Indian Journal of Endocrinology and Metabolism最新文献

{"title":"Retraction: Prevalence of Testosterone Deficiency in Elderly Male and its Association with Frailty and Mobility at a Tertiary Care Centre.","authors":"","doi":"10.4103/ijem.ijem_305_24","DOIUrl":"10.4103/ijem.ijem_305_24","url":null,"abstract":"<p><p>[This retracts the article on p. 589 in vol. 26.].</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 5","pages":"550"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828371","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":"Higher Body Mass Index is Associated with Increased Oxidative Stress in Patients of Type 2 Diabetes Mellitus.","authors":"Edelbert A Almeida, Mohit Mehndiratta, Sri V Madhu, Rajarshi Kar","doi":"10.4103/ijem.ijem_474_23","DOIUrl":"10.4103/ijem.ijem_474_23","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) is closely associated with the obesity; however, certain proportion of T2DM patients is non-obese or lean (BMI < 18.5 kg/m²). Obesity has long been associated with oxidative stress; however, there are no studies available documenting levels of oxidative stress in the lean patients of T2DM. Therefore, this study was done to compare the levels of makers of oxidative stress (TL, mtDNA, TAS) and their regulators (mRNA expression of <i>TERT, Nrf2</i> and <i>Nqo1</i>) in lean and obese patients of T2DM.</p><p><strong>Methods: </strong>60 newly diagnosed patients (treatment naïve) of T2DM were recruited and divided into lean (BMI < 18.5 kg/m²) and obese (BMI > 25 kg/m²) groups. Relative telomere length (T/S) and mtDNA content were estimated via real-time PCR. Serum total antioxidant status (TAS) was measured using a commercially available kit. mRNA expression of <i>TERT, Nrf2</i> and <i>Nqo1</i> was measured by real-time PCR.</p><p><strong>Results: </strong>Mean T/S and mtDNA content were lower in the obese group compared to the lean group (<i>P</i> = 0.16 and <i>P</i> = 0.06, respectively). Mean serum TAS levels were higher in obese group compared to the lean group (<i>P</i> = 0.001). mRNA expression of <i>TERT</i> and <i>Nrf2</i> was increased in obese group compared to the lean group. mRNA expression of <i>Nqo1</i> was similar in both the groups.</p><p><strong>Conclusion: </strong>Obese patients of T2DM are exposed to a greater degree of OS compared to the lean patients of T2DM.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 5","pages":"517-521"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828307","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 Growth Hormone Therapy in Metabolic-Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis.","authors":"Deep Dutta, Lakshmi Nagendra, Ritin Mohindra, Saptarshi Bhattacharya, Ameya Joshi, Abm Kamrul-Hasan","doi":"10.4103/ijem.ijem_488_23","DOIUrl":"10.4103/ijem.ijem_488_23","url":null,"abstract":"<p><p>Multiple observation studies and meta-analysis have linked growth hormone (GH) deficiency with metabolic-dysfunction-associated steatotic liver disease (MASLD). No meta-analysis has analysed the efficacy and safety of GH therapy on different aspects of MASLD. We undertook this meta-analysis to address this gap in knowledge. Electronic databases were searched for RCTs involving patients with MASLD receiving GH therapy. Primary outcome was to evaluate changes in radiologic measures of MASLD (magnetic resonance spectroscopy (MRS) and ultrasonography) and liver enzymes. Secondary outcomes were to evaluate alterations in body composition parameters [dual-energy X-ray absorptiometry (DXA)], lipids, glycaemia and side effects. From initially searched 1047 articles, data from three RCTs (120 patients) which fulfilled all criteria were analysed. After 6 months of GH therapy in MASLD, the per cent reduction in intrahepatic lipid (MRS) was significantly higher with GH as compared to placebo [MD -5.85% (95%CI:-11.41- -0.30); <i>P</i> = 0.04; I² = 63%]. Visceral adipose tissue (VAT) area reduction (DXA) was significantly higher with GH [MD-9.94 cm² (95%CI:-19.04- -0.84); <i>P</i> = 0.03; I² = 0%]. Serum insulin-like growth factor-1 (IGF-1) was significantly raised in MASLD patients receiving GH as compared to placebo [MD +166.86 ng/ml (95%CI: 79.19-254.53); <i>P</i> < 0.0.001; I² = 90%]. High-sensitivity C-reactive protein (hsCRP) was significantly lower in patients receiving GH [MD -0.89 mg/L (95%CI:-1.40--0.38); <i>P</i> = 0.0.0006; I² = 0%]. Patients receiving GH had similar changes in triglycerides [MD-1.06 mg/L (95%CI:-20.45-18.34); <i>P</i> = 0.91; I² = 15%] and fasting glucose [MD -0.56 mg/L (95%CI:-4.67-3.55); <i>P</i> = 0.79; I² = 39%]. Gamma-glutamyl transpeptidase was significantly lower in patients receiving GH [MD -7.86 U/L (95%CI:-12.46--3.27); <i>P</i> = 0.0008; I² = 0%]. No increase in new-onset hypothyroidism was noted [OR 5.49 (95%CI: 0.25-121.18); <i>P</i> = 0.28]. Short-term 6-month GH therapy in MASLD is associated with a significant reduction in intrahepatic lipid content, visceral adiposity, GGT and hsCRP without any increased occurrence of dysglycaemia or hypothyroidism.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"336-342"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380734","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":"Prevalence and Clinical Course of Water and Electrolyte Disturbances Following Transsphenoidal Pituitary Adenoma Surgery in Immediate and Early Postoperative Period: A Prospective Observational Study.","authors":"Shivendu Bhardwaj, Awadhesh K Jaiswal, Subhash C Yadav, Devendra Gupta, Rajanikant Yadav, Alok P Singh, Eesh Bhatia","doi":"10.4103/ijem.ijem_79_24","DOIUrl":"10.4103/ijem.ijem_79_24","url":null,"abstract":"<p><strong>Introduction: </strong>Transsphenoidal pituitary adenoma surgery (TSS) was commonly associated with water and electrolyte disturbances (WEDs) in the postoperative period, which could lead to prolonged hospital stay, readmission and is rarely life threatening. The present study aimed to investigate the prevalence and predictive factors of WEDs following TSS.</p><p><strong>Methods: </strong>Fifty-eight patients with pituitary adenoma were prospectively studied for the occurrence of WEDs. Patients were checked at 6 weeks postoperatively for persistence of diabetes insipidus and new-onset hormone deficiencies or recovery. Multivariate regression was applied to determine predictive factors for the occurrence of WEDs.</p><p><strong>Results: </strong>A total of 58 patients underwent TSS (median age: 43 years, 66% male). In the immediate postoperative period, 16 (27.6%) had transient diabetes insipidus (DI), two (3%) had transient DI followed by syndrome of inappropriate antidiuretic hormone (SIADH), five (8.6%) had isolated SIADH, five (8.6%) had persistent DI and only one patient had a triple-phase response. At 6 weeks, five (11%) patients continued to have persistent DI. In multivariate analysis, apoplexy and duration of surgery were predictive of DI occurrence. Recovery rate at 6 weeks was 11.1%, 13% and 9.3% for cortisol, thyroid and gonad axis, respectively. New-onset hormone deficiencies at 6 weeks were 5.6%, 5.6% and 7.4% for cortisol, thyroid and gonad axis, respectively.</p><p><strong>Conclusions: </strong>WEDs remain an important concern post-TSS. Timely follow-up should always be integral part of postoperative care for early diagnosis of new hormone deficiencies and avoiding unnecessary treatment in those with recovered axis.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"370-377"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380733","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":"Efficacy and Safety of Levoketoconazole in Managing Cushing's Syndrome: A Systematic Review.","authors":"Shinjan Patra, Deep Dutta, Lakshmi Nagendra, Nishant Raizada","doi":"10.4103/ijem.ijem_477_23","DOIUrl":"10.4103/ijem.ijem_477_23","url":null,"abstract":"<p><p>No systematic review has holistically analysed the efficacy and safety of levoketoconazole, a novel purified 2S,4R enantiomer of ketoconazole, believed to be 15- to 25-fold more potent than ketoconazole for managing Cushing's syndrome (CS). We undertook this meta-analysis to address this knowledge gap. Electronic databases were searched for studies involving patients with CS receiving levoketoconazole in the intervention arm. The primary outcome was to evaluate changes in mean 24-hour urine-free cortisol (mUFC) levels. Secondary outcomes were to evaluate alterations in cortisol and adverse events. SONICS study showed that normalisation of mUFC was seen in 61%, 55%, and 41% of the patients at the end of 6, 9, and 12 months therapy, respectively. The LOGICs study showed that withdrawal of levoketoconazole was associated with a significant increase in mUFC from 81.3 ± 35.7 to 220.8 ± 333.5 nmol/24h. The late-night salivary-cortisol (LNSC) increase during the drug withdrawal phase was 2.6 nmol/L in the placebo group (PG) compared to 2.2 nmol/L in the levoketoconazole group (LG) (<i>P</i> < 0.05). Re-initiation of levoketoconazole in original LG was associated with a decrease in mUFC from 224.3 ± 341.3 to 135.6 ± 87.3 nmol/24h. Initiation of levoketoconazole in the original PG was associated with a decrease in mUFC from 537.9 ± 346.0 to 141.3 ± 130.3 nmol/24h. Normalisation of mUFC was observed in 50.0% patients in LG compared to 4.5% in the placebo group. The median time for the response was 25 days. The median time to loss of therapeutic response was significantly shorter for PG (24 days) compared to LG (62 days) (<i>P</i> < 0.0001). Levoketoconazole has good efficacy and safety in CS. Bigger and longer studies are warranted to establish its superiority over ketoconazole.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"343-349"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383300","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":"A Man with Klinefelter's Syndrome having Normal Stature.","authors":"Mohammad M Shahid, Sharmin Ferdousi","doi":"10.4103/ijem.ijem_33_23","DOIUrl":"10.4103/ijem.ijem_33_23","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"429-431"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380729","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":"Diet in Thyroid Disorders: A Survey among Clinicians and a Review of the Current Perspective.","authors":"Awadhesh Kumar Singh, Subhankar Chatterjee, Akriti Singh, Rana Bhattacharjee","doi":"10.4103/ijem.ijem_68_24","DOIUrl":"10.4103/ijem.ijem_68_24","url":null,"abstract":"<p><p>Physicians and endocrinologists commonly face various questions related to dietary interventions during clinical encounters with their patients with thyroid disorders. Indeed, both patients and treating physicians have various misconceptions regarding thyroid-specific diets, possibly because of misinformation circulated in lay media or grey literature and the misinterpretation of contradictory scientific data, respectively. In this review, we attempted to answer some frequently asked questions by the patients in the backdrop of contraindicatory perceptions of physicians observed in our survey. Additionally, we tried to put a perspective on dietary factors related to thyroid disorders through the available scientific evidence to help make an informed decision-making.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"378-384"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380731","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":"Variability in Sex Assignment at Birth and Etiological Diagnosis of Differences of Sex Development: A Ten-Year Institutional Experience from Assam.","authors":"Praveen Nagarajaiah, Ashok K Bhuyan, Abhamoni Baro, Uma K Saikia","doi":"10.4103/ijem.ijem_385_23","DOIUrl":"10.4103/ijem.ijem_385_23","url":null,"abstract":"<p><strong>Introduction: </strong>Differences of sex development (DSD) also known as disorders of sex development encompass a wide spectrum of conditions with varying clinical presentations across different age groups. This study aims to analyse various aetiologies of DSD in Assam and the variability of sex assignment at birth.</p><p><strong>Methods: </strong>This retrospective study included the records of people with DSD presenting to a tertiary centre over 10 years. The age at presentation, sex assignment, gender identity, degree of ambiguity, pertinent hormonal and radiological investigations were noted. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>The age of presentation varied widely, with peaks during infancy and puberty. The most prevalent DSD type was 46, XY DSD (61.2%), followed by 46, XX DSD (19.7%) and sex chromosome DSD (19.1%). Among people with 46, XY DSD, androgen biosynthesis disorders were dominant, particularly 5-a reductase 2 deficiency (46.7%). Among 46, XX DSDs, the most common subtype was androgen excess disorders (51.7%) comprising 21a-hydroxylase deficiency (48,3%) and 11β-hydroxylase deficiency (3.4%). Turner syndrome was most prevalent among sex chromosome DSD (71.4%) with others being Klinefelter syndrome, 45, XO/46, XY mixed gonadal dysgenesis and 46, XX/46, XY chimerism. The degree of ambiguity was variable depending on the type of DSD and similarly, sex assignment at birth was influenced by the level of ambiguity.</p><p><strong>Conclusion: </strong>The study underscores the significance of comprehensive approaches for DSD diagnosis and management, especially in regions with limited resources. The insights gained from this clinical study offer valuable understanding and aid in addressing the complexities associated with these conditions.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"417-423"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380737","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 Glucocorticoid Taper: A Primer for the Clinicians.","authors":"Gagan Priya, Bashir A Laway, Mythili Ayyagari, Milinda Gupta, Ganesh H K Bhat, Deep Dutta","doi":"10.4103/ijem.ijem_410_23","DOIUrl":"10.4103/ijem.ijem_410_23","url":null,"abstract":"<p><p>Glucocorticoid (GC) therapy can ameliorate debilitating and life-threatening symptoms in several inflammatory/immunological disorders. However, it can also cause significant side effects, especially with higher doses and longer duration of use. Therefore, GCs should be used at the lowest effective dose for the shortest possible time to minimise adverse effects. GC therapy may cause suppression of the endogenous hypothalamic-pituitary-adrenal (HPA) axis and abrupt discontinuation predisposes patients to features of GC-induced adrenal insufficiency. The practice of tapering GC therapy allows for recovery of the HPA axis while minimising the risk of a disease flare-up or symptoms of AI. Moderate-to-high dose GC therapy may be tapered rapidly to near-physiological doses while watching for features of disease reactivation. Once close to the physiological dose, tapering is slower and at longer intervals to allow for recovery of the HPA axis. It is important to use short- or intermediate-acting GC preparations such as hydrocortisone or prednisolone in physiological doses, administered in the morning to mimic the endogenous cortisol rhythm. A general principle to follow is that HPA axis recovery takes longer if the period of suppression has been long. In such cases, tapering should be slower over a few months to even a year. In select cases at high risk of AI or if symptoms appear during tapering, the decision to further taper and discontinue steroids may be based on testing of HPA axis function using basal and/or stimulated serum cortisol. All patients on exogenous steroids should be advised about the need for an appropriate increase in GC doses during acute medical or surgical illness and should carry a steroid alert card to avoid adrenal crisis.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"350-362"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380735","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":"A Comparative Study of Bone-Health and Associated Factors in Healthy Indian Adolescents and Young Women.","authors":"Neha A Kajale, Chirantap Oza, Dipali Ladkat, Ketan Gondhalekar, Tarun R Katapally, Jasmin Bhawra, Nina Mansukhani, Anita Bapat, Vaman Khadilkar, Anuradha Khadilkar","doi":"10.4103/ijem.ijem_424_23","DOIUrl":"10.4103/ijem.ijem_424_23","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health.</p><p><strong>Methods: </strong>This cross-sectional case-control study was performed on 110 apparently healthy unmarried, nonpregnant, nonlactating, postmenarchal adolescent girls and young women aged 11 to 24 years residing in urban slums with the same number of age-matched controls from NS areas. Anthropometric, dietary, physical-activity and bone-health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography-DXA and pQCT-respectively) were evaluated using standard protocols. A <i>P</i> value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Slum girls were significantly shorter and lighter and had lower dietary intakes of calcium and protein after adjusting for total daily calorie intake than NS girls (<i>P</i> < 0.05). Areal bone-mineral density (BMD) at lumber spine (0.940 ± 0.13 vs1.042 ± 0.15 g/cm²), femur and total body (less-head), bone-mineral apparent density adjusted for volume at the lumbar spine (0.295 ± 0.04 vs 0.319 ± 0.04 g/cm³) and height-adjusted bone density at femur (0.862 ± 0.011 vs 0.905 ± 0.011 g/cm²) were significantly lower in slum dwelling participants as compared to their NS counterparts (<i>P</i> < 0.05). After adjusting for confounders like sunlight exposure, anthropometric parameters and dietary calcium intake, area of dwelling was still a significant factor for the difference in BMD.</p><p><strong>Conclusions: </strong>The potential determinants of poor bone density and geometry in girls and young women residing in slums include residential location, dietary habits, and physical activity levels. Despite adjustments for confounding factors, differences in bone health between those in slum and nonslum areas suggest adaptations developed over generations of deprivation in these individuals, necessitating urgent intervention.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"397-404"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380728","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}