Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Annual Acknowledgement of Reviewers.","authors":"Hamid R Baradaran","doi":"10.47176/mjiri.38.151","DOIUrl":"https://doi.org/10.47176/mjiri.38.151","url":null,"abstract":"<p><p>The editors of Medical Journal of the Islamic Republic of Iran (MJIRI) would like to thank all our reviewers who have contributed to the journal in Volume 38 (2024).</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"151"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234498","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":"How Does an Unplanned Pregnancy Affect Maternal Stress and Depression From Pregnancy to 12 Months Postpartum? A Longitudinal Study.","authors":"Mahdi Khodadoust, Reyhane Mohamadi, Gholamreza Asadi-Karam, Zahra Mahmoodian, Zahra Ensafi, Maedeh Sarreshteh, Nouzar Nakhaee","doi":"10.47176/mjiri.38.150","DOIUrl":"10.47176/mjiri.38.150","url":null,"abstract":"<p><strong>Background: </strong>Research studies have shown an increased prevalence of mental health issues in women with unplanned pregnancies. However, many of these studies use cross-sectional methods. This particular study aimed to examine perceptions of stress and depression in women with unplanned pregnancies compared with those with planned pregnancies. The study tracked these perceptions, from the early stages of pregnancy to 12 months postpartum.</p><p><strong>Methods: </strong>In this quasi-experimental study, pregnant women attending health centers completed a baseline questionnaire around the fifth month of pregnancy. This survey gathered demographic information and inquired about pregnancy planning. Perceived stress and depression were assessed using the Perceived Stress Scale (PSS4) and the Patient Health Questionnaire (PHQ) 4 times up to 12 months postpartum. The relationship between pregnancy planning and PSS4 and PHQ2 scores was analyzed using generalized estimating equations (GEE).</p><p><strong>Results: </strong>A total of 302 women, with a mean age of 29.31 years and a standard deviation of 6, participated in the study. The findings revealed that women with unplanned pregnancies exhibited significantly higher levels of stress and depression throughout both the prenatal and postpartum periods, even after controlling for confounding variables. Additionally, the unplanned pregnancy group reported lower educational attainment, higher parity, older age, and less support from their marital and family networks.</p><p><strong>Conclusion: </strong>An unplanned pregnancy can significantly impact a mother's mental health, potentially lasting for months after giving birth. Women going through an unplanned pregnancy can greatly benefit from emotional support from their partners and family.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"150"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234503","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 Association between Oligohydramnios and the Risk of Malpresentation: A Meta-Analysis.","authors":"Maryam Nurzadeh, Mahsa Naemi","doi":"10.47176/mjiri.38.149","DOIUrl":"10.47176/mjiri.38.149","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the role of oligohydramnios on the increased risk of fetal malpresentation. Therefore, we decided, for the first time, to collect all published studies on this topic to synthesize all available data through a systematic review and meta-analysis to evaluate the effect of oligohydramnios on the increased risk of fetal malpresentation.</p><p><strong>Methods: </strong>A search was done in the following international electronic bibliographic databases: PubMed, Web of Science, and Scopus to April 2021. Heterogeneity among studies was determined by the Q-test and I2 statistic. Publication bias was assessed by Begg and Egger tests. The results were reported using odds ratio (OR) estimates with 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Stata software Version 14 (StataCorp).</p><p><strong>Results: </strong>The meta-analysis identified 431 articles, comprising 227,351 participants, exploring the link between oligohydramnios and malpresentation. A significant association was found (OR, 1.79 [95% CI, 1.42-2.15]), indicating that oligohydramnios increases the risk of malpresentation. The analysis also revealed substantial heterogeneity among the included studies (I² = 80.2%; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This meta-analysis provides robust evidence that oligohydramnios is a significant risk factor for fetal malpresentation. These findings underscore the critical importance of monitoring amniotic fluid levels during pregnancy. The results suggest that healthcare providers should prioritize the assessment of amniotic fluid volume in pregnant patients, especially those presenting with risk factors for oligohydramnios.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"149"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234506","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":"Determinants of Educational Technology Acceptance: Medical Teachers' Perception.","authors":"Monirsadat Khamesi, Rita Mojtahedzadeh, Snor Bayazidi, Aeen Mohammadi","doi":"10.47176/mjiri.38.148","DOIUrl":"https://doi.org/10.47176/mjiri.38.148","url":null,"abstract":"<p><strong>Background: </strong>Educational technology is becoming an additional tool for interaction between students and teachers, along with traditional systems, in developing and improving the quality of education. The activities of faculty members have a direct impact on the overall quality of the educational process. Therefore, this study aimed to determine factors affecting educational technology adoption in the medical education context.</p><p><strong>Methods: </strong>A sequential qualitative-quantitative mixed-method approach was used for this research. Firstly, a scoping literature review on related studies was conducted to extract involved factors in the adaption of educational technology. Next, using the three-round Fuzzy Delphi method, experts' perspectives about these factors were obtained. The Fuzzy Decision-Making Trial and Evaluation Laboratory (F. DEMATEL) was applied to investigate the relationships among these factors, and the Analytic Network Process (ANP) method was used to rank them.</p><p><strong>Results: </strong>Conducting the scoping review resulted in extracting the factors affecting educational technology adoption in education, which were organized into nine indicators and four categories, including perceived usefulness, improved performance, social benefit, and facilitating processes through a three-round Delphi. The weights of these indicators were determined in the third and fourth steps of the study.</p><p><strong>Conclusion: </strong>The findings of this study determined the most important factors affecting the acceptance of educational technologies, showed their relationship, and prioritized them. These findings can be used to integrate technology into the educational environment effectively. Investigating other factors according to the level of majors at the universities is recommended for future studies.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"148"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234500","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":"Treatment Satisfaction with Teriflunomide in Patients with Multiple Sclerosis: A Systematic Review of Observational Studies.","authors":"Hamid Pourasghari, Mohammad Ali Rezaei, Samad Azari, Fahimeh Haji Akhoundi","doi":"10.47176/mjiri.38.146","DOIUrl":"10.47176/mjiri.38.146","url":null,"abstract":"<p><strong>Background: </strong>Research on treatment satisfaction with treatments of multiple sclerosis (MS) is essential for delivering patient-centered care and improving treatment adherence. We aimed to review studies that have used the Treatment Satisfaction Questionnaire for Medication (TSQM) to assess treatment satisfaction with teriflunomide in patients with MS.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, PsycINFO, the Cochrane Library, and Google Scholar were searched by 2 independent reviewers to identify all relevant studies. Studies were selected based on the inclusion and exclusion criteria. The quality of observational studies was appraised using the 14-item National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.</p><p><strong>Results: </strong>The search strategy was employed and 97 possible publications were found. After carefully reviewing the titles, abstracts, and full texts, a total of 9 articles have been selected for inclusion in the review. In all studies, teriflunomide had been prescribed in the treatment group, and in all studies, some patients had received previous disease-modifying therapies (DMTs). Study periods of all studies were between 3 months to 24 months. The results showed that all studies were of relatively high quality. In all studies, 4 domains of TSQM, especially the convenience domain, were improved after treatment with teriflunomide. Mean scores of the convenience domain in patients treated with teriflunomide were higher than other DMTs but some studies showed that some other DMTs may provide higher scores in other domains of TSQM.</p><p><strong>Conclusion: </strong>Treatment with teriflunomide improves satisfaction in patients with MS.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"146"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234508","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":"Physiotherapy Training Program Defects in Geriatrics: A Qualitative Study.","authors":"Maryam Taghinezhad, Shohreh Noorizadeh Dehkordi, Marzieh Yassin, Javad Sarrafzadeh","doi":"10.47176/mjiri.38.145","DOIUrl":"10.47176/mjiri.38.145","url":null,"abstract":"<p><strong>Background: </strong>To review the educational program of physical therapy students at the basic level, it is necessary to understand the challenges and problems faced by physical therapy graduates when working with the elderly. This study aimed to explain the deficiencies of the basic level educational program of physical therapy students with a qualitative study of the content analysis type.</p><p><strong>Methods: </strong>In-depth and semi-structured face-to-face interviews were conducted in qualitative research with a content analysis approach, with 13 physical therapists with at least 1 year of experience in the specialized field of geriatrics. The obtained data were analyzed using Granheim and Loudman's content analysis method.</p><p><strong>Results: </strong>A total of 29 codes of the physical therapy program defects in the field of geriatrics were obtained and placed in the 3 main categories as follows: The physical therapist's knowledge, the physical therapist's attitude, and the physical therapist's skill.</p><p><strong>Conclusion: </strong>The findings indicated that revisions are necessary to the undergraduate physical therapy training curriculum. It is possible to provide a lesson unit with a holistic approach to the elderly in the form of a physical therapy unit for the elderly, as well as valid instructions and guidelines in the field of aging for physical therapists. This can be done through basic or master's level internships in elderly care centers.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"145"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234505","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":"Effort-Reward Imbalance and Low Back Pain Among Industrial Workers: A Cross-sectional Study.","authors":"Seyed Abolfazl Zakerian, Saba Nematbakhsh, Alireza Mortezapour, Hadi Asady","doi":"10.47176/mjiri.38.144","DOIUrl":"10.47176/mjiri.38.144","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) in workers is a leading cause of disability and loss of work time, adversely affecting job performance and overall well-being. The primary objective of this study was to evaluate the potential role of effort-reward imbalance (ERI) as a risk factor for the development of LBP among workers.</p><p><strong>Methods: </strong>This analytical cross-sectional study was conducted among industrial workers (n = 1127) in Tehran province. Data were collected using 3 different questionnaires-an occupational-sociodemographic questionnaire, the van Vegchel version of the ERI questionnaire, and the Dutch Musculoskeletal Questionnaire (DMQ). Workers who reported experiencing pain in the past 12 months and the past 7 days were classified as having LBP. To assess the relationship between ERI and other independent factors with LBP, univariate logistic regression was employed. Subsequently, to adjust for the effects of influential factors on the dependent variable, a multiple logistic regression model with backward elimination was utilized.</p><p><strong>Results: </strong>Out of 1127 participants, 1015 (90.06%) were men. The prevalence of ERI among the participants was 60.69%. The results of the multivariate logistic regression model indicated that having ERI (adjusted odds ratio [AOR], 2.985 [95% CI, 1.994-4.470]; <i>P</i> < 0.001), having accident experience (AOR, 3.338 [95% CI, 2.378-4.685]; <i>P</i> < 0.001), and being married (AOR, 1.602 [95% CI, 1.028- 2.498]; <i>P</i> = 0.037) were associated with an increased risk of LBP among industrial workers.</p><p><strong>Conclusion: </strong>Similar to findings in other countries and various occupational studies, ERI was prevalent among industrial workers in Iran. Additionally, we found that ERI is a significant risk factor for LBP.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234502","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":"Peripheral Arterial Disease is Associated with Sensorimotor Peripheral Neuropathy in People with Type 2 Diabetes.","authors":"Nahid Hashemi-Madani, Masoumeh Azadi, Alireza Khajavi, Zahra Emami, Mohammad E Khamseh","doi":"10.47176/mjiri.38.143","DOIUrl":"10.47176/mjiri.38.143","url":null,"abstract":"<p><strong>Background: </strong>Micro- and macro-vascular complications of diabetes seem to be interconnected. This study aimed to evaluate the association between peripheral arterial diseases (PAD) and diabetic sensorimotor peripheral neuropathy (DSPN).</p><p><strong>Methods: </strong>This cross-sectional study was conducted among 748 people with type 2 diabetes (T2DM) referred to a tertiary care center between 2017 and 2022. PAD was defined as Ankle-brachial index (ABI) ≤ 0.9. Loss of protective sensation (LOPS) was applied for the detection of DSPN. Logistic regression analysis was used to determine the association between PAD and DSPN.</p><p><strong>Results: </strong>The mean age of the participants was 59.6 (±8.8) years, and the median duration of diabetes was 10 (5-16) years. LOPS was detected in 491 individuals (65.6%). ABI ≤ 0.9 was associated with a significantly higher risk of LOPS (OR: 3.65, 95% Confidence Interval (CI): 1.97- 6.74). In addition, every 0.1 decrease in ABI increased the risk of LOPS by 21% (95%CI: 10- 34%). Toe brachial index (TBI) ≤0.7 was also associated with a significantly higher risk of LOPS (OR: 1.77, 95%CI: 1.28- 2.46). Each 0.1 decrease in TBI increased the risk of LOPS by 19% (95%CI: 10- 28%).</p><p><strong>Conclusion: </strong>PAD is strongly associated with DSPN. Assessment of DSPN could be considered in the presence of PAD.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"143"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234504","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":"Analysis of Birth Growth: Using a Mixture Cure Frailty Model.","authors":"Azadeh Naderi, Hadis Najafimehr, Kamal Azam, Abbas Rahimi Foroushani, Ali Moghadas Jafari, Mohammed Ibrahim Gubari, Hende Sadeghi, Mostafa Hosseini, Mehdi Yaseri","doi":"10.47176/mjiri.38.142","DOIUrl":"10.47176/mjiri.38.142","url":null,"abstract":"<p><strong>Background: </strong>The birth rate is important in population growth. Concerns are growing over declining birth rates in Iran, as a developing country in the past decade. The present study aimed to examine population growth in Hamadan and the factors influencing the birth rate.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from 633 families with their first child in 2012 in Hamadan-information updated in 2022. The Kaplan-Meier plateau indicates a curing pattern; therefore, a mixture cure frailty model was employed to estimate the probability and hazard rate of having different numbers of children. This model comprises 2 components: the first estimates the probability of birth (or nonbirth, indicating cure), while the second component calculates the birth hazard rate for having different number of children.</p><p><strong>Results: </strong>Mothers with high school diploma (odds ratio [OR], 0.049; <i>P</i> = 0.004) and under diploma (OR, 0.449; <i>P</i> < 0.001) education levels and fathers with under diploma (OR, 0.802; <i>P</i> = 0.021) education levels were linked to a lower risk of birth and a higher chance of a cure. Moreover, high school diploma (hazard ratio [HR] = 0.668; <i>P</i> < 0.001) and under diploma (HR = 0.821; <i>P</i> < 0.001) education levels in mothers significantly decreased the birth hazard rate. The shape parameter in the hazard function (μ = 0.933; SE = 0.049) indicates that the hazard rate of birth was decreasing during the follow-up time.</p><p><strong>Conclusion: </strong>The study found that the mixture cure frailty model was effective in analyzing birth rates, with couples showing a decreased inclination to have more than 2 children. One contributing factor to this trend is the mothers' education and employment.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"142"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234497","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":"Effects of General Anesthesia on the Success Rate of Pneumatic Reduction in the Treatment of Intussusception.","authors":"Sayed A Elhady, Osama I Ramadan, Abdullah M Shbeer, Rafik E Ereba, Mohamed A Elsaid, Ahmed F Abd-Ellatief, Randa M Abobaker, Hoda M Flifel, Elsayed M Abd El-Hamid Hassan","doi":"10.47176/mjiri.38.141","DOIUrl":"10.47176/mjiri.38.141","url":null,"abstract":"<p><strong>Background: </strong>Intussusception is one of the most frequent reasons for intestinal obstruction in young children, which needs to be treated immediately. When it comes to non-operative reduction, there is no gold standard. Our goal was to look into how general anesthesia affected the success rate of pneumatically reduced intussusception guided by fluoroscopy.</p><p><strong>Methods: </strong>This prospective study was done throughout the time between January 2023 and January 2024 by collaboration between the Pediatric Surgery Unit and Diagnostic Radiology Departments, Al-Azhar University Hospital, New Damietta, Egypt. Under general anesthesia, pneumatic reduction guided by fluoroscopy was performed on all intussusception patients. Children with pathologic lead points discovered by ultrasonography, those with symptoms of intestinal perforation or peritonitis, and those who were hemodynamically unstable were excluded. Statistical analysis of the obtained data was done using the SPSS program (version 20).</p><p><strong>Results: </strong>In all, 34 children between the ages of 3-28 months, pneumatic reduction under general anesthesia was successful in 32 individuals (94.1% overall). On the first trial, the intussusception was succeeded in 26 patients; on the second try, it was reduced in 5 patients, and in the third, in 1 patient. In two cases, the intussusception failed after three successive trials. One of them was diagnosed as an extended intussusception mass, which was later surgically confirmed, and the other was an appendico-cecal intussusception. During the reduction efforts, there was no bowel perforation or death reported.</p><p><strong>Conclusion: </strong>As a first-line therapy for pediatric intussusception, fluoroscopy-guided PR under GA is straightforward, risk-free, and successful, with no complications or mortalities.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"141"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234501","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}