Indian Journal of Community Medicine最新文献

{"title":"Growing Concerns on Antimicrobial Resistance - Past, Present, and Future Trends.","authors":"Deepak Saxena, Richa Gwalani, Aarti Yadav, Ragini Shah","doi":"10.4103/ijcm.ijcm_838_23","DOIUrl":"10.4103/ijcm.ijcm_838_23","url":null,"abstract":"<p><p>Antimicrobial resistance [AMR] is a global problem that affects multiple domains including healthcare, agriculture, aquaculture, and many more. Every year, 700,000 people die from it. AMR is predicted to claim 10 million lives by 2050 if immediate action is not taken. Thus, to halt the spread of AMR it is important to understand what contributes to its emergence and transmission across borders and domains. The burden is disproportionately higher in Low middle income countries (LMICs) due to multiple factors such as environmental, social, healthcare, and cultural barriers. This review paper describes the comprehensive analysis of the past, present, and future trends in AMR, focusing on the complex interconnectedness of the factors contributing to this issue. Historical trends reveal antibiotic discoveries, resistance periods, resistance genes, and multidrug-resistant pathogens, providing insights into crisis evolution and the emergence of multidrug-resistant pathogens. The present trends reflect the current state of AMR in India and emphasize the negative consequences of AMR for clinical medicine and healthcare systems. It identifies the factors driving the global pandemic surge and examines current global and country-level policies and actions to mitigate its impact. The future trends anticipate the trajectories of AMR and discuss innovative approaches to combat resistance, including the exploration of alternative therapies and the implementation of stewardship programs. Thus, by synthesizing existing knowledge and identifying emerging gaps, this review paper presents a holistic perspective on the evolution of AMR.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"4-8"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693883","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":"Prevalence of Alcohol Use Disorder among Medical Students in New Delhi: A Cross-Sectional Study.","authors":"Aninda Debnath, Anita Verma, Priyansha Gupta, Sneha Jindal","doi":"10.4103/ijcm.ijcm_596_23","DOIUrl":"10.4103/ijcm.ijcm_596_23","url":null,"abstract":"<p><strong>Background: </strong>Amid the global concern over alcohol consumption's ramifications for public health, the escalating prevalence of alcohol misuse among young individuals, especially students, is alarming. This study examines the prevalence of alcohol use disorder (AUD) among medical students, exploring its link to depression, anxiety, and socioeconomic factors.</p><p><strong>Material and methods: </strong>We conducted this cross-sectional study at a medical college in New Delhi in the month of June, 2023. We determined a sample size of 425 using prevalence estimates for AUD, a 4% margin of error, and a 15% nonresponse rate. We selected participants using simple random sampling from the MBBS enrollment list and provided them with self-administered questionnaires. We utilized validated screening tools, including PHQ-9, GAD-7, AUDIT-C, and CAGE, to assess depression, anxiety, and AUD. Statistical analysis was performed using STATA 18. AUD prevalence was presented with 95% confidence intervals. Associations between AUD and variables were examined using Chi-square tests. Significant variables (<i>P</i> < 0.2) in univariate analysis were considered in multivariate logistic regression (<i>P</i> < 0.05).</p><p><strong>Results: </strong>In our study, 413 students participated. The prevalence of AUD was 13.6%, depression was 31.5%, and anxiety was 24.2%. Univariate and multivariate logistic regression revealed significant associations between AUD and factors such as gender, current living space, tobacco use, and anxiety.</p><p><strong>Conclusion: </strong>The current study highlights worrisome levels of AUD, depression, and anxiety among medical students in New Delhi. Our research also reveals connections between AUD and factors like gender, living situation, tobacco use, and anxiety.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"43-47"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693891","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 Prevalence and Risk Factors of Postpartum Depression in Western India: A Cross-Sectional Study.","authors":"Dharti J Kansagra, Chikitsa D Amin, Rajendra B Chauhan","doi":"10.4103/ijcm.ijcm_232_23","DOIUrl":"10.4103/ijcm.ijcm_232_23","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) is a nonpsychotic mental health condition associated with child birth. It poses a major global public health challenge as it remains unrecognized most of the time and impairs both the immediate and long-term health of both the mother and child. The study was conducted to estimate the prevalence and associated risk factors for PPD.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among 450 women who delivered babies within the past 1-12 months and attending a tertiary care hospital during April to November 2021. Systemic random sampling was used to obtain the desired sample size. Basic sociodemographic variables (age, duration of postpartum period, residence, religion, education, occupation, birth spacing, complication during pregnancy, desired gender of child, birth weight of baby) related to pregnancy were collected. The Edinburgh Postnatal Depression Scale was used to estimate the prevalence of PPD.</p><p><strong>Results: </strong>The prevalence of PPD in the study was 14.2%. The mean ± standard deviation age of women was 27.1 ± 4.7 years. Sociodemographic factors such as maternal age, low level of education, and family type and obstetric factors such as age at first pregnancy, parity, and history of abortion were significantly associated with PPD (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Risk factors related to sociodemographic and obstetric history were found to be significantly associated with PPD. To prevent major depression in postpartum, early detection and timely referral are needed.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"70-75"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693900","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":"Engagement and Preparedness of Urban Accredited Social Health Activists (U-ASHAs) for Delivery of Tuberculosis (TB) Care: Findings From two Cities in Maharashtra, India.","authors":"Vidula S Purohit, Shilpa Santosh Karvande, Daksha Y Shah, Omprakash B Vallepawar, Omprakash J Yadav, Nerges F Mistry","doi":"10.4103/ijcm.ijcm_744_23","DOIUrl":"10.4103/ijcm.ijcm_744_23","url":null,"abstract":"<p><p>Finding missing tuberculosis (TB) cases from the \"under-reached\" population of urban slums and connecting them with TB services is a priority and ongoing challenge for India. It requires the effective engagement of community health workers including urban Accredited Social Health Activists (U-ASHAs). The study aimed to understand the current engagement of U-ASHAs in TB care and their commensurate preparedness in terms of TB knowledge and training. An exploratory study was conducted in Mumbai and Pune cities of Maharashtra during 2022-23. The study used a mixed-methods approach, including a semi-structured survey of U-ASHAs (n = 222) and in-depth interviews with relevant stakeholders (n = 33). The statistical analysis used was descriptive statistics using MS Excel. The average age and work experience of U-ASHAs were 35.4 (21-50) years and 2.7 (0.5-6) years, respectively. They considered maternal child health services as their main portfolio and TB as an ancillary program. They were mainly involved in a biannual active case finding (ACF) and were recently envisioned as TB treatment supporters with poor clarity about other roles in TB care. Just half-day training for TB as part of 8-day general induction training, brief updates before ACFs, and the absence of an on-the-job supervisory structure resulted in TB knowledge gaps particularly for the latest diagnostic tests, adverse drug reactions, government schemes for TB patients, and contact tracing. Conclusions: Intermittent TB activities coupled with insufficient training impede U-ASHAs' functionality in TB care. Clarity of TB-related roles, integration of TB activities in daily tasks, comprehensive training, and on-the-job supervisory structures have merit in strengthening U-ASHAs' engagement in urban TB care.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"225-229"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693768","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":"An Assessment of High-Risk Sexual Behavior and Associated Factors Among Self-identified Hijras Residing in an Urban Slum of Mumbai, India.","authors":"Deepak K Mundhe, Saniya S Qureshi, Yuvaraj B Chavan","doi":"10.4103/ijcm.ijcm_740_23","DOIUrl":"10.4103/ijcm.ijcm_740_23","url":null,"abstract":"<p><strong>Background: </strong>A high proportion of sexual minorities like Hijras/Eunuch engage in sex work and thus become a high-risk population for HIV and sexually transmitted infections (STIs). Hence, we conducted a study with objective to assess prevalence of high-risk behavior among self-identified Hijras/Eunuch and associated factors.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted in a field practice area of Tertiary Care Hospital from December 2019 to December 2020. All participants in the age group of 18 to 45 years were interviewed. Univariate and bivariate analysis was done to determine the correlates.</p><p><strong>Results: </strong>Out of 163, 85% of participants were involved in high-risk sexual behavior and 46.63% did only sex work, 51.5% of participants had comprehensive knowledge about HIV/STI. On applying logistic regression, the factors associated with high-risk sexual behavior include 18-24 years of age group, history of addiction, practicing paid sex, using psychotropic substances, comprehensive knowledge regarding HIV/STI, and comprehensive exposure to preventive measures.</p><p><strong>Conclusion: </strong>Our study findings suggest the urgent need for appropriate preventive measures to understand and address sexual health and risk behavior vulnerabilities faced by Hijras to make significant progress against the HIV epidemic in the country.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"48-52"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693807","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":"Off-label Prescriptions for Rabies Management in India: Deviations from National Standards.","authors":"Vijay Barwal, Anjali Mahajan","doi":"10.4103/ijcm.ijcm_648_23","DOIUrl":"10.4103/ijcm.ijcm_648_23","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"253-254"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693890","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":"Risk Factor-Specific Mortality Analysis of the Outborn Newborns to Improve the Neonatal Mortality Rate: A Cross-Sectional Descriptive Study.","authors":"Tapan K Kundu, Abhilash Chatterjee, Mitali Bera, Aditi Chowdhury, Riya Guchhait","doi":"10.4103/ijcm.ijcm_213_23","DOIUrl":"10.4103/ijcm.ijcm_213_23","url":null,"abstract":"<p><p>The 2030 Sustainable Development Goal (SDG) envisions eliminating preventable newborn deaths and reducing neonatal mortality to 12 per 1000 live births. There is a paucity of data on outborn newborns. By doing this study, areas for further reductions in neonatal mortality rate (NMR) can be identified and interventions can target these areas for reduction of NMR. The objectives of this study were to determine the causes of admission of outborn newborns, identify the timing and causes of mortality, distinguish between possibly preventable or probably unpreventable deaths, and identify areas for further reductions in NMR. A cross-sectional, retrospective, and descriptive study was conducted on outborn newborns at a Special Newborn Care Unit (SNCU) of a medical college hospital in eastern India from January 1, 2021 to December 31, 2021. Admission and mortality data were collected after ethics committee approval and analyzed. Sick outborn newborns admitted to the SNCU were 1671. Deaths occurred in 281. Males were 62.28%. The highest number of deaths occurred in birth weight ≤999 g, (91.84%), gestational age <28 weeks (100%). The causes of death were sepsis in 35.23%, perinatal asphyxia in 22.78%, and prematurity (<28 weeks) and ELBW (≤999 grams) in 16.73%. First-day deaths were 55.87%, deaths in the first 2 days were 69.85%, and deaths in the first 7 days were 86.83%. To reduce NMR, interventions should target male gender, scheduled tribe social category, <28 weeks gestation, birth weight ≤999 g, cases of sepsis, perinatal asphyxia, and prematurity.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"197-201"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693896","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":"Burden and Associated Factors of Tuberculosis Among Household Contacts of Sputum Positive Tuberculosis Patients of Aligarh.","authors":"Simon Jude, Ali J Abedi, Saira Mehnaz, Mohammad Shameem","doi":"10.4103/ijcm.ijcm_149_23","DOIUrl":"10.4103/ijcm.ijcm_149_23","url":null,"abstract":"<p><strong>Background: </strong>Engaging patients in healthcare for diagnosis and treatment through active case-finding, which is initiated by healthcare providers, involves methodically searching for tuberculosis in individuals who may not seek medical attention otherwise. Active case finding provides a promising opportunity to identify additional undetected cases of tuberculosis within the community. The current study aimed at evaluating household contact tracing of Tuberculosis among the household contacts of pulmonary TB cases who were recently diagnosed, as well as to identify risk factors in both household contacts and index cases that contribute to the transmission of TB within households.</p><p><strong>Materials and method: </strong>This cross-sectional study, which was conducted within the community, focused on the household contacts of recently diagnosed patients of Pulmonary Tuberculosis (TB) who were confirmed through microbiological testing. These patients were registered at Tuberculosis Units (TUs) of JNMC and Jawan of Aligarh district, West U.P. The investigator conducted visits to each household and met with both the index case and their corresponding household contacts to establish rapport and gather necessary information.</p><p><strong>Results: </strong>Within this investigation, a total of 103 individuals who tested positive for sputum smear were identified as index cases, alongside 405 household contacts of these index cases. The predominant symptom observed in household contacts who tested positive during the screening process was a cough, with fever following closely behind. Among the 405 household contacts examined, 54 individuals (13.3%) exhibited symptoms associated with Tuberculosis. Further investigation revealed that 11 of these individuals (20.37%) tested positive for tuberculosis. The total prevalence of tuberculosis cases among household contacts was determined to be 2.72%.</p><p><strong>Conclusion: </strong>The present research affirms that conducting contact screening for households of active TB cases is a comparatively feasible and beneficial strategy that could result in prompt diagnosis and initiation of treatment for active TB, thereby diminishing the severity of the disease and lowering the rate of transmission. Also, it can help to improve TB-related health effects, social and economic implications, and treatment outcomes in the index cases.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"181-186"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693649","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 Novel Classification System of Smart Mechanical Plaque Control: A Cross-Sectional Survey with Cluster Analysis.","authors":"Balraj R Shukla, Anup K Panda","doi":"10.4103/ijcm.ijcm_439_23","DOIUrl":"10.4103/ijcm.ijcm_439_23","url":null,"abstract":"<p><strong>Background: </strong>Recurring advances in the field of mechanical plaque control (MPC) devices have shown promise in improving the oral hygiene status of the community. However, little is known about the association between the knowledge of healthcare professionals regarding these advances, the manufacturers in understanding the demand of the community, and the community's willingness to switch to these \"smarter\" advances in MPC. This article puts forth a novel classification system of smart MPC to bridge this research gap.</p><p><strong>Materials and methods: </strong>After a Delphi consensus and a sample pretesting, a customized questionnaire survey based on the knowledge, attitude, and practice model was filled by 618 participants. The participants were divided into two groups: Group I from the healthcare profession (n = 236) and Group II from other professions (n = 382). A Chi-square test was used to determine the significant variables. These variables went through K-means and cluster silhouette scoring for cluster analysis. A correlation coefficient using regression line was used to analyze the relation between related variables.</p><p><strong>Results: </strong>The Chi-square test revealed nine components with statistically significant associations (<i>P</i> < 0.05). K-means clustering of the nine parameters revealed six clusters (silhouette score >0.5) that guided in drawing a classification of smart MPC.</p><p><strong>Conclusion: </strong>This study reveals the dearth of knowledge among the participants regarding advanced MPC and their negligence in following basic oral hygiene routines. The classification system derived through cluster analysis provides a basis for understanding the upgraded modes of MPC.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"175-180"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693791","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":"Incidence, Causes, and Perinatal Outcomes of \"Near-Miss\" Obstetric Emergencies during the COVID-19 Pandemic: Experience from a Tertiary Referral Center of Western Rajasthan, India.","authors":"Garima Yadav, Charu Sharma, Pratibha Singh, Vrushti Solanki, Swati Chhabra, Priyanka Kathuria, Meenakshi Gothwal, Manisha Jhirwal, Shashank Shekhar","doi":"10.4103/ijcm.ijcm_552_23","DOIUrl":"10.4103/ijcm.ijcm_552_23","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women and neonates are often considered as being a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. Several studies have compared the impact of COVID-19 on pregnant and nonpregnant women. This study aimed to examine the reasons for severe acute maternal morbidity (SAMM) and \"near-miss cases\" and their effects on perinatal outcomes before and during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>All women admitted to our facility with pregnancy-related complications for birth or in the puerperium who required critical care unit (CCU) or high dependency unit (HDU) admission were included in the study. A modified version of the World Health Organization (WHO)'s Maternal Near-Miss Screening Tool was used to identify maternal near-miss cases and other obstetric emergencies requiring CCU admission.</p><p><strong>Results: </strong>The incidence of \"near-miss\" obstetric emergencies was -30.7 per 1000 live births. Over the 3 years of data obtained, 152 near-miss cases were found. Thirty-five cases were seen in the pre-COVID-19 period, whereas 117 near-miss cases were noted during the COVID-19 pandemic. The most common cause of near-miss cases in both groups was severe preeclampsia (65.8%). The rate of ICU admissions was 80.3% (94/117) during COVID-19, while only three cases required ICU before the COVID-19 pandemic. There were a total of 11 maternal deaths, and all were reported during the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>There was a significant increase in ICU admission rates and \"near-miss\" obstetric emergencies during the COVID-19 pandemic. The COVID-19 infection indirectly led to higher maternal morbidity secondary to lockdown effects on antenatal care and delayed referrals. This study will contribute to the existing literature on the impact of the COVID-19 pandemic on maternal and child health. The results will help inform policy decisions and guide the development of interventions to improve the quality of care for pregnant women during the pandemic.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 1","pages":"76-80"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693885","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}