Journal of the Turkish German Gynecological Association最新文献

{"title":"Family planning behavior before and during the COVID-19 pandemic.","authors":"Jonathan Kazakov, Joshua Fogel, Tara Savannah Lowery, Maggie Tetrokalashvili","doi":"10.4274/jtgga.galenos.2024.2024-3-2","DOIUrl":"10.4274/jtgga.galenos.2024.2024-3-2","url":null,"abstract":"<p><strong>Objective: </strong>Contraception use and follow-up visit data from before and in two periods during the coronavirus disease-2019 (COVID-19) pandemic were compared to investigate change in behavior.</p><p><strong>Material and methods: </strong>A retrospective study of women aged 18-49 years from New York City during three one-year time periods: pre-COVID-19 pandemic [(COV-PRE); n=4,261], early COVID-19 pandemic when the COVID-19 vaccine was not available [(COV-VACNO); n=3,365], and later COVID-19 pandemic when the COVID-19 vaccine was available [(COV-VACAV); n=4,170].</p><p><strong>Results: </strong>There were higher odds of implant use [odds ratio (OR): 1.42, 95% confidence interval (CI): 1.05, 1.93, p=0.02] during COV-VACNO. There were lower odds for any contraception (OR: 0.88, 95% CI: 0.79, 0.98, p<0.001) or intrauterine device (IUD) (OR: 0.73, 95% CI: 0.61, 0.86, p<0.001) use during COV-VACAV. No differences occurred for bilateral tubal ligation, pill, patch, injection, medical elective abortion, or surgical elective abortion. There was a greater percentage of follow-up visits for any contraception (p=0.02) and IUD (p=0.02) use during COV-VACNO and COV-VACAV than COV-PRE.</p><p><strong>Conclusion: </strong>When COVID-19 vaccines were unavailable, there were higher odds for use of implants. Once COVID-19 vaccines were available, there were lower odds for any contraception and IUD use. These findings highlight changes in behavior in terms of contraceptive concerns and preferences during a public health crisis that should be planned for by healthcare providers.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 4","pages":"200-206"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807508","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":"Testing the role of unstimulated in vitro maturation for potential development of immature oocytes in women with oocyte maturation abnormalities","authors":"Şenol Kalyoncu, Alper Başbuğ, Ebru Hatırnaz, Aşkı Ellibeş Kaya, Nur Dokuzeylül Güngör, Sebati Sinan Ürkmez, Yeşim Civil Ürkmez, Şafak Hatırnaz","doi":"10.4274/jtgga.galenos.2024.2023-10-9","DOIUrl":"10.4274/jtgga.galenos.2024.2023-10-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the developmental potential of immature oocytes and evaluate whether unstimulated in vitro maturation (IVM) could serve as a treatment option for women with oocyte maturation abnormalities (OMAs).</p><p><strong>Material and methods: </strong>This cohort study was conducted between September 2019 and December 2022, and included women who underwent unstimulated, non-human chorionic gonadotropin (hCG) priming IVM. Oocytes were incubated with IVM medium for 26-48 hours and evaluated to compare their maturation profiles with the immature oocytes retrieved from the same patients in their previous in vitro fertilization cycles.</p><p><strong>Results: </strong>Among the twelve women in the study, eleven (91.6%) underwent whole exome sequencing analysis. Of these, 18 variants were identified in 10 individuals, excluding case 1, who had no previous mutation analysis. Of the mutations identified, 9 (50%) were located in <i>FSHR</i>, 5 (27.8%) in <i>TUBB8</i>, 1 (5.6%) in <i>ZP1</i>, 1 (5.6%) in <i>SLFN14</i>, 1 (5.6%) in <i>AR</i>, and 1 (5.6%) in <i>STEAP3</i>. Apart from one woman with resistant ovary syndrome (ROS), none treated with unstimulated IVM had oocyte maturation. Remarkably, the only patient to achieve oocyte maturation in an unstimulated IVM cycle was case 11, who had ROS and a single <i>FSHR</i> variant.</p><p><strong>Conclusion: </strong>Unstimulated, non-hCG primed IVM does not appear to be effective in the treatment of OMAs, perhaps with the exception of women with ROS. However, this study led our team to develop novel treatment options based on physiological mechanisms for some subtypes and supraphysiological approach for other subtypes of OMAs.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"219-223"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788507","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 role of leptin in the male reproductive system.","authors":"Melek Obaideen, Tuğçe Önel, Ecem Yıldırım, Aylin Yaba","doi":"10.4274/jtgga.galenos.2024.2023-7-3","DOIUrl":"10.4274/jtgga.galenos.2024.2023-7-3","url":null,"abstract":"<p><p>Leptin is a hormone produced from adipose tissue, targeting the hypothalamus and regulating energy expenditure, adipose tissue mass, and reproductive function. Leptin concentration reflects body weight and the amount of energy stored, as well as the level of reproductive hormones and male fertility. In this review, the aim was to focus on leptin signaling mechanisms and the significant influence of leptin on the male reproductive system and to summarize the current knowledge of clinical and experimental studies. The PubMed database was searched for studies on leptin and the male reproductive system to summarize the mechanism of leptin in the male reproductive system. Studies have shown that obesity-related, high leptin levels or leptin resistance negatively affects male reproductive functions. Leptin directly affects the testis by binding to the hypothalamic-pituitary-gonadal axis and the receptors of testicular cells, and thus the location of leptin receptors plays a key role in the regulation of the male reproductive system with the negative feedback mechanism between adipose tissue and hypothalamus. Based on the current evidence, leptin may totally inhibit male reproduction, and investigation of this role of leptin has established a potential interaction between obesity and male infertility. The mechanism of leptin in the male reproductive system should be further investigated and possible treatments for subfertility should be evaluated, supported by better understanding of leptin and associated signaling mechanisms.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 4","pages":"247-258"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807480","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":"Interstitial ectopic pregnancy in a patient with absent ipsilateral fallopian tube.","authors":"Kavita Khoiwal, Amrita Gaurav, Priyanka Gupta, Jaya Chaturvedi","doi":"10.4274/jtgga.galenos.2024.2024-2-3","DOIUrl":"10.4274/jtgga.galenos.2024.2024-2-3","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 3","pages":"186-188"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108709","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":"Serum anti-Mullerian hormone levels in Turkish girls aged 18 and younger for ovarian reserve determination","authors":"İpek Betül Özçivit Erkan, Mahmut Öncül, Zafer Başıbüyük, Ceren Çebi, İsmail Çepni","doi":"10.4274/jtgga.galenos.2024.2023-8-5","DOIUrl":"10.4274/jtgga.galenos.2024.2023-8-5","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to show that anti-Mullerian hormone (AMH) may be used as a quantitative marker of ovarian reserve in Turkish girls aged 18 years and younger and establish the reference values for AMH in Turkish girls.</p><p><strong>Material and methods: </strong>This retrospective study included girls between 8-18 years old, without premature ovarian failure or without genetic factors resulting in ovarian dysgenesis. Blood specimens were collected after overnight fasting early in the morning during the early follicular phase. Measurement of serum levels of gonadotropins and AMH was done. Mean serum AMH levels of different age groups and best fitting curve representing AMH percentiles (10^th, 25^th, 50^th, 75^th, 90^th) were calculated.</p><p><strong>Results: </strong>In total 785 girls with a mean age of 16.16±1.90 years were included, divided into seven age groups. The mean serum AMH level for the total cohort was 5.20±4.19 ng/mL. There was a significant difference between the mean values of AMH in age groups as follows: ≤12 and 17-≤18 (p=0.011). The best fitting curves for AMH percentiles were 4^th order polynomial functions. There was a significant correlation between AMH and age and follicle stimulating hormone levels (r=0.148, p<0.001 and r=-0.092, p=0.010).</p><p><strong>Conclusion: </strong>Our results reflect the real-life data for serum AMH values in Turkish girls. Our nomogram may be useful for counseling adolescents about their ovarian reserve and diagnosing other gynecological diseases. A longitudinal study is necessary for improving the predictive value of AMH values in girls aged 18 and younger.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"138-143"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076154","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 of candidate gene (<i>INSR & THADA</i>) polymorphism with polycystic ovary syndrome: meta-analysis and statistical power analysis.","authors":"Saranya Velmurugan, Rashmi Pauline, Gowtham Kumar Subbaraj","doi":"10.4274/jtgga.galenos.2024.2024-1-7","DOIUrl":"10.4274/jtgga.galenos.2024.2024-1-7","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder that impacts women before reaching menopause. In addition to notable features (irregular ovulation, elevated androgen levels, and the existence of numerous ovarian cysts), individuals with PCOS frequently encounter diverse metabolic, cardiovascular, and psychological conditions. The onset of PCOS is influenced by a combination of factors, and various genetic variations are believed to play a significant role in its progression. The objective of the current study was to explore the link between genetic variations in the candidate genes <i>thyroid-adenoma-associated (THADA)</i> gene and insulin receptor (<i>INSR</i>) and susceptibility to developing PCOS. We conducted an extensive search across various databases, including Google Scholar, PubMed, Science Direct, Scopus, and EMBASE, to compile relevant case-control studies and literature reviews for subsequent statistical analysis. In the present study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed, a guideline for Systematic Reviews and Meta-Analysis. While a previous meta-analysis explored the correlation between <i>INSR</i> rs1799817 and <i>THADA</i> rs13429458 and their association with susceptibility to PCOS, our current study did not integrate any findings from these prior investigations. Our research encompassed articles published between 2017 and 2023, and we employed MetaGenyo software to assess the collected data. Statistical power analysis was performed using G*Power 3.1 software. Odds ratios and their corresponding 95% confidence intervals were calculated for each genetic model. Fifteen studies that met the criteria were analyzed. Out of these, ten studies, involving 1,189 cases and 1,005 controls, examined the <i>INSR</i> rs1799817 gene polymorphism, while five studies, including 783 cases and 553 controls, investigated the <i>THADA</i> rs13429458 gene polymorphism. The meta-analysis results indicated that there was no statistically significant association between the <i>INSR</i> rs1799817 gene polymorphism and the risk of PCOS (p>0.05). In contrast, the <i>THADA</i> rs13429458 gene polymorphism showed a significant association with PCOS risk under the over-dominant model (p<0.05). The present meta-analysis demonstrated a notable association between the <i>THADA</i> rs13429458 gene polymorphism and the likelihood of developing PCOS. Further rigorous studies with expanded sample sizes and diverse ethnic representation will be important to comprehensively evaluate and validate these findings.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 3","pages":"167-178"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108727","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":"When did the confusion between vulvodynia and vaginismus start?","authors":"Pedro Vieira-Baptista, Koray Görkem Saçıntı, Mario Preti, Hans Verstraelen, Jacob Bornstein","doi":"10.4274/jtgga.galenos.2024.2024-8-12","DOIUrl":"10.4274/jtgga.galenos.2024.2024-8-12","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 3","pages":"189-191"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108738","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":"Single-center experience of laparoscopic hysterectomy: analysis of one thousand five hundred and fifteen patients","authors":"Gülşen Doğan Durdağ, Songül Alemdaroğlu, Şirin Aydın, Seda Yüksel Şimşek, Erhan Şimşek, Hüsnü Çelik","doi":"10.4274/jtgga.galenos.2024.2023-9-12","DOIUrl":"10.4274/jtgga.galenos.2024.2023-9-12","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic hysterectomy has become an increasingly used surgery in recent years. The aim of this study was to evaluate the clinical features and perioperative outcomes of patients who underwent laparoscopic hysterectomy for benign or malignant indications in a single center during a period of eight years.</p><p><strong>Material and methods: </strong>Data of patients who underwent laparoscopic hysterectomy in the gynecological oncology department of a university hospital over a period of eight years was analyzed retrospectively. Two groups were formed based on being operated for benign or malignant indications. Demographic characteristics and perioperative data of these groups were evaluated.</p><p><strong>Results: </strong>A total of 1,515 patients underwent laparoscopic hysterectomy. The mean age of the patients was 52.0±9.8 years and mean body mass index (BMI) was 31.3±8.5 kg/m2. Of these, 1,219 had benign and 296 had malignant histopathology results. In the whole cohort, intraoperative complications were seen in 1.6% and postoperative complications in 3.5%. The patients in the malignant group were older, had a higher BMI and a higher comorbidity rate. The duration of operation and length of hospital stay were significantly longer in this group (p=0.0001 for all parameters). However, intraoperative and postoperative complication rates, rate of blood transfusion and amount of transfusion were similar between the two groups (p>0.05).</p><p><strong>Conclusion: </strong>Laparoscopic hysterectomy can be performed with low complication rates in benign and malignant indications, regardless of the patient’s contributing factors. However, since experience is important, financial resources and personnel training processes should be supported.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"144-151"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036150","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 three umbilical entry sites for intraperitoneal access by the direct trocar insertion technique: a randomized pilot study.","authors":"Ghazal Mansouri, Afsaneh Nikseresht, Fatemeh Karami Robati, Hamid Salehiniya, Leila Allahqoli, Ibrahim Alkatout","doi":"10.4274/jtgga.galenos.2024.2023-6-11","DOIUrl":"10.4274/jtgga.galenos.2024.2023-6-11","url":null,"abstract":"<p><strong>Objective: </strong>The most effective methods and entry sites for laparoscopic surgery remain a subject of ongoing investigation and discussion. The purpose of the study was to analyze and compare three umbilical entry sites for intraperitoneal access using the direct trocar insertion technique.</p><p><strong>Material and methods: </strong>A randomized pilot study was conducted between March 2021 and January 2023, involving women eligible for laparoscopic gynecological surgery. The women were allocated to one of three equally sized groups based on trocar entry points: subumbilical, supraumbilical, or umbilical. Success and failure rates of trocar entry, factors influencing success or failure, and early and late complications were systematically evaluated and compared across groups.</p><p><strong>Results: </strong>A total of 243 patients, with a mean age of 32.93±8.33 years, were included in three groups of 81 each. Trocar entry success rates were 97.5%, 89.2%, and 89.5% in the supraumbilical, umbilical, and subumbilical groups, respectively (p>0.05). Failed trocar entry was significantly associated with age, gravidity, body mass index (BMI), waist circumference, hip circumference, and abdominal subcutaneous fat thickness (p<0.001). Regression analysis revealed that, in the subumbilical group, higher gravidity [odds ratios (OR): 0.390, 95% confidence interval (CI): 0.174-0.872, p=0.022) and greater abdominal subcutaneous fat thickness (OR: 0.090, 95% CI: 0.019-0.431, p=0.03) were associated with lower odds of successful trocar entry. In contrast, in the umbilical group, a higher waist circumference was associated with lower odds of successful trocar entry (OR: 0.673, 95% CI: 0.494-0.918, p=0.012). None of the covariates were significant in the supraumbilical group.</p><p><strong>Conclusion: </strong>The study highlighted the importance of selecting the appropriate trocar entry site in laparoscopic gynecological surgery. Surgeons should consider factors such as age, gravidity, BMI, waist circumference, hip circumference, and abdominal subcutaneous fat thickness, as these factors significantly influence the success of trocar entry.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"25 3","pages":"116-123"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108708","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 effect of the distance between mesh and the urethra on sexual function in patients who underwent transobturator tape","authors":"Fatih Şahin, Ozan Doğan","doi":"10.4274/jtgga.galenos.2024.2023-11-7","DOIUrl":"10.4274/jtgga.galenos.2024.2023-11-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of mesh-urethra distance on sexual function in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence (SUI).</p><p><strong>Material and methods: </strong>Continent patients who had undergone TOT surgery for SUI were eligible. Objective treatment for SUI was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed six months after surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: <5 mm and >5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form and Female Sexual Function Index (FSFI) were compared between groups.</p><p><strong>Results: </strong>Eighty-two patients were included. The postoperative FSFI scores for the >5 mm group were significantly lower than those of the <5 mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p<0.001). There was no statistically significant relationship between the percentile occupied and postoperative FSFI score (p=0.553), and the FSFI preoperative-postoperative difference was not significant (p=0.905).</p><p><strong>Conclusion: </strong>Sexual functions are more affected in patients with a mesh-urethra distance >5 mm as measured by perineal ultrasound.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"124-131"},"PeriodicalIF":1.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199085","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}