Pharmacy最新文献

{"title":"Attitudes and Experiences of Patients Regarding Gender-Specific Aspects of Pain Management.","authors":"Carolin Alexandra Boldt, Dirk Keiner, Norman Best, Thilo Bertsche","doi":"10.3390/pharmacy12060175","DOIUrl":"10.3390/pharmacy12060175","url":null,"abstract":"<p><strong>Background: </strong>Biological, pharmacological, and socio-cultural aspects influence gender-specific effects in pain management.</p><p><strong>Methods: </strong>Gender-specific aspects of pain management were assessed in a rural outpatient center via semi-structured patient interview: (i) general gender aspects (total population) from 1 = \"fully disagree\" to 5 = \"fully agree\"; and (ii) individual pain (matched pairs) via numeric analog scale (NAS) from 0 = \"no pain\" to 10 = \"maximum pain\". Patient charts were assessed for pain management (WHO-ladder).</p><p><strong>Results: </strong>In total, 113 patients were enrolled (59.18 [SD: 12.76] years, 46% female, 54% male, 0% diverse), and 42 were matched into female-male pairs. (i) Women and men agreed that men and women should be treated equally despite biological differences (median: 5 [women] vs. 5 [men]; <i>p</i> = 0.789). As a reason for gender-specific aspects, \"medication concentration\" was reported more frequently by women (<i>p</i> = 0.038) and \"no answer\" by men (<i>p</i> = 0.014). (ii) Mean value (SD) of pain (NAS) was 4.0 (SD 2.3) for women and 3.3 (SD 2.6) for men (<i>p</i> = 0.215) with a positive correlation between pain management escalation (WHO-ladder) and the pain score (NAS) only in men (r = 0.704, <i>p</i> = 0.001). Women rather reported an influence of adverse drug reactions on treatment contentment than men (<i>p</i> = 0.042).</p><p><strong>Conclusions: </strong>Although patients pleaded for gender-independent equal treatment, gender-specific differences in pain therapy were found.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711066","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":"Tackling Pharmaceutical Pollution Along the Product Lifecycle: Roles and Responsibilities for Producers, Regulators and Prescribers.","authors":"Gillian Parker, Fiona A Miller","doi":"10.3390/pharmacy12060173","DOIUrl":"10.3390/pharmacy12060173","url":null,"abstract":"<p><p>Pharmaceuticals produce considerable environmental harm. The industry's resource-intensive nature, coupled with high energy costs for manufacturing and transportation, contribute to the \"upstream\" harms from greenhouse gas emissions and ecosystem pollution, while factors such as overprescription, overuse, and pharmaceutical waste contribute to the \"downstream\" harms. Effectively addressing pharmaceutical pollution requires an understanding of the key roles and responsibilities along the product lifecycle. In this commentary, we argue that three actors-producers, regulators, and prescribers-have unique and interdependent responsibilities to address these issues. Producers and market access regulators are upstream actors who can manage and mitigate harms by both shifting manufacturing, business practices, and regulatory requirements and producing transparent, robust data on environmental harms. By contrast, prescribers are downstream actors whose capacity to reduce environmental harms arises principally as a \"co-benefit\" of reducing inappropriate prescribing and overuse. Potentially complicating the prescriber's role are the calls for prescribers to recommend \"environmentally preferable medicines\". These calls continue to increase, even with the sparsity of transparent and robust data on the impact of pharmaceuticals on the environment. Recognizing the interdependencies among actors, we argue that, rather than being ineffectual, these calls draw needed attention to the critical responsibility for upstream actors to prioritize data production, reporting standards and public transparency to facilitate future downstream efforts to tackle pharmaceutical pollution.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711212","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":"Assessment of Potential Drug-Drug Interactions of Psycholeptics and Antidepressants in Outpatient Settings.","authors":"Iva Marović, Ivana Marinović, Vesna Bačić Vrca, Ivana Samardžić","doi":"10.3390/pharmacy12060174","DOIUrl":"10.3390/pharmacy12060174","url":null,"abstract":"<p><p>Mental health is an important segment in preserving overall health and represents a significant public health issue. In modern times, mental health disorders have risen, often requiring complex pharmacotherapy and chronic monitoring. The aim of this research was to determine the prevalence and clinical significance of potential psychotropic drug interactions in outpatient settings and compare the differences in potential drug-drug interaction (pDDIs) exposure with age. The psychotropic drugs included antipsychotics-N05A, anxiolytics-N05B, hypnotics and sedatives-N05C, and antidepressants-N06A. This retrospective study analyzed prescribed pharmacotherapy in 492 outpatients who were treated with at least one psychotropic drug. We determined 1.64 prescribed psychotropic drugs per patient and 2.2 pDDIs that involved psychotropic drugs. In total, 2285 pDDIs were recorded, of which almost half (47.6%) were pDDIs with psychotropic drugs. More prescribed psychotropic drugs were found in patients younger than 65 years, and equal exposure to pDDIs of psychotropic drugs (<i>p</i> = 0.5077) was found in both age groups. The most commonly identified psychotropics involved in pDDIs were benzodiazepines, promazine, and zolpidem. The results indicate that psychotropic drug interactions represent important drug-related problems for primary health care. The widespread use of psychotropic drugs and the determined clinical significance of their interactions require pharmacist interventions which can reduce the prevalence of pDDIs and increase patient safety.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711148","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":"Evaluating Pharmacists' Knowledge of Food-Drug Interactions in Croatia: Identifying Gaps and Opportunities.","authors":"Josipa Bukić, Doris Rušić, Antonela Turic, Dario Leskur, Toni Durdov, Joško Božić, Martin Kondža, Darko Modun, Ana Šešelja Perišin","doi":"10.3390/pharmacy12060172","DOIUrl":"10.3390/pharmacy12060172","url":null,"abstract":"<p><p>Food-drug interactions (FDIs) are pharmacokinetic or pharmacodynamic changes in drug effects caused by the presence of specific foods. To identify and prevent FDIs, pharmacists, alongside other healthcare professionals, should possess a certain level of knowledge. This study aimed to assess knowledge of FDIs among Croatian pharmacists. A total of 206 participants were included in this cross-sectional study. The median knowledge score among Croatian pharmacists was 69.44%, with an interquartile range of 19.44. Croatian pharmacists most commonly recognized FDIs involving theophylline, warfarin, and tetracycline, while the lowest rate of correct answers was observed with digoxin interactions. Future studies should evaluate pharmacists' clinical practice concerning FDIs. Additionally, more research is needed to develop educational programs on this topic, either at the university level or for continuing education.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711166","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":"Cardiovascular Diseases and Metabolic Medications in the Lebanese Population: A Post Hoc Analysis from a Nationwide Cross-Sectional Study.","authors":"Rony M Zeenny, Rachel Abdo, Chadia Haddad, Aline Hajj, Rouba Karen Zeidan, Pascale Salameh, Jean Ferrieres","doi":"10.3390/pharmacy12060171","DOIUrl":"10.3390/pharmacy12060171","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the association of metabolic drugs (specifically hypoglycemic and hypolipemic agents) with cardiovascular diseases (CVD) among the Lebanese population and patients' subgroups.</p><p><strong>Methods: </strong>A nationwide cross-sectional retrospective study was carried out in Lebanon. The survey collected information on sociodemographic characteristics, lifestyles, comorbidities, and medication use. Logistic regression models were employed to analyze the data and determine associations between CVD and metabolic drugs. Stratification analyses were performed based on diabetes and dyslipidemia status.</p><p><strong>Results: </strong>The study found significant associations with CVD among the 2048 participants. Higher scores on the Lebanese Mediterranean Diet Score (LMDS; ORa = 1.06), hypertension (ORa = 1.71), diabetes (ORa = 1.75), dyslipidemia (ORa = 1.89), family history of CVD (ORa = 1.58), and smoking (previous: ORa = 1.63, current: ORa = 2.15) were linked to increased CVD odds. Higher income (intermediate: ORa = 0.64, high: ORa = 0.40) was inversely related to it. A subsequent model that included hypoglycemic and lipid-lowering medications yielded similar results. However, neither hypoglycemic nor lipid-lowering medications demonstrated a significant association with CVD risk. A third regression model was conducted by taking the classes of drugs as an independent variable. Also, the result revealed that all the classes of medication were not associated with the risk of CVD. Stratification by diabetes revealed LMDS and hypertension as risk factors in both groups. Among non-diabetic participants, dyslipidemia (ORa = 2.40), current smoking (ORa = 2.28), and higher income (intermediate: ORa = 0.57, high: ORa = 0.62) were linked to CVD. Among people with diabetes, a family history of CVD (ORa = 2.69) increased the CVD odds, while being an employer (ORa = 0.49) lowered it. Stratification by dyslipidemia showed consistent risk factors, and higher LMDS (ORa = 1.07), diabetes (ORa = 2.14), hypertension (ORa = 1.79), and previous smoking (ORa = 1.95) were linked to CVD without dyslipidemia. Being a female (ORa = 0.52) and having a lower income (ORa = 0.40) were associated with lower CVD odds in those with dyslipidemia. Subgroup analyses showed that medications were not significantly associated with CVD odds among patients with diabetes or hyperlipidemia.</p><p><strong>Conclusions: </strong>This study's findings highlight the importance of addressing modifiable risk factors and socioeconomic factors to reduce the burden of CVD. Targeted interventions and longitudinal research are necessary to optimize preventive strategies and improve the management of CVD in individuals using hypoglycemic and hypolipemic agents in low- and medium-income countries.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711072","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":"Medication Reconciliation of Patients by Pharmacist at the Time of Admission and Discharge from Adult Nephrology Wards.","authors":"Hossein Ahmadi, Yalda Houshmand, Ghanbar Ali Raees-Jalali, Iman Karimzadeh","doi":"10.3390/pharmacy12060170","DOIUrl":"10.3390/pharmacy12060170","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study was to investigate the impact of medication reconciliation by pharmacists at both admission and discharge in hospitalized patients with different kidney diseases.</p><p><strong>Methods: </strong>A prospective study was performed in adult nephrology wards of a teaching referral hospital in Iran from September 2020 to March 2021. All patients hospitalized in the nephrology ward for at least 1 day who received the minimum of one medication during their ward stay within the study period were considered eligible. Medication reconciliation was performed by taking a best-possible medication history from eligible patients during the first 24 h of ward admission. Medications were evaluated for possible intentional as well as unintentional discrepancies.</p><p><strong>Results: </strong>Here, 178 patients at admission and 134 patients at discharge were included. The mean numbers of unintentional drug discrepancies for each patient at admission and discharge were 6.13 ± 4.13 and 1.63 ± 1.94, respectively. The mean ± SD numbers of prescribed medications for patients before ward admission detected by the nurse/physician and pharmacist were 6.06 ± 3.53 and 9.22 ± 4.71, respectively (<i>p</i> = 0.0001). The number of unintentional discrepancies at admission and discharge had a significant correlation with the number of drugs used and underlying diseases. The number of unintentional discrepancies at admission was also correlated with patients' age. The number of comorbidities was significantly associated with the number of unintentional medication discrepancies at both admission and discharge. At the time of ward discharge, all patients were given medication consultations.</p><p><strong>Conclusions: </strong>The rate of reconciliation errors was high in the adult nephrology ward. The active contribution of pharmacists in the process of medication reconciliation can be significantly effective in identifying these errors.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711174","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 Qualitative Study of Pharmacists' Perceptions of the Advantages and Disadvantages of Telepharmacy.","authors":"Masaki Shoji, Mitsuko Onda","doi":"10.3390/pharmacy12060169","DOIUrl":"10.3390/pharmacy12060169","url":null,"abstract":"<p><p>In Japan, telepharmacy is becoming increasingly popular due to deregulation triggered by the outbreak of COVID-19. The purpose of this study was to gain an understanding of the actual state of telepharmacy in Japan by interviewing pharmacists who have experience with telepharmacy and describing its advantages and disadvantages, as well as their outlook for its use going forward. The interviews were conducted online using Zoom. Each interview lasted approximately 30 min. Eleven people were interviewed. The advantages mentioned by the pharmacists were classified into three main categories: \"Better communication\", \"Time savings\", and \"Improved safety\". The disadvantages were classified into the following nine categories: \"Drug delivery problems\", \"Communication failures\", \"Ease of use for patients\", \"Emotional reactions\", \"Pharmacy system\", \"Communication issues\", \"Healthcare system issues\", \"App system issues\", and \"Cost\". Many of these factors correspond to the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs presented by Venkatesh, et al. Many of the pharmacists mentioned that the use of telepharmacy is likely to expand further in the future, but that this will require further development of communication technology and the widespread use of systems such as electronic prescriptions.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711141","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":"Potential Adverse Drug Events Identified with Decision Support Algorithms from Janusmed Risk Profile-A Retrospective Population-Based Study in a Swedish Region.","authors":"Tora Hammar, Emma Jonsén, Olof Björneld, Ylva Askfors, Marine L Andersson, Alisa Lincke","doi":"10.3390/pharmacy12060168","DOIUrl":"10.3390/pharmacy12060168","url":null,"abstract":"<p><p>Adverse drug events (ADEs) occur frequently and are a common cause of suffering, hospitalizations, or death, and can be caused by harmful combinations of medications. One method used to prevent ADEs is by using <i>clinical decision support systems</i> (CDSSs). Janusmed Risk Profile is a CDSS evaluating the risk for nine common or serious ADEs resulting from combined pharmacodynamic effects. The aim of this study was to examine the prevalence of potential ADEs identified using CDSS algorithms from Janusmed Risk Profile. This retrospective, cross-sectional study covered the population of a Swedish region (<i>n</i> = 246,010 inhabitants in year 2020) using data on all medications dispensed and administered. More than 20% of patients had an increased risk of bleeding, constipation, orthostatism, or renal toxicity based on their medications. The proportion of patients with an increased risk varied from 3.5% to almost 30% across the nine categories of ADEs. A higher age was associated with an increased risk of potential ADEs and there were gender differences. A cluster analysis identified groups of patients with an increased risk for several categories of ADEs. This study shows that combinations of medications that could increase the risk of ADEs are common. Future studies should examine how this correlates with observed ADEs.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711208","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":"Views from Multinational Pharmaceutical Companies on Allocation of Clinical Trials in Saudi Arabia-Qualitative Study.","authors":"Nouf M Aloudah, Ahmed M Shaman","doi":"10.3390/pharmacy12060167","DOIUrl":"10.3390/pharmacy12060167","url":null,"abstract":"<p><p>Clinical trials conducted by pharmaceutical companies are essential for bridging local research efforts with broader populations, facilitating the transfer of valuable insights and solutions. This study aimed to explore the barriers and facilitators affecting clinical trials in Saudi Arabia from the perspective of key personnel within the pharmaceutical industry and Contract Research Organizations (CROs). We conducted in-depth semi-structured interviews with nine participants, which provided a holistic understanding of the intricate dynamics shaping the landscape of clinical trials in the country. The analysis revealed three prominent themes: operational challenges, complexities in navigating approval hurdles, and the unique value proposition for conducting clinical trials in Saudi Arabia. The participants expressed pride in the local infrastructure but acknowledged existing flaws, particularly in regulatory processes that contribute to delays in trial initiation. They emphasized the importance of conducting clinical trials in areas such as diabetes, crowd management during pilgrimages, and rare diseases, which are prevalent in the region. Despite the limited number of clinical trials registered (354 from 2009 to 2020, with only 1% being phase 1 studies), Saudi Arabia's total pharmaceutical market exceeds SAR 13 billion, positioning it as the largest market in the region. Stakeholders recognized the country's potential as a research hub, particularly within the Gulf Cooperative Council (GCC) region. However, to attract more trials and enhance the medical research landscape, it is crucial to address the identified barriers, streamline processes, and improve stakeholder alignment. The findings highlight the need for targeted interventions to overcome these challenges and leverage Saudi Arabia's investments in healthcare infrastructure since its transformation program launched in 2010. By enhancing the regulatory environment and fostering collaboration among stakeholders, Saudi Arabia can solidify its role as a key player in international clinical research.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711216","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":"Drug Shortages in Albania: Pharmacists' Experiences and Perspectives.","authors":"Delina Xhafaj, Sonila Vito, Alban Xhafaj","doi":"10.3390/pharmacy12060166","DOIUrl":"10.3390/pharmacy12060166","url":null,"abstract":"<p><p>Drug shortages are a significant global issue, particularly affecting healthcare systems in resource-limited countries such as Albania. Pharmacists play a critical role in managing these shortages, yet little is known about their experiences and perspectives. This study aims to explore pharmacists' views on the current drug shortages in Albania, identifying the most affected drug classes, and suggesting potential strategies for mitigating these shortages. A cross-sectional survey was conducted with 93 pharmacists across Albania between December 2023 and May 2024. Data were collected using an online questionnaire that addressed the types of drugs experiencing shortages, the causes of these shortages, and pharmacists' coping strategies. Cardiovascular and central nervous system medications were reported as the most frequently affected, with supply chain disruptions, regulatory hurdles, and low domestic production cited as key contributors. The findings suggest an urgent need for national policy reforms focusing on improving supply chain resilience and boosting the local pharmaceutical production. The pharmacists proposed mitigation strategies, including stricter regulatory oversight, improved communication channels, and increased local production to reduce dependence on imports. These recommendations underscore the study's contribution to understanding how tailored, pharmacist-informed strategies could strengthen Albania's healthcare system.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"12 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711164","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}