Avicenna Journal of Medicine最新文献

{"title":"PAX5 and TDT-Negative B-Acute Lymphoblastic Leukemia with Unusual Genetic Mutations: A Case Report.","authors":"Tariq N Aladily,&nbsp;Jamil F Qiqieh,&nbsp;Alaa Alshorman,&nbsp;Salem Alhyari,&nbsp;Majd Khader","doi":"10.1055/s-0042-1758387","DOIUrl":"https://doi.org/10.1055/s-0042-1758387","url":null,"abstract":"<p><p>B-acute lymphoblastic leukemia (B-ALL) is commonly encountered in clinical practice. Patients present with increased percentage of lymphoblasts in bone marrow and/or peripheral blood. Immunophenotypic study by flow cytometry or immunohistochemistry is essential to establish the diagnosis. Paired box-5 (PAX5) is a B cell lineage protein and terminal deoxynucleotidyl transferase (TDT) is an immature marker, both of which are routinely tested in the pathologic workup of acute leukemia. In this report, we describe a case of B-ALL in a 37-year-old woman in which both PAX5 and TDT were negative. Next-generation sequencing test detected mutations in DNA methyltransferase 3 α and Fms related receptor tyrosine kinase 3 genes, which are frequently mutated in acute myeloid leukemia rather than B-ALL. The constellation of these rare findings in a single case signifies the importance of examining a wide panel of markers when the diagnosis of ALL is suspected.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 4","pages":"186-190"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/d7/10-1055-s-0042-1758387.PMC9771627.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10804800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Understanding and Impact of COVID-19 and Pandemic Policies on Syrian and Other Arabic-Speaking Refugees in Tampa, Florida.","authors":"Ahmad M Harb,&nbsp;Brennan Ninesling,&nbsp;Alfredo Ortega Cotte,&nbsp;Asa Oxner,&nbsp;Lynette J Menezes,&nbsp;Dillon Mahoney,&nbsp;Roberta D Baer","doi":"10.1055/s-0042-1756674","DOIUrl":"https://doi.org/10.1055/s-0042-1756674","url":null,"abstract":"<p><p><b>Background</b>  Vulnerable communities around the world, such as Syrian refugees, faced increased social and financial strain due to coronavirus disease 2019 (COVID-19). We evaluated the underlying issues and inequities of Arabic-speaking refugees during the pandemic. <b>Methods</b>  Data were collected from Arabic-speaking refugees ( <i>N</i>  = 20) in July 2020, using an online 97-item questionnaire, in short response and multiple-choice formats. <b>Results</b>  Participants' reports indicate adequate knowledge about COVID-19 symptoms and preventative measures, but experienced linguistic, financial, and cultural challenges during the pandemic. \"Essential\" low-paying occupations put the population at risk for COVID-19. Local mosques and nonprofits have provided essential social support and food. <b>Conclusion</b>  Syrian and Arabic-speaking refugees reported several problems suggesting the need for increased understanding of this understudied, marginalized, and vulnerable population. Making resources and governmental programs more accessible is critical, so refugees can better access information regarding jobs, housing, and education. Organizations central to community support, including mosques, should be assisted.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 4","pages":"174-177"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/e4/10-1055-s-0042-1756674.PMC9771630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10786836","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":"Effect of Esophagogastroduodenoscopy Volume and Gastric/Esophageal Pathology on the Rate of Lymphocytic Duodenosis Reporting in Children and Adolescents.","authors":"Janaki Devara,&nbsp;Mhd Louai Manini,&nbsp;Joseph A Murray,&nbsp;Imad Absah","doi":"10.1055/s-0042-1755388","DOIUrl":"https://doi.org/10.1055/s-0042-1755388","url":null,"abstract":"<p><p><b>Background</b>  It is not clear if the increase in the number of esophagogastroduodenoscopies (EGDs) performed has any significant effect on the rate of lymphocytic duodenosis (LD) reporting in children and adolescents and whether it correlates with abnormal gastric and/or esophageal pathology.\" <b>Methods</b>  We performed a single-center retrospective study using the Mayo Clinic electronic health record and pathology database. We reviewed all EGD procedures performed in children and adolescents (<18 years) between January 1, 2000, and December 31, 2018, and identified two groups, the LD group and matched age and sex control group (normal duodenal biopsies). We evaluated the correlation of LD rate with the yearly number of EGDs performed and the presence of abnormal gastric and/or esophageal pathology. <b>Results</b>  Of 11,870 EGDs performed, we identified 338 (3%) individuals with LD and 390 (3%) randomly selected controls, with a mean (SD) age of 9.6 (5.3) and 11.7 (5.0) years, respectively. Based on logistic regression analysis, abnormal gastric histology was associated with the presence of LD when compared with controls (odds ratio, 2.85; 95% CI, 2.05-3.97; <i>P </i> < 0.001). The rate of LD-positive biopsies per year was highly correlated with the number of EGDs performed (ρ = 0.931; 95% CI, 0.826-0.974; <i>P </i> < 0.001). <b>Conclusion</b>  The rate of LD reporting is correlated with the number of EGDs performed and is more likely seen in children and adolescents with abnormal gastric histology.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 4","pages":"169-173"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/5c/10-1055-s-0042-1755388.PMC9771610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10786837","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":"Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients.","authors":"Cahit Yılmaz,&nbsp;Bedia Gülen,&nbsp;Ertan Sönmez,&nbsp;Dursun Akbay,&nbsp;Özgür Söğüt,&nbsp;Serdar Özdemir,&nbsp;Ömer Faruk Özer","doi":"10.1055/s-0042-1755389","DOIUrl":"https://doi.org/10.1055/s-0042-1755389","url":null,"abstract":"<p><p><b>Background</b>  SCUBE 1-has been used as a biomarker for the diagnoses of myocardial infarction, stroke, mesenteric ischemia, and gastric cancer in some recent studies. In this study, we investigated the relationship between serum SCUBE-1 levels and return of spontaneous circulation (ROSC) in patients who received cardiopulmonary resuscitation (CPR). <b>Methods</b>  Patients over 18 years of age who were not pregnant and received CPR were divided into two groups: those who achieved ROSC and those who died. There were 25 patients in each group. SCUBE-1 and other routine biochemical parameters were studied in blood samples taken at the time of admission. <b>Results</b>  There was no significant difference between the age and gender distribution of the patients between the two groups. The SCUBE-1 value of the ROSC group was significantly higher than that of the non-survivor group ( <i>p</i> ˂ 0.05). At a cut-off value of 9 ng/mL, SCUBE-1 had a sensitivity of 100%, a positive predictive value of 65.8%, specificity of 48%, and a negative predictive value of 100% in predicting ROSC. <b>Conclusions</b>  The SCUBE-1 values were found to be significantly higher in the ROSC group compared with the non-survivor group.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"148-153"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/3b/10-1055-s-0042-1755389.PMC9458353.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461088","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":"Construction and Writing Flaws of the Multiple-Choice Questions in the Published Test Banks of Obstetrics and Gynecology: Adoption, Caution, or Mitigation?","authors":"Magdy H Balaha, Mona T El-Ibiary, Ayman A El-Dorf, Shereef L El-Shewaikh, Hossam M Balaha","doi":"10.1055/s-0042-1755332","DOIUrl":"10.1055/s-0042-1755332","url":null,"abstract":"<p><p><b>Background</b>  The item-writing flaws (IWFs) in multiple-choice questions (MCQs) can affect test validity. The purpose of this study was to explore the IWFs in the published resources, estimate their frequency and pattern, rank, and compare the current study resources, and propose a possible impact for teachers and test writers. <b>Methods</b>  This cross-sectional study was conducted from September 2017 to December 2020. MCQs from the published MCQ books in Obstetrics and Gynecology was the target resources. They were stratified into four clusters (study-book related, review books, self-assessment books, and online-shared test banks). The sample size was estimated and 2,300 out of 11,195 eligible MCQs were randomly selected. The MCQs (items) were judged on a 20-element compiled checklist that is organized under three sections as follows: (1) structural flaws (seven elements), (2) test-wiseness flaws (five elements), and (3) irrelevant difficulty flaws (eight elements). Rating was done dichotomously, 0 = violating and 1 = not violating. Item flaws were recorded and analyzed using the Excel spreadsheets and IBM SPSS. <b>Results</b>  Twenty three percent of the items ( <i>n</i>  = 537) were free from any violations, whereas 30% ( <i>n</i>  = 690) contained one violation, and 47% ( <i>n</i>  = 1073) contained more than one violation. The most commonly reported IWFs were \"Options are Not in Order (61%).\" The best questions with the least flaws (75th percentiles) were obtained from the self-assessment books followed by study-related MCQ books. The average scores of good-quality items in the cluster of self-assessment books were significantly higher than other book clusters. <b>Conclusion</b>  There were variable presentations and percentages of item violations. Lower quality questions were observed in review-related MCQ books and the online-shared test banks. Using questions from these resources needs a caution or avoidance strategy. Relative higher quality questions were reported for the self-assessment followed by the study-related MCQ books. An adoption strategy may be applied with mitigation if needed.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"138-147"},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/4e/10-1055-s-0042-1755332.PMC9458348.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461089","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":"Medical Research Conduct and Publication during Higher Education in Syria: Attitudes, Barriers, Practices, and Possible Solutions.","authors":"Ibrahem Hanafi,&nbsp;Luma Haj Kassem,&nbsp;Mouaz Hanafi,&nbsp;Sulafa Ahmad,&nbsp;Ola Abbas,&nbsp;Mohammad Younis Hajeer,&nbsp;Marah Alsalkini,&nbsp;Fares Alahdab","doi":"10.1055/s-0042-1755387","DOIUrl":"https://doi.org/10.1055/s-0042-1755387","url":null,"abstract":"<p><p><b>Background:</b>  The huge workload on doctors especially residents, who are the main health care providers in public hospitals, in addition to the vanishing incomes and lack of personal safety during the decade-long Syrian crisis, led to further hurdles in the focus on research. Postgraduate students in the medical and paramedical fields must conduct original research projects as part of their graduation requirements. However, this does not reflect on research publications coming from Syria. <b>Methods:</b>  This is a nation-wide cross-sectional study targeting medical, dental, and pharmacy postgraduate students who are at the phase of planning for their required projects. The questionnaire aimed to capture their attitudes toward research, perceived barriers, and previous research experiences in order to suggest evidence-based recommendations. <b>Results:</b>  The sample consisted of 429 residents representing about 22% of the target population. Nearly all the participants had positive opinion toward the important role of medical research and the significance of their participation. Agreement was also clear regarding perceived barriers, including the lack of adequate training and research facility. Seventy-one percent of the participants were not involved in any research before the time of their master theses, less than 13% of them had submitted an article for publication, and less than 5% had submitted more than one paper. Despite that, high-quality internet connectivity and rich English writing skills were associated with further research experiences. Additionally, mentors' support and self-paced learning of research skills had significant positive impact on students' research contributions with odds ratios of 2.04 [[95% Confidence Interval]: 1.02-4.06] and 2.68 [1.48-4.84], respectively. <b>Conclusion:</b>  Lack of training and mentorship, in addition to several common barriers to medical research, hampered residents' capacity of conducting and publishing research despite their positive attitudes toward it. Nevertheless, the variance within our sample exposed a promising window for implementing low-cost institutional and individual solutions such as peer-run self-paced training opportunities and long-distance mentoring.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"127-137"},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/be/10-1055-s-0042-1755387.PMC9458349.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461084","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":"Strategies to Reduce the Cost of Medical Education in India: A Narrative Review.","authors":"Saurabh R Shrivastava,&nbsp;Prateek S Shrivastava","doi":"10.1055/s-0042-1755333","DOIUrl":"https://doi.org/10.1055/s-0042-1755333","url":null,"abstract":"<p><p><b>Background</b>  The global population is being plagued by several diseases and health conditions, and this calls for the need to adopt a strategy to enable people from all socioeconomic backgrounds to have the freedom and choice to opt for a medical profession as their career. The purpose of the current review is to explore the reasons which make medical education expensive and identify the strategies by which the cost of medical education can be minimized. <b>Methods</b>  An extensive search of all materials related to the topic was performed on the PubMed search engine and web site of the National Medical Commission. Relevant research articles focusing on costs in medical education published in the period 2005 to 2021 were included in the review. A total of 37 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include medical education and cost in the title alone only. <b>Results</b>  We have to accept the fact that medical education is quite expensive and that's not the case with one nation but the trend is worldwide. It is the need of the hour to plan and implement strategies that make medical training accessible and available to people from all socioeconomic classes and regardless of other variables. <b>Conclusion</b>  In conclusion, the process of training medical students is expensive and accounts for a wide range of impacts on the medical aspirants. Thus, there is an indispensable need for the policy makers and the concerned stakeholders to join their hands together and take appropriate steps to minimize the overall cost of medical training, and thereby making it affordable to everyone.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/89/10-1055-s-0042-1755333.PMC9458346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461090","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":"Graft and Patient Outcomes of Kidney Transplant Tourism: A Single-Center Experience.","authors":"Abdulrahman Altheaby, Kenana Owaidah, Aljowharah Alotaibi, Rahaf Salem, Rihaf Algain, Areij Alotaibi, Ahmad Alnasrullah, Mohammed F Shaheen, Mohammed Tawhari, Mohamad Abdulgadir","doi":"10.1055/s-0042-1750715","DOIUrl":"10.1055/s-0042-1750715","url":null,"abstract":"<p><p><b>Background</b>  The supply-demand mismatch between organ donor and patient waiting for transplant has led to the growth of transplant tourism. This type of transplant is considered unethical and illegal, as it is usually performed in poor environments and carries a higher risk of infectious, vascular, and immunological complications. <b>Methods</b>  In this single-centered retrospective cohort study, we compared patients who underwent transplant tourism to patients who were transplanted locally and followed up in our hospital from January 2015 to December 2018. <b>Result</b>  A total of 254 local transplants and 60 patients from the transplant tourism group were included. Transplant tourism recipients were younger otherwise both groups were similar in gender, body mass index, diabetes, and hypertension. Recipients in the transplant tourism group had a significantly higher rate of delayed graft function (18.3% vs. 6.3%, <i>p</i> 0.005), acute rejection (40% vs. 7.9%, <i>p</i>  < 0.001), and higher posttransplant infection in general. With more urological complications and higher graft failure at 3-years' follow-up (11.7% vs. 0.8%, <i>p</i>  < 0.001). <b>Conclusion</b>  Transplant tourism is associated with a higher risk of infection and poor graft outcomes. Extra efforts are required to cut down transplant tourism by educating patients about its clinical risk and ethical considerations. In addition, measures to increase the number of deceased donor pool to provide a better alternative options for patients are essential.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"120-126"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/20/10-1055-s-0042-1750715.PMC9458345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461086","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":"Medical Students Will Take Care of the People, We Need to Take Care of Them.","authors":"Fares Alahdab","doi":"10.1055/s-0042-1755183","DOIUrl":"10.1055/s-0042-1755183","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"97-99"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/ca/10-1055-s-0042-1755183.PMC9458351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Anxiety and Depression on Academic Performance: A Cross-Sectional Study among Medical Students in Syria.","authors":"Hasan Jamil,&nbsp;Mohab Alakkari,&nbsp;Mohammed Saleem Al-Mahini,&nbsp;Muhammad Alsayid,&nbsp;Omar Al Jandali","doi":"10.1055/s-0042-1755181","DOIUrl":"https://doi.org/10.1055/s-0042-1755181","url":null,"abstract":"<p><p><b>Background</b>  The National Medical Unified Examination (NMUE) is a milestone in the life of medical students in Syria. The selection for residency programs depends mainly on the NMUE score, where competitive specialties require higher scores. Therefore, preparation for the NMUE might be a source of anxiety and depression. This study aims at evaluating the impact of anxiety and depression on the NMUE score. A secondary objective is to determine the effect of some factors (i.e., exercise, having breakfast, adequate sleep, and social media) on anxiety and depression. <b>Methods</b>  A cross-sectional study was conducted using an online questionnaire and included medical students who were preparing for the October 2019 NMUE exam. The Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9) were used to screen for anxiety and depression, respectively. NMUE scores were obtained from the official score report. Demographics and other potential confounding factors, such as Cumulative Grade Point Average, were obtained through the questionnaire. <b>Results</b>  One hundred and thirty ( <i>n</i>  = 130) students participated in the study, 83 of them were women (63.8%). The prevalence of anxiety and depression were 59.2 and 58%, respectively, with no difference between men and women. Both anxiety and depression were negatively correlated with the NMUE score. However, this relationship did not persist after controlling for other important predictors through multiple regression. Only exercising was statically significant in reducing PHQ-9 scores. None of the studied factors were significant in reducing GAD-7 scores. <b>Conclusion</b>  Although participants with higher anxiety/depression had lower NMUE scores, this association does not imply causation. The high prevalence of anxiety and depression (approximately two-thirds of the participants) is concerning and may pose a great threat to students' well-being and adversely affect the quality of care provided by them as future health care professionals.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"12 3","pages":"111-119"},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/d5/10-1055-s-0042-1755181.PMC9458347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33461541","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}