Salim Al-Busaidi, Hatim Al-Lawati, Nasiba Al-Maqrashi, Arunodaya R Gujjar
{"title":"Utility of Routine 24-Hour Electrocardiographic Holter Monitoring for Detecting Atrial Fibrillation in Patients Admitted with Acute Stroke Syndromes.","authors":"Salim Al-Busaidi, Hatim Al-Lawati, Nasiba Al-Maqrashi, Arunodaya R Gujjar","doi":"10.18295/2075-0528.2824","DOIUrl":"10.18295/2075-0528.2824","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the operating characteristics of standard 12-lead electrocardiogram (ECG) and 24-hour Holter studies in detecting atrial tachyarrhythmia in patients with acute stroke syndromes. The study's objective was to determine the potential factors that increased the likelihood of detecting atrial fibrillation (AF) and its impact on management.</p><p><strong>Methods: </strong>This retrospective cohort study included adults (aged ≥18 years) admitted at Sultan Qaboos University Hospital from January 2010 to December 2019, with ischaemic stroke or transient ischaemic attack and had undergone a 24-hour Holter study. The hospital stroke registry was used to screen patients.</p><p><strong>Results: </strong>A total of 1,258 patients were screened and only 460 patients, who had undergone 521 Holter studies, met the inclusion criteria. Among them, AF was detected with baseline ECG in 20 patients (4.4%), while new AF was detected in only eight patients (1.7%). Significant predictors for increased AF detection by Holter included advanced age, peripheral vascular disease (PVD), left ventricular diastolic dysfunction and chronic kidney disease Stage III, with PVD highlighted as an independent predictor (odds ratio = 17.133, 95% confidence interval = 2.139-137.201, <i>P</i> = 0.007). The degree of agreement between the baseline ECG and Holter ECG was substantial (K = 0.649, <i>P</i> < 0.001). A total of 130 Holter needs to be performed to detect one case of treatable AF.</p><p><strong>Conclusions: </strong>This study showed that a routine ECG Holter study in acute stroke has a low clinical yield in detecting AF, which is in substantial agreement with baseline ECG. Therefore, further investigation of paroxysmal AF in acute stroke should be reserved for high-risk patients.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"191-199"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609651","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":"Profile of Perinatal Infections Among Abandoned Neonates Admitted in a Tertiary Hospital in Oman.","authors":"Mahmood Dhahir Al-Mendalawi","doi":"10.18295/2075-0528.2881","DOIUrl":"10.18295/2075-0528.2881","url":null,"abstract":"","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"611-612"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733310","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}
Miguel Mansilla-Polo, Fernando Navarro-Blanco, Javier López-Davia, Rafael Botella-Estrada
{"title":"Successful Treatment of Recalcitrant Eosinophilic Pustular Folliculitis with Dupilumab.","authors":"Miguel Mansilla-Polo, Fernando Navarro-Blanco, Javier López-Davia, Rafael Botella-Estrada","doi":"10.18295/2075-0528.2873","DOIUrl":"10.18295/2075-0528.2873","url":null,"abstract":"<p><p>Eosinophilic pustular folliculitis (EPF) is a chronic inflammatory condition characterised by the appearance of excoriated papules involving the face, neck, trunk, and root of limbs. It is a rare disease, and most treatments rely on reports of isolated cases or small case series. Numerous treatments have been employed throughout history, with variable effectiveness, including indomethacin, corticosteroids, calcineurin inhibitors, dapsone, cyclosporine, tetracyclines, isotretinoin or narrowband ultraviolet B therapy. We report the successful treatment of a 77-year-old female patient who presented to a tertiary care hospital in Valencia, Spain, in 2024 with refractory EPF, which significantly affected her quality of life due to uncontrollable pruritus, with dupilumab. With the advent of new biologic drugs and small molecule therapies, it is hoped that diseases traditionally lacking effective treatments will have new valid and safe treatment options.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"622-627"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733313","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}
Yusriya Al Rawahi, Hussain AlSaffar, Amr Abdalla, Azza N Al Shidhani
{"title":"Levothyroxine Requirement in a Patient with LRBA Deficiency and GVHD Induced Cholestasis.","authors":"Yusriya Al Rawahi, Hussain AlSaffar, Amr Abdalla, Azza N Al Shidhani","doi":"10.18295/2075-0528.2879","DOIUrl":"10.18295/2075-0528.2879","url":null,"abstract":"<p><p>Levothyroxine is a lipophilic hormone that is absorbed in the small intestine, mainly in the jejunum and ileum. The absorption of levothyroxine after oral administration averages 60-80%. We report a 7-year-old male patient who presented to a tertiary care hospital in Muscat, Oman, in 2020 at the age of three years with an early diagnosis of lipopolysaccharide beige-like anchor protein (LRBA) deficiency. LRBA deficiency is characterised by recurrent infections, autoimmune thyroid disease and autoimmune cytopenia. The patient was prescribed levothyroxine treatment (112.5 mcg daily) and underwent haematopoietic stem cell transplantation (HSCT) in March 2023; four months post-HSCT, he developed appendicitis followed by jaundice and elevation of liver enzymes. His physical examination revealed a distended abdomen with enlarged liver and spleen. Graft-versus-host disease (GVHD) was diagnosed and confirmed by a liver biopsy and treatment for GVHD was initiated. Despite ongoing levothyroxine therapy, he exhibited biochemically severe hypothyroidism with very low free-throxine and high thyroid-stimulating hormone, prompting a dosage increment. Investigations to determine the cause of his severe hypothyroidism were unremarkable, ultimately attributing the need for increased thyroxine to cholestasis induced by chronic GVHD. This case emphasises the complexities of managing thyroid function in patients with hepatic GVHD, highlighting the necessity for frequent monitoring and levothyroxine dosage adjustments.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"592-597"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733355","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}
Nasiba Al Maqrashi, Salim Al Busaidi, Sara Al-Rasbi, Abdullah M Al Alawi, Juhaina S Al-Maqbali
{"title":"Effect of Magnesium Supplements on Improving Glucose Control, Blood Pressure and Lipid Profile in Patients With Type 2 Diabetes Mellitus: <i>A systematic review and meta-analysis</i>.","authors":"Nasiba Al Maqrashi, Salim Al Busaidi, Sara Al-Rasbi, Abdullah M Al Alawi, Juhaina S Al-Maqbali","doi":"10.18295/2075-0528.2848","DOIUrl":"10.18295/2075-0528.2848","url":null,"abstract":"<p><p>This study evaluated the effects of magnesium (Mg) supplementation on glycaemic control in type 2 diabetes mellitus through a meta-analysis of 23 randomised controlled trials involving 1,345 participants. Mg supplementation significantly increased serum Mg levels (weighted mean difference [WMD] = 0.69, 95% CI: 0.32 to 1.06) and reduced fasting blood glucose levels (WMD = -0.58, 95% CI: -0.87 to -0.28). However, the impact on glycated haemoglobin was minimal (WMD = -0.16, 95% CI: -0.32 to 0.00). Subgroup analysis showed a greater reduction in glycated haemoglobin among participants aged ≥65 years and those receiving longer durations of supplementation. Additionally, Mg supplementation was linked to lower diastolic blood pressure and potential improvements in lipid profile. This review highlights the importance of considering patient characteristics, dosage and intervention duration in future research on Mg supplementation for glycaemic control in diabetes.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"382-394"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609572","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}
Narges S Soltani, Farahnaz Heshmat, Mohsen Dehghani, Robab L Roudsari, Mohadese B Ghalibaf, Samira E Zagami
{"title":"The Relationship between Female Genital Mutilation and Infertility: <i>A systematic review and meta-analysis</i>.","authors":"Narges S Soltani, Farahnaz Heshmat, Mohsen Dehghani, Robab L Roudsari, Mohadese B Ghalibaf, Samira E Zagami","doi":"10.18295/2075-0528.2839","DOIUrl":"10.18295/2075-0528.2839","url":null,"abstract":"<p><p>This systematic review aimed to investigate the relationship between female genital mutilation (FGM) and infertility. Online databases were systematically searched up to January 2024 using MeSH keywords to retrieve relevant observational studies. The methodological quality of the analytical cross-sectional studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated, and a random-effects meta-analysis was used to address any heterogeneity. Additionally, a sensitivity analysis was performed. A total of 5 analytical cross-sectional studies involving 37,146 participants, with 3 studies meeting the criteria for the meta-analysis. The results indicated that female circumcision (FC) was linked to a 21% increase in the odds of developing infertility compared to non-circumcision, although this finding was not statistically significant (OR = 1.21, 95% CI: 0.98-1.50). Notably, there was no evidence of significant heterogeneity between the studies (<i>P</i> = 0.84 [Q statistics], I<sup>2</sup> = 0.0%). While a statistically significant relationship between FGM and infertility was not established, the odds of infertility were higher in the circumcised group. Consequently, it is imperative to prioritise efforts to eradicate FC, especially among young girls.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"310-318"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609644","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}
Rima Khuzaimah, Fiastuti Witjaksono, Novi Silvia Hardiany
{"title":"The Correlation Between Zinc Intake and Superoxide Dismutase Activity with Cognitive Function in the Elderly.","authors":"Rima Khuzaimah, Fiastuti Witjaksono, Novi Silvia Hardiany","doi":"10.18295/2075-0528.2866","DOIUrl":"10.18295/2075-0528.2866","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyse the correlation between zinc intake and superoxide dismutase (SOD) with cognitive function in the elderly. Thus, the role of zinc as a structural component of SOD, along with SOD's contribution to cognitive function, can be established.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at Panti Sosial Tresna Wredha Budi Mulia 1 in Jakarta, Indonesia, from July to September 2024. Elderly men and women were included. Zinc intake was assessed using the Semi-Quantitative Food Frequency Questionnaire, while plasma SOD activity was measured by spectrophotometer. Cognitive function was assessed using the Montreal Cognitive Assessment-Indonesia version. Data were analysed using bivariate testing and multivariate linear regression.</p><p><strong>Results: </strong>A total of 85 subjects were included with a median age of 69 years (61.2% were female and 38.8% male). The majority (72.9%) had primary-level education and 87.1% had chronic diseases. The mean physical activity score was 75.4 ± 39.8, the mean body mass index was 21.8 ± 3.9 kg/m<sup>2</sup> and the median daily calorie intake was 1,927.8 kcal/day (range: 1,341.7-2,167.0 kcal/day). No correlation was found between zinc intake and cognitive function. However, a significant correlation (<i>P</i> = 0.006, <i>r</i> = 0.296) was observed between SOD levels and cognitive function, with multivariate analysis indicating that gender, education and SOD accounted for 15.9% of the variance in cognitive function.</p><p><strong>Conclusion: </strong>This study found no significant correlation between zinc intake and cognitive function. However, SOD activity were significantly correlated with cognitive function in the elderly.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"506-514"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627118","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}
Ayobola A Sonuga, Oyebola O Sonuga, Olatunbosun O Olawale, Sunday P Ogundeji
{"title":"Vitamin D Status and Oxidative Stress in Children with Sickle Cell Anaemia in Sagamu, Nigeria.","authors":"Ayobola A Sonuga, Oyebola O Sonuga, Olatunbosun O Olawale, Sunday P Ogundeji","doi":"10.18295/squmj.10.2024.054","DOIUrl":"10.18295/squmj.10.2024.054","url":null,"abstract":"<p><strong>Objectives: </strong>Sickle cell anaemia (SCA) is characterised by nutritional deficiencies and oxidative stress. Vitamin D possesses antioxidant properties; however, its role in SCA within sub-Saharan Africa remains inadequately understood. This study aimed to investigate the relationship between vitamin D status, oxidative stress and antioxidant levels in children with SCA, exploring its possible role in mitigating complications associated with oxidative stress in SCA.</p><p><strong>Methods: </strong>This study was conducted for a period of 9 months from November 2022 until July 2023 at the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. This case-control study involved 100 HbS genotype and 100 HbA genotype children (control group), all of whom were of comparable age (5-12 years). Baseline characteristics were collected, and serum levels of vitamin D, calcium, CAT, SOD, GPX, GST and XO were quantified using standard laboratory methods.</p><p><strong>Results: </strong>Serum levels of vitamin D, calcium, CAT, SOD, GPX and GST were significantly lower in the SCA group compared to the control group. Conversely, the XO level was significantly higher in the HbS group than in the control group. A positive correlation was observed between vitamin D, CAT and SOD (r = 0.821, 0.869), a weak positive association was found between vitamin D and Calcium (r = 0.545), and no significant relationship was identified between vitamin D and the other measured variables in the SCA group.</p><p><strong>Conclusions: </strong>Sufficient vitamin D levels may positively influence the antioxidant status in SCA individuals, thereby reducing associated complications.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627120","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":"Healthcare-Associated Infections Secondary to Multidrug-Resistant Organisms in Hospitalised Patients with COVID-19 Pneumonia: <i>A single-centre experience</i>.","authors":"Yahyia Al Hanashi, Abdullah Balkhair","doi":"10.18295/2075-0528.2826","DOIUrl":"10.18295/2075-0528.2826","url":null,"abstract":"<p><strong>Objectives: </strong>Hospitalisations related to COVID-19 pneumonia have increased the risk of healthcare-associated infections (HCAIs), including those caused by multidrug-resistant organisms (MDROs). This study aimed to investigate the epidemiology of HCAIs secondary to MDROs among hospitalised patients with COVID-19 pneumonia.</p><p><strong>Methods: </strong>This retrospective study population included patients with COVID-19 pneumonia aged 18 years and older who were admitted to Sultan Qaboos University Hospital, Muscat, Oman, for more than 48 hours between March 2020 and December 2021.</p><p><strong>Results: </strong>A total of 486 patients were included in this study. Among the cohort, 76 patients (15.6%) were diagnosed with concurrent HCAIs with an MDRO as the causative pathogen. Of these patients, 31 (40.8%) had infections caused by MDR Acinetobacter baumannii, 15 (19.7%) had infections secondary to carbapenem-resistant Klebsiella pneumoniae and 8 (10.5%) had infections caused by extended-spectrum betalactamase Escherichia coli. Pneumonia and bacteraemia were the two most common concurrent healthcare-associated MDRO infection sites, accounting for 42% and 36% of all events, respectively. Among the 486 patients, 155 died (31.9%). Among these, 64 (41.3%) had concurrent HCAIs caused by 1 or more MDROs. Contrarily, among the 331 patients with COVID-19 pneumonia who recovered, only 12 (3.6%) had concurrent HCAIs.</p><p><strong>Conclusions: </strong>There is high prevalence of healthcare-associated MDRO infections.predominantly pneumonia and bacteraemia.in hospitalised patients with COVID-19 pneumonia. This reveals a significant association between infection with MDROs and death underlining the substantial impact of infection with MDROs in this vulnerable patient population.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"186-190"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609617","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}
Masoud Kashoub, Al-Baraa Al-Jabri, Mohammed Al Rashdi, Jamal Al-Aghbari
{"title":"The Diagnostic Utility of Bronchoalveolar Lavage in Pulmonary Infections: <i>Study from a tertiary care hospital in Oman</i>.","authors":"Masoud Kashoub, Al-Baraa Al-Jabri, Mohammed Al Rashdi, Jamal Al-Aghbari","doi":"10.18295/2075-0528.2834","DOIUrl":"10.18295/2075-0528.2834","url":null,"abstract":"<p><strong>Objectives: </strong>Bronchoalveolar lavage (BAL) is an important diagnostic tool. Despite advancements in microbiological strategies, BAL's yield remains inconsistent. Hence, this study aimed to evaluate the yield of BAL in terms of microbial detection and correlate these results with computed tomography (CT) findings and antimicrobial usage duration before bronchoscopy.</p><p><strong>Methods: </strong>This retrospective cohort study included all adult patients who underwent bronchoscopy with BAL at Sultan Qaboos University Hospital, Muscat, Oman, from January 2021 to December 2022.</p><p><strong>Results: </strong>A total of 203 patients underwent bronchoscopy. The primary indication for bronchoscopy was lung infiltrates in patients with haematological malignancies (49.3%). The overall BAL yield was 58.1%. All immunocompromised patients with a halo sign on CT scans had negative BAL galactomannan (GM) results (<i>P</i> = 0.559). In immunocompromised patients, there was a higher prevalence of negative BAL cultures with antibiotics usage, regardless of its usage duration, with rates of 72.7% and 71.4% for durations of 1-5 days and 6-10 days, respectively (<i>P</i> = 0.004). Similarly, there was increasing negative BAL GM in immunocompromised patients with longer antifungal usage durations (94.1% for 1-5 days compared to 100% for 6-10 days; <i>P</i> = 0.610). The BAL yield was higher when more than 1 lobe was lavaged bilaterally (25.4%).</p><p><strong>Conclusion: </strong>This study revealed a BAL diagnostic yield of 58.1%, aligning with existing literature. Performing BAL on both lungs may enhance this yield. No correlation was found between the CT findings and BAL GM results. The study highlights the importance of early BAL intervention before antimicrobial usage.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"251-257"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609642","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}