Journal of Family Medicine and Primary Care最新文献

{"title":"Letter to editor: Re: \"Prevalence of HIV, hepatitis B and hepatitis C infections among patients with thalassemia attending a tertiary care (rural) hospital\".","authors":"Bijurica Chakraborty, Sounik Sarkar, Rajib De","doi":"10.4103/jfmpc.jfmpc_327_25","DOIUrl":"10.4103/jfmpc.jfmpc_327_25","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2600-2601"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731635","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":"Overcoming barriers to oral healthcare in India's tribal regions: Insights and strategies.","authors":"Akash P Muralidharan, Kalyani Bhate","doi":"10.4103/jfmpc.jfmpc_1266_24","DOIUrl":"10.4103/jfmpc.jfmpc_1266_24","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2579-2580"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731640","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":"Awareness and attitudes toward euthanasia: A cross-sectional study among diverse demographic groups in India.","authors":"Padmakumar Krishnankutty Nair","doi":"10.4103/jfmpc.jfmpc_175_25","DOIUrl":"10.4103/jfmpc.jfmpc_175_25","url":null,"abstract":"<p><strong>Background: </strong>Euthanasia remains a contentious issue worldwide, with attitudes and awareness varying significantly across different cultures and professional groups. This study aims to explore the knowledge and attitudes toward euthanasia among a diverse group of participants and identify demographic factors influencing these perspectives.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted among 600 participants using a structured questionnaire to assess their knowledge and attitudes toward euthanasia. The data were analyzed using statistical methods, with focus on demographic variables such as sex, age, occupation, and religious beliefs.</p><p><strong>Results: </strong>The study found that male participants had higher awareness scores (mean score: 4.52) compared to females (mean score: 4.27), although this difference was not statistically significant (<i>P</i> = 0.068). However, males exhibited significantly more positive attitudes toward euthanasia than females (<i>P</i> < 0.001). Significant differences were observed in attitudes based on age (<i>P</i> = 0.0055) and professional background (<i>P</i> = 0.0147).</p><p><strong>Conclusion: </strong>The findings highlight the need for targeted educational programs and legal frameworks to address knowledge gaps and support informed decision-making regarding euthanasia. Demographic factors significantly influence attitudes, necessitating culturally sensitive policy development.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2538-2543"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731642","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":"Closing the care gap: Empowering primary physicians in palliative care.","authors":"Pallavi Singh, Nidhi Shree","doi":"10.4103/jfmpc.jfmpc_2037_24","DOIUrl":"10.4103/jfmpc.jfmpc_2037_24","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2595"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731648","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":"Comparison of cardiovascular autonomic function and biomarkers between vitamin D insufficient and deficient people with newly diagnosed type 2 diabetes mellitus.","authors":"Visakamutharasi Murugiah, Pravati Pal, Jaya Prakash Sahoo, Nivedita Nanda, Suryanarayana Bettadpura Shamanna","doi":"10.4103/jfmpc.jfmpc_1804_24","DOIUrl":"10.4103/jfmpc.jfmpc_1804_24","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin D is a neuroactive hormone having influence on several biological functions. Cardiovascular autonomic dysfunctions as well as inflammation and oxidative stress are evident in newly diagnosed type 2 diabetes mellitus (T2DM). Vitamin D deficiency has been associated with the development and progression of cardiovascular autonomic dysfunctions in T2DM. Vitamin D insufficiency is prevalent in T2DM. However, the autonomic function status and biomarkers in vitamin D deficient and vitamin D insufficient newly diagnosed T2DM subjects are not clear. Therefore, the present study aimed to compare the cardiovascular autonomic function and biomarkers between vitamin D insufficient and vitamin D deficient people with newly diagnosed T2DM.</p><p><strong>Methods: </strong>Newly diagnosed 47 T2DM subjects (mean age 38 ± 4.2 years) were recruited based on American Diabetes Association criteria. They were divided into vitamin D deficient (<20 ng/ml; <i>n</i> = 30) and vitamin D insufficient group (20-30 ng/ml, <i>n</i> = 17) according to Endocrinology Society guidelines. Heart rate variability (HRV), baroreflex sensitivity (BRS) and conventional autonomic function tests, 25 (OH) D, oxidative stress parameters and inflammatory markers were measured.</p><p><strong>Results: </strong>Compared to the vitamin D insufficient group, the vitamin D deficient group showed significantly decreased 25 (OH) D (<i>P</i> < 0.001), BRS (<i>P</i> = .004), high frequency (normalised units) (<i>P</i> < .001), total power (<i>P</i> = .048), adiponectin (<i>P</i> = .050); and significantly increased low frequency (normalised units) (<i>P</i> = .036) and low frequency: high frequency ratio (<i>P</i> = .038), malondialdehyde (<i>P</i> < .001), interleukin-6 (<i>P</i> = .009), fibroblast growth factor-21 (<i>P</i> = .043), and redox ratio (<i>P</i> = .005).</p><p><strong>Conclusion: </strong>The present study found the vitamin D deficient group had a reduced parasympathetic and higher sympathetic tone along with greater oxidative stress and inflammation compared to the vitamin D insufficient group in newly diagnosed T2DM subjects.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2294-2300"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and pattern of cognitive dysfunction in young adults and middle-aged patients with type-2 diabetes.","authors":"Subhankar Chatterjee, Rana Bhattacharjee, Anirban Sinha, Animesh Maiti, Anustup Mukherjee, Ritwik Ghosh, Souvik Dubey","doi":"10.4103/jfmpc.jfmpc_1900_24","DOIUrl":"10.4103/jfmpc.jfmpc_1900_24","url":null,"abstract":"<p><strong>Background and aims: </strong>With the world's aging population, twin epidemics of type-2 diabetes (T2D) and dementia take a great toll on the healthcare burden. T2D carries a 2-3 times greater risk of developing cognitive impairment than controls. Early identification of cognitive impairment is important as it impairs diabetes self-management, making patients prone to complications. However, data about the assessment of cognitive impairment in T2D using a comprehensive cognitive battery is sparse in India. This study was undertaken to estimate the prevalence and pattern of cognitive impairment among young and middle-aged patients with T2D.</p><p><strong>Materials and methods: </strong>A cross-sectional observational study was conducted in a tertiary care teaching hospital in Kolkata (2022-2024) among 125 Bengali-speaking T2D patients with formal education > class IV, aged between 20 and 60 years. The cognitive evaluation was done using the clinical dementia rating scale, mini-mental status examination (MMSE), Montreal cognitive assessment (MoCA), and Addenbrooke's cognitive examination (ACE)-III. Statistical analyses were done by Jeffrey's Amazing Statistics Program version 0.19 with appropriate tests (Chi-squared test, Mann-Whitney U test, Spearman correlation statistics, and logistic regression). <i>P</i> value < 0.05 was considered significant.</p><p><strong>Results: </strong>T2D patients reported a more subjective sensation of forgetfulness compared to the control group (<i>P</i> = 0.001). MMSE was an insufficient screening tool to distinguish between these two groups. On MoCA and ACE-III, there was a significant difference in total scores between case and control groups (MoCA, <i>P</i> = 0.012 and ACE-III, <i>P</i> < 0.001). Based on ACE-III, 59.20% of T2D patients had cognitive impairment (<i>P</i> < 0.001). The odds of having cognitive impairment in T2D were 3.72 times higher than in the control group (<i>P</i> < 0.001). There was significant impairment of memory (<i>P</i> < 0.001), fluency (<i>P</i> = 0.020), and visuospatial ability (<i>P</i> = 0.032). Females (<i>P</i> = 0.010), less education (<i>P</i> < 0.001), lower socioeconomic status (<i>P</i> < 0.001), BMI < 23 kg/m² (<i>P</i> = 0.049), peripheral neuropathy (<i>P</i> = 0.001), hypothyroidism (<i>P</i> = 0.007), anxiety (<i>P</i> < 0.001), and depression (<i>P</i> < 0.001) were significantly associated with cognitive impairment in diabetes.</p><p><strong>Conclusion: </strong>This is the first study from Eastern India to use a comprehensive cognitive scale validated in the local vernacular. Cognitive impairment is prevalent among a significant portion of middle-aged, educated individuals with T2D. Cognitive evaluation should be incorporated into diabetes management from the onset, with a focus on addressing modifiable factors.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2527-2537"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731664","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":"Reasons for childbirth-related fear among pregnant women. A cross-sectional study in a teaching institution.","authors":"Nashwa F AlDardeir, Jumana A Shafei, Hadel H Abdulaziz, Ghalia W Edrees, Reyof A Jifri, Sara H AlShehri, Aya F Srouji, Naseem A AlHujaili","doi":"10.4103/jfmpc.jfmpc_1828_24","DOIUrl":"10.4103/jfmpc.jfmpc_1828_24","url":null,"abstract":"<p><strong>Background: </strong>Though both the woman and the fetus are healthy, fear and anxiety of childbirth have led to the cesarean section (CS) of many women in recent years.</p><p><strong>Aim: </strong>To investigate the level of antenatal fear of childbirth at various gestational ages and factors associated with intense fear among pregnant women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at King Abdulaziz University Hospital from February 2024 to April 2024, on women of reproductive age, who requested a CS without a medical reason, excluding women with medical indications for CS, high-risk pregnancy, or refusal to participate. A questionnaire was used, which included participants' demographics, obstetric history, the Childbirth Attitude Questionnaire (CAQ), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).</p><p><strong>Results: </strong>There were 48.1% of the participants with ages 25-34 years, 97.2% were married, 74.1% had a university degree, 42.5% were housewives, and 27.4% had chronic conditions. Only 1.4% suffered from anxiety, and 0.5% had depression. 34.4% of respondents reported having 3-4 previous pregnancies, and 87.3% and 65.1% had never experienced fetal death and/or abortions, respectively. Of them, 24.1% had two spontaneous vaginal deliveries, 30.2% had delivery complications, 66.5% attended regular follow-up antenatal appointments, and 97.6% had husband's support during pregnancies. The primary fears included the fear of the baby being injured during delivery, fear of something being wrong with the baby, fear of needing a CS, and fear of experiencing tearing during birth (episiotomy). Older age, having an abortion, or having a vaginal birth were significantly associated with increased childbirth fears.</p><p><strong>Conclusion: </strong>In order to maximize the goals of pregnant moms, lessen anxiety, and ultimately enhance maternal wellbeing, prenatal healthcare providers should be equipped to handle these fears and provide comprehensive support and therapies. This will reduce anxiety, increase women's trust in their healthcare providers, and enhance their birth experience.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2407-2415"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731669","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":"Response to \"Telemedicine and its impact on academic medical centers: A narrative review\"-A letter to the editor.","authors":"Raymond Haward, Rachel Haward, Joshua Chacko","doi":"10.4103/jfmpc.jfmpc_40_25","DOIUrl":"10.4103/jfmpc.jfmpc_40_25","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2596-2597"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731671","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":"Study of association and diagnostic utility of novel anthropometric and lipid indices for nonalcoholic fatty liver disease: A hospital-based study.","authors":"Anand K Pyati, Sakthivadivel Varatharajan, Abhishek Arora, Vaman Kulkarni, Aparna Varma Bhongir, Sangeetha Sampath, Gomathi Ramaswamy, Madhu Latha Karra, Priyanka Das, Pawan Pagaku","doi":"10.4103/jfmpc.jfmpc_1609_24","DOIUrl":"10.4103/jfmpc.jfmpc_1609_24","url":null,"abstract":"<p><strong>Context: </strong>Given the prevalence of nonalcoholic fatty liver disease (NAFLD) of 25% and an expected prevalence of 55.4% by 2040 and its associated complications, it is essential to prioritize large-scale screening programs in the general population.</p><p><strong>Objectives: </strong>1. To examine the association of the conventional and novel anthropometric and lipid indices in NAFLD and 2. To determine diagnostic ability, their cutoff values, and best parameter/model for detecting NAFLD.</p><p><strong>Settings and design: </strong>A case-control study was done among 262 NAFLD cases and 186 non-NAFLD controls in a tertiary care hospital.</p><p><strong>Methods and material: </strong>BMI, WC/Ht, LAP, VAI, TC, TG, HDL, LDL, VLDL, Non-HDL-C, TG: HDL-C, TC: HDL-C, LDL-C/HDL-C, TyG, CMI, RC, AIP, and AC were measured/calculated by recommended methods.</p><p><strong>Statistical analysis used: </strong>Binary univariate and multivariate logistic regression analyses and ROC analysis to determine the association, best statistical model, and diagnostic validity of study variables.</p><p><strong>Results: </strong>The individuals with BMI >30 had highest risk (OR = 9.636) of NAFLD followed by those with TG >500 mg/dl (7.054), LAPM (3.157) and LAPF (2.975), WC (M) (3.07), WC: Ht >0.6 (2.893), TyG (2.361), VAI-M (2.053), and VAI-F (2.253) in decreasing order. On ROC analysis, anthropometric parameters outperformed the lipid indices, among which BMI [AUC = 0.702; <i>P</i> < 0.001] and WC [0.671; <i>P</i> < 0.001] showed the highest AUC, followed by WC: Ht [0.657; <i>P</i> < 0.001]. Among lipid indices, LAP had the highest AUC [0.666; <i>P</i> < 0.001], followed by CMI [0.629; <i>P</i> < 0.001] and TyG [0.621; <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>BMI, WC, LAP, WC/Ht, VAI, CMI, and TyG are the best simple and reliable indices for predicting/detecting NAFLD in the decreasing order of their diagnostic abilities which can identify the population at risk of NAFLD.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2365-2373"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731676","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 comparative effects of injecting intra-articular platelet-rich plasma and hypertonic dextrose prolotherapy in osteoarthritis knee - A randomized control trial.","authors":"Neeraj Singh, Anil K Gupta, Dileep Kumar, Sudhir Mishra, Ganesh Yadav, Shreya Singh","doi":"10.4103/jfmpc.jfmpc_1206_24","DOIUrl":"10.4103/jfmpc.jfmpc_1206_24","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis is an age-dependent disease caused by degenerative and healing processes in subchondral tissue of articular and bone cartilage, resulting in changes of its biochemical properties that eventually causes pain, stiffness, and decreased articular function. Therefore, this study aims to compare the effectiveness of platlet-rich plasma (PRP) therapy and 25% hypertonic dextrose (Dextrose) prolotherapy in patients with knee osteoarthritis.</p><p><strong>Material and methods: </strong>Single-blind randomized control trial was conducted for 18 months. Patients satisfying the inclusion and exclusion criteria were enrolled from the indoor/outdoor facility of the Department of Physical Medicine and Rehabilitation, King George's Medical University (KGMU), Lucknow, India. The informed consent form was duly signed by all the enrolled patients, who were randomly assigned into two groups by the computer-generated system, A total of 85 study participants in this group I (43 patients) received 5 ml Platelet-Rich Plasma (PRP) and Group II (42 patients) received 5 ml of 25% hypertonic dextrose prolotherapy (Dextrose). To compare the effect in terms of reduction of pain, according to the Numeric pain rating scale (NPRS) and Pain/Discomfort, Walking and Activities of Daily Living (ADL) according to the Lequesne Knee Index (LKI) and assessment of each patient was done at specified period, i.e., 0 weeks (Baseline means immediately before intervention), and 6 weeks after the intervention.</p><p><strong>Result: </strong>Overall, the baseline to 6 weeks change of LKI-Pain in group I (PRP) was significantly more than the group II (DEXTROSE) (<i>P</i> < 0.001). On considering the parameter of LKI-Pain at baseline and 6 weeks for PRP and Dextrose, it was found that in Group I, the mean ± SD reduced more at 6 weeks from 4.81 ± 1.55 to 2.44 ± 1.76 as compared to participants in Group II with 4.83 ± 1.17 at baseline to 6 weeks 3.64 ± 0.98, LKI-Activities of Daily Living (ADL) for group I PRP the Mean ± SD score dropped more from 4.66 ± 1.40 to 2.95 ± 1.35 whereas for group II Dextrose the Mean ± SD score dropped from 4.68 ± 1.40 to 3.65 ± 1.51 at baseline and 6 week respectively and At baseline, the mean LKI-Total score in group I was 12.85 ± 3.59 while in group II the mean score was 13.11 ± 3.15. At 6 weeks, the mean LKI-Total score in group I was 7.63 ± 3.85; in group II the mean score was 10.11 ± 2.93. A significant difference was found in the mean LKI-Total score between the groups at 6 weeks (<i>P</i> = 0.001) and found to be lesser in group I.</p><p><strong>Conclusion: </strong>It could thus be concluded that on considering the effect of platelet-rich plasma and 25% hypertonic dextrose prolotherapy in patients with knee osteoarthritis, significant improvement was seen in participants administered with both platelet-rich plasma and dextrose with the higher effect being with platelet-rich plasma.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2180-2186"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731678","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}