Ghana Medical Journal最新文献

{"title":"Detection of Helicobacter pylori infection in children using rapid urease and histologic methods of diagnosis","authors":"Taiba J. Afaa, Nana A. H. Seneadza, Afua D. Abrahams, Victor K. Etwire, Eric Odei","doi":"10.4314/gmj.v58i1.10","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.10","url":null,"abstract":"Objective: The study aimed to detect the presence of Helicobacter pylori infection in children using two investigative methods: the rapid urease test and histological methods. It also examined the relationship between socioeconomic status and Helicobacter pylori infection.Design: This was a cross-sectional study conducted in the paediatric theatre at Korle Bu Teaching Hospital in Accra, Ghana.Participants: Children who were scheduled for upper gastrointestinal endoscopy were recruited into the study.Main outcome measures: The presence of Helicobacter pylori in gastric biopsies was measured using a rapid urease test and histology.Results: Seventy-three children aged 2 years to 16 years were seen during the period. Both tests were positive at the same time in 36 (49.3%) out of the 73 children (p<0.0001). The positivity rates for the rapid urease test and histology were 57.5% and 53.4 %, respectively. Significant predictors of the histology presence of H. pylori were a large household size of at least 6 members (AOR: 4.03; p<0.013) and the presence of pets at home (AOR: 3.23; p<0.044).Conclusions: Substantial agreement was found between the rapid urease test and histology examination of gastric biopsies for the presence of H. pylori. Children from large households and those with pets at home appear to have increased odds of having H. pylori infection of the gastric mucosa.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140383544","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":"Economic cost of management of glaucoma in public and private health facilities in the Tema metropolis in Ghana","authors":"Matilda Adda, S. Amon, J. Nonvignon, Moses Aikins, Genevieve C. Aryeetey","doi":"10.4314/gmj.v58i1.4","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.4","url":null,"abstract":"Objectives: This study sought to determine the economic cost of the management of glaucoma among patients seeking care in health facilities in Ghana.Design: A cross-sectional cost-of-illness (COI) study from the perspective of the patients was employed.Setting: The study was conducted in public and private eye care facilities in the Tema Metropolis of Ghana.Participants: About 180 randomly selected glaucoma patients seeking healthcare at two facilities participated in the study.Main outcome measure: Direct cost, including medical and non-medical costs, indirect cost, and intangible burden of management of glaucoma.Results: the cost per patient treated for glaucoma in both facilities was US$60.78 (95% CI: 18.66-107.80), with the cost in the public facilities being slightly higher (US$62.50) than the private facility (US$ 59.3). The largest cost burden in both facilities was from direct cost, which constituted about 94% of the overall cost. Medicines (42%) and laboratory and diagnostics (26%) were the major drivers of the direct cost. The overall cost within the study population was US$10,252.06. Patients paid out of pocket for the frequently used drug- Timolol, although expected to be covered under the National Health Insurance Scheme (NHIS). Patients, however, expressed moderate intangible burdens due to glaucoma.Conclusion: The cost of the management of glaucoma is high from the perspective of patients. The direct costs were high, with the main cost drivers being medicines, laboratory and diagnostics. It is recommended that the National Health Insurance Authority (NHIA) should consider payment for commonly used medications to minimize the burden on patients.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384550","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 sexual and reproductive health knowledge and utilization of services among adolescents in Ghana’s Adaklu district","authors":"Clare Westerman, M. Gyapong, Evelyn K. Ansah, D. Klu, M. Aberese-Ako, Maxwell A. Dalaba","doi":"10.4314/gmj.v58i1.9","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.9","url":null,"abstract":"Objective: To explore factors associated with adolescents’ sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical servicesDesign: Regression analysis of secondary data collected during a community surveySetting: Adaklu district, Volta Region, GhanaParticipants: 221 adolescent caregiver pairsMain outcome measures: The study employed three main outcome measures: (1) adolescents’ level of SRH knowledge (assessed via questionnaire), (2) membership in district-sponsored adolescent health clubs (AHCs), and (3) ever-utilization of clinical SRH services.Results: Greater SRH knowledge was significantly associated with older age, AHC membership, and relying primarily on teachers or friends for SRH information. Increased odds of AHC membership were observed among females (AOR = 2.38, 95% CI 1.14-4.95); those who had communicated with one parent about sexual issues (OR 2.70, 95% CI 1.17-6.21); and those with a history of transactional sex (OR 5.53, 95% CI 1.04-29.37). Decreased odds were observed among adolescents whose caregivers were educated to the primary level (AOR = 0.24, 95% CI = 0.07-0.79). Overall, utilization of clinical SRH services was low, but higher odds were detected among individuals reporting a history of forced sex (AOR = 117.07, 95% CI 3.82-3588.52) and those who had discussed sexual issues with both oftheir parents (AOR = 13.11, 95% CI 1.85-92.93).Conclusions: Awareness of the predictors of knowledge, AHC involvement, and clinical service utilization can empower adolescent SRH initiatives—both present and future—to enhance their teaching, develop targeted outreach to underserved groups, and promote engagement with key clinical resources.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384718","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":"Abdominal wound closure in the presence of sepsis: our experience with the use of subcutaneous drain","authors":"E. Tagar, J. Kpolugbo, Andrew E. Dongo, C. Osime, Irekpita Eshiobo, David Irabor","doi":"10.4314/gmj.v58i1.5","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.5","url":null,"abstract":"Objectives: Patients requiring surgery for secondary peritonitis demonstrate a significantly increased risk for incisional surgical site infection. This study aimed to evaluate the efficacy of subcutaneous wound drain post-laparotomy for contaminated surgical wounds.Design: This was a prospective comparative hospital-based study.Setting: Patients who had surgery for secondary peritonitis in Irrua Specialist Teaching Hospital were studied.Participants: Fifty patients aged 16 years and above who presented with secondary peritonitis.Intervention: Patients who met the inclusion criteria were randomized into two equal groups. Group A had a suction drain placed in the subcutaneous space after laparotomy while Group B did not.Main outcome measures: Development of incisional surgical site infection, wound dehiscence, and duration of postoperative hospital stay.Results: The incidence of incisional surgical site infection was significantly less in Group A (20%) than in Group B (68%). There was no case of wound dehiscence in Group A as against 3 (12%) in Group B. The difference was not statistically significant. The mean duration of hospital stay was significantly less with subcutaneous suction drain (8.96+2.81 Vs 14.04+8.05; p = 0.005).Conclusion: Subcutaneous suction drainage is beneficial in abdominal wall closure in cases of peritonitis as it significantlyreduces the incidence of incisional surgical site infection and the duration of postoperative hospital stay. Thereduction in surgical wound dehiscence observed in this study was, however, not statistically significant.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140381581","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":"Satisfaction levels and associated influencing factors among inpatients and outpatients with breast cancer at a tertiary health facility in Ghana","authors":"Benedict NL Calys-Tagoe, K. Brownson, Josephine Nsaful, F. Dedey, John Tetteh, Nathaniel Coleman, Ruth Y Laryea, J. Clegg-Lamptey","doi":"10.4314/gmj.v58i1.3","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.3","url":null,"abstract":"Objectives: To uncover variables linked to breast cancer patient satisfaction in order to improve policy choices and actions for breast cancer care in Ghana.Design: We employed a cross-sectional design using a quantitative approachSetting: The Radiotherapy, Oncology and Surgery Departments of the Korle Bu Teaching Hospital, AccraParticipants: Inpatient and outpatient breast cancer patients.Main outcome measures: The level of inpatient and outpatient satisfaction was measured using descriptive and inferential statistical analyses. The Shapiro-Wilk test was employed to assess normality, while the Heckman selection model assessed significance with outcomes of interest.Results: A total of 636 participants, with a mean age of 52.64±14.07 years, were recruited. The measured inpatient and outpatient levels of satisfaction out of 100 were 74.06±7.41 and 49.99±1.00 respectively, while the self-reported satisfaction levels out of 5 were 4.22±0.63 and 4.11±0.85 respectively. The level of inpatient satisfaction was significantly influenced by age, marital status, income level, and number of previous facilities visited (p<0.05). Outpatient satisfaction level was significantly associated with place of residence and income level (p<0.05).Conclusions: The study offers insight into the satisfaction levels of breast cancer patients receiving inpatient and outpatient services at the largest tertiary referral centre and teaching hospital in Ghana, as well as the factors influencing attendance and satisfaction levels. Understanding and improving breast cancer patients' levels of satisfaction is a way that providers can safeguard their emotional well-being. Improvement in patient satisfaction at our institution among outpatients is an area for future growth.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140383459","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":"Effects of chloramphenicol, povidone-iodine 1% and 5% eye drops on the colonisation of conjunctival flora in patients undergoing cataract surgery","authors":"Nasrin Tofighi, Mohsen Gohari, Maryam Sadeh, Hosein Fallahzadeh, Fatemeh Jabinian","doi":"10.4314/gmj.v57i2.1","DOIUrl":"https://doi.org/10.4314/gmj.v57i2.1","url":null,"abstract":"Objectives: the aim was to compare 2 drops of either 5% chloramphenicol, 1% povidone-iodine or 5% povidone-iodine before cataract surgery on reducing the colonisation of bacterial flora in the conjunctiva.Design: This was a double-blind, randomised clinical trial study.Setting: Patients referred to Shahid Sadoughi Hospital in Yazd, Iran, for cataract surgery were studied.Participants: Totally 260 patients were enrolled.Intervention: The affected lower fornix was gently sampled with a sterile swab and cultured on appropriate microbiological media. Then one of the 3 solutions mentioned above was instilled into the conjunctival sac of the cases in groups 1, 2 and 3, respectively. After thirty minutes, new conjunctival swabs were taken and cultured.Main outcome measures: The type of bacteria isolated and their colony-forming unit per mL (CFU/mL) number were primary end-points. The statistical tests of Phi and Cramer's V and Wilcoxon and Kruskal-Wallis were applied to evaluate the relationship between the studied variables and culture results as the secondary end-point.Results: The studied patients were 129 (49.6%) males and 131 (50.4%) females. Bacterial growth was observed in 49 cases (18.85%); the most commonly isolated bacteria were Staphylococcus epidermidis (71.42%). In the povidone-iodine 5% and chloramphenicol groups (but not the povidone-iodine 1%), the decrease in the number of CFU/mL was statistically significant (P = 0.032 and P = 0.005, respectively, Wilcoxon test).Conclusion: A single dose of povidone-iodine 5% and chloramphenicol effectively reduces the colonisation of normal conjunctival bacteria and can be used as effective prophylaxis.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136027393","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":"Emeritus Professor Samuel Ofosu-Amaah (1931-2023)","authors":"David Ofori-Adjei","doi":"10.4314/gmj.v57i1.1","DOIUrl":"https://doi.org/10.4314/gmj.v57i1.1","url":null,"abstract":"Emeritus Professor Samuel Ofosu-Amaah, who died on 22 January 2023, was highly regarded in academia, medical education, and public health. Trained as a pae-diatrician, he built a significant niche in Community Health early in his career at the University of Ghana Medical. A review of his career in the last half-century reveals a man best described as a visionary leader. The words of Ralph Waldo Emerson, “Do not follow where the path may lead. Go instead where there is no path and leave a trail”, are well suited to the life of Emeritus Professor Samuel Ofosu-Amaah. Dr Anarfi Asamoah-Baah (Former Deputy Director-General of the World Health Organisation and alumnus of the University of Ghana Medical School) said this about him: “Prof [Ofosu-Amaah] was a rare cocktail of brilliance, intellectual dexterity, softness, dogged determination and foresight, stammering eloquence, compassion and respect, tolerance”.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135778102","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":"Association of erectile dysfunction with coronary artery disease in Type 2 Diabetes mellitus.","authors":"Sydney C Dsouza,&nbsp;Obaid Rahman","doi":"10.4314/gmj.v57i1.7","DOIUrl":"https://doi.org/10.4314/gmj.v57i1.7","url":null,"abstract":"<p><strong>Objectives: </strong>Association of severity of Erectile Dysfunction (ED) and coronary artery disease (CAD) in type 2 diabetics based on the number of vessels involved.</p><p><strong>Design: </strong>an observational, cross-sectional study.</p><p><strong>Setting: </strong>tertiary level health care centre.</p><p><strong>Participants: </strong>104 diabetics, as defined by ADA(American Diabetes Association) criteria, who fulfilled the inclusion criteria of positive coronary angiogram (in the last six months), were selected to participate in the study after obtaining informed consent. Details regarding ED were obtained using the IIEF-5 questionnaire, and based on their scores, participants were divided into four categories ranging from mild to severe.</p><p><strong>Interventions: </strong>use of questionnaire International Index of Erectile Function-5.</p><p><strong>Main outcome measures: </strong>Karl Pearson association was done between the number of major coronary vessels involved and the severity of ED. The receiver operating characteristic curve was plotted between ED status and coronary vessels involved to predict the cut-off limit of ED score to predict CAD.</p><p><strong>Results: </strong>Out of 104 diabetics with CAD, 85.5% gave a history of ED. Most participants had mild to moderate degrees of ED, which was reported as occurring 4-6 years before the diagnosis of CAD. Cross tabulation between the severity of ED and association with the number of coronary vessels involved found no statistically significant association (p>0.05). However, ROC analysis showed sufficient accuracy in predicting the severity of CAD.</p><p><strong>Conclusion: </strong>The presence of ED in diabetic patients warrants screening for cardiovascular disease. A clear association between the severity of ED and the number of coronary vessels involved is still questionable.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9999498","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":"Leadership in health and medical education: lessons from a symposium on health sector development in Ghana.","authors":"Cephas K Avoka,&nbsp;Martha S Nabila,&nbsp;Akua Addy,&nbsp;Abena Okoh","doi":"10.4314/gmj.v57i1.11","DOIUrl":"10.4314/gmj.v57i1.11","url":null,"abstract":"<p><p>The Ghana College of Physicians and Surgeons (GCPS) has established an annual leadership symposium celebrating innovative leadership in the health sector. The 2022 symposium under the theme \"Health Sector Development in Ghana; The Power of Good Leadership\" was held in honour of Professor Samuel Ofosu-Amaah (the laureate), an Emeritus Professor of Public Health at the University of Ghana, about his leadership legacy. This article reflects on the leadership challenges in the health sector, the lessons learnt from the symposium, and the way forward. Leadership challenges identified in the health sector included the need for mentorship and coaching, the importance of teamwork and networking for delivering high-quality healthcare, and the role of leadership and governance in the health system. Key lessons from the symposium focused on skills in leading an event organisation, effective collaboration and teamwork, and learning from recognising prominent leaders' contributions to the health sector while these leaders are still alive. Key lessons from the personal and professional life of the laureate included a focus on giving back to the community, building mentorship of health leaders, being a catalyst of change, leadership and governance in public health institutions and publication of research findings. Suggestions were made to name the School of Public Health of the University of Ghana after Professor Ofosu-Amaah, to include a leadership and management module in all training modules at the GCPS and to establish a health leadership \"Observatory\" to focus on research on how leadership influences relevant health sector policy issues.</p><p><strong>Funding: </strong>The World Health Organization (WHO) country office in Ghana funded the symposium.</p>","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10003019","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":"Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus.","authors":"Fred S Sarfo,&nbsp;Nana K Ayisi-Boateng,&nbsp;Samuel B Nguah,&nbsp;Osei Sarfo-Kantanka,&nbsp;Collins Kokuro,&nbsp;Hanson Ababio,&nbsp;Yaw Adu-Boakye,&nbsp;Bruce Ovbiagele","doi":"10.4314/gmj.v57i1.5","DOIUrl":"https://doi.org/10.4314/gmj.v57i1.5","url":null,"abstract":"<p><strong>Objective: </strong>To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians.</p><p><strong>Design: </strong>We undertook a secondary analysis of data collected in a prospective study.</p><p><strong>Setting: </strong>The study involved patients with hypertension and or diabetes receiving care in five hospitals in Ghana.</p><p><strong>Main outcome measures: </strong>We assessed determinants of SBPV among 2,785 Ghanaian patients. We calculated the standard deviation (SD) of systolic BP recordings of 3 to 10 visits per patient over 18 months as a measure of SBPV. A multivariate linear regression analysis was fitted to identify factors independently associated with risk visit-to-visit SBP standard deviation.</p><p><strong>Results: </strong>The mean SD of individual patient visit-to-visit SBP overall was 14.8± 6.3 mm Hg. Those with hypertension and diabetes had the highest SD of 15.4 ±6.2 mm Hg followed by 15.2 ±6.5 mm Hg among those with hypertension only and then 12.0 ± 5.2 mm Hg among those with diabetes only, p<0.0001. Factors independently associated with SBPV with adjusted β coefficients (95% CI) included age: 0.06 (0.03 - 0.08) for each year rise in age, eGFR -0.03 (-0.05 - -0.02) for each ml/min rise, low monthly income of <210 Ghana cedis 1.45 (0.43-2.46), and secondary level of education -1.10 (-1.69, -0.50). Antihypertensive classes were associated with SBPV, the strongest associations being hydralazine 2.35 (0.03 - 4.68) and Methyldopa 3.08 (2.39 - 3.77).</p><p><strong>Conclusion: </strong>Several socio-demographic and clinical factors are associated with SBPV. Future studies should assess the contribution of SBPV to CVD outcomes among indigenous Africans and identify actionable targets.</p><p><strong>Funding: </strong>Funding for this study was provided by MSD, Novartis, Pfizer, Sanofi (each a Participant Company) and the Bill and Melinda Gates Foundation (collectively, the Funders) through the New Venture Fund (NVF). FSS and BO are also supported by funding from the National Heart, Lung, and Blood Institute (R01HL152188).</p>","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053335","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}