Rwanda journal of medicine and health sciences最新文献

{"title":"Overview of Rehabilitation in Low- and Middle-Income Countries.","authors":"Jean Claude Karimwabo","doi":"10.4314/rjmhs.v9i2.1","DOIUrl":"10.4314/rjmhs.v9i2.1","url":null,"abstract":"","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 2","pages":"264-265"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898781","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":"Community-Delivered, Task-Shifted Trauma-Focused Intervention for Youth in Northwest Nigeria: Mental Health and Functional Outcomes of a Mixed-Methods Study.","authors":"Yakubu Abdullahi, Bashar Summayyah, Aveka Audu, Yakasai Bashir","doi":"10.4314/rjmhs.v9i2.7","DOIUrl":"10.4314/rjmhs.v9i2.7","url":null,"abstract":"<p><strong>Background: </strong>Trauma affected youth in northwest Nigeria's humanitarian crisis face trauma exposure and limited mental health care; this study evaluated outcomes of a task-shifted, community delivered intervention.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods, quasi-experimental design was employed. Participants (N=412, aged 15-24) were allocated to intervention (n=206) receiving a culturally adapted 10-session group Trauma-Focused Cognitive Behavioural Therapy (CBT) delivered by trained community lay providers, or to the waitlist control (n=206). Primary outcomes were posttraumatic stress disorder (PTSD) symptoms (Child PTSD Symptom Scale [CPSS]) and functional impairment (WHO Disability Assessment Schedule for Children). Assessments occurred at baseline, post-intervention, and 3 month follow up. Analysis used intention to treat three level linear mixed models accounting for clustering within communities. Qualitative methods involved 24 key informant interviews analysed using thematic analysis following COREQ guidelines.</p><p><strong>Results: </strong>At post-intervention, the intervention group showed significantly greater reductions in CPSS (mean difference: -8.3, 95% CI: -10.6 to -6.0, p<0.001, d=1.35) and WHODAS-Child scores (mean difference: -8.9, 95% CI: -11.5 to -6.3, p<0.001, d=1.40) compared to controls. Gains were maintained at follow-up. Qualitative themes highlighted the necessity of health system integration and community ownership for sustainability.</p><p><strong>Conclusion: </strong>A task-shifted, community-delivered trauma-focused intervention demonstrates promising effectiveness in reducing PTSD symptoms and improving functioning among youth in northwest Nigeria, indicating potential for scale-up pending confirmatory evidence from randomised controlled trials and health system integration.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 2","pages":"342-355"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898389","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":"Hepatotoxic Potentials of Food Additives on Liver Enzymes and Tissues of Wistar Rats.","authors":"Ude Ugomma, Okorie Nnaemeka, Uzor Simon, Kalu Micheal, Okekpa Simon, Valentine Nyirahafashimana, Usanga Victor, Mmesomachi Bethel Uche, Obi Ihuoma, Onwe Doris, Iyke-Ogbo Pauline, Onwudiwe Victor","doi":"10.4314/rjmhs.v9i2.6","DOIUrl":"10.4314/rjmhs.v9i2.6","url":null,"abstract":"<p><strong>Background: </strong>Food additives such as monosodium glutamate (MSG), sodium benzoate (SB), and Sunset Yellow (SY) are widely consumed and have been linked to adverse hepatic effects. However, the available evidence is largely derived from in vitro or single-additive studies, with limited comparative in vivo data integrating biochemical and histopathological outcomes under uniform experimental conditions.</p><p><strong>Objective: </strong>This study compared the hepatotoxic effects of MSG, SB, and SY in a Wistar rat model to address gaps in controlled in vivo evidence on multiple food additives.</p><p><strong>Methods: </strong>Sixteen healthy Wistar rats were randomly assigned to four groups. The control group received a standard diet, while Groups II-IV received MSG, SB, and SY respectively. Hepatotoxicity was assessed by measuring serum activities of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, together with histopathological examination of liver tissue.</p><p><strong>Results: </strong>The MSG and SB significantly increased aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels compared with controls (p < 0.05), indicating hepatocellular and cholestatic injury. Sunset Yellow did not significantly alter ALT levels (p = 0.074) but showed mild histopathological changes.</p><p><strong>Conclusion: </strong>Both MSG and SB exhibited greater hepatotoxic effects than SY in Wistar rats. These findings highlight the need for routine safety re-evaluation of commonly consumed food additives, strengthened regulatory oversight, and further long-term studies to inform evidence-based public health policies.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 2","pages":"327-341"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898767","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":"Clinical Significance of Lipoprotein and Ceruloplasmin Variations in Type 2 Diabetes Mellitus: A Cross-Sectional Study in Owo, Nigeria.","authors":"Adedeji David Atere, Oluomachi Precious Nwimo, Mega Obukohwo Oyovwi, Yekeen Adebisi Kosamat, Adekunle Abiodun Adesiyan","doi":"10.4314/rjmhs.v9i2.4","DOIUrl":"10.4314/rjmhs.v9i2.4","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance leading to hyperglycemia, dyslipidemia, and oxidative stress. Ceruloplasmin (CP), the major oxidase and copper-binding protein, has recently been under investigation as an indicator of metabolic dysfunction. Increased CP levels cause oxidative stress and inflammation and thus promote numerous cardiovascular and renal complications. Determination of CP could serve as an early reliable biomarker for timely intervention in the holistic management of T2DM. The present study was designed to compare lipoprotein levels, CP, and oxidative stress markers between participants with diabetes and those without diabetes.</p><p><strong>Methods: </strong>Fifty patients with T2DM were evaluated along with 30 age- and sex-matched non-diabetic controls visiting Federal Medical Centre, Owo. Standard enzymatic and ELISA techniques assessed biochemical parameters such as fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), CP, malondialdehyde (MDA), and total antioxidant status (TAS). Data were analyzed by SPSS Version 25. The independent t-test was then used to determine the difference between group means in the biochemical markers. Spearman's correlation was applied to establish relationships, and the level of significance was set at p<0.05.</p><p><strong>Results: </strong>The FBS, CP, TC, TG, HDL, VLDL, and MDA levels were all statistically significant in patients with T2DM, while TAS decreased remarkably (p<0.05). Obese participants showed exacerbated dyslipidemia and oxidative stress. Positive correlations were observed between CP and lipid parameters, while MDA negatively correlated with TAS.</p><p><strong>Conclusion: </strong>Ceruloplasmin was raised in T2DM, dyslipidemia, and lowered antioxidant capability were early markers that prompt intervention for oxidative stress and biochemical derangements in patients with T2DM. In this regard, CP could potentially emerge as a novel marker to monitor the progression of complications in T2DM.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 2","pages":"299-310"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898429","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":"Perceptions of Sexual and Reproductive Health and Rights among Students at a Higher Learning Institution in Rwanda.","authors":"Alice Muhayimana, Aline Uwase, Pacifique Umubyeyi, Irene Josephine Kearns, Aimable Nkurunziza","doi":"10.4314/rjmhs.v9i2.2","DOIUrl":"10.4314/rjmhs.v9i2.2","url":null,"abstract":"<p><strong>Background: </strong>Higher Learning Institution (HLI) students face many risks, including unintended pregnancies, sexually transmitted infections, and unsafe abortions, due to limited knowledge of Sexual and Reproductive Health and Rights (SRHR), and while this issue is documented in low- and middle-income countries, evidence from Rwanda remains scarce. This study explored the experiences and perceptions of SRHR among undergraduate students at a HLI in Rwanda.</p><p><strong>Methods: </strong>The study conducted in February 2023 used a qualitative exploratory approach was employed, involving in-depth interviews with 10 purposively selected students, one male and one female from each of the five colleges who had participated in a prior quantitative study. The interviews, conducted in Kinyarwanda, were transcribed verbatim, translated into English, and analysed thematically.</p><p><strong>Results: </strong>Four major themes emerged: 1) Acceptance of premarital sexual intercourse among youth, 2) Contraceptive awareness, myths, and method preferences, 3) Sources of SRHR information, and 4) Divergent views on abortion. The study found limited access to accurate SRHR information, persistent contraceptive myths, and stigma affecting contraceptive use.</p><p><strong>Conclusion: </strong>There are gaps in SRHR among HLI students in Rwanda. They have limited understanding of contraceptive methods and side effects, misconceptions shaped by sociocultural norms, restricted access to reliable SRHR information sources, and uncertainty surrounding sexual rights, premarital sexual practices, and abortion. We recommend creating safe, non-judgmental environments where students can seek SRHR information, increasing awareness about long-acting contraceptive methods, and improving condom availability on campuses. Addressing these gaps is critical to promote informed, safe, and responsible SRHR decision-making among HLI students in Rwanda.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 2","pages":"266-280"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898755","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":"Understanding Risk Factors for Unmet Contraceptive Needs Among Married and Cohabiting Women in Sub-Saharan Africa: Evidence from 22 Countries.","authors":"Turnwait Otu Michael, Michael Ayodele Ibikunle, Tesky Oghalomeno Agoben, Bukola Olaiya Ilori, Richard Dele Agbana, Tolulope Funmilola Ojo","doi":"10.4314/rjmhs.v9i1.6","DOIUrl":"10.4314/rjmhs.v9i1.6","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for contraception remains a pressing challenge in sub-Saharan Africa (SSA), contributing to high rates of unintended pregnancies and adverse maternal outcomes despite interventions. This study assessed individual and contextual factors associated with unmet contraceptive needs among married and cohabiting women.</p><p><strong>Methods: </strong>We analyzed Demographic and Health Survey data from 22 SSA countries collected between 2016 and 2023, comprising a weighted sample of 186,813 women aged 15-49 years. Multilevel logistic regression was applied to identify predictors of unmet need.</p><p><strong>Results: </strong>The overall prevalence of unmet need was 21.8%, ranging from 12.5% in Rwanda to 33.9% in Liberia. Central Africa recorded the highest regional prevalence (23.5%), while Southern Africa reported the lowest (18.5%). Cohabiting women, younger women, and those with higher parity had increased odds of unmet need. In contrast, higher educational attainment, employment, and exposure to family planning messages through mass media reduced the odds. Unexpectedly, internet use and reported sexual autonomy were associated with slightly higher unmet need.</p><p><strong>Conclusion: </strong>Policies should prioritize education, increase access to contraception, and strengthen community health outreach, with particular focus on cohabiting women and those with large family sizes.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 1","pages":"84-99"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937231","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":"Lived Experiences of Trained Motorcyclists and Bicyclists Providing First Aid after Road Traffic Accidents in Rwanda: A Phenomenological Study.","authors":"Liberatha Rumagihwa, Gerard Nyiringango, Sandra Musabwasoni, Claudien Thierry Uhawenimana, David Ryamukuru, Philomene Uwimana, Peace Uwambaye, Madeleine Mukeshimana","doi":"10.4314/rjmhs.v9i1.14","DOIUrl":"10.4314/rjmhs.v9i1.14","url":null,"abstract":"<p><strong>Background: </strong>Road traffic accidents (RTAs) are a major cause of death and disability, particularly in low- and middle-income countries. Although motorcyclists and bicyclists have been trained to provide first aid, little is known about their experiences. This study explored their experiences while providing first aid after RTAs in Rwanda.</p><p><strong>Methods: </strong>A phenomenological study was conducted using two focus group discussions with 10 purposively selected first aid-trained participants from Nyarugenge and Nyagatare districts. Data were collected in February 2025, transcribed, and thematically analyzed using ATLAS.ti. Data saturation was achieved, as no new themes emerged from additional discussions.</p><p><strong>Results: </strong>Four main themes emerged: (1) first aid response at accident scenes, (2) transformation following first aid training, (3) community impact and recognition, (4) challenges faced during first aid provision. Participants reported increased confidence, readiness to assist, and emotional satisfaction. However, they faced barriers such as mistrust from bystanders, lack of official identification, and limited resources.</p><p><strong>Conclusion: </strong>First aid training empowered participants to provide timely care and highlighted their role in Rwanda's prehospital system. Strengthening public awareness, formal recognition, and access to supplies could enhance community emergency response and improve outcomes.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 1","pages":"191-200"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936787","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":"Nurses' and Midwives' Experiences of Participating as Mentees in a Clinical Mentorship Program in Rwanda: Benefits and Challenges.","authors":"Yvonne Kasine, Yolanda Babenko, Sandra Regan, Richard Garnet Booth","doi":"10.4314/rjmhs.v9i1.7","DOIUrl":"10.4314/rjmhs.v9i1.7","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that clinical mentorship enhances the competence and professional development of nurses and midwives, thereby improving patient outcomes. However, there is limited knowledge of their experience with mentorship programs in Rwanda and similar resource-limited contexts. This study aimed to explore the benefits and challenges faced by nurse and midwife mentees in a clinical mentorship program in Rwanda.</p><p><strong>Objectives: </strong>The study aimed to understand the specific benefits and challenges mentees experienced in the Training, Support, and Access Model (TSAM) mentorship program.</p><p><strong>Methods: </strong>An interpretive phenomenological design was used to conduct 28 in-depth interviews with nurse and midwife mentees in selected health facilities in Rwanda. Audio recordings were transcribed and translated into English, and NVivo software was used to organize the data and conduct thematic analysis based on Crist and Tanner's framework.The analysis revealed three primary themes: 1) developing professional competencies, highlighting new knowledge acquisition and enhanced clinical skills, 2) perceptions of the mentorship process, which included mentorship insights and improvement suggestions, and 3) experiences of support, challenges, and coping strategies.</p><p><strong>Conclusion: </strong>The findings substantiate the critical role of mentorship in enhancing professional competencies and advancing clinical practice. The insights gained on support mechanisms, challenges encountered, and effective coping strategies underscore mentorship as a dynamic tool for fostering professional development and resilience among nurses and midwives. This study articulates the multifaceted nature of clinical mentorship in nursing and midwifery.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 1","pages":"100-115"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Bee Sting-Induced Facial Palsy: Diagnosis, Treatment, and Recovery.","authors":"Balasubramaniam Arun, Kandhasamy Sasirekha, Jayakumar Priya, Balasubramanian Ganesan","doi":"10.4314/rjmhs.v9i1.19","DOIUrl":"10.4314/rjmhs.v9i1.19","url":null,"abstract":"<p><strong>Introduction: </strong>Bee stings commonly cause allergic reactions ranging from mild local symptoms to severe systemic manifestations. Neurological complications are rare, and isolated facial nerve palsy is particularly uncommon.</p><p><strong>Case presentation: </strong>This case report a 25-year-old man who developed right-sided facial paralysis one day after a periauricular bee sting. There were no systemic or central neurological deficits. Multidisciplinary evaluation by neurology and otorhinolaryngology revealed no other otorhinolaryngological or central nervous system pathology. Investigations excluded alternative etiologies. The palsy was attributed to venom-induced inflammatory or ischemic mechanisms. The patient received corticosteroids and physiotherapy. Recovery was monitored using the Sunnybrook Facial Grading System.</p><p><strong>Conclusion: </strong>Early management with intensive physiotherapy played a critical role in facilitating favourable neurological recovery.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 1","pages":"252-257"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937320","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":"Prevalence, Awareness, and Treatment of Hypertension among Older Adults: A Cross- Sectional Study in Egor Community, Edo State, Nigeria.","authors":"Timothy A Ehwarieme, Uzezi Josiah, Festus E Imoebe, Mabel Abote","doi":"10.4314/rjmhs.v9i1.10","DOIUrl":"10.4314/rjmhs.v9i1.10","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a global, long-term health issue that primarily affects adults due to accumulated risk factors. This study examined the prevalence, awareness, and treatment of hypertension among older adults in Egor Community, Edo State.</p><p><strong>Methods: </strong>A cross-sectional design was used, involving 312 systematically selected adults. Data were collected through a validated, self-design validated questionnaire. Analysis was conducted using SPSS version 28, applying descriptive statistics, bivariate and multinomial logistic regression, and Spearman correlation at a 5% significance level.</p><p><strong>Results: </strong>Hypertension prevalence was 51.6%, with 52.9% of participants showing low awareness. Dietary modifications included reduced sodium (93.9%) consumption of refined sugar-containing foods (91.0%), and increased fruit and vegetable intake (63.1%). Key behavioral changes were medication adherence (88.5%) and dietary adjustments (61.9%). Common physical activities were brisk walking (67.9%) and stretching (16.3%). Awareness of hypertension declined significantly with increasing age (OR = 0.570, p < 0.001). Awareness was significantly higher among males compared to females (OR = 1.354, p = 0.033). However, level of education was not a significant predictor of awareness (OR = 1.353, p = 0.101). In addition, a weak but statistically significant negative correlation was observed between treatment modalities and blood pressure levels (r = -0.173, p = 0.002), indicating that improved treatment modalities were associated with lower blood pressure readings.</p><p><strong>Conclusion: </strong>Effective hypertension management should integrate medication, lifestyle changes, and health education, particularly targeting older and less educated populations through tailored interventions.</p>","PeriodicalId":520910,"journal":{"name":"Rwanda journal of medicine and health sciences","volume":"9 1","pages":"140-155"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937235","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}