Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Depressive Symptoms and Clinical and Nutritional Outcomes among Adults Living with HIV Initiating Antiretroviral Therapy in Dar es Salaam, Tanzania.","authors":"Kynza Khimani, Alfa Muhihi, Wafaie W Fawzi, Nzovu Ulenga, Christopher R Sudfeld","doi":"10.1177/23259582261442282","DOIUrl":"10.1177/23259582261442282","url":null,"abstract":"<p><p>BackgroundDepression is highly prevalent among people living with HIV (PLWH). However, few studies have examined its relationship with clinical and nutritional outcomes in sub-Saharan Africa.MethodsWe conducted a cohort study of 3996 PLWH in Tanzania. Depressive symptoms were measured at antiretroviral therapy (ART) initiation with the Hopkins Symptom Checklist-25 (HSCL-25). Symptoms consistent with depression were defined using the conventional HSCL-25 (score >1.75) and Tanzania-adapted (score >1.06) cutoffs. We evaluated the association of depression defined by both cut-offs and tertiles of HSCL-25 scores with clinical and nutritional outcomes using regression models.ResultsUsing the conventional HSCL-25 cutoff, men with symptoms consistent with depression had increased risk of all-cause mortality (hazard ratio (HR): 1.68; 95% CI: 1.17-2.39) and HIV disease progression (HR: 1.59; 95% CI: 1.15-2.19). Women in the highest tertile of depressive symptom scores had increased risk of >10% weight loss (HR: 1.27; 1.05-1.55) and incident pulmonary TB (HR: 1.93, 95% CI: 1.19-3.12).ConclusionsDepressive symptoms at ART initiation were associated with poor clinical and nutritional outcomes; however, the risks appear to differ by gender and depression severity.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261442282"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633942","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":"Support Groups for Caregivers of Adolescents With HIV - A Qualitative Analysis of Caregivers' Experiences in Mozambique.","authors":"Joana Falcão, Jennifer M Belus, Ricardino Zandamela, Niklaus D Labhardt, Aleny Couto, Allison Zerbe, Eduarda Pimental De Gusmão, Maja Weisser, Elaine J Abrams","doi":"10.1177/23259582261471850","DOIUrl":"https://doi.org/10.1177/23259582261471850","url":null,"abstract":"<p><p>BackgroundFamilies are the primary source of care during adolescence, when HIV management is shared between adolescents with HIV (AHIV) and caregivers. Peer support interventions that improve caregiver well-being may strengthen AHIV self-management.MethodsWe conducted qualitative interviews with caregivers of AHIV to explore how peer group participation influenced support for AHIV self-management. This was a substudy from the CombinADO trial, which, from 2018 to 2023, evaluated an intervention to improve viral suppression among adolescents and young adults with HIV in Mozambique.Results53 caregivers were interviewed (median age 37; 74% female). Caregivers reported enhanced knowledge of disease and treatment clarified HIV negative beliefs augmented AHIV treatment adherence monitoring psychosocial changes, and improved caregiver-adolescent relationship quality.ConclusionsSupport groups for caregivers could strengthen caregivers' role in supporting AHIV self-management. Expanding caregiver support groups may improve HIV care for AHIV in Mozambique and similar settings.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261471850"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Triple Burden of HIV, Noncommunicable Diseases, and Mental Health Conditions Among Female Sex Workers With HIV in the Dominican Republic.","authors":"Clare Barrington, Deshira D Wallace, Carolina Ruiz, Yeycy Donastorg, Martha Perez, Hoisex Gomez, Yicenia Brito Beltre, Meredith Dockery, Deanna Kerrigan","doi":"10.1177/23259582261455718","DOIUrl":"10.1177/23259582261455718","url":null,"abstract":"<p><p>ObjectivesThe purpose of this study was to determine the prevalence of type 2 diabetes, hypertension, and mental health conditions among female sex workers with HIV in Santo Domingo, Dominican Republic.MethodsWe conducted a cross-sectional survey, blood draw, and medical exam with women (n = 200) recruited by peer navigators. We determined prevalence and used multivariable logistic regression to assess the relationship between conditions.ResultsMean participant age was 46.1 years (SD: 9.15). Most participants (89.0%) were virally suppressed. Diabetes prevalence was 7.0% and hypertension was 63.0%. Nearly half reported moderate-to-severe depressive symptoms (46.0%) and over half (65.8%) anxiety. Women with moderate-to-severe depressive symptoms were over 4 times more likely to be virally unsuppressed (adjusted odds ratio [aOR]=4.17 [95% CI: 1.37-12.68]) and over 3 times more likely to have diabetes (aOR=3.45 [95% CI: 1.00-11.91]).ConclusionFindings indicate the need for holistic, integrated healthcare models to address multiple health conditions and support overall wellbeing.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261455718"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150236","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":"Clinically Probable Guillain-Barré Syndrome and Herpesvirus-Associated Syndromes in Advanced Untreated HIV: A Retrospective Case Cluster from India.","authors":"Murali K Yanamadala","doi":"10.1177/23259582261491789","DOIUrl":"https://doi.org/10.1177/23259582261491789","url":null,"abstract":"<p><p>BackgroundGuillain-Barré syndrome (GBS) can be difficult to recognise in advanced untreated HIV, particularly where cerebrospinal fluid analysis and electrophysiology are unavailable.MethodsWe retrospectively reviewed adults with advanced HIV who were not receiving antiretroviral therapy and presented with acute symmetrical weakness at an Indian HIV specialty centre during 2019-2020. Cases were classified as clinically probable GBS with Brighton Collaboration level 3 diagnostic certainty.ResultsEight cases were identified among 139 admissions (5.8%). Mean CD4 count 78 cells/mm³. All eight had multiple concurrent infectious conditions. Herpesvirus-associated syndromes included ulcerative oesophagitis compatible with a herpesvirus-associated process (n=5), antecedent herpes zoster (n=2), or diarrhoeal illness with supportive CMV IgG serology (n=1). Seven recovered after multimodal treatment; one died.ConclusionsThis repeated clinical pattern of coexistence is hypothesis-generating but does not establish active viral reactivation, directionality, or causality. Pragmatic syndromic recognition and treatment remain necessary when definitive diagnostics are unavailable.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261491789"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predisposition to Pre-Exposure Prophylaxis and Associated Factors Among Men who Have Sex with Men in Brazil: A Cross-Sectional Study.","authors":"Yndiara Kássia da Cunha Soares, Álvaro Francisco Lopes de Sousa, Ana Paula Morais Fernandes, Lariane Angel Cepas, Talita Morais Fernandes, Aires Garcia Dos Santos Junior, Wínola Dafny Douglas de Oliveira, Chrystiany Plácido de Brito Vieira, Lidya Tolstenko Nogueira, Rosilane de Lima Brito Magalhães, Paulo de Tarso Moura Borges, Telma Maria Evangelista de Araújo","doi":"10.1177/23259582251407470","DOIUrl":"10.1177/23259582251407470","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the predisposition to use pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) and associated factors among men who have sex with men (MSM). <b>Method:</b> Cross-sectional, analytical study, developed at the Testing and Counseling Center and social locations of the target population, in Teresina, Piauí, Brazil, with a sample composed of 320 MSM, recruited by the snowball sampling technique. Data collection was performed in two consecutive stages, the first being HIV testing and counseling. The second stage consisted of the application of instruments to characterize the sample regarding sociodemographic aspects, sexual behavior, knowledge, and acceptability of PrEP for HIV and an HIV Risk Perception Scale. For the descriptive analysis, measures of position and dispersion were used. In the univariate analysis, Simple Logistic Regression was used, with selection by the Wald test at the 20% level. In the multivariate analysis, Multiple Logistic Regression with a Bayesian approach was used. <b>Results:</b> MSM in the age group between 20 and 39 years were predominant 290 (90.6%), income greater than four minimum wages 103 (32.2%) and complete higher education 219 (68.4%). The expressive majority 297 (92.8%) reported predisposition to use PrEP for HIV, which was associated with MSM with complete higher education (OR = 5.56; 95% CI = 1.03-30.44; P = 0.046), having presented signs/symptoms of STI in the last 12 months (OR = 3.08; 95%CI = 1.05-9.09; P = 0.041) and satisfactory knowledge about PrEP (OR = 1.69; 95%CI = 1.01-2.83; P = 0.045). <b>Conclusion:</b> A high predisposition to use PrEP was found among MSM in the sample, despite the unsatisfactory knowledge about PrEP and unsatisfactory perception of risk regarding HIV. Understanding the risk factors and protective factors for the use of this important prevention method is essential for its expansion and consequent effectiveness in controlling the HIV epidemic.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251407470"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12894643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165600","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 Factors Associated With Hyperglycemia Among Patients on Dolutegravir-Based Antiretroviral Therapy: A Cross-Sectional Study From Central Uganda.","authors":"Charles Nkubi Bagenda, Carol Nantongo, Michael Junior Mugisa, Elastus Ssemwanga, Sylivia Achieng Lumumba, Edward Kikabi, Ritah Kiconco, Simon Peter Rugera","doi":"10.1177/23259582261426447","DOIUrl":"10.1177/23259582261426447","url":null,"abstract":"<p><p>BackgroundThe use of dolutegravir (DTG)-based antiretroviral therapy (ART) has been associated with the development of hyperglycemia. This study determined the prevalence and factors associated with hyperglycemia among people living with HIV (PLWH) on DTG-based ART in Uganda.MethodsWe conducted a cross-sectional study among 219 systematically recruited PLWH on DTG-based ART for ≥1 year at a Health Centre IV in Central Uganda. Data were collected using a structured questionnaire, anthropometric measurements, and laboratory investigations. Logistic regression was performed to identify factors associated with hyperglycemia.ResultsOut of 219 participants, 45 had fasting glucose ≥110 mg/dL, giving a hyperglycemia prevalence of 20.55% (95% confidence interval [CI]: 15.68%-26.45%). Overweight (aOR 8.11, 95% CI: 2.76-23.85, <i>P</i> < .001) and abnormal waist-to-hip ratio (aOR 4.36, 95% CI: 1.23-15.37, <i>P</i> = .022) were significantly associated with hyperglycemia.ConclusionsHyperglycemia is prevalent among PLWH on DTG-based ART and is potentially associated with overweight and abnormal waist-to-hip ratio.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426447"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276191","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":"Incidence and Predictors of Loss to Follow-Up Among ART Patients on Follow-Up at Public Health Facilities in Southwest Ethiopia. A Time-to-Event Analysis.","authors":"Oftana Daba, Dereje Tsegaye, Mohammed Reshad","doi":"10.1177/23259582261426232","DOIUrl":"10.1177/23259582261426232","url":null,"abstract":"<p><p>BackgroundLoss to follow-up (LTFU) remains a major challenge to successful antiretroviral therapy (ART), contributing to increased morbidity, mortality, and drug resistance, particularly in Sub-Saharan Africa. Evidence on the timing and predictors of LTFU in rural Ethiopia is limited. This study aimed to determine the time to LTFU and its predictors among adults on ART in selected health facilities of Ilu Aba Bor Zone, Southwest Ethiopia.MethodsA retrospective cohort study was conducted among 372 adults living with human immune virus (HIV) on ART at 4 public health facilities from October 2018 to November 2022. Data were extracted from standardized ART forms and patient charts. Kaplan-Meier survival analysis estimated survival probabilities, and Cox proportional hazards regression identified predictors of LTFU, reporting adjusted hazard ratios with 95% confidence intervals (CI). Proportional hazards assumptions were checked using Schoenfeld residuals and log-log plots.ResultsOver 6993 person-months of follow-up (median: 19 months), 70 participants (18.8%) were LTFU, mostly within the first year (34.3% in the first 6 months; 32.9% in the second 6 months). Independent predictors included absence of a registered phone number, World Health Organization clinical stage III/IV, noninitiation of cotrimoxazole preventive therapy, nondisclosure of HIV status, and poor or fair adherence.ConclusionLTFU was common during early antiretroviral. Strengthening patient tracing, promoting disclosure, initiating preventive therapy, and improving adherence support may enhance retention and contribute to achieving human Immune deficiency virus epidemic control targets.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261426232"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317527","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":"Perspectives of Local Health Departments Among People Receiving HIV Services in a Southern \"Ending the HIV Epidemic\" Region: A Qualitative Study.","authors":"Ian Dale, Alicia Diggs, Maria Esposito, Grace Galphin, Carol Golin, Eunice Okumu, Ujunwa Onyeama, Stephanie Sherard, Meagan Zarwell, Ann M Dennis","doi":"10.1177/23259582261451971","DOIUrl":"10.1177/23259582261451971","url":null,"abstract":"<p><p>IntroductionPublic health departments (HDs) are central to HIV prevention and care, yet client perspectives remain understudied. Before implementing a social network strategy within a HD, we examined how prior experiences with HDs influence engagement.MethodsWe conducted 17 in-depth interviews with Black sexual and gender minority individuals in Charlotte, North Carolina, to explore experiences with HDs.ResultsParticipants described emotional and navigational support during critical health encounters, including compassionate linkage to care and HIV/STI testing. Identity-affirming interactions and shared cultural backgrounds fostered trust and comfort. However, stigma, concerns about privacy, and intrusive exposure notifications created barriers and, in some cases, distrust of HDs.ConclusionsFindings underscore the importance of identity-concordant care and transparent communication. Tailoring partner services to address confidentiality and affirm identity is essential for public health approaches that build trust, reduce stigma, and meet the needs of underserved communities, ultimately improving engagement in HIV prevention and care.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261451971"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973370","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":"Association Between High Serum Aspartate Transaminase to Alanine Transaminase Ratio and Probable HIV Dementia Among People Living With HIV on Dolutegravir-Based Antiretroviral Therapy: A Cross-Sectional Study from Central Uganda.","authors":"Charles Nkubi Bagenda, Carol Nantongo, Michael Junior Mugisa, Vincent Olwoch, Fauziya Naziiwa, Christier Masereka, Bright Bagambe, Godfrey Somikwo, Fred Sempijja, Jazira Tumusiime, Deusdedit Tusubira","doi":"10.1177/23259582261475552","DOIUrl":"10.1177/23259582261475552","url":null,"abstract":"<p><p>BackgroundProbable HIV dementia (PHD) remains a significant complication among people living with HIV(PLWH), particularly in resource-limited settings where access to comprehensive neurocognitive assessment is limited<b>.</b> This study investigated the association between AST-to-ALT ratio and PHD among PLWH on Dolutegravir-based antiretroviral therapy (DTG-based ART).MethodsWe conducted a secondary analysis using a dataset generated from hospital-based cross-sectional study that consecutively recruited 235 PLWH on DTG-based ART at St. Francis Nsambya Hospital in Kampala, Central Uganda. PHD was defined as International HIV Dementia Scale score ≤10.ResultsPHD prevalence was 22.1% (52/235; 95% CI: 17.3-27.9) and increased across AST-to-ALT ratio tertiles (13%, 23%, and 31%; p=0.023). Participants in the second and third tertiles had higher odds of PHD (aOR=2.85, 95% CI: 1.13-7.15; p=0.026 and aOR=4.28, 95% CI: 1.75-10.45; p=0.001). Each 0.5-unit increase in the AST-to-ALT ratio increased the odds of PHD by 40% (aOR=1.40, 95% CI: 1.02-1.92; p=0.036). An AST-to-ALT ratio cutoff of 1.26 showed modest discrimination for PHD (AUC=0.622), with 73% sensitivity, 51% and specificity, 29%.ConclusionA higher AST-to-ALT ratio is a potentially useful screening predictor for PHD in PLWH on DTG-based ART in resource limited settings, pending validation in larger prospective studies.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261475552"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663992","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 of Hyperlipidemia and Associated Factors Among People Living With HIV Attending Care at Rugazi Health Center IV, Rubirizi District South-Western Uganda.","authors":"Mellon Mwikiriize, Fred Kaizirege Gervas, William George Nekejju, Joseph Madaha Mnyeti, Paul Onesmo Mgaya, Charles Nkubi Bagenda, Innocent B Mugume, Yona Mbalibulha","doi":"10.1177/23259582261456428","DOIUrl":"10.1177/23259582261456428","url":null,"abstract":"<p><strong>The purpose of the research: </strong>Although antiretroviral therapy (ART) has significantly reduced HIV-related morbidity and mortality worldwide, its long-term use is increasingly associated with metabolic complications, particularly hyperlipidemia, a major risk factor for ischemic heart disease. This study therefore assessed the prevalence of hyperlipidemia and its associated factors among people living with HIV receiving care at Rugazi Health Centre IV in Rubirizi District, South-Western Uganda.</p><p><strong>Major findings: </strong>The prevalence of hyperlipidemia was found to be 11.7%. Physical activity and having high blood pressure were the factors found to be significantly associated with the reduction and increase of hyperlipidemia respectively.</p><p><strong>Conclusion and recommendation: </strong>There was a low prevalence of hyperlipidemia among people living with HIV as compared to several studies published in similar populations. Regular physical activity interventions, routine lipid measurement, and blood pressure screening should be exclusively integrated within the HIV care system among patients receiving ART.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261456428"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031946","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}