International journal of MS care最新文献

{"title":"Current Practices, Challenges, and Future Directions in Multiple Sclerosis Management in Sub-Saharan Africa.","authors":"Nicholas Aderinto","doi":"10.7224/1537-2073.2024-080","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-080","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a chronic, inflammatory, and neurodegenerative condition characterized by the immune system's attack on the myelin sheath, leading to neurological dysfunction. While the prevalence of MS in Africa remains lower than in other regions, it has been rising steadily in recent years, with unique challenges hindering its effective management. These challenges include limited health care resources, inadequate diagnostic tools, financial constraints on accessing disease-modifying therapies, and a lack of trained health care professionals (HCPs). Cultural stigma surrounding MS further complicates patient care and treatment adherence. However, ongoing efforts by patient organizations, international collaborations, and local HCPs are focused on raising awareness, enhancing diagnosis and treatment access, and training HCPs. Future directions include integrating MS into national health policies, expanding education and research initiatives, and improving patient support networks. These efforts are vital in addressing the growing burden of MS in Africa and ensuring equitable access to care.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Theme","pages":"T13-T16"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001476","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":"Resilience Indirectly Affects Functional Capabilities Through Physical Activity Engagement in Individuals With Multiple Sclerosis.","authors":"Elizabeth S Gromisch, Aaron P Turner, Lindsay O Neto, Heather M DelMastro, Frederick W Foley","doi":"10.7224/1537-2073.2024-038","DOIUrl":"https://doi.org/10.7224/1537-2073.2024-038","url":null,"abstract":"<p><strong>Background: </strong>The role of resilience on functional outcomes in multiple sclerosis (MS) has been debated. One theorized pathway is that healthy lifestyle behaviors contribute to better functioning capabilities, which resilient individuals with MS tend to engage in more. This study aimed to explore whether resilience might influence functioning in individuals with MS indirectly through specific lifestyle behaviors.</p><p><strong>Methods: </strong>Participants (N = 64) were individuals with MS who completed measures assessing resilience (Multiple Sclerosis Resiliency Scale; MSRS), lifestyle behaviors (Simple Lifestyle Indicator Questionnaire and Alcohol Use Disorders Identification Test), and functional capabilities (PROMIS Physical Function-Short Form 20a; PROMIS-PF). Mediation models were constructed with the MSRS as the independent variable and significant individual lifestyle behaviors as the mediators, and PROMIS-PF as the dependent variable, with demographics and disease-related factors as covariates.</p><p><strong>Results: </strong>Physical activity was the only lifestyle behavior associated with functioning capabilities (ρ = 0.43, <i>P</i> < .001). Resilience had a significant indirect effect on functioning through physical activity (<i>b</i> = 0.16; 95% CI, 0.04-0.32). Its corresponding direct effect was not significant (<i>b</i> = -0.02, <i>P</i> = .860).</p><p><strong>Conclusions: </strong>These findings suggest that resilience indirectly influences functioning through engagement in physical activity. The results highlight the important role of resilience in promoting well-being among individuals with MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014407","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":"Developing and Piloting a Dedicated Support Group for Young Adults With Multiple Sclerosis.","authors":"Nora Sekella, Hannah Gilmore, Eileen French, Vanessa Zimmerman, Dina Jacobs, Sona Narula","doi":"10.7224/1537-2073.2023-071","DOIUrl":"https://doi.org/10.7224/1537-2073.2023-071","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic, unpredictable, and potentially highly debilitating neurological condition. It is often diagnosed in young adulthood but can start earlier in childhood and adolescence. When MS is diagnosed and treated in pediatric clinics, the level of support is often higher than in adult clinics. A dedicated young adult (YA) support group may help fill the gap that patients may experience when transitioning to adult care. This qualitative descriptive pilot study explores the feasibility and outcomes of a virtual support group for YAs with MS receiving care from an adult MS center.</p><p><strong>Methods: </strong>This purposive, convenience sample consisted of 8 participants between the ages of 18 and 25 years who met monthly for 6 virtual sessions. Participants completed a pregroup questionnaire with 6 open-ended questions, and the sessions were based on these results. The results of the pilot implementation were evaluated through postgroup questionnaires with 5 open-ended questions. The data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Several themes were identified from the pregroup questionnaires, including the transition from pediatric to adult care, support, coping skills, and the need for more information about MS. Themes from the postgroup questionnaire included suggestions for smooth transfer from pediatric to adult care, benefits of support and feeling less alone, coping strategies, and increased knowledge about MS.</p><p><strong>Conclusions: </strong>The results of this study suggest that a dedicated virtual support group may provide YAs with MS with psychosocial support and validation through shared experiences and knowledge about living with MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q2","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029902","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 Vaccine Literacy in People Affected by Multiple Sclerosis: A Cross-Sectional Study From Italy.","authors":"Francesco Pastore, Dania Comparcini, Giancarlo Cicolini, Chiara Esposto, Valentina Simonetti, Pietro Iaffaldano","doi":"10.7224/1537-2073.2024-061","DOIUrl":"10.7224/1537-2073.2024-061","url":null,"abstract":"<p><strong>Background: </strong>Vaccine literacy (VL) is an individual's ability to obtain, understand, and use information related to vaccines to make informed health decisions. This concept is strongly correlated with vaccine hesitancy, which is common among people with multiple sclerosis (MS). The study aims to assess VL in people with MS.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from April 2023 to September 2023 at the MS Policlinic of Bari. A structured questionnaire of 10 questions from the European Health Literacy Survey Consortium covered vaccination behavior, beliefs, trust, and perceived risks, and 4 questions from the Health Literacy Population Survey 2019-2021 Vaccine (HLS19-VAC) tool covered access, understanding, evaluation, and application of vaccination information.</p><p><strong>Results: </strong>There were 157 respondents (mean age, 34.77 years; 86.4% women; 90.4% with relapsing-remitting MS). Fewer than half (41.4%) had a high school diploma, 73.9% were employed, and 93% were satisfied with nursing care. The HLS19-VAC questionnaire results revealed high vaccination adherence (99%) but mixed beliefs about vaccine safety and efficacy. Trust in vaccines was generally high, though VL scores were lower. Significant correlations were found between VL and education level.</p><p><strong>Conclusions: </strong>Findings from this study reveal high vaccination adherence and trust among people with MS, but VL remains low, leading to misconceptions and hesitancy. Interventions tailored to age and education level offered by health care providers, especially MS nurses, are essential to improve VL and reduce vaccine hesitancy.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763714","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":"Proteomic Biomarker Panel for Gauging Multiple Sclerosis Disease Activity: A Case Series From Real-World Use.","authors":"Taylor Gonyou, Patricia Izbicki, Jim Eubanks, Ferhan Qureshi, William Boudouris, Martin Belkin, Sonda Rossman, Yang Mao-Draayer","doi":"10.7224/1537-2073.2023-094","DOIUrl":"10.7224/1537-2073.2023-094","url":null,"abstract":"<p><strong>Background: </strong>Advances in serum proteomics have provided more precise tools for the characterization of multiple sclerosis (MS) and enabled enhanced clinical management of the disease. The multivariate proteomic Multiple Sclerosis Disease Activity (MSDA) test has been analytically and clinically validated.</p><p><strong>Methods: </strong>This is a single-center retrospective case series. Four women with MS were monitored between 2022 and 2023 with up to 2 MSDA time points. Their full clinical histories and exams, along with treatment and MRI changes, were collected with the MSDA tests.</p><p><strong>Results: </strong>Patients' baseline and follow-up MSDA scores were consistent with disease activity, treatment response, and disease stability.</p><p><strong>Conclusions: </strong>We provide a real-world case series to show that MSDA could help to determine MS disease activity at baseline and throughout the disease course. MSDA could help to differentiate clinically stable vs active patients to monitor DMT treatment response.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709762","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":"Physical Activity Together for MS: Quality Participation Experiences of People With Multiple Sclerosis and Their Caregivers in a Dyadic Physical Activity Intervention.","authors":"Afolasade Fakolade, Miles Lambert, Mariah Keeling, Katherine Cardwell, Emily Broitman, Mark Freedman, Marcia L Finlayson, Amy Latimer-Cheung, Lara A Pilutti","doi":"10.7224/1537-2073.2023-105","DOIUrl":"10.7224/1537-2073.2023-105","url":null,"abstract":"<p><strong>Background: </strong>Despite unequivocal evidence for the benefits of regular physical activity (PA), many people with multiple sclerosis (MS) and their family caregivers find it challenging to fully participate to the same extent as the general population. Achieving full participation in PA requires addressing both quantity and quality of participation. Although elements fostering quality participation (QP) in people with disabilities are increasingly recognized, our knowledge of how QP is experienced and fostered in dyadic PA interventions targeting MS dyads is limited. Therefore, we aimed to explore QP experiences of MS dyads during a 12-week, group-based, dyadic, behavioral PA intervention to inform future efforts to optimize full participation in PA in these groups.</p><p><strong>Methods: </strong>We conducted semistructured interviews with 6 participants who completed the dyadic intervention. Data were inductively analyzed using thematic analysis and deductively mapped to the Quality Parasport Participation Framework.</p><p><strong>Results: </strong>We identified 6 themes mapped to the 6 building blocks (autonomy, belonging, challenge, engagement, mastery, and meaning) of quality participation that provide insights into how people with MS and their caregivers experienced QP in the intervention. Additionally, various intervention characteristics that fostered QP experiences were identified, including the dyadic approach, program duration, financial incentivization, individualized tailoring of program components, group composition and dynamics, facilitator knowledge and expertise related to MS and caregiving, and the opportunity for participants to apply the knowledge gained in the group sessions.</p><p><strong>Conclusions: </strong>Our findings outline QP considerations for researchers and interventionists designing dyadic PA programs in MS, offering insights that can inform the development of such programs to support full participation for both people with MS and their caregivers.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"82-89"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669717","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":"Final COVID-19 Vaccination Status, Attitude, and Adverse Events Among People With Multiple Sclerosis: A Cross-Sectional Study From Egypt.","authors":"Eman Hamdy, Eman Hamdy Darweesh, Abdallah Dabbas, Sonia El-Bahrawy","doi":"10.7224/1537-2073.2024-057","DOIUrl":"10.7224/1537-2073.2024-057","url":null,"abstract":"<p><strong>Background: </strong>Until the World Health Organization declared an end to COVID-19 as a global health emergency worldwide in 2023, people with multiple sclerosis (MS) were hesitant to get the COVID-19 vaccine. This study aimed to assess the final vaccination status, attitude, and adverse events related to the COVID-19 vaccine among people with MS in Egypt.</p><p><strong>Methods: </strong>A self-administered survey was offered to people with MS who came to the Alexandria University MS Clinic in Egypt between June 2023 and November 2023.</p><p><strong>Results: </strong>Of 150 surveys completed, 77% of participants were women. Their median age was 35.5 years (range, 19-59 years); their median disease duration was 4 years. Only 81 (54%) participants received a COVID-19 vaccine. Of that 81, 81.5% received 2 doses. The median fear of COVID-19 score (FCV-19S) was 11, and 15.3% had high levels of fear. Worrying about the worsening effect of the vaccine on MS (69.3%) and about the long-term adverse events (AEs) of the vaccines (63.3%) were the most common causes of fear. The only factor that was significantly related to receiving the vaccine was the FCV-19S score (<i>P</i> = .049). Among those who received the vaccine, fatigue was the most common AE reported in 48%; 5% had a neurological relapse. No other serious AEs occurred.</p><p><strong>Conclusions: </strong>In this study, almost half of study participants with MS did not receive a COVID-19 vaccination, mainly due to fear. AEs attributed to the vaccine were mild. Implementing educational programs during future pandemics will be necessary to improve the vaccination rates of people with MS.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"74-81"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605083","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":"Anxiety and Cognition in Multiple Sclerosis: A Narrative Review.","authors":"Roberto Martin Susini, Natalia Ciufia, Aldana Lucía Marinangeli, Ricardo Alonso, María Bárbara Eizaguirre","doi":"10.7224/1537-2073.2024-037","DOIUrl":"10.7224/1537-2073.2024-037","url":null,"abstract":"<p><strong>Background: </strong>People with multiple sclerosis (MS) often experience psychiatric symptoms, such as anxiety and depression, that impact disease progression and quality of life. Cognitive impairment, particularly in processing speed and episodic memory, is common in MS. There are several studies studying the relationship between anxiety and cognition in the population with MS. This study reviews that literature.</p><p><strong>Methods: </strong>This bibliographic review covers publications in Spanish and English from January 2006 to June 2022. It focuses on quantitative investigations of the relationship between anxiety symptoms and cognitive variables in people with MS.</p><p><strong>Results: </strong>A majority of studies found an association between anxiety and cognition in people with MS. Anxiety significantly affects information processing speed, learning, memory, attention, working memory, and verbal fluency in people with MS. However, some studies find no association. The impact of depressive symptoms and the bidirectional relationship between anxiety and cognition are highlighted.</p><p><strong>Conclusions: </strong>Anxiety in people with MS is associated with cognitive impairment. Further research is needed to understand the mechanisms and establish causal relationships between anxiety and cognition in this population.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"63-73"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556830","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":"Psychosocial Factors are Associated With Walking-Related Goal Attainment in Multiple Sclerosis: A Preliminary Study.","authors":"Kayla E Gomes, Kaitlin E Riegler, Heather M DelMastro, Aaron P Turner, Lindsay O Neto, Elizabeth S Gromisch","doi":"10.7224/1537-2073.2024-045","DOIUrl":"10.7224/1537-2073.2024-045","url":null,"abstract":"<p><strong>Background: </strong>Many individuals with multiple sclerosis (MS) have difficulty walking, which may prompt a physical therapy (PT) referral. Psychosocial factors, including mood, pain, and social support, may affect patients' participation and overall success in meeting PT goals; however, this has yet to be examined in MS. This study aimed to explore the associations between walking-related PT goal attainment and psychosocial factors.</p><p><strong>Methods: </strong>Participants (N = 41) were individuals with MS from a larger study who engaged in PT per usual care during a 2-year study window. They had at least 1 walking-related goal in their PT plan of care, which could be based on subjective (eg, Multiple Sclerosis Walking Scale-12) or objective measurement (eg, 6-Minute Walk Test). Examined psychosocial factors included impact of pain and fatigue, depression and anxiety symptom severity, and social support. Group differences were examined using bivariate analyses.</p><p><strong>Results: </strong>Participants who met all their walking-related PT goals had lower levels of pain impact (14.15 ± 5.22 vs 19.14 ± 5.29; <i>P</i> = .004; <i>d</i> = 0.95) and symptoms of depression (5.45 ± 3.53 vs 7.71 ± 3.51; <i>P</i> = .046; <i>d</i> = 0.64) and greater social support (median: 14.00 vs 12.00; <i>P</i> = .019 <i>d</i> = 0.79).</p><p><strong>Conclusions: </strong>These findings highlight the potential links between psychosocial factors and the attainment of walking-related goals by individuals who have MS. Further evaluation into psychosocial impact on PT plans of care is needed to help guide targeted assessment and intervention approaches.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491937","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":"Financial Assistance Value for Equitable Access to Specialty Medications for Adults With Multiple Sclerosis Using Health System Pharmacy Services.","authors":"Julie Wawrzyniak Heppner, Andrew Choma, Tiffany Otto, Erin Collins","doi":"10.7224/1537-2073.2023-095","DOIUrl":"10.7224/1537-2073.2023-095","url":null,"abstract":"<p><strong>Background: </strong>Contributing to the total economic burden of multiple sclerosis (MS) in the United States, the estimated direct medical costs of MS in 2019 were $63.3 billion, with medications accounting for over half of these expenses.¹ MS disease-modifying therapy (DMT) costs can limit access, causing patients not to adhere to the medication regimen, which may lead to relapse, progression, disability, hospitalizations, and increased health care costs. Integrated health system specialty pharmacies (HSSPs) provide assistance to patients to alleviate the financial burden of specialty medications. MS center medication access specialists (MAS) obtain assistance for DMTs. This study quantifies the financial assistance obtained for patients with MS receiving medications through an integrated HSSP or infusion center.</p><p><strong>Methods: </strong>This single-center retrospective chart review evaluated claims data for University of Rochester MS Center patients receiving financial assistance for MS specialty medications dispensed through the HSSP or infused at the MS center between July 20, 2020, and July 20, 2022. Descriptive statistics were used to assess all outcomes data.</p><p><strong>Results: </strong>Patients received $3,377,172.96 in financial assistance. The median financial assistance used per patient per day of medication coverage was $2.08 (IQR, 12.02). The median out-of-pocket cost per patient per day after financial assistance was $0 (IQR, 0). Manufacturers provided the most financial support with a total contribution of $2,404,883.31, followed by grant foundations, which provided $574,659.27. Internal facility funds and the New York State Elderly Pharmaceutical Insurance Coverage program provided $241,377.97 and $156,252.41, respectively.</p><p><strong>Conclusions: </strong>Patients at this MS center were able to save thousands of dollars in out-of-pocket costs using financial assistance. Integrated HSSPs and MAS teams can help reduce the out-of-pocket cost of MS specialty medications, which may improve access to these medications.</p>","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"27 Q1","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440531","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}