Indian Journal of Endocrinology and Metabolism最新文献

{"title":"Prevalence and Determinants of Sexual Dysfunction among Clinically Diagnosed Diabetic Patients: A Mixed Method Study.","authors":"Nipin Kalal, Khina Sharma, Suresh K Sharma, Ashok Kumar, Priya Sharma, Ravindra Shukla, Ramswaroop Garwa","doi":"10.4103/ijem.ijem_682_25","DOIUrl":"10.4103/ijem.ijem_682_25","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual dysfunction (SD) is a neglected yet distressing complication of diabetes mellitus (DM), adversely affecting the physical as well as psychological well-being of patients. Despite its high prevalence globally, research exploring SD among both male and female diabetic patients remains limited, particularly in the Indian context, where cultural barriers hinder open discussions. This study was conducted to assess the prevalence and identify the determinants of sexual dysfunction among clinically diagnosed type 1 and type 2 DM patients.</p><p><strong>Methods: </strong>Using a sequential explanatory mixed-method design, this study was conducted in the tertiary care hospital of western Rajasthan between June 2022 and August 2023. Quantitative data were collected from 251 diabetic patients using Sexual Functioning Questionnaire. Binary logistic regression was used to identify predictors of sexual dysfunction. In the qualitative phase, thematic analysis was performed using Hycner's phenomenological framework.</p><p><strong>Results: </strong>The prevalence of global SD was 66.9%, with higher rates in males (80.1%) compared to females (47%). Dysfunction across individual domains desire, arousal, pleasure, and orgasm was notably high. Significant predictors included age (31-50 years), female gender, physical inactivity, and presence of depressive symptoms (<i>P</i><0.05). Qualitative data revealed four major themes: altered sexual functioning, physical fatigue, psychological distress, and barriers to help-seeking, reflecting the multifactorial nature of SD.</p><p><strong>Conclusion: </strong>SD is highly prevalent among diabetic individuals and is influenced by both clinical and psychosocial factors. Routine screening for sexual health concerns should be integrated into diabetes care, especially in culturally sensitive contexts, to promote holistic and patient-centered management.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"37-44"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591365","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":"Pulmonary Arterial Hypertension in Graves' Disease: Role of Thyroid Autoimmunity and NEDD9.","authors":"Pradosh K Sahu, Ravi K Padala, Deepak K Dash, Debasish Patro, Chhabi Satpathy, Bandana Dash","doi":"10.4103/ijem.ijem_747_25","DOIUrl":"10.4103/ijem.ijem_747_25","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary arterial hypertension (PAH) is an underrecognized cardiovascular complication of Graves' disease (GD). The role of thyroid autoimmunity and neural precursor-cell-expressed developmentally downregulated 9 (NEDD9), a profibrotic protein, in GD with PAH remains unclear. This study evaluated the prevalence, predictors of PAH, role of thyroid autoimmunity and NEDD9, and reversibility with carbimazole in newly diagnosed GD and PAH.</p><p><strong>Methods: </strong>This prospective observational study enrolled 90 newly diagnosed GD patients. PAH was defined as mean pulmonary artery pressure (mPAP) >20 mmHg and was assessed non-invasively by echocardiography. Serum FT3, FT4, TSH, and anti-thyroid peroxidase (anti-TPO) antibodies were measured using chemiluminescent immunoassay (CLIA), while TSH receptor antibodies (TRAb) and plasma NEDD9 were quantified by enzyme-linked immunosorbent assay (ELISA). Binary logistic regression identified independent predictors of PAH. Thyroid autoimmunity markers and NEDD9 were evaluated in relation to a ≥10 mmHg reduction in mPAP after carbimazole therapy.</p><p><strong>Results: </strong>Among 90 GD patients, PAH was observed in 39 (43.3%). On correlation analysis, only TRAb was positively correlated with mPAP. In binary logistic regression, TSH receptor antibody levels (OR: 1.093; 95% CI: 1.035-1.155; <i>P</i> = 0.002), anti-TPO antibody levels (OR: 1.003; 95% CI: 1.001-1.005; <i>P</i> = 0.001), and heart rate (OR: 1.164; 95% CI: 1.059-1.280; <i>P</i> = 0.002) were independent predictors of PAH. Delta change in TRAb levels was the only significant factor for predicting a ≥10 mmHg reduction in mPAP post-carbimazole therapy.</p><p><strong>Conclusion: </strong>Thyroid autoimmunity significantly contributes to PAH in GD, while NEDD9 showed no association.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"89-95"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591403","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 Association Between Type 2 Diabetes Mellitus and Frozen Shoulder: Expert Insights on Developing a Screening Tool.","authors":"Anirban Majumdar, Voleti S Nagesh, Rakesh K Sahay, Nilanjan Sengupta, Debmalya Sanyal, Griddaluru V Chanukya, Rana Bhattacharjee, Amit Goel, Raman Boddula, Sudhakar R Pendyala, Amitabh Sur","doi":"10.4103/ijem.ijem_48_25","DOIUrl":"10.4103/ijem.ijem_48_25","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is associated with various musculoskeletal disorders, including frozen shoulder (FS), a condition marked by pain and restricted movement. FS is more common in T2DM patients, with increased severity and longer recovery time. Chronic inflammation, collagen accumulation, and hyperglycemia-induced changes contribute to FS development in T2DM limiting daily activities and may hinder diabetes management by restricting self-care tasks. Early detection and timely intervention may improve outcomes and enhance quality of life. Existing shoulder assessment questionnaires are often lengthy, complex, and require physician intervention, limiting their use in routine practice. To address this, a concise, patient-administered screening questionnaire has been proposed for patients with T2DM. This six-question tool covers shoulder pain, movement limitations, and sleep disruption, thus potentially offering a quick, effective method for early FS screening in routine practice settings. Further validation in real-world settings will assess the clinical utility of this screening tool.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"20-25"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591763","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":"Evaluation of Serum Irisin Levels in Individuals with Gender Incongruence and Its Metabolic Correlations.","authors":"Pooja U Kamath, Umamaheswara R Golamari, Anjana S Nair, Pramila Kalra","doi":"10.4103/ijem.ijem_631_25","DOIUrl":"10.4103/ijem.ijem_631_25","url":null,"abstract":"<p><strong>Introduction: </strong>Irisin, a myokine implicated in energy homeostasis, has been proposed as a biomarker for metabolic dysfunction. This study aimed to assess serum irisin levels and their associations with metabolic parameters in gender-incongruent individuals compared to healthy cisgender controls and to assess the predictive value of irisin and related metabolic indices for metabolic syndrome (MetS) using both affirmed and birth-assigned gender criteria.</p><p><strong>Methods: </strong>A cross-sectional \"observational, non-randomised\" study was conducted from June 2024 to February 2025 among 123 participants (transgender women, transgender men, cisgender women and cisgender men), matched for age and body mass index. Individuals with confounding metabolic conditions were excluded. Serum irisin was measured using a sandwich enzyme-linked immunosorbent assay, and metabolic parameters were evaluated. Statistical analyses assessed the diagnostic utility of irisin and various metabolic indices for MetS.</p><p><strong>Results: </strong>In transgender women, serum irisin showed inverse correlation with diastolic blood pressure (<i>r</i> = -0.307, <i>P</i> = 0.036). In transgender men, it was inversely correlated with high-density lipoprotein (HDL) cholesterol (<i>r</i> = -0.339, <i>P</i> = 0.046) and prolactin (<i>r</i> = -0.357, <i>P</i> = 0.035). Receiver operating characteristic analysis revealed a limited predictive value of irisin for MetS (area under the curve (AUC) <0.5). The triglyceride (Ty)/HDL index performed better in transgender women (AUC = 0.748) and the triglyceride-glucose index (Ty/G index) in transgender men (AUC = 0.67).</p><p><strong>Conclusion: </strong>Serum irisin is associated with select metabolic parameters but has limited utility in predicting MetS in gender incongruent individuals. Affirmed gender-based assessment enhances risk stratification, with Ty/HDL and Ty/G indices offering better predictive value in transgender populations.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"64-70"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591940","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":"Approach to Renal Tubular Acidosis - A Review.","authors":"Sambit Das, Vishal Agarwal, Thomas V Paul, Kripa E Cherian","doi":"10.4103/ijem.ijem_774_25","DOIUrl":"10.4103/ijem.ijem_774_25","url":null,"abstract":"<p><p>Acid-base homeostasis is maintained by renal and respiratory systems. The inability of the renal tubules to excrete acids or retain bicarbonate in adequate amounts leads to renal tubular acidosis (RTA). These disorders are characterised by the presence of normal anion gap metabolic acidosis with hyperchloremia. Both distal RTA (type 1) and proximal RTA (type 2) can occur due to a primary/inherited defect in the renal tubule or may arise due to some secondary/acquired causes. Urinary acidification defect defines type 1 RTA, while type 2 RTA is characterised by defective bicarbonate handling in the proximal tubule. Type 3 RTA includes features of both type 1 and type 2 RTA, whereas type 4 RTA is characterised by the presence of hyperkalaemia with normal anion gap metabolic acidosis. In this review article, we describe the various types of RTA and its pathophysiology along with a systematic and practical approach to a suspected case of RTA and its management.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"26-36"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591831","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":"Sleep and Mental Health Disorders in Transgender Individuals on Gender-Affirming Hormone Therapy at a Tertiary Care Centre.","authors":"Bharathi Kolla, Pramila Kalra","doi":"10.4103/ijem.ijem_208_25","DOIUrl":"10.4103/ijem.ijem_208_25","url":null,"abstract":"<p><strong>Introduction: </strong>The transgender populations have a higher rate of sleep disorders, secondary to psychosocial stressors, anxiety, mood disturbances, and hormonal influences. The role of gender-affirming hormonal therapy (GAHT) on sleep has not yet been explored. The current study was done to estimate the burden of sleep disorders and mental health among the transgender population receiving GAHT.</p><p><strong>Methods: </strong>This was a single-centre cross-sectional study done in transgender individuals aged greater than 18 years at the Endocrinology department at a tertiary care centre. Demographic characteristics and response to various validated questionnaires like Pittsburgh sleep quality index (PSQI), Epworth sleepiness score, Berlin Sleep questionnaire, Hamilton anxiety rating scale, Hamilton depression rating scale, Montreal Cognitive Assessment, and Patient health questionnaire were analysed.</p><p><strong>Results: </strong>The total number of participants was 45; 26 were transgender women and 19 were transgender men. The mean score of the PSQI among transgender women was 8.88 ± 1.98, and that among the transgender men was 8.58 ± 1.00 indicating poor sleep quality. Depression was seen in 68.42% of transgender men and 53.48% transgender women. Around 10% among both the groups had severe depression. Among transgender women, 88.46% had mild anxiety, while 11.54% had mild to moderate anxiety. Among transgender men, 78.94% had mild anxiety, and 21.05% had mild to moderate anxiety.</p><p><strong>Conclusion: </strong>Sleep disorders are very common in transgender people on GAHT. Interventions should focus on a multidimensional approach, encompassing gender-affirming care, mental health support, and strategies for managing stress and discrimination.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"58-63"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591782","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":"Gender Disparities in the Care of Type 1 Diabetes Mellitus: Myth or Reality?","authors":"Hiya Boro","doi":"10.4103/ijem.ijem_89_25","DOIUrl":"10.4103/ijem.ijem_89_25","url":null,"abstract":"<p><p>Type 1 diabetes mellitus (T1DM) is a lifelong condition requiring intensive management; however, gender disparities persist in its care, particularly in conservative and resource-limited settings. This manuscript explores the impact of gender bias on the treatment and well-being of female patients with T1DM through three real-life case studies. The first case highlights the neglect of an eight-year-old girl with diabetic ketoacidosis (DKA), whose delayed treatment was influenced by gender-based devaluation. The second case emphasizes the emotional burden faced by a 16-year-old girl whose exemplary glycaemic control was overshadowed by concerns about marriageability. The third case illustrates the reproductive pressures imposed on a 32-year-old woman with T1DM, whose recurrent miscarriages were met with blame rather than medical support. These cases reveal systemic gender disparities in healthcare access, emotional support and societal attitudes toward women with T1DM. Addressing these challenges requires community education, integrated family counselling and multidisciplinary pre-conception care.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"107-110"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592012","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":"Assessment of Hypogonadism and Erectile Dysfunction in Males with Prediabetes: A Cross-Sectional Study from North India.","authors":"Harsheel Gupta, Ram Singh, Kamal Singh, Monica Gupta, Jasbinder Kaur, Mandeep Singla, Swati Garg","doi":"10.4103/ijem.ijem_842_25","DOIUrl":"10.4103/ijem.ijem_842_25","url":null,"abstract":"<p><strong>Introduction: </strong>Prediabetes is associated with sexual health complications, including erectile dysfunction (ED) and hypogonadism. This study aimed to evaluate the prevalence of low testosterone, hypogonadism, and ED in men with prediabetes. It also explored the correlation of hypogonadism with indices of metabolic syndrome (MetS).</p><p><strong>Methods: </strong>This cross-sectional investigation was undertaken at a public teaching institution in northern India. It sampled 103 males with prediabetes and 103 euglycemic controls aged between 18 and 50 years. The participants were assessed using the qADAM questionnaire, the IIEF-5 scale, and total testosterone levels. Analyses were conducted using standard statistical tests.</p><p><strong>Results: </strong>The mean age of participants in the prediabetes and euglycemic groups was comparable (35.28 ± 8.22 vs. 35.53 ± 8.69 years; <i>P</i> = 0.831). However, individuals with prediabetes exhibited significantly higher fasting blood glucose levels (100.57 mg/dL vs. 89.38 mg/dL; <i>P</i> = 0.001) and HbA1c values (6.02% vs. 5.13%; <i>P</i> = 0.001), along with a higher prevalence of MetS (32.0% vs. 13.6%; <i>P</i> = 0.002). Moreover, ED and hypogonadism were frequent among men with prediabetes compared with their normoglycemic counterparts (72.8% vs. 51.5%; <i>P</i> = 0.002 and 38.8% vs. 25.2%; <i>P</i> = 0.032, respectively). Additionally, 53.4% patients with prediabetes had low testosterone levels. (177.11 ± 150.62 ng/dl). Normogonadotropic hypogonadism was the most prevalent subtype.</p><p><strong>Conclusion: </strong>There is a substantial burden of hypogonadism and ED among young males with prediabetes, underscoring the importance of early detection and timely intervention to mitigate adverse outcomes.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"45-50"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591812","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":"Transgender Health: A Metabolic Wake-Up Call.","authors":"Sri Venkata Madhu, Nishant Raizada","doi":"10.4103/ijem.ijem_58_26","DOIUrl":"10.4103/ijem.ijem_58_26","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"1-3"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591780","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 of Metabolic Dysfunction Associated Steatotic Liver Disease in Craniopharyngioma Patients Using Non-Invasive Investigations.","authors":"Anurag A V Nitya, Jayaditya Ghosh, Sunil Taneja, Veenu Singla, Naveen Kalra, Pinaki Dutta","doi":"10.4103/ijem.ijem_821_25","DOIUrl":"10.4103/ijem.ijem_821_25","url":null,"abstract":"<p><strong>Introduction: </strong>Craniopharyngiomas are rare intracranial tumors that, despite being histologically benign, cause significant long-term morbidity due to hypothalamic and pituitary involvement. Survivors often develop hypothalamic obesity and metabolic syndrome components, predisposing them to metabolic dysfunction-associated steatotic liver disease (MASLD)-a newly defined entity emphasizing metabolic risk factors over alcohol exclusion. Data on MASLD in endocrine populations like craniopharyngioma survivors, especially in India, remain scarce.</p><p><strong>Methods: </strong>In this cross-sectional observational study, 48 adult craniopharyngioma survivors at a tertiary center in Northern India were evaluated using non-invasive tools for MASLD. MASLD was diagnosed in patients with hepatic steatosis (by USG or CAP ≥248 dB/m) and at least one cardiometabolic risk factor. Anthropometry, body fat analysis (via dual energy x-ray absorptiometry), liver ultrasound, FibroScan (CAP and LSM), and biochemical/metabolic markers including HOMA-IR, lipid profile, HbA1c, and FIB-4 were assessed. Hormonal profile was performed to identify pituitary deficiencies.</p><p><strong>Results: </strong>MASLD was present in 62.5% (USG) and 66.7% (CAP) of patients. Despite a mean BMI <25 kg/m² in most, 72.9% had elevated waist-hip ratio and 62.5% had body fat ≥30%, indicating significant central adiposity. MASLD was significantly associated with insulin resistance (<i>P</i> = 0.028), elevated HbA1c (<i>P</i> = 0.031), hypertriglyceridemia (<i>P</i> < 0.001), low HDL (<i>P</i> = 0.005), GH deficiency (<i>P</i> = 0.032), and low IGF-1. Advanced fibrosis (F3-F4) was noted in 6.3% by FibroScan.</p><p><strong>Conclusion: </strong>MASLD and visceral adiposity are highly prevalent in craniopharyngioma survivors, driven by hypothalamic-pituitary dysfunction. Routine metabolic and hepatic screening, beyond BMI, and optimized endocrine care are vital to prevent long-term morbidity in this vulnerable population.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 1","pages":"79-84"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591330","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}