Acta Medica Lituanica最新文献

{"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}

{"title":"Cutaneous Melanoma with Tonsillar Metastasis: Treatment with Cryoablation.","authors":"Audrius Dulskas,&nbsp;Mantas Trakymas,&nbsp;Jolita Gibavičienė,&nbsp;Vytautas Čepulis,&nbsp;Agnė Čižauskaitė,&nbsp;Narimantas E Samalavičius","doi":"10.15388/Amed.2021.29.1.5","DOIUrl":"https://doi.org/10.15388/Amed.2021.29.1.5","url":null,"abstract":"<p><p>Metastasis of cutaneous melanoma to the oral cavity is a rare condition. Male patient with cutaneous melanoma metastasis to right tonsil 2 years after radical skin lesion resection was treated with surgery: tonsillectomy and later resection of soft palate were performed. Two years later the patient was diagnosed with progressive disease to right tonsil and soft palate. Rapid inoperable relapse was detected six months later. The patient underwent two procedures of palliative cryoablation of the metastasis. Postoperative course was uneventful. Patient died 7 months later due to progression of the disease. Cryoablation alone or together with surgery may be a relatively safe option for treatment of inoperable disease of head and neck tumours.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"118-123"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351317","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":"Implementation and Evaluation of Preimplantation Genetic Testing at Vilnius University Hospital Santaros Klinikos.","authors":"Eglė Stukaitė-Ruibienė,&nbsp;Živilė Gudlevičienė,&nbsp;Andrė Amšiejienė,&nbsp;Evelina Dagytė,&nbsp;Rimantas Gricius,&nbsp;Kristina Grigalionienė,&nbsp;Algirdas Utkus,&nbsp;Diana Ramašauskaitė","doi":"10.15388/Amed.2022.29.2.9","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.9","url":null,"abstract":"<p><strong>Background and objectives: </strong>The most effective treatment of infertility is in vitro fertilization (IVF). IVF with Preimplantation Genetic Testing (PGT) allows to identify embryos with a genetic abnormality associated with a specific medical disorder and to select the most optimal embryos for the transfer. PGT is divided into structural rearrangement testing (PGT-SR), monogenetic disorder testing (PGT-M), and aneuploidy testing (PGT-A). This study mostly analyzes PGT-SR, also describes a few cases of PGT-M. The aim of this study was to implement PGT procedure at Vilnius University Hospital Santaros Klinikos (VUHSK) Santaros Fertility Centre (SFC) and to perform retrospective analysis of PGT procedures after the implementation.</p><p><strong>Materials and methods: </strong>A single-center retrospective analysis was carried out. The study population included infertile couples who underwent PGT at SFC, VUHSK from January 01st, 2017 to December 31st, 2020. Ion PGM platform (Life Technologies, USA) and Ion ReproSeq PGS View Kit (Life Technologies, USA) were used for the whole genome amplification. Results were assessed using descriptive statistics.</p><p><strong>Results: </strong>PGT was successfully implemented in VUHSK in 2017. During the analyzed time period, thirty-four PGT procedures were performed for 26 couples. Two procedures were performed in 2017, 7 procedures - in 2018, 13 - in 2019, and 12 - in 2020. In comparison with all IVF procedures, 2.5% procedures were IVF with PGT, a highest percentage was in 2020 (3.8% of all procedures). The main indication for PGT was balanced chromosomal rearrangements (in 85.3% cases). In all 34 cases 515 oocytes were aspirated in total, 309 oocytes were fertilized, oocytes fertilization rate exceeded 60%. A normal diploid karyotype was found in 46 (16.8%) biopsied embryos. Out of all PGT procedures, 9 (26.5%) resulted in a clinical pregnancy. Six (66.7%) pregnancies were confirmed in 2019, and 3 (33.3%) - in 2020. Three (33.3%) pregnancies resulted in spontaneous abortion, 6 (66.7%) - in delivery.</p><p><strong>Conclusions: </strong>The implementation of PGT in VUHSK was successful. The most common indication for PGT was a reciprocal translocation. Oocytes fertilization rate exceeded 60%, a normal karyotype was found less than in one-fifth of biopsied embryos. A highest clinical pregnancy rate was achieved in 2019 when almost half of women conceived, which is probably related to the experience gained by the multidisciplinary team. This is the first study analyzing IVF with PGT in Lithuania, however, the results should be interpreted with caution due to a low number of total procedures performed.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"225-235"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154732","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 Insight into Obstetric Care near the Front Line in Kharkiv.","authors":"Igor Lakhno","doi":"10.15388/Amed.2022.29.2.10","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.10","url":null,"abstract":"<p><strong>Objectives: </strong>The invasion of Russian troops into independent Ukraine has changed the humanitarian situation in the Kharkiv region. The paper is focused on the peculiarities and issues of the management of labor and delivery near the front line.</p><p><strong>Materials and methods: </strong>Totally 2030 patients were enrolled in the study. 1410 women who delivered in the second half of 2021 were enrolled in Group I. 620 women who delivered in the first half of 2022 were observed in Group II. Some patients from Group II were used for the investigation of the comparative situation during first months of 2022. 85 women who delivered in January were included in Subgroup IIA. 94 women who have completed their pregnancies and delivered in February were observed in Subgroup IIB. 67 case histories of deliveries which occurred during March were united in Subgroup IIC.</p><p><strong>Results: </strong>The level of anemia, uterine contractile activity in labor abnormalities, and episiotomies were surprisingly lower during wartime in March. The obtained results showed an almost similar level of obstetric complications, maternal comorbidities, and interventions during labor and delivery in all groups. The stressed environment was a possible reason for the elevation of cardiovascular disease and endocrine disorders.</p><p><strong>Conclusion: </strong>The study did not reveal any significant changes in the structure of maternal pathologies and obstetric complications during the first months of wartime near the front line. But later the levels of cardiovascular disease and endocrine disorders were found to be elevated.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"236-244"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131434","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":"Reproductive Outcome of the Patients with Uterus Unicornis: Five Year Experience in a Tertiary Center.","authors":"Sule Atalay Mert,&nbsp;Berna Dilbaz,&nbsp;Ece Sevin Cukurova,&nbsp;Caner Kose,&nbsp;Yaprak Engin Ustun","doi":"10.15388/Amed.2022.29.2.14","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.14","url":null,"abstract":"<p><strong>Aim: </strong>The aim is to evaluate the pregnancy outcomes of patients with uterus unicornis for 5-year experience in a tertiary center.</p><p><strong>Material and method: </strong>Twenty patients with uterus unicornis who were diagnosed with hysterosalpingography and/or 3D TVUSG between 2017 and 2021 and then confirmed with laparoscopy and simultaneous hysteroscopy were recruited into this retrospective study. The reproductive outcome and obstetric complications of the patients were followed up for two years postoperative period.</p><p><strong>Results: </strong>Overall 20 patients who fulfilled the inclusion criterion were recruited for the study. The mean age was 28.65±5.03 years. Thirteen patients (65%) had primary infertility while the remaining seven had secondary infertility with two of them having a previous ectopic pregnancy. Rudimentary communicating uterine horn was observed in 7 (35%) of the patients. The horns were excised during laparoscopy. Overall, 14 (70%) pregnancies were achieved during the 2 years follow-up period. Twelve (85.7%) patients had a live birth (71.4% term delivery, 21.4% preterm delivery), and two (15.3%) had a first-trimester spontaneous abortion. Six (50%) of 12 patients who had a live birth received tocolytics for preterm labor.</p><p><strong>Conclusion: </strong>Unicorn uterus is a rare anomaly diagnosed mostly during infertility work-up and might be related to the poor obstetric outcome, but early diagnosis is important for successful pregnancy results for preterm delivery especially in the secondary infertile group. In addition, rudimentary horn excision is recommended due to the high risk of obstetric complications.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"295-303"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159451","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":"Immunohistochemical Evaluation of BARX1, DLX4, FOXE1, HOXB3, and MSX2 in Nonsyndromic Cleft Affected Tissue.","authors":"Mārtiņš Vaivads,&nbsp;Ilze Akota,&nbsp;Māra Pilmane","doi":"10.15388/Amed.2022.29.2.13","DOIUrl":"https://doi.org/10.15388/Amed.2022.29.2.13","url":null,"abstract":"<p><strong>Background: </strong>Nonsyndromic craniofacial clefts are relatively common congenital malformations which could create a significant negative effect on the health status and life quality of affected individuals within the pediatric population. Multiple cleft candidate genes and their coded proteins have been described with their possible involvement during cleft formation. Some of these proteins like Homeobox Protein BarH-like 1 (BARX1), Distal-Less Homeobox 4 (DLX4), Forkhead Box E1 (FOXE1), Homeobox Protein Hox-B3 (HOXB3), and Muscle Segment Homeobox 2 (MSX2) have been associated with the formation of craniofacial clefts. Understanding the pathogenetic mechanisms of nonsyndromic craniofacial cleft formation could provide a better knowledge in cleft management and could be a possible basis for development and improvement of cleft treatment options. This study investigates the presence of BARX1, DLX4, FOXE1, HOXB3, and MSX2 positive cells by using immunohistochemistry in different types of cleft-affected tissue while determining their possible connection with cleft pathogenesis process.</p><p><strong>Materials and methods: </strong>Craniofacial cleft tissue material was obtained during cleft-correcting surgery from patients with nonsyndromic craniofacial cleft diagnosis. Tissue material was gathered from patients who had unilateral cleft lip (n=36), bilateral cleft lip (n=13), and cleft palate (n=26). Control group (n=7) tissue material was received from individuals without any craniofacial clefts. The number of factor positive cells in the control group and patient group tissue was evaluated by using the semiquantitative counting method. Data was evaluated with the use of nonparametric statistical methods.</p><p><strong>Results: </strong>Statistically significant differences were identified between the number of BARX1, FOXE1, HOXB3, and MSX2-containing cells in controls and cleft patient groups but no statistically significant difference was found for DLX4. Statistically significant correlations between the evaluated factors were also notified in cleft patient groups.</p><p><strong>Conclusions: </strong>HOXB3 could be more associated with morphopathogenesis of unilateral cleft lip during postnatal course of the disorder. FOXE1 and BARX1 could be involved with both unilateral and bilateral cleft lip morphopathogenesis. The persistence of MSX2 in all evaluated cleft types could indicate its possible interaction within multiple cleft types. DLX4 most likely is not involved with postnatal cleft morphopathogenesis process.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 2","pages":"271-294"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168447","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 Case of Post-COVID-19 Fibrosis Mimicking Thoracic Manifestation of Ankylosing Spondylitis.","authors":"Emrah Doğan,&nbsp;Sabri Serhan Olcay,&nbsp;Tuba Çınar Olcay,&nbsp;Utku Tapan,&nbsp;Ozge Tapan,&nbsp;Fatih Alaşan","doi":"10.15388/Amed.2021.29.1.10","DOIUrl":"https://doi.org/10.15388/Amed.2021.29.1.10","url":null,"abstract":"<p><p>The most common thoracic manifestation form of ankylosing spondylitis is apical fibrocystic changes. It is also known as apical fibrobullous disease (AFBD). The patient was diagnosed with ankylosing spondylitis before 9 years. He suffered COVID-19 infection and passed an intensive care period. However, post-covid fibrosis (PCF) atypically affected dominantly apical zones. If we had no sequential CT evaluations, our case could be easily confused with AFBD. On CT taken before COVID-19, the lung apex was normal. Thus, it was confirmed that there was no rheumatologic thoracic manifestation in the patient before suffering from COVID-19 pneumonia. PCF created similar changes as AFBD. Our case is the first reported paper on this topic.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"29 1","pages":"81-85"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350761","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}