Divya Joshi, Alexandra Hruby, Julius P A Dewald, Carson Ingo
{"title":"Quantifying structural properties of forearm flexor muscles in individuals with hemiparetic cerebral palsy using diffusion tensor imaging.","authors":"Divya Joshi, Alexandra Hruby, Julius P A Dewald, Carson Ingo","doi":"10.14814/phy2.70404","DOIUrl":"10.14814/phy2.70404","url":null,"abstract":"<p><p>This study investigated diffusion tensor imaging (DTI) derived macro- and micro-structural musculoskeletal adaptations in forearm flexor muscles in individuals with hemiparetic cerebral palsy (HCP) and typically developing (TD) individuals, and their relationship to reduced grip strength. In 14 individuals with HCP and 16 TD individuals, T1-weighted and diffusion-weighted magnetic resonance images of both forearms were acquired, and maximum grip strength was measured. In two forearm flexors, muscle volume, DTI-based diffusivity metrics, and probabilistic tractography derived fascicle architecture was estimated. Linear mixed-effects models evaluated interlimb differences in structural parameters and their impact on grip strength. In the HCP group, paretic muscles showed significant reductions in volume, diffusivity values, fascicle lengths, and physiological cross-sectional area as compared to nonparetic forearm and TD participants. Furthermore, reduced muscle volume and diffusivity together explained 62% of the grip strength deficit. These findings demonstrate that decreased muscle volume and altered microstructure, as indicated by reduced diffusivity, contribute significantly to functional impairments in HCP. DTI-based diffusivity metrics non-invasively reveal crucial insights into pathophysiological changes in muscle tissue, such as muscle atrophy and fibrosis. Future therapies should focus on both muscle macro- and micro-structural adaptations as targets to improve motor function in HCP.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70404"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234798","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}
Xiangyu Zheng, Mostafa Sabouri, Bryan J Irwin, Joseph Bernardo, Daniel R Machin
{"title":"TcMAC21 mouse model recapitulates abnormal vascular physiology observed in humans with Down syndrome.","authors":"Xiangyu Zheng, Mostafa Sabouri, Bryan J Irwin, Joseph Bernardo, Daniel R Machin","doi":"10.14814/phy2.70384","DOIUrl":"10.14814/phy2.70384","url":null,"abstract":"<p><p>People with Down syndrome (DS) have abnormal vascular physiology, demonstrated by low systolic blood pressure (BP) and low aortic stiffness that are accompanied by endothelial dysfunction. The TcMAC21 mouse model of DS has many features observed in people with DS, although vascular physiology has not been studied. At 4 months old, male and female TcMAC21 mice exhibited lower systolic BP and aortic stiffness, as determined by aortic pulse wave velocity, which are accompanied by blunted carotid artery flow-mediated vasodilation, indicating endothelial dysfunction, compared to euploid (i.e., control) mice. To determine a potential mechanism for blunted flow-mediated vasodilation, we assessed endothelial glycocalyx properties, which mechanotransduces fluid shear stress to the endothelial cells, stimulating flow-mediated vasodilation. We observed a lower glycocalyx thickness in the mesenteric microcirculation of TcMAC21 mice. Vascular abnormalities in TcMAC21 mice were accompanied by systemic inflammation. This is the first study to examine vascular physiology in the TcMAC21 mouse model of DS and investigate glycocalyx properties in any model of DS, including humans. Taken together, these findings support the use of the TcMAC21 mouse model to study the vascular physiology in people with DS and may provide translational insight into the role of glycocalyx in vascular abnormalities in DS.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70384"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234800","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}
Sebastian F Möbus, Chris J Harding, Catherine L Taylor, Karl P Sylvester, Jonathan P Fuld
{"title":"Characterization of dysfunctional breathing using cardiopulmonary exercise testing.","authors":"Sebastian F Möbus, Chris J Harding, Catherine L Taylor, Karl P Sylvester, Jonathan P Fuld","doi":"10.14814/phy2.70388","DOIUrl":"10.14814/phy2.70388","url":null,"abstract":"<p><p>Cardiopulmonary exercise testing (CPET) is emerging as a useful tool in the identification of dysfunctional breathing (DB). We aimed to evaluate the prevalence and functional impact of different patterns of DB in 628 adult patients referred for CPET due to unexplained dyspnoea (August 2019-December 2023). Patients were assigned to four groups following CPET interpretation: normal, breathing pattern disorder (BPD), hyperventilation (HV), and combined BPD with HV (BPDHV). Demographic and CPET performance data were analyzed using non-parametric tests as appropriate. 94 (15.0%) patients had normal CPETs and 267 (42.5%) were identified as having DB. The remaining 267 were excluded as having alternative diagnoses. Of those with DB, 145 (54.3%) had BPD, 41 (15.4%) had HV, and 81 (30.3%) had BPDHV. VE/VCO<sub>2</sub> was significantly increased in HV or BPDHV only (p < 0.001). Patients in all three DB groups exhibited significantly impaired peak VO<sub>2</sub> compared to those with normal CPETs (p < 0.001). These CPET findings highlight DB as a common driver of symptoms in unexplained dyspnoea. Over half of patients with DB had isolated BPD, which requires visual inspection of relevant CPET plots to diagnose. Those identified with DB had significantly reduced peak VO<sub>2</sub>, which may be a useful classifier of functional severity in DB.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70388"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209155","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}
Colin J Gimblet, Anthony J Donato, Diana I Jalal, Gary L Pierce
{"title":"Sex differences in endothelial glycocalyx thickness and the response to glycocalyx-targeted therapy among older adults.","authors":"Colin J Gimblet, Anthony J Donato, Diana I Jalal, Gary L Pierce","doi":"10.14814/phy2.70428","DOIUrl":"https://doi.org/10.14814/phy2.70428","url":null,"abstract":"<p><p>Endothelial glycocalyx thickness declines with age, potentially increasing cardiovascular disease risk. However, sex differences in glycocalyx thickness and responses to glycocalyx-targeted therapies remain unclear. This post hoc analysis examined sex differences in glycocalyx thickness and the effects of Endocalyx Pro supplementation in older adults. We analyzed data from 22 participants in a prior clinical trial (NCT06071728) that assessed 12-week Endocalyx Pro (3712 mg/day) supplementation on vascular function. Glycocalyx thickness was estimated as the perfused boundary region (PBR) using the GlycoCheck, with higher PBR indicating smaller glycocalyx thickness. Postmenopausal females had higher PBR 4-25 than older males (2.11 ± 0.14 vs. 1.97 ± 0.13 μm; p = 0.02), particularly in microvessels 9-17 μm in diameter. Male sex (B [95% CI], -0.14 [-0.26, -0.02]; p = 0.02) and body mass index (BMI) (B [95% CI], -0.02 [-0.04, -0.01]; p = 0.01) were associated with lower PBR 4-25 in univariate analyses; however, when included in a multivariate model, the association with sex was attenuated (p = 0.15), while BMI remained significant (p = 0.04). After 12 weeks of Endocalyx Pro, PBR 4-25 increased in older males (+0.087 ± 0.148 μm) but decreased in postmenopausal females (-0.178 ± 0.148 μm; p = 0.009). In conclusion, we observed that postmenopausal females had smaller glycocalyx thickness, partially explained by BMI, and demonstrated a greater improvement with Endocalyx Pro, suggesting sex-specific therapy effects.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 12","pages":"e70428"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chuqi He, Moritz Eggelbusch, Jelle Y Huijts, Andi Shi, Gerard J de Wit, Carla Offringa, Richard T Jaspers, Rob C I Wüst
{"title":"The commonly used antibiotic streptomycin reduces protein synthesis and differentiation in cultured C2C12 myotubes.","authors":"Chuqi He, Moritz Eggelbusch, Jelle Y Huijts, Andi Shi, Gerard J de Wit, Carla Offringa, Richard T Jaspers, Rob C I Wüst","doi":"10.14814/phy2.70353","DOIUrl":"https://doi.org/10.14814/phy2.70353","url":null,"abstract":"<p><p>The antibiotic streptomycin is an integral part of cell culture medium. Because streptomycin inhibits bacterial protein synthesis, streptomycin might also have off-target effects on muscle cell function. Here, we studied the effect of streptomycin on C2C12 myoblasts, myofiber growth, and metabolism. C2C12 myoblasts were cultured with or without streptomycin. The control condition consisted of carbenicillin and ampicillin. Streptomycin did not impair myoblast proliferation rate. Streptomycin exposure led to a ~ 40% reduction in myotube diameter and reduced protein synthesis rate. Myotubes with streptomycin showed a 25% lower differentiation and 60% lower fusion index. Expression of cell stress markers was upregulated by streptomycin. Mitochondrial respiration rate was unaffected by streptomycin, but gene expression levels of Myh3 and Acta1 were lower, as well as the protein content of mitochondrial complex I subunits. Myotubes cultured in the presence of streptomycin showed fragmentation of the mitochondrial network, a smaller mitochondrial footprint (-64%), and shorter branch lengths (-34%). Streptomycin does not alter C2C12 myoblast proliferation but reduces global protein synthesis rates in differentiating myotubes. The routine use of streptomycin in muscle cell cultures should be carefully evaluated, particularly when investigating muscle growth, metabolism, or protein synthesis, where off-target effects may confound experimental outcomes.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 12","pages":"e70353"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of muscle quality by phase angle and body physique in nonathlete students and trained/developmental athletes.","authors":"Kazushige Oshita, Akihisa Hikita, Ryota Myotsuzono, Satoki Murai","doi":"10.14814/phy2.70412","DOIUrl":"10.14814/phy2.70412","url":null,"abstract":"<p><p>Phase angle (PhA), measured using bioelectrical impedance analysis, has recently gained attention as an indicator of muscle quality. This study investigates the relationship between PhA and body mass index (BMI) in nonathletic students and trained/developmental athletes. Seventy-one male and 83 female students participated in the Normal group, while 159 male and 95 female students participated in the Sports group. Each group was further divided into two subgroups: those with a BMI higher (L-Normal and L-Sports) and lower (S-Normal and S-Sports) than the median BMI. Although fat-free mass (FFM) did not differ significantly between the S-Sports and L-Normal groups, PhA was significantly higher in the S-Sports group with a large effect size. While FFM was significantly higher in the L-Sports group than in the S-Sports group, PhA did not differ significantly with a small effect size. PhA and BMI showed no significant relationship in the Sports group, whereas a positive correlation was observed in the Normal group. These results suggest that PhA can be used to assess differences in competition and activity levels that are not represented by BMI or FFM. Furthermore, although PhA is related to BMI in the nonathletic populations, this relationship is not observed in trained/developmental-level athletes.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70412"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275554","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}
Melissa Roths, Tori E Rudolph, Alyssa D Freestone, Lance H Baumgard, Joshua T Selsby
{"title":"Environment-induced heat stress causes ventricular-dependent biochemical changes in the heart in female pigs.","authors":"Melissa Roths, Tori E Rudolph, Alyssa D Freestone, Lance H Baumgard, Joshua T Selsby","doi":"10.14814/phy2.70414","DOIUrl":"10.14814/phy2.70414","url":null,"abstract":"<p><p>Prolonged exposure to inescapable heat and humidity can lead to environment-induced heat stress (EIHS). The extent to which EIHS damages the heart is largely unknown, though our previous work indicated EIHS caused ventricle-dependent changes. The purpose of this investigation was to determine the extent to which EIHS increased proteolysis and altered calcium homeostasis in the left (LV) and right ventricles (RV). We hypothesized that in the RV, EIHS would increase proteolysis, whereas in the LV, EIHS would cause calcium dysregulation. To test this hypothesis, 3-month-old female pigs were assigned to thermoneutral (TN; 20 ± 0.2°C; n = 8) or EIHS (37.4 ± 0.2°C; n = 8) conditions for 24 h and hearts were removed. In the RV, we discovered increased markers of proteolysis such that the relative protein abundance of calpain II, MuRF-1, and MAFbx/Atrogin1 was increased, as was a marker of calpain activity. Conversely, in the LV, we discovered that EIHS increased the relative protein abundance of calcium regulatory proteins, including PMCA, SERCA2a, STIM1, calsequestrin, CaMKII, and VDAC. These data demonstrate EIHS caused ventricular-dependent changes such that in the RV, the balance of proteostasis was shifted toward proteolysis and in the LV, calcium dysregulation may underlie, at least in part, our previous discovery of ventricular thickening.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70414"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249200","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}
Tommi Grönlund, Kari Kaikkonen, M Juhani Junttila, Olavi Ukkola, Risto Kerkelä, Heikki V Huikuri, Mikko P Tulppo
{"title":"Cardiac structure and function across the continuum of glucose metabolism.","authors":"Tommi Grönlund, Kari Kaikkonen, M Juhani Junttila, Olavi Ukkola, Risto Kerkelä, Heikki V Huikuri, Mikko P Tulppo","doi":"10.14814/phy2.70429","DOIUrl":"https://doi.org/10.14814/phy2.70429","url":null,"abstract":"<p><p>Diabetes and prediabetes increase the risk of heart failure, but the relationship between glycated hemoglobin (HbA1c) and left ventricular systolic function in the general population is not known. This study aimed to investigate the relationship between HbA1c and global longitudinal strain (GLS) in nondiabetic and prediabetic subjects. A subpopulation of the Northern Finland Birth Cohort 1966 took part in a follow-up, including extensive medical examination and echocardiography (n = 1155), at the age of 46. The final study population included 636 healthy subjects. Normal HbA1c levels were divided into sex-specific tertiles and prediabetes, which were later pooled together. Univariate analysis after adjusted with covariates was used to compare cardiac function in HbA1c groups. HbA1c groups were defined as low (30.9 ± 1.7 mmol/mol, n = 190), medium (34.6 ± 1.0 mmol/mol, n = 189), high (37.4 ± 1.0 mmol/mol, n = 190) and prediabetes (41.0 ± 1.3 mmol/mol, n = 67) groups. Subjects with abnormal absolute GLS (<18) comprised 7.4%, 12.7%, 21.1%, and 17.9% (main effect p < 0.01) of low, medium, high HbA1c and prediabetes groups, respectively. HbA1c was not associated with any cardiac structure variables. High normal HbA1c levels and prediabetes are associated with reduced myocardial contractility in a healthy middle-aged population, potentially predicting the development of heart failure.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 12","pages":"e70429"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Garella, F Palmieri, F Chellini, L Tarchi, V Ricca, G Castellini, C Sassoli, R Squecco
{"title":"Adiponectin and gastric fundus: A potential target for gut-brain axis dysfunctions.","authors":"R Garella, F Palmieri, F Chellini, L Tarchi, V Ricca, G Castellini, C Sassoli, R Squecco","doi":"10.14814/phy2.70398","DOIUrl":"10.14814/phy2.70398","url":null,"abstract":"<p><p>Adiponectin (ADPN) is a pleiotropic hormone produced by adipose tissue involved in the control of body weight, energy expenditure, and feeding behaviors. Alongside a central effect, ADPN acts on peripheral organs such as the stomach, where it can favor gastric fundus relaxation, reinforcing central satiety signals. Notably, ADPN serum levels are dysregulated in several conditions affecting the gastrointestinal tract. Moreover, altered hormone levels coexist with disorders related to the gut-brain axis malfunctioning, that is, eating disorders and inflammatory bowel diseases. Aiming at considering the effective utility of ADPN in a wide range of clinical conditions, there is an urgent need to identify its targets, clarify its mechanism of action, and downstream effectors. In this view, the present review highlights the advancement in elucidating ADPN effects on gastric fundus, describing its ability to cause morphofunctional alterations of smooth muscle cells, affecting their excitability, contractile machinery, and motor response. This comprehensive overview also provides a critical appraisal on the potential translational applications, including the possibility to consider ADPN as a biomarker for the diagnosis and staging of different clinical conditions. Finally, this review explores the potential employment of ADPN analogues for treating disorders characterized by functional gastric disturbances or altered feeding behaviors.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70398"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199878","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}
Silvia Lee, Alison Castley, Matthew Knuiman, David Nolan, Frank Sanfilippo, Girish Dwivedi
{"title":"Inflammatory and vascular biomarkers as predictors of all-cause death and cardiovascular outcomes in an Australian community-based cohort.","authors":"Silvia Lee, Alison Castley, Matthew Knuiman, David Nolan, Frank Sanfilippo, Girish Dwivedi","doi":"10.14814/phy2.70379","DOIUrl":"10.14814/phy2.70379","url":null,"abstract":"<p><p>Biomarkers that identify individuals who are at higher risk of cardiovascular outcomes will allow for early intervention, lowering the incidence of adverse outcomes. This study investigated whether circulating levels of GDF-15, E-selectin, CD14, and ST2 are predictors of death and cardiovascular outcomes in 981 individuals who did not have a history of cardiovascular disease (CVD) during follow-up periods of 5, 10, and 20 years. During the 20-year follow-up, there were 389 deaths (including 147 from CVD), 105 participants had acute coronary syndrome (ACS), and 467 people had major adverse coronary and cerebrovascular events (MACCE) (including all-cause death). In the fully adjusted model, sE-selectin (5-year HR, 3.03; 95% CI 1.31-7.01), sCD14 (5 years 3.11; 1.02-9.45 and 10 years 2.52; 1.23-5.16), and sGDF-15 (10 years 2.07; 1.13-3.78 and 20 years 1.79; 1.24-2.56) predicted all-cause death. sE-selectin (5 years 2.19; 1.13-4.26), sCD14 (10 years 2.00; 1.08-3.68), and sGDF-15 (10 years 1.95; 1.18-3.22 and 20 years 1.53; 1.11-2.12) predicted MACCE. sGDF-15 predicted ACS at 5 (4.44; 1.01-19.49), 10 (2.86; 1.08-7.57) and 20 years (2.57; 1.31-5.04). High serum levels of sE-selectin, sGDF-15, and sCD14 at baseline are important independent risk factors for all-cause death and cardiovascular outcomes in a population without prevalent CVD.</p>","PeriodicalId":20083,"journal":{"name":"Physiological Reports","volume":"13 11","pages":"e70379"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266945","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}