Portuguese Journal of Public Health最新文献

{"title":"Social Prescribing in Portugal: Towards Regulation, Equity, and a National Evidence Base.","authors":"Zacharoula Sidiropoulou","doi":"10.1159/000551978","DOIUrl":"10.1159/000551978","url":null,"abstract":"","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"213-216"},"PeriodicalIF":0.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278987","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":"\"We Had Unexpected Reactions from Everywhere\": A Qualitative Study on the Impact of the COVID-19 Pandemic on Supported Accommodations for People with Serious Mental Disorders.","authors":"Bárbara Pedrosa, Graça Cardoso, Manuel Gonçalves-Pereira, Ugnė Grigaitė, Deborah Aluh, Margarida Santos-Dias, Manuela Silva, José Caldas-de-Almeida","doi":"10.1159/000551736","DOIUrl":"10.1159/000551736","url":null,"abstract":"<p><strong>Background: </strong>Limited information is available on the impact of the COVID-19 pandemic on supported accommodations (SAs) for people with serious mental disorders. A quantitative study recently conducted in Portugal showed that these services struggled with a more challenging environment, residents' fears, and a lack of support from community services. We now aim to complement it by reporting qualitative data on the experiences of residents and professionals of SAs for people with serious mental disorders during the pandemic.</p><p><strong>Methods: </strong>A purposive sample of 11 residents and 11 professionals from 11 different organisations responsible for SAs in Portugal was included. Data were collected through semi-structured interviews. The interview guide included questions regarding changes in the functioning of SAs and implemented measures during COVID-19 and the impact of the pandemic on the well-being of residents and professionals. Thematic analysis was used.</p><p><strong>Findings: </strong>Some SAs had to close or relocate, and several procedures were changed. Residents felt that the most impactful changes included not being able to go outside or see loved ones. Despite some residents reporting anxiety or sadness, almost none relapsed. However, some professionals noted an impact on the autonomy and cognition of residents. Despite reporting a negative impact of the pandemic on their own well-being, professionals struggled to maintain the functioning of SAs and the well-being of residents. Residents recognised the effort made by professionals and felt supported by them during COVID-19.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic significantly impacted the functioning of SAs. In line with our findings, some actions seem fundamental to improve SAs' resilience in the future. These relate to human resources, training, structural conditions, new technologies, and professionals' well-being.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"54-65"},"PeriodicalIF":0.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Climate Change on the Emergence and Reemergence of Diseases Transmitted by Mosquitoes in Temperate Regions: An Umbrella Review.","authors":"Raquel Rosado E Silva, Sabine Dittrich, Helena Donato, Christopher Millett","doi":"10.1159/000551375","DOIUrl":"10.1159/000551375","url":null,"abstract":"<p><strong>Introduction: </strong>Mosquito-borne diseases (MBD) represent a global public health concern. Many mosquito species have rapidly expanded globally due to climate change and are expected to continue spreading beyond their current range into temperate regions. To support policy action, an umbrella review was conducted to summarize the growing literature on the impact of climate change indicators on MBD patterns in temperate zones.</p><p><strong>Methods: </strong>Studies published until December 31, 2023, were searched in PubMed, EMBASE, Cochrane, Epistemonikos, and Web of Science Core Collection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. The quality of the methodology and evidence of the included reviews was assessed using \"A Measurement Tool to Assess Systematic Reviews 2\" (AMSTAR 2).</p><p><strong>Results: </strong>The initial search yielded 6,518 studies, with 78 undergoing full-text assessment. Ten studies met the inclusion criteria. Key findings include a significant association between climate factors (specifically temperature, rainfall and humidity) and MBD in temperate regions, mostly malaria and dengue, with temperature consistently showing a strong predictive value. Our findings are likely to be robust as we employed strict quality criteria to ensure the quality of included primary studies and systematic reviews.</p><p><strong>Conclusion: </strong>This umbrella review identifies concerning impacts of climate change on MBD in temperate regions, highlighting significant correlations between climate variables and diseases such as dengue, malaria, and the Ross River virus. The review underscores the importance of targeted public health strategies that integrate climatic data for effective management of MBD in temperate regions and calls for further research on extreme weather events and less-studied diseases.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"85-96"},"PeriodicalIF":0.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983723","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":"High Utilisation Behaviour in Emergency Departments: Predictors in Baixo Alentejo Region.","authors":"Allan Alves Nogueira, Ana Dionísio, José Queimado, Paulo Sousa","doi":"10.1159/000551067","DOIUrl":"10.1159/000551067","url":null,"abstract":"<p><strong>Introduction: </strong>High utilisation of emergency departments (EDs) is a behaviour present in a minority of patients but accounts for a disproportionate share of visits and resources. Understanding their characteristics and predictors is essential for planning targeted interventions.</p><p><strong>Methods: </strong>A retrospective cohort study analysed all ED visits in 2024 at the Unidade Local de Saúde do Baixo Alentejo (ULSBA). Patient behaviour was classified as control (≤3 visits), moderate frequent use (4-9 visits), or high frequent use (≥10 visits). Variables included sociodemographic characteristics, comorbidities, outcomes, and utilisation measures. Descriptive, bivariate, and multivariate analyses were performed.</p><p><strong>Results: </strong>Among 50,626 patients accounting for 116,885 ED visits, 5,315 (10.5%) presented high utilisation, responsible for 31.7% of visits. These patients were more likely to be female and to present mental or social comorbidities. A bimodal age distribution was observed, with peaks under 30 years and over 60 years. Multivariate analysis identified female sex, mental and social comorbidities, and residence in Castro Verde or Moura as predictors of high utilisation. These patients were more likely to leave without treatment but less likely to die during ED episodes compared with controls.</p><p><strong>Discussion/conclusion: </strong>High utilisations are present in heterogeneous populations, concentrated mostly in younger psychosocially vulnerable patients and older multimorbid adults. While they do not appear to drive ED overcrowding directly, their profiles reflect unmet needs in social and primary care systems. Tailored interventions across health and social services are needed to solve their issues and reduce avoidable ED use.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"32-42"},"PeriodicalIF":0.9,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821673","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 Maternal Near Miss: A Facility-Based Case-Control Study in Luanda, Angola.","authors":"Maria Castelo, Paulo Campos, Pedro Magalhães, Cristina Teixeira","doi":"10.1159/000551230","DOIUrl":"10.1159/000551230","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the determinants of maternal near miss is crucial for designing preventive strategies and health policies to reduce preventable maternal deaths. This study aimed to identify the determinants of maternal near miss among women admitted to two tertiary hospitals in Luanda, Angola.</p><p><strong>Methods: </strong>A facility-based case-control study was conducted at two referral hospitals from June to September 2022. Case participants were recruited among women admitted who met at least one of the WHO near miss criteria. The controls were women admitted for vaginal birth, without any criteria for severe maternal morbidity. For each maternal near-miss case, three age-matched controls were selected. Bivariate analysis was used to evaluate the differences between these two groups. Multivariate unconditional logistic analysis models were constructed to identify determinants of maternal near miss. Reduced models (forward technique) were adjusted, and adjusted odds ratios and 95% confidence intervals were obtained. The level of significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>In this study, 245 cases of maternal near miss and 735 controls were included. Maternal near miss was strongly associated with a long delay in seeking care (AOR = 27.38; 95% CI: 12.60-59.47), being referred to referral hospitals (AOR = 11.07; 95% CI: 7.25-16.91), having a preexisting medical disorder (AOR = 12.00; 95% CI: 6.25-23.04), having a previous cesarean section (AOR = 2.42; 95% CI: 1.43-4.10), and consuming alcohol (AOR = 1.59; 95% CI: 1.04-2.43).</p><p><strong>Discussion/conclusion: </strong>Delay in seeking care and being referred to referral hospitals were the main determinants of maternal near miss. Decision makers and health system managers must provide primary and secondary healthcare facilities with resources to manage obstetric complications before and during transfer to tertiary hospitals. Additionally, community interventions focused on overcoming barriers and constraints in seeking healthcare should be prioritized as they can positively impact the prevention of maternal near miss.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"43-53"},"PeriodicalIF":0.9,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869776","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 Application of Artificial Intelligence in Public Health Surveillance in Portugal: An Exploratory Study of Expert Perspectives.","authors":"Liliana Certo, Maurício Alves, Teresa Magalhães","doi":"10.1159/000550578","DOIUrl":"10.1159/000550578","url":null,"abstract":"<p><strong>Introduction: </strong>The application of AI in public health surveillance presents a transformative potential for more efficient work methodologies, offering new capabilities for the detection, notification, and response to public health threats. However, it is important to be aware of the associated risks and the ethical and legal challenges linked to AIs use in such a sensitive area as public health. The general objective of this study was to explore the application of AI in public health surveillance in Portugal, as viewed by Portuguese experts.</p><p><strong>Methods: </strong>The methodological approach employed was a qualitative study, utilising a descriptive and exploratory investigation. A content analysis was performed on 28 anonymised semi-structured interviews. This process identified concepts, themes, key ideas, and emergent patterns. The findings were then grouped into categories and subcategories, which allowed us to highlight significant consensuses and meaningful insights.</p><p><strong>Results: </strong>Experts recognised AIs transformative potential in enhancing predictive capacity, automating data processes, and supporting decision-making. However, they highlighted critical limitations of the Portuguese system, notably entrenched reactivity, fragmented infrastructures, under-utilisation of primary care and personal device data, and insufficient surveillance of non-communicable diseases. Key barriers include poor data quality and interoperability, absence of comprehensive data governance, shortage of AI-skilled professionals, resistance to organisational change, and limited financial sustainability. Ethical concerns, privacy, algorithmic bias, and explainability were emphasised as central to AIs legitimacy. Comparisons with international experiences revealed that progress depends less on technological readiness than on systemic reform, data harmonisation, and strong governance aligned with European Union (EU) and World Health Organization (WHO) frameworks.</p><p><strong>Conclusion: </strong>AI can shift Portuguese public health surveillance from reactive to predictive, but only if supported by robust data ecosystems, clear governance, and investment in human capital. A national roadmap is required, prioritising interoperability, sustainable financing, and ethical implementation, to ensure that AI serves as a complement to, rather than a replacement for, human judgement in protecting population health.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"120-139"},"PeriodicalIF":0.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200313","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":"Quality and Safety Indicators in Neonatal Care: An Integrative Review of Their Evolution.","authors":"Ana Malveira, Ana Dias, Margarida Goes, Sandra Oliveira","doi":"10.1159/000550584","DOIUrl":"10.1159/000550584","url":null,"abstract":"<p><strong>Objective: </strong>The neonatal intensive care unit (NICU) environment is characterised by demanding specialised care, complex technologies, and agile and assertive practice by the multidisciplinary team due to the profile of the neonatal patient. The prioritisation of neonatal patient safety has led to the development of quality tools that enable the monitoring of quality and safety through the operationalisation of a set of indicators across the continuum of care. The aim of the study was to critically analyse the evolution of quality and safety indicators used in neonatal care and discuss their applicability to the creation of a Neonatal Patient Safety Checklist (NPSC) based on developmental centred care (DCC).</p><p><strong>Methods: </strong>An integrative review was conducted according to the methodology of Whittemore and Knafl, involving structured research using MeSH/DeCS and Boolean operators in the PubMed, Scopus, Web of Science, CINAHL, and SciELO databases. Empirical studies (qualitative, quantitative, or mixed methods) published in Portuguese, English, Spanish, or French between 2011 and 2023 were included. The report adhered to the PRISMA 2020 guidelines, and critical appraisal was conducted using the JBI, CASP, and MMAT grids where applicable. The synthesis mapped the indicators according to Donabedian's model (structure-process-outcome), with a focus on DCC.</p><p><strong>Results: </strong>Fourteen studies were included. There was a shift from a technoprocedural paradigm focussing on infection prevention, medication safety, and procedures, to an integrated approach combining safety culture, safe leadership, resource allocation, communication during transitions, structured records, and experiential metrics (e.g., parental satisfaction). This is consistent with DCC. The overall methodological quality was moderate to high. However, there are still gaps in the validation process (about content, reliability, and sensitivity to change), particularly with regard to experiential and parental indicators. There is also operational heterogeneity that limits comparability between NICU.</p><p><strong>Conclusion: </strong>Conceptual advances have been made in measuring quality and safety in NICUs, with the progressive integration of DCC. Systematic incorporation of these indicators requires standardisation of definitions, structured records, and robust psychometric validation. The findings provide an operational basis for developing and implementing NPSC, which are useful for continuous improvement and decision support in NICU.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"66-84"},"PeriodicalIF":0.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463790","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":"Unpacking Sociocultural Barriers to Stunting Prevention: A Phenomenological Inquiry into Policy and Community Challenges.","authors":"Rina Doriana Pasaribu, Maida Pardosi","doi":"10.1159/000549813","DOIUrl":"10.1159/000549813","url":null,"abstract":"<p><p>Stunting remains a major public health challenge in Indonesia, and sociocultural barriers hinder policy effectiveness. This study explored these barriers using a phenomenological approach, analyzing the lived experiences of mothers, health workers, and policymakers in Samosir Regency. Data were collected through in-depth interviews with 25 mothers of stunted children and focus group discussions with twelve key stakeholders. Findings revealed psychological resistance to the stunting label, social stigma, gender disparities, reliance on traditional health practices, and economic constraints limiting access to nutrition. These factors create a disconnect between national policies and local realities, reducing the effectiveness of intervention. This study highlights the need for culturally sensitive, community-driven public health strategies that integrate local beliefs with evidence-based interventions. The findings provide critical insights for policymakers to develop inclusive, context-specific, and stunting prevention strategies within broader social and infrastructure policies. Future research should evaluate integrated policy innovations on long-term nutritional outcomes.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"4-17"},"PeriodicalIF":0.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272356","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":"Characterizing the Competencies for Public Health Graduates in Australasia: Protocol for a Mixed-Methods Study.","authors":"Nathan Dawes, Melissa Graham, Jane Taylor, Summer May Finlay, Rimante Ronto, Louise Clarke, Kannaka Hannah Wechkunanukul, Christina Severinsen, Kristen Beek, Etu Buka, Natasha Lee, Holly Donaldson, Casey Yates, Chris Haydock, Jack Seaton","doi":"10.1159/000550358","DOIUrl":"10.1159/000550358","url":null,"abstract":"<p><strong>Introduction: </strong>This study protocol aims to develop a validated competency framework to address the absence of a contemporary, Australasian-specific framework for public health graduates, aligning their education with workforce demands in an evolving public health landscape.</p><p><strong>Methods: </strong>A mixed-methods approach, combining qualitative and quantitative methods, will be used across three phases. Phase 1 will involve semi-structured interviews with public health experts, academics, and students to capture insights on essential competencies. In phase 2, a systematic synthesis of competencies from existing frameworks will be conducted, triangulating these findings with interview data to develop a preliminary framework. Phase 3 will employ a modified Delphi process and Content Validity Index (CVI) to assess and refine the framework's content validity with Australasian public health experts.</p><p><strong>Results: </strong>Expected outcomes from the interviews and framework synthesis include a draft competency framework detailing core public health skills, knowledge, and attributes required to address contemporary challenges. The Delphi rounds are anticipated to confirm the framework's relevance, clarity, and importance, achieving strong content validity metrics.</p><p><strong>Conclusions: </strong>The resulting competency framework is expected to provide a validated structure for guiding public health education and workforce development within Australasia. By equipping graduates with competencies aligned with current and future public health needs, this framework aims to enhance the region's capacity to address significant health challenges and disparities. Dissemination of findings across Council of Academic Public Health Institutions Australasia (CAPHIA) member institutions will support the integration of this framework into curricula, thereby informing public health education and workforce initiatives in Australasia.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"97-106"},"PeriodicalIF":0.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143958","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":"School Meals at Home: Contributions of the Sintra Municipality Initiative during the COVID-19 Pandemic to the Design of Interventions in Public Health Emergencies.","authors":"Telma Nogueira, Raquel Ferreira, Vitória Dias da Silva, Mariana Liñan Pinto, Lara Guerreiro, Liliana Oliveira Dias, Joana Sousa","doi":"10.1159/000549868","DOIUrl":"10.1159/000549868","url":null,"abstract":"<p><strong>Introduction: </strong>Despite school closure, continuing school-provided meals is crucial to prevent the wider spread of food insecurity. The goal of this study was to describe Sintra municipality's response to adapt the school meal service during the COVID-19 pandemic and to provide some process evaluation data.</p><p><strong>Methods: </strong>During two school closures, through the School Meals at Home service, the municipality provided a meal kit that supplied most of the children's daily energy requirements. To evaluate satisfaction with the service, a questionnaire was administered to the children's legal guardians.</p><p><strong>Results: </strong>During the first school closure (26 weeks), 315,130 meals were delivered, 1,031 self-administered questionnaires were applied to children's legal guardians, and overall satisfaction with the service was 98.4%. In the second school closure (10 weeks), 218,660 meals were delivered, 1,784 self-administered questionnaires were applied to children's legal guardians, and overall satisfaction with the service was 96.2%.</p><p><strong>Conclusion: </strong>The School Meals at Home service provided a timely and structured response to ensure food access during school closures, achieving high levels of family satisfaction. The initiative supported vulnerable households and represents a replicable model for equity-oriented action in future public health emergencies.</p>","PeriodicalId":37244,"journal":{"name":"Portuguese Journal of Public Health","volume":" ","pages":"18-31"},"PeriodicalIF":0.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182900","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}