Journal of Medicine and Life最新文献

{"title":"Prognostic factors and relapse in nodal vs. extranodal non-Hodgkin lymphoma of the ENT region: a prospective cohort study.","authors":"Raluca Morar, Norberth-Istvan Varga, Claudia Raluca Balasa Virzob, Nicolae Constantin Balica, Ioana Delia Horhat, Alexandru Chioreanu, Oana Silvana Sarau, Sonia Tanasescu, Razvan Susan, Ion Cristian Mot","doi":"10.25122/jml-2025-0064","DOIUrl":"10.25122/jml-2025-0064","url":null,"abstract":"<p><p>Non-Hodgkin Lymphoma (NHL) arising from the ear, nose, and throat (ENT) region presents unique challenges with regard to diagnosis and treatment. This study investigated the clinical characteristics, prognostic factors, and relapse patterns in patients with NHL originating from lymph nodes (nodal NHL) or other extranodal structures, aiming to identify factors associated with relapse between these two groups. This prospective cohort study included 50 patients diagnosed with NHL in the ENT region at a tertiary hospital in South-Western Romania between 2019 and 2021. Patients were categorized as having nodal or extranodal disease based on histopathological examination and were followed for three years to assess disease evolution, including relapse. Cox proportional hazards regression analysis was employed to identify factors associated with relapse-free survival. Extranodal NHL was associated with a significantly higher prevalence of multiple-site involvement compared to nodal NHL (53.3% vs. 30%, <i>P</i> = 0.021). While a trend towards increased relapse was observed in extranodal NHL, this was not statistically significant (<i>P</i> = 0.125). The presence of disseminated disease (HR = 27.295; <i>P</i> < 0.001) and undergoing only a biopsy (compared to total excision, HR = 4.301; <i>P</i> = 0.027) were identified as independent predictors of relapse. Kaplan-Meier analysis demonstrated significantly different relapse-free survival patterns among groups stratified by NHL localization and dissemination status (<i>P</i> < 0.001). The extent of surgical intervention is a crucial factor influencing relapse risk in ENT NHL, with total excision associated with a lower hazard of relapse. At the same time, extranodal involvement may indicate a more aggressive disease course, particularly when combined with dissemination. However, larger studies with longer follow-ups are needed to validate these findings and refine treatment strategies, especially in regions with limited access to healthcare and screening programs.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"344-350"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127941","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":"A comprehensive congenital syphilis case report with evidence-based insights into current practices.","authors":"Ramona Mohora, Alexandra Diaconu, Silvia-Maria Stoicescu, Octaviana Cristea","doi":"10.25122/jml-2024-0363","DOIUrl":"10.25122/jml-2024-0363","url":null,"abstract":"<p><p>Congenital syphilis is one of the most well-known congenital infections. Despite notable progress in early diagnosis of syphilis paired with the accessibility of cost-effective treatment and preventive strategies, a few cases continue to be diagnosed in the department of obstetrics. This paper presents a case study of an infant with low birth weight, delivered by an adolescent mother, part of a marginalized demographic group. Due to the mother's lack of routine prenatal care, the infant's management required a series of investigations to establish a comprehensive differential diagnosis. Maternal serological assessments for syphilis, including both non-treponemal antibody test (RPR) and treponemal antibody test (TPHA), yielded positive results following fetal extraction via cesarean section, specifically after diagnosis of syphilis in the infant. Within the first 24 hours of life, newborn serologic tests for syphilis (STS) (including RPR and TPHA assays) exhibited reactivity with titers equivalent to maternal samples. Furthermore, at three weeks of life, the neonatal STS titer exceeded that of the maternal titer, displaying a fourfold increase over the maternal STS level. This finding was concomitant with the detection of IgM antibodies against T. pallidum. Screening for other congenital infections yielded negative results. Subsequent to the high-risk infant follow-up, in accordance with the National Guidelines, the infant had a good outcome.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"324-331"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127961","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":"Renal cell carcinoma and upper tract urothelial carcinoma in kidney transplant recipients.","authors":"Oana Moldoveanu, Cătălin Baston, Bogdan Sorohan, Lucas Discalicău, Ioanel Sinescu","doi":"10.25122/jml-2025-0065","DOIUrl":"10.25122/jml-2025-0065","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is the most common solid-organ malignancy in Western countries, and upper tract urothelial carcinoma (UTUC) is the most common malignancy in Asian countries. The management of RCC/UTUC in kidney transplant recipients is complex and clinically challenging due to post-transplant modifications associated with immunosuppressive treatment. This retrospective study evaluated the incidence, risk factors, treatment outcomes, and oncological implications of RCC and UTUC in kidney transplant recipients from 2008 to 2023. Data were collected from clinical records, and follow-up calls for 20 patients diagnosed with RCC and UTUC among 2,283 kidney transplant recipients, revealing an incidence rate of 0.78% for RCC (18 patients) and 0.087% (two patients) for UTUC. Most patients presented localized disease at diagnosis. Surgical interventions included radical nephrectomy for the native kidney's RCC, radical or partial nephrectomy for allograft RCC, and radical nephroureterectomy for UTUC in the native kidney and allograft. Oncological outcomes indicated a mean follow-up of 51.29 months, during which five patients (25%) developed metastases, which achieved prolonged survival through surgical management, adjuvant therapy, and immunosuppression adjustments. The study highlights the increased cancer risk in this population and underscores the necessity for established screening protocols and individualized treatment strategies to optimize patient outcomes while preserving kidney function. These findings contribute to the ongoing research on managing malignancies in transplant recipients, with implications for further research and clinical guidelines.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"357-363"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127948","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":"Retrospective analysis of general surgery outcomes in multicenter cohorts in Saudi Arabia.","authors":"Abdulsalam Mohammed Aleid, Nouf Abdullah Alyabis, Fouad Abdulsalam Alghamidi, Reema Hamad Almuneef, Sadeem Khalid Alquraini, Lubna Abdulaziz Alsuraykh, Abdullah Mohammed Al Amer, Hussam Sulaiman AlQifari, Waad Abdullah Alsharari, Nada Fahad Albishri, Hadeel Abdullah Alosaimi, Leen Yahya Algahtany, Loai Saleh Albinsaad, Saud Nayef Salem Aldanyowi","doi":"10.25122/jml-2024-0337","DOIUrl":"10.25122/jml-2024-0337","url":null,"abstract":"<p><p>General surgery outcomes remain a concern despite advancements in techniques, anesthesia, and perioperative care. Achieving consistent, high-quality results and accurately predicting risks remains challenging. This study aimed to identify factors associated with adverse outcomes through a retrospective analysis of general surgery cases across multiple centers in Saudi Arabia. A retrospective cohort study analyzed 14,635 medical records of patients who underwent general surgery across multiple centers in Saudi Arabia from 2010 to 2020. Data from the General Directorate of Health Affairs registry included demographics, comorbidities, procedure details, and outcomes. The study focused on risk factors for 30-day mortality and complications, with subgroup analyses comparing outcomes across facilities. Common surgeries included hernia repair, cholecystectomy, appendectomy, and bowel resection. The overall 30-day mortality rate was 0.74%, and the complication rate was 11.1%. Independent predictors of mortality were ASA grade III/IV, Charlson index ≥3, cardiovascular disease, dementia, renal disease, and longer procedures. Teaching hospitals had lower mortality and complication rates. Complication predictors included older age, ASA III/IV, diabetes, cardiac disease, and high-risk procedures. Evening surgeries were associated with fewer complications. This multicenter study identified patient risk factors and procedure characteristics that predict 30-day outcomes after general surgery. Older age, multiple comorbidities, and high-risk surgeries were linked to poorer outcomes. Teaching centers had better results, emphasizing the role of institutional factors. These findings can guide risk stratification and quality improvement efforts to enhance recovery and provide a foundation for future research to improve surgical practices globally.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"299-305"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127920","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":"Hand hygiene knowledge, beliefs, and practices among healthcare professionals in the primary healthcare centers in Riyadh, Saudi Arabia: a cross-sectional study.","authors":"Shuaa Rahail Alanazi, Abeer Jassam Alanazi, Mona Salem Alanazi, Fatima Rashid Alenazi, Nessreen Mohammed Algushiry, Ebtisam Awadh Alotaibi, Amerah Ayedh Alenazi, Hind Farhan Alanazi, Mariyyaha Mahdi Alanazi, Hani Rahail Alanazi, Mshari Anwar Alanezi, Latifah Rahail Alanazi","doi":"10.25122/jml-2025-0007","DOIUrl":"10.25122/jml-2025-0007","url":null,"abstract":"<p><p>Hand hygiene (HH) is vital for preventing healthcare-associated infections and ensuring patient safety. This study evaluated the knowledge, beliefs, and practices of healthcare professionals in primary healthcare centers (PHCs) in Riyadh, Saudi Arabia. A cross-sectional descriptive study was conducted using an online validated questionnaire based on the World Health Organization Hand Hygiene Knowledge Questionnaire. Data were analyzed to identify gaps and patterns across professional roles and demographics. A total of 221 healthcare professionals participated, 76% women and 24% men, 57% aged 30-39 years. Most had over 15 years of experience (33%), with nurses comprising the largest professional group. Nearly all participants (91%) had received HH training in the past 3 years, and 88% reported routine use of alcohol-based hand sanitizer. However, only 67% correctly identified the minimum time for alcohol-based sanitizer to kill germs, and misconceptions about hand rubbing efficacy persisted. The primary route of germ transmission was identified as healthcare workers' unclean hands. Most participants agreed that hand rubbing is faster than handwashing and emphasized HH after patient contact, exposure to body fluids, or contact with the patient's surroundings. Nearly all endorsed using both hand rubbing and handwashing for specific scenarios, such as before injections. This study highlights strong HH knowledge and adherence among healthcare workers in Riyadh PHCs, reflecting effective training programs. However, persistent misconceptions and knowledge gaps regarding germ transmission and hand rubbing efficacy require targeted interventions.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"332-337"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127909","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":"Rendu-Osler disease, a cause of recurrent epistaxis: a case report.","authors":"Raluca Oana Pulpă, Cătălina Voiosu, Ruxandra Oana Aliuș, Irina Gabriela Ioniță, Andreea Rusescu, Răzvan Hainăroșie, Viorel Zainea","doi":"10.25122/jml-2025-0070","DOIUrl":"10.25122/jml-2025-0070","url":null,"abstract":"<p><p>Rendu-Osler disease is a rare, autosomal dominant vascular malformation disorder with diverse clinical manifestations. It commonly presents with recurrent epistaxis, iron deficiency, and secondary anemia. The condition affects small vessels in the nasal, oral, and gastrointestinal mucosa, the skin of the face, lips, and fingertips, and solid organs. This article discusses general and specific manifestations of the disease, along with its general and particular management. A case presentation is included to demonstrate that treatment must be individualized, taking into account all aspects of the condition, including local and systemic manifestations, comorbidities, and the patient's chronic treatment.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"397-401"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127950","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":"Public perceptions and practices on air quality and respiratory health: insights from a cross-sectional study in Saudi Arabia.","authors":"Turki Alanzi, Norah Aljarbooa, Faris AlSalem, Rahaf Sawan, Bushra Albalawi, Gumashah Ababtain, Reema Taha, Mirnan Toonsi, Mohammed Aloufi, Husain Alsharifa, Joud Alshangiti, Nouf Alanzi","doi":"10.25122/jml-2024-0385","DOIUrl":"10.25122/jml-2024-0385","url":null,"abstract":"<p><p>This study aimed to assess public perceptions and practices regarding air quality and its impact on respiratory health in Saudi Arabia. A cross-sectional survey was conducted among 539 participants, selected through stratified random sampling across urban, semi-urban, and rural areas. Data were collected via an online questionnaire and analyzed using descriptive statistics, <i>t</i>-tests, and ANOVA. Findings indicated that 63.2% (<i>n</i> = 341) of participants occasionally checked air quality reports, with moderate confidence in interpreting them (52.5%, <i>n</i> = 283). Awareness of the health impacts of air pollution was higher in urban areas, while rural participants showed less concern and lower awareness (<i>P</i> < .0001). Younger participants (18-30 years) had the highest concern about air pollution (mean: 3.39), whereas older participants demonstrated lower awareness of associated health risks (<i>P</i> < .0001). The study found no significant gender differences in perceptions (<i>P</i> > .05). Despite moderate concern about air pollution, participants perceived a low impact on their quality of life (mean: 2.85). The study underscores the importance of localized public health strategies to address air quality concerns and mitigate respiratory health risks in Saudi Arabia.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"315-323"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127944","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":"Regional anesthesia in colorectal laparoscopy: a retrospective comparison of quadratus lumborum and TAP blocks.","authors":"Mihaela Roxana Oliță, Mihai Adrian Eftimie, Andrei Andreșanu, Mihai Adrian Dobra, Elena Liliana Mirea, Dana Rodica Tomescu","doi":"10.25122/jml-2025-0067","DOIUrl":"10.25122/jml-2025-0067","url":null,"abstract":"<p><p>Effective postoperative pain control is pivotal in enhancing recovery following laparoscopic colorectal surgery. Regional anesthesia techniques such as the transversus abdominis plane (TAP) block and the quadratus lumborum (QL) block have gained prominence as components of multimodal analgesia. However, their comparative efficacy remains underexplored. This retrospective observational cohort study analyzed data from 289 patients undergoing laparoscopic colon surgery. Patients were stratified into three groups: TAP block (Group A, <i>n</i> = 54), QL block (Group B, <i>n</i> = 62), and no regional block (Group C, <i>n</i> = 173). Primary endpoints included time to first analgesic administration and total analgesic consumption (opioids and non-opioids). Statistical analyses were conducted using R (v4.4.2) and Jamovi (v2.3), with significance set at <i>P</i> < 0.05. Group B (QL block) demonstrated significantly reduced opioid consumption (mean 13.16 ± 2.69 mg) compared to both Group A (16.80 ± 5.51 mg) and Group C (18.03 ± 4.29 mg), <i>P</i> < 0.001. Time to first analgesic request was longer in Group B (16.06 ± 2.53 h), indicating more durable analgesia. Non-opioid usage (paracetamol, tramadol, nefopam) was similarly lower in Group B across all comparisons (<i>P</i> < 0.001). Group B also exhibited a significantly shorter hospital stay (4.87 ± 1.14 days) relative to Groups A and C. The QL block was associated with superior postoperative analgesia, reduced opioid and adjunct analgesic requirements, prolonged pain-free intervals, and accelerated postoperative recovery in laparoscopic colorectal surgery. These findings underscore QL block as a potent element of opioid-sparing, multimodal analgesic strategies and support its broader adoption in enhanced recovery protocols.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"285-291"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127947","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":"Surgical management of burns in functional areas: a 5-year retrospective study.","authors":"Matei Iordache, Eliza-Maria Bordeanu-Diaconescu, Andreea Grosu-Bularda, Mihaela-Cristina Andrei, Adrian Frunza, Sabina Grama, Raducu Costache, Tiberiu-Paul Neagu, Ioan Lascar, Cristian-Sorin Hariga","doi":"10.25122/jml-2025-0077","DOIUrl":"10.25122/jml-2025-0077","url":null,"abstract":"<p><p>Burns represent one of the most complex types of trauma that can occur in the human body and, as such, remain a subject of constant debate in the medical world. Globally, burns account for approximately 180,000 deaths annually, with the vast majority (95%) occurring in low- and middle-income countries. Severe burns, which involve more than 20% of the total body surface area (TBSA), lead to high mortality and morbidity rates, more so when they affect some of the critical areas such as the face or the hands, feet, and perineum. Each region has its characteristics and challenges that arise from injury to these parts, and thus, each anatomical section should be individually studied to help determine how to prioritize one over the others. In this way, a guideline could be developed to treat the burned patient effectively. A key issue is where to begin-should functional areas be prioritized over others, or should the reverse approach be taken? Current literature has failed to establish a clear algorithm for the optimal management of these patients. This article takes into account the latest recommendations and compares them with our experience and results.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"292-298"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127986","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 impact of inadequate prenatal care on maternal anemia and pregnancy outcomes in Romania.","authors":"Giorgia Zampieri, Cringu Antoniu Ionescu","doi":"10.25122/jml-2025-0074","DOIUrl":"10.25122/jml-2025-0074","url":null,"abstract":"<p><p>Prenatal care aims to ensure the well-being of both mother and baby by closely watching for potential problems and addressing them promptly. A lack of such care often stems from a combination of issues, including financial hardship, limited education, challenges in accessing healthcare, inadequate medical services, and insufficient social support. The study aimed to assess how iron supplements given during prenatal care affect the prevalence of anemia and whether lack of prenatal care leads to increased maternal and fetal morbidity. This analysis is based on the retrospective evaluation of medical data from 125 patients admitted to the Obstetrics and Gynecology Department of Sf. Pantelimon Hospital in Bucharest, Romania, from August 2024 to February 2025. The parameters considered in this study include prenatal care access, mode of delivery, antepartum anemia and its severity, iron supplementation, postpartum anemia and the necessity of blood transfusions, and length of hospitalization. The link between prenatal care and reduced antepartum anemia underscores the importance of monitoring during pregnancy to mitigate risks. Postpartum hemoglobin levels were significantly higher in patients who received prenatal care, leading to a decrease in severe and moderate anemia cases. Additionally, prenatal care was associated with shorter hospital stays for newborns. Comprehensive prenatal care demonstrably enhanced both maternal and neonatal prognoses across the continuum of pregnancy and the puerperium, thereby contributing to a significant reduction in rates of maternal and fetal morbidity and mortality.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 4","pages":"306-314"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127563","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}