South Asian Journal of Cancer最新文献

{"title":"Real-World Evidence for Comparative Outcomes between Innovator and Biosimilar Bevacizumab in Advanced Colorectal Cancers.","authors":"Arvind Vaidyanathan, Pranaya Vana, Nachiket Joshi, Bikash Sourav, Prabhat Bhargava, George John, Anant Ramaswamy, Vikas Ostwal","doi":"10.1055/s-0045-1804535","DOIUrl":"10.1055/s-0045-1804535","url":null,"abstract":"<p><strong>Purpose: </strong>Generic versions of bevacizumab are commonly used in India in patients with advanced/metastatic colorectal cancers (mCRCs), but there is limited real-world evidence (RWE) about their efficacy in comparison to the innovator bevacizumab.</p><p><strong>Methods: </strong>Patients diagnosed with mCRC between January 2017 and January 2022 and receiving a combination of chemotherapy and bevacizumab were retrospectively analyzed for demographic variables and survivals. The primary endpoint of the study was the estimation and comparison of median progression-free survival (mPFS) between patients receiving innovator versus generic bevacizumab as first-line therapy (CT1) by the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 944 patients were included in the analysis, of whom 652 patients (69%) received bevacizumab as CT1, 449 patients (48%) during second-line chemotherapy (CT2), and 74 patients (8%) during third-line therapy (CT3). The innovator was administered to 132 patients (14%), while the remaining 812 patients (86%) received a generic molecule. With a median follow-up of 18 months, there was no difference in mPFS between patients receiving the innovator or biosimilar (10 vs. 9.3 months, <i>p</i>  = 0.62). Similarly, there was no difference in median overall survival (mOS) between patients receiving the innovator or biosimilar during CT1 (17.8 vs. 18 months, <i>p</i>  = 0.85). Among the patients who received bevacizumab during CT2, there was no statistically significant difference in mPFS between the innovator and the biosimilar (5.5 vs. 5.8 months, <i>p</i>  = 0.97), nor was there a difference in mOS between patients receiving the innovator or biosimilar during CT2 (8.15 vs. 8.58 months, <i>p</i>  = 0.16).</p><p><strong>Conclusion: </strong>The current study offers RWE to suggest similar outcomes with innovator and generic bevacizumab when combined with chemotherapy in mCRCs. This has significant implications in India and other low- and middle-income countries besides providing oncologists with greater confidence to use these molecules in their clinical practice.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"296-299"},"PeriodicalIF":0.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587116","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":"Adjuvant Chemotherapy in Colon Cancer: Simple is Better… Less is More.","authors":"Prasad Narayanan, Shyam Aggarwal, Manish Singhal, Vamshi Krishna, A K Rathi, Brig H P Singh, Atul Sharma, J B Sharma, Amit Bhargava, P Suresh, Meenu Walia, H S Darling, K Medhi, Kumardeep Dutta, Sajjan Singh Rajpurohit, Prashant Mehta, Vikas Goswami, Saumitra Rawat, C Selvasekar, Purvish M Parikh","doi":"10.1055/s-0045-1802564","DOIUrl":"10.1055/s-0045-1802564","url":null,"abstract":"<p><p>A significant number of patients with colorectal cancer (CRC) benefit from adjuvant therapy. While 6 months of FOLFOX is standard of care, newer regimens like CAPOX and SOX allow for shorter durations. Trials of importance include SCOT (U.K., Denmark, Spain, Sweden, Australia, New Zealand), TOSCA (Italy), Alliance/SWOG80702 (U.S., Canada), IDEA (France), ACHIEVE (Japan), and HORG (Greece). Management recommendation is also based on patient preferences, dividing them into fighters and fatalists. Better patient selection is possible with the use of novel molecular-based biomarkers and circulating tumor deoxyribonucleic acid monitoring of minimal residual disease. There also needs to be special consideration for the geriatric patients-especially due to their limited mobility, comorbidities, and polypharmacy.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"281-286"},"PeriodicalIF":0.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587095","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":"Current Status of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Colorectal Cancer (CRC).","authors":"S P Somashekhar, Adwaith Krishna Surendran, Deep Goyal, Saumitra Rawat, Shyam Aggarwal, C Selvasekar, Purvish M Parikh","doi":"10.1055/s-0045-1802982","DOIUrl":"10.1055/s-0045-1802982","url":null,"abstract":"<p><p>Accounting for 8.7% of global cancer deaths, colorectal cancer (CRC) is one of the leading causes of cancer-related mortality. Cytoreduction surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is part of a multimodal strategy for managing CRC. HIPEC is designed to target residual microscopic disease using heated chemotherapy. There are several techniques including the open abdomen \"coliseum\" technique, which uses a silastic sheet to create a perfusion chamber and allows for manipulation of contents; whereas the closed abdomen technique maintains a sterile environment and may involve abdominal wall massage for heat distribution; lastly, the laparoscopic method combines the benefits of both techniques with enhanced drug distribution through laparoscopy. Research has shown that the coliseum technique offers superior heat uniformity, while the laparoscopic method provides optimal distribution with advanced monitoring tools. We examined early trials, procedural variations, and recent clinical research to assess its efficacy. HIPEC involves the administration of heated chemotherapy directly into the peritoneal cavity after CRS in order to enhance local tumor control and survival. Various regimens that have been explored, including the Sugarbaker, triple dosing, and low dose mitomycin C regimen, report mixed results. The selection of chemotherapy drugs and their efficacy at high temperatures is crucial, with studies yielding mixed results for oxaliplatin and mitomycin C. The advantages of HIPEC, especially with oxaliplatin-based regimens, have been questioned by recent trials such as the PRODIGE 7 study because of problems like chemoresistance and greater postoperative morbidity. On the other hand, HIPEC is still supported by some as a good choice for individuals who are carefully chosen, particularly when combined with other forms of treatment. Despite being widely used in several cancer centers around the world for other pathologies, HIPEC remains a debated treatment option in CRC with peritoneal metastases. Even though the current evidence suggests that it might not provide a statistically meaningful overall survival improvement when compared to CRS alone, it might still be useful in some clinical settings or when combined with well-designed protocols. Thus, the necessity of more research and standardized protocols is paramount. Determining the role of HIPEC, maximizing patient selection, and contrasting its effectiveness with other intraperitoneal treatments such as pressurized intraperitoneal aerosol chemotherapy and early postoperative intraperitoneal chemotherapy will require ongoing trials and future research. Until clearer evidence emerges, HIPEC should be considered a therapeutic option for selected patients and offered by dedicated, experienced centers and surgical teams.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"267-273"},"PeriodicalIF":0.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587103","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":"Screening for Colorectal Carcinoma in India: Real-World Scenario, Pitfalls, and Solutions.","authors":"Mansi Agrawal, Adwaith Krishna Surendran, Karthik Kanna Venkatesh, Praveen Nandha Kumar Pitchan Velammal, Sarvesh Zope, Anika Goel, Aarnav Pathak, Mallika Mittal, Varshitha K K, Archana Sameer Vinakar, Daksh Agrawal, Purvish M Parikh","doi":"10.1055/s-0045-1802655","DOIUrl":"10.1055/s-0045-1802655","url":null,"abstract":"<p><strong>Introduction: </strong>Noninvasive colorectal cancer (CRC) screening has introduced innovative blood- and stool-based biomarkers, improving early detection and enabling personalized solutions. Global and Indian adoption of CRC screening remains a public health challenge. This study evaluates the real-world utility of screening colonoscopy, as recommended by global guidelines.</p><p><strong>Methodology: </strong>A survey based on the American Medical Association (AMA) guidelines was designed, setting 45+ years as the cutoff age for colonoscopy screening. A Google form was shared via social media application with health care professionals. Participation was voluntary, responses were collected over 30 days, and data were analyzed.</p><p><strong>Results: </strong>A total of 2,199 individuals' data were analyzed. Among these, 1,374 were eligible for screening colonoscopy, out of which only 7.14% (98/1,374) actually underwent the procedure.</p><p><strong>Conclusion: </strong>Among various cancer programs, screening sigmoidoscopy has proved to improve both CRC-specific mortality and all-cause mortality. Unfortunately, its utilization is suboptimal, at best. Even among the highly educated medical community, the real-world utility was only in 7.14% of the eligible population. Barriers include invasive nature of intervention, need for appropriate bowel preparation, operator dependence, and small but significant risk of serious toxicity. An important method of increasing utility of screening colonoscopy is use of a test that can identify high-risk population, who can then be persuaded to undergo screening colonoscopy. This is the value of recently developed noninvasive blood- and stool-based tests, like Guardant Health's Shield. Being U.S. Food and Drug Administration (FDA) approved with specificity of 90% and sensitivity of 84%, it should be offered to all eligible persons who can afford it, thereby increasing colonoscopy use and potentially saving lives.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"229-235"},"PeriodicalIF":0.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587118","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":"Familial Polyposis and Colon Cancer.","authors":"Amit Kumar Jain, Purvish M Parikh, Subash Chandra Dadhich, Anil Arora, Mandhir Kumar, Piyush Ranjan, Naresh Kumar Bansal, Praveen Sharma, Shyam Aggarwal, C Selvasekar, Saumitra Rawat","doi":"10.1055/s-0045-1802333","DOIUrl":"10.1055/s-0045-1802333","url":null,"abstract":"<p><p>Familial adenomatous polyposis is an important hereditary risk factor for colon cancer. Such patients and families need special attention for prevention, early detection, and optimal treatment. Molecular testing is key to identify the specific mutation in the proband and can then make it easier to identify other family members at risk. Aggressive surveillance and colonoscopy will be indicated in most patients. Both colonic and extra-colonic manifestations are important. Chemoprevention is worth considering. Almost all patients will ultimately need colectomy. These details will be discussed in this review.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"305-308"},"PeriodicalIF":0.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587109","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":"Neoadjuvant Treatment in Rectal Cancer.","authors":"Srinath Bhradwaj R, Aditya Sarin, Shyam Aggarwal, Shikha Halder, S Hukku, Taha Mustafa, Vijay Arora, V K Malik, Shivendra Singh, G V Rao, Avinash Saklani, Rajesh Bhojwani, Saumitra Rawat, C Selvasekar, Purvish M Parikh","doi":"10.1055/s-0045-1802334","DOIUrl":"10.1055/s-0045-1802334","url":null,"abstract":"<p><p>A major advance in rectal cancer was the evidence supporting short-course radiotherapy and long-course chemoradiotherapy. Both have been shown to improve local outcomes. Total neoadjuvant therapy (TNT) is the new kid on the block that provides further benefit of improving local responses as well as reducing systemic relapses, thus increasing overall survival. Details of the four key TNT trials are discussed. They pave the way for nonoperative management for patients who achieve clinical complete responses.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"274-280"},"PeriodicalIF":0.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587115","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":"Inflammatory Bowel Disease and Colorectal Cancer: An Eternal Fire in a Beautiful Garden.","authors":"Venkata Pradeep Babu Koyyala, Chetan Kantharia, Naitica Darooka, Mandhir Kumar, Piyush Ranjan, Shrihari Anikhindi, Naresh Kumar Bansal, Praveen Sharma, Dr V P Bhalla, Manish Kumar, Mohit Sharma, Deepak Abrol, Peush Sahni, Ramesh Ardhanari, R Pradeep, Amitabh Yadav, Suviraj John, Saumitra Rawat, Purvish Parikh, C Selvasekar, Shyam Aggarwal","doi":"10.1055/s-0045-1802335","DOIUrl":"10.1055/s-0045-1802335","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, significantly increases the risk of colitis-associated cancer (CAC). Chronic inflammation, a key contributor to carcinogenesis, disrupts immune surveillance, induces deoxyribonucleic acid (DNA) damage, and alters genetic and epigenetic pathways. Molecular pathways such as STAT3, mTOR, and NF-κB drive CAC progression, while unique microbiome alterations-loss of <i>Faecalibacterium prausnitzii</i> and increases in <i>Escherichia coli</i> and <i>Fusobacterium</i> species-exacerbate the inflammatory milieu. CAC accounts for 2% of all colon cancers and up to 15% of IBD-related deaths. Risk correlates with IBD duration, increasing approximately 1% annually after the first decade. Surveillance via colonoscopy is crucial, with chromoendoscopy recommended for high-risk cases. Preventive drugs, including aminosalicylates, thiopurines, and biologics, offer modest benefits but lack conclusive evidence. Post-CAC diagnosis, immunosuppressants are discontinued in favor of corticosteroids, with 5-aminosalicylates continued as needed. The use of immune checkpoint inhibitors remains controversial due to exacerbation of colitis. Emerging insights into the gut microbiota's role in IBD and CAC may revolutionize prevention and management strategies. Advances in screening, surveillance, and therapeutic approaches have reduced CAC mortality, underscoring the importance of personalized medicine and ongoing research to address these complex conditions.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"300-304"},"PeriodicalIF":0.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587110","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":"CT and MR Imaging in Colorectal Carcinoma: A Tool for Diagnosis, Staging, Response Evaluation, and Follow-Up.","authors":"Samarjit Singh Ghuman, Rohit Kochhar, Harsh Mahajan, T B S Buxi, Arun Gupta, Anil Arora, K K Saxena, Seema Sud, Aditi Sud, Kishan Rawat, Munish K Sachdeva, Ajit Yadav, Saumitra Rawat, Shyam Aggarwal, Purvish M Parikh, C Selvasekar","doi":"10.1055/s-0045-1802336","DOIUrl":"10.1055/s-0045-1802336","url":null,"abstract":"<p><p>The present review highlights the role of computed tomography (CT), CT colonography (CTC), and magnetic resonance imaging (MRI) in the diagnosis, staging, response evaluation, and follow-up of colorectal cancer. For a CT scan, prior bowel preparation is required. This is done to enhance imaging of the colon with the use of oral or rectal contrast agents. Negative contrast like air or carbon dioxide are helpful in detecting polyps and masses by distending the colon. Virtual colonoscopy offers a lower-radiation alternative for polyp and cancer detection. Intravenous contrast administration with arterial and venous phase CT images is also important in complete staging of a known case of colon cancer and for evaluation of residual/recurrent disease. With respect to MRI, high-resolution T2-weighted images in multiple planes are important, with diffusion-weighted imaging (DWI) sequences being important for restaging. Intravenous contrast is not generally recommended. Contrast-enhanced CT and MRI are used for nodal and distant metastasis staging, with special attention to the pelvic side wall nodes. Positron emission tomography (PET) CT is to be considered for further evaluation if the findings are unclear and recurrence is suspected.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"236-240"},"PeriodicalIF":0.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587099","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":"To Identify and Discuss the Enablers or Facilitators and Barriers to International Medical Graduates Adapting to the United Kingdom National Health Service in a Defined Surgical Trainee Population: A Qualitative Study.","authors":"Ajit Singh Oberoi, C R Selvasekar, S R Murali, B Nirmal Kumar, Shreyas Aggarwal, Shyam Aggarwal, Soumitra Rawat","doi":"10.1055/s-0044-1801774","DOIUrl":"10.1055/s-0044-1801774","url":null,"abstract":"<p><strong>Background: </strong>International medical graduates (IMGs) play a crucial role in the United Kingdom National Health Service (NHS), yet they encounter significant challenges adapting to the NHS environment. This study aims to identify the enablers and barriers affecting the adaptation of IMGs, specifically focusing on surgical trainees in the Master of Surgery (MCh) program at Edge Hill University.</p><p><strong>Methods: </strong>A qualitative approach was employed, utilizing an interpretivist philosophy and descriptive design. Data were collected through focus group discussions with first-year MCh surgical trainees. Thematic analysis was conducted to extract key themes related to adaptation.</p><p><strong>Results: </strong>Three focus groups with a total of seven participants revealed several enablers and barriers. Enablers included robust administrative support, effective communication courses, comprehensive mentorship programs, and supportive hospital staff. Barriers identified were limited access to formal teaching, a fast-paced academic environment, language and cultural differences, and variations in medical practice.</p><p><strong>Conclusion: </strong>The successful integration of IMGs into the NHS hinges on strong support systems, including administrative assistance, mentorship, and cultural and communication training. Addressing these barriers can facilitate smoother adaptation, enhance retention, and improve patient care.</p><p><strong>Recommendations: </strong>To enhance IMG adaptation, the study recommends extensive induction programs, improved mentorship and support networks, cultural competence training, and better access to formal teaching with feedback.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"309-314"},"PeriodicalIF":0.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587119","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":"Current Issues of Next-Generation Sequencing-Based Circulating Tumor DNA Analysis in Colorectal Cancer.","authors":"Narmadha Rathnasamy, Viraj Lavingia, Shyam Aggarwal, Vineet Talwar, Pragya Shukla, Nitesh Rohtagi, K M Prathasarathy, Deni Gupta, Rajesh Pasricha, Sunil Pasricha, R K Choudhary, Gautam Goyal, Saumitra Rawat, Purvish M Parikh, C Selvasekar","doi":"10.1055/s-0044-1801755","DOIUrl":"10.1055/s-0044-1801755","url":null,"abstract":"<p><p>Evidence is mounting that circulating tumor deoxyribonucleic acid can be tested accurately, frequently, and in a noninvasive form. Its role in monitoring patients with cancer, particularly colorectal cancer, is increasing. In this brief review, we discuss its current role when measured using next-generation sequencing-based methods.</p>","PeriodicalId":22053,"journal":{"name":"South Asian Journal of Cancer","volume":"13 4","pages":"241-245"},"PeriodicalIF":0.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587100","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}