>Iodine deficiency persists in many regions worldwide. Thyroid size responds to iodine intake and, together with urinary iodine concentration (UIC), they serve as biomarkers of iodine status.</div></div><div><h3>Objective</h3><div>To examine the association between iodine status and Tvol across regions of Japan with differing iodine intake and to establish local thyroid volume (Tvol) reference values for school-aged children (SAC).</div></div><div><h3>Design subjects and measurement</h3><div>Cross-sectional survey. From 2019–2023 thyroid ultrasonography and UIC measurement were conducted in SAC in five regions of Japan previously identified as having the highest or lowest median UIC (mUIC) values. The raw data from a 2002 survey three regions were also included and analyzed.</div></div><div><h3>Results</h3><div>Among 2301 children with the mean age of 9.4 years from two surveys, the overall median Tvol and UIC were 2.75 mL and 298.0 μg/L, respectively. Regional variations in median Tvol paralleled differences in UIC, with the highest Tvol in Rebun Island and the lowest in Asahikawa. Age- and BSA-specific Tvol medians were smaller than those reported in most iodine-sufficient countries, but larger than the 2004 WHO reference values. No significant association was found between individual Tvol and UIC values.</div></div><div><h3>Conclusions</h3><div>In areas with long-standing iodine sufficiency, higher population iodine intake is associated with larger thyroid volumes; however, increasing iodine intake reflected as an increase in mUIC from 200 to 600 μg/L appears to have only modest effects on Tvol. Further studies are needed on the relationships between iodine intake, thyroid size, focal lesions, and thyroid function in children.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 2","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two levator glandulae thyroideae muscles crossed in an X shape: Case report and implications for cervical surgery","authors":"Tata Touré ,&nbsp;Abdoulaye Kanté ,&nbsp;Babou Ba ,&nbsp;Gadji Dady Gadji ,&nbsp;Niagamé dit Bamba Camara ,&nbsp;Gaoussou Simpara ,&nbsp;Fatogoma Issa Koné","doi":"10.1016/j.thscie.2026.100042","DOIUrl":"10.1016/j.thscie.2026.100042","url":null,"abstract":"<div><h3>Background</h3><div>The levator glanduleae thyroideae muscle is the second most common morphological variation of the thyroid gland after the pyramidal lobe. Bilateral cases of levator glanduleae thyroideae are rare. This case report describes a rare anatomical configuration: the presence of two levator glanduleae thyroideae muscles with distinct origins and terminations, and crossing of the two muscles in an X shape.</div></div><div><h3>Case description</h3><div>A bilateral case levator glanduleae thyroideae muscle was observed during a dissection on the anterolateral region of the neck in a male cadaveric subject. On each side, both levator glanduleae thyroideae muscles originated on the inferior edge of the thyroid cartilage, lateral to the re-entrant angle of this cartilage and medial to the insertion of the cricothyroid muscle. They crossed at the superior border of the thyroid isthmus, anterior to the supra-isthmic arterial arch. They terminated on the opposite side from their origins, on the lower part of the thyroid isthmus and the adjacent part of the thyroid lobe. At the crossing point, the levator glanduleae thyroideae muscle on the left side gave off a small bundle that joined the levator glanduleae thyroideae muscle on the right side. The pyramidal lobe was absent.</div></div><div><h3>Conclusion</h3><div>The anatomical variation reported here is important for cervical surgeons, particularly thyroid surgeons, to be aware of. It can be a source of confusion or difficulty during thyroidectomy.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 2","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myxedema coma with reversible pulmonary arrest accompanied with massive pericardial effusion: A case report","authors":"Masakazu Uejima ,&nbsp;Yoshiyuki Nakai ,&nbsp;Kuniaki Ozaki ,&nbsp;Ayame Takahashi ,&nbsp;Takuma Moriguchi ,&nbsp;Taichi Deguchi ,&nbsp;Yasuhiro Niida ,&nbsp;Miho Katsumata ,&nbsp;Maiko Nishigori ,&nbsp;Yukako Kurematsu ,&nbsp;Shinsaku Nagamatsu ,&nbsp;Hideki Matsuo ,&nbsp;Kei Moriya ,&nbsp;Kosuke Kaji ,&nbsp;Tadashi Namisaki ,&nbsp;Akira Mitoro ,&nbsp;Hitoshi Yoshiji","doi":"10.1016/j.thscie.2026.100038","DOIUrl":"10.1016/j.thscie.2026.100038","url":null,"abstract":"<div><div>Myxedema coma (MC) is a rare life-threatening endocrine emergency with a high mortality rate, frequently triggered by factors, including infection in untreated hypothyroidism. Early diagnosis and treatment are crucial, but frequently delayed owing to nonspecific symptoms and slow turnaround of laboratory results.</div><div>We here report a case of a 68-year-old female with previously undiagnosed thyroid disorders who presented with impaired consciousness, hypothermia, bradycardia, and severe anasarca. The patient developed massive pericardial effusion, causing cardiac tamponade and respiratory arrest. Lifesaving measures encompassed emergency pericardial window and mechanical ventilation in the intensive care unit. It was 6 days delay that MC diagnosis was made and levothyroxine (LT4) was initiated because the thyroid function test was temporarily unobtainable due to year-end and New Year period. After confirming hypothyroidism (thyroid-stimulating hormone, 20.22 mIU/L; free thyroxine, &lt;0.3 ng/dL), LT4 200 μg via nasogastric tube was promptly initiated and subsequently continued at 100 μg starting the following day. Intravenous hydrocortisone 100 mg was simultaneously administered, which led to a favorable outcome. This patient recovered without neurologic deficits, highlighting that timely intervention can reverse severe organ dysfunction. This case underscores the significance of high clinical suspicion for MC, even without immediate laboratory confirmation.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 2","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconceptional thyroid autoimmunity, dysfunction and associated factors in nulliparous Indian women","authors":"C. Jayakumari ,&nbsp;Ashwin Valliyot ,&nbsp;Sreejith Babu ,&nbsp;Abilash Nair ,&nbsp;Ravleen Kaur Bakshi ,&nbsp;P.K. Jabbar ,&nbsp;K. Amal ,&nbsp;Chintha Sujatha ,&nbsp;TS Anish ,&nbsp;C. Nirmala ,&nbsp;Lekshmi Vinod ,&nbsp;Riaz Ismail ,&nbsp;Bipin Gopal","doi":"10.1016/j.thscie.2025.100036","DOIUrl":"10.1016/j.thscie.2025.100036","url":null,"abstract":"<div><h3>Background</h3><div>Hypothyroidism in young women is associated with adverse reproductive outcomes. There are no previous population-based studies regarding the prevalence of hypothyroidism or thyroid autoimmunity in nulliparous preconceptional women. The current study was done to determine the prevalence of thyroid autoimmunity and thyroid dysfunction in newly married nulliparous Indian women.</div></div><div><h3>Methods</h3><div>Multistage sampling was employed to enrol married nulliparous women of 18–35 years age group from four socio geographic regions of Thiruvananthapuram district (urban, rural, coastal and hilly) based on ‘eligible couple register’ with the help of community health workers. Trained staff collected demographic and medical information and also conducted limited clinical examination for vital signs, goitre and anthropometric measurements. Biochemical investigations including serum thyrotropin (TSH), total thyroxine(T4), anti-thyroid-peroxidase (TPOAb) antibody were done in all participants.</div></div><div><h3>Results</h3><div>A total of 1507 women were enrolled, of whom 1379 with complete metabolic, anthropometric, and thyroid profile data were included in the final analysis. The prevalence of overt hypothyroidism was 3.0 % (n = 42) and subclinical hypothyroidism was 9.7 % (n = 134). The prevalence of TPOAb positivity was 19.2 %. In euthyroid, subclinical hypothyroid and overt hypothyroid population, TPOAb positivity was 13.28 %, 42.7 % and 71.8 % respectively. Fasting serum insulin, triglyceride, low-density lipoprotein (LDL) levels were higher in the hypothyroid group compared to euthyroid females. No associations with metabolic parameters were seen for TPOAb positivity.</div></div><div><h3>Conclusion</h3><div>One in eight preconceptional South Indian women suffer from hypothyroidism. Thyroid autoimmunity contributes to hypothyroidism in participants with higher TSH values whereas insulin resistance may contribute to subclinical hypothyroidism. Screening for hypothyroidism in the preconceptional period is recommended.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 1","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Severe skin eruptions and acute kidney injury during propylthiouracil treatment: A case report with review of literature” [Thyroid Sci 3 (2026) 100034]","authors":"Hiroyuki Onose ,&nbsp;Koki Kimura ,&nbsp;Shinya Ishii ,&nbsp;Masahiro Tsuchiya ,&nbsp;Fumihiko Yasuda ,&nbsp;Emiko Yamada","doi":"10.1016/j.thscie.2025.100035","DOIUrl":"10.1016/j.thscie.2025.100035","url":null,"abstract":"","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 1","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe skin eruptions and acute kidney injury during propylthiouracil treatment: A case report with review of literature","authors":"Hiroyuki Onose ,&nbsp;Koki Kimura ,&nbsp;Shinya Ishii ,&nbsp;Masahiro Tsuchiya ,&nbsp;Fumihiko Yasuda ,&nbsp;Emiko Yamada","doi":"10.1016/j.thscie.2025.100034","DOIUrl":"10.1016/j.thscie.2025.100034","url":null,"abstract":"<div><div>A 71-year-old female with Graves’ disease treated with propylthiouracil (PTU) developed severe skin eruptions with itching. About a month after PTU administration, drug eruptions appeared, and PTU was discontinued after 51 days of administration. Two days later, her creatinine level rose to 6.69 mg/dl, and she was diagnosed with acute kidney injury. Prednisolone therapy and emergency dialysis improved her renal function, and 81 days after discontinuation of PTU, her creatinine level improved to 1.26 mg/dl. We should promptly discontinue PTU in case of drug eruptions and be cautious of acute kidney injury, as reports have indicated PTU-induced drug eruptions and acute kidney injury due to acute interstitial nephritis not associated with anti-neutrophil cytoplasmic antibody. In cases of renal dysfunction, steroid therapy following renal biopsy should be considered.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"3 1","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Japanese patients with Graves’ disease who fail first radioiodine therapy","authors":"Yuki Yamamoto ,&nbsp;Hiroshi Fukazawa ,&nbsp;Jun Ito ,&nbsp;Kei Ito ,&nbsp;Masanao Fujii ,&nbsp;Aiko Hosoda ,&nbsp;Yoshinori Osaki ,&nbsp;Hiroaki Yagyu","doi":"10.1016/j.thscie.2025.100028","DOIUrl":"10.1016/j.thscie.2025.100028","url":null,"abstract":"<div><div>The factors predisposing to failure of radioiodine therapy (RIT) using ¹³¹I for Graves’ disease have been reported in various studies, but there are few reports from Japan. We investigated predictors of first RIT outcome. We retrospectively investigated outcomes of first RIT for 59 patients with Graves’ disease and divided into two groups with regard to the outcome of first RIT and factors associated with the failure of first RIT were determined. Binary logistic analysis showed thyroid weight as the only factor associated with outcome of first RIT. Receiver operating characteristic analysis demonstrated that the optimal cutoff value for thyroid weight to discriminate between patients who would or would not achieve success with first RIT was 33.4 g (81.6 % sensitivity, 80.0 % specificity; area under the curve, 0.837; 95 % confidence interval, 0.695–0.978; <em>p</em> &lt; 0.001). Thyroid weight was the most important predictor of first RIT outcome.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"2 4","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for the diagnosis of Graves' disease, hypothyroidism, painless thyroiditis, chronic thyroiditis (Hashimoto's thyroiditis), and subacute thyroiditis (acute phase)","authors":"Tetsuya Tagami ,&nbsp;Miyuki Katai ,&nbsp;Seigo Kinuya ,&nbsp;Noriyuki Koibuchi ,&nbsp;Tetsuo Kondo ,&nbsp;Hiroki Shimura ,&nbsp;Akira Sugawara ,&nbsp;Iwao Sugitani ,&nbsp;Hidemitsu Tsutsui ,&nbsp;Nagaoki Toyoda ,&nbsp;Eijun Nishihara ,&nbsp;Koshi Hashimoto ,&nbsp;Tomonobu Hasegawa ,&nbsp;Yoshitaka Hayashi ,&nbsp;Shigeru Hirano ,&nbsp;Norisato Mitsutake ,&nbsp;Kanshi Minamitani ,&nbsp;Natsuko Watanabe ,&nbsp;Naoko Arata ,&nbsp;Hitoshi Noguchi","doi":"10.1016/j.thscie.2025.100032","DOIUrl":"10.1016/j.thscie.2025.100032","url":null,"abstract":"<div><div>In 2002, the Japan Thyroid Association (JTA) established the Thyroid Disease Diagnostic Guidelines Development Working Group, which developed diagnostic guidelines for five major diseases: Graves' disease, hypothyroidism, painless thyroiditis, chronic thyroiditis (Hashimoto's thyroiditis), and subacute thyroiditis (acute phase). Since then, the guidelines have been repeatedly revised under the leadership of successive JTA Presidents. Meanwhile, several other diagnostic and treatment guidelines have been established by JTA Working Groups on Important Clinical Issues and published elsewhere. Here, with the launch of Thyroid Science, an English-language medical journal published by the JTA, we have decided to republish the original guidelines for the five diseases in this journal. However, because these guidelines were originally formulated as expert opinions, the papers have been updated to include new references supporting each description. Furthermore, definitions of each disease have been provided, and the format has been adapted to match the latest guidelines.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"2 4","pages":"Article 100032"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three cases of methimazole-induced fever in patients with Graves’ hyperthyroidism","authors":"Izumi Koyama ,&nbsp;Kenji Ohba ,&nbsp;Keisuke Kakizawa ,&nbsp;Takuya Hashimoto ,&nbsp;Daisuke Tsuriya ,&nbsp;Miho Yamashita ,&nbsp;Akio Matsushita","doi":"10.1016/j.thscie.2025.100031","DOIUrl":"10.1016/j.thscie.2025.100031","url":null,"abstract":"<div><div>Methimazole (MMI), a widely used antithyroid drug (ATD), is generally well tolerated, but adverse effects such as agranulocytosis may occur. We report three cases of MMI-induced fever in patients with newly diagnosed Graves’ hyperthyroidism. All patients developed fever within 11–12 days of MMI initiation, but without neutropenia and other major adverse events. The fevers resolved within 48 h of MMI withdrawal, supporting the diagnosis of drug-induced fever. In all three cases, initial physical and laboratory findings were non-specific, and patients appeared clinically well despite having high-grade fever. Potassium iodide (KI) monotherapy was used as interim therapy and was effective in maintaining euthyroidism without recurrence of fever. Two patients were subsequently switched to propylthiouracil (PTU), with one developing a cutaneous drug eruption but no recurrence of fever. Although rare, ATD-induced fever should be considered in differential diagnosis when fever arises, especially in the absence of neutropenia or elevated inflammatory markers. Prompt recognition and discontinuation of the offending agent are essential for preventing misdiagnosis and inappropriate treatment. KI monotherapy can serve as a safe and effective bridging therapy in such cases. Switching to alternative ATDs may be acceptable when definitive treatment such as radioactive iodine or surgery is not feasible, though careful monitoring is warranted due to risks of new adverse events. To our knowledge, this is the first English-language case series to provide detailed clinical descriptions of three consecutive cases of MMI-induced fever which highlights practical strategies for diagnosis and management.</div></div>","PeriodicalId":101253,"journal":{"name":"Thyroid Science","volume":"2 4","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}