Open Forum Infectious Diseases最新文献

{"title":"Anti-Nonstructural Protein 1 Antibody Kinetics and Their Association With Disease Severity in Pediatric Dengue.","authors":"Sansanee Noisakran, Patchanika Hengtrakool, Kattaleeya Jindapornprasert, Chunya Puttikhunt, Tanapan Prommool, Nattaya Tangthawornchaikul, Nuttapong Kaewjiw, Pucharee Songprakhon, Kanokwan Sriruksa, Wannee Limpitikul, Dumrong Mairiang, Panisadee Avirutnan, Prida Malasit","doi":"10.1093/ofid/ofaf529","DOIUrl":"10.1093/ofid/ofaf529","url":null,"abstract":"<p><strong>Background: </strong>Dengue is an immune-mediated disease with severe manifestations often linked to secondary infections. Dengue virus nonstructural protein 1 (DENV NS1) and corresponding antibodies are thought to play a crucial role in disease pathogenesis.</p><p><strong>Methods: </strong>This study investigated the kinetics of anti-NS1 antibody responses in relation to NS1 levels and NS1 immune complexes (ICs) in pediatric dengue patients with varying disease severity following secondary DENV infections with all four serotypes, using retrospective plasma samples collected in Thailand and analyzed by enzyme-linked immunosorbent assays (ELISAs). Plasma samples from pediatric patients with other febrile illnesses (OFI) and healthy adults served as non-dengue control groups.</p><p><strong>Results: </strong>Anti-NS1 IgG (particularly IgG1 and IgG4) and IgA persisted for at least 6 months after illness and were associated with increased dengue severity, whereas the shorter-lived anti-NS1 IgM was higher in patients with milder dengue. Anti-NS1 IgG also persisted notably longer than anti-DENV IgG. Anti-NS1 IgG3 showed a transient surge across all four serotypes, suggesting its potential as a marker of recent infection. NS1 proteins and NS1 ICs were positively correlated, inversely related to anti-NS1 IgG, and strongly associated with severe dengue.</p><p><strong>Conclusions: </strong>Anti-NS1 antibody isotypes and IgG subclasses exhibited distinct associations with dengue severity, influenced by both infecting serotypes and time since illness onset. Correlations among NS1, anti-NS1 antibodies, and NS1 ICs were observed during the acute phase of secondary infection, potentially influencing dengue disease outcomes. These findings enhance our understanding of dengue immunopathogenesis and may inform improved diagnostic and surveillance tools.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf529"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Mycology Education in Brazil: A Cross-Sectional Survey of Medical Schools.","authors":"Alessandro C Pasqualotto, Valerio R Aquino, Diego R Falci, Cecilia B Severo, Melissa O Xavier, Eduardo N Trindade","doi":"10.1093/ofid/ofaf540","DOIUrl":"10.1093/ofid/ofaf540","url":null,"abstract":"<p><strong>Background: </strong>Despite the high burden of fungal infections in Brazil, little is known about how medical mycology is taught in Brazilian medical schools. Adequate education is essential to improve clinical recognition, diagnosis, and treatment of fungal diseases.</p><p><strong>Objectives: </strong>To assess the structure, content, and challenges of medical mycology education across medical schools in Rio Grande do Sul, Brazil.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among all 21 medical schools in the state. Nineteen schools (90.5%) responded to a structured questionnaire addressing curricula, infrastructure, faculty training, and perceived barriers.</p><p><strong>Results: </strong>All responding institutions include medical mycology in their curricula, though none offer it as a stand-alone subject. Teaching is typically embedded within microbiology (89.5%) and infectious diseases (57.9%). Only 21.1% dedicate over 40 h to the topic. While most schools address superficial (94.7%), systemic (94.7%), subcutaneous (89.5%), and opportunistic (94.7%) mycoses, practical diagnostic exercises are limited. Only 52.6% provide hands-on diagnostic training, and 42.1% have a dedicated mycology lab. Most instructors have doctoral degrees (73.7%), but only 10.5% specialized in mycology. Student evaluation and curricular updates are infrequent, and institutional support for mycology education remains constrained.</p><p><strong>Conclusions: </strong>Mycology teaching in southern Brazil is widespread but insufficiently structured. Although the state has a strong historical tradition in fungal disease research, significant gaps remain in faculty expertise, infrastructure, and curricular innovation. Targeted investment in laboratory training and faculty development is urgently needed to strengthen clinical education preparedness.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf540"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is COVID-19 Associated With an Increased Risk of Subsequent Upper Respiratory Tract Infections in Adults? A Prospective Cohort Study.","authors":"Fazia Tadount, Guy Boivin, Yves Longtin, Patrice Savard, Matthew P Cheng, Hélène Decaluwe, Gaston De Serres, Élise Fortin, Caroline Quach","doi":"10.1093/ofid/ofaf544","DOIUrl":"10.1093/ofid/ofaf544","url":null,"abstract":"<p><strong>Background: </strong>In Autumn 2022, a surge in upper respiratory tract infections (URTIs) was observed worldwide. Individuals anecdotally reported increased URTIs in the months following their coronavirus disease 2019 (COVID-19). The objective was to assess if COVID-19 is associated with a higher incidence of URTI in adults in the following months.</p><p><strong>Methods: </strong><b>\"</b>RECOVER\" is a prospective cohort of health care workers (HCWs) from Montreal, Canada. HCWs completed biweekly surveys to report incident COVID-like symptoms. We included HCWs actively followed up for ≥90 days, between December 1, 2021, and December 31, 2022. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were confirmed via reverse transcriptase polymerase chain reaction/antigenic testing. Non-COVID-19 URTI cases were defined as new onset of fever/sensation of fever, rhinitis, nasal congestion, sore throat/pharyngitis, sneezing, coughing, wheezing, difficulty breathing, increased respiratory secretions, or change in characteristics of chronic secretions, excluding symptoms within 48 hours of vaccination. Time-dependent Cox regression was used to assess the association between recent COVID-19 and URTI, adjusting for sex, age, workplace, household children <5 years, and asthma.</p><p><strong>Results: </strong>Among 320 HCWs (82.5% females; mean age, 42.4 years) followed for a median of 342 days, 152 (47.5%) participants tested positive for SARS-CoV-2. No significant difference in the incidence of URTI was observed following COVID-19 (hazard ratio, 1.03; 95% CI, 0.74-1.43; <i>P</i> = .87). However, having at least 1 child <5 years was associated with a 74% (95% CI, 20%-153%; <i>P</i> = .003) increase in the risk for URTI. Findings remained similar in sensitivity analysis.</p><p><strong>Conclusions: </strong>There was no association between COVID-19 and subsequent URTI. Other epidemiological, individual, and social factors could explain the increase in the incidence of URTI.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf544"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the Prevalence of Antimalarial Partner Drug Resistance Markers and Policy in 6 Sub-Saharan African Countries From 2000 to 2021: A Systematic Review.","authors":"Alexandra Walker, Amanda Ross, Christian Nsanzabana","doi":"10.1093/ofid/ofaf508","DOIUrl":"10.1093/ofid/ofaf508","url":null,"abstract":"<p><strong>Background: </strong>Prompt malaria case management is a cornerstone for malaria control and elimination. However, this strategy is threatened by the development of antimalarial drug resistance. Resistance is mediated through spontaneous genetic changes such as mutations, but drug pressure is the main driver of resistance spread. Molecular markers of resistance may provide insight into spatiotemporal dynamics of drug resistance and how drug policy changes may affect the spread of resistance.</p><p><strong>Methods: </strong>We conducted a systematic review to assess the dynamics of <i>Pfcrt</i>, <i>Pfmdr1</i>, <i>Pfdhfr</i>, and <i>Pfdhps</i> mutations from 2000 to 2021. Six countries from sub-Saharan Africa were selected by availability of molecular data and varying antimalarial drug policies: Kenya, Malawi, and Uganda in East Africa and Burkina Faso, Côte d'Ivoire, and Nigeria in West Africa. Medline, Embase, Cochrane, and Elsevier databases were searched for relevant literature, and identified records were screened for prevalence data and extracted.</p><p><strong>Results: </strong>Overall, 138 studies were included. The estimated prevalence of <i>Pfcrt</i> 76T declined following cessation of chloroquine, though at variable levels among countries. All countries saw an increase in <i>Pfmdr1</i> N86/D1246 prevalence, with faster increases in East Africa, while <i>Pfmdr1</i> 184F prevalence increased, except in Burkina Faso. The prevalence of <i>Pfdhfr</i> (51I/59R/108N) and <i>Pfdhps</i> (436A/437G/540E) mutations reached fixation levels in most countries; however, the 164L and 581G mutations increased during the period only in Kenya and Uganda.</p><p><strong>Conclusions: </strong>Our study provides compelling evidence on the impact of antimalarial drug policy change on molecular markers of resistance and their potential use to monitor drug resistance spread.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf508"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Findings in Migrants With Asymptomatic <i>Plasmodium</i> Infections.","authors":"Isabelle Eliasson, Katja Wyss, Rebecca Tafesse Bogale, Sofia Forsblom, Emil Lindquist, Caroline Rönnberg, Magnus Hansson, Soheir Beshara, Irene Nordling, Olof Hertting, Andreas Wångdahl, Anna Färnert","doi":"10.1093/ofid/ofaf525","DOIUrl":"10.1093/ofid/ofaf525","url":null,"abstract":"<p><strong>Background: </strong>Migrants from malaria-endemic areas may have asymptomatic parasitemia that persists after relocating to nonendemic countries. Recommendations on malaria screening and treatment of asymptomatic infections in migrants are lacking. The aim of this study was to explore the clinical features of subclinical blood-stage <i>Plasmodium</i> infections in migrants, to inform screening and management strategies.</p><p><strong>Methods: </strong>A retrospective observational study was performed to evaluate clinical data from medical records of asymptomatic sub-Saharan African migrants identified with parasitic infection within a screening study in Stockholm, Sweden. Clinical data from hospital outpatient visits were compared between malaria polymerase chain reaction (PCR)-positive and PCR-negative individuals, the latter assessed for schistosomiasis and/or strongyloidiasis.</p><p><strong>Results: </strong>Clinical features and chemistry tests from 65 <i>Plasmodium</i> PCR-positive individuals were compared with data from 54 PCR-negative individuals. Study participants with <i>Plasmodium</i> infection had a higher proportion of anemia (21.1% vs 6.1%, <i>P</i> = .048), elevated erythrocyte sedimentation rate (ESR) (58.1% vs 25.0%, <i>P</i> = .008), raised plasma/serum immunoglobulin M (30.5% vs 10.5%, <i>P</i> = .030), and splenomegaly (25.4% vs 2.5%, <i>P</i> = .002). After antimalarial treatment, splenomegaly and laboratory parameters improved in <i>Plasmodium</i>-infected individuals.</p><p><strong>Conclusions: </strong>Migrants with subclinical <i>Plasmodium</i> infection have a high proportion of splenomegaly and abnormal laboratory findings, such as anemia and elevated ESR. Screening and treatment of subclinical malaria infections could prevent adverse outcomes and should be considered both in endemic and nonendemic settings.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf525"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Care of Patients With Bone and Joint Infections Through Educational Interventions.","authors":"Neel B Shah, Jessica Seidelman, Katherine Belden, Elizabeth Thottacherry, Allison Lastinger, Priya Nori, Ronald M Beaulieu, Don Bambino Geno Tai","doi":"10.1093/ofid/ofaf552","DOIUrl":"10.1093/ofid/ofaf552","url":null,"abstract":"<p><p>Musculoskeletal infections represent a significant proportion of the clinical workload for infectious diseases (ID) providers, often presenting complex diagnostic and therapeutic challenges. Many providers may feel inadequately prepared to manage these conditions, which require a nuanced understanding of microbiology, musculoskeletal anatomy, surgical intervention, and orthopedic hardware. We implemented a pair of educational interventions including an online library of high-yield musculoskeletal ID literature and an educational podcast.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf552"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Nirmatrelvir-Ritonavir Against Severe Outcomes of COVID-19 in Taiwan: A Nationwide Population-Based Cohort Study.","authors":"Raymond N Kuo, Wanchi Chen, Wen-Yi Shau, Shan-Chwen Chang","doi":"10.1093/ofid/ofaf553","DOIUrl":"10.1093/ofid/ofaf553","url":null,"abstract":"<p><strong>Background: </strong>Real-world data evaluating the effectiveness of nirmatrelvir-ritonavir across diverse age groups and vaccination statuses remain limited, particularly in East Asian populations. This study evaluates its effectiveness in reducing severe COVID-19 outcomes using a large, comprehensive nationwide healthcare database and to provide new evidence.</p><p><strong>Method: </strong>This retrospective observational cohort study involved outpatient COVID-19 patients diagnosed between 1 January 2022, and 1 December 2022, within Taiwan's National Health Insurance Research Database. Patients who received nirmatrelvir-ritonavir were compared with untreated patients. Primary outcomes include COVID-19-related hospitalization, ICU admission, invasive ventilatory support, death, and the composite outcome of hospital admission or death.</p><p><strong>Results: </strong>A total of 2 300 131 nonhospitalized patients with confirmed COVID-19 between 1 January 2022 and 1 December 2022, including 530 807 patients treated with nirmatrelvir-ritonavir and 1 769 324 untreated patients. Treatment with nirmatrelvir-ritonavir was associated with a significantly lower risk of COVID-19-related hospitalization (hazard ratio 0.32 [95% CI .31-.34]), ICU admission (0.41 [.38-.45]), invasive ventilatory support (0.38 [.33-.43]), death (0.42 [.40-.45]), and the composite outcome of hospital admission or death (0.34 [.33-.35]). Effectiveness was consistent across subgroups stratified by age and vaccination status, with the greatest benefit observed in unvaccinated individuals and those aged ≥65 years with additional risk factors.</p><p><strong>Conclusions: </strong>In a large, nationally representative cohort, outpatient use of nirmatrelvir-ritonavir was associated with a significantly lower risk of severe COVID-19-related outcomes, regardless of age or vaccination status. These findings reinforce the clinical value of early antiviral treatment, particularly in aging and unvaccinated populations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf553"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Prevalence of Naturally Occurring HIV-1 Capsid Inhibitor Resistance-Related Mutations in Antiretroviral Therapy-Naïve and -Experienced Individuals in Taiwan\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/ofid/ofaf523","DOIUrl":"10.1093/ofid/ofaf523","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf523"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on \"Prevalence of Naturally Occurring HIV-1 Capsid Inhibitor Resistance-related Mutations in Antiretroviral Therapy-naïve and -Experienced Individuals in Taiwan\".","authors":"Nan-Yu Chen, Stephane Wen-Wei Ku, Zhuo-Hao Liu","doi":"10.1093/ofid/ofaf524","DOIUrl":"10.1093/ofid/ofaf524","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf524"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mortality Among People With HIV in Mexico: Analysis of National Death Registries (1998-2022).","authors":"Isaac Núñez, Yanink Caro-Vega, Jesús Alegre-Díaz, Brenda Crabtree-Ramírez, Raúl Ramírez-Reyes, Pablo Kuri-Morales, Malaquías López-Cervantes, Juan Sierra-Madero, Pablo F Belaunzarán-Zamudio","doi":"10.1093/ofid/ofaf551","DOIUrl":"10.1093/ofid/ofaf551","url":null,"abstract":"<p><strong>Background: </strong>We aimed to describe the frequency of deaths related to advanced HIV disease (AHD) and its associated characteristics, as well as the frequency of very early and early mortality after HIV diagnosis, among people with HIV in Mexico between 1998 and 2022.</p><p><strong>Methods: </strong>We used data from the Mexican National Death Registry. We defined deaths related to AHD as those listed in the AIDS-defining conditions of the Centers for Disease Control and Prevention, very early mortality as deaths occurring within the first month after HIV diagnosis, and early mortality as those occurring between the first month and the first year after HIV diagnosis. We used logistic regression models to describe trends of deaths related to AHD, early mortality, very early mortality, and specific causes of death over time.</p><p><strong>Results: </strong>There were 106 056 registered deaths among people with HIV, ranging from 507 to 5287 annually. The most common cause of death was related to AHD throughout the study period (54%). The predicted probability of death related to AHD decreased from 75% to 35% between 2000 and 2012 but increased after 2014 to 52% in 2022. Overall, 22% of deaths occurred very early and 25% early after HIV diagnosis. Calendar year was the only strong predictor of death due to AHD.</p><p><strong>Conclusions: </strong>A high and increasing proportion of deaths were attributed to advanced HIV disease in Mexico; a fifth of them occurred in the first month of HIV diagnosis and almost a half in the first year. In the context of universal access to antiretroviral therapy, these results suggest that additional components of the public health HIV response could be lacking.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf551"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}