Indian Journal of Endocrinology and Metabolism最新文献

{"title":"Immunohistochemical Expression of HBME-1 in a Spectrum of Thyroid Neoplasms.","authors":"Archi A Chawla, Reeta Dhar, Shilpi Sahu","doi":"10.4103/ijem.ijem_451_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_451_23","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid neoplasms are the most common malignancy of the endocrine system, representing 3.8% of new cancer cases, and it is the ninth most common cancer overall. The immuno-histochemical marker Hector Battifora Mesotheilial-1 (HBME-1) is a monoclonal antibody that now finds its diagnostic utility as a positive marker for well-differentiated thyroid carcinomas. The aim was to study the expression of HBME-1 and to differentiate between malignant and non-malignant lesions by demonstrating their usefulness in the categorisation of thyroid neoplasms.</p><p><strong>Methods: </strong>A prospective study was conducted at a tertiary care centre from August 2022 to May 2023, comprising 25 cases. All thyroidectomy specimens were included. They were subjected to histopathological examination using routine haematoxylin and eosin stain, and further confirmation was made by immuno-histochemical staining for HBME-1.</p><p><strong>Results: </strong>There were a total of 25 cases consisting of 23 (92%) females and two (8%) males. The maximum number of cases was seen in the age group of 21-30 years (27%), followed by 31-40 years (24%) and 41-50 years (24%). The most common thyroid neoplasm noted was the follicular variant of papillary thyroid carcinoma (40%) with HBME-1 being strongly positive for papillary thyroid carcinoma and its variants compared to other tumour sub-types, where it shows diffuse and focal expression.</p><p><strong>Conclusion: </strong>HBME-1, due to its high sensitivity, can be significantly used as a marker for identification and differentiation, particularly papillary thyroid carcinoma. However, using a panel of markers comprising Galectin-3 and Ck-19 along with HBME-1 increases the accuracy and specificity for the correct diagnosis of thyroid neoplasms.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"629-632"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Vasopressin Stimulated Bilateral Inferior Petrosal Sinus Sampling in Corticotropin Dependent Cushing's Syndrome with Negative or Equivocal 3 Tesla Contrast Enhanced Magnetic Resonance Imaging of Pituitary.","authors":"Puneet Shivnani, Rajeev Kasliwal, Gourav Goyal, Jyoti Sharma, Utkarsh Balani, Pankaj Gupta, Bhawani S Sharma, Dinesh Yadav, Vineet Mishra, Surendra K Sharma","doi":"10.4103/ijem.ijem_60_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_60_24","url":null,"abstract":"<p><strong>Introduction: </strong>Corticotropin releasing hormone (CRH)-stimulated bilateral inferior petrosal sinus sampling (BIPSS) is the most accurate procedure in the differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) with a sensitivity of 88-100% and a specificity of 67-100%. However, CRH is not available globally currently. We undertook this study of BIPSS using lysine vasopressin (LVP) as an agent to stimulate the release of ACTH from corticotrophs. Our objective was to assess the accuracy of LVP-stimulated BIPSS in differentiating Cushing's disease (CD) from ectopic ACTH syndrome (EAS) with negative or equivocal 3T contrast-enhanced MRI (CEMRI).</p><p><strong>Methods: </strong>Seventeen patients with clinically and biochemically confirmed ACTH-dependent CS with equivocal or negative CEMRI pituitary underwent BIPSS using LVP as a stimulating agent.</p><p><strong>Results: </strong>Of seventeen patients who underwent BIPSS, nine patients had a raised central-to-peripheral ACTH ratio and were classified as having CD that was confirmed on histopathology following transsphenoidal sinus surgery. Remaining eight patients, who did not show a raised central-to-peripheral ACTH ratio, were classified to have EAS. All patients with EAS underwent contrast-enhanced computerised tomography of the neck, chest, and abdomen and/or Gallium 68 DOTANOC positron emission tomography/computerised tomography. Seven out of eight patients demonstrated solitary pulmonary nodule in the lung (bronchial carcinoid), and one patient had a mass in the thymus (thymic carcinoid).</p><p><strong>Conclusion: </strong>BIPSS using LVP confirmed the source of ACTH excess correctly in all the patients with ACTH-dependent CS without the loss of specificity.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"589-595"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Artificial Intelligence in Diabetes Mellitus Care: A SWOT Analysis.","authors":"Priya Kataria, Srivenkata Madhu, Madhu K Upadhyay","doi":"10.4103/ijem.ijem_183_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_183_24","url":null,"abstract":"<p><p>Diabetes mellitus has become one of the major public health problems in India. Chronic nature and the rising epidemic of diabetes have adverse consequences on India's economy and health status. Recently, machine learning (ML) methods are becoming popular in the healthcare sector. Human medicine is a complex field, and it cannot be solely handled by algorithms, especially diabetes, which is a lifelong multisystem disorder. But ML methods have certain attributes which can make a physician's job easier and can also be helpful in health system management. This article covers multiple dimensions of using artificial intelligence (AI) for diabetes care under the headings Strengths, Weaknesses, Opportunities, and Threats (SWOT), specifically for the Indian healthcare system with a few examples of the latest studies in India. We briefly discuss the scope of using AI for diabetes care in rural India, followed by recommendations. Identifying the potential and challenges with respect to AI use in diabetes care is a fundamental step to improve the management of disease with best possible use of technology.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"562-568"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Calcium Intake and Association with Serum Calcium in Healthy Urban North Indian Adults: The Calcium-Chandigarh Urban Bone Epidemiological Study.","authors":"Rimesh Pal, Sanjay K Bhadada, Anshita Aggarwal, Amanpreet Kaur","doi":"10.4103/ijem.ijem_184_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_184_24","url":null,"abstract":"<p><strong>Introduction: </strong>Data on dietary calcium intake (DCI) from healthy North Indian adults are limited. Hence, the present study aims to assess DCI in healthy community-dwelling adults residing in an affluent North Indian city and correlate with serum biochemical parameters.</p><p><strong>Methods: </strong>Healthy men and women were recruited from the community by door-to-door surveys. Serum total calcium, phosphate, 25-hydroxyvitamin D, and iPTH were estimated. DCI was assessed by recalling the diet consumed in the previous 7 days.</p><p><strong>Results: </strong>A total of 291 participants were included (mean age = 39.4 ± 12.9 years). The mean (± standard deviation) and median (inter-quartile range) DCI were 392.6 ± 169.1 mg/day and 391 (274-518) mg/day, respectively. DCI was higher in men compared with women. Only 21.3% of participants had DCI more than RDA (600 mg/day). Serum calcium was found to be significantly higher across each quartile of DCI. On multiple linear regression analysis, DCI emerged as an independent positive predictor of serum total calcium.</p><p><strong>Conclusion: </strong>DCI is low in urban Indians. Promotion of consumption of dairy products and fortification of commonly consumed foods with calcium is needed.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"596-600"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Labyrinth of Gender Incongruence in Conservative Societies: A Call for Compassion and Understanding.","authors":"Hiya Boro","doi":"10.4103/ijem.ijem_223_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_223_24","url":null,"abstract":"<p><p>In the conservative heartland of Haryana, India, a poignant encounter in a hospital chamber revealed the raw, often overlooked struggles of gender incongruence. A young woman, presenting in masculine attire and identifying herself with the pronouns 'he' and 'him', sought not only medical assistance for transition to male but also the validation of his identity amidst a backdrop of societal prejudice. This case underscores the complexities faced by individuals with gender incongruence in a society resistant to non-binary identities. The narrative illustrates the profound impact of societal norms on personal identity and highlights the urgent need for comprehensive support systems. It calls for a multifaceted approach encompassing medical, psychological, and social support, advocating for education and empathy to dismantle ignorance and foster acceptance. By embracing diversity and advocating for transgender rights, healthcare professionals and society can facilitate the journey toward self-acceptance and dignity for individuals struggling with gender incongruence. The resilience and courage of this young patient serve as a powerful testament to the human spirit's quest for authenticity, urging a compassionate and inclusive societal transformation.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"579-580"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Epigenetics on the Pathophysiology of Type 2 Diabetes and Associated Nephropathic Complications.","authors":"Amit Mukherjee, Tanusree Debbarman, Basu D Banerjee, Sheelu S Siddiqi","doi":"10.4103/ijem.ijem_43_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_43_24","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) is a long-term metabolic condition that presents considerable health challenges globally. As the disease progresses, the interplay between genetic, environmental, and lifestyle factors becomes increasingly evident, leading to complications. Epigenetics has emerged as a critical area of research, providing insights into how these factors can modify the expression and cellular behavior without altering the underlying DNA sequence. Various epigenetic mechanisms, including DNA methylation, histone modifications, chromatin remodeling, and non-coding RNA regulation, drive cell dysfunction, inflammation, and fibrosis, aggravating diabetes and its complications. Amongst all the complications diabetic kidney disease (DKD) also known as diabetic nephropathy (DN), is a significant microvascular complication often regarded as a silent killer, as early diagnosis remains highly complicated. This review investigates various epigenetic modifications associated with T2D and DKD, employing a database search strategy incorporating the PICO framework method to ensure comprehensive coverage of relevant literature. Advancements in epigenome profiling provide valuable insights into the functional outcomes and chromatin states of cells impacted by T2D. Understanding epigenetics thus emphasizes its crucial role in the development and progression of T2D and transition to DKD, while also highlighting the potential reversibility of epigenetic modifications and potency as a biomarker for predicting DKD. More extensive research is needed to identify specific epigenetic mechanisms involved in DKD to further refine predictive models and therapeutic strategies. This unified exploration of significant epigenetic modifications offers a focused analysis of how these alterations influence the trajectory of disease and presents new avenues for therapeutic intervention.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"569-578"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients.","authors":"Vijay S R Danda, Chandrashekhar Bhandiwad, Sharmila Palle, Srinivas R Paidipally, Vivek Kyatham","doi":"10.4103/ijem.ijem_103_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_103_24","url":null,"abstract":"<p><strong>Introduction: </strong>Conflicting research on cortisol levels and COVID-19 mortality prompted this study to comprehensively assess glucocorticoid status, its links to severity and outcomes, and the role of Acton prolongatum-stimulated cortisol.</p><p><strong>Methods: </strong>This is a prospective observational study, conducted in 100 RT-PCR-positive COVID-19 patients of mild, moderate, and severe grades from June 2021 to May 2023. Random cortisol, plasma ACTH, and action prolongatum stimulated cortisol were measured, categorized, and analyzed.</p><p><strong>Results: </strong>Among 100 patients, 25 had severe disease, 35 had moderate disease, and 40 had mild disease. In the same study group, 88 recovered and 12 expired from the COVID-19-related cause. The median random basal serum cortisol level (median (IQR): 10.2 (8) vs. 11.6 (9.7) vs. 16.2 (9.5) mcg/dl; <i>P</i> value 0.06), median delta value (median (IQR): 6.3 (5.8) vs. 7.6 (4.8) vs. 10.9 (5.6) mcg/dl; <i>P</i> value < 0.001), and median plasma ACTH (median (IQR): 13 (14.7) vs. 14.4 (14.1) vs. 22.3 (13) pg/ml; <i>P</i> value = 0.002) were lower in severe group subjects than in the moderate and mild group. When patients were labeled as adrenal insufficiency based on random basal serum cortisol < 10 mcg/dl or delta value < 9 mcg/dl, 48% of patients had adrenal insufficiency. There was a linear correlation between random basal and ACTH-stimulated cortisol (<i>r</i> = 0.908, <i>P</i> value < 0.001).</p><p><strong>Conclusion: </strong>The study highlights the significance of adrenal function in COVID-19 prognosis and suggests for routine random cortisol and ACTH assessments for glucocorticoid evaluation.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"633-638"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Performance of the American Thyroid Association (ATA) and American College of Radiology (ACR-TIRAD) Thyroid Nodule Risk-Stratification Systems in Determining High-Risk Nodules, and the Correlation of Site, Size, and Autoimmunity with High-Risk Features.","authors":"Ibrahim H Hussein, Mahmood T Altemimi, Haider A Alidrisi, Ammar M Saeed Almomin, Nassar T Alibrahim, Muqdam A Hamza, Husam J Imran, Ibrahim A Zaboon, Ali H Alhamza, Hussein A Nwayyir, Abbas A Mansour","doi":"10.4103/ijem.ijem_154_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_154_23","url":null,"abstract":"<p><strong>Introduction: </strong>Neck ultrasonography (US) and fine-needle aspiration (FNA) biopsy are usually used to evaluate thyroid nodules. This study aimed to evaluate the performance of two popular thyroid imaging reporting systems in detecting thyroid malignancy and to evaluate the correlation between thyroid autoimmunity, nodule site, and size in the development of malignancy.</p><p><strong>Methods: </strong>This prospective study was conducted from January 2019 to July 2021 in Basrah, Iraq. The American Thyroid Association (ATA) and American College of Radiology-Thyroid Imaging Reporting and Data (ACR-TIRAD) systems were used to evaluate the malignant potential of 143 thyroid nodules in 131 patients.</p><p><strong>Results: </strong>The sensitivity and positive predictive value (PPV) of the ATA system for detecting malignancy were 96% and 20.8% for low-risk and 100% and 4.3% for high-risk nodules, respectively. ACR-TIRAD sensitivity and PPV were 84% and 22.1% for low-risk and 80% and 4.2% for high-risk nodules, respectively. The specificity and negative predictive value (NPV) of the ATA system for detecting malignancy were 11.6% and 92.3% for low-risk and 10.5% and 100% for high-risk nodules, respectively. The ACR-TIRAD specificity and NPV were 28% and 87.8% for low-risk and 26% and 96.9% for high-risk nodules, respectively. The strength of the correlation between FNA performed across different Bethesda categories and age, sex, nodule size, and positive thyroid peroxidase (TPO) antibodies were 0.25, 0.01, 0.22, and 0.4, respectively.</p><p><strong>Conclusion: </strong>Both systems are effective; however, adopting TI-RADS stratification results in fewer biopsies being performed for thyroid nodule assessment. Only sex was found to be significantly correlated with FNA performance in thyroid-nodule evaluation.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"622-628"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"QRISK 3^® and ASCVD Risk Calculator in Patients with Diabetes and Their Correlation with Coronary Artery Calcium Scores.","authors":"Subramanian Kannan, Murali M B Venkataraman, Salila S Chandorkar","doi":"10.4103/ijem.ijem_27_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_27_24","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is an independent risk factor for asymptomatic cardiovascular disease (CVD). The QRISK 3^® score and atherosclerotic cardiovascular disease (ASCVD) risk scores determine the risk of developing CVD over 10 years. The CT coronary artery calcium score (CACS) is a non-invasive imaging modality that identifies sub-clinical atherosclerosis. We studied the correlation between the QRISK 3^® and ASCVD scores and the CACS and determined the cut-off for QRISK 3^® and ASCVD scores that corresponded to a moderate or accentuated CACS (≥100).</p><p><strong>Methods: </strong>In this prospective study, outpatients with diabetes and no prior coronary artery disease (CAD) or their equivalents, or having symptoms suggestive of angina or heart failure, had their QRISK 3^® and ASCVD scores calculated. They subsequently underwent 256 slice cardiac CT, and CACS was calculated by the Agatston method.</p><p><strong>Results: </strong>A statistically significant correlation (r = 0.28) was found between QRISK 3^® and ASCVD with CACS (<i>P</i> = 0.004 and <i>P</i> = 0.007, respectively). A QRISK^® score >23 and ASCVD score >10 predicted a CACS score >100 with sensitivities of 85% and 90%, respectively.</p><p><strong>Conclusion: </strong>The QRISK 3^® and ASCVD scores can be used to triage patients who require further evaluation with CACS to determine the risk of future CVD.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"639-644"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Millets Mitigate Diabetes?","authors":"Nishant Raizada, S V Madhu","doi":"10.4103/ijem.ijem_514_24","DOIUrl":"https://doi.org/10.4103/ijem.ijem_514_24","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 6","pages":"551-553"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}