Przegla̜d Gastroenterologiczny最新文献

{"title":"Should physicians prescribe probiotics alongside antibiotics? A practical perspective.","authors":"Wojciech Marlicz, Grażyna Rydzewska","doi":"10.5114/pg.2025.148588","DOIUrl":"10.5114/pg.2025.148588","url":null,"abstract":"","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795916","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 physical activity on symptoms of irritable bowel syndrome.","authors":"Elżbieta Poniewierka, Ewa Szura, Petr Valach","doi":"10.5114/pg.2025.152029","DOIUrl":"10.5114/pg.2025.152029","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid urbanization and constant technological progress contribute to a change in lifestyle in terms of physical activity. Lack of free time and reluctance to engage in physical activity may lead to impaired functioning of internal organs, including the digestive system.</p><p><strong>Aim: </strong>In the present study, by creating an exercise regimen, an attempt was made to demonstrate the impact of this activity on the symptoms of patients with irritable bowel syndrome (IBS).</p><p><strong>Material and methods: </strong>Forty-one women with diagnosed irritable bowel syndrome were included in the study. To assess the effectiveness of the method used, the validated IBS-SSS questionnaire was used. The study used an original training programme based on fitness lessons, yoga positions improving intestinal motility and relaxation techniques: autogenic training developed by Schultz and progressive muscle relaxation developed by Jacobson. Twenty-nine women completed the entire 2-month training cycle, in line with the assumptions of the study. The following methods were used: <i>t</i>-test for dependent samples, Wilcoxon pairwise order test, McNemar's χ² test and Spearman's <i>R</i> correlation coefficient.</p><p><strong>Results: </strong>It was found that nearly 80% of the study participants experienced abdominal pain before participating in the study. The training cycle caused pain in 52% of the surveyed women. The intensity of pain in the subjects decreased by 20%. After the study, the incidence of flatulence decreased by 38% and the severity of flatulence by 30%.</p><p><strong>Conclusions: </strong>The relationship between physical activity and the severity of symptoms of irritable bowel syndrome in the surveyed women was confirmed. The study group of women showed a reduction in IBS-related symptoms after 8 weeks of training.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"173-177"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Toll-like receptors in liver regeneration after partial hepatectomy.","authors":"Spyridon Dritsas, Maximos Frountzas, Dimitrios Schizas, Francesk Mulita, Michalis Katsimpoulas, Paraskevas Gkolfakis, Irene Lidoriki, Ioannis Karavokyros, Elias Liolis, Evangelos Missiakos, Theodore Liakakos, Alkistis Kapelouzou","doi":"10.5114/pg.2025.154724","DOIUrl":"10.5114/pg.2025.154724","url":null,"abstract":"<p><strong>Introduction: </strong>Toll-like receptors (TLRs) play a key role in activating the immune system response after liver injury.</p><p><strong>Aim: </strong>This experimental study aimed to investigate the expression of TLRs and their connecting signaling molecules in liver regeneration.</p><p><strong>Material and methods: </strong>Eighty C57BL/6J mice were divided into eight equal groups: four groups underwent partial hepatectomy (liver resection, LR), and four groups underwent an abdominal incision without hepatectomy (sham, Sh). One group of each type was sacrificed at 12 h (LR12 and Sh12), 24 h (LR24 and Sh24), 36 h (LR36 and Sh36), and 168 h (LR168 and Sh168). Histological and immunohistochemical analyses, blood tests, and quantitative real-time polymerase chain reaction (qRT-PCR) were performed.</p><p><strong>Results: </strong>The qRT-PCR tests indicated significant differences in all immune response proteins (TLR1, TLR2, TLR6, IRAK4, TIRAP, NF-kB, MYD88) between all LR and Sh groups. A progressive increase in the expression of TLRs was observed in the first three pairs, with stabilization of their expression in the last group. Histological examination of liver specimens revealed regeneration of liver tissue in the LR groups. Immunohistochemical analysis revealed increased expression of signaling proteins (TLR1, TLR2, MYD88, IRAK4, TIRAP, NF-kB) in the LR groups as compared to the control groups. White blood, red blood cell count and liver function tests were significantly different between LR and Sh groups.</p><p><strong>Conclusions: </strong>TLR expression was significantly higher in mice that underwent partial hepatectomy than the controls. Further research is required to investigate their potential as therapeutic targets in the management of acute or chronic liver failure after partial hepatectomy.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 3","pages":"294-304"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280926","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":"Stem cell therapy for chronic diffuse liver lesions: main symptoms and causes.","authors":"Yedil Kurakbayev, Samat Saparbayev, Botagoz Turdalieva, Mairash Baimuratova, Bauyrzhan Sarsembayev","doi":"10.5114/pg.2025.154589","DOIUrl":"10.5114/pg.2025.154589","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic liver damage is one of the most important and complex problems in modern gastroenterology. The relevance of studying chronic hepatitis of various aetiologies is associated with its high socio-economic and medical significance due to the steady progressive course, with the development of fibrosis, and then cirrhosis of the liver.</p><p><strong>Aim: </strong>The purpose of this study was to search for and analyse new biotechnological methods for the treatment of diffuse liver diseases to improve patient survival, since the main contingent of patients is typically the able-bodied, socially active part of the population.</p><p><strong>Material and methods: </strong>To achieve this goal, general theoretical methods of scientific knowledge were used, such as analysis, generalization, questioning, and systematization.</p><p><strong>Results: </strong>The article presents a meta-analysis of the results of studies conducted in the field of cellular technologies by leading scientists in the field of the treatment of liver diseases. The issues of transdifferentiation, the mechanisms of action of stem cells in hepatology, as well as the possible risks of this therapy (pro-oncogenic effect, increased fibrosis), are covered.</p><p><strong>Conclusions: </strong>Cell therapy in embryonic, mononuclear, and mesenchymal stromal cells is the most advanced area of modern biotechnology and medicine. Its therapeutic application in chronic liver diseases is base on the possibility of regulating disturbed intercellular interactions in the liver, influencing the mechanisms of cell death (necrosis, apoptosis) and fibrogenesis, which makes this method the most relevant and promising in hepatology.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 3","pages":"318-324"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280936","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 early and long-term clinical outcomes in obstructed proximal and distal colon cancers undergoing emergent surgery.","authors":"Ulaş Aday, Abdulkadir Akbaş, Hikmet Özesmer, Hasan Akkoç","doi":"10.5114/pg.2024.145475","DOIUrl":"10.5114/pg.2024.145475","url":null,"abstract":"<p><strong>Introduction: </strong>Studies comparing proximal and distal colon tumours undergoing emergent surgery for obstruction are limited.</p><p><strong>Aim: </strong>The purpose of our study was to compare the clinical and oncological outcomes of patients with proximal and distal colon cancer, who underwent emergent surgery for obstruction.</p><p><strong>Material and methods: </strong>From January 2012 to June 2022, patients with colon cancer presenting with obstruction and undergoing emergent surgery were analysed. The 2 groups were defined as proximal and distal according to the tumour location with respect to the splenic flexure. Postoperative early and long-term clinical and oncological outcomes were analysed.</p><p><strong>Results: </strong>Of the 118 patients included in the study, there were 46 patients (38.9%) in the proximal group and 72 patients (61.1%) in the distal group. Single-session surgery including resection and anastomosis was performed on 31 (67.4%) and 29 (40.3%) patients in the proximal and distal groups, respectively (<i>p</i> = 0.007). The global mortality rate was 11%, and there was no difference between the groups. Five-year survival was similar in the proximal and distal groups, being 80.4% and 68.1%, respectively. In the analysis of patients who did not develop early mortality and underwent R0 resection, 3-year disease-free survival was 89.5% in the proximal group and 81.5% in the distal group; the difference was not significant (<i>p</i> = 0.165).</p><p><strong>Conclusions: </strong>Mortality is high in emergent surgeries for obstructed proximal and distal colon cancers. If curative resection is achieved, oncological results are good and tumour localisation does not affect survival.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"71-77"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795908","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":"Connection of vitamin D levels in blood serum with <i>Helicobacter pylori</i> infection in paediatric patients.","authors":"Kairat Rysbekov, Sagira Abdrakhmanova, Rashida Satybaeva, Dmitry Babenko, Zhanat Abdikadyr","doi":"10.5114/pg.2024.146213","DOIUrl":"10.5114/pg.2024.146213","url":null,"abstract":"<p><strong>Introduction: </strong><i>Helicobacter pylori</i> is a globally prevalent infection, particularly in developing countries, with significant implications for gastrointestinal health in children. Recent studies suggest a potential link between vitamin D and its metabolites in enhancing the effectiveness of <i>H. pylori</i> eradication therapies through their bactericidal properties.</p><p><strong>Aim: </strong>To investigate the correlation between the vitamin D levels and their influence on clinical management and treatment results of children patients, tested for <i>H. pylori</i>.</p><p><strong>Material and methods: </strong>The study was conducted on a cohort of 128 paediatric patients. They were divided into 2 groups, depending on whether positive (first group - A) or negative (second group - B) for <i>H. pylori</i>. To determine vitamin D levels, venous blood was taken from all participants from both groups. Group 1 included patients whose indexes were up to 10 ng/ml; Group 2 included patients whose indexes were from 10 ng/ml to 20 ng/ml; Group 3 levels were from 20 ng/ml to 30 ng/ml; and Group 4 indexes were over 30 ng/ml. The efficiency of the <i>H. pylori</i> eradication scheme in participants of these groups was evaluated.</p><p><strong>Results: </strong>The mean values in Group A were higher than those in Group B: 17.1 and 14.9, respectively, <i>p</i>-value 0.03. <i>Helicobacter pylori</i> prevalence was higher in participants with vitamin D levels below 30 ng/ml. As a result of the study, it was established that vitamin D levels below 30 ng/ml in blood serum could be a predisposing factor in the spread of <i>H. pylori</i> in paediatric patients. At the same time, different levels of deficiency below 30 ng/ml did not affect the frequency of <i>H. pylori</i> infection.</p><p><strong>Conclusions: </strong>The obtained data can be used in developing guidelines for clinical management of children patients who are primarily diagnosed with <i>H. pylori</i> and require eradication therapy.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"84-91"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795991","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":"A proposed comprehensive model of care for inflammatory bowel disease in Poland.","authors":"Grażyna Rydzewska, Piotr Eder, Maciej Gonciarz, Magdalena Kaniewska, Maria Kłopocka, Ewa Małecka-Wojciesko, Jarosław Reguła","doi":"10.5114/pg.2025.151866","DOIUrl":"10.5114/pg.2025.151866","url":null,"abstract":"<p><p>Epidemiological data of the Polish healthcare model of care indicate that the current management of inflammatory bowel disease (IBD) requires improvements in clinical practice and service organization. Integrated care models for patients with IBD, particularly those centred on a multidisciplinary team, offer a promising approach to improving outcomes, reducing admissions, and rationalizing resources. The coordination of specialists, nurses, dietitians, psychologists, and other professionals within a single reference unit could strengthen continuity of care with primary care providers and enable treatment strategies to be tailored to individual needs. In addition, education and ongoing support foster greater patient involvement, potentially lowering relapse rates and enhancing quality of life. These models, with reforms in care provision and quality measurement based on digital solutions, can reduce fragmentation and alleviate burdens on both patients and the healthcare system. Thus, integrated care represents an evolution in IBD management, benefiting all stakeholders in the healthcare continuum.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"142-147"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576059","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 ultrasound-guided radiofrequency ablation (EUS-RFA) and endoscopic ultrasound-guided ethanol ablation (EUS-EA) of pancreatic neuroendocrine tumors and adenocarcinoma: a prospective multicenter study.","authors":"Hussein H Okasha, Ahmed Y Altonbary, Khaled Ragab, Elsayed Ghoneem, Mohammed Tag-Adeen, Abeer Abdellatef, Mohammed S Naguib, Bogdan Miutescu, Eyad Gadour","doi":"10.5114/pg.2025.151852","DOIUrl":"10.5114/pg.2025.151852","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and endoscopic ultrasound-guided ethanol ablation (EUS-EA) are emerging novel methods for managing non-functioning and functioning pNET and adenocarcinoma in the pancreas.</p><p><strong>Aim: </strong>To assess the safety profile, feasibility, and outcomes of EUS-RFA and EUS-EA of focal pancreatic masses.</p><p><strong>Material and methods: </strong>This prospective study included 27 patients, 15 males and 12 females, with a mean age of 36.38 years. EUS-RFA was carried out in 13 patients; 11 had pancreatic insulinoma, and 2 had advanced pancreatic adenocarcinoma. The mean size of the masses was 20.6 mm, while that of the insulinomas was 17.4 mm. The median number of needle passes was 3, with a range of 1 to 6. RFA was conducted using 19G EUSRA needles from Taewoong Co., Ltd., South Korea. No minor or major complications were observed. EUS-EA was carried out in 14 patients, all of whom had pancreatic insulinoma. The mean size of the masses was 15.3 mm. The median number of needle passes was 2, with a range of 1 to 3. We used 19G and 22G echo tip FNA needles from Cook Company, USA. The mean duration of follow-up was 12.4 months. There was mild to moderate acute pancreatitis in 4 patients in the EUS-EA group; all were relieved by conservative therapy, and no hospital admission was required. No early or late significant complications were reported in the EUS-RFA group.</p><p><strong>Results: </strong>There was a complete clinical cure of 10 out of 11 (91%) patients with pancreatic insulinoma who underwent EUS-RFA. However, 1 patient required three sessions, and 2 patients required two sessions of EUS-RFA. The 11^th patient with insulinoma showed a poor response after the first session, then a partial response after the second session of EUS-RFA. The size of the two masses with advanced adenocarcinoma was decreased, but no downstaging of the masses was achieved. There was a complete clinical cure of 8 out of 14 (57%) patients with pancreatic insulinoma who underwent EUS-EA. No clinical cure was observed in 4 patients; 3 underwent major surgery, and the 4^th one underwent EUS-RFA. The last 2 patients showed a partial clinical response with decreased frequency, duration, and severity of hypoglycemic attacks. They were managed by diet regulation; no major surgery was needed.</p><p><strong>Conclusions: </strong>EUS-RFA and EUS-EA can potentially treat lesions and control symptoms. EUS-RFA is a more promising and safer technique for managing functioning insulinomas. However, it cannot downstage pancreatic ductal adenocarcinoma patients. EUS-EA seems less efficient, with more adverse events than EUS-RFA.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"158-164"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576129","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":"Markers of bacterial translocation as a possible indicator of subclinical inflammation in pediatric inflammatory bowel diseases patients.","authors":"Kinga Kowalska-Duplaga, Przemysław Tomasik, Andrzej Wędrychowicz, Krzysztof Fyderek","doi":"10.5114/pg.2025.151888","DOIUrl":"10.5114/pg.2025.151888","url":null,"abstract":"<p><strong>Introduction: </strong>Recently there has been significant progress in research on the pathogenesis of inflammatory bowel diseases (IBD).</p><p><strong>Aim: </strong>Our study aimed to assess selected markers of bacterial translocation in children with IBD in relationship to disease activity.</p><p><strong>Material and methods: </strong>Lipopolysaccharides (LPS) - markers of bacterial translocation - and proinflammatory cytokines - interleukin (IL)-8, IL-12 and tumor necrosis factor (TNF) α - were assessed in the serum of 27 pediatric IBD patients at the outbreak of the illness and then 1 and 3 months after the introduction of the treatment. The analyzed markers were taken once in 6 healthy children in the control group.</p><p><strong>Results: </strong>Serum TNF-α and LPS concentrations were significantly higher in IBD patients than in the control group (1.74 vs. 0.83 ng/ml and 21.83 vs. 10.26 pg/ml, <i>p</i> < 0.05). In the study group, clinical and laboratory activity mediators significantly decreased during 3 months of the treatment. All proinflammatory cytokines decreased, but significant down-regulation was observed only in relation to IL-12 (129.21 vs. 82.98 pg/ml, <i>p</i> < 0.05) in CD and IL-8 (32.72 vs. 20.97 pg/ml, <i>p</i> < 0.05) in UC patients. TNF-α levels decreased but did not reach values as in healthy children, while LPS levels increased in both groups.</p><p><strong>Conclusions: </strong>IL-12 in CD and IL-8 in UC could be non-invasive markers of reduced inflammation during IBD in children. Improvements in clinical status and reductions in systemic inflammatory markers do not necessarily mean complete cessation of the inflammatory cascade. The elevated TNF-α and LPS levels found in patients in early remission may be a marker of subclinical inflammation.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"185-191"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576133","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":"Major complications following a \"simple\" segmental resection of the distal duodenum: lessons learnt.","authors":"Artur Kośnik, Bernard Piotuch, Anna Stadnik, Anna Wiechowska-Kozłowska, Piotr Milkiewicz, Jerzy Lubikowski, Maciej Wójcicki","doi":"10.5114/pg.2025.154596","DOIUrl":"10.5114/pg.2025.154596","url":null,"abstract":"","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 3","pages":"340-344"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281009","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}