{"title":"Heart Rate Variability during Nostril-Regulated Yoga Breathing: A Randomized Crossover Study.","authors":"Shirley Telles, Alok Singh, Sachin Kumar Sharma, Acharya Balkrishna","doi":"10.4103/ijoy.ijoy_119_24","DOIUrl":"10.4103/ijoy.ijoy_119_24","url":null,"abstract":"<p><strong>Background: </strong>Previous studies of nostril-regulated yoga breathing have focused on unilateral breathing with both inspiration and expiration through a specified nostril. However, traditionally described yoga breathing involves inspiration through one nostril and expiration through the other, called <i>suryabhedan pranayama</i> (SBP) (right nostril inspiration) and <i>chandrabhedan pranayama</i> (CBP) (left nostril inspiration). The effects of these practices were investigated here.</p><p><strong>Methods: </strong>Forty-seven healthy male participants (group mean age ± standard deviation [SD]; 26.34 ± 6.38 years) with prior experience of yoga breathing (group mean age ± SD; 43.64 ± 32.84 months) were randomly assigned to four sessions on separate days: (i) SBP, (ii) CBP, (iii) Breath awareness, and (iv) Quiet rest. The heart rate variability (HRV) and breath rate were recorded pre, during, and post each practice.</p><p><strong>Results: </strong>There was a significant increase in low frequency (LF) power and SD of NN intervals during SBP and CBP in comparison to the respective preceding (<i>P</i> < 0.05; repeated measures analyses of variance with Bonferroni adjusted <i>post hoc</i> analysis), while LF increased post-CBP alone. During both interventions, there were significant reductions in respiration rate.</p><p><strong>Conclusion: </strong>The changes in HRV suggest common rather than distinct changes in SBP and CBP suggestive of respiration-related increased cardiac parasympathetic activity. The involvement of both nostrils in SBP and CBP may have contributed to the comparable effects of the two practices.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"203-210"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433152","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}
Balakrishna Shetty, Geetha Balakrishna Shetty, H L Nanjeshgowda, Prashanth Shetty
{"title":"A Randomized Controlled Trial in Obese Adults with Polycystic Ovarian Syndrome: Examining the Impact of Short-term Integrated Naturopathy and Yoga Interventions on Testosterone, Oxidative Stress, and Mental Health.","authors":"Balakrishna Shetty, Geetha Balakrishna Shetty, H L Nanjeshgowda, Prashanth Shetty","doi":"10.4103/ijoy.ijoy_180_24","DOIUrl":"10.4103/ijoy.ijoy_180_24","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovarian syndrome (PCOS) is a metabolic and endocrinological condition that affects many women of reproductive age. Pathology manifests as the changes in reproductive functions, encompassing disorders such as hyperandrogenism, irregular menstrual cycles, and insulin resistance with oxidative stress. We investigated the effect of naturopathy and yoga interventions on oxidative stress and androgens with metabolic parameters in patients with PCOS.</p><p><strong>Methods: </strong>We enrolled the 120 obese teenagers with PCOS, and we divided the patients into two groups as study (<i>n</i> = 60) and control (<i>n</i> = 60). In the study group, the patients were given 10 days of naturopathy and yoga interventions, whereas the other group was a waitlist control group. They were assessed for testosterone, lipid profile, malonaldehyde (MDA), total antioxidant capacity (TAC) with Hamilton Anxiety (HAM-A), and Depression (HAM-D) Scale at baseline and after 10 days of intervention.</p><p><strong>Results: </strong>We found out that the study group exhibited a significant decrease in testosterone, MDA, HAM-A, HAM-D, body mass index (BMI), and lipid profile compared to the control group also with an effective improvement in the TAC. The stepwise multiple regression data highlight that BMI as a significant predictor for the reduction of testosterone in PCOS after taking naturopathy and yoga interventions.</p><p><strong>Conclusion: </strong>The results indicate that short-term integrated yoga and naturopathy interventions are effective in modifying the disease progression of PCOS through endocrinological and metabolic balance.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"195-202"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433086","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":"Functional Recovery and Cognitive Improvement in Poststroke Rehabilitation through Integrated Yoga and Naturopathy Intervention.","authors":"Shweta Mishra, Sriloy Mohanty, Ragini Shrivastava, Monika Pathania","doi":"10.4103/ijoy.ijoy_112_24","DOIUrl":"10.4103/ijoy.ijoy_112_24","url":null,"abstract":"<p><p>Despite advancements in acute medical management, poststroke rehabilitation (PsR) remains a critical aspect in maximizing recovery and quality of life (QOL) for stroke survivors. In the present case report, poststroke survivor was administered a 90-day tailored integrated yoga and naturopathy (IYN) intervention including daily neutral arm bath, partial massage, and yoga therapy. Following interventions, clinically significant improvement in the range of motion of joints, handgrip strength (Lt. 2.7 kg vs. 14.9 kg), improvement in mid-arm circumference, gait, and cognition (Montreal Cognitive Assessment scores 16 vs. 29) was achieved. In QOL, there was an improvement in each domain of the Short Form 36 questionnaire except for role limitations due to the physical health domain. Improvement in blood pressure (150/60 mmHg vs. 118/70 mmHg) led to a reduction in need of medication. Notably, there was improvement in depression (19 vs. 08), anxiety (18 vs. 08), and stress (21 vs. 07) scores. This case report underscores the potential of IYN intervention in PsR.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"246-250"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433149","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":"Establishment of a Comprehensive Platform for Sustained Delivery of Yoga Therapy for Sickle Cell Anemia in Rural and Remote Tribal Pocket in India.","authors":"Thota Neeraja, Ramesh Nanjundaiah Mavathur, Himanshu Anirudhbhai Shukla, Manmath Gharote","doi":"10.4103/ijoy.ijoy_133_24","DOIUrl":"10.4103/ijoy.ijoy_133_24","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell anemia (SCA) is the most common inherited genetic red blood cell disorder, highly prevalent in the tribal population residing in the Central India. The affected populace are disadvantaged due to a lack of accessibility and unavailability of transportation, flawed communication systems, insufficiency of health professionals, and basic health infrastructure.</p><p><strong>Objective: </strong>The objective was to set up a yoga-based lifestyle intervention (YBLI) center that is sustainable, accessible, affordable, and acceptable as the part of the Integrated Sickle Cell Anemia Research Program (ISCARP) randomized control trial study.</p><p><strong>Methodology: </strong>By analyzing previous government screenings, the study identified remote, high-prevalence areas. Based on these criteria, encompassing 58 villages were surveyed in Maharashtra. Bijari village in Nandurbar was chosen for setting up the YBLI center. This center was equipped with basic health facilities and Information and Communication Technology infrastructure, managed in a hybrid model by ISCARP staff and incentive-based government health workers. A Central Control Center was established at SVYASA University in Bangalore to coordinate all the activities.</p><p><strong>Results: </strong>The YBLI center was successfully set up in Bijari village. At the center, around 69 children and adolescents got benefited during Yoga intervention. Only one subject out of 34 in intervention cohort experienced mild crisis. Their basic vitals were recorded regularly. On 11 different occasions, sever crisis of the participants was addressed which reduced morbidity and mortality rate. Furthermore, a social and health profile of these participants was created and updated regularly using sickle cell patient Information Management System, SIMS Portal.</p><p><strong>Discussion: </strong>Establishment of easily accessible YBLI center for providing primary healthcare, tele consultation with doctors, and maintaining electronic medical record and monitoring and recording vitals in addition to providing adjuvant Yoga therapy.</p><p><strong>Conclusion: </strong>By offering prompt medical help and counseling, the YBLI center reduced the psychological and economic strain of sickle cell disease on the local populace. The center also captures and stores medical health records, updated on regular basis, which is of great value to the government in deciding and designing policies.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"182-194"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433147","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}
Reshma Jogdand, Satyapriya Maharana, Kasinath G Metri, B S Anuradha, R Nagarthan
{"title":"Is Tele-yoga Safe for Pregnant Women with First-trimester Uterine Artery Doppler Positive? A Feasibility Study.","authors":"Reshma Jogdand, Satyapriya Maharana, Kasinath G Metri, B S Anuradha, R Nagarthan","doi":"10.4103/ijoy.ijoy_175_24","DOIUrl":"10.4103/ijoy.ijoy_175_24","url":null,"abstract":"<p><strong>Background: </strong>Positive uterine artery Doppler (UAD+) in the first trimester is an indication of abnormalities in the formation of the placenta, UAD+ is associated with an increased risk of pregnancy complications in the later part of pregnancy. Yoga practice during normal pregnancy has positive effects on pregnancy outcomes. However, no study to date has examined the feasibility and safety of yoga during pregnancy in pregnant women with UAD+.</p><p><strong>Methods: </strong>Twenty-one women aged between 20 and 35 years (mean: 28.8 years) who had a UAD+ (uterine artery pulsatility index >2) at 12 weeks of gestation were recruited from the gynecology department of a tertiary care hospital in southern India. Institutional ethical approval and informed consent was obtained before the intervention. All participants received a 45-min yoga session in virtual mode three times a week for 2 months from a certified yoga therapist. The yoga module consisted of simple yoga postures, breathing techniques, and meditation. Enrollment, attrition, retention, adverse events, difficulties in practicing yoga, and subjective experience were assessed at the completion of 2 months.</p><p><strong>Results: </strong>A total of 346 pregnant women underwent Doppler ultrasound in the first trimester during the study period, of whom 35 (10.1%) had UAD+. Twenty-one women participated in the study and 18 completed it. Enrollment and retention rates were 7.7% and 78%, respectively. Three women dropped out of the study due to personal reasons. No adverse events were reported during the study. Overall satisfaction with the program was rated 4.3 out of 5 points. Most women experienced relaxation, less stress, and lightness in the body after yoga sessions. The duration of the yoga session was found to be acceptable and sufficient.</p><p><strong>Conclusion: </strong>This study reports that tele-yoga is a safe and feasible intervention for pregnant women with UAD+ in the first trimester. Further studies with randomized controlled trial are warranted.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"232-241"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432271","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":"Trataka: A Promising Intervention to Reduce Anxiety in Children? A Randomized Controlled Trial with Cognitive and Electrodermal Measures.","authors":"Parth Rajesh Pandya","doi":"10.4103/ijoy.ijoy_122_24","DOIUrl":"10.4103/ijoy.ijoy_122_24","url":null,"abstract":"<p><strong>Background: </strong>One in five children suffers crippling dental anxiety, and traditional calming methods often fall short. Trataka, an ancient yogic technique, offers a powerful new approach to manage this anxiety.</p><p><strong>Objective: </strong>The objective is to investigate whether Trataka practice is more effective than relaxation techniques in reducing anxiety in children undergoing dental procedures.</p><p><strong>Methodology: </strong>A two-arm, parallel-group, randomized controlled trial was conducted with 120 children aged 8-11 years requiring local anesthesia for dental procedures. Participants were randomized to either a Trataka group (<i>n</i> = 60) or a relaxation techniques group (<i>n</i> = 60). Both groups received 4 weeks of training on their assigned intervention. The primary outcome was anxiety level measured by the Mood and Anxiety Symptom Questionnaire (MASQ) administered pre- and postintervention. Secondary outcomes included electro-dermal activity (EDA) test results and the Stroop Colour Word Test (SCWT), both performed pre- and postintervention, and observed anxiety-related behaviors during procedures.</p><p><strong>Results: </strong>Children in the Trataka group exhibited a significantly greater reduction in anxiety compared to the relaxation techniques group, as measured by the MASQ score (<i>P</i> < 0.001) and lower EDA response during the SCWT (<i>P</i> < 0.01). The Trataka group also displayed fewer observed anxiety-related behaviors during procedures (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The findings suggest that Trataka may be more effective than relaxation techniques in reducing anxiety in children undergoing dental procedures.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"217-221"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432560","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":"Culturally Tailored Home-based Yoga Intervention for Lymphoma Patients on Chemotherapy.","authors":"Gurpreet Kaur, Gaurav Prakash, Sukhpal Kaur, Mahender Singh, Sandhya Ghai, Alka Khadwal, Pankaj Malhotra","doi":"10.4103/ijoy.ijoy_126_24","DOIUrl":"10.4103/ijoy.ijoy_126_24","url":null,"abstract":"<p><strong>Context: </strong>Although proven effective in solid cancers, there is a dearth of evidence-based studies supporting yoga as an intervention to improve health-related quality of life (HRQOL) among patients with lymphoma.</p><p><strong>Aim: </strong>The aim of this study was to develop a remotely supervised, home-based yoga intervention to improve HRQOL for lymphoma patients undergoing chemotherapy.</p><p><strong>Settings: </strong>This project was conducted at a tertiary care hospital in Northern India.</p><p><strong>Methodology: </strong>Experts in lymphoma, yoga, psychiatry, and nursing collaborated to formulate the intervention. Following a comprehensive literature review and stakeholder consultations, the intervention, named \"Yoga Therapy\" for patients with lymphoma, was developed. It included counseling regarding the benefits of yoga, a video and booklet on yoga, practical yoga sessions, telephonic support, regular follow-ups, random and need-based re-demonstrations, and adherence charts. The feasibility and safety of the intervention were assessed through a pilot study.</p><p><strong>Results: </strong>The developed intervention was found feasible, effective, and safe to be conducted during the pilot study. Reasonable adjustments were made in the final intervention to address individual needs, lymphoma burden, and other patient-specific concerns.</p><p><strong>Conclusion: </strong>The developed intervention was explicitly developed for patients with lymphoma during chemotherapy and seemed to be appropriate for its effectiveness testing during a randomized controlled trial.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"211-216"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433197","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}
Babasaheb P Sonwane, Pooja Raut, Jyotsna Chitalkar, Smita Godbole, Shanta Sabnis, Jyoti Gupta, B Santhakumari, Mukund V Deshpande, Mahesh J Kulkarni
{"title":"Yoga Therapy Attenuates the Progression of Diabetes - Insights from Proteomics and Metabolomics Analysis.","authors":"Babasaheb P Sonwane, Pooja Raut, Jyotsna Chitalkar, Smita Godbole, Shanta Sabnis, Jyoti Gupta, B Santhakumari, Mukund V Deshpande, Mahesh J Kulkarni","doi":"10.4103/ijoy.ijoy_178_24","DOIUrl":"10.4103/ijoy.ijoy_178_24","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes management remains challenging despite advancements in therapeutics, with many subjects developing complications. Yoga has been shown to aid diabetes management. This study investigates the impact of yoga therapy on diabetes progression, utilizing proteomics and metabolomics analyses to explore underlying molecular mechanisms.</p><p><strong>Methodology: </strong>A 3-month longitudinal study involving healthy subjects with prediabetes and diabetes was conducted. Blood glucose, glycated hemoglobin (HbA1c), lipid profile, and malondialdehyde (MDA) levels were measured before and after the yoga intervention.</p><p><strong>Results and conclusion: </strong>Healthy subjects showed no significant changes in blood glucose, lipid profile, HbA1c, or MDA levels. However, subjects with prediabetes and diabetes experienced positive changes, with decreases in HbA1c and MDA levels. Proteomics and metabolomics analyses provided insights into the molecular mechanisms by which yoga attenuates diabetes progression in subjects with prediabetes and diabetes. This study is a pioneering effort to understand the molecular basis of yoga's beneficial effects on diabetes management.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"163-174"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432795","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}
Massimiliano Buoli, Francesca Legnani, Monic Mastroianni, Letizia Maria Affaticati, Enrico Capuzzi, Massimo Clerici, Alice Caldiroli
{"title":"Effectiveness of Yoga as a Complementary Therapy for Anorexia Nervosa: A Systematic Review.","authors":"Massimiliano Buoli, Francesca Legnani, Monic Mastroianni, Letizia Maria Affaticati, Enrico Capuzzi, Massimo Clerici, Alice Caldiroli","doi":"10.4103/ijoy.ijoy_191_24","DOIUrl":"10.4103/ijoy.ijoy_191_24","url":null,"abstract":"<p><p>Anorexia nervosa (AN) is a severe psychiatric condition associated with high disability and mortality. The purpose of the present manuscript is to critically summarize evidence about the effectiveness of yoga for this condition. A bibliographic search was conducted in the main database sources (PubMed, Embase, and Scopus). Articles in English about the effectiveness of yoga in AN were included. Two hundred thirty-three articles were initially identified and 5 articles were included in the present review. With the exception of one study, all had several methodological limitations such as the presence of confounding factors (e.g., psychiatric comorbidity) or a too limited sample of patients. However, globally yoga seems to ameliorate AN symptoms, especially those regarding emotional dysregulation. Yoga is a candidate complementary treatment for the management of AN, but more randomized controlled studies with larger samples and limited bias are necessary to draw robust conclusions. It would be also interesting to verify in comparative trials the effectiveness of yoga with respect to other treatments such as psychotherapy or the administration of pharmacological compounds. Finally, the practice should be modified adapting to the specific needs of this type of patient.</p>","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"155-162"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433145","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 Yoga in Rehabilitation: Avenues and Challenges.","authors":"Nandi Krishnamurthy Manjunath","doi":"10.4103/ijoy.ijoy_273_24","DOIUrl":"10.4103/ijoy.ijoy_273_24","url":null,"abstract":"","PeriodicalId":14436,"journal":{"name":"International Journal of Yoga","volume":"17 3","pages":"153-154"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432463","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}