British Journal of Pain最新文献

{"title":"Assessing the feasibility of the GOTT (Gabapentinoid and Opioid Tapering Toolkit) in a primary care setting in North-East England.","authors":"Lucy Johnson, Frances Cole, Rebecca Kinchin, Andrea Francis, Konrad Winiarek, Kate Hampshire, Paul Chazot","doi":"10.1177/20494637241291534","DOIUrl":"10.1177/20494637241291534","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and possible impacts of implementation of systematic non-pharmacological interventions to reduce the level of prescribing of opioid and gabapentinoid analgesics for chronic non-cancer pain (CNCP), particularly high-dose prescriptions, through a proof-of-concept study in a deprived area (second lowest decile) primary care practice in North-East England.</p><p><strong>Participant: </strong>Twenty-five primary care staff (clinical and non-clinical) of which 18 clinicians received the intervention.</p><p><strong>Intervention used in this study practice known as gott gabapentinoid and opioid toolkit: </strong>All clinicians received an educational skills programme to support patient pain self-management, tailored on the clinicians' self-assessment of their learning needs, embedding both clinician skill learning and patient self-care resources for rapid access within consultations into a GP clinical management computer system.</p><p><strong>Outcome measures: </strong>Clinical staff completed questionnaires before and after the GOTT intervention to assess levels of knowledge and confidence in their own skills to support chronic pain self-management across several domains. Prescription data were used to measure changes in opioid and gabapentinoid prescribing at the practice across the 12-month intervention and 30-month follow-up period.</p><p><strong>Results: </strong>Prescribing of opioid and gabapentinoid/pregabalin decreased substantially in the practice across the intervention period (c. 90% in high-dose opioid [<i>p</i> = .0118], and 15% gabapentin/pregabalin prescriptions, respectively), over a one-year period during the COVID-19 pandemic. Follow-up analysis showed 100% and c.50% reductions, respectively, in December 2022. The questionnaire data showed an increase in clinician confidence in skills to enable self-management over the intervention period, overall (<i>p</i> = .044) and, specifically across three of the five domains measured: supporting behavioural change (<i>p</i> = .028), supporting self-care (<i>p</i> = .008), and managing difficult consultations (<i>p</i> = .011).</p><p><strong>Conclusion: </strong>The GOTT intervention program provided some initial evidence of a proof-of-concept for the implementation of a systematic non-pharmacological pain management skills and resources programme addressing lack of confidence in skills to introduce and support self-management and reduce use of strong opioids and gabapentinoids.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"29-42"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629722","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":"Chronic pain as a long-term burden for veterans.","authors":"Jan Vollert, Nadia Soliman","doi":"10.1177/20494637251313896","DOIUrl":"10.1177/20494637251313896","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"19 1","pages":"4-5"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383736","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":"Social prescribing for adults with chronic pain in the U.K.: a rapid review.","authors":"Gerlinde Pilkington, Mark I Johnson, Kate Thompson","doi":"10.1177/20494637241312064","DOIUrl":"10.1177/20494637241312064","url":null,"abstract":"<p><strong>Introduction: </strong>Social prescribing links patients to community groups and services to meet health needs; however, it is uncertain what the benefits and impacts of social prescribing are for people with chronic pain. The National Institute for Health and Care Excellence (NICE) undertook a systematic review to investigate the clinical and cost effectiveness of social interventions aimed at improving the quality of life of people with chronic pain; no relevant clinical studies comparing social interventions with standard care for chronic pain were found, though the inclusion criteria for studies was narrow.</p><p><strong>Objectives: </strong>To undertake a rapid review of all types of research and policy on social prescribing for adults with chronic pain in the U.K. (i) to describe the characteristics of relevant research and (ii) to synthesise data on impact.</p><p><strong>Methods: </strong>A two-stage rapid review was planned. Stage (i) scoped and categorised knowledge from a comprehensive representation of the literature. In stage (ii), we undertook a descriptive synthesis of quantitative data along with a thematic analysis of qualitative data identified by stage (i).</p><p><strong>Results: </strong>Of 40 full-text records assessed for inclusion, three met the inclusion criteria from academic databases. An additional five records were found in grey literature. Six records reported quantitative findings suggesting that social prescribing reduced pain severity and discomfort, pain medication and clinical appointments; and improved quality of life and ability to manage health. Five records captured qualitative data from interviews, case studies and anecdotal quotes that suggested positive impact on health and wellbeing; and increased self-efficacy in social prescribers undertaking training on pain.</p><p><strong>Conclusions: </strong>There is tentative evidence that social prescribing improves health and wellbeing outcomes in adults with chronic pain and that there is a need to upskill social prescribers in contemporary pain science education. Research on the routes to referral, outcomes and impacts is needed.</p><p><strong>Perspective: </strong>Social prescribing is valued and may be of benefit for people with chronic pain. There is a need to further develop and evaluate social prescribing services for people with chronic pain to enhance holistic patient centered care.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637241312064"},"PeriodicalIF":1.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029924","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":"Activating waitlists: Identifying barriers and facilitators to pain self-management while waiting.","authors":"Lydia V Tidmarsh, Richard Harrison, Harriet Wilkinson, Megan Harrington, Katherine A Finlay","doi":"10.1177/20494637241311456","DOIUrl":"https://doi.org/10.1177/20494637241311456","url":null,"abstract":"<p><strong>Objectives: </strong>Waitlists for pain management services are often extensive, risking psychological and physical decline and patient non-engagement in treatment once accessed. Currently, for outpatient pain management, no standardised waiting list interventions exist, resulting in passive waiting. To arrest prospective wait-related decline(s), this study aimed to identify the barriers and facilitators to pain self-management while waiting, forming the foundation for a waitlist intervention development.</p><p><strong>Design: </strong>An inductive qualitative approach was utilised to explore the barriers and drivers of pain self-management while waiting for chronic pain management.</p><p><strong>Method: </strong>Semi-structured interviews, underpinned by the Theoretical Domains Framework and COM-B model, were conducted with people waiting for pain management services (<i>N</i> = 38). Interviews were audio-recorded, transcribed verbatim, and analysed via reflexive thematic analysis.</p><p><strong>Results: </strong>The analysis demonstrated four thematised barriers and one facilitator: (1) Shunted Around the System <i>(barrier)</i>; (2) The Information Gap <i>(barrier)</i>; (3) Resisting Adaptation (<i>barrier</i>); (4) Losing Hope (<i>barrier);</i> and (5) Help Yourself or Lose Yourself <i>(facilitator)</i>.</p><p><strong>Conclusion: </strong>This study demonstrates the severe emotional and motivational impact of waiting, increasing treatment disengagement. The waitlist represents a prime opportunity for prehabilitation to protect wellbeing and optimise self-management engagement. Infrastructural and interpersonal barriers of poor communication and healthcare professional pain invalidation must be addressed to improve emotional wellbeing and motivation to engage with planned treatment. Enhancing self-efficacy, pain acceptance, self-compassion, and internal HLOC are fundamental to increasing pain self-management. These can all be met within a prehabilitation framework. This study is foundational for the development of psychological prehabilitation in outpatient chronic pain management.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637241311456"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956691","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":"Impact of different treatments for chronic pain on cognitive function: A systematic review.","authors":"Allan Botura Brennecke, Eduardo Silva Reis Barreto, Liliane Lins-Kusterer, Liana Maria Torres de Araujo Azi, Durval Kraychete","doi":"10.1177/20494637241311784","DOIUrl":"https://doi.org/10.1177/20494637241311784","url":null,"abstract":"<p><strong>Introduction: </strong>Experimental evidence supports the hypothesis of reciprocal influence between neural systems involved in cognition and central pain processing circuits. Furthermore, studies have demonstrated bidirectional communication between central pain processing areas and the immune system, leading to changes in behaviour, sensory perception, mood, and cognition. However, the academic community has not yet reached a consensus on whether effective analgesic interventions can mitigate or reverse cognitive deterioration.</p><p><strong>Methods: </strong>This systematic review evaluated the effectiveness of various therapeutic interventions in improving cognitive functions (primary outcome) and altering the profile of immunological markers (secondary outcome) in chronic pain patients. The review was limited to randomised controlled trials addressing chronic pain of any aetiology, with searches conducted in PubMed, EMBASE, and Scopus databases.</p><p><strong>Results: </strong>The qualitative synthesis of twelve studies conducted between 2003 and 2021, involving 1432 participants in experimental (<i>n</i> = 950) and control (<i>n</i> = 482) groups, revealed some interesting patterns. Only half of the studies (6/12) reported cognitive improvement, with attention being the most analysed cognitive domain, followed by memory and executive function. Fibromyalgia was the most studied aetiology of chronic pain. The strategies of intervention/treatment and durations varied widely; however, milnacipran versus placebo emerged as the most frequently employed intervention. Only one study reported immunological markers, limiting the evaluation of this outcome.</p><p><strong>Conclusion: </strong>Based on this analysis, it is not possible to affirm that interventions targeting chronic pain improve cognition. This review suggests new research directions and calls for more robust methodological approaches.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637241311784"},"PeriodicalIF":1.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956694","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 case series of new-onset headache and neurological issues after thoracolumbar spinal cord stimulators.","authors":"Ramkumar Kalaiyarasan, Hemkumar Pushparaj, Manohar Sharma","doi":"10.1177/20494637241310705","DOIUrl":"https://doi.org/10.1177/20494637241310705","url":null,"abstract":"<p><p>Although spinal cord stimulator (SCS) therapy is generally used safely to treat chronic neuropathic pain conditions, this document highlights the less reported complication of unusual neurological problems including headaches. These developed temporally after the initiation of SCS therapy despite initial positive response to pain. The mechanisms might include activation of trigeminal receptors and neuroplasticity after SCS. We present a series of four cases where patients developed new neurological symptoms like headaches, facial twitching, and tinnitus, that were related to SCS activation. Despite adjustments to the SCS settings and extensive evaluations, these symptoms persisted in all cases, leading to the decision to explant SCS which was otherwise helping pain.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637241310705"},"PeriodicalIF":1.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956689","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":"Global and regional trends and projections of chronic pain from 1990 to 2035: Analyses based on global burden of diseases study 2019.","authors":"Mengyi Zhu, Jiarui Zhang, Diefei Liang, Junxiong Qiu, Yuan Fu, Zhaopei Zeng, Jingjun Han, Junmeng Zheng, Liling Lin","doi":"10.1177/20494637241310697","DOIUrl":"10.1177/20494637241310697","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain poses a significant public health challenge. We present the global and regional data on Prevalence, Incidence and Years Lived with Disability (YLDs) for Chronic pain from the Global burden of disease (GBD) study 2019 data and analyze their associations with Socio-demographic index (SDI), age, and gender, and the future trends from 2020 to 2035.</p><p><strong>Methods: </strong>Regional trends in the burden of chronic pain and its association with age, gender, and SDI were assessed from 1990 to 2019. Joinpoint analysis was employed to describe trends in chronic pain burden across different SDI regions. Additionally, the Bayesian Age-Period-Cohort model (BAPC) was used for predicting future trends. Age-standardized rates (ASRs) of prevalence, incidence, and YLDs were employed to quantify the burden of chronic pain.</p><p><strong>Results: </strong>Between 1990 and 2019, a significant increase was observed in global prevalence and YLDs rates of chronic pain. Higher rates were found among females, whereas a faster rise was noted among males. Notably, Low Back Pain (LBP) and Migraine accounted for predominant YLDs globally, particularly among those aged 75 and above. A notable prevalence of Tension-type Headache (TTH) was observed among younger populations. Furthermore, ASRs for chronic pain were highest in high-SDI regions. Projections suggest an increase in headache ASRs globally for both genders from 2020 to 2035.</p><p><strong>Conclusion: </strong>From 1990 to 2019, the global burden of chronic pain increased significantly, with projections indicating a continued rise in headache burden over the next 15 years, underscoring the need for heightened attention to these issues.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637241310697"},"PeriodicalIF":1.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899052","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":"Differences in the relationship between pain and anxiety in total knee and hip arthroplasty: a longitudinal cross-lagged analysis mediated by depression and pain catastrophizing.","authors":"Ana Cristina Paredes, Patrício Costa, Márcia Costa, Patrícia Oliveira, Pedro Varanda, Armando Almeida, Patrícia R Pinto","doi":"10.1177/20494637241273905","DOIUrl":"10.1177/20494637241273905","url":null,"abstract":"<p><p>Acute postsurgical pain (APSP) is an important risk factor for pain chronification, with reports of being more intense after total knee arthroplasty (TKA) than after total hip arthroplasty (THA). Psychological variables have been associated with differences in postsurgical pain experience. This study aimed to analyse the longitudinal reciprocal association between pain and anxiety levels in patients undergoing TKA or THA, to investigate the moderator role of the type of surgery and to explore psychological mediators in the anxiety - pain association. Patients undergoing TKA (<i>n</i> = 120) or THA (<i>n</i> = 109) were evaluated before surgery and in the acute postsurgical period (48 h postsurgery). Presurgical assessment comprised sociodemographic, pain-related and psychological variables (anxiety, depression, pain catastrophizing, self-efficacy, optimism and satisfaction with life). Postsurgical assessment focused on pain frequency, pain intensity and anxiety. Longitudinal associations were explored using cross-lagged panel models that included the indirect effect paths through possible mediators (pain catastrophizing and depression). Multigroup analyses compared TKA and THA. In the global sample, higher APSP was predicted by higher presurgical pain and worse presurgical anxiety. Multigroup analyses revealed that worse APSP was predicted by higher presurgical anxiety in patients undergoing TKA and by higher presurgical pain in patients undergoing THA. Furthermore, there was a positive significant indirect effect of pain catastrophizing, but not depressive symptoms, in the relationship between presurgical anxiety and APSP in THA. Anxiety and APSP are differently interrelated in TKA and THA. Psychological characteristics could be managed before surgery to favour better APSP control and potentially prevent pain chronification after total joint arthroplasty.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"482-496"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649243","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":"Patient safety of adjunct pre-operative intravenous S-ketamine for pain relief in third molar surgery - a randomised, placebo-controlled, double-blind trial.","authors":"Lars B Eriksson, Torsten Gordh, Rolf Karlsten, Andreas Thor, Åke Tegelberg","doi":"10.1177/20494637241262509","DOIUrl":"10.1177/20494637241262509","url":null,"abstract":"<p><strong>Purpose: </strong>To study patient safety in third molar surgery, where two different doses of S-ketamine were administered for pain relief and compared to a placebo (saline). The primary focus was capillary oxygen saturation of the blood (SpO₂) and secondarily, alterations in respiratory rate, blood pressure, pulse or adverse events.</p><p><strong>Methods: </strong>One hundred and sixty-eight subjects were included in a randomised, placebo-controlled, double-blind trial. The two subanaesthetic study drugs were low-dose S-ketamine (0.125 mg/kg) and high-dose S-ketamine (0.25 mg/kg). Every patient was sedated with midazolam prior to infusion of the investigational drug. The teeth were surgically removed according to a routine clinical procedure, under local anaesthesia.</p><p><strong>Results: </strong>Primary end-point for the safety aspects was capillary oxygen saturation (SpO₂) after administration of the investigational drug was finished. A significant difference was found between the placebo and the high-dose group at that point (<i>p</i> = .021), with a decrease of saturation in the high-dose group. The lowest saturation and the number of registrations of SpO₂ <90% did not show any difference between groups. Oxygen supplementation was given in circa 40% of the cases with no differences between the intervention groups. No other significant differences between groups regarding saturation or respiratory rate were noted.</p><p><strong>Conclusion: </strong>In this study, it was safe to use adjunct preoperative single-dose intravenous S-ketamine 0.25 mg/kg body weight for pain relief, in midazolam-sedated patients receiving third molar surgery. There were no serious adverse events or symptoms of overdose nor any clinically relevant effects on circulatory or respiratory parameters.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"450-460"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649249","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":"Persistent post-discharge opioid use and opioid stewardship: A single-centre retrospective cohort study.","authors":"Sandra Hapca, Louise Peet, Christine Gibson, Andrea Harvey, Patrice Forget","doi":"10.1177/20494637241276106","DOIUrl":"10.1177/20494637241276106","url":null,"abstract":"<p><p>Persistent post-operative opioid use is a public health concern contributing to population morbidity and mortality. Opioid stewardship is a strategy adopted to rationalise opioid prescribing and limit harmful use. We describe persistent post-discharge opioid use rates and risk factors in a single-centre cohort and describe the opioid stewardship role of our Acute Pain Service (APS). We conducted a retrospective 4-year cohort study of inpatients referred to the APS and discharged with new strong opioids prescribed. We investigated persistent post-discharge opioid use rates, risk factors and patterns of opioid use after community follow-up by APS. We found that 24% of patients discharged with new strong opioids developed persistent opioid use. Risk factors associated with persistent post-discharge opioid use in our cohort included female sex (Odds Ratios [95% confidence interval], <i>p</i> value, OR: 1.89 [1.11-3.22], <i>p</i> = 0.019), pre-admission mental health history (OR: 2.85 [1.64-4.95], <i>p</i> < 0.001) and pre-admission opioid use (OR: 1.79 [1.03-3.11], <i>p</i> = 0.004). A smaller proportion of patients with APS follow-up in community developed persistent opioid use (22%) compared to those without (32%). We conclude that having opioids prescribed at time of discharge can result in persistent opioid use in up to a quarter of patients. The APS has an important protective role in rationalising opioid use in hospital but also following discharge. Development of further opioid stewardship policies is needed including improvement of patient and staff awareness and pre-operative assessment of patients with recognised risk factors.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"497-503"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649185","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}