Indian Journal of Community Medicine最新文献

{"title":"Non-alcohlic Fatty Liver Disease (NAFLD): Is it a Dormant Volcano or Tip of an Iceberg?","authors":"Prashasti Gupta","doi":"10.4103/ijcm.ijcm_174_24","DOIUrl":"10.4103/ijcm.ijcm_174_24","url":null,"abstract":"<p><p>Non-alcoholic fatty liver disease (NAFLD), a major cause of chronic liver disease, is known to affect a quarter of the global adults. Natural history of NAFLD shows interindividual variation, traditionally it progresses from simple steatosis to steatohepatitis to fibrosis/cirrhosis and finally yet rarely to hepatocellular carcinoma. It is largely a lifestyle-related disease and is often labeled as the hepatic manifestation of metabolic syndrome. Both prevention and control of NAFLD include controlling risk factors (obesity, diabetes mellitus, hypertension and dyslipidemia), through lifestyle modification and medications. Drug therapy for NAFLD <i>per se</i> is still evolving and till date, no drugs are approved. It is clinically silent, especially in the early stages, and is a diagnosis of exclusion. Certain easily calculated indices can stratify cases into high or low risk for advanced fibrosis, thereby dictating appropriate monitoring and treatment measures. In addition to complications specific to liver disease in those who do progress to advanced fibrosis or cirrhosis, an increased risk of nonliver disease-related morbidity and mortality is also present. Challenges are manifold and include rising burden due to ever-growing epidemic of diabetes and obesity, low public awareness, fragmented healthcare, no approved drugs, and dearth of data on magnitude and epidemiology of the disease. The recent integration of NAFLD into the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS) by the Ministry of Health and Family Welfare of India is a welcome step in this direction as the contributory factors are mostly the same for all diseases and controlling any one or all of them will have a desired impact on the prevalence of all the diseases under this program.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"780-785"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819811","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":"Physical Inactivity and its Sociodemographic Determinants among Adults: A Community-Based Study.","authors":"Jalaluddin, Tabassum Nawab, Najam Khalique, Anees Ahmad","doi":"10.4103/ijcm.ijcm_130_23","DOIUrl":"10.4103/ijcm.ijcm_130_23","url":null,"abstract":"<p><strong>Introduction: </strong>Physical inactivity (PI) is the fourth leading risk factor for global mortality and is potentially modifiable. Understanding its sociodemographic correlates can contribute in planning preventive measures to reduce the same.</p><p><strong>Aims and objectives: </strong>1) To estimate the prevalence of PI among adults aged 20-60 years and 2) to identify the sociodemographic determinants of PI among adults.</p><p><strong>Material and methods: </strong>A community-based cross-sectional study was done in district Aligarh, Uttar Pradesh. 304 adults aged 20-60 years, giving informed consent were selected by simple random sampling. Pregnant women and those with febrile disease and physical defect were excluded. Predesigned structured proforma and Global Physical Activity Questionnaire were used. Chi-square test and logistic regression analysis were applied using IBM SPSS 23.0.</p><p><strong>Results: </strong>Prevalence of PI was 47.7% (95% CI: 42.0-52.6). It was significantly higher in urban (55.3% vs 41.1%) than in rural area and among females than in males (68.7% vs 34.9%). PI during work was 74.3%, during travel 78.9%, and during recreation 88.5%. Being female increased odds of PI by almost ten times (adjusted odds atio (AOR) =9.7, 95% CI: 1.6-58.5). Unskilled workers/laborers and farmers (those involved in active occupational work) were found to have lesser odds of PI (AOR = 0.2, 95% CI: 0.1-0.5 and AOR = 0.2, 95% CI: 0.01-0.6, respectively).</p><p><strong>Conclusion: </strong>PI is highly prevalent among adults. Targeted interventions to increase physical activity in recreational domain are recommended, specially in urban areas and among women. Further studies to explore barriers to physical activity are needed to address this problem.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"849-854"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819812","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":"Public-Private Partnership Model in Delivering Quality Health Care and Medical Education - An Enduring Success Story for the Past Seven Decades.","authors":"Bhaskaran Unnikrishnan, Gurpur Guni Laxman Prabhu, Potti Laxminarayana Gangadhara Rao, Nithin Kumar","doi":"10.4103/ijcm.ijcm_430_24","DOIUrl":"10.4103/ijcm.ijcm_430_24","url":null,"abstract":"<p><p>Public-private partnerships (PPPs) are integral to the National Health Mission (NHM). Kasturba Medical College (KMC), Mangalore, was the first private institution in India to embrace the PPP model way back in 1953. The then Government of Madras permitted KMC Mangalore to partner with the 2 district hospitals - the Government Wenlock and the Lady Goschen Hospitals. For almost seven decades, KMC Mangalore has been using the clinical facilities at District Wenlock and Lady Goschen hospitals to provide quality health care and also train the Undergraduate and Postgraduate students of KMC. The Manipal experiment is a shining example of public-private collaboration to provide quality accessible health care to everyone, which is in line with the Sustainable Development Goal (SDG) 3 and its targets.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"786-790"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819814","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":"COPD Unveiled: Insights from Dwellers along a Busy Highway in Kattankulathur Block.","authors":"Mvm Pradeep, M Logaraj, K Bincy","doi":"10.4103/ijcm.ijcm_981_22","DOIUrl":"10.4103/ijcm.ijcm_981_22","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a serious lung condition that imposes a significant financial burden on individuals and society, straining the medical system. According to the World Health Organization, it was the third leading cause of death worldwide in 2020. In India, it ranks as the second leading cause of death, and in Tamil Nadu, it is the tenth. The Global Burden of Disease study in 2018 found that COPD accounted for 50% of all cases and 69% of disability. Outdoor air pollution plays a major role in India's burden of chronic respiratory diseases. Early diagnosis and intervention can help to alleviate symptoms, prevent complications, and reduce morbidity and mortality, ultimately improving quality of life.</p><p><strong>Objectives: </strong>(1) To estimate the prevalence of COPD among the study population (2) To assess the risk factors associated with COPD among the study population.</p><p><strong>Methodology: </strong>A community-based cross-sectional study was conducted among adults along the roadside dwelling of a National Highway. Using a multi-stage random sampling technique 403 elderly was selected. Participants were interviewed by a pre-tested structured questionnaire followed by spirometry (pulmonary function test) evaluation. Data entry was performed in an Excel sheet and analyzed using SPSS. The odds ratio and Chi-square test were performed to determine the association between qualitative variables.</p><p><strong>Results: </strong>Among 403 study population 58% were male and 42% were female. The prevalence of COPD was found to be 22%, it was 11.1% among males and 10.9% among females. It is evident that individuals, who had exposure to risk factors such as cigarette smoking 78%, overcrowding 35.8%, lack of cross ventilation 10.9%, and living near a highway within 50 m of distance 36.2% are at more risk for developing COPD.</p><p><strong>Conclusion: </strong>Study revealed that people living in closer proximity with roadways increases the risk of COPD.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"831-836"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819764","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":"Intimate Partner Violence and Mental Health Problems in Married Women in Rural Central India: A Community-based Cross-sectional Study.","authors":"Harshal S Sathe, Chetna H Maliye, Poonam S Varma, Bishan S Garg, Kalyani Shahare, Roshan Rathod","doi":"10.4103/ijcm.ijcm_677_22","DOIUrl":"10.4103/ijcm.ijcm_677_22","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is a significant social issue affecting women in rural India, with deleterious consequences for their physical and mental health. The \"mental health problems and psychosocial factors associated with IPV\" is an under-researched topic in Central India. The cross-sectional observational descriptive study was part of a project aimed at strengthening the health sector response to gender-based violence. Eighty consenting women from 19 villages in a district in Central India, who acknowledged experiencing IPV, participated in the study. A predesigned and pretested sociodemographic questionnaire, the WHO multicountry women's questionnaire, and self-report scales for depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were used to interview the women. The mean age of the respondents was 31.13 ± 6.96 years. The majority of the women (95%) experienced severe physical violence. In addition, a majority of these women simultaneously faced emotional abuse, whereas more than one-third suffered from sexual abuse from their partners. Self-reporting measures showed that nearly two-thirds of the participants had PTSD and moderate-to-severe depression and anxiety. A substantial number of study participants believed that IPV is a private matter for a couple and justified violence if the wife was unfaithful, disobedient, or neglectful of children and household duties. The under-reporting of IPV, presence of misconceptions, and high prevalence of associated mental health problems among IPV-affected women highlight the need for interventions tailored to the needs of battered women.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"866-872"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819809","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":"Determination of Direct and Indirect Costs Incurred by Tuberculosis Patients During Diagnosis and Treatment in Urban Areas of South Gujarat: A Mixed Method Approach.","authors":"Rutu Buch, Rahul Damor, J K Kosambiya","doi":"10.4103/ijcm.ijcm_711_22","DOIUrl":"10.4103/ijcm.ijcm_711_22","url":null,"abstract":"<p><p>Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"873-878"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819805","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 and Predictors of Depression Among Drug-Sensitive Tuberculosis Patients - A Cross-Sectional Study.","authors":"Deepak Sharma, Naveen K Goel, Ajeet Sidana, Kawaljeet S Sandha, Mamta Bishnoi","doi":"10.4103/ijcm.ijcm_167_23","DOIUrl":"10.4103/ijcm.ijcm_167_23","url":null,"abstract":"<p><strong>Background: </strong>According to World Health Organization, India is a high tuberculosis (TB) and depression burden state. The risk of depression is higher among TB patients. Therefore, it is vital to focus on the mental well-being of TB patients.</p><p><strong>Objective: </strong>The present study aimed to determine the prevalence and predictors of depression among drug-sensitive TB patients in Chandigarh city.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 305 TB patients. Trained investigators administered Patient Health Questionnaire 9 to screen for depression. Data analysis was done using Epi info software for windows.</p><p><strong>Results: </strong>The prevalence rate of depression among drug-sensitive TB patients was 7.2%. Current nonworking individuals were more likely to be depressed than their counterparts (OR = 3.7 (1.2-10.9)).</p><p><strong>Conclusion: </strong>Around one-tenth of the TB patients were suffering from depression. This necessitates physicians to regularly screen TB patients for depression and manage accordingly, which will help improve treatment adherence and outcome.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"879-882"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819813","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":"Telemedicine-Enabled Otoscopes as Catalysts for Accessible and Preventive Ear Health Care: Systematic Review and Meta-analysis.","authors":"Girish Chandra Dash, Krushna Chandra Sahoo, Shubhankar Dubey, Rakesh Kumar Sahoo, Jyotsna Naik, Kavitha Rajsekar, Debdutta Bhattacharya, Sanghamitra Pati","doi":"10.4103/ijcm.ijcm_9_24","DOIUrl":"10.4103/ijcm.ijcm_9_24","url":null,"abstract":"<p><strong>Background: </strong>Maintaining optimal hearing health and preventing ear infections is crucial across all life stages, spanning from before birth and infancy to middle age and beyond. The primary aim of the research was to evaluate and compare the effectiveness of the telemedicine-enabled otoscope (TEO) in diagnosing ear diseases with that of the conventional otoscope.</p><p><strong>Materials and methods: </strong>The databases PubMed, Cochrane, and Embase were thoroughly searched to find original studies on TEO at the community as well as hospital levels along with meta-analysis for comparison with standard diagnostic methods using traditional otoscopes.</p><p><strong>Results: </strong>The telemedicine-equipped otoscope displays a sensitivity of 82% (confidence interval 0.78-0.95) and a specificity of 95% (confidence interval 0.93-0.96). When employed by physicians, the combined sensitivity and specificity become 84% (confidence interval 0.79-0.88) and 91% (confidence interval 0.87-0.94), respectively. Community Health Workers (CHWs) using telemedicine-enabled otoscopes exhibit a collective sensitivity of 80% (confidence interval 0.72-0.87) and a collective specificity of 97% (confidence interval 0.95-0.98). Snapping multiple photographs and removal of cerumen where necessary in increasing the quality of the photographs for diagnosis.</p><p><strong>Conclusions: </strong>The TEO holds the promise of substantially enhancing the accessibility of audiology services, encompassing evaluation, public outreach, and fundamental care. Its implementation has the potential to fortify primary health care environments, contributing to the prevention of ear diseases and assisting in mitigating the shortage of skilled ear care professionals.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"796-804"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819382","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":"Verification of Sub-national Claim for 'TB-free' Status of Rajsamand District, Rajasthan, India-2020.","authors":"Kalika Gupta, Mitin Parmar, Kush Davda, Shivangi Davda, Pooja Soni, Ashok K Bhardwaj, Bhavesh Modi, Rajendra Awate","doi":"10.4103/ijcm.ijcm_35_23","DOIUrl":"10.4103/ijcm.ijcm_35_23","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) caused by Mycobacterium tuberculosis is an opportunistic infection that affects the lungs in humans. Caseload of TB has been deemed it endemic in various regions of the world and India is on top of that list. The Government of India has set out a goal to eliminate tuberculosis in India by the year 2025 with the help of the National Strategic Plan (NSP) 2017-25. The objective of the index study was to verify the claim of Rajsamand district in Rajasthan, that it witnessed a >20% reduction in TB incidence between 2015 and 2020.</p><p><strong>Methodology: </strong>This was a mixed-methods study. Quantitative component (cross-sectional study): Secondary data review (review of records from Nikshay notification systems and National tuberculosis elimination program (NTEP) reports, utilization of drugs in the public sector, and drug sales in the private sector). Primary data collection through survey. Qualitative component: nominal group technique and key informant interviews.</p><p><strong>Result: </strong>Percentage decline of a ≥ 20% incidence in 2020 compared to baseline 2015 was not seen. The number needed to test (increased by 18.26% in 2020 as compared to the baseline of 2015. TB Score of Rajsamand district for the year 2020 was 68.34 out of 100.</p><p><strong>Conclusion: </strong>Rajsamand district's claim of ≥20% reduction in TB incidence in the year 2020, was rejected.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"855-860"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819396","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":"To Evaluate Structured Competency-Based Curriculum for Health Programs among Community Medicine Postgraduates: Mixed Method Approach.","authors":"Rashmi Kundapur, Anusha Rashmi, Kumar Guru Mishra, Gunvanti Rathod, Meely Panda, Vikas Bhatia, Shyamala Ravikoti","doi":"10.4103/ijcm.ijcm_66_22","DOIUrl":"10.4103/ijcm.ijcm_66_22","url":null,"abstract":"<p><strong>Background: </strong>The postgraduate curriculum needs to be given a definite shape so as to make health programs more intensive and integrative. In the present scenario, most of the information is unclear and infrequent. A structured public health competency-based education is an important aspect to consider for integrative health care. Evaluate the structured competency-based curriculum (SCBC) prepared on health program matters<i>.</i></p><p><strong>Methods: </strong>Mixed method model involving postgraduate students, faculties in community medicine departments of selected medical colleges and stakeholders from district administration. The SCBC was piloted and validated for use. The evaluation was then done based on pre- and posttest performance analysis, satisfaction survey, and questionnaires for reaction and learning components.</p><p><strong>Results: </strong>For a complete understanding of the program, students had to invest 52 hours of stipulated time. CBC assessment mean scores for a) problems in PHC and programmatic evaluation (78.9%) and b) identification of success and failure of programs (78.2%) were more than 75% mean score; whereas, assessment scores for topics on a) resource allocation and b) evaluation of program as write-up was 65% and 52%, respectively. As compared to the conventional method, the SCBC showed a critical evaluation score of 70% with a 0.001 significance level.</p><p><strong>Discussion and conclusion: </strong>Students' narratives were that they could understand as well as integrate them better on the field. There was enhanced satisfaction and encouragement. Structured curriculum will also help in making learning more student-centric and go a long way in boosting their creativity.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"812-817"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819393","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}