Einstein-Sao Paulo最新文献

{"title":"Demographic and economic disparities in hand surgical procedures in Brazil: Analysis of DATASUS data.","authors":"Lucas Ferracini Viotto, Tiago Lorenzi da Rocha E Silva, Mariana Cristina Apude, Tiago Guedes da Motta Mattar, Vinícius Ynoe de Moraes, Raquel Bernardelli Iamaguchi, Gustavo Bersani Silva, Rames Mattar Junior, Mario Vieira Guarnieri","doi":"10.31744/einstein_journal/2026GS2322","DOIUrl":"10.31744/einstein_journal/2026GS2322","url":null,"abstract":"<p><strong>Objective: </strong>To analyze epidemiological, demographic, and health cost data of major hand surgery procedures in Brazil's public health system and explore inequalities, regional utilization patterns, and economic impact to inform policy improvements.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 1,026,582 hand surgery procedures from DATASUS (2018-2024). The data included distal radius fractures, amputations, replantations, carpal tunnel syndrome, and brachial plexus injuries linked to ICD-10 codes. The variables included sex, race/color, age, geographic region, and hospital costs. Statistical analysis employed one-way ANOVA, Tukey's test, χ2, Pearson's correlation, confidence intervals, and significance was set at p<0.05. The analysis used SPSS v.26, Minitab v.21.2, and Excel 2010.</p><p><strong>Results: </strong>Health procedures were predominantly performed in male patients (53.5%, n=549.641) and were concentrated in the Southeast region (38.1%, n=391,340). Significant regional variation was observed in total procedure costs, with higher mean values in the South (mean=458,82, SD=455,20, p<0.001), Southeast (mean=453.75, SD=458.93, p<0,001) and West-Central (mean=480,09, SD=446.24, p<0,001) regions. Urgent admissions accounted for 72% of cases, reflecting the traumatic profile of hand surgery within the Brazilian Public Health System. Regarding procedure type, regional disparities were evident, with high-complexity surgeries such as those for brachial plexus injuries costing most in the South (Mean=1295,61, SD=502.28, p<0.001), and low-complexity procedures (for carpal tunnel syndrome) showing higher mean costs in the South (Mean=476.55, SD=348.50, p<0.001) and West-Central regions (Mean=396.38, SD=160.04, p<0.001).</p><p><strong>Conclusion: </strong>DATASUS data showed that procedures were concentrated in the Southeast region (38.1%) and were predominantly performed in men (53.5%), with 72% of the procedures classified as urgent. Higher mean costs were noted in the West-Central/Southeast/South than in the North/Northeast. Brazil requires adequate infrastructure and training to ensure equitable access to healthcare.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eGS2322"},"PeriodicalIF":1.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116298","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":"Mini experiences X Major allergies.","authors":"Jullia Eduarda Feijó Belluco, Paulo Eduardo Silva Belluco, Fabíola da Silva Maciel Azevedo, Maurício Domingues-Ferreira, Rosana Zabulon Feijó Belluco","doi":"10.31744/einstein_journal/2026CE2542","DOIUrl":"10.31744/einstein_journal/2026CE2542","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eCE2542"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992044","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":"Bacteria-induced immunity: from homeostasis to immune subversion in periodontitis.","authors":"Vallentine Louzada Miranda, Mel de Araujo Teixeira, João Gabriel Silva Souza, Letícia Mello Bezinelli, Nídia Cristina Castro Dos Santos","doi":"10.31744/einstein_journal/2026RW2369","DOIUrl":"10.31744/einstein_journal/2026RW2369","url":null,"abstract":"<p><p>This review synthesizes current evidence on host immune responses to bacteria, their roles in the development and progression of periodontitis, and emerging immunomodulatory therapeutic strategies designed to restore periodontal homeostasis. Periodontitis develops through interactions between a dysbiotic bacterial community that disrupts host-microbe homeostasis and a chronic, maladaptive interaction with the host immune system. Key immune subversion microorganisms such as Porphyromonas gingivalis trigger inflammation while subverting immune surveillance by evading complement-mediated clearance and impairing neutrophil function. This dual behavior creates a biological paradox: bacteria induce inflammation to obtain nutrients while simultaneously suppressing effective antimicrobial activity, thereby perpetuating chronic, tissue-destructive immune activation. The osteoimmune response, particularly the Th17/IL-17 axis, is a central pathway linking microbial dysbiosis to persistent inflammation and alveolar bone resorption. These findings suggest that successful periodontal therapy must extend beyond mechanical biofilm removal by addressing underlying immune dysregulation. Potential adjunctive strategies for modulating this response include specialized pro-resolving mediators, complement inhibitors such as Cp40, and selected probiotics with immunoregulatory properties. Collectively, these approaches are intended to restore immune balance, enhance resolution of inflammation, and promote periodontal tissue repair. Current evidence demonstrates that periodontitis is not solely a microbial infection but also involves dysregulated host immunity. Clarifying how bacteria manipulate immune pathways may facilitate the development of therapies that complement bacterial control by targeting the inflammatory mechanisms underlying tissue destruction. Immunomodulatory interventions therefore represent promising candidates for promoting sustained periodontal stability and inflammatory resolution.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 spe3","pages":"eRW2369"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991964","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":"Healthcare mission to a humanitarian disaster: a descriptive study of multidisciplinary interventions during the 2024 floods in Rio Grande do Sul, Brazil.","authors":"Tarso Augusto Duenhas Accorsi, Renata Albaladejo Morbeck, Claudia Candido da Luz, Fabio de Castro Jorge Racy, Flavio Tocci Moreira, Karen Francine Köhler, Carlos Henrique Sartorato Pedrotti","doi":"10.31744/einstein_journal/2026AO2192","DOIUrl":"10.31744/einstein_journal/2026AO2192","url":null,"abstract":"<p><strong>Objective: </strong>Floods are the most common natural disasters worldwide, and their health impacts are exacerbated by climate change and population vulnerability. Humanitarian missions are essential for providing rapid and sustained medical care in disaster settings. However, evidence regarding the clinical and procedural aspects of multidisciplinary care during such missions remains limited. We examined the clinical profile and interventions provided during a humanitarian mission conducted in response to severe flooding in southern Brazil.</p><p><strong>Methods: </strong>This retrospective observational study was conducted during a humanitarian mission organized by Hospital Israelita Albert Einstein in Canoas, one of the municipalities most severely affected by the 2024 floods in Rio Grande do Sul. From May to June 2024, all individuals who voluntarily sought medical care were included. Multidisciplinary teams provided in-person assistance. Data from manual medical records were analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 2,060 patients were evaluated. General practitioners conducted 33.16% of consultations. The most frequent procedures were dermatological, including wound care (72.69%) and abscess drainage (7.63%). Point-of-care testing primarily targeted dengue (50.58%) and influenza (19.77%), with 54.15% of tests yielding positive results. The most frequently administered medications were analgesics (34.61%), bronchodilators (8.98%), and antibiotics (8.14%). Mental health consultations accounted for 6.46% of total visits. Most patients (94.34%) were discharged, whereas 3.28% required referral to emergency care.</p><p><strong>Conclusion: </strong>The mission demonstrated the effectiveness of a rapid multidisciplinary care model in addressing acute healthcare needs during flooding. Integrating diagnostic testing and mental healthcare may help reduce disease burden and alleviate pressure on local healthcare systems.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO2192"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992025","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":"Case reports: are they still useful?","authors":"Jacyr Pasternak","doi":"10.31744/einstein_journal/2026ED2691","DOIUrl":"10.31744/einstein_journal/2026ED2691","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eED2691"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991977","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":"Can photobiomodulation prevent herpes labialis recurrences? A systematic review.","authors":"Karen Müller Ramalho, Nicolly Dias Dos Santos, Juliana Mota Siqueira, Anna Carolina Ratto Tempestini Horliana, Carlos de Paula Eduardo, Leticia Mello Bezinelli, Fernanda de Paula Eduardo, Anna Luíza Damaceno Araújo","doi":"10.31744/einstein_journal/2026RW2359","DOIUrl":"10.31744/einstein_journal/2026RW2359","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluated the effectiveness of photobiomodulation for preventing recurrent herpes labialis.</p><p><strong>Methods: </strong>Eligibility criteria were defined using the PICOS framework, and only randomized clinical trials were included. We searched PubMed, Embase, Scopus, the Cochrane Library, the Virtual Health Library, and gray-literature sources. Of the records identified, nine reports underwent full-text assessment, and three studies met the eligibility criteria.</p><p><strong>Results: </strong>Two trials reported lower recurrence frequencies after photobiomodulation compared to control interventions, while one trial found no difference. Findings regarding recurrence severity and duration were inconsistent across studies. No adverse events were reported in the studies that provided safety data.</p><p><strong>Conclusion: </strong>The available evidence suggests that photobiomodulation may reduce the recurrence frequency, severity, and duration of herpes labialis. However, the certainty of the evidence was rated as low due to small sample sizes, incomplete blinding, and variations in laser parameters and comparators. These limitations restrict generalizability and preclude definitive clinical recommendations. Well-designed randomized controlled trials with standardized protocols and consistent outcome measures are needed to establish the clinical utility of photobiomodulation for recurrent herpes labialis.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 spe3","pages":"eRW2359"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992028","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":"Predicting 30-day unplanned readmissions in patients with cancer in a Brazilian hospital: a Machine Learning approach.","authors":"Nickolas Stabellini, Marilia Melo Favalesso, Claudia Szlejf, Cesar Gomes Miguel, Roberto Carmagnani Pestana, Hanna Kim, Gabriela de Carvalho Ferreira, Kristin A Waite, Alberto J Montero, Jill S Barnholtz-Sloan, Edson Amaro Junior, Nelson Hamerschlak","doi":"10.31744/einstein_journal/2026AO2210","DOIUrl":"10.31744/einstein_journal/2026AO2210","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to develop Machine Learning models to predict 30-day unplanned readmissions in cancer patients treated at a private hospital in Brazil.</p><p><strong>Methods: </strong>This retrospective cohort study included admission records of hospitalizations lasting >24 hours, with a corresponding diagnosis of a solid malignancy. The primary outcome was 30-day unplanned readmission. We tested five supervised Machine Learning algorithms to develop predictive models: a \"48-hour\" model, which used data from the first 48 hours after admission, and a \"discharge\" model, which used data from the entire hospitalization. The optimal models were selected based on their median performance (area under the ROC curve [AUC], precision, recall, F1, and Fβ-Score). Model explainability was assessed using SHAP scores (SS).</p><p><strong>Results: </strong>We analyzed 3,728 admissions from 1,573 cancer patients, with an unplanned 30-day readmission rate of 21.13%. The Random Forest algorithm demonstrated the best-balanced performance for the 48-hour model (AUC = 0.70, IQR= 0.68-0.71), whereas LightGBM performed best for the discharge model (AUC = 0.70, IQR= 0.68-0.72). In both models, the top predictor was prior emergency department visits in the past six months (SS=0.074 and 0.053, respectively). The top 10 predictors included: laboratory values (including lymphocyte count, Gamma-glutamyl transferase, Red Cell Distribution Width, hemoglobin, sodium, monocyte count, hematocrit, and urea), vital signs, and emergency index admission in both models, with colon cancer ranking among the top predictors in the 48-hour model.</p><p><strong>Conclusion: </strong>The models underscored the significance of prior emergency department visits, laboratory values, and vital signs as key predictors of 30-day unplanned readmission. The timing of laboratory and vitals influenced their predictive strength. Implementing these models could help providers develop personalized care strategies to reduce readmission risk. External validation is needed.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eAO2210"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992012","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":"Biventricular endomyocardial fibrosis with right ventricular hypertrabeculation and rapid progression to heart transplantation: imaging and pathologic correlation.","authors":"Sofia Alves Figueiredo Faustino, Ana Clara Tude Rodrigues, Ebe Christie de Oliveira, João de Azevedo, Fernando Hideki Sakamoto, Claudio Henrique Fischer, Sandrigo Mangini, Edgar Lira-Filho, Samira Saady Morhy, Ana Olga H Mocumbi, Marcelo Luiz Campos Vieira","doi":"10.31744/einstein_journal/2026RC2390","DOIUrl":"10.31744/einstein_journal/2026RC2390","url":null,"abstract":"<p><p>Endomyocardial fibrosis is a restrictive cardiomyopathy characterized by the deposition of fibrotic tissue in the endocardium, predominantly affecting the ventricular apices and atrioventricular valves. Although classically described in endemic regions and low socioeconomic settings, its pathophysiology remains incompletely understood. The coexistence of endomyocardial fibrosis with noncompacted myocardium has not been previously reported. Here, we describe a 57-year-old man, an amateur endurance cyclist, who presented with a two-year history of progressive heart failure symptoms, including fatigue, ascites, and lower limb edema. Transthoracic echocardiography revealed severe biatrial enlargement, grade III diastolic dysfunction, valvular regurgitation, and apical obliteration of both ventricles. Marked right ventricular trabeculation with deep intertrabecular recesses and turbulent flow was observed, raising suspicion of non-compacted myocardium. Despite optimized medical therapy, the patient experienced recurrent hospitalizations and progressed to advanced restrictive heart failure, requiring orthotopic heart transplantation. Pathological examination of the explanted heart confirmed chronic-stage endomyocardial fibrosis with extensive endocardial fibrosis and prominent right ventricular trabeculation. This case demonstrates a previously unreported association between endomyocardial fibrosis and right ventricular hypertrabeculation, expanding the phenotypic spectrum of endomyocardial fibrosis and emphasizing the importance of comprehensive imaging assessment in atypical presentations.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 ","pages":"eRC2390"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991994","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":"Pandemic-related disruption and post-pandemic recovery of dental service production in Brazilian Primary Health Care, 2015-2025.","authors":"Laura Jackeline García Rincón, Ana Luiza Felizardo David, Raphael Daniel Rodrigues, Giovanna Oliveira Souza, Emanuelle Thomazini Zambom, Caio Possi Yazaki, Gabriela Fulanetto Crestana, Lorrayne Belotti","doi":"10.31744/einstein_journal/2026AO2527","DOIUrl":"10.31744/einstein_journal/2026AO2527","url":null,"abstract":"<p><strong>Objective: </strong>To analyze changes in dental service production in Brazilian Primary Health Care from 2015 to 2025 and characterize pandemic-associated disruption and post-pandemic recovery by procedure type and Federative Unit.</p><p><strong>Methods: </strong>This ecological interrupted time-series study used secondary data on primary health care dental procedures recorded in the Brazilian Unified Health System. Six indicators were evaluated: scheduled consultations, health promotion and prevention activities, and surgical, endodontic, periodontal, and restorative procedures. Annual rates per 100,000 inhabitants were calculated. Three periods were defined: pre-pandemic (2015-2019), pandemic (2020-2021), and recovery (2022-2025). National percentage changes were calculated using selected annual rates, whereas the proportion of the pandemic-related decline recovered was calculated using period means. Interrupted time-series analyses were performed using segmented regression with Newey-West standard errors.</p><p><strong>Results: </strong>Dental service production declined during the pandemic across all indicators, and mean recovery-period levels remained below pre-pandemic means. The largest reductions between 2019 and 2021 occurred in health promotion and prevention activities (-79.6%), periodontal procedures (-62.5%), scheduled consultations (-58.8%), and surgical procedures (-53.8%). Recovery remained incomplete across all indicators, ranging from 7.6% for scheduled consultations to 68.8% for restorative procedures. Total procedure rates showed a significant pre-pandemic annual decline of 21.4% (95%CI=-24.9% to -17.7%), an immediate reduction of 56.1% in 2020 (95%CI=-71.4% to -32.6%), and a positive post-2020 annual change of 14.8% (95%CI=1.2% to 30.2%). Marked territorial heterogeneity was observed in both the magnitude of decline and the pattern of recovery.</p><p><strong>Conclusion: </strong>Dental service production in Brazilian Primary Health Care declined substantially during the COVID-19 pandemic and recovered only partially during 2022-2025, with persistent territorial disparities in recorded service production.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 spe3","pages":"eAO2527"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991967","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":"Porphyromonas gingivalis as a keystone pathogen in systemic diseases.","authors":"Yaniv Mayer, Daniela Matanes, Jamil Awad Shibli","doi":"10.31744/einstein_journal/2026RW2362","DOIUrl":"10.31744/einstein_journal/2026RW2362","url":null,"abstract":"<p><p>Porphyromonas gingivalis (P. gingivalis) is a Gram-negative anaerobic bacterium recognized as a keystone pathogen in periodontitis. Beyond its established role in periodontal tissue destruction, accumulating evidence links P. gingivalis to several systemic conditions, including cardiovascular disease, Alzheimer's disease, rheumatoid arthritis, diabetes mellitus, and adverse pregnancy outcomes. This review synthesizes current evidence on how P. gingivalis may contribute to systemic disease beyond the oral cavity, with particular emphasis on its virulence factors, including gingipains and lipopolysaccharide, and the pathways linking periodontal infection to pathological processes in distant organs. We discuss how hematogenous dissemination, immune-evasion mechanisms, and chronic inflammatory responses may mediate these systemic effects. A clearer understanding of these associations may inform integrated approaches to periodontal care and systemic disease management.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":"24 spe3","pages":"eRW2362"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921254","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}