Journal of Bone Metabolism最新文献

{"title":"Thioredoxin Interacting Protein Expressed in Osteoblasts Mediates the Anti-Proliferative Effects of High Glucose and Modulates the Expression of Osteocalcin.","authors":"Sarah McGarry, Karen Kover, Francesco De Luca","doi":"10.11005/jbm.2024.31.3.209","DOIUrl":"10.11005/jbm.2024.31.3.209","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycemia is associated with impaired bone health in patients with diabetes mellitus. Although a direct detrimental effect of hyperglycemia on the bone has been previously reported, the specific molecular mediator(s) responsible for the inhibitory effect of high glucose levels on the bone remains unclear. We hypothesized that thioredoxin-interacting protein (Txnip), an essential mediator of oxidative stress, is such a mediator.</p><p><strong>Methods: </strong>We cultured MG-63 cells (immortalized human osteoblasts) with normal or high glucose concentrations and transfected them with scrambled or Txnip-specific small interfering RNA (siRNA).</p><p><strong>Results: </strong>High glucose levels increased Txnip expression and reduced MG-63 cell proliferation. The high-glucose level mediated reduction in cell proliferation was prevented in Txnip siRNA-transfected cells. In addition, we demonstrated that silencing Txnip mRNA expression in osteoblasts reduced the expression of the osteocalcin gene. Our results suggest that high glucose levels or silencing of Txnip mRNA expression may induce apoptosis in osteoblasts.</p><p><strong>Conclusions: </strong>Our findings indicate that Txnip is an intracellular mediator of the anti-proliferative effects of extracellular high glucose levels on osteoblasts.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"209-218"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287947","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":"Bone Mineral Density and Clinical Outcome after Ankle Fracture.","authors":"Hyunseong Kang, Ho-Hyup Kim, Chaemoon Lim","doi":"10.11005/jbm.2024.31.3.228","DOIUrl":"10.11005/jbm.2024.31.3.228","url":null,"abstract":"<p><strong>Background: </strong>No gold standard exists for bone mineral density (BMD) measurement of the ankle. This study aimed to determine the correlation between bone density using Hounsfield units (HU) based on computed tomography (CT) and BMD using dual energy X-ray absorptiometry (DXA) as well as to evaluate the correlation between HU and clinical outcome of ankle fracture.</p><p><strong>Methods: </strong>Fifty-one patients aged ≥65 years who underwent surgical treatment for trimalleolus or bimalleolus ankle fractures were included. The HU were measured at the distal tibia metaphyseal region approximately 1 cm proximal to the plafond on the axial images of preoperative CT. BMD was measured using DXA within one year before the injury. The clinical outcome was evaluated according to the Foot and Ankle Outcome Score (FAOS).</p><p><strong>Results: </strong>Although the HU of an osteoporosis group was lower than that of a non-osteoporosis group, we observed no significant difference between the two groups. The mean HU significantly correlated with the lumbar and total lumbar spine BMD using DXA. Increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, activity of daily living (ADL), and quality of life (QOL). In a linear regression analysis adjusted for age and body mass index, increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, ADL, and QOL.</p><p><strong>Conclusions: </strong>The correlations between bone density using HU and BMD and those between HU and the clinical outcome were confirmed in ankle fractures. The HU of preoperative CT might provide valuable information for predicting postoperative clinical outcomes.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"228-235"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287943","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":"Open, Active-Controlled Clinical Study to Evaluate the Correlation between Whole Body DEXA and BIA Muscle Measurements.","authors":"Yong-Chan Ha, Shinjune Kim, Jun-Il Yoo","doi":"10.11005/jbm.2024.31.3.219","DOIUrl":"10.11005/jbm.2024.31.3.219","url":null,"abstract":"<p><strong>Background: </strong>Dual energy X-ray absorptiometry (DXA) is the gold standard for diagnosing sarcopenia. However, comparative studies using bioelectrical impedance analysis (BIA) would be required in the Korean population. This study aimed to evaluate the correlation between total-body bone density measuring devices (Hologic and GE Lunar) and a bioelectrical impedance measurement device (InBody 970) as well as the correlation between upper body muscle mass.</p><p><strong>Methods: </strong>A total of 119 participants were involved in this study, aged 20 to 70 years, with specific body mass index ranges and no severe health conditions used both DXA (or DEXA) and BIA technologies to assess body composition. The participants were scanned using a Hologic QDR-4500W DXA scanner and GE-Lunar Prodigy DXA systems, and the InBody 970 type of multi-frequency BIA machine. Statistical analysis was performed to determine the correlation between the devices, with a coefficient of at least 0.8.</p><p><strong>Results: </strong>The muscle mass measurement comparisons between the InBody 970 and Hologic devices demonstrated remarkably high correlation coefficients (exceeding 0.9) across all limbs. Similarly, the muscle mass comparison between the Inbody 970 and GE Lunar devices also revealed substantial correlation coefficients, ranging from 0.83 upwards, across all limbs.</p><p><strong>Conclusions: </strong>Limb muscle mass measurements using Hologic and GE Lunar whole-body DXA and Inbody 970 BIA demonstrated particularly high levels of concordance. In addition, a conversion formula that bridges limb muscle mass measurements from two widely used whole-body DXA machines and a BIA machine will facilitate sarcopenia research and patient management.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"219-227"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287946","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":"Antidiabetic Agents and Bone Quality: A Focus on Glycation End Products and Incretin Pathway Modulations.","authors":"Muthanna K Zaki, Mohammed N Abed, Fawaz A Alassaf","doi":"10.11005/jbm.2024.31.3.169","DOIUrl":"10.11005/jbm.2024.31.3.169","url":null,"abstract":"<p><p>Diabetes mellitus is associated with inadequate bone health and quality and heightened susceptibility to fractures, even in patients with normal or elevated bone mineral density. Elevated advanced glycation end-products (AGEs) and a suppressed incretin pathway are among the mechanisms through which diabetes affects the bone. Accordingly, the present review aimed to investigate the effects of antidiabetic medications on bone quality, primarily through AGEs and the incretin pathway. Google Scholar, Cochrane Library, and PubMed were used to examine related studies until February 2024. Antidiabetic medications influence AGEs and the incretin pathway directly or indirectly. Certain antidiabetic drugs including metformin, glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl-peptidase-4 (DDP-4) inhibitors, α-glucosidase inhibitors (AGIs), sodium-glucose co-transporter-2 inhibitors, and thiazolidinediones (TZDs), directly affect AGEs through multiple mechanisms. These mechanisms include decreasing the formation of AGEs and the expression of AGEs receptor (RAGE) in tissue and increasing serum soluble RAGE levels, resulting in the reduced action of AGEs. Similarly, metformin, GLP-1RA, DDP-4 inhibitors, AGIs, and TZDs may enhance incretin hormones directly by increasing their production or suppressing their metabolism. Additionally, these medications could influence AGEs and the incretin pathway indirectly by enhancing glycemic control. In contrast, sulfonylureas have not demonstrated any obvious effects on AGEs or the incretin pathway. Considering their favorable effects on AGEs and the incretin pathway, a suitable selection of antidiabetic drugs may facilitate more protective effects on the bone in diabetic patients.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"169-181"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287941","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":"Body Composition, Sarcopenia, and Serum Myokines in Acromegaly: A Narrative Review.","authors":"Arthur Costa Inojosa, Ana Vitória Hirt Ribeiro, Thaís Florêncio Araújo, Maria Eduarda Xavier, Daniella Rêgo, Francisco Bandeira","doi":"10.11005/jbm.2024.31.3.182","DOIUrl":"10.11005/jbm.2024.31.3.182","url":null,"abstract":"<p><p>Patients with active acromegaly have a higher percentage of lean body mass, a lower percentage of fat body mass, and an increase in their extracellular water compartment compared to healthy individuals. However, muscle function appears to be compromised in patients with acromegaly, with some experiencing worsened physical performance and sarcopenia. Myokine alterations, insulin resistance, dysregulation of protein metabolism, muscle oxidative stress, neuromuscular junction impairment, and increased ectopic intramuscular fat deposits may play roles in muscle dysfunction in patients with acromegaly.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"182-195"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287942","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":"Effects of Psychogenic Stress Frequency during the Growth Stage on Oxidative Stress, Organ and Bone Development.","authors":"Sangun Lee, Maho Tairabune, Yuka Nakamura, Atsunori Itagaki, Issei Sugimoto, Takumi Saito, Yoshihiko Shibukawa, Atsuko Satoh","doi":"10.11005/jbm.2024.31.3.196","DOIUrl":"10.11005/jbm.2024.31.3.196","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the effects of psychogenic stress (PS) frequency on oxidative stress and organ development during growth and to gain fundamental insights into developmental processes during this period.</p><p><strong>Methods: </strong>Four-week-old male Wistar rats were randomly assigned to a control and three PS groups according to PS frequencies. PS was induced using restraint and water immersion techniques once daily for 3 hr at a time for a period of 4 weeks.</p><p><strong>Results: </strong>Oxidative stress increased with increasing PS frequency. The weights of organs other than the adrenal glands significantly decreased with increasing PS frequency, indicating growth suppression. Furthermore, bone morphology, weight, and length significantly decreased with increasing PS frequency.</p><p><strong>Conclusions: </strong>High-frequency PS exposure during developmental growth significantly negatively affects oxidative stress and organ and bone development. In particular, increased oxidative stress due to excessive PS has detrimental effects on organ and bone growth.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 3","pages":"196-208"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287945","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":"Exploring the Interplay between Vitamin D, Insulin Resistance, Obesity and Skeletal Health.","authors":"Mohammed N Abed, Fawaz A Alassaf, Mohannad E Qazzaz","doi":"10.11005/jbm.2024.31.2.75","DOIUrl":"10.11005/jbm.2024.31.2.75","url":null,"abstract":"<p><p>Vitamin D (ViD), plays an important role in calcium absorption and bone mineralization, is associated with bone mineral density. Severe deficiency in ViD has long been linked to conditions such as rickets in children and osteomalacia in adults, revealing its substantial role in skeletal health. Additionally, investigations show an existing interconnection between ViD and insulin resistance (Ins-R), especially in patients with type 2 diabetes mellitus (T2DM). Obesity, in conjunction with Ins-R, may augment the risk of osteoporosis and deterioration of skeletal health. This review aims to examine recent studies on the interplay between ViD, Ins-R, obesity, and their impact on skeletal health, to offer insights into potential therapeutic strategies. Cochrane Library, Google Scholar, and Pubmed were searched to investigate relevant studies until December 2023. Current research demonstrates ViD's impact on pancreatic β-cell function, systemic inflammation, and insulin action regulation. Our findings highlight an intricate association between ViD, Ins-R, obesity, and skeletal health, providing a perspective for the prevention and/or treatment of skeletal disorders in patients with obesity, Ins-R, and T2DM.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 2","pages":"75-89"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419261","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":"Publication Trends in Osteoporosis Treatment: A 20-Year Bibliometric Analysis.","authors":"Seung-Ju Kim, Dong-Woo Lee","doi":"10.11005/jbm.2024.31.2.90","DOIUrl":"10.11005/jbm.2024.31.2.90","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis prevalence continues to escalate with the growth of the older adult population. In this study, we aimed to investigate the profile of osteoporosis treatment-related research articles published in the past 20 years using bibliometric analysis.</p><p><strong>Methods: </strong>We analyzed all osteoporosis treatment-related articles published between 2001 and 2020 in the Web of Science (WoS) database using bibliometric methods. In the Title search section in WoS, we searched the documents using \"osteoporosis treatment\"-related keywords. We used the VOSviewer software to construct the bibliometric maps of keyword co-occurrences.</p><p><strong>Results: </strong>Our search yielded 29,738 publications, 21,556 (72.5%) were original articles and 4,529 (15.2%) were review articles and review articles (4,529). We noticed a steady increase in the publication numbers from 2001 to 2020. The overall scientific publication number in WoS increased 3.5-fold, with the five most productive countries being the USA, China, Germany, the United Kingdom, and Japan. The largest contributor was the University of California system. The most productive journals were Osteoporosis International (1,679, 6.4%), Bone (832, 3.2%), and the Journal of Bone and Mineral Research (727, 2.8%). We observed increasing trends in the appearance of denosumab and teriparatide during the last two decades. In our keyword co-occurrence analysis, we constructed four keyword clusters using VOSviewer.</p><p><strong>Conclusions: </strong>In this study, we provided a gross overview of the visibility and productivity of research studies in osteoporosis treatment. Substantial changes have occurred in osteoporosis treatment over the last 20 years. The effector mechanism of anti-osteoporosis medications could be future hot spots in osteoporosis research. We believe that our study is a valuable guide for clinicians related to the global outputs of osteoporosis treatment.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 2","pages":"90-100"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419264","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":"Systematic Review and Meta-Analysis of the Effect of Osteoporosis on Reoperation Rates and Complications after Surgical Management of Lumbar Degenerative Disease.","authors":"Elizabeth A Lechtholz-Zey, Mina Ayad, Brandon S Gettleman, Emily S Mills, Hannah Shelby, Andy T Ton, Ishan Shah, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.11005/jbm.2024.31.2.114","DOIUrl":"10.11005/jbm.2024.31.2.114","url":null,"abstract":"<p><strong>Background: </strong>There is considerable heterogeneity in findings and a lack of consensus regarding the interplay between osteoporosis and outcomes in patients with lumbar degenerative spine disease. Therefore, the purpose of this systematic review and meta-analysis was to gather and analyze existing data on the effect of osteoporosis on radiographic, surgical, and clinical outcomes following surgery for lumbar degenerative spinal disease.</p><p><strong>Methods: </strong>A systematic review was performed to determine the effect of osteoporosis on the incidence of adverse outcomes after surgical intervention for lumbar degenerative spinal diseases. The approach focused on the radiographic outcomes, reoperation rates, and other medical and surgical complications. Subsequently, a meta-analysis was performed on the eligible studies.</p><p><strong>Results: </strong>The results of the meta-analysis suggested that osteoporotic patients experienced increased rates of adjacent segment disease (ASD; p=0.015) and cage subsidence (p=0.001) while demonstrating lower reoperation rates than non-osteoporotic patients (7.4% vs. 13.1%; p=0.038). The systematic review also indicated that the length of stay, overall costs, rates of screw loosening, and rates of wound and other medical complications may increase in patients with a lower bone mineral density. Fusion rates, as well as patient-reported and clinical outcomes, did not differ significantly between osteoporotic and non-osteoporotic patients.</p><p><strong>Conclusions: </strong>Osteoporosis was associated with an increased risk of ASD, cage migration, and possibly postoperative screw loosening, as well as longer hospital stays, incurring higher costs and an increased likelihood of postoperative complications. However, a link was not established between osteoporosis and poor clinical outcomes.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 2","pages":"114-131"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419286","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":"Increased Osteoblastic and Osteocytic in Vitro Cell Viability by Yerba Mate (Ilex paraguariensis).","authors":"Laureana Villarreal, Natasha Sanz, Florencia Buiatti Fagalde, Florencia D'Andrea, Mercedes Lombarte, María J Rico, Viviana R Rozados, O Graciela Scharovsky, Lilian I Plotkin, Verónica E Di Loreto, Lucas R Brun","doi":"10.11005/jbm.2024.31.2.101","DOIUrl":"10.11005/jbm.2024.31.2.101","url":null,"abstract":"<p><strong>Background: </strong>Yerba mate (YM, Ilex paraguariensis) consumption beneficially affects the bones. However, whether YM components exert their effect on bone cells directly remains elusive.</p><p><strong>Methods: </strong>We evaluated how main YM components affect osteoblastic (MC3T3-E1) and osteocytic (MLO-Y4) cells in vitro when administered separately or in an aqueous extract. MC3T3-E1 and MLO-Y4 cells were exposed to three different experimental conditions: (1) Caffeine, chlorogenic acid, and their combinations; (2) Caffeine, rutin, and their combinations; (3) Aqueous YM extract.</p><p><strong>Results: </strong>All polyphenol and caffeine concentrations as well as that of their tested combinations significantly increased MC3T3-E1 cell viability from 16.6% to 34.8% compared to the control. In MLO-Y4 cells, the lowest rutin and the two highest caffeine concentrations significantly increased cell viability by 11.9, 14.9, and 13.7%, respectively. While rutin and caffeine combinations tended to increase MLO-Y4 cell viability, different chlorogenic acid and caffeine combinations did not affect it. Finally, the aqueous YM extract significantly increased MLO-Y4, MC3T3-E1, and differentiated MC3T3-E1 cell viability compared to the control without treatment.</p><p><strong>Conclusions: </strong>YM components (rutin, chlorogenic acid, and caffeine) positively affected bone cells, mainly pre-osteoblast cells. Moreover, the aqueous YM extract significantly increased MLO-Y4, MC3T3-E1, and differentiated MC3T3-E1 cell viabilities indicating an additional relevant nutritional property of YM infusion. Further studies would be required to elucidate the underlying effector mechanism of YM on the bones and its relationship with previously described in vivo positive effects.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"31 2","pages":"101-113"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419263","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}