Rheumatology Advances in Practice最新文献

{"title":"Correction to: OA20 A case of rapidly progressive interstitial lung disease in anti-Ro52 positive amyopathic dermatomyositis.","authors":"","doi":"10.1093/rap/rkag068","DOIUrl":"https://doi.org/10.1093/rap/rkag068","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/rap/rkaf111.019.].</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag068"},"PeriodicalIF":2.8,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353492","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":"MRI-defined sacroiliitis and spinal inflammation in chronic back pain: real-world patterns in axial spondyloarthritis and axial psoriatic arthritis.","authors":"Mauricio Parada, María L Molina, Daniel Ríos, Daniela Suárez, Mauricio Ochoa, Natalie Hitchin, Cristóbal Bravo, Nicolás Guzmán, Pablo Barahona, Annelise Goecke","doi":"10.1093/rap/rkag072","DOIUrl":"10.1093/rap/rkag072","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance of MRI-defined sacroiliitis for axial spondyloarthritis (axSpA) in routine clinical practice and to characterize inflammatory spinal lesions (ISLs) and clinical factors associated with sacroiliitis across non-psoriatic axSpA (nPsA-axSpA), axial psoriatic arthritis (axPsA) and non-inflammatory chronic back pain (NI-CBP).</p><p><strong>Methods: </strong>We conducted a retrospective study of adults with chronic back pain who underwent SI joint and whole-spine MRI for suspected axSpA. Following longitudinal follow-up, patients were classified by expert rheumatologists as nPsA-axSpA, axPsA or NI-CBP. Two blinded musculoskeletal radiologists independently assessed MRI scans for sacroiliitis and ISLs using Assessment of SpondyloArthritis international Society/OMERACT definitions. Diagnostic accuracy metrics for MRI-defined sacroiliitis were calculated using expert diagnosis as the reference standard and multivariate logistic regression was used to identify predictors of sacroiliitis.</p><p><strong>Results: </strong>Ninety-five patients were included (29 nPsA-axSpA, 21 axPsA, 45 NI-CBP). MRI-defined sacroiliitis showed high specificity (91%) and moderate sensitivity (77-83%) for axSpA diagnosis. Independent predictors of sacroiliitis included age [odds ratio (OR) 1.05/year], regular physical activity (OR 3.50), expert-assessed inflammatory back pain (OR 35.11) and the number of SpA features (OR 1.72). ISLs were present in 40% of patients overall and were most prevalent in axPsA (76%). In axPsA, ISLs frequently occurred in the absence of sacroiliitis and displayed a broader and more heterogeneous distribution.</p><p><strong>Conclusion: </strong>MRI-defined sacroiliitis is highly specific but insufficient as a stand-alone diagnostic tool for axSpA in real-world settings and should be interpreted in context.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag072"},"PeriodicalIF":2.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707531","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":"Assessing the diagnostic utility of baseline creatine kinase levels in patients with suspected idiopathic inflammatory myopathies and neuromuscular disorders.","authors":"Nikola Wilk, Filipe O Pinheiro, Linn Renken, Natalia Molina-Esteban, Chanakya Kodishala, Catherine Ivory, Nancy Maltez, Latika Gupta, James B Lilleker, Hector Chinoy","doi":"10.1093/rap/rkag061","DOIUrl":"10.1093/rap/rkag061","url":null,"abstract":"<p><strong>Objectives: </strong>Serum creatine kinase (CK) is widely used in the diagnostic evaluation of neuromuscular disorders, including idiopathic inflammatory myopathies (IIM). As most laboratories define reference ranges using the central 95% of values from white populations, elevated CK levels are common in otherwise healthy individuals. We investigated the predictive value of baseline CK at defined cutoffs for diagnosing an underlying myopathic illness including IIM.</p><p><strong>Methods: </strong>A retrospective chart review was performed of consecutive adult patients attending a tertiary neuromuscular clinic from January 2018 to June 2022. We investigated the test characteristics of CK based on several a priori defined thresholds.</p><p><strong>Results: </strong>From a total of 488 patients, we identified 276 IIM cases, 89 with a non-inflammatory myopathy and 123 had an alternative/reassuring aetiology. Baseline CK levels were significantly higher in the IIM and non-inflammatory myopathy groups vs the alternative/reassuring group. The laboratory defined cutoffs for CK yielded a sensitivity of 77.0%, a specificity of 66.7% and a positive predictive value (PPV) of 87.3% for identifying IIM or other neuromuscular disorders, which only marginally improved when evaluating the 97.5th percentile (75.6, 67.5 and 87.3%) or the European Federation of Neurological Societies (EFNS) thresholds (68.8, 78.0 and 90.3%).</p><p><strong>Conclusion: </strong>The current thresholds defined by the EFNS guidelines compared with laboratory defined cutoff to pursue investigations for elevated CK only marginally improve specificity. A baseline CK >1000 IU/l is highly predictive of an IIM or other neuromuscular disorders. This study highlights the role of baseline CK levels in suspected IIM and neuromuscular disorders, clarifying its diagnostic value.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag061"},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346274","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":"Impact of concomitant fibromyalgia on disease activity assessment and quality of life in Vietnamese patients with rheumatoid arthritis.","authors":"Ngan Tran Thi, Hanh Dang Thi, Hue Vu Thi, Thuy Nguyen Thi Phuong","doi":"10.1093/rap/rkag067","DOIUrl":"10.1093/rap/rkag067","url":null,"abstract":"<p><strong>Objectives: </strong>FM is increasingly recognised as a contributor to RA and may influence disease activity assessment. However, data from low- and middle-income countries remain limited. We aimed to investigate the prevalence and clinical impact of concomitant FM on disease activity assessment, quality of life (QoL) and treatment patterns in Vietnamese patients with RA.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, adult patients with RA were assessed for FM using the 2016 ACR criteria. Disease activity [28-joint DAS with CRP (DAS28-CRP)], objective inflammatory markers, patient-reported outcomes, QoL and treatments were analysed. Multivariable linear regression analysis was performed to assess whether FM was independently associated with DAS28-CRP after adjustment for demographic and relevant clinical covariates.</p><p><strong>Results: </strong>Among 187 patients with RA, 34.2% fulfilled criteria for concomitant FM. Patients with FM had significantly higher DAS28-CRP scores compared with those without FM. The FM-related increase in DAS28-CRP was driven predominantly by subjective components, while objective inflammatory measures differed modestly. In multivariable analysis, FM remained independently associated with higher DAS28-CRP scores. Patients with FM also reported significantly worse QoL and were more likely to receive corticosteroids despite less frequent use of DMARDs.</p><p><strong>Conclusion: </strong>Concomitant FM is common among Vietnamese patients with RA and is associated with symptom amplification, poorer QoL and higher DASs independent of objective inflammation. In resource-limited settings, reliance on DAS28-CRP alone may contribute to symptom-driven treatment escalation and corticosteroid overuse. Recognition of FM is essential to support accurate disease assessment and safer, more appropriate management strategies.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag067"},"PeriodicalIF":2.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303004","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":"Pregnancy outcomes in patients with axial spondyloarthritis: a UK-based survey.","authors":"Maria Mouyis, Thomas A Ingram, Bayram Farisogullari, Jill Hamilton, Zoe Clark, Dale Webb, Helena Marzo-Ortega, Pedro M Machado","doi":"10.1093/rap/rkag063","DOIUrl":"10.1093/rap/rkag063","url":null,"abstract":"<p><strong>Objectives: </strong>To explore pregnancy outcomes in patients with axial spondyloarthritis (axSpA) in the UK.</p><p><strong>Methods: </strong>A patient-reported online survey, based on the EULAR core dataset for pregnancy registries in rheumatology, was conducted via the REDCap platform with data included between October 2022 and October 2023. Data were analysed descriptively.</p><p><strong>Results: </strong>A total of 139 pregnancies from 89 women following a diagnosis of axSpA were analysed. The mean age at pregnancy was 32.1 years (s.d. 4.3), at diagnosis was 27.6 years (s.d. 5.1) and at symptom onset was 20.8 years (s.d. 5.8). Most pregnancies were planned (90.6%) and achieved by natural conception (90.2%), with 68.3% conceiving within 1 year. Assisted conception was reported infrequently. Pre-pregnancy concerns such as pain levels increasing (74.8%), birth complications (62.6%) and passing on axSpA to a child (63.3%) were frequently reported. Flares occurred during 33.6% of pregnancies and in more than half (55.6%) during postpartum. The live birth rate was 76.4%. Rates of pre-eclampsia and congenital anomalies were 5.4% and 9.5%, respectively. Caesarean section occurred in 53.8% of pregnancies, with active disease and patient choice being core reasons. Most infants received vaccinations as scheduled (83.5%). AxSpA did not affect the decision to breastfeed for 82.5% of pregnancies, but it did affect perceived ability to care for the baby in the first 6 months (61.3%).</p><p><strong>Conclusion: </strong>Many women with axSpA experience increased time to pregnancy, disease-related pre-pregnancy worries, flares and delivery via caesarean section. Pre-pregnancy counselling may be important for women of reproductive age with axSpA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag063"},"PeriodicalIF":2.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302972","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":"<i>Bartonella-</i>associated aortitis: expanding the differential diagnosis of large-vessel inflammation.","authors":"Michiel De Moor, Marie-Angélique De Scheerder, Robbe Waterschoot, Stien Vandendriessche, Bernard Peeters, Steven Callens, Leslie Naesens","doi":"10.1093/rap/rkag069","DOIUrl":"10.1093/rap/rkag069","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag069"},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296077","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":"Values, preferences, and informational needs of individuals living with ANCA-associated vasculitis: a systematic review.","authors":"Mats Junek, Seungwon Choi, Yuan Qi, Ali Sulaiman A Al-Magooshi, Gordon Guyatt, Lehana Thabane, Arielle Mendel, Nader Khalidi, Michael Walsh","doi":"10.1093/rap/rkag057","DOIUrl":"10.1093/rap/rkag057","url":null,"abstract":"<p><strong>Objectives: </strong>ANCA-associated vasculitis (AAV) is associated with a marked health burden and uncertainties across multiple treatment options. We aimed to complete a systematic review of previous research concerning individual values, preferences and informational needs in AAV to inform efforts to facilitate shared decision-making that can help manage this uncertainty.</p><p><strong>Methods: </strong>We conducted a qualitative systematic review with thematic synthesis of studies assessing values and preferences of individuals with AAV. We searched the CENTRAL, Medline, Embase, PsychInfo, HealthStar, CINAHL and three health decision databases for studies that assessed values, preferences, the utility of a decision aid and/or unmet informational needs for adults with AAV on 27 August 2024. The thematic synthesis approach guided our analysis. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for qualitative studies and the Risk of Bias in Studies of Values and Utilities tool for quantitative studies.</p><p><strong>Results: </strong>We identified 1038 abstracts and included 18 studies. Seven qualitative studies included at least 177 individuals; the 11 quantitative studies included 1727 individuals. Three themes emerged: 'living with AAV', focusing on self-management needs and living within a supportive environment; 'information exchange', focusing on effective sharing of information and methods of information sharing; and 'treatment of AAV', focusing on preferences and experiences regarding the benefits and harms of therapy. We did not find any studies on values and preferences regarding therapies aside from glucocorticoids and plasma exchange.</p><p><strong>Conclusion: </strong>AAV affects many aspects of lives of individuals living with it, raising multiple issues around values, preferences and informational needs. Understanding these common concerns can improve care for individuals with AAV and facilitate shared decision-making.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag057"},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265826","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":"Recombinant zoster vaccine immunization rate in patients on Janus kinase inhibitors for rheumatologic and dermatologic conditions.","authors":"Jessica B Michaud, Ruta Brazauskas, Sarah Wigfield, Shelby Shepard, Teresa Mysliwiec, Kylie Perez, Shikha Singla","doi":"10.1093/rap/rkag071","DOIUrl":"10.1093/rap/rkag071","url":null,"abstract":"<p><strong>Objectives: </strong>Patients who receive Janus kinase (JAK) inhibitors are at an increased risk of varicella zoster virus reactivation. The primary objective of this study was to evaluate the vaccination rates of recombinant zoster vaccine (RZV) for patients taking a JAK inhibitor for dermatologic or rheumatologic conditions.</p><p><strong>Methods: </strong>A facility-based cross-sectional study design was employed to select patients who were ≥18 years of age and were prescribed a JAK inhibitor for at least 6 months by a rheumatologist or dermatologist for any rheumatologic or dermatologic condition. Data analysis was undertaken using descriptive methods.</p><p><strong>Results: </strong>There were 102 patients included in this study, with most patients being female (77.5%), ≥50 years of age (71.6%), White (77.5%) and with RA (76.5%). The proportion of patients who received at least one RZV (at any time in relation to JAK inhibitor initiation) was 27.5% (28/102). Only three patients received at least one dose of RZV within 30 days before or after initiation of a JAK inhibitor.</p><p><strong>Conclusion: </strong>Many patients receiving JAK inhibitors are not vaccinated with RZV, and of those who are vaccinated, the timing of vaccination rarely coincided with JAK inhibitor initiation and thus did not appear to be the motivation for vaccination. These data will be used to optimize vaccination workflow within ambulatory clinics to mitigate herpes zoster risk in this population.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag071"},"PeriodicalIF":2.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391510","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 test of a conceptual model of uncertainty, benefit and burden in children and young people with juvenile dermatomyositis.","authors":"Polly Livermore, Klaudia H Kupiec, Kathleen Mulligan, Shashi P Hirani, Faith Gibson, Claire Deakin, Deborah Ridout, Andrea M Knight, Lucy R Wedderburn, Brian M Feldman","doi":"10.1093/rap/rkag070","DOIUrl":"10.1093/rap/rkag070","url":null,"abstract":"<p><strong>Objectives: </strong>Mental health concerns are highly prevalent in children and young people (CYP) with chronic conditions. This is further exacerbated by perceived feelings of illness uncertainty and illness burden, which have negative implications for CYP with childhood-onset chronic conditions and their families. Understanding the mechanisms that reduce health-related quality of life (HRQoL) and identifying resilience factors is important to improve outcomes for these vulnerable populations. The current study aimed to assess HRQoL in CYP with juvenile dermatomyositis (JDM) and to test a new conceptual model of illness representations and resilience in depression and anxiety.</p><p><strong>Methods: </strong>CYP ages ≥8 years who were enrolled in the UK-wide JDM cohort and Biomarker Study (JDCBS) in 15 UK National Health Service tertiary paediatric rheumatology services were invited to complete five validated paediatric measures: PedsQL 4.0 Core, PedsQL 3.0 Rheumatology Module, Paediatric Index of Emotional Distress (PI-ED), Childhood Uncertainty in Illness Scale (CUIS) and Benefit and Burden Scale for Children (BBSC). Data were analysed using descriptive statistics and structural equation modelling.</p><p><strong>Results: </strong>Results showed that the HRQoL in CYP with JDM is affected as a result of their chronic condition. Moreover, the proposed model revealed that illness uncertainty and burden are key driving factors that cause an increase in anxiety and depression, while benefit finding did not ameliorate poor mental health outcomes.</p><p><strong>Conclusion: </strong>Addressing illness uncertainty and reducing the perceived disease burden is vital to improve HRQoL and well-being in CYP with JDM who struggle to cope with the unpredictable nature of their disease.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag070"},"PeriodicalIF":2.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437519","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":"Turkish adaptation and psychometric testing of the Perceived Workplace Support Scale in people with inflammatory arthritis.","authors":"Gonca Bumin, Ezginur Gündoğmuş, Alan Tennant, Sevilay Karahan, Umut Kalyoncu, Yeliz Prior","doi":"10.1093/rap/rkag066","DOIUrl":"10.1093/rap/rkag066","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to adapt the Perceived Workplace Support Scale (PWSS) into Turkish and evaluate its psychometric properties among individuals diagnosed with inflammatory arthritis (IA).</p><p><strong>Methods: </strong>A total of 200 employed individuals with IA (mean age = 37.9 ± 10.6 years; 66.5% female) participated in the study. The cultural adaptation followed Beaton's method, including forward translation, synthesis, back-translation, expert committee review and cognitive debriefing. Construct validity was assessed using Rasch analysis. Internal consistency was examined with Cronbach's alpha, and test-retest reliability was evaluated in a subsample using intraclass correlation coefficients (ICCs). Concurrent validity was examined by correlating PWSS dimension scores with the Work Limitation Questionnaire-Short Form (WLQ-SF), Rheumatoid Arthritis Work Instability Scale (RA-WIS) and Work Productivity and Activity Impairment Questionnaire: General Health (WPAI: GH).</p><p><strong>Results: </strong>Rasch analysis supported the structural validity of the Turkish PWSS, showing adequate model fit after addressing local item dependencies. Cronbach's alpha ranged from 0.59 (manager) to 0.81 (coworker). Test-retest reliability indicated fair stability, with ICCs of 0.47 (manager), 0.52 (coworker) and 0.59 (organization). These findings suggest that the scale is more appropriate for group-level comparisons rather than individual-level assessment. The scores for PWSS subdimensions showed moderate correlations with work and health measures, supporting concurrent validity.</p><p><strong>Conclusions: </strong>The Turkish version of the PWSS demonstrates potential utility for assessing perceived workplace support in individuals with IA. However, given the fair level of test-retest reliability, it should be used with caution and primarily for group-level analyses.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag066"},"PeriodicalIF":2.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272339","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}