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

{"title":"Depression, Medication Adherence, and Beliefs as Determinants of Health-Related Quality of Life among People Living with HIV: A Cross-Sectional Pharmacoepidemiologic Study in Indonesia.","authors":"Muh Akbar Bahar, Hardiyanti Syarif, Neily Zakiyah, Najmiatul Fitria","doi":"10.1177/23259582261452316","DOIUrl":"10.1177/23259582261452316","url":null,"abstract":"<p><p>ObjectiveTo examine the associations of depression, medication adherence, and medication beliefs with HRQoL among people living with HIV (PLWH) in primary healthcare (PHC) settings in Indonesia.MethodsThis cross-sectional study included PLWH attending 6 PHCs in Makassar (July-September 2025). HRQoL was assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L); depression using the Patient Health Questionnaire-9 (PHQ-9); adherence using the Medication Adherence Report Scale (MARS); and beliefs using the Beliefs about Medicines Questionnaire (BMQ). Multivariable linear regression examined associations with HRQoL.ResultsAmong 400 participants (median age 30 years, interquartile range: 11), mean EQ-5D-5L utility was 0.94 ± 0.10. Higher depression severity was associated with lower HRQoL (β=-0.006; <i>P</i> < .001), while adherence and beliefs were not significant after adjustment.ConclusionDepression was the only independent psychosocial predictor of HRQoL, highlighting the need for integrated mental health support in HIV care within PHC settings.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261452316"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973338","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 Social Vulnerability on Exercise Outcomes: A Longitudinal Study of Physical Function in Older People With HIV.","authors":"Evelyn Iriarte, Kellie L Hawkins, Melissa P Wilson, Allison R Webel, Vitor Hf Oliveira, Vincent Khuu, Grace L Kulik, Paul Cook, Debashis Ghosh, Catherine Jankowski, Kristine M Erlandson","doi":"10.1177/23259582261448699","DOIUrl":"10.1177/23259582261448699","url":null,"abstract":"<p><p>ObjectivesTo examine whether the Social Vulnerability Index (SVI) moderated changes in physical function during supervised and unsupervised phases of an exercise intervention in older adults with HIV.MethodsThis exploratory analysis used data from the High Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV. Participants completed 16 weeks of supervised high- or moderate-intensity exercise, followed by 12 weeks of unsupervised support (personalized coaching or educational text messages). Linear mixed-effects models assessed SVI moderation effects on 400-meter walk time (400-MWT) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF).ResultsAmong 117 participants, SVI did not moderate 400-MWT in either phase or PROMIS-PF during supervised exercise; however, higher SVI was associated with declines in self-reported physical function during the unsupervised phase (<i>P</i> = .03), robust to adjustment and sensitivity analyses.ConclusionsFindings suggest supervised exercise benefits participants across vulnerability levels, but sustained support may be needed to prevent disparities.Parent Trial InformationThe High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV trial, ClinicalTrials.gov: NCT04550676.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261448699"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930692","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 Review of Chronic Comorbidities in People Living With HIV in Peru.","authors":"Marleny Nolasco, Evelyn Hsieh, Patricia J Garcia, Monica M Diaz","doi":"10.1177/23259582261470497","DOIUrl":"10.1177/23259582261470497","url":null,"abstract":"<p><p>BackgroundAdvances in antiretroviral therapy (ART) have extended the life expectancy of people living with HIV (PWH) in Peru, shifting the healthcare focus toward managing chronic non-communicable comorbidities (NCDs). Yet data on NCD burden among aging PWH in Peru are sparse.MethodsWe conducted a scoping review of peer-reviewed studies from PubMed and LILACS, in English or Spanish, that assessed non-AIDS comorbidities in Peruvian adults with HIV.ResultsWe identified 23 studies, all from Lima, mostly cross-sectional or retrospective, involving predominantly male ART patients. Commonly investigated comorbidities included neurocognitive impairment, mental health disorders (especially depression), cardiovascular disease, and metabolic syndrome; bone disease and non-AIDS malignancies were less studied.ConclusionsFindings suggest frequent cognitive, metabolic, and cardiovascular issues among PWH. Yet critical gaps remain: little is known about frailty, disability, or long-term outcomes. Expanded screening, longitudinal studies, and integrated care models are needed to improve long-term health in aging PWH in Peru.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261470497"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471509","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":"Hepatitis B and C Virus Among Prisoners in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.","authors":"Tsegaamlak Kumelachew Derse, Desalegn Mitiku Kidie, Addisu Simachew Asgai, Tadios Lidetu, Yideg Abinew, Asaye Worku Agegn, Misganaw Alelign, Moges Tadesse Abebe","doi":"10.1177/23259582261494741","DOIUrl":"https://doi.org/10.1177/23259582261494741","url":null,"abstract":"<p><p>ObjectiveTo estimate the pooled prevalence and identify transmission drivers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among incarcerated populations in sub-Saharan Africa.MethodsA systematic review and meta-analysis was conducted following a search encompassing Medical Subject Headings (MeSH) and free-text terms from database inception through February 2025. Data were synthesized from 26 studies involving 77,760 prisoners across sub-Saharan Africa. A random-effects model was used to calculate pooled prevalence estimates, assess regional variation, and evaluate odds ratios (OR) for potential transmission risk factors.ResultsThe overall pooled prevalence was 13.0% for HBV and 8.0% for HCV among prisoners. Significant regional disparities were observed, with West Africa presenting the highest HBV burden (16.3%) and East Africa showing the highest HCV burden (8.8%). Key independent predictors of infection included sharing sharp objects (OR, 1.98), tattooing (OR, 1.92), and intravenous drug use (OR, 1.38).ConclusionIncarcerated populations in sub-Saharan Africa experience a high burden of viral hepatitis driven by parenteral exposure and high-risk sexual interactions. Addressing these gaps requires targeted screening, comprehensive harm reduction, condom provision, and integrating prison health services into national elimination strategies.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261494741"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168716","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":"Process Evaluation of Pediatrics Antiretroviral Treatment Service at Health Centers in South Gondar Zone, Northwest Ethiopia, 2026: A Mixed Method Study.","authors":"Endalkachew Mesfin Gebeyehu, Enyew Dagnew Yehuala, Emaway Belay, Mulugeta Ashagrie","doi":"10.1177/23259582261497903","DOIUrl":"https://doi.org/10.1177/23259582261497903","url":null,"abstract":"<p><p>BackgroundPaediatric antiretroviral therapy (ART) is essential for improving treatment outcomes among children living with HIV. Assessing service implementation helps identify gaps affecting quality of care.ObjectiveTo evaluate the process of paediatric ART services at selected health centres in South Gondar Zone, Northwest Ethiopia, 2026.MethodsA facility-based single-case study using a concurrent mixed-methods design was conducted. Data were collected through resource inventories, document reviews, structured observations, caregiver interviews, and key informant interviews. Thirty-one indicators assessed service availability, provider compliance, and caregiver satisfaction. Quantitative data were analysed using SPSS version 25 and qualitative data thematically.ResultsOverall process performance was 80.8%, indicating fair performance requiring improvement. Resource availability and provider compliance were very good, while caregiver satisfaction was excellent. Satisfaction was significantly associated with educational status, medication adherence, and availability of medical supplies (p<0.05).ConclusionsStrengthening adherence support and ensuring uninterrupted medical supplies could improve paediatric ART quality.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261497903"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194864","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":"High Burden of Cardiac Abnormalities in Adults with HIV in Ethiopia: A Multicenter Cross-Sectional Study.","authors":"Biniyam Fiseha Abera, Mikiyas G Teferi, Biruk T Mengistie, Chernet T Mengistie, Rebecca Haile Tesfay, Caleb M Hailemariam, Temesgen H Gebremeskel, Gadisa Megersa","doi":"10.1177/23259582261444796","DOIUrl":"10.1177/23259582261444796","url":null,"abstract":"<p><p>ObjectivesTo estimate the prevalence and patterns of cardiac abnormalities among adults with HIV attending antiretroviral therapy clinics in Ethiopia and to identify clinical predictors of dilated cardiomyopathy (DCM).MethodsA multicenter cross-sectional study enrolled 312 adults with HIV from three tertiary hospitals in Addis Ababa. All participants underwent transthoracic echocardiography and standardized clinical assessment; multivariable logistic regression identified independent predictors of DCM.ResultsEchocardiographic abnormalities were detected in 42.1% of participants, including diastolic dysfunction (8.9%), left ventricular hypertrophy (8.9%), systolic dysfunction (6.1%), DCM (5.4%), coronary artery disease (3.9%), pericardial effusion (2.5%), and pulmonary hypertension (1.4%). DCM was independently associated with CD4 < 200 cells/mm³, antiretroviral therapy-naïve status, and BMI <18.5 kg/m².ConclusionsEthiopian adults with HIV had a high burden of largely asymptomatic cardiac disease. Integrating targeted echocardiographic screening into routine HIV care, prioritizing patients with advanced immunosuppression, lack of ART, or malnutrition, may improve early detection and management.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261444796"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775056","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":"Barriers to Belonging: How Stigma Disrupts Social Roles for Malawian Adolescents Living with HIV and Opportunities for Change.","authors":"Maria F Faidas, Bradley N Gaynes, Laika Maganga, Steven M Mphonda, Maureen Matewere, Jeromy Nyirenda, Jack Kramer, Kazione Kulisewa, Nivedita L Bhushan, Brian W Pence, Melissa A Stockton","doi":"10.1177/23259582251413319","DOIUrl":"10.1177/23259582251413319","url":null,"abstract":"<p><p>BackgroundHuman immunodeficiency virus (HIV) stigma has detrimental impacts on HIV care outcomes, mental health, and psychosocial well-being. Adolescents living with HIV (ALWH) in Malawi experience HIV stigma as gossip, insults, and physical distancing, contributing to decreased HIV care engagement and mental health issues including depression, substance use disorders, and suicidality. To inform future stigma-reduction interventions for this vulnerable population, we investigate how HIV stigma impacts an ALWH's ability to meaningfully participate in their social roles and responsibilities.MethodsThis qualitative study recruited 68 participants from three government healthcare facilities in Lilongwe, Malawi. Our study sample consisted of 13 ALWH aged 13-19 years who screened positive for depressive symptoms on the Beck Depression Inventory-II with a score ≥13 (5 females, 8 males) and 55 stakeholders aged 13-54 years (38 females, 17 males). Guided by the What Matters Most Framework, we conducted 13 in-depth interviews and 10 focus group discussions with ALWH, adolescent peers without HIV, caregivers, teachers, HIV care providers, and mental health providers to examine culturally relevant manifestations of HIV stigma and its impact on ALWH's ability to fulfill socially expected roles. We organized data into four life domains-home, community, school, healthcare-which we analyzed to understand how stigma hinders social role performance, to assess how role fulfillment shapes stigma, and to identify strategies to reduce stigma.ResultsALWH identified their most salient social roles as being a family member, church member, student, friend, and active participant in one's healthcare. In each life domain, HIV stigma negatively impacted an ALWH's ability to meaningfully engage in their prescribed roles, resulting in ostracization from family and friends, displacement from one's home or school, disengagement from church, poor school performance and attendance, and reduced retention in HIV care. Key recommendations from study participants included engagement and collaboration with caregivers, increasing counseling services for ALWH with peer support, promoting community awareness and education, and redress systems for acts of stigmatization.ConclusionsThis study revealed that HIV stigma disrupts an ALWH's ability to fulfill key social roles in home, community, school, and healthcare settings. Stigmatization from caregivers within the home has the most detrimental impact on ALWH, identifying caregivers as critical part of stigma-reduction efforts. To effectively address stigma across all life domains, targeted stigma-reduction is needed, particularly through specialized counseling that addresses the unique aspects of ALWH personhood, and community education to disseminate accurate knowledge.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582251413319"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064378","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":"Barriers to HIV Prevention and Treatment Services in Achieving Epidemic Control Among Key Population in Nigeria: An Implementation Science Study on NAHI Project.","authors":"Ganiyat O Kareem, Christiana Laniyan, Christopher Akolo, Philip Imohi, Joseph Ashivor, Emeka Anoje, James E Uba, Ugbe Maurice-Joel Ugbe, Samson Bamidele, Uche Amalu, Oluwapelumi Aliu, Joyce Ndam, Nibretie Workneh, Uchenna Michael Ugwoke, Onyinoyi Aishatu Adegbe, Mary Morenike Oguntokun, Ofem Obeten, Leah Umeokeke","doi":"10.1177/23259582261423609","DOIUrl":"10.1177/23259582261423609","url":null,"abstract":"<p><p>ObjectiveThis mixed-method cross-sectional study identified different barriers faced by key population in accessing HIV services hindering epidemic control on National Aligned HIV/AIDS Initiative (NAHI) in Nigeria.MethodologyData were collected from 1932 participants (≥18 years) in 12 NAHI states using structured surveys and analyzed with SPSS. Focus Group Discussion and Key Informant Interview were conducted among 312 KPs and 12 health workers respectively and thematically analyzed using NVivo.ResultsFrom 1932 respondents, 40% were Female Sex Workers (FSW), 37% Men who have Sex with Men (MSM) and 24% People who inject drugs (PWID). About 82% self-reported receiving HIV testing, 67% accessed prevention services and 63% currently receiving ART treatment among participants. Major barriers faced by KP included distance to facilities (57%), financial constraints (30%) and stigma (24%). Socioeconomic status significantly predicted risky behaviors (<i>R</i> = 0.201, <i>p</i> < 0.001). Qualitative findings highlighted abuse and violence, attitude of health workers, mental health, homelessness and drug stock-outs, as barriers.ConclusionStructural, biomedical, and behavioral barriers hinder HIV epidemic control among KPs in Nigeria. Multilevel interventions addressing commodity supply, socioeconomic support, abuse and stigma reduction are critical to improve HIV outcomes in Nigeria.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261423609"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639229","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":"Cervical Cancer Screening Utilization and Its Associated Factors Among Women Living With HIV in Public Health Facilities of Gondar Town, Northwest Ethiopia.","authors":"Yeshiwas Ayale Ferede, Agerie Mengistie Zeleke, Worku Chekole Tassew, Ayanaw Dinku Abebe, Jember Ayelgne Beyene","doi":"10.1177/23259582261460521","DOIUrl":"10.1177/23259582261460521","url":null,"abstract":"<p><p>BackgroundCervical cancer remains a major global health challenge, disproportionately affecting low- and middle-income countries. Women living with HIV are at increased risk due to weakened immunity. This study assessed cervical cancer screening utilization and associated factors among HIV-positive women attending antiretroviral therapy (ART) clinics in Gondar town, Northwest Ethiopia.MethodsA multicenter institution-based cross-sectional study was conducted from November 1 to 30, 2025, using systematic random sampling. Data were collected through structured interviewer-administered questionnaires and analyzed using STATA 14. Bivariable and multivariable logistic regression analyses were performed, with <i>P</i> < .05 considered statistically significant.ResultsScreening utilization was 30.2%. Good knowledge (AOR = 3.44; 95% CI: 2.22-5.16), favorable attitude (AOR = 2.81; 95% CI: 2.28-6.61), and history of sexually transmitted infections (AOR = 2.22; 95% CI: 1.83-4.13) were significantly associated.ConclusionScreening utilization was low. Strengthening health education, improving ART counseling, and integrating screening into routine HIV care are recommended.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261460521"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258324","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 First Thing I Must do is Become Undetectable\": Examining U=U Awareness and the HIV Care Continuum Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV in Lima, Peru.","authors":"Reni Forer, Julien Brisson, Hugo Sanchez, Diego Veneros, Alexander Lankowski, Ann Duerr","doi":"10.1177/23259582261471983","DOIUrl":"10.1177/23259582261471983","url":null,"abstract":"<p><p>ObjectivesAwareness of \"Undetectable = Untransmittable\" (U=U) may strengthen HIV care engagement, yet its influence remains underexamined, particularly in Latin America. Among gay and bisexual men living with HIV in Lima, Peru, we examined (1) sociostructural correlates of U=U awareness; (2) U=U educational experiences and trust; (3) associations between U=U awareness and self-reported ART use; and (4) associations between U=U awareness and viral load.MethodsWe conducted a sequential explanatory mixed-methods study including a survey (N=310) and individual interviews (N=30).ResultsMost participants (86%) were aware of U=U. Awareness was less common among those diagnosed more recently, those without income in the past month, and non-binary participants. Participants aware of U=U were more likely to report linkage to care, current ART use, and viral suppression. Qualitative findings highlighted U=U as a motivator for ART adherence and viral suppression.ConclusionsTogether, these findings underscore the importance of integrating clear, consistent U=U counseling into HIV services in Peru and globally.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"25 ","pages":"23259582261471983"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604362","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}