Archives of medical sciences. Atherosclerotic diseases最新文献

{"title":"Comparative outcomes of drug-eluting stents and drug-eluting balloons in treating in-stent restenosis.","authors":"Neeraj Mahajan, Gautam Singal, Munish Sharma","doi":"10.5114/amsad/210583","DOIUrl":"10.5114/amsad/210583","url":null,"abstract":"<p><strong>Introduction: </strong>Several treatment modalities have been proposed and used for bare-metal in-stent restenosis (ISR). We compared the efficacy of drug-eluting balloons (DEB) versus drug-eluting stents (DES) in the treatment of ISR in terms of binary restenosis, target lesion revascularization (TLR) and late lumen loss (LLL) by coronary angiography at 6 months.</p><p><strong>Material and methods: </strong>A total of 41 patients were enrolled in the study. The patients were then randomized to the two arms of the study wherein the control group was treated by the implantation of a second-generation DES and the study group was treated with a paclitaxel-eluting DEB. Late lumen loss and any ISR (the difference between the in-segment minimal lumen diameter (MLD) after the procedure and at 6 months) was the primary end point. Secondary end points included the rate of restenosis and the rate of the combined clinical events up to 6 months, including stent thrombosis, target-lesion revascularization, myocardial infarction, and death.</p><p><strong>Results: </strong>There was a statistically significant difference between DEB and DES treatment in the immediate post-procedure outcome, with DES giving a better immediate post-procedure outcome. No significant difference was observed in late lumen loss between patients treated with either DEB or DES at 6 months follow-up.</p><p><strong>Conclusions: </strong>There was no significant difference in the late lumen loss with either DEB or DES for treatment of ISR.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e167-e171"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373562","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":"Cardiac disease in systemic sclerosis: a narrative review.","authors":"Azka Naeem, Muhammad Hashim Khan, Omair Khan, Syed Mujtaba Baqir, Sheharyar Raashid, Marlon Rivera Boadla, Olayiwola Bolaji, Syed Mohammad Mazhar-Uddin","doi":"10.5114/amsad/209030","DOIUrl":"10.5114/amsad/209030","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is an autoimmune disorder causing immune dysregulation, leading to microvascular damage and fibrosis. Cardiovascular involvement begins with endothelial dysfunction and progresses to vasospasm, ischemia, and fibrosis, impairing cardiac function. Common manifestations include myocardial fibrosis, conduction abnormalities, heart failure, and valvular dysfunction, affecting 15-35% of patients and contributing to 27.2% of SSc-related deaths. High-risk factors include male gender, older disease onset, African American ethnicity, diffuse cutaneous SSc, and poor quality of life. Subclinical cardiac dysfunction is common but underdiagnosed, and cardiovascular complications worsen outcomes. Pulmonary arterial hypertension is a major cause of morbidity and mortality and requires early diagnosis and multidisciplinary management. Treatments include calcium channel blockers, phosphodiesterase inhibitors, endothelin receptor antagonists, and prostacyclin analogs. Imaging (echocardiography, cardiac MRI, stress tests) and biomarkers (troponin, NT-proBNP, endothelin-1) help in diagnosis and monitoring. Early recognition and comprehensive management improve patient outcomes.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e121-e138"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380261","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":"Coronary artery disease and dementia-related mortality among older adults in the United States from 2000 to 2020.","authors":"Muhammad Umer Sohail, Zainab Siddiqua Ibrahim, Saad Ahmed Waqas, Muhammad Saad, Muhammad Ovais Sohail, Alistair Boyd, Megan Jenkins, Syed Khurram Mushtaq Gardezi, Muhammad Rashid, Azfar Zaman, Raheel Ahmed","doi":"10.5114/amsad/209846","DOIUrl":"10.5114/amsad/209846","url":null,"abstract":"","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e146-e150"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380530","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":"Efficacy and safety of catheter ablation for atrial arrhythmias in patients with cardiac amyloidosis: a systematic review and meta-analysis.","authors":"Jawad Basit, Mushood Ahmed, Zaofashan Zaheer, Usman Ali Akbar, Mohammad Hamza, Hamza Naveed, Ali Hasan, Raheel Ahmed, Justin Saunders, M Chadi Alraies","doi":"10.5114/amsad/209031","DOIUrl":"10.5114/amsad/209031","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac amyloidosis (CA) is a restrictive cardiomyopathy characterized by amylin deposits in the heart muscle. While the prevalence of atrial arrhythmias in CA is high, the data regarding the outcomes of catheter ablation in these patients are limited. This study aimed to elucidate the safety and efficacy of catheter ablation for treating atrial arrhythmias in patients with CA.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search across PubMed, Embase and Cochrane from inception till January 2024 for randomized control trials and observational studies reporting catheter ablation (cryoablation or radiofrequency ablation) for the treatment of atrial arrhythmias (AAs) (atrial flutter, atrial fibrillation, atrial tachycardia) in patients with cardiac amyloidosis. The primary outcome of interest was pooled recurrence rate. The secondary outcomes were re-ablation rate and all-cause mortality. All data were analyzed using the Hedges-Olkin random-effects model and presented as percentage proportions.</p><p><strong>Results: </strong>A total of 9 cohort studies (<i>n</i> = 283) were included. The median age ranged from 67.6 years to 76.5 years, with a median follow-up of 13 to 60 months. The pooled incidence of recurrence rate was 45% (95% CI = 23.4% to 66.5%). The pooled proportion of re-ablation rate was 20% (95% CI = 3.3% to 36.7%) and of all-cause mortality was 30.7% (95% CI = 15.5% to 46%).</p><p><strong>Conclusions: </strong>The high rates of recurrence, need for re-ablation, and associated mortality highlight the need for better patient selection. Prospective and randomized controlled data are needed to further study the outcomes of catheter ablation in these patients.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e139-e145"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380535","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":"Charlson Comorbidity Index predicts contrast-induced nephropathy following transcatheter aortic valve replacement.","authors":"Murat Gök, Alparslan Kurtul, İrem B Bulburu, Emirhan Çakır, Nilay Solak, Kenan Yalta","doi":"10.5114/amsad/209029","DOIUrl":"10.5114/amsad/209029","url":null,"abstract":"<p><strong>Introduction: </strong>Transcatheter aortic valve replacement (TAVR) is increasingly used for the management of patients with severe aortic stenosis at high risk for surgical valve replacement. In this setting, we analysed the potential value of the Charlson Comorbidity Index (CCI) in contrast-induced nephropathy (CIN) prediction in subjects undergoing TAVR.</p><p><strong>Material and methods: </strong>We analysed consecutive subjects who had undergone TAVR at our institution between June 2013 and March 2023, and defined their co-morbid conditions as measured with the CCI. Thereafter, we analysed the association of this index with CIN development following TAVR. In this context, the CCI score was calculated separately for each subject. The subjects were then categorized into two groups based on their CIN status: CIN- group and CIN+ group.</p><p><strong>Results: </strong>In a population of 118 subjects (mean age: 79.3 ±6.8 years), the mean CCI score was found to be 4.83 ±1.32. The CIN+ group had a significantly higher mean CCI value in comparison to the CIN- group (5.80 ±1.15 vs. 4.56 ±1.25, <i>p</i> < 0.001). After multivariable adjustment, CCI was found to have an independent association with CIN evolution (OR = 1.845, 95% CI: 1.053-3.233, <i>p</i> = 0.032). The area under the ROC curve was 0.766 (95% CI: 0.663-0.869, <i>p</i> < 0.001), whereas the sensitivity and specificity values were 78.0% and 52.0%, respectively, based on an optimum cut-off value of 4.5.</p><p><strong>Conclusions: </strong>The CCI was independently associated with CIN evolution and may help predict CIN alongside other risk models after TAVR.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e115-e120"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380282","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":"Mortality trends in elderly patients with disseminated intravascular coagulation: a retrospective CDC WONDER Analysis (1999-2020).","authors":"Piyush Ratan, Kritika, Umair Iqbal, Hoorish Khan, Parsa Ijaz, Fareeda Brohi, Fatima Zahra, Saad Ahmed Waqas, Farhan Shahid, Ashish Gupta, Saba Aliha, Raheel Ahmed","doi":"10.5114/amsad/209037","DOIUrl":"10.5114/amsad/209037","url":null,"abstract":"<p><strong>Introduction: </strong>A rising trend in mortality due to disseminated intravascular coagulation (DIC) was observed in the US population. However, DIC-related mortality trends among older adults > 65 years have not been investigated before. The objective of the study was to analyze the mortality trends in elderly patients with DIC.</p><p><strong>Material and methods: </strong>Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) database were analyzed from 1999 to 2020 for DIC-related mortality in elderly patients > 65 years of age. Age-adjusted mortality rates (AAMR) per 100,000 people and annual percentage change (APC) were calculated and stratified by age, sex, race/ethnicity, and geographic region.</p><p><strong>Results: </strong>This study examines the mortality trend in older patients (> 65 years) with disseminated intravascular coagulation between 1999 and 2020. Out of the total 39,853 deaths, 93.1% occurred in medical facilities. From 6.4 to 4.0 per 100,000, the overall age-adjusted mortality (AAMR) decreased steadily until 2015, followed by a slight increase. Mortality trends varied by sex, race, and geographic region, with African Americans showing the highest AAMR and the Southern U.S. reporting the highest regional burden. The necessity for focused treatments to address racial and regional disparities in DIC-related mortality is underscored by persistent differences, even when overall trends indicate improvement.</p><p><strong>Conclusions: </strong>Although DIC-related mortality decreased between 1999 and 2020, a recent upward trend has been observed. Notable disparities persist, with the Southern region and non-Hispanic African Americans experiencing the highest burden. Targeted interventions and enhanced surveillance are essential to address these inequalities and prevent further increases.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e159-e166"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380513","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":"Efficacy and safety of microaxial flow pump in infarct-related cardiogenic shock: a meta-analysis.","authors":"Rafia Hussain, Saira Bano, Hanzalah Bin Arshad, Komal Fatima, Muhammad Umar Liaqat, Aeman Waqar, Muhammad Hamza Nasim, Ayesha Javed, Saad Javed, Mfonobong Umoh, Raheel Ahmed, Mushood Ahmed, Muhammad Ayyan, Saad Ur Rahman, Mudassar Baig, Farhan Shahid","doi":"10.5114/amsad/209032","DOIUrl":"10.5114/amsad/209032","url":null,"abstract":"<p><strong>Introduction: </strong>Data regarding mechanical circulatory support with a microaxial flow pump (Impella) in patients with myocardial infarction complicated by cardiogenic shock are limited.</p><p><strong>Methods: </strong>PubMed/Medline, Embase, and the Cochrane Library were used to search for randomized controlled trials (RCTs) from inception to 16 June 2024. Risk ratios (RRs) were pooled with corresponding 95% confidence intervals (CIs) using the random effects model.</p><p><strong>Results: </strong>Four RCTs were included. The pooled analysis demonstrated a significantly reduced risk of all-cause death in patients with the use of a microaxial flow pump at 6-month follow-up (RR = 0.80; 95% CI: 0.67 to 0.97) and cardiac death (RR = 0.68; 95% CI: 0.49 to 0.94) as compared to the control group. However, the use of a microaxial flow pump was associated with a significantly increased risk of major bleeding (RR = 2.27; 95% CI: 1.21 to 4.24), limb ischemia (RR = 4.46; 95% CI: 1.31 to 15.16), and sepsis (RR = 2.01; 95% CI: 1.11 to 3.67). The risk of stroke and rehospitalizations remained comparable across the two groups.</p><p><strong>Conclusions: </strong>The use of a microaxial flow pump in infarct-related cardiogenic shock can reduce mortality at the expense of increased risk of bleeding, limb ischemia, and sepsis. Further research is required to validate our findings.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e151-e158"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380488","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":"Changing trends in myocardial infarction mortality among young adults in the United States: a 25-year analysis of disparities and the COVID-19 impact.","authors":"Ahmad Mesmar, Rawan Abukhater, Waleed Abdalla, Eeshal Zulfiqar, Maryam Shahzad, Sonia Hurjkaliani, Sidra Shah, Noha Aboukhater, Duaa Aljuhaymi, Ahmad Talaat Deiab, Babiker Elsiraj, Muhammad Usman, Talal Warsi, Samah Fadlelseed, Omar Mohamad Alhaj, Mushood Ahmed, Ashish Gupta, Farhan Shahid, Raheel Ahmed, Syed Khurram M Gardezi","doi":"10.5114/amsad/209035","DOIUrl":"10.5114/amsad/209035","url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial infarction (MI) generally occurs among old individuals. However, changing dietary patterns, stress, and smoking have led to an increased risk of MI among young adults. This study aimed to analyze 25-year MI-mortality-related trends among young adults (15-44 years) in the US.</p><p><strong>Material and methods: </strong>The death certificates from the CDC WONDER database (1999-2023) were analyzed to identify MI-related mortality, reporting age-adjusted mortality rates (AAMRs) per 100,000 people, and annual percentage changes (APCs).</p><p><strong>Results: </strong>A total of 91,482 deaths were attributed to MI among young adults in the US from 1999 to 2023. The AAMRs declined from 3.8 in 1999 to 2.5 in 2018, followed by an increase to 3.2 by 2021 (APC = 8.1), coinciding with the COVID-19 pandemic. This was followed by a decline to an AAMR of 2.3 in 2023. Men had consistently higher AAMR compared to women throughout the study period (average AAMR: 4.5 vs. 1.8). Among racial/ethnic groups, the highest AAMR was observed in the non-Hispanic (NH) Black or African American individuals (5), followed by the NH White (3.2), Hispanic or Latino (1.5), and NH Other populations (1.3) in 2023. The southern region had the highest AAMR when stratified by census regions, and rural areas had higher mortality rates than urban areas (6.4 vs. 2.6).</p><p><strong>Conclusions: </strong>From 1999 to 2023, MI-related mortality among young adults in the US showed an overall decline, with a temporary increase during the COVID-19 pandemic. Men, NH Black individuals, and those in rural or southern regions had consistently higher mortality rates. These findings highlight persistent disparities in MI-related mortality across demographic and geographic groups.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e104-e111"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380233","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":"Oxidized HDL status in hemodialysis patients with peripheral arterial disease: a pilot study.","authors":"Kazuhiko Kotani, Daisuke Matsubara, Hideyuki Mukai, Manabu Ogura, Yoshitaka Iwazu","doi":"10.5114/amsad/209040","DOIUrl":"10.5114/amsad/209040","url":null,"abstract":"","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e112-e114"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380497","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":"Correlation of acute myocardial injury and long-term cardiac function in COVID-19 survivors with acute myocarditis.","authors":"Spyridon Maragkoudakis, Manolis Sideras, Grigoris Chlouverakis, Eirene Lagoudaki, Gabriella Lilikaki, Vasiliki Papakosta, Eleutherios Kallergis, Evangelos Zacharis, Emmanouil Simantirakis, George Kochiadakis, Maria Marketou","doi":"10.5114/amsad/209039","DOIUrl":"10.5114/amsad/209039","url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial injury, indicated by elevated troponin levels, is common among patients hospitalized with COVID-19. This study aimed to evaluate the correlation between the degree of myocardial injury in myocarditis patients and imaging parameters of systolic and diastolic cardiac function and clinical outcome over a 6-month follow-up period.</p><p><strong>Material and methods: </strong>Atotal of 59 COVID-19 myocarditis patients with elevated high-sensitivity troponin levels (hs-cTnI) were included. Demographic data, laboratory results, and clinical outcomes were collected from hospital electronic health records. All patients underwent cardiac magnetic resonance imaging (cMRI) and a comprehensive echocardiographic evaluation at baseline and at the 6-month follow-up.</p><p><strong>Results: </strong>COVID-19 myocarditis was confirmed in all patients undergoing cMRI. The mean hs-cTnI level among the patients was 281.27 ±400.86 ng/l. Hs-cTnI elevation showed a significant positive correlation with left ventricular global longitudinal strain (LVGLS) values (<i>p</i> < 0.001, <i>r</i> = 0.6) but not with right ventricular global longitudinal strain (RVGLS) values (<i>p</i> = 0.155, <i>r</i> = 0.187). Reduced LVGLS values were significantly associated with late gadolinium enhancement (LGE) (<i>p</i> < 0.001, <i>r</i> = 0.509) in cMRI and with the administration of antiviral medications, including treatment of remdesivir (<i>p</i> < 0.001, <i>r</i> = 0.62) indicative of more severe disease.</p><p><strong>Conclusions: </strong>The increase in hs-cTnI levels in COVID-19 myocarditis patients is associated with future impairment in left ventricular systolic function and deterioration of left ventricular myocardial strain. These findings highlight the importance of monitoring cardiac function in patients with acute myocarditis following COVID-19 infection during long-term follow-up.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e89-e95"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380480","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}