Middle East Journal of Digestive Diseases最新文献

{"title":"Epigenetically Regulating Non-coding RNAs in Colorectal Cancer: Promises and Potentials.","authors":"Zahra Taheri, Majid Zaki-Dizaji","doi":"10.34172/mejdd.2025.404","DOIUrl":"https://doi.org/10.34172/mejdd.2025.404","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a common malignancy with high mortality. Despite advancements in understanding its molecular causes and improved drug therapies, patient survival rates remain low. The main reasons for the high mortality rate are cancer metastasis and the emergence of drug-resistant cancer cell populations. While genetic changes are recognized as the main driver of CRC occurrence and progression, recent studies suggest that epigenetic regulation is a crucial marker in cancer, influencing the interplay between genetics and the environment. Research has shown the significant regulatory roles of non-coding RNAs (ncRNAs) in CRC development. This review explores epigenetically regulated ncRNAs and their functions, aiming to understand key regulatory mechanisms that impact CRC development. Additionally, it discusses the potential use of these ncRNAs in CRC diagnosis, prognosis, and targeted treatments.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"40-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018699","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":"COVID-19 and Upper Gastrointestinal Bleeding; Etiology, Risk Factors, and Outcomes: A Case-Control Study.","authors":"Sara Shafieipour, Mohammad Rezaei Zadeh Rukerd, Niloofar Farsiu, Mohsen Nakhaie, Samaneh Jahangiri, Maysam Yousefi, Hanieh Mirkamali, Aryan Mohamadinezhad","doi":"10.34172/mejdd.2025.406","DOIUrl":"https://doi.org/10.34172/mejdd.2025.406","url":null,"abstract":"<p><strong>Background: </strong>COVID-19-associated gastrointestinal (GI) symptoms are often self-limiting; however, gastrointestinal bleeding (GIB) is a critical complication in patients with COVID-19. The present study investigates the etiology, risk factors, esophagogastroduodenoscopy (EGD) findings, and outcomes associated with upper gastrointestinal bleeding (UGIB) in hospital inpatients with COVID-19.</p><p><strong>Methods: </strong>In this retrospective case-control study, 127 patients with COVID-19 in Kerman, Iran, were diagnosed using reverse transcription polymerase chain reaction (RT-PCR) and subsequently divided into case and control groups from January 2022 to July 2022.</p><p><strong>Results: </strong>This study evaluated 64 patients with COVID-19 with UGIB and 63 patients without. The case group reported previous history of GIB and cirrhosis at 17.2% and 12.5%, respectively (<i>P</i>=0.001 and <i>P</i>=0.01). Melena (37.5%) and peptic ulcer (21.87%) were the most common UGIB symptom and EGD findings, respectively. In the comparison of the case group with the control group, the duration of the patient's stay in the intensive care unit (ICU) (11.58±1.13 vs. 8.29±1.06 days), the need for invasive mechanical ventilation (IMV) (17.2% vs. 8.1%), and the mortality rate (26.6% vs. 18.9%) were recorded (<i>P</i>=0.03, 0.124, and 0.07, respectively).</p><p><strong>Conclusion: </strong>Patients with COVID-19 and UGIB have a more prevalent ICU stay compared with those without. Melena and peptic ulcer were the most common presentations and EGD findings in these patients. Additionally, liver cirrhosis and a history of previous GIB increased the risk of GIB in patients with COVID-19.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031648","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":"Hepatocellular Carcinoma: The Search for an Optimal Screening Test.","authors":"Sara Haj Ali, Shahd I Alqato, Amjad M Almansi, Noor S Haj Ali, Mohammad A Amaireh","doi":"10.34172/mejdd.2025.407","DOIUrl":"https://doi.org/10.34172/mejdd.2025.407","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the third leading cause of cancer-related death, with a 5-year survival rate of 10%-12%. It usually develops in the setting of chronic liver disease (CLD), with chronic viral hepatitis, alcohol, and non-alcoholic fatty liver disease (NAFLD) being the most common risk factors. Some patients are at higher risk of developing hepatocellular cancer, so it is important to screen them regularly to diagnose the disease at an early stage and improve their chances for curative treatment. Six-monthly ultrasound with or without alpha-fetoprotein (AFP) is the currently recommended surveillance method. AFP has been used as a biomarker for liver cancer; however, it has low sensitivity and specificity, which necessitates the search for other, more accurate biomarkers. Promising biomarkers include lens culinaris agglutinin-reactive AFP, des-gamma-carboxy prothrombin, methylated DNA markers, plasma microRNA expression, circulating tumor DNA, and circulating tumor cells. In addition, combinations of biomarkers, like the GALAD score and the Doylestown algorithm, may help in the early detection of HCC. In this review, we summarize the screening tests for early detection of HCC that have been studied over the last decade.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007324","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 Interplay of Coping Strategies and Quality of Life in Inflammatory Bowel Disease: A Systematic Review.","authors":"Lining Wang, Norafisyah Makhdzir, Zarina Haron","doi":"10.34172/mejdd.2025.409","DOIUrl":"https://doi.org/10.34172/mejdd.2025.409","url":null,"abstract":"<p><strong>Background: </strong>This systematic review, grounded in coping theory, examines the relationship between coping strategies and quality of life (QoL) in patients with inflammatory bowel disease. It synthesizes current findings and guides future research to address existing knowledge gaps.</p><p><strong>Methods: </strong>A comprehensive search of Scopus, PubMed, Google Scholar, and Web of Science (from April 2000 to April 2024) identified 17 peer-reviewed studies.</p><p><strong>Results: </strong>Coping strategies directly and indirectly influence the QoL of patients with inflammatory bowel disease (IBD). Adaptive strategies, such as problem-solving and seeking social support, consistently improve QoL even in patients with active disease by promoting better disease management and emotional well-being. Maladaptive strategies, such as avoidance and emotional detachment, lead to decreased QoL and increased psychological distress. In addition, self-efficacy and psychological resilience play a key role in mediating the relationship between coping and QoL. However, coping strategies differ by disease stage and between demographic groups.</p><p><strong>Conclusion: </strong>This study identifies significant gaps in research, such as limited multi-center and longitudinal studies, cross-cultural inconsistencies, and insufficient focus on specific populations. These gaps restrict understanding of the long-term effects of coping strategies. Future research should combine quantitative and qualitative methods to better capture patients' experiences, aiding the development of personalized interventions.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"60-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981451","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 Performance between White Light Imaging and Narrow Band Imaging in Distinguishing Neoplastic and Non-neoplastic Colorectal Polyps.","authors":"Kaka Renaldi, Lily Verawati, Hasan Maulahela, Nur Rahadiani, Aulia Rizka, Ari Fahrial Syam, Dyah Purnamasari, Chyntia Olivia Maurine Jasirwan, Dicky Levenus Tahapary","doi":"10.34172/mejdd.2025.405","DOIUrl":"https://doi.org/10.34172/mejdd.2025.405","url":null,"abstract":"<p><strong>Background: </strong>White light imaging (WLI) is the current standard colonoscopy technique for diagnosing colorectal polyps in Indonesia. Various endoscopic imaging techniques have been developed to improve the accuracy of diagnosing colorectal polyps, one of which is narrow band imaging (NBI). We conducted a diagnostic study comparing the performance of NBI against WLI in distinguishing neoplastic from non-neoplastic colorectal polyps.</p><p><strong>Methods: </strong>This was a diagnostic study that analyzes endoscopic pictures of colorectal polyps in patients who underwent colonoscopy using the WLI and NBI techniques. Previously collected biopsy tissue specimens were re-examined by a single pathologist.</p><p><strong>Results: </strong>There were 117 subjects analyzed, and the proportion of subjects with neoplastic polyps was 65.8%. Common indications for colonoscopy were hematochezia (24.8%) and abdominal pain (23.9%). WLI showed moderate inter-observer reliability (kappa value=0.591), while NBI showed significant reliability (kappa value=0.674). NBI demonstrated better sensitivity (84.4%; 95% CI 74.4%-91.7%) and accuracy (78.6%; 95% CI 70.1%-85.7%) compared with WLI (sensitivity 74%; 95% CI 62.8%-83.4% and accuracy 71.8%; 95% CI 62.7%-79.7%). However, the specificity was the same (67.5%; 95% CI 50.9%-81.4%).</p><p><strong>Conclusion: </strong>NBI has better performance than WLI in distinguishing neoplastic and non-neoplastic colorectal polyps.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029001","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":"L-Shaped Configuration of Multiple Magnet Ingestion: A Case Report.","authors":"Mehran Hakimzadeh, Mitra Ahmadi, Hazhir Javaherizadeh","doi":"10.34172/mejdd.2025.410","DOIUrl":"https://doi.org/10.34172/mejdd.2025.410","url":null,"abstract":"<p><p>Multiple magnet ingestion is an urgent situation in pediatric gastroenterology that requires endoscopy or surgical intervention to remove the magnet. We report a case in which multiple magnets attract each other in a special geometric shape in the gastrointestinal tract of a 2-year-old boy.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"76-78"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029217","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":"Endoscopic Findings in Patients Presenting Dyspepsia: A Population-Based Study in Mashhad, North East of Iran.","authors":"Mina AkbariRad, Abdollah Firoozi, AmirAli Moodi Ghalibaf, Hassan Mehrad-Majd, Bahram Kangi, Ali Beheshti Namdar","doi":"10.34172/mejdd.2025.402","DOIUrl":"https://doi.org/10.34172/mejdd.2025.402","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to evaluate the endoscopic findings of patients with dyspepsia in Ghaem Hospital, Mashhad, Iran.</p><p><strong>Methods: </strong>This cross-sectional study collected endoscopic findings in patients with dyspepsia, including epigastric pain or heartburn, postprandial fullness, and early satiety from Ghaem Hospital from 2019 to 2020.</p><p><strong>Results: </strong>Totally, 743 patients were studied, and 42.3% (n=314) were male. The mean age was 46 years. Among participants, 85.6% (n=636) were included in the functional dyspepsia group, and the rest were included in the organic dyspepsia group. In the organic dyspepsia group, the highest frequency was related to peptic ulcer disease, with 7.2% (n=53). Moreover, the most common complaint was epigastric pain and heartburn. No significant association was found between comorbidities (<i>P</i>=0.083), smoking, and sex (<i>P</i>=0.532) with the risk of organic dyspepsia.</p><p><strong>Conclusion: </strong>Dyspepsia is not necessarily accompanied by other comorbidities. The most mentioned chief complaint was epigastric pain or heartburn. Functional dyspepsia was the most common diagnosis in patients with dyspepsia, and the peptic ulcer was the leading cause of organic dyspepsia. There was no difference in the underlying cause of dyspepsia in the sexes.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029193","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":"Efficacy, Safety, and Tolerance of Split Dose Oral Sulfate Solution Versus Split-Dose Polyethylene Glycol Versus Single Dose Polyethylene Glycol for Colonoscopy Preparation: A Prospective Randomized Study.","authors":"George Sarin Zacharia, Varghese Thomas","doi":"10.34172/mejdd.2025.403","DOIUrl":"https://doi.org/10.34172/mejdd.2025.403","url":null,"abstract":"<p><strong>Background: </strong>The quality of bowel preparation is one of the key determinants of a successful colonoscopy. Bowel preparation regimens have evolved greatly over the past few decades, with attempts to improve the efficiency and tolerability; still an ideal agent or regimen continues to be oblivious. To compare the efficacy, safety, and tolerance of three bowel preparation regimens for colonoscopy: split dose of oral sulfate solution (OSS), split dose of polyethylene glycol (PEG), and same-day single dose PEG.</p><p><strong>Methods: </strong>This study was a randomized, single-blind control design with three study groups. Group A received a split dose of OSS, group B received a split dose of PEG, and Group C received a single dose of PEG for bowel preparation. The quality of preparation was assessed using the Boston Bowel Preparation Scale (BBPS), and the adverse effects and tolerance were noted. The data were compared statistically for any significant difference between the regimens.</p><p><strong>Results: </strong>Mean total BBPS scores were 8.08, 7.52, and 7.92 for groups A, B, and C, respectively (<i>P</i>=0.076). Segmental BBPS scores were statistically similar for the right and transverse colon but differed for the left colon (A: B: C=2.79: 2.54: 2.75; <i>P</i><0.01). Gastrointestinal side effects and electrolyte disturbances were similar across the three groups. Split-dose preparations were associated with more significant sleep disturbances than single-dose PEG (<i>P</i><0.001). Patients who received OSS reported more taste intolerance (<i>P</i><0.01), while those who received single PEG reported more volume intolerance (<i>P</i><0.001).</p><p><strong>Conclusion: </strong>Split-dose OSS, split-dose PEG, and single-dose PEG regimens provide adequate and comparable bowel preparation for colonoscopy with good patient tolerance and no significant adverse effects. Overnight PEG and OSS preparations were associated with more substantial sleep disturbances. OSS is associated with more taste intolerance, while single PEG is associated with more volume intolerance.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027509","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":"Bidirectional Association between Gastroesophageal Reflux Disease and Bipolar Disorder: A Systematic Review and Meta-analysis of Longitudinal Studies.","authors":"Rahma Nurita, Adit Faturohman, Febrina Mustika Santoso, Bianca Magdalena, Muhana Fawwazy Ilyas","doi":"10.34172/mejdd.2025.411","DOIUrl":"https://doi.org/10.34172/mejdd.2025.411","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) and bipolar disorder impose substantial global burdens on individuals and healthcare systems. Previous studies suggest a bidirectional association between GERD and bipolar disorder. By searching and reviewing the results of existing studies, this systematic review and meta-analysis aims to review the two-way relationship between GERD and bipolar disorder.</p><p><strong>Methods: </strong>This study adhered to PRISMA Guidelines, including a comprehensive search of PubMed and Scopus for observational longitudinal studies. Quality (risk of bias) assessment employed the Newcastle-Ottawa Scale, and RevMan version 5.3 facilitated meta-analysis.</p><p><strong>Results: </strong>Five longitudinal studies (161888 patients) revealed a significant bidirectional link between GERD and bipolar disorder. Patients with GERD had a 2.29-fold higher risk of bipolar disorder (OR=2.29 [1.64, 3.21]; <i>P</i><0.001), while individuals with bipolar disorder had a 2.80-fold higher risk of GERD (OR=2.80 [1.36, 5.76]; <i>P</i>=0.005). This study also identified independent risk factors, including sex, age under 60 years, and alcohol consumption disorders, influencing the occurrence of bipolar disorder in patients with GERD, as well as there is an influence of the number of psychoactive drugs in the occurrence of GERD in patients with bipolar disorder.</p><p><strong>Conclusion: </strong>These findings highlight a bidirectional relationship between GERD and bipolar disorder, emphasizing the necessity for integrated care models and personalized treatment plans. The results underscore the importance of considering both gastrointestinal and mental health aspects in managing these interconnected conditions.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"68-75"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027599","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":"Risk Factors for Non-alcoholic Fatty Liver Disease from the Perspective of Medical Professionals: A Systematic Review and Expert Opinion.","authors":"Mahdie ShojaeiBaghini, Mohammadreza Fattahi, Mehdi Mohammadi, Fateme Hamzavi","doi":"10.34172/mejdd.2025.408","DOIUrl":"https://doi.org/10.34172/mejdd.2025.408","url":null,"abstract":"<p><strong>Background: </strong>The incidence of non-alcoholic fatty liver disease (NAFLD) has increased with the global increase in the outbreak of obesity, type 2 diabetes, and metabolic syndrome, reaching a 25% prevalence. However, there is currently no effective treatment for this disease apart from lifestyle modification. Furthermore, NAFLD commonly presents without symptoms, hence, leading to potentially severe and irreparable consequences.</p><p><strong>Methods: </strong>This study was based on a systematic review. The search used the keywords \"non-alcoholic fatty liver\" and \"risk factor\" across the PubMed, Scopus, and Web of Science databases. First, the articles were evaluated based on their abstract and then on their full text. The risk factors were extracted from the articles and entered into the Excel form, and then a dataset was provided to the expert panel. The risk factors were investigated, and those related to NAFLD were selected.</p><p><strong>Results: </strong>The results led to the identification of 180 risk factors in 15 categories. First, the risk factors mentioned in fewer than five articles were removed. Then, the remaining 101 risk factors were presented to the expert panel, of which 39 risk factors related to NAFLD were selected.</p><p><strong>Conclusion: </strong>In summary, this study shows that NAFLD is caused by various factors such as metabolic syndrome, certain diseases, demographic information, specific surgeries, drug consumption, different foods and beverages, occupation, physical activity status, and socioeconomic status. Recognizing these risk factors enables doctors to make earlier diagnoses, potentially preventing disease progression. Additionally, it is possible to develop treatment strategies aimed at reducing the risk factors of the disease, which could result in fewer patients suffering from NAFLD in the future.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 1","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969432","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}