Geriatrics (Basel, Switzerland)最新文献

{"title":"\"I Think Deprescribing as a Whole Is a Gap!\": A Qualitative Study of Student Pharmacist Perceptions about Deprescribing.","authors":"Sydney P Springer, Alina Cernasev, Rachel E Barenie, David R Axon, Devin Scott","doi":"10.3390/geriatrics7030060","DOIUrl":"10.3390/geriatrics7030060","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults often manage multiple medications simultaneously, contributing to significant pill burden. Pill burden is a major concern for both patients and providers alike, and student pharmacists may play a role in decreasing that burden. Few studies exist evaluating student pharmacists' roles in and perceptions of deprescribing in the healthcare team. Thus, the aim of this study was to explore student pharmacist perceptions regarding deprescribing in their pharmacy curricula.</p><p><strong>Methods: </strong>This study used a focus group discussion (FGD) methodology to facilitate discussion on deprescribing among student pharmacists. The theory of planned behavior (TPB) informed the conceptualization of this study, data collection, and thematic analysis. Student pharmacists enrolled in three different colleges of pharmacy across various geographical regions of the U.S. were recruited to participate in the study. Data collection occurred in the Fall of 2021, and recruitment proceeded until thematic saturation was achieved. The audio recordings were transcribed verbatim, and the transcripts were uploaded into Dedoose^®, a qualitative software that facilitated the data analysis. The inductive codes were grouped into categories based on similarities that resulted in the themes.</p><p><strong>Results: </strong>Three colleges, totaling 1366 student pharmacists across different geographic regions of the U.S., were invited to participate in this study (UTHSC, N = 682; UNE, N = 158, University of Arizona, N = 526). Twenty-six student pharmacists participated in four FGDs. Of 26 participants, fourteen self-identified as male and two declined to state their gender identity. The mean age was 24 years old, with participants ranging from 21 to 37 years old. Thematic analysis revealed two major themes: (1) student pharmacists indicated that they possessed limited information about the deprescribing process, which is best illustrated by the following quote: \"I think deprescribing as a whole is a gap!\"; and (2) student pharmacists recommended increasing emphasis on deprescribing in pharmacy curricula.</p><p><strong>Conclusions: </strong>Student pharmacists identified few educational experiences on deprescribing in their curriculum while demonstrating a strong desire for more emphasis on deprescribing in the pharmacy curricula. This study highlights an opportunity to improve the integration of deprescribing education into pharmacy curricula, and colleges of pharmacy should evaluate whether, where, and to what extent the incorporation of this topic into their curricula is appropriate.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40253502","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":"Age as a Risk Factor in the Occurrence of Complications during or after Bronchoscopic Lung Biopsy.","authors":"Irina Pocienė,&nbsp;Rasa Gauronskaitė,&nbsp;Domantas Galkauskas,&nbsp;Antanas Mainelis,&nbsp;Vygantas Gruslys,&nbsp;Edvardas Danila","doi":"10.3390/geriatrics7020034","DOIUrl":"https://doi.org/10.3390/geriatrics7020034","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchoscopic lung biopsy (BLB) is a widely used procedure. As the world's population is ageing, more BLBs are performed for older people with comorbidities. The aim of the study was to investigate if an older age is a risk factor for BLB related complications.</p><p><strong>Materials and methods: </strong>A prospective study at the Centre of Pulmonology and Allergology of Vilnius University Hospital Santaros klinikos was conducted. Seven hundred and eighty-six patients (male 60.6%), mean age 57 ± 16, who underwent BLB, were included. The complications that occurred due to BLB were evaluated. Bleeding and pneumothorax were classified into I° or II° grades depending on their severity. Potential determinants, which may increase the risk of complications, emphasizing on age, were analyzed.</p><p><strong>Results: </strong>Fifty-seven (7.2%) BLB-related complications occurred. There were 27 (3.4%) pneumothoraxes, and 19 (70%) of them required thoracic drainage. Thirty (3.8%) bleeding complications occurred, and four (16%) of them were severe. Higher rates of bleeding were found in the age group ≥65 years, <i>p</i> = 0.001. The risk of bleeding in older patients was 3.2 times higher (95% CI 1.51-6.87).</p><p><strong>Conclusions: </strong>Older age is related to a higher incidence of mild bleeding during BLB. However, the risk of life-threatening complications is low despite the age, and older age should not be considered as a contraindication for the procedure if needed.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312933","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":"An Ounce of Prevention, a Pound of Complications: A Case of Statin-Induced Necrotizing Myopathy in a Frail Elderly Patient.","authors":"Oleg Stens,&nbsp;Bradley Neutel,&nbsp;Elizabeth L Goodman","doi":"10.3390/geriatrics7020033","DOIUrl":"https://doi.org/10.3390/geriatrics7020033","url":null,"abstract":"<p><p>The use of statins for primary prevention in older adults remains controversial. In this manuscript, we present a case of an 81-year-old woman with a history of HTN, HLD, Alzheimer's dementia and osteoporosis, who presented to a geriatrics clinic with profound muscle weakness accompanied by new functional deficits in the setting of taking double her prescribed dose of atorvastatin. She was admitted to the hospital where she was found to have rhabdomyolysis. Muscle biopsy and serologic work up revealed anti-HMG statin co-reductase myopathy as the cause of her symptoms. The patient was treated with steroids IVIG and immunomodulators with marked improvement in her weakness; however, her course was complicated by delirium and multiple falls, resulting in several fragility fractures. This case highlights the need to conduct a risk-benefit analysis prior to initiating new therapies in patients with limited life expectancy, including the consideration of the potential for medication errors.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312932","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":"The Challenge of Subjective Cognitive Complaints and Executive Functions in Middle-Aged Adults as a Preclinical Stage of Dementia: A Systematic Review.","authors":"Felipe Webster-Cordero,&nbsp;Lydia Giménez-Llort","doi":"10.3390/geriatrics7020030","DOIUrl":"https://doi.org/10.3390/geriatrics7020030","url":null,"abstract":"<p><p>Subjective cognitive complaints correspond to a heterogeneous construct that frequently occurs in the early stages of older adult life. Despite being a common source of worry for middle-aged people, it can be underestimated when clinical and neuropsychological assessments discard any underlying pathological processes. Negative age stereotyping but also self-stereotyping can contribute to doing so. Although its diagnosis is a challenge, its implication as a possible predictor of mild cognitive impairment or dementia increases the interest in its early diagnosis and intervention. The present systematic review analyzes the empirical data on the relationship between these complaints and early executive dysfunction with possible predictive value for preclinical stages of dementia. The sixteen papers obtained from the PubMed and Embase databases were exploratory, cross-sectional and prospective in scope. The studies corroborated the relationship between subjective cognitive complaints and some executive processes, which is noteworthy since many people with subjective executive complaints progress to dementia. The relational studies confirmed that impaired executive performance is associated with CSF biomarkers and reduced cortical volume in specific brain regions. However, the heterogeneity of reports in these studies demands stronger efforts in future research with specific tools applied in clinical and neuropsychological assessments and analyzed under a gender perspective.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311538","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":"Economic Evaluation of Healthcare Resource Utilization and Costs for Newly Diagnosed Dementia-Related Psychosis.","authors":"Nazia Rashid,&nbsp;James B Wetmore,&nbsp;Muna Irfan,&nbsp;Victor Abler","doi":"10.3390/geriatrics7020029","DOIUrl":"https://doi.org/10.3390/geriatrics7020029","url":null,"abstract":"<p><p>This retrospective cohort study described changes in all-cause healthcare resource utilization (HCRU) and associated costs in dementia patients newly diagnosed with psychosis. Dementia and incident psychosis were identified using diagnostic and pharmacy claims using a Medicare 20% random sample dataset. All-cause HCRU and unweighted and weighted (by person-years of follow-up) HCRU-associated costs were evaluated in the year prior to and the 4 years following diagnosis of psychosis. In 49,509 dementia patients with psychosis, physician visits per patient per year increased from a mean of 26.7 (standard deviation (SD) 20.0) prior to psychosis to 38.4 (SD 41.9) post-psychosis diagnosis. The number of inpatient stay claims increased from 1.0 (SD 1.4) to 1.7 (SD 5.8). Mean unweighted costs for inpatient stays and home healthcare/hospice during 2008-2016 were USD 9989 and USD 3279 prior to a diagnosis of psychosis but increased to USD 25,982 and USD 9901 (weighted: USD 11,779 and USD 6709), respectively, in the year after a psychosis diagnosis. This pattern of a sharp increase in mean costs was also observed in costs adjusted to 2015 USD, and in both unweighted and weighted total and psychosis-related costs. These results indicate the importance of identifying newly diagnosed psychosis in dementia patients as well as the pressing need for management strategies and treatments that can reduce HCRU and costs.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311537","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":"Determinants of Undernutrition and Associated Factors of Low Muscle Mass and High Fat Mass among Older Men and Women in the Colombo District of Sri Lanka.","authors":"Samantha Chandrika Vijewardane,&nbsp;Aindralal Balasuriya,&nbsp;Phyo Kyaw Myint,&nbsp;Alexandra M Johnstone","doi":"10.3390/geriatrics7020026","DOIUrl":"https://doi.org/10.3390/geriatrics7020026","url":null,"abstract":"<p><p>Undernutrition is a health challenge due to an expanding older population. The aims of the study were to assess the prevalence and determinants of undernutrition and, associated factors of low muscle and high fat mass among older men and women in the Colombo district of Sri Lanka. A cross sectional study was conducted using a multistage cluster sampling technique. Undernutrition was defined based on anthropometry and body composition assessed using bio-electrical impedance. Sex-specific multivariable logistic regression analyses were conducted. Of 800 participants (30.6% men), 35.3% were undernourished. The factors significantly associated with undernutrition among older women were hypertension with an adjusted odds ratio (aOR) (1.97; 1.36-2.88) and musculoskeletal disabilities aOR (2.19; 1.36-3.53). Among women, age ≥ 70 (1.79; 1.18-3.34) and diabetes (1.77; 1.10-2.84) were associated with low muscle mass and age ≥ 70 (2.05; 1.21-3.47), diabetes (2.20; 1.35-3.59) and disability in chewing (2.39; 1.30-4.40) were associated with high fat mass. Among men, age ≥ 70 years, no/up to grade 5 education, diabetes, visual disability, little/no responsibility in food shopping and not getting nutritional advice from media were associated with reduced odds of low muscle mass and no/up to grade 5 school education, disability in chewing and little/no responsibility in food shopping were associated with reduced odds of high fat mass. Undernutrition among older people is common in Sri Lanka. We have identified key factors associated with low muscle mass and high fat mass in this setting. Given the potential consequences of these conditions, our study provides potential targets for prevention of undernutrition and sarcopenic obesity.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311533","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":"Inhalation Therapy with Nebulized Capsaicin in a Patient with Oropharyngeal Dysphagia Post Stroke: A Clinical Case Report.","authors":"Anna Maria Pekacka-Egli,&nbsp;Jana Herrmann,&nbsp;Marc Spielmanns,&nbsp;Arthur Goerg,&nbsp;Katharina Schulz,&nbsp;Eveline Zenker,&nbsp;Wolfram Windisch,&nbsp;Stefan Tino Kulnik","doi":"10.3390/geriatrics7020027","DOIUrl":"https://doi.org/10.3390/geriatrics7020027","url":null,"abstract":"<p><p>Dysphagia and aspiration risk are common sequelae of stroke, leading to increased risk of stroke-associated pneumonia. This is often aggravated by stroke-related impairment of cough, the most immediate mechanical defense mechanism against aspiration. In humans, reflex cough can be repeatedly and safely elicited by inhalation of nebulized capsaicin, a compound contained in chili peppers. Could this cough-eliciting property of capsaicin support the recovery of stroke survivors who present with dysphagia and aspiration risk? We present a clinical case report of a 73-year-old man, admitted to inpatient stroke rehabilitation following a right middle cerebral artery infarct with subsequent dysphagia and hospital-acquired pneumonia. A course of daily inhalation therapy with nebulized capsaicin was initiated, triggering reflex coughs to support secretion clearance and prevent recurrence of pneumonia. Clinical observations in each inhalation therapy session demonstrate good patient response, safety and tolerability of nebulized capsaicin in this mode of application. Repeated Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assessments show concurrent improvement in the patient's swallowing status. Inhalation therapy with nebulized capsaicin may offer a viable treatment to facilitate coughing and clearing of secretions, and to minimize aspiration and risk of aspiration-related pneumonia post stroke. Further investigation in a randomized controlled trial design is warranted.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311535","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":"The Multifaceted Role of Neuroprotective Plants in Alzheimer's Disease Treatment.","authors":"Tarek Zieneldien,&nbsp;Janice Kim,&nbsp;Chuanhai Cao","doi":"10.3390/geriatrics7020024","DOIUrl":"https://doi.org/10.3390/geriatrics7020024","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is an age-related, progressive neurodegenerative disorder characterized by impaired cognition, memory loss, and altered personality. Many of the available pharmaceutical treatments do not alter the onset of disease progression. Recently, alternatives to developed drug candidates have been explored including medicinal plants and herbal treatments for the treatment of AD. This article examines the role of herbal plant extracts and the neuroprotective effects as alternative modes of intervention for AD progression. These extracts contain key metabolites that culminate alterations in AD progression. The traditional plant extracts explored in this article induce a variety of beneficial properties, including antioxidants, anti-inflammatory, and enhanced cognition, while also inducing activity on AD drug targets such as Aβ degradation. While these neuroprotective aspects for AD are relatively recent, there is great potential in the drug discovery aspect of these plant extracts for future use in AD treatment.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311534","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 of Single Tocilizumab Administration in an 88-Year-Old Patient with Severe COVID-19 and a Mini Literature Review.","authors":"Cid Ould Ouali,&nbsp;Nadia Ladjouzi,&nbsp;Khidher Tamas,&nbsp;Hendriniaina Raveloson,&nbsp;Jihene Ben Hassen,&nbsp;Nesrine El Omeiri,&nbsp;Georges Zouloumis,&nbsp;Mohamed Moataz Al Zoabi,&nbsp;Muneer Asadi,&nbsp;Aziza Jhouri,&nbsp;Joël Schlatter","doi":"10.3390/geriatrics7010022","DOIUrl":"https://doi.org/10.3390/geriatrics7010022","url":null,"abstract":"<p><p>The new coronavirus disease 2019 (COVID-19) could be associated with elevated inflammatory cytokine levels, suggesting the involvement of cytokine release syndrome. This syndrome is characterized by release of interleukin 6 correlated with COVID-19 severity and mortality. Targeting IL-6 with Tocilizumab treatment could be a potential therapeutic option for old patients. We report the case of an 88-year-old man with COVID-19 disease who presented at the admission with anemia, fever, oxygen desaturation (92%), and inflammatory syndrome (C-reactive protein (CRP) at 182.5 mg/L; reference range <5.0 mg/L). After remaining CRP level increase (206.6 mg/L), Tocilizumab administration led to rapid clinical outcome and resolution of his inflammatory syndrome. This case report represents a supplementary data confirming the efficacy and safety of Tocilizumab for COVID-19 in elderly patients.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39950051","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":"Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia.","authors":"Chukwuma Okoye,&nbsp;Sara Rogani,&nbsp;Riccardo Franchi,&nbsp;Igino Maria Pompilii,&nbsp;Alessia Maria Calabrese,&nbsp;Tessa Mazzarone,&nbsp;Elena Bianchi,&nbsp;Bianca Lemmi,&nbsp;Valeria Calsolaro,&nbsp;Fabio Monzani","doi":"10.3390/geriatrics7010021","DOIUrl":"https://doi.org/10.3390/geriatrics7010021","url":null,"abstract":"<p><p>Corticosteroids have been widely used for acute respiratory distress syndrome (ARDS), but their role in the early phase of SARS-CoV-2 infection is controversial. Our study aimed to determine the effectiveness of early corticosteroid therapy (ECT) in preventing the progression of disease, reducing the escalation of care and improving clinical outcome in older patients hospitalized for COVID-19 pneumonia. A total of 90 subjects (47.7% women; mean age = 82.3 ± 6.7 years) were enrolled. ECT was administered to 33 out of 90 patients before the hospitalization. At admission, no difference was detected in median SOFA score (2, IQR:2 vs. 2, IQR: 2). We found a significant difference in mean PaO₂/FiO₂ ratio during the first week of hospitalization between ECT patients and controls (F = 5.49, <i>p</i> = 0.002) and in mean PaO₂/FiO₂ ratio over time (F = 6.94, <i>p</i> < 0.0001). We detected no-significant differences in terms of in-hospital mortality and transfer to ICU between ECT patients and controls (27.1% vs. 22.8%, respectively, <i>p</i> = 0.63). ECT was associated with worse clinical outcomes, showing no benefit in attenuating the progression of the disease or reducing the escalation of care. These findings are crucial given the current pandemic, and further studies are needed to provide additional data on the optimal timing of initiating corticosteroid treatment.</p>","PeriodicalId":520631,"journal":{"name":"Geriatrics (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39950050","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}