Acta Medica Lituanica最新文献

{"title":"Magnetic Resonance Imaging Appearance of Giant Intracerebral Tuberculoma: A Retrospective Analysis","authors":"Deb K. Boruah, K. Sarma, Pallavi Gogoi, Binoy K. Singh, Bidyut B. Gogoi, Karuna Hazarika, B. Sharma, P. Phukan","doi":"10.15388/amed.2022.29.2.19","DOIUrl":"https://doi.org/10.15388/amed.2022.29.2.19","url":null,"abstract":"Background: Giant intracerebral tuberculomas are rare lesions but should be considered in the differential diagnosis of intracranial space-occupying lesion in an endemic region.Objective: The purpose of this study is to analyze the clinical data and magnetic resonance imaging (MRI) findings of giant intracerebral tuberculomas to improve the diagnostic precision.Material and Methods: The clinical and MRI findings of 22 patients of giant intracerebral tuberculoma were analyzed retrospectively. For the statistical analysis independent sample Student t-test was used.Results: For 22 patients included in this sample the giant intracerebral tuberculoma was of size more than 2.5cm. The majority of the giant tuberculomas (19 patients (86.4%))was located in the supratentorial area.T2-weighted hypointense core of giant tuberculoma was observed in 12 patients (54.5%) and T1 hyperintensities were observed in peripheral (wall) of the giant tuberculoma in 14 patients (63.6%). The mean ADC value of the peripheral (wall) of the giant tuberculoma was 1.034± 0.466[SD] x 10-3mm2/s and the core was 0.994± 0.455[SD] x 10-3mm2/s with a statistically significant difference (p-value <0.0005) in between. MR spectroscopy showed raised lipid peak at 0.9 to 1.33 ppm in 10 patients (45.5%),raised lipid-lactate peak in 12 patients (54.5%),raised Choline/Cr ratio more than 1.2 in 14 patients(63.6%) and Choline/Cr ratio less than 1.2 in 5 patients (22.7%). Associated involvement of lung was observed in the 6patients (27.3%), cervical lymph node in 1 patient (4.5%) and spine in 1patient (4.5%).Conclusions: MRI plays a vital role in distinguishing giant intracerebral tuberculomas from other intracranial space-occupying lesions, thereby allows the early institution of anti-tubercular treatment (ATT), decreased patient morbidity, mortality, and prevents unnecessary neurosurgical excision.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44264977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Chronic Kidney Disease after Partial Nephrectomy","authors":"J. Makevičius, B. Kirstukaite, A. Želvys, F. Jankevicius, M. Miglinas, R. Komiagienė","doi":"10.15388/amed.2022.29.2.18","DOIUrl":"https://doi.org/10.15388/amed.2022.29.2.18","url":null,"abstract":"Background: In comparison with radical nephrectomy, partial nephrectomy (PN) is considered a better option for small renal mass surgery, because of optimal kidney tissue removal and parenchyma preservation. But there are patients with worsening postoperative renal function (RF) and chronic kidney disease (CKD) after PN. Therefore, the study aimed to evaluate and detect risk factors for CKD after PN.Materials and Methods. A prospective observational study was conducted, which consisted of 91 individuals who received PN with warm ischemia and an estimated preoperative glomerular filtration rate (eGFR) ≥ 60 ml/min/1.72m2 without pathologic albuminuria. Preoperative and intraoperative factors like intraoperative hypotension (IOH), blood loss, and resected part volume were analyzed.Results. At 6-month follow-up, 14 (15.4 %) patients experienced postoperative CKD. After 12 months of follow-up, 15 (16.5 %) patients had CKD. Patients with CKD had a lower preoperative eGFR than non-CKD group (69.0 vs 91.0 ml/min/1.72m2, p < 0.001), longer ischemia (20.0 vs 14.0, p = 0.002) and IOH time (40.0 (40.0; 47.5) vs 0.0 (0.0; 26.2) min, p < 0.001). Also, higher volumes of resected kidney part tumor and removed parenchyma with higher glomerulosclerosis amounts (73.3 % vs 14.5 %, p = 0.009) were found in CKD group. Estimated blood loss > 500 ml during PN was discovered to be the major risk factor for CKD development (OR 11.13, 95 % CI 1.88–65.92, p = 0.008). Furthermore, kidney resected part volume (OR 1.05, 95% CI 1.05-1.10, p = 0.033) and IOH time (OR 1.11, 95% CI 1.03-1.19, p = 0.005) were identified as risk factors for postoperative CKD. Conclusions. Patients after PN are at an increased risk of CKD development. Most commonly, postoperative CKD occurs in the first 6 months after PN and appears stable after 12 months of follow-up. Blood loss > 500 ml during PN, IOH and resected kidney volume can have an impact on postoperative RF and increase the risk of CKD.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49097868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Tranexamic Acid to Reduce PostOperative Bleeding in Orthopaedic Oncology","authors":"L. Andreani, A. Del Chiaro, E. Ipponi, Federico di Sacco, Martina Caterino, R. Capanna","doi":"10.15388/amed.2022.29.2.17","DOIUrl":"https://doi.org/10.15388/amed.2022.29.2.17","url":null,"abstract":"Background: Orthopaedic oncology often causes major blood losses that may put at risk patients’ hemodynamic balance and their overall clinical stability. To this date, transfusion therapy still represents the pivotal treatment to counterbalance the reduction in hemoglobin levels which occur after surgery. Although effective, transfusions are expensive and inevitably associated with a number of complications and therefore other solutions, such as procoagulative drugs, could play an important role to prevent massive blood losses.Material and methods: We reviewed the clinical intercourse of 37 patients who underwent major bone resection due to malignant tumors of the lower limb. Cases were divided in two different groups: group G1 consisting of 12 patients treated intraoperatively with tranexamic acid and group G2 which was made of 25 controls.Results: On average, patients treated with tranexamic acid (G1) required transfusion of 3.9 concentrated blood cells units during surgery and 0.9 units during the postoperative course. Other patients (G2), for their part, required on average 3.1 units intraoperatively and 2.1 units postoperatively. No significant difference was found in intraoperative transfusion rate (p=0.402). Instead, postoperative transfusions were significantly less frequent for patients treated with tranexamic acid (p=0.023). None of the 12 patients treated with tranexamic acid had evidence of Deep Vein Thrombosis.Conclusion: Our outcomes indicate that the use of TXA was effective in reducing blood losses also for major surgical interventions in orthopedic oncology.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41768397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Real-World Parents' Acceptance to Vaccinate Their Children Against the COVID-19.","authors":"Petros Galanis, Irene Vraka, Olga Siskou, Olympia Konstantakopoulou, Aglaia Katsiroumpa, Ioannis Moisoglou, Daphne Kaitelidou","doi":"10.15388/Amed.2021.29.1.4","DOIUrl":"10.15388/Amed.2021.29.1.4","url":null,"abstract":"<p><strong>Background: </strong>As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Our aim was to investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision.</p><p><strong>Materials and methods: </strong>We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic.</p><p><strong>Results: </strong>Study population included 656 parents. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. We found that increased parents' age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children's vaccination.</p><p><strong>Conclusions: </strong>Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"33-43"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350759","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":"Vertigo and Ischemic Stroke after Hyperextension (Beauty Parlour Stroke syndrome).","authors":"Bünyamin Tosunoğlu,&nbsp;Sultan Merve Ünal,&nbsp;Seyfi Emre Aksoy,&nbsp;Tahir Kurtuluş Yoldaş","doi":"10.15388/Amed.2022.29.2.2","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.2","url":null,"abstract":"<p><p>Beauty parlour stroke syndrome is a stroke syndrome that occurs secondary to hyperextension of the neck due to compression of the vertebral artery in the atlanto-occipital region. It was first defined as \"pearl beauty stroke syndrome\" in 1992 by Weintraub et al. Vertigo syndrome caused by cervical region pathologies, bad posture of the neck and/or trauma [1]. We present a young, 23-year-old patient who has no disease, no trauma history nor substance-drug use. He was diagnosed with vertigo that started after going to the barber's and then had an infarction in the cerebellum.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"167-170"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172969","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":"Attitudes toward COVID-19 Pandemic among Fully Vaccinated Individuals: Evidence from Greece Two Years after the Pandemic.","authors":"Petros Galanis,&nbsp;Irene Vraka,&nbsp;Aglaia Katsiroumpa,&nbsp;Olga Siskou,&nbsp;Olympia Konstantakopoulou,&nbsp;Theodoros Katsoulas,&nbsp;Theodoros Mariolis-Sapsakos,&nbsp;Daphne Kaitelidou","doi":"10.15388/Amed.2022.29.2.11","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.11","url":null,"abstract":"<p><strong>Background: </strong>Considering the major effects of COVID-19 pandemic on health, social, economic, and political dimensions of all countries, positive attitudes toward COVID-19 pandemic are essential to control the pandemic. In our study, we investigated attitudes toward COVID-19 pandemic among fully COVID-19 vaccinated individuals two years after the pandemic and we identified predictors of attitudes.</p><p><strong>Materials and methods: </strong>We conducted an on-line cross-sectional study with 815 fully COVID-19 vaccinated individuals in Greece during May 2022. A self-administered and valid questionnaire was disseminated through social media platforms. We measured socio-demographic variables and COVID-19-related variables as potential predictors of attitudes toward COVID-19 pandemic. The outcome variable was attitudes toward COVID-19 pandemic (compliance with hygiene measures, trust in COVID-19 vaccination, fear of COVID-19, and information regarding the COVID-19 pandemic and vaccination).</p><p><strong>Results: </strong>We found a very high level of compliance with hygiene measures, a high level of trust and information about the COVID-19 pandemic and vaccination, and a moderate level of fear of COVID-19. Also, we identified that females, participants with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis adhered more in hygiene measures. Trust in COVID-19 vaccination was higher among females, older participants, those with a higher educational level, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis. Moreover, females, older participants, those with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, those that received a flu vaccine in previous season, and those without a previous COVID-19 diagnosis experienced more fear of COVID-19. Finally, level of information regarding COVID-19 pandemic and vaccination was higher for participants with a higher educational level, those without a chronic disease, those with a better self-perceived physical health, and those that received a flu vaccine in previous season.</p><p><strong>Conclusions: </strong>Understanding predictors of attitudes toward COVID-19 pandemic among fully vaccinated individuals is crucial for developing appropriate public health campaigns in the future. Vaccination should be accompanied by positive attitudes in order to decrease the frequency of negative outcomes of COVID-19, such as hospitalization, complications and mortality.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"245-257"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41136261","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":"All that Glitters is not Cholecystitis. A Rare Presentation of Acute Pericarditis Mimicking Cholecystitis and Review of the Literature.","authors":"Anna Garmpi,&nbsp;Christos Damaskos,&nbsp;Nikolaos Garmpis,&nbsp;Vasiliki E Georgakopoulou,&nbsp;Vaios Vasileios Kaminiotis,&nbsp;Evangelos Diamantis,&nbsp;Alexandros Patsouras,&nbsp;Athanasios Syllaios,&nbsp;Dimitrios Dimitroulis","doi":"10.15388/Amed.2022.29.2.8","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.8","url":null,"abstract":"<p><p>Acute pericarditis is the most common inflammatory disorder of the pericardium, responsible for approximately 5% of visits to the emergency departments, concerning chest pain without myocardial infarction. We report a case of a 41-year-old man who presented to our hospital, complaining about retrosternal and epigastrium pain. The transthoracic echocardiogram showed pericardial effusion while the electrocardiogram and laboratory findings revealed acute pericarditis. An abdominal ultrasound revealed gallbladder edema. The pericardial effusion was treated with pericardial catheter insertion, diuretics, and nonsteroidal anti-inflammatory drugs. This case shows that acute pericarditis can be clinically presented with many ways, one of them being gallbladder edema. Furthermore, in this case-based review we present all cases of simultaneous appearance of pericarditis and acalculous cholecystitis or gallbladder edema.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"217-224"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163478","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":"Vaccinating with a COVID-19 Vaccine: Experience of the Tertiary Allergology Center.","authors":"Eglė Žilėnaitė,&nbsp;Laura Malinauskienė,&nbsp;Kęstutis Černiauskas,&nbsp;Linas Griguola,&nbsp;Kotryna Linauskienė,&nbsp;Violeta Kvedarienė,&nbsp;Anželika Chomičienė","doi":"10.15388/Amed.2021.29.1.1","DOIUrl":"https://doi.org/10.15388/Amed.2021.29.1.1","url":null,"abstract":"<p><strong>Background: </strong>Allergic reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but detailed descriptions and further actions are not well characterized.</p><p><strong>Objective: </strong>To describe the symptoms of possible allergic reactions after the mRNA COVID-19 vaccine and outcomes of further vaccination.</p><p><strong>Methods: </strong>We descriptively analyzed data of adult (≥18 years of age) patients, who were sent for vaccination to our outpatient center for the Diagnostics and Treatment of Allergic and Immune diseases. All patients were vaccinated with the Pfizer-BioNTech Comirnaty® vaccine.</p><p><strong>Results: </strong>From January 2021 to July 2021 twenty-two patients were vaccinated in our center. Six patients experienced a reaction after the first Comirnaty® dose in different vaccination centers. The majority of them complained of various types of rashes after the first dose, one case was consistent with anaphylaxis. The latter patient was tested with the skin prick using Pfizer-BioNTech Comirnaty® vaccine and the test was negative. Other sixteen patients were vaccinated in our center from the first dose because of past allergic reactions to other medication or due to concomitant mast cell disorder. All patients were vaccinated without any immediate adverse reactions.</p><p><strong>Conclusions: </strong>None of our patients experienced repeated cutaneous reactions after the second dose. Patients with previous anaphylaxis or mastocytosis also were safely vaccinated.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351324","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":"Unrecognized Primary Hypoparathyroidism with Severe Hypocalcemia in the Presence of COVID-19 Infection.","authors":"Domas Grigoravičius,&nbsp;Laura Šiaulienė,&nbsp;Žydrūnė Visockienė","doi":"10.15388/Amed.2021.29.1.9","DOIUrl":"https://doi.org/10.15388/Amed.2021.29.1.9","url":null,"abstract":"<p><p>Primary hypoparathyroidism (PHPT) is a rare disease most commonly caused by surgical parathyroid glands destruction or genetic disorders. PHPT manifestation varies from subclinical to acute or even lethal symptoms. In atypical presentation the signs of hypocalcemia could be missed, and asymptotic chronic hypocalcemia could manifest only in the presence of exacerbated comorbidities, infections, hypomagnesemia or certain medications. We present a case of PHPT with severe hypocalcemia manifesting as seizures and delirium in a presence of COVID-19 infection.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"136-143"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350760","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":"Appendicitis in a Newborn: Case Report and Review of the Literature.","authors":"Eleonora Ivanova,&nbsp;Rasa Garunkštienė,&nbsp;Arūnas Liubšys","doi":"10.15388/Amed.2021.29.1.3","DOIUrl":"https://doi.org/10.15388/Amed.2021.29.1.3","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis in a newborn is rare and may be fatal. The reported incidence is 0,04 % to 0,2 %. Diagnosis remains challenging as the symptoms are undefined.</p><p><strong>Case presentation: </strong>Here we present a full-term newborn boy of 9 days presenting with malaise, reluctance to feed and subfebrile fever. Over the course of 6 days his condition became worse. The newborn was febrile, passed no stool and his stomach became distended. Perforation due to necrotizing enterocolitis was highly suspected. The diagnosis of acute appendicitis was finalized perioperatively after the perforation and worsening condition made the emergency surgery inevitable. After 16 days of admission the patient was discharged in good condition.</p><p><strong>Conclusion: </strong>Appendicitis in neonates is a dangerous yet manageable condition. While rare it should be included in differential diagnosis when presented with atypical necrotizing enterocolitis or unexplained peritonitis. Quick and accurate diagnosis may increase survival rates.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350763","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}