Advances in Medical Education and Practice最新文献

{"title":"Improving Resident Comfort with Central Venous Catheter Supervision: Use of an Error Management Training Approach.","authors":"Carleen R Spitzer, Kyle R Stinehart, Will C Jensen, Amanda R Start","doi":"10.2147/AMEP.S513443","DOIUrl":"10.2147/AMEP.S513443","url":null,"abstract":"<p><strong>Background: </strong>Simulation is a well-established component of central venous catheter (CVC) training. However, there is little published regarding how to train residents to supervise CVC insertion.</p><p><strong>Purpose: </strong>We describe a curriculum designed to help trainees identify potential procedural errors and improve their comfort with supervising CVC insertion.</p><p><strong>Patients and methods: </strong>We conducted a one-group, pre-post-posttest study. All participants completed a pre-simulation assessment (Time 1) that evaluated residents' ability to identify potential complications with CVC insertion and their procedural completion and procedural supervision comfort. Residents then participated in a simulation in which they supervised a mock proceduralist insert a CVC and commit five pre-specified errors. Participants completed the same comfort assessment immediately following the simulation (Time 2) and repeat knowledge and comfort assessments five months later (Time 3).</p><p><strong>Results: </strong>Forty-seven interns participated in the study. Relative to Time 1 (M = 3.00, SD = 1.02), interns were significantly more comfortable supervising CVC insertion at Time 2 (M = 3.75, SD = 0.85) and at Time 3 (M = 4.08, SD = 0.58).</p><p><strong>Conclusion: </strong>We describe a simulation designed to help residents identify errors when supervising CVC insertion. Due to a poor survey response rate, no comparisons between pre- and post-simulation error identification could be determined. However, following our CVC supervisor simulation, participants reported immediate and sustained increases in their comfort supervising CVC placement.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"795-800"},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112474","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":"Educational Commission for Foreign Medical Graduates (ECFMG) Accreditation Policy Change: A Boon or Setback for Caribbean Medical Schools?","authors":"Sateesh B Arja, Pranathi Chundru","doi":"10.2147/AMEP.S521024","DOIUrl":"https://doi.org/10.2147/AMEP.S521024","url":null,"abstract":"<p><p>According to the World Federation of Medical Education (WFME), \"accreditation is the certification of the suitability of medical education programs and the competence of medical schools in the delivery of medical education.\" There are more than 100 medical schools in the Caribbean. The educational programs and accreditation requirements of Caribbean medical schools vary from island to island. In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG) in the USA mandated that graduates applying for ECFMG certificates must come from an accredited medical school starting in 2023. The accreditation agency must be recognized by the WFME. This motivated the Caribbean medical schools to go for accreditation and invest considerable financial resources. However, the ECFMG changed its stance and implemented a recognized accreditation policy in 2024, which does not require graduates from an accredited medical school. Is this a progressive or regressive change in Caribbean medical schools? The authors would like to explore this perspective based on current practices and available data, expectations of the future situation of the global healthcare systems, and perceptions of accreditation in the Caribbean, especially in undergraduate medical education programs.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"789-793"},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081387","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":"Piloting Virtual Multiple Mini Interviews (MMI) on Undergraduate Medical Students: A Multisource Feedback Analysis.","authors":"Bidyadhar Sa, Pradeep Kumar Sahu, Curt Bodkyn, Farid Youssef, Averell Bethelmy, Rohan Maharaj, Md Anwarul Azim Majumder","doi":"10.2147/AMEP.S511568","DOIUrl":"https://doi.org/10.2147/AMEP.S511568","url":null,"abstract":"<p><strong>Background: </strong>The Multiple Mini Interview (MMI) is a structured interview format that involves a series of station-based assessment, commonly used for medical admissions. With the COVID-19 pandemic, MMIs transitioned to an online format to ensure continuity. However, the effectiveness and reception of online MMIs remain unexplored. This study aims to assess the experiences and feedback of interviewees, interviewers and technical facilitators regarding a pilot implementation of online MMIs for newly accepted medical students.</p><p><strong>Methods: </strong>This descriptive survey at the School of Medicine, The University of the West Indies (UWI), St. Augustine, involved year 1 medical students, interviewers, and technical facilitators who participated in the virtual MMI. We developed three self-directed questionnaires for interviewees (19 items), interviewers (14 items), and technical staff (09 items) based on literature. We administered the web-based questionnaires to the participants from the 2021 and 2022 mmIs. Data analysis used SPSS version 29, applying descriptive statistics and chi-square tests. Open-ended responses were analysed thematically.</p><p><strong>Results: </strong>The majority of interviewees (85.2% in 2021 and 91.1% in 2022 with median = 3, IQR = 1) agreed that MMI helped to assess their non-academic personal attributes, interests, and motivation to study medicine which are vital to the success of health care providers. Interviewers also believed that (80% with median = 3 and IQR = 0 in 2021 and 90.6% with median = 3 and IQR = 1 in 2022) MMI is a good measure to assess the non-cognitive ability of projection medical students. The MMI technical facilitators believed that the MMI process was well organized, and they were happy with the time management.</p><p><strong>Conclusion: </strong>The study highlights the feasibility and benefits of the virtual MMIs, with interviewees, interviewers, and technical facilitators expressing predominantly positive perspective on the piloted approach. Utilizing technology for conducting virtual MMI is a welcomed innovation, even in the post-pandemic era. However, to optimize their effectiveness, the admission staff should refine the selection of cases, enhance the scoring system, improve time management strategies, and strengthen infrastructure and technical support.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"761-772"},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024473","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":"Exploring Nursing and Medical Students' Experiences of Handling Challenging Conversations: A Qualitative Focus Group Study.","authors":"Germanus Natuhwera, Peter Ellis, Eve Namisango","doi":"10.2147/AMEP.S518988","DOIUrl":"https://doi.org/10.2147/AMEP.S518988","url":null,"abstract":"<p><strong>Background: </strong>Handling challenging conversations remains a major challenge for both undergraduate and qualified nurses and medical doctors. However, challenging conversations are inevitable in daily patient-clinician encounters in clinical and care settings.</p><p><strong>Aim: </strong>To explore nursing and medical students' experiences in handling challenging conversations with patients and their families.</p><p><strong>Setting and participants: </strong>The study was conducted among final-year undergraduate nursing and medical students selected from seven nursing and medical training schools and universities in Southwest, Midwest and Central Uganda.</p><p><strong>Design and methods: </strong>This was an exploratory qualitative study. Purposive and convenience sampling were used to select training schools/universities and participants respectively. Data were collected between November 2022 and February 2023 through 10 face-to-face audio-recorded focus group interviews and were analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>82 nursing and medical students participated in the study. The analysis yielded four major themes: (1) Students' understanding of bad news, (2) Emotional labor of handling challenging conversations, (3) Handling challenging conversations a theory but not a practice experience, (4) Sociocultural and medico-cultural dilemmas.</p><p><strong>Conclusion: </strong>The study revealed that participants possessed limited theoretical knowledge, preparedness, and a significant unwillingness to engage in challenging conversations, particularly when communicating bad news or handling conversations related to death and dying. These issues are closely linked to inadequate training and particularly limited or deficient clinical exposure. Simulation-based learning and exposure to challenging conversations are required in clinical settings.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"773-787"},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054099","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":"Exploring Interventional Radiology: A Multicentre Study on Saudi Medical and Radiology Technology Students' Perspectives.","authors":"Shrooq Aldahery, Renad Qwader, Raghad Talal Asiri, Afnan Al-Alfy, Lubna Bushara, Abdulaziz Qurashi, Fahad H Alhazmi, Awadia Gareeballah, Adnan A S Alahmadi, Mohamed Yousef, Hanady Osman, Walaa Alsharif, Khalid M Alshamrani","doi":"10.2147/AMEP.S514876","DOIUrl":"https://doi.org/10.2147/AMEP.S514876","url":null,"abstract":"<p><strong>Background: </strong>Interventional radiology (IR) is a subspecialty of diagnostic radiology that uses image-guided radiological methods to carry out minimally invasive procedures. Medical schools in Saudi Arabia minimally expose students to IR unless it is part of an elective rotation. The study aims to gauge how well informed medical and radiology technology students are regarding the variations in educational and clinical experiences offered at different universities in Jeddah, Saudi Arabia. It also aims to assess students' interest in IR as a potential career path and their opinions about their life experiences concerning the department's future.</p><p><strong>Methods: </strong>This study used a cross-sectional study design. Between April and May 2023 in Jeddah, Saudi Arabia, students studying radiology technology and medicine who were in their second year to internship year were given access to a cross-sectional questionnaire.</p><p><strong>Results: </strong>The study found that 31.5% of the students reported having poor knowledge of IR, while 7.8% reported not knowing about it at all. Additionally, 45.9% of respondents felt that their knowledge was adequate, while a minority of 14.7% reported having an excellent understanding of IR concepts. Therefore, in order to enhance students' knowledge about IR, IR courses should be introduced early into curricula, IR symposiums and conferences.</p><p><strong>Conclusion: </strong>The limited exposure of medical and radiology technology students to IR was highlighted. Over one-third indicated interest in IR as a career, with radiology technology students demonstrating greater familiarity. Enhancing IR education through early curriculum integration, symposiums, and conferences is essential. Furthermore, addressing the lack of a standardized radiology curriculum in Saudi medical schools could further enhance IR awareness and career development.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"749-760"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064956","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":"Gaps in MASLD/MASH Education: A Quantitative and Qualitative Survey with Leaders of US Graduate Medical Education Programs.","authors":"Alina M Allen, Anthony R Hoovler, Amy Articolo, Travis Fisher, Mazen Noureddin, Douglas Dieterich","doi":"10.2147/AMEP.S491271","DOIUrl":"https://doi.org/10.2147/AMEP.S491271","url":null,"abstract":"<p><strong>Purpose: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) and its inflammatory subtype, metabolic dysfunction-associated steatohepatitis (MASH), are associated with cardiometabolic risk factors, including obesity and type 2 diabetes. The prevalence of both conditions is rising rapidly and is underdiagnosed (<5%). We aimed to gather qualitative and quantitative insights from program leaders in US medical education training on their experience with MASH-related training and education.</p><p><strong>Participants and methods: </strong>A cross-sectional study consisting of a quantitative survey and qualitative discussions with individuals in primary care (internal medicine and family medicine) and specialty programs (hepatology, gastroenterology, and endocrinology) were held from February 21 to August 28, 2023. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>A total of 190 leaders participated in the online survey and 11 leaders joined the focus groups. Almost all respondents reported that MASLD (96%) and MASH (92%) were included in their program's curricula. However, many believed that little time was devoted to discussing MASH in their program. Most respondents agreed that MASH is extremely underdiagnosed. Program leaders agreed that the interconnectedness of MASH with other cardiometabolic conditions necessitates instruction time on MASH beyond that of its dedicated curriculum time. All participants believed that emergence of regulatory-approved drugs for MASH will drive a decision to increase the time allotted for MASH in the curriculum.</p><p><strong>Conclusion: </strong>Although program leaders agreed that MASH has an important place in medical education curricula, the relative paucity of treatment options reduces its coverage in training, thereby limiting healthcare practitioners' understanding of MASH.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"729-748"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034706","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":"Attachment as a Primary Mechanism in Physician Cognition and Bias During Complex Medical Cases: A Narrative Review.","authors":"Carrie Rein","doi":"10.2147/AMEP.S496784","DOIUrl":"https://doi.org/10.2147/AMEP.S496784","url":null,"abstract":"<p><strong>Introduction: </strong>In recent decades, improvements in diagnostic accuracy in medical cases have been minimal despite rapid advancements in technology. Moreover, in complex cases, diagnostic accuracy remains a significant challenge, often reflecting practices from the 18th and 19th centuries. This comprehensive narrative review explores how cognitive bias may act as a critical, yet neglected, factor contributing to the persistent diagnostic error rate.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted through a search of the George Washington University library databases and Google Scholar to identify studies related to physician cognition, complex medical diagnosis, and cognitive error.</p><p><strong>Results: </strong>This review synthesizes existing literature to propose a theoretical framework explaining how cognitive error, clinician cognition, tolerance of uncertainty, and attachment theory interact to influence the formation of cognitive bias at the cost of diagnostic accuracy and efficiency.</p><p><strong>Discussion: </strong>It is not only necessary for clinicians to focus on a patient's words, symptoms, or data to improve diagnostic accuracy, but also for clinicians to relate to others' distress through their own attachment styles: technology's critical blind spot. Clinicians with insecure attachment styles may struggle with metacognition, exhibit lower cognitive flexibility, have reduced tolerance for uncertainty, experience lower thresholds for cognitive load, and rely more heavily on heuristics, leading to an increased likelihood of cognitive error during complex medical cases. This theory provides a foundation for further research into how attachment influences clinician decision-making and diagnostic performance while also highlighting how medical education may reinforce these patterns.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"713-728"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054132","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":"Non-Native Language Questionnaire Usage [Letter].","authors":"Danielle Durant","doi":"10.2147/AMEP.S533250","DOIUrl":"https://doi.org/10.2147/AMEP.S533250","url":null,"abstract":"","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"711-712"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Online System Implementation to Enhance Team-Based Learning at a Medical School.","authors":"Sami Shaban, Imran Zafar, Mohammad Irfan Tariq, Mohi Eldin Magzoub","doi":"10.2147/AMEP.S513341","DOIUrl":"https://doi.org/10.2147/AMEP.S513341","url":null,"abstract":"<p><strong>Introduction: </strong>Team-Based Learning (TBL) is an effective learning model utilized in education to address the concerns of student active learning, participation, critical thinking and teamwork. However, faculty members must invest significant time in preparing TBL sessions, creating appropriate material and assessments, preparing paper answer sheets for group tests, and managing the logistics of student groups.</p><p><strong>Methods: </strong>We have designed, developed and implemented a novel TBL online system at our institution by integrating the standard TBL process into a customized IT solution. The objective of this research is to identify important items in the requirements analysis based on sound pedagogy, describe the developed system while highlighting benefits and obstacles faced, and gauge user feedback of the system.</p><p><strong>Results: </strong>The system reduces the burden on faculty by guiding in the preparation of assessments, randomizing students into groups containing students from all academic levels, allowing students to take the individual and group tests efficiently and with instant grading, providing a mechanism for answering questions in the group test in such a way that indicates to students that their answer is incorrect and then allowing them to continue discussion until they reach the correct answer and then grade the question appropriately, allowing facilitator and students to view the progress of each group in the group exams in real-time on a projected screen, and giving an immediate indication on which questions are performing poorly so that immediate discussion and feedback can occur.</p><p><strong>Conclusion: </strong>The system has demonstrated its value in enhancing the learning experience for medical students and has received positive feedback from both facilitators and students. By continuing to innovate, TBL has the potential to play an even greater role in the education and assessment processes of medical professionals.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"699-710"},"PeriodicalIF":1.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039500","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":"\"It's the Time they Take to Give Feedback; it has Become a Problem\" Exploring Barriers and Facilitators for Research Supervision in Postgraduate Medical Education in Tanzania. A Qualitative Study.","authors":"Muzdalifat Abeid, Columba Mbekenga, Ahmed Mussa Jusabani, Sherin A Kassamali, Miriam Lucy Mgonja, Mwanaarab Sibuma, Nathanael Sirili, Mariam Noorani","doi":"10.2147/AMEP.S512498","DOIUrl":"https://doi.org/10.2147/AMEP.S512498","url":null,"abstract":"<p><strong>Background: </strong>Research supervision is a multifaceted task that combines academic knowledge with managing interpersonal relationships. Postgraduate trainees often receive inadequate supervision due to their supervisors' demanding schedules and limited supervision competencies. Most supervisors, especially in low-resource settings, lack formal training in supervision and thus rely on personal experiences to fulfil this role. Poor supervision contributes to high dropout rates and subpar research output in many universities. We aimed to explore the barriers and facilitators for research supervision in postgraduate medical education in Tanzania.</p><p><strong>Methods: </strong>We adopted an exploratory qualitative case study and conducted key informant interviews with three purposively selected faculty in leadership and four focus group discussions with 14 postgraduate trainees and 10 faculty members. Topic guides focusing on experiences, challenges, and needs were used for data collection. The data were audio recorded and transcribed verbatim. A framework matrix was used to summarize and analyze data using an excel workbook. An inductive qualitative data analysis approach was employed using thematic analysis as described by Braun and Clarke.</p><p><strong>Results: </strong>Two main thematic areas emerged from analysis: Barriers and facilitators for research supervision in postgraduate medical education. Difficulty balancing workload, delays in feedback, limited access to some resources, funding constraints and limited research skills emerged as key barriers. Participants recognised the role of a well-equipped library in facilitating the supervision process and trainees appreciated flexibility from their supervisors.</p><p><strong>Conclusion: </strong>Addressing the identified barriers is crucial to enhance the supervisor-trainee relationship and overall dissertation outcomes. Ensuring protected time for research and strengthening faculty research and supervision skills through targeted training is important to ensure high quality research output.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"685-698"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024494","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}