{"title":"Factors associated with decline in activities of daily living in home-based medical care.","authors":"Masaaki Nagae, Hiroyuki Umegaki, Hitoshi Komiya, Kazuhisa Watanabe, Yosuke Yamada","doi":"10.18999/nagjms.87.1.173","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.173","url":null,"abstract":"<p><p>We sought to explore factors associated with changes in activities of daily living (ADL) in home-based medical care (HBMC). We used data from the Observational Study of Nagoya Elderly with Home Medical Care 2, in which HBMC was provided for physical and/or mental disability. ADL were assessed using the Barthel Index and its mobility and self-care categories. Of 40 eligible participants, half were classified into an ADL decline group. The percentage with a decreased Mini-Nutritional Assessment-Short Form (MNA-SF) score was significantly higher in the ADL decline group. Worsening of MNA-SF was significantly associated with a decline in the mobility category but not in the self-care category. ADL decline was frequently observed and was associated with worsening of nutritional status in HBMC.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"173-177"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"16p13.11 microduplication with growth retardation and developmental disorders: a case report and literature review.","authors":"Daisuke Watanabe, Hideaki Yagasaki, Hiromune Narusawa, Takeshi Inukai","doi":"10.18999/nagjms.87.1.144","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.144","url":null,"abstract":"<p><p>Short stature and growth retardation is a common condition in children. Genetic variations are responsible for many cases of short stature of unknown etiology. In particular, pathogenic copy number variants (CNVs) have been found in 10%-16% of children with unexplained short stature. This paper reports on a 5-year-old Japanese girl with both growth retardation and developmental delay associated with a 16p13.11 microduplication. Although the patient's mother also carries this microduplication, she did not show growth retardation and developmental delay. These cases illustrate the diverse phenotypic manifestations of 16p13.11 microduplication. Consequently, we conducted the literature review of 274 cases associated with this duplication revealed neurological disorders in approximately 70% of cases, 15.3% of these cases were associated with short stature. Diagnosis of 16p13.11 microduplication remains challenging due to its diverse symptomatology and elusive genotype-phenotype correlations. Comprehensive genetic evaluation is crucial for patients presenting with short stature and developmental disorders, underscoring the need for further investigation into the 16p13.11 microduplication to clarify its specific role and implications.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"144-149"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Electrical gaps in recurrence of atrial tachyarrhythmias after Maze surgery: regional patterns and clinical significance.","authors":"Daisuke Yano, Yoshiyuki Tokuda, Nao Yasuda, Naoki Tsurumi, Yuji Mashiko, Fumiaki Kuwabara, Yuichi Hirate, Kazuyoshi Tajima, Masato Mutsuga","doi":"10.18999/nagjms.87.1.122","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.122","url":null,"abstract":"<p><p>The Maze procedure is a well-established technique for treating atrial fibrillation; however, atrial tachyarrhythmias can recur postoperatively. This study analyzed the mechanisms of recurrence in patients who underwent electrophysiological studies and catheter ablation following the Maze procedure. Among 88 patients who underwent treatment with a modified Maze procedure, 42 developed recurrent atrial tachyarrhythmias. Among these, 18 underwent electrophysiological studies and simultaneous transcatheter radiofrequency ablation. The median period between the Maze procedure and catheter ablation was 29 months. Macro-reentrant circuits were identified in 12 patients (67%) with or without atrial fibrillation. Most patients (n = 15, 83%) had more than one conduction gap. The most frequently identified gap was around the left inferior pulmonary vein (n = 10, 56%), followed by the peri-coronary sinus area (n = 8, 44%), and the mitral isthmus area (n = 5, 28%). Catheter ablation targeting these gaps successfully eliminated tachyarrhythmias in 15 (83%) patients. At a follow-up examination 49 months after catheter ablation, 14 patients (78%) had no recurrence of tachyarrhythmia. An electrophysiological study revealed conduction gaps in patients with recurrent atrial tachyarrhythmia after the Maze procedure. Modifications to the Maze procedure should include meticulous ablation around the left inferior pulmonary vein orifice, mitral isthmus, and coronary sinus where conduction gaps frequently occur. In cases of recurrence, catheter ablation targeting the lesion effectively controlled the tachyarrhythmia.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"122-132"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical outcomes of emergency open appendectomy for acute appendicitis: an audit of 2268 patients in a single center.","authors":"Katsuya Sakashita, Yuichi Takayama, Takamasa Takahashi, Hiroki Aoyama, Takahiro Hosoi, Masayoshi Sakuma, Atsuyuki Maeda","doi":"10.18999/nagjms.87.1.84","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.84","url":null,"abstract":"<p><p>Although conservative treatment and laparoscopic surgery are becoming increasingly popular for acute appendicitis, emergency open appendectomy is still performed in many situations. The purpose of this study was to examine the surgical outcomes of emergency open appendectomy for acute appendicitis. Between July 2008 and August 2022, 2,268 patients who underwent emergency open appendectomy for acute appendicitis were enrolled in this study. Of these patients, 417 (18.4%) had complicated appendicitis (CA), and 1,851 (81.6%) had uncomplicated appendicitis (UA). Clinical characteristics and both surgical and postoperative outcomes were compared between the groups. The percentage of CA patients increased after 2020, and by age, the proportion was greater for those aged 50 and older. In the CA group, patients were older (55.5 vs 30.0 years, p<0.001) and had more comorbidities (34% vs 12%, p<0.001). Additionally, in the CA group, the operation time was longer (86 vs 55 min, p<0.001), and the rate of postoperative complications was greater (16% vs 3.0%, p<0.001). There was one mortality in the CA group due to postoperative cerebral infarction. The postoperative hospital stay was significantly longer in the CA group (9 vs 5 days, p<0.001). In conclusion, in the CA group, the patients were older and had more comorbidities. Patients who underwent emergency open appendectomy for CA had longer operation times and more complications. This large single-center study provides insights into emergency open appendectomy for acute appendicitis and useful information in terms of comparisons with other treatment modalities, such as laparoscopic appendectomy and elective appendectomy.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"84-92"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The risk factors for development or progression of locomotive syndrome: a systematic review.","authors":"Yoshitaka Iwamoto, Takeshi Imura, Kazuhiko Hirata, Yasunari Ikuta, Kai Ushio, Yukio Mikami, Nobuo Adachi, Makoto Takahashi, Ryo Tanaka","doi":"10.18999/nagjms.87.1.60","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.60","url":null,"abstract":"<p><p>Locomotive syndrome is a decline in mobility and is believed to occur before the occurrence of frailty and sarcopenia; therefore, early detection of risk factors is important. However, systematic reviews have not been conducted. A systematic review of observational studies was performed to identify risk factors for the development or progression of locomotive syndrome. We searched the electronic databases of MEDLINE, Scopus, Web of Science, Ichushi Web (in Japanese), and Cumulative Index to Nursing and Allied Health Literature. Studies that used the development or progression of locomotive syndrome as an outcome and were written in English or Japanese were included. However, studies with nonadult participants and review articles were excluded. The quality of the eligible studies was evaluated using the Cochrane risk-of-bias instrument. This study included 79 observational studies (8 cohort and 71 cross-sectional studies). A meta-analysis was not performed. All studies were conducted in Japan. The eight cohort studies included 2,343 participants aged 57.0-79.3 years upon study initiation. The risk factors for developing locomotive syndrome were objectively assessed by parameters of motor function and muscle strength, such as short one-leg standing time and weak grip strength. The progression of locomotive syndrome was associated with the preoperative risk stage of locomotive syndrome and postoperative surgical failure syndrome. Locomotive syndrome can be detected through the regular assessment of motor function and muscle strength. To prevent locomotive syndrome in middle-aged and older people, an examination by an expert is necessary.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"60-75"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A systematic review of the relationship between body composition including muscle, fat, bone, and body water and frailty in Asian residents.","authors":"Kazuaki Hamada, Tsubasa Mitsutake, Tomonari Hori, Yoshitaka Iwamoto, Naoki Deguchi, Takeshi Imura, Ryo Tanaka","doi":"10.18999/nagjms.87.1.1","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.1","url":null,"abstract":"<p><p>International guidelines suggested that overweight and underweight are risk factors for frailty. However, body composition, which directly affects body weight, was not mentioned as a risk factor. We aimed to investigate whether the body composition, including muscle, fat, bone, and body water, is a risk factor for frailty. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched up to June 03, 2022. We included cohort studies or observational studies using a cross-sectional design that reported an association between body composition and frailty. Two reviewers assessed the quality of the included cohort studies. Furthermore, we examined whether body composition as a risk factor for frailty varies depending on the participant's place of residence. Of the 3871 retrieved studies, 77 were ultimately included, 7 of which were cohort studies. The risk-of-bias evaluation in each cohort study showed that all studies had at least one concern. Low lean mass, waist circumference-defined abdominal obesity, and bone mineral density were significantly associated with frailty in the cohort studies. The results of bone mineral density were conflicted in the cross-sectional studies. Considering the participants' place of residence, a significant association between lower-extremity muscle mass and frailty was demonstrated, particularly among Asian residents. Low lean mass and abdominal obesity were likely risk factors for frailty. These results could be useful for developing frailty prevention strategies and could have a positive impact on individual health management. Further, future studies are needed because body composition affecting frailty may differ by race.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"1-21"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention of central venous catheter occlusion by saline with or without heparin in intensive care unit after surgical intervention: a double-blind, randomized trial.","authors":"Masayuki Nakamoto, Takahiro Tamura, Eri Kobayashi, Mariko Kawaguchi, Yuri Matsuoka, Akiko Fujii, Masahiko Ando, Yoko Kubo, Takahiro Imaizumi, Yasuhiro Miyagawa, Takayuki Inagaki, Shogo Suzuki, Kimitoshi Nishiwaki","doi":"10.18999/nagjms.87.1.51","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.51","url":null,"abstract":"<p><p>Heparinized saline is used to prevent catheter obstruction; however, it is associated with concerns regarding the incidence of heparin-induced thrombocytopenia and the accuracy of the blood test results. This study compared the impact of saline with and without heparin on central venous catheter occlusion rates in post-surgical intensive care unit patients using a prospective, double-blinded, randomized, controlled design. Patients aged 20-90 years planned to experience central venous catheter insertion and postoperative intensive care unit admission were enrolled and were randomly assigned to either the heparin group (administered normal saline with heparin) or the control group (administered normal saline alone), based on a 1:1 ratio. Nurses blinded to patient allocation performed the occlusion assessment (every 24 h). The Kaplan-Meier curve was used to assess the time to occlusion or removal of each catheter. Central venous catheter insertion results of 136 patients showed no significant variation in occlusion rates between the heparin and control groups within the first 3 days. There was no significant difference between normal saline with and without heparin in preventing central venous occlusion in the intensive care unit up to 3 days post-surgery. The results of this study suggest that it is not necessary to use normal saline with heparin in the management of central venous catheter occlusion, at least when moving from the operating room to the intensive care unit.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"51-59"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spatial clusters with high mortality rates for chronic obstructive pulmonary disease among municipalities in Japan between 2017 and 2021: a flexible spatial scan statistics approach.","authors":"Kakei Iwahara, Mayumi Mizutani, Ritsuko Nishide, Susumu Tanimura","doi":"10.18999/nagjms.87.1.133","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.133","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease is one of the leading causes of death worldwide and in Japan. This study aimed to detect the location and area of spatial clusters with high chronic obstructive pulmonary disease mortality rates in Japan during 2017-2021. Age-standardized numbers of expected chronic obstructive pulmonary disease deaths by sex and municipality were estimated from publicly available data from 1,895 municipalities in Japan. We performed flexible spatial scan statistics to detect the clusters with significantly high risk of chronic obstructive pulmonary disease death using the expected and observed cumulative mortality. During 2017-2021, the cumulative expected number of chronic obstructive pulmonary disease deaths was 87,450 (72,551 males and 14,899 females). There were 23 significant spatial clusters for males and 14 for females. The 23 clusters were scattered in 251 municipalities of 27 prefectures for males, while the 14 clusters for females were localized in 105 municipalities of 12 prefectures. The primary cluster for both sexes was detected in the Osaka Prefecture (males: log-likelihood ratio [LLR] = 188.23, relative risk [RR] = 1.46, <i>p</i> = 0.001; females: LLR = 106.42, RR = 1.95, <i>p</i> = 0.001). We found 23 significant spatial clusters for males and 14 for females. There were obvious sex differences in the distribution of the clusters. Our findings provide supporting evidence to discuss the prioritized areas in the allocation of health care resources to prevent and control the deaths associated with chronic obstructive pulmonary disease.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"133-143"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thi Hong Chuyen Nguyen, Tran Bao Song Nguyen, Thanh Phuc Nguyen, Thi Minh Thi Ha, Nguyen Cuong Pham, Thi Thu Giang Nguyen, Minh Tri Phan, Thanh Huy Le, Thanh Thanh Ha, Tran Thuc Huan Nguyen, Cong Thuan Dang
{"title":"Mismatch repair deficiency and its relationship with histopathological features in gastric cancer patients.","authors":"Thi Hong Chuyen Nguyen, Tran Bao Song Nguyen, Thanh Phuc Nguyen, Thi Minh Thi Ha, Nguyen Cuong Pham, Thi Thu Giang Nguyen, Minh Tri Phan, Thanh Huy Le, Thanh Thanh Ha, Tran Thuc Huan Nguyen, Cong Thuan Dang","doi":"10.18999/nagjms.87.1.93","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.93","url":null,"abstract":"<p><p>Gastric cancer is a common malignancy disease with a poor prognosis. Deficient mismatch repair is a prognostic and predictive marker of response to systemic therapies. However, deficient mismatch repair frequency and the relationship between this status and microscopic characteristics are inconsistent across nations. We aimed to determine the rate of deficient mismatch repair and its association with histopathological features in gastric cancer patients. A cross-sectional study was conducted on 226 gastric cancer patients treated at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital from June 2020 to January 2024. Mismatch repair protein expression was evaluated using immunohistochemical staining, and any absence of mismatch repair proteins was regarded as deficient mismatch repair. The deficient mismatch repair rate was 12.8%. Deficient mismatch repair appeared to be more frequent in the intestinal subtype of Lauren classification odds ratio (OR) = 4.767 (95% confidence interval [CI], 1.086-20.921; p = 0.039), tubular/papillary adenocarcinoma (OR = 5.25; 95% CI, 1.185-23.251; p = 0.029), mucinous adenocarcinoma (OR = 6.19; 95% CI, 1.113-34.445; p = 0.037), and differentiated type (OR = 3.24; 95% CI, 1.324-7.931; p = 0.01). No statistically significant association was detected with histopathological features according to the Tumor Location-Modified Lauren classification and mucinous secreting morphology. Deficient mismatch repair status was unusual in gastric cancer. The degree of cell differentiation and microscopic characteristics based on the World Health Organization and Lauren classification could all impact the predictive power for microsatellite-instable status.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"93-104"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endoscope-assisted brain tumor removal overcomes the restriction of using intraoperative open magnetic resonance imaging in the suboccipital approach.","authors":"Kei Sasaki, Fumiharu Ohka, Kazuya Motomura, Yuichi Nagata, Kazuhito Takeuchi, Ryuta Saito","doi":"10.18999/nagjms.87.1.168","DOIUrl":"https://doi.org/10.18999/nagjms.87.1.168","url":null,"abstract":"<p><p>Intraoperative magnetic resonance imaging (iMRI) plays a crucial role in improving the precision of brain tumor surgeries. However, the use of iMRI can impose certain limitations on intraoperative head positioning. In regular microscopic surgery, head positioning is of utmost importance because an appropriate surgical field is important for the efficacy and safety of surgery. Therefore, in cases where adequate head positioning is difficult, usually, iMRI will not be utilized. Herein, we report an adult case of cerebellar astrocytoma whose tumor extended to the culmen of the cerebellum. Upon surgery via the suboccipital approach, the positional limitations imposed by iMRI led to an insufficient vertex-down position and limited surgical field, which hampered the removal of the upper portion of the tumor. However, this concern could be overcome when used in combination with an endoscope. The potential of iMRI applications is anticipated to be enhanced by overcoming positional limitations through combined endoscopic surgery. The use of multimodality in surgery is an optimal example of how surgical support equipment can also improve surgical outcomes. Here, we report on the new possibilities offered by multimodality.</p>","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 1","pages":"168-172"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}