Journal of Osteopathic Medicine最新文献

{"title":"Comparing cranial suture interdigitation in humans and non-human primates: unearthing links to osteopathic cranial concept.","authors":"Janice Blumer, Irisa Arney, Anna Hardin, Morgan Nichols, Luke Arsenault, John Petrucci","doi":"10.1515/jom-2023-0243","DOIUrl":"https://doi.org/10.1515/jom-2023-0243","url":null,"abstract":"<p><strong>Context: </strong>Since William Garner Sutherland's inception of osteopathic cranial manipulative medicine (OCMM), osteopathic physicians have practiced with the knowledge that cranial sutures exhibit motion. We hypothesize that the complexity of suture interdigitation in humans may provide clues to elucidate the concept of OCMM.</p><p><strong>Objectives: </strong>We compared the interdigitation of sagittal, coronal (left and right), and lambdoid (left and right) sutures in computed tomography (CT) scans of humans and five nonhuman primate species (<i>Gorilla gorilla</i>, <i>Pongo pygmaeus</i>, <i>Pan troglodytes</i>, <i>Hylobates lar</i>, and <i>Nasalis larvatus</i>).</p><p><strong>Methods: </strong>Human ages are evenly distributed between 10 and 65 years of age, with an equal number of males (n=16) and females (n=16) in the sample. Nonhuman primates are all females, and the sample includes juveniles (n=6) and adults (n=34). Sutures were evaluated on a scale ranging from 0 to 3 (0: fused sutures; 1: no interdigitation; 2: low complexity; and 3: representing the highest degree of interdigitation and complexity).</p><p><strong>Results: </strong>Based on ordinary least squares linear regression, we found no significant relationship between suture interdigitation and age in humans. Chi-square tests were utilized to assess sex differences within humans, species-level differences, and differences between humans and nonhuman primates across all five sutures. Humans exhibited a statistically significant greater degree of suture complexity than all five nonhuman species across all five sutures.</p><p><strong>Conclusions: </strong>These findings indicate that human suture interdigitation is more complex than their closest living relatives (African apes) and other primates (Asian monkeys and apes). We theorize that this would enable subtle movement and serve to transmit forces at the cranial sutures from dietary or ethological behaviors, similar to the pattern observed in other mammals. While humans have a softer diet compared to other living primates, the uniqueness of human craniofacial growth and extended developmental period could contribute to the necessity for complex cranial sutures. More studies are needed to understand variation in human and nonhuman sutural complexity and its relationship to cranial motion.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156223","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":"Protecting the profession: lessons from the recent physician scandals.","authors":"R Andrew Kelso, Deborah Schmidt, Celia McLay","doi":"10.1515/jom-2024-0127","DOIUrl":"https://doi.org/10.1515/jom-2024-0127","url":null,"abstract":"<p><p>Sexual abuse scandals in recent years have eroded some of the trust that is foundational for the physician-patient relationship. A closer analysis of some of these stories of abuse from the standpoint of medical professionalism, primarily utilizing the example of Larry Nassar, DO, yields potential ways in which instances of abuse may be reduced or eliminated. The goal of this paper is to elicit lessons that can be learned from these tragic sequences of events so that physicians, healthcare institutions, physician practices, medical boards, and even patients themselves can introduce measures that help prevent future stories like these.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112970","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":"Analysis of self-reported confidence in independent prescribing among osteopathic medical graduating seniors.","authors":"Khalil Eldeeb","doi":"10.1515/jom-2022-0187","DOIUrl":"https://doi.org/10.1515/jom-2022-0187","url":null,"abstract":"<p><strong>Context: </strong>Prescribing medications is one of the physicians' most important professional activities throughout their careers. Lack of confidence and competency to prescribe may lead to preventable medical errors. The prevalence of prescription errors among new graduate physicians has been widely studied. Studies have linked this to inadequate foundational pharmacology education and work environment, among other factors. Suggestions were made for different educational interventions to increase the physicians' confidence and competency in prescribing to reduce the risk of medical errors. However, many of these studies were about students or graduates of medical schools other than osteopathic medical schools.</p><p><strong>Objectives: </strong>This study analyzed the self-reported confidence of graduating seniors in the United States osteopathic medical schools in their current ability to prescribe safely and independently and the possible associated factors.</p><p><strong>Methods: </strong>This study analyzed secondary data on the graduating seniors' surveys published by the American Association of Colleges of Osteopathic Medicine (AACOM) from the 2012/2013 to 2020/2021 academic years. Data were analyzed utilizing SPSS version 26.0 and MedCalc version 22.009, and statistical inferences were considered significant whenever p≤0.05.</p><p><strong>Results: </strong>The aggregated data show that 38,712 Doctor of Osteopathic Medicine (DO) seniors responded to the AACOM survey, representing 72.1 % of expected graduates during the study period. Most of the DO graduating seniors (70.8 %) reported feeling confident in their current abilities to independently write safe and indicated orders and to prescribe therapies or interventions in various settings. The percentage of respondents who perceived the time devoted to clinical pharmacology instruction as appropriate increased systematically over these reported years. A positive correlation was found between the percentage of students who reported the time dedicated to clinical pharmacology as excessive and the percentage of students who reported being confident in prescribing. A statistically significant positive correlation was found between the percentage of students who agreed that the first two years of medical school were well organized and the percentage of students who reported being confident in prescribing. A statistically significant correlation was found between the percentage of students who agreed with statements about frequent interactions with the attendee, testing at the end of each rotation, and being prepared for Comprehensive Osteopathic Medical Licensing Examination Level 2-Cognitive Evaluation (COMLEX Level 2-CE) during the required clerkships and the percentage of students who reported being confident in independent prescribing.</p><p><strong>Conclusions: </strong>During this study period, most osteopathic medical graduating seniors (70.8 %) felt confident about their cu","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082049","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":"Foot and ankle fellowship-trained osteopathic orthopaedic surgeons: a review, analysis, and understanding of current trends.","authors":"James P Henry, Matthew J Partan, Katharine M Chen, Randy M Cohn, Adam D Bitterman","doi":"10.1515/jom-2024-0092","DOIUrl":"https://doi.org/10.1515/jom-2024-0092","url":null,"abstract":"<p><strong>Context: </strong>Over the past several decades, orthopedic surgery has seen a substantial increase in the number of surgeons completing fellowship training. Doctors of Osteopathic Medicine (DOs) continue to advance their orthopedic education through subspecialty fellowship training. DOs have represented between approximately 6 % and 15 % of American Orthopaedic Foot and Ankle Society (AOFAS) fellows. Although historical representation has been considered strong, the fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships. This deviates from the recent trends of increasing participation across orthopedic subspecialities.</p><p><strong>Objectives: </strong>To investigate and review the trends of orthopedic foot and ankle fellowship training.</p><p><strong>Methods: </strong>Data was reviewed from the AOFAS regarding number of fellows matched and degree obtained. Data from the Federation of State Medical Boards (FSMB), American Orthopaedic Foot and Ankle Society (AOFAS) and Association of American Medical Colleges (AAMC) were reviewed for physician trends and match statistics.</p><p><strong>Results: </strong>Fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships, with only roughly 3% of AOFAS fellows being osteopathic trained.</p><p><strong>Conclusions: </strong>Orthopedic surgery has the highest rate of subspecialty training of all surgical specialties. Although there is hope for an increasing osteopathic presence in orthopedic surgery, recent literature has pointed to potential for continued bias in opportunities for osteopathic students. We hope that increased participation of osteopathic graduates in orthopedic surgery training programs will result in the continued expansion of osteopathic orthopedic surgeons completing fellowship training, including in foot and ankle surgery.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976839","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":"Alcohol consumption among older adults in the United States amidst the COVID-19 pandemic: an analysis of the 2017-2021 Behavioral Risk Factor Surveillance System.","authors":"Macy Haight, Parker Smith, Natasha Bray, Douglas Nolan, Micah Hartwell","doi":"10.1515/jom-2024-0054","DOIUrl":"https://doi.org/10.1515/jom-2024-0054","url":null,"abstract":"<p><strong>Context: </strong>Alcohol consumption is responsible for numerous life-threatening diseases, including liver cirrhosis, heart disease, and various cancers. During the pandemic, alcohol-related deaths increased from 2019 to 2021, topping out at approximately 108,000 deaths related to alcohol. This trend also introduced the question whether heavy alcohol consumption and binge drinking increased during the pandemic, particularly in those 65 and older.</p><p><strong>Objectives: </strong>The objective of this study is to determine whether heavy alcohol consumption and binge drinking increased during the pandemic in older adults in the United States.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of the Behavioral Risk Factor Surveillance System (BRFSS) to determine whether rates of overall alcohol consumption, heavy consumption, or binge drinking deviated from 2017 through 2021. We utilized chi-square tests to determine changes in rates over the included years.</p><p><strong>Results: </strong>Our findings show that the overall rate of alcohol use in populations 65 and older from 2017 through 2021 was approximately 42.1 %, which peaked in 2017 at 43.7 % and declined each year, resulting in the lowest rate (41.3 %) in 2021 (<i>χ</i> ^<i>2</i> =8.96, p<0.0001). Binge and heavy drinking rates were 5.1 % and 4.2 % overall during this time frame, respectively, and the annual changes were not statistically significant.</p><p><strong>Conclusions: </strong>The impact of COVID-19 on the drinking behavior of older US adults was minimal in terms of binge or heavy drinking, although the overall rates of alcohol consumption among this group declined. Reports among other US age groups showed increased consumption and deaths from alcohol use. Future research is needed to determine the causes for the overall decrease in consumption or adaptive measures that this group may have taken, which led to minimal changes in binge or heavy drinking in contrast to younger populations.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789292","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":"Educating our colleagues and hospital administrators regarding osteopathic medicine.","authors":"Steven B Soliman","doi":"10.1515/jom-2023-0160","DOIUrl":"https://doi.org/10.1515/jom-2023-0160","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789314","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":"Comprehensive review of the heart failure management guidelines presented by the American College of Cardiology and the current supporting evidence.","authors":"Lia Lazareva, Jay H Shubrook, Milind Dhond","doi":"10.1515/jom-2024-0071","DOIUrl":"https://doi.org/10.1515/jom-2024-0071","url":null,"abstract":"<p><strong>Context: </strong>Heart failure (HF) is a chronic condition that affects the heart's functional capacity, resulting in symptoms such as fatigue, edema, and dyspnea. It affects millions of adults in the United States and presents challenges in optimizing treatment and coordinating care among clinicians. Additionally, the various classifications for HF and limited research on treatment outcomes in heart failure with midrange ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) further complicate the pharmacological management of patients with this disease.</p><p><strong>Objectives: </strong>The objectives of this article are to review the pharmacotherapy guidelines for HF provided by the American College of Cardiology (ACC) and offer an update on the current trials conducted on these agents.</p><p><strong>Methods: </strong>The paper includes a post hoc analysis of established randomized controlled trials (RCTs), current RCTs, analysis of HF registries, and the guidelines published by the ACC. The gathering of research began in June 2023 and completed in August 2023. PubMed was utilized with the following search items: \"treatment for HFrEF\" (heart failure with reduced ejection fraction), \"treatment for HFmrEF,\" and \"treatment for HFpEF.\" The screening process was completed by one author. The automation tools utilized were \"clinical trials,\" \"randomized control trials,\" and \"five years\". Meta-analyses, systematic reviews, and case reports were excluded from the screening process. This review does not include research regarding medical devices, interventional therapies, and lifestyle modifications. Finally, research regarding additional comorbidities, nonpharmacological focused research, and agents not recommended by the ACC are not included in this paper.</p><p><strong>Results: </strong>The search began with 6,561 records identified from PubMed, with 407 records screened after automation tools were utilized to filter for \"clinical trials,\" \"randomized control trials,\" \"one year,\" and \"five years\". A total of 22 duplicates were reviewed, 318 were sought for screening after trials from 2019 were removed, and 31 studies were ultimately included in the review. A detailed summary of the most recent recommendations by the ACC are provided. The discussion includes indications, mechanisms of action, side effects, and contraindications for the selected agents. Additionally, recent clinical trials are included to provide evidence on the efficacy of the recommended classes of drugs.</p><p><strong>Conclusions: </strong>The current guidelines for managing HFrEF have been consistent, but there is limited consensus on treating HFmrEF and HFpEF. Large RCTs have provided compelling evidence supporting the use of the recommended pharmacological agents. However, despite the new effective treatment protocols, slow clinical inertia and underoptimization of HF management persist. Thus, it is crucial to synchronize care among cli","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761446","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":"The predictive validity of MCAT scores and undergraduate GPA for COMLEX-USA licensure exam performance of students enrolled in osteopathic medical schools.","authors":"Kenneth D Royal, Christian Meyer, Erik Guercio, Mark Speicher, Joseph Flamini, Jeanne M Sandella, Tsung-Hsun Tsai, Cynthia A Searcy","doi":"10.1515/jom-2023-0265","DOIUrl":"https://doi.org/10.1515/jom-2023-0265","url":null,"abstract":"<p><strong>Context: </strong>Osteopathic (Doctor of Osteopathic Medicine [DO]) medical students account for more than 25 % of all medical students in the United States.</p><p><strong>Objectives: </strong>This study examined the predictive validity of Medical College Admission Test (MCAT) total scores and cumulative undergraduate grade point averages (UGPAs) for performance on the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 1 and Level 2-CE (Cognitive Evaluation) licensure examinations administered by the National Board of Osteopathic Medical Examiners (NBOME). Additionally, the study examined the degree to which MCAT total scores and UGPAs provide comparable prediction of student performance by key sociodemographic variables.</p><p><strong>Methods: </strong>This study involved a collaborative effort between the Association of American Medical Colleges (AAMC), the American Association of Colleges of Osteopathic Medicine (AACOM) and the NBOME. Data were examined for 39 accredited DO-granting medical schools in the United States during the 2017 application cycle. Researchers utilized three regression models that included MCAT total scores, cumulative UGPA, and combined MCAT total scores and cumulative UGPA to determine predictive validity. Researchers also examined the comparability of prediction for sociodemographic variables by examining the differences between observed and predicted error for both scores and pass/fail success rates.</p><p><strong>Results: </strong>Medium to large correlations were discernible between MCAT total scores, UGPA, and COMLEX-USA examination outcomes. For both COMLEX-USA Level 1 and Level 2-CE scores and pass/fail outcomes, MCAT scores alone provided superior predictive value to UGPA alone. However, MCAT scores and UGPA utilized in conjunction provided the best predictive value. When predicting both licensure examination scores and pass/fail outcomes by sociodemographic variables, all three models provided comparable predictive accuracy.</p><p><strong>Conclusions: </strong>Findings from this comprehensive study of DO-granting medical schools provide evidence for the value-added benefit of taking MCAT scores and UGPA into consideration, particularly when these measures are utilized in conjunction. Further, findings provide evidence indicating that individuals from different sociodemographic backgrounds who enter medical school with similar MCAT scores and UGPA perform similarly on licensure examination outcome measures.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627942","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":"Investigating trends in orthopedic surgery match for osteopathic and allopathic graduates post-single accreditation transition.","authors":"Michael Megafu, Omar D Guerrero","doi":"10.1515/jom-2024-0064","DOIUrl":"https://doi.org/10.1515/jom-2024-0064","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459751","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 prenatal substance exposure and the development of the amygdala, hippocampus, and parahippocampus.","authors":"Micah Hartwell, Molly Bloom, Covenant Elenwo, Trey Gooch, Kelly Dunn, Florence Breslin, Julie M Croff","doi":"10.1515/jom-2023-0277","DOIUrl":"10.1515/jom-2023-0277","url":null,"abstract":"<p><strong>Context: </strong>Prenatal substance exposure (PSE) can lead to various harmful outcomes for the developing fetus and is linked to many emotional, behavioral, and cognitive difficulties later in life. Therefore, examination of the relationship between the development of associated brain structures and PSE is important for the development of more specific or new preventative methods.</p><p><strong>Objectives: </strong>Our study's primary objective was to examine the relationship between the physical development of the amygdala, hippocampus, and parahippocampus following prenatal alcohol, tobacco, and prescription opioid exposure.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of the Adolescent Brain and Cognitive Development (ABCD) Study, a longitudinal neuroimaging study that measures brain morphometry from childhood throughout adolescence. Data were collected from approximately 12,000 children (ages 9 and 10) and parents across 22 sites within the United States. Prenatal opioid, tobacco, and alcohol use was determined through parent self-report of use during pregnancy. We extracted variables assessing the volumetric size (mm³) of the amygdala, hippocampus, and parahippocampal gyrus as well as brain volume, poverty level, age, sex, and race/ethnicity for controls within our adjusted models. We reported sociodemographic characteristics of the sample overall and by children who had PSE. We calculated and reported the means of each of the specific brain regions by substance exposure. Finally, we constructed multivariable regression models to measure the associations between different PSE and the demographic characteristics, total brain volume, and volume of each brain structure.</p><p><strong>Results: </strong>Among the total sample, 24.6% had prenatal alcohol exposure, 13.6% had prenatal tobacco exposure, and 1.2% had prenatal opioid exposure. On average, those with prenatal tobacco exposure were found to have a statistically significant smaller parahippocampus.</p><p><strong>Conclusions: </strong>We found a significant association between prenatal tobacco exposure and smaller parahippocampal volume, which may have profound impacts on the livelihood of individuals including motor delays, poor cognitive and behavioral outcomes, and long-term health consequences. Given the cumulative neurodevelopmental effects associated with PSE, we recommend that healthcare providers increase screening rates, detection, and referrals for cessation. Additionally, we recommend that medical associations lobby policymakers to address upstream barriers to the effective identification of at-risk pregnant individuals, specifically, eliminating or significantly reducing punitive legal consequences stemming from state laws concerning prenatal substance use.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447234","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}