JBRA assisted reproduction最新文献

{"title":"SRY-negative 46,XX testicular disorder of sex development (de la Chapelle syndrome) presenting with primary infertility: a case report.","authors":"Shubhi Srivastava, Sangita Sharma","doi":"10.5935/1518-0557.20260040","DOIUrl":"10.5935/1518-0557.20260040","url":null,"abstract":"<p><p>De la Chapelle syndrome describes phenotypic males with a 46,XX karyotype, most commonly caused by translocation of the SRY gene. The SRY-negative variant is exceptionally rare and invariably associated with non-obstructive azoospermia. Awareness of this condition is important for infertility specialists, as genetic evaluation can establish an accurate diagnosis early in the workup and guide appropriate counselling. We report the case of a 30-year-old man who presented with primary infertility. Clinical examination revealed small testes with an otherwise normal male phenotype. Semen analysis confirmed azoospermia, and hormonal testing showed elevated gonadotropins with borderline testosterone levels. Imaging demonstrated reduced testicular volume without malignant features. Karyotype analysis revealed a 46,XX constitution, and molecular testing confirmed the absence of the SRY gene, establishing the diagnosis of SRY-negative de la Chapelle syndrome. Based on these findings, the patient was counselled regarding the futility of autologous sperm retrieval and was advised on donor-assisted reproductive options. Written informed consent was obtained for publication. This case highlights the value of incorporating genetic testing into the evaluation of non-obstructive azoospermia. Early recognition avoids unnecessary invasive interventions such as testicular sperm extraction and allows couples to receive timely counselling about realistic reproductive options. Although natural fertility cannot be achieved, assisted reproduction with donor sperm offers a viable pathway to parenthood. Comprehensive care, including endocrine monitoring, psychosocial support, and multidisciplinary management, ensures optimal outcomes for affected individuals.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"433-435"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304594","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":"Integrated Role of NRF2 and p53 Gene Expression in Hormonal and Biochemical Dysregulation Among Infertile Males.","authors":"Aswathy Sundaresh, J S Jiju, Arun William, Aswathi Rajan, Soumya Jose, G Aswathy, Aksa Simon, Vineetha Vijayan, Bobby Joseph, E V Ajitha, Sreeshma P Pillai, D Dinesh Roy","doi":"10.5935/1518-0557.20260010","DOIUrl":"10.5935/1518-0557.20260010","url":null,"abstract":"<p><strong>Objective: </strong>Male infertility is a multifactorial condition often linked to oxidative stress and apoptosis. Key molecular regulators, such as NRF2 (antioxidant defense) and p53 (cell cycle and apoptosis), are influenced by hormonal and inflammatory pathways; however, their combined role in infertility remains underexplored. This study investigates the integrated expression of NRF2 and p53 genes and their association with hormonal, inflammatory, and biochemical markers in infertile males.</p><p><strong>Methods: </strong>A case-control study was conducted on 300 males (150 infertile, 150 fertile controls). Gene expression (NRF2, p53) was analyzed using RT-PCR. Hormonal (FSH, testosterone, estradiol), inflammatory (IL-6), and biochemical (SOD, PSA) markers were measured via ELISA. Statistical analysis included t-tests, ROC, scatter plot, and multiple regression.</p><p><strong>Results: </strong>Infertile men showed significantly reduced NRF2 expression and SOD levels, with elevated FSH, estradiol, IL-6, PSA, and p53 expression (p<0.001). ROC analysis identified FSH and NRF2 as strong predictors of infertility. Regression revealed IL-6 and PSA as significant positive predictors of p53 expression, while SOD positively correlated with NRF2. Scatterplots highlighted contrasting biomarker associations for NRF2 and p53.</p><p><strong>Conclusions: </strong>Combined dysregulation of NRF2 and p53, driven by oxidative, hormonal, and inflammatory factors, plays a critical role in male infertility. These genes hold promise as both diagnostic biomarkers and therapeutic targets.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"294-301"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304597","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":"Global Research Trends in Immunotherapies for Recurrent Pregnancy Loss: A Bibliometric Analysis.","authors":"Marcelo Borges Cavalcante, Daniel de Sousa Sobral, Raíssa Helen de Andrade Praciano, Maria Edith Holanda Banhos, Cristiana Libardi Miranda Furtado","doi":"10.5935/1518-0557.20250188","DOIUrl":"10.5935/1518-0557.20250188","url":null,"abstract":"<p><p>This bibliometric study investigates global research trends in the application of immunotherapies for managing recurrent pregnancy loss (RPL). Data were retrieved from the Web of Science (WoS) database, encompassing 1,735 publications from 1964 to 2024. The analysis demonstrates a steady increase in research activity, with an average annual growth rate of 1.14%. Leading journals in the field include The American Journal of Reproductive Immunology and Human Reproduction, while prominent contributors such as Ole Bjarne Christiansen and William H. Kutteh have significantly influenced the domain. The United States, China, and the United Kingdom were identified as the most productive countries in terms of publication volume and citation metrics. Keyword co-occurrence analysis reveals a thematic progression from early-stage experimental treatments to a more advanced focus on immunological and molecular mechanisms underlying RPL. Among various therapeutic modalities, heparin, aspirin, and intravenous immunoglobulin have been the most frequently studied. Meanwhile, novel immunotherapies are emerging as promising alternatives, although their clinical efficacy remains to be thoroughly validated. This study emphasizes the critical role of international collaboration in advancing the field and highlights persistent research gaps that warrant further investigation. Overall, the findings provide a comprehensive overview of the evolution, current status, and future directions of immunotherapy research in the context of recurrent pregnancy loss..</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"371-381"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314529","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":"In Vitro Fertilization and Placenta Accreta (spectrum): A Systematic Review.","authors":"Ana Carolina Wickert Theisen, Nathália Fritsch Camargo, Talita Colombo","doi":"10.5935/1518-0557.20250192","DOIUrl":"10.5935/1518-0557.20250192","url":null,"abstract":"<p><p>In vitro fertilization (IVF) has transformed infertility treatment, providing options for individuals struggling to conceive naturally, with significant success rates, particularly in women under 35. However, IVF pregnancies are associated with potential obstetric complications, notably placenta accreta spectrum (PAS), which necessitates early diagnosis and a multidisciplinary approach to safeguard maternal-fetal health. This systematic review involved a comprehensive search of databases such as PubMed, Cochrane Library, BVS, Embase, Web of Science, and Scopus using specific terms related to IVF and PAS. Original studies comparing spontaneous pregnancies to IVF pregnancies were included, while case reports and non-peer-reviewed articles were excluded. Data extraction was standardized, and study quality was assessed using the Newcastle-Ottawa tool. The analysis covered thirteen articles involving 252,295 assisted reproductive technology pregnancies and over 16 million spontaneous pregnancies. A key finding is the increased risk of PAS in IVF pregnancies, with some studies indicating that frozen embryo transfer (FET) poses a higher risk than fresh embryo transfer. Additional complications include hypertension, preeclampsia, and intrauterine growth restriction (IUGR). Interestingly, some research suggests a lower Intensive Care Unit admission rate for women with placenta accreta after IVF compared to those with spontaneous conception. This indicates that while assisted reproductive technology is an independent risk factor for PAS, it presents a unique risk profile. The review emphasizes the need for further research into maternal outcomes related to PAS after assisted reproductive techniques (ART) and highlights the importance of specialized follow-up and rigorous prenatal diagnosis to minimize complications in these pregnancies.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"364-370"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314527","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":"Causal Relationship Between Gut Microbiota and Female Infertility: A Bidirectional Mendelian Randomization Analysis.","authors":"Qiuying Gan, Lidan Liu, Bo Liu, Mujun Li","doi":"10.5935/1518-0557.20260016","DOIUrl":"10.5935/1518-0557.20260016","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the causal relationship between gut microbiota and female infertility using a Mendelian randomization (MR) approach.</p><p><strong>Methods: </strong>A bidirectional MR analysis was conducted using genome-wide association study (GWAS) data from European populations. Genetic variants (SNPs) linked to 473 bacterial species were used as instrumental variables. Data on female infertility were obtained from the FinnGen study, while gut microbiota-related genetic data were sourced from the NHGRI-EBI GWAS Catalog. Several MR methods, including inverse-variance weighted (IVW) analysis, were employed to assess causal associations.</p><p><strong>Results: </strong>Seven bacterial taxa, including Actinomycetales, Bifidobacterium, Bifidobacteriaceae, Actinobacteria, Prevotella sp002933775, GCA-900199385 sp900320755, and CAG-841 sp002479075, were found to have a protective effect against female infertility. Higher levels of these bacterial taxa were associated with a lower risk of infertility. No evidence of reverse causality was found, indicating a unidirectional relationship between gut microbiota and female infertility.</p><p><strong>Conclusion: </strong>This study supports the concept of a gut-reproductive axis by establishing causal relationships between specific bacterial species and female infertility, suggesting potential avenues for therapeutic interventions.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"334-340"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304606","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":"Anti-Mullerian Hormone As A Predictor Of Live Birth For Patients With Unexplained Recurrent Pregnancy Loss.","authors":"Edward R McClellan, Yael Eliner, Hillary Pearson, Timothy J Rafael, Ji Yoon Lee, Randi Goldman, Mary Rausch","doi":"10.5935/1518-0557.20260002","DOIUrl":"10.5935/1518-0557.20260002","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether anti-mullerian hormone (AMH) levels were associated with live birth and miscarriage rates following the first euploid frozen embryo transfer (FET) cycle for patients with unexplained recurrent pregnancy loss (URPL).</p><p><strong>Methods: </strong>This retrospective cohort study included all patients (n=63) at an academic medical center in New York undergoing their first euploid FET with a sole diagnosis of URPL between October 2019 and October 2023. URPL was defined as a history of two or more spontaneous abortions (SAB) after a pregnancy (defined as a positive home pregnancy test or serum hCG > 2mIU/mL) and before 20 weeks of gestation without a known cause. Patient demographic data was obtained, and the primary outcomes of live birth and miscarriage were assessed while controlling for relevant clinical variables (obesity, prior number of spontaneous abortions, and aneuploidy). Significance was set at p<0.05.</p><p><strong>Results: </strong>Lower AMH (<1 ng/mL) was associated with having fewer total blastocysts from prior IVF cycles (p=0.02). Patients with lower AMH also had fewer euploid blastocysts from prior IVF cycles, although this difference was not statistically significant (p=0.08). There were no significant differences based on AMH, and the overall miscarriage rate was 21.3%. Adjusting for obesity and prior number of SABs, AMH was not associated with live birth (aOR 1.12 (95% CI 0.93-1.35), p=0.23) or miscarriage (aOR 0.88 (95% CI 0.64-1.19), p=0.40).</p><p><strong>Conclusions: </strong>These results suggest that once a euploid embryo is created, AMH is not associated with subsequent transfer outcomes among women with URPL.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"282-285"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304625","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":"Impact of a Medical Career on Reproductive Planning and Knowledge of Assisted Reproductive Technology Among Brazilian Women.","authors":"Kadija Rahal Chrisostomo, Ana Paula Muller Penachio, Camila de Angelis Bazzaneze, Najila de Marco Sandrin, Renato Nisihara","doi":"10.5935/1518-0557.20260027","DOIUrl":"10.5935/1518-0557.20260027","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether women in the medical field have different reproductive plans compared to women in other areas of higher education. Also, to assess their knowledge of assisted reproductive technologies (ART) and their interest in oocyte cryopreservation.</p><p><strong>Methods: </strong>This cross-sectional, analytical study was conducted using an anonymous online questionnaire administered between November and December 2024. The study included Brazilian women who were nulliparous, had higher education, and were divided into two groups: the study group (medical students and physicians) and the comparison group (women from other higher education fields). The questionnaire covered sociodemographic data, lifestyle habits, professional trajectories, affective relationships, reproductive intentions, and knowledge about ART.</p><p><strong>Results: </strong>A total of 905 women were included. The groups they were divided into had a similar age distribution. Most participants were aged between 18 and 29 years. The study group (n=490) reported higher income, greater levels of physical activity, and less smoking (p<0.0001). The impact of workload on relationship quality, academic plans, partner preferences, and perceived professional impact was more significant in the study group compared with controls (p<0.0001). They more frequently cited the demands of the medical profession as detrimental to their relationships. A higher proportion of women in this group planned to conceive later in life (61.8% vs. 34.1%; p<0.0001). Knowledge and acceptance of ART, especially oocyte cryopreservation, were significantly higher, with over 58% considering future use.</p><p><strong>Conclusions: </strong>A medical career greatly affects women's reproductive choices, resulting in delayed motherhood despite strong reproductive desires. Providing early access to fertility education and ART options could be a strategy to promote reproductive autonomy among women in medicine.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"346-352"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304595","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":"Use of Artificial Intelligence in the choice of sperm for ICSI - A Literature Review.","authors":"Lorrany Lima Ricarte, Raissa de Vasconcelos Cavalcanti, Paula Bruno Monteiro","doi":"10.5935/1518-0557.20260008","DOIUrl":"10.5935/1518-0557.20260008","url":null,"abstract":"<p><p>This study aimed to verify, through a systematic literature review, the effects of using artificial intelligence (AI) for sperm selection in intracytoplasmic sperm injection (ICSI). Searches were conducted in the PubMed, SciELO and MEDLINE (Academic) databases, including full-text cohort studies, cross-sectional studies and clinical trials published between 2015 and April 2025 in English, Portuguese and Spanish. Animal studies, review articles, letters to the editor, case reports, duplicate records, incomplete papers and unavailable articles were excluded. Extracted data comprised author, year of publication, AI type, assessed stage/section and classification. Overall, the available evidence indicates that AI-based approaches may be effective for selecting sperm for ICSI.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"396-400"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304588","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":"Disparity between Post-thaw Survival and Functional Integrity of Vitrified-thawed Oocytes from Obese Mice.","authors":"Sandhya Kumari, Aparna Chelvi, Vanishree Vasave Madhvacharya, Aishwarya Ashok, Mouna Bannur Karunakara, Yashas Kiran Ninjoor, Jyolsna Ponnaratta Kunhiraman, Amrutha Nedumbrakkad Kunnath, Keerthana Karunakar Poojary, Sneha Guruprasad Kalthur, Satish Kumar Adiga, Guruprasad Kalthur","doi":"10.5935/1518-0557.20260020","DOIUrl":"10.5935/1518-0557.20260020","url":null,"abstract":"<p><strong>Objective: </strong>Obesity in women is known to be associated with compromised ovarian function. The oocytes are characterized by elevated cytoplasmic oxidative stress and poor cytoplasmic organization under such conditions, which might affect their tolerance to exogenous stresses such as the freeze-thaw process. This study investigates the cryosusceptibility of oocytes derived from mice with high-fat diet (HFD)-induced obesity.</p><p><strong>Methods: </strong>Three-weeks-old female mice were divided into a control group (fed a normal chow diet) and an obese group (fed with HFD for 12 weeks). Oocytes from both groups were subjected to vitrification and thawing. Post-thaw survival, reactive oxygen species (ROS) levels, mitochondrial and endoplasmic reticulum (ER) distribution, ER stress, and the maturation potential of GV stage oocytes were evaluated.</p><p><strong>Results: </strong>Despite increased lipid accumulation and higher ROS levels observed in the oocytes of obese mice, the post-thaw survival rate of GV oocytes was comparable between the groups. However, obesity induced alterations in mitochondrial and ER distribution. Additionally, MII oocytes derived from vitrified-thawed germinal vesicle (GV) stage oocytes of obese mice showed a significantly higher percentage of spindle defects. A notable increase in ER stress markers GRP78 and ATF4 was detected in frozen-thawed GV oocytes compared to the control group.</p><p><strong>Conclusions: </strong>These findings suggest that maternal obesity does not significantly affect the cryosurvival of oocytes, but it does compromise oocyte quality after vitrification, underscoring the need for optimized cryopreservation strategies in obese patients undergoing ART.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"324-333"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304589","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 Emotional Experience of Pregnancy in a Transgender Man: A Case Report.","authors":"Juliana Roberto Dos Santos, Caio Parente Barbosa, Bianca Bianco","doi":"10.5935/1518-0557.20260021","DOIUrl":"10.5935/1518-0557.20260021","url":null,"abstract":"<p><p>The present study aimed to understand the lived experience of a transgender man who underwent pregnancy. The existing literature indicates that many professionals are not prepared to assist transgender individuals, often supporting a heteronormative view of sexuality and reproduction. This case report explored whether the experience of pregnancy impacted the gender identity and experience of masculinity in a transgender man. A clinical case study methodology was employed. Initially, it was hypothesized that pregnancy would neither compromise the participant's male identity nor weaken his experience as a transgender man. One transgender man expressed a desire to carry his genetic child. Our findings revealed that he began to enjoy the experience and was positively reconnected with his pregnant body by the sixth month of pregnancy. The psychic elaboration of the fantasy that \"carrying a pregnancy is not a man's thing\" made him reconsider the feelings of impotence and vulnerability that are traditionally attributed to the females. He had a satisfactory experience with the healthcare team. He actively assumed the role of \"father-birthgiver,\" demonstrating that fathers are also capable of sensitively responding to a baby's emotional needs. Although it mobilized complex psychological processes, the pregnancy experience did not cause identity disruption. This study indicates that transgender men can be psychologically and emotionally available for a baby in a state of absolute dependence.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 2","pages":"429-432"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304582","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}