Therapeutic Advances in Infectious Disease最新文献

{"title":"Therapeutic advances in neuroinfectious diseases.","authors":"Rumyar Ardakani, Lucy Jia, Elizabeth Matthews, Kiran T Thakur","doi":"10.1177/20499361241274246","DOIUrl":"10.1177/20499361241274246","url":null,"abstract":"<p><p>There have been several major advances in therapeutic options for the treatment of neurological infections over the past two decades. These advances encompass both the development of new antimicrobial therapies and the repurposing of existing agents for new indications. In addition, advances in our understanding of the host immune response have allowed for the development of new immunomodulatory strategies in the treatment of neurological infections. This review focuses on the key advances in the treatment of neurological infections, including viral, bacterial, fungal, and prion diseases, with a particular focus on immunomodulatory treatment options. This review also highlights the process by which clinicians can request access to therapeutic agents on a compassionate or emergency basis when they may not be commercially available. While many therapeutic advances have been achieved in the past several years, there remains a pressing need for the continued development of additional therapeutic agents in the treatment of neurological infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241274246"},"PeriodicalIF":3.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308749","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 health trends in neurologically relevant infections: a global perspective.","authors":"Jackson A Roberts, Ronak K Kapadia, Daniel M Pastula, Kiran T Thakur","doi":"10.1177/20499361241274206","DOIUrl":"https://doi.org/10.1177/20499361241274206","url":null,"abstract":"<p><p>Neuroinfectious diseases represent a growing threat to public health globally. Infections of the central nervous system remain challenging to diagnose and treat, partially driven by the fact that a high proportion of emerging pathogens are capable of causing neurological disease. Many of the trends driving the emergence of novel pathogens, including climate change, ecological degradation, urbanization, and global travel, have accelerated in recent years. These circumstances raise concern for the potential emergence of additional pathogens of pandemic potential in the coming years, necessitating a stronger understanding of the forces that give rise to the emergence and spread of neuroinvasive pathogens and a commitment to public health infrastructure to identify and treat these diseases. In this review, we discuss the clinical and epidemiological features of three types of emerging neuroinvasive pathogens of significant public health consequences that are emblematic of key ongoing trends in global health. We first discuss dengue viruses in the context of climate change, considering the environmental factors that allow for the expansion of the geographic range and seasonal population of the viruses' vector. We then review the rising prevalence of fungal meningitis secondary to medical tourism, a trend representative of the highly globalized nature of modern healthcare. Lastly, we discuss the increasing prevalence of antibiotic-resistant neurological infections driven by the intersection of antibiotic overuse in medical and agricultural settings. Taken together, the rising prevalence of these conditions necessitates a recommitment to investment in public health infrastructure focused on local and global infectious disease surveillance coupled with ongoing development of novel therapeutics and vaccines for emerging pathogens. Such emerging threats also obviate the need to address the root causes driving the emergence of novel infectious diseases, including a sustained effort to address anthropogenic climate change and environmental degradation.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241274206"},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298259","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":"Clinical and diagnostic features of central nervous system tuberculosis in Indian children - a descriptive study.","authors":"Bella Devaleenal Daniel, Elilarasi Selladurai, Sarath Balaji, Arunagirinathan Venkatesan, Mythily Venkatesan, Prathiksha Giridharan, Sivakumar Shanmugam, Saravanan Natrajan, Ramesh Karunaianantham, Devika Kandasamy, Rajakumar Subramani, Kannan Muthuramalingam, Snegha K Pramila, Syed Hissar, Kelly E Dooley, Kiran T Thakur","doi":"10.1177/20499361241274251","DOIUrl":"https://doi.org/10.1177/20499361241274251","url":null,"abstract":"<p><strong>Background: </strong>Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features.</p><p><strong>Objective: </strong>To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma).</p><p><strong>Design: </strong>Retrospective descriptive study.</p><p><strong>Methods: </strong>Children less than 12 years presenting with neurological signs and symptoms were assessed for a therapeutic TBM trial eligibility. The results of their clinical, laboratory, neuroimaging, cerebrospinal fluid evaluations were analysed for TBM diagnosis.</p><p><strong>Results: </strong>Of 600 children evaluated, 61(10%) had CNS tuberculosis; TBM 47, tuberculoma 14. 20(33%) had definite TBM. Mean age of children with TBM was 5 ± 3.4 years. Of 47, 13(28%), 21(45%) and 13(28%) had grade I, II, and III disease respectively. Abnormalities suggestive of TBM in MRI and computed tomography brain were observed in 76% (26/34) and 77% (24/31) respectively. Abnormal cerebrospinal fluid white blood cell count, protein and glucose were observed in 56% (24/43), 49% (22/45), 47% (21/45) respectively. Among 41 patients with TBM followed up until discharge, five died.</p><p><strong>Conclusion: </strong>Younger children with TBM have severe forms. Confirmatory results may not be available in all. A holistic approach to care including addressing complications of hydrocephalus and strokes is needed.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241274251"},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298257","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 factors associated with hyperglycemia among persons living with HIV/AIDS on dolutegravir-based antiretroviral therapy in Uganda.","authors":"Lillian Happy Byereta, Ronald Olum, Edrisa Ibrahim Mutebi, Robert Kalyesubula, Majid Kagimu, David B Meya, Irene Andia-Biraro","doi":"10.1177/20499361241272630","DOIUrl":"https://doi.org/10.1177/20499361241272630","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir-based (DTG) regimens are rapidly becoming the preferred first-line antiretroviral therapy (ART) for people living with HIV (PLHIV) in low and middle-income countries. However, there are rising concerns over the development of hyperglycemia and, in some cases, diabetes mellitus in patients switched to DTG.</p><p><strong>Objectives: </strong>To determine the prevalence and factors associated with hyperglycemia among PLHIV receiving DTG-based ART at Kiruddu National Referral Hospital (KNRH), Uganda.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>The study was conducted in the inpatient wards and the infectious disease outpatient clinic of KNRH from May to July 2022. Participants aged ⩾18 years on a DTG-based ART regimen for at least 3 months were consecutively enrolled and interviewed using a research assistant administered questionnaire for sociodemographic and clinical characteristics. HbA1c was measured using whole blood Architect Ci4100^® (Abbott, Illinois, USA), with hyperglycemia defined using a cut-off of ⩾5.7% as per the Uganda Diabetes Association guidelines. Factors associated with hyperglycemia were examined through logistic regression, adjusting for pertinent confounders, in STATA 17. A significance level was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 398 PLHIV with a median age of 40.5 years (IQR: 32-49) were enrolled. More than half were females (58.3%, <i>n</i> = 232) and the majority (90%) had a CD4 count above 200 cells/µL. About 16% had a family history of diabetes, 11.73% (<i>n</i> = 46) showed elevated blood pressure levels, and 16.7% (<i>n</i> = 64) had obesity. Hyperglycemia was present in 12.8% (<i>n</i> = 51), with 10.3% having pre-diabetes (<i>n</i> = 41) and 2.5% with diabetes mellitus (<i>n</i> = 10). At bivariate analysis, hyperglycemia was significantly associated with age >40 years (<i>p</i> < 0.001), herbal medicine use (<i>p</i> = 0.03), being widowed (<i>p</i> < 0.001), obesity (<i>p</i> = 0.042), hypertension (<i>p</i> = 0.002) and >3 since diagnosis with HIV (<i>p</i> = 0.030). At multivariable regression, only age >40 (AOR 2.55, 95% CI: 1.05-6.23, <i>p</i> = 0.039) and hypertension (AOR 2.93, 95% CI: 1.07-8.02, <i>p</i> = 0.036) remained significantly associated with hyperglycemia.</p><p><strong>Conclusion: </strong>More than 1 in 10 patients on DTG-based ART in our study had hyperglycemia. We recommend regular monitoring of plasma glucose, especially for patients >40 years old and those with other comorbidities, before starting/switching to DTG regimens. Longitudinal studies are recommended to determine the underlying mechanisms of hyperglycemia in this population.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241272630"},"PeriodicalIF":3.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298258","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":"Spectrum of bacterial pathogens in inflammatory and noninflammatory cutaneous ulcers of American tegumentary leishmaniasis.","authors":"Ruwandi Kariyawasam, Bryan Gascon, Priyanka Challa, Jordan Mah, Rachel Lau, Braulio M Valencia, Alejandro Llanos-Cuentas, Andrea K Boggild","doi":"10.1177/20499361241274200","DOIUrl":"https://doi.org/10.1177/20499361241274200","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis (CL) ulcers exhibiting an inflammatory phenotype, characterized by purulent exudate, erythema, pain, and/or lymphatic involvement, are empirically treated with antibiotics.</p><p><strong>Objective: </strong>The spectrum of bacteria present in localized versus inflammatory phenotypes of CL is elucidated herein.</p><p><strong>Methods: </strong>Filter paper lesion impressions (FPLIs) from 39 patients with CL (19 inflammatory and 20 noninflammatory ulcers) were evaluated via real-time polymerase chain reaction (qPCR) and end-point PCR targeting: <i>Staphylococcus aureus</i>, <i>Enterobacter cloacae</i>, <i>Streptococcus pyogenes</i>, <i>Enterococcus</i> spp., <i>Citrobacter freundii</i>, <i>Escherichia coli</i>, <i>Pseudomonas aeruginosa</i>, <i>Klebsiella pneumoniae</i>, and 16S rDNA. Whole genome sequencing (WGS) was performed on six specimens.</p><p><strong>Results: </strong>In total, 30/39 (77%) patients' ulcers had ⩾1 bacterium detected, which included the following species: <i>S. aureus</i> (<i>n</i> = 16, 41%), <i>C. freundii</i> (<i>n</i> = 13, 33%), <i>P. aeruginosa</i> (<i>n</i> = 12, 31%), <i>E. cloacae</i> (<i>n</i> = 12, 31%), <i>K. pneumoniae</i> (<i>n</i> = 11, 28%), <i>Enterococcus</i> spp. (<i>n</i> = 7, 18%), <i>E. coli</i> (<i>n</i> = 6, 15%), and <i>S. pyogenes</i> (<i>n</i> = 4, 10). Prevalence of bacterial species did not differ by CL phenotype (<i>p</i> = 0.63). However, patients with inflammatory phenotypes were, on average, over a decade older than patients with noninflammatory phenotypes (42 years vs 27 years) (<i>p</i> = 0.01). The inflammatory phenotype was more prevalent among ulcers of <i>Leishmania Viannia braziliensis</i> (58%) and <i>L. V. panamensis</i> (83%) compared to those of <i>L. V. guyanensis</i> (20%) (<i>p</i> = 0.0369).</p><p><strong>Conclusion: </strong>The distribution of flora did not differ between inflammatory and noninflammatory CL phenotypes. Further prospective analysis, including additional WGS studies of all CL ulcers for nonbacterial organisms, is necessary to determine the role of empiric antibiotic therapy in inflammatory and purulent CL.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241274200"},"PeriodicalIF":3.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298260","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 Second International Collaborative Mycology Conference: evidence-informed fight against fungal diseases in Pakistan.","authors":"Joveria Farooqi, Felix Bongomin, Rumina Hasan, Nosheen Nasir, Muhammad Irfan, Syed Faisal Mahmood, Afia Zafar, Fatima Mir, Summiya Nizamuddin, Kauser Jabeen","doi":"10.1177/20499361241272510","DOIUrl":"10.1177/20499361241272510","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241272510"},"PeriodicalIF":3.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156301","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":"Acute drug-use-related native tricuspid valve infective endocarditis: a non-surgical disease.","authors":"Sami El-Dalati, Talal Alnabelsi, John Gurley, Kelli Cremeans, Hassan Reda, Tessa London-Bounds, Erinn Ogburn, Michael Sekela","doi":"10.1177/20499361241267124","DOIUrl":"10.1177/20499361241267124","url":null,"abstract":"<p><p>As a result of the ongoing opioid epidemic, physicians have encountered increasing rates of drug-use-related native tricuspid valve infective endocarditis (DU-TVIE), a complex multi-faceted disease that is best managed by interdisciplinary teams. Despite the large number of patients with DU-TVIE, there is little data to support the optimal treatment strategy with respect to medical and surgical therapy. The recent introduction of percutaneous mechanical aspiration of tricuspid valve vegetations has added another treatment modality that is also of uncertain benefit. Here we review the literature on the management of DU-TVIE and highlight the multi-step treatment approach developed by the multidisciplinary endocarditis team at the University of Kentucky.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241267124"},"PeriodicalIF":3.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11311191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917739","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 factors for treatment non-completion among patients with syphilis.","authors":"Abigail Clarkson-During, Ellen Almirol, Dylan Eller, Aniruddha Hazra, Kimberly A Stanford","doi":"10.1177/20499361241265941","DOIUrl":"10.1177/20499361241265941","url":null,"abstract":"<p><strong>Background: </strong>With recent increases in syphilis, there is growing interest in expanding screening; however, treatment rates have historically been low.</p><p><strong>Objectives: </strong>This study examines demographic and clinical factors that may contribute to non-completion of syphilis treatment.</p><p><strong>Design: </strong>This is a retrospective comparative cohort study of all patients with syphilis from January through November 2018 at an urban, tertiary care hospital.</p><p><strong>Methods: </strong>Demographics and clinical information were extracted from the electronic medical record. Descriptive statistics and odds ratios (ORs) were calculated.</p><p><strong>Results: </strong>Of 171 patients with syphilis, 89 (52.0%) completed treatment. Patients ages 40-49 were least likely to complete treatment (OR 0.14; 95% CI 0.03-0.72, <i>p</i> = 0.02) compared to those ages 18-24. Non-heterosexual patients were significantly more likely to complete treatment (OR 3.60; 95% CI 1.13-11.49, <i>p</i> = 0.03) compared to heterosexual patients. Patients diagnosed in the emergency department completed treatment at the lowest rate.</p><p><strong>Conclusion: </strong>A major gap in syphilis treatment still exists, which must be addressed to achieve optimal impact from syphilis screening programs.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241265941"},"PeriodicalIF":3.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876262","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":"Barriers and facilitators to pre-exposure prophylaxis uptake among Black/African American men who have sex with other men in Iowa: COM-B model analysis.","authors":"Oluwafemi Adeagbo","doi":"10.1177/20499361241267151","DOIUrl":"10.1177/20499361241267151","url":null,"abstract":"<p><strong>Background: </strong>In Iowa, men who have sex with men (MSM) accounted for 54% of persons with HIV in 2022 and Non-Hispanic Black/African Americans were over 10 times more likely to be diagnosed with HIV than Non-Hispanic white Iowans. To address this disparity in HIV incidence and prevalence, the United States (US) government ending the HIV epidemic (EHE) initiative seeks to expand pre-exposure prophylaxis (PrEP) coverage across the United States. Recent data showed that PrEP coverage is suboptimal in Iowa (a rural state), and Black Iowans were less likely to engage with PrEP services.</p><p><strong>Objectives: </strong>Using capability, opportunity, motivation and behavior (COM-B) model for behavior change, this study sought to identify the key barriers and facilitators to PrEP uptake among Black/African American MSM in small urban areas in Iowa.</p><p><strong>Design: </strong>This was a phenomenological study aimed to explore subjective views of Black MSM on PrEP use.</p><p><strong>Methods: </strong>In-depth semistructured interviews were conducted with 12 Black MSM aged 20-42 years in two small urban counties. Broad themes identified from the interview transcripts were analyzed inductively and mapped onto the COM-B constructs deductively.</p><p><strong>Results: </strong>Results showed that barriers to PrEP uptake were closely associated with five (of six) COM-B subcomponents: physical capability, psychological capability, social opportunity, reflective motivation, and automatic motivation. The thematized barriers were (1) lack of medical insurance; (2) limited PrEP awareness; (3) PrEP stigma; (4) fear of distrust among partners; (5) anticipated side effects; and (6) doubt about PrEP effectiveness. Similarly, facilitators to PrEP uptake were aligned with four subcomponents of COM-B model: physical capability, psychological capability, social opportunity, and physical opportunity. The thematized facilitators were (1) increased PrEP awareness; (2) PrEP access without discrimination; (3) state provision of PrEP to uninsured; and (4) physicians buy-in and recommendation. No motivation-related facilitators were reported.</p><p><strong>Conclusion: </strong>To reduce the current disparity in HIV incidence and to achieve the EHE goals of expanding PrEP coverage in Iowa, efforts should be directed toward the provision of low-cost or free PrEP services, healthcare providers' training on cultural competence, and the development of culturally appropriate strategies to deliver PrEP to the Black MSM community.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241267151"},"PeriodicalIF":3.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789443","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":"Alert and surveillance on H5N1 influenza virus: risks to agriculture and public health.","authors":"Vasso Apostolopoulos, Vivek P Chavda, Rachana Mehta, Alfonso J Rodriguez-Morales, Andrés F Henao-MartÍnez, Ranjit Sah","doi":"10.1177/20499361241266521","DOIUrl":"10.1177/20499361241266521","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241266521"},"PeriodicalIF":3.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789442","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}