Journal of the colleges of medicine of South Africa最新文献

{"title":"A cost-effective ultrasound model for demonstrating the whirlpool sign in testicular torsion.","authors":"Hanlie Dreyer, Izak Petrus Scholtz, Ahmed Adam, Abdullah E Laher","doi":"10.4102/jcmsa.v3i1.181","DOIUrl":"10.4102/jcmsa.v3i1.181","url":null,"abstract":"<p><p>Testicular torsion is a urological emergency requiring rapid diagnosis to prevent testicular loss, with the whirlpool sign on ultrasound being a critical indicator. In resource-limited settings, access to specialised ultrasound training is often constrained. To address this, we developed a cost-effective, reusable ultrasound training model that replicates the whirlpool sign using easily accessible materials. Our model consists of a boiled egg and coiled tubing set in gelatine, with iodine simulating blood flow. Emergency Medicine residents used the model during hands-on training sessions. This model offers a simple yet effective way to improve diagnostic skills in resource-constrained settings, potentially enhancing early detection and outcomes for testicular torsion.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067674","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":"South African health professional associations urged to end commercial milk formula industry sponsorship.","authors":"Catherine J Pereira-Kotze, Lori Lake, Max Kroon, Haroon Saloojee, Lisanne du Plessis, Zandile Kubeka, Sheila Clow, Renier Coetzee, Mariatha Yazbek, Nomajoni Ntombela, Sithembile Dlamini-Nqeketo, Gilbert Tshitaudzi, Silingene J Ngcobo, Nthuseni S Murudi-Manganye, Sue Fawcus, Nzama Mbalati, Tanya Doherty","doi":"10.4102/jcmsa.v3i1.150","DOIUrl":"10.4102/jcmsa.v3i1.150","url":null,"abstract":"<p><p>Despite the wealth of evidence about the benefits of breastfeeding, the commercial milk formula (CMF) industry continues to grow and project future profits, fuelled by aggressive and pervasive marketing practices that include the targeting of health care professionals. When health professionals and their associations accept funding from the CMF industry, this creates a conflict of interest (COI). The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) have therefore issued clear unequivocal guidance including through World Health Assembly resolutions that health care institutions and professional associations should refuse sponsorship from the CMF industry. We urge health professionals in South Africa to heed this call to protect their professional integrity and ensure that care and support for pregnant and breastfeeding women, children and families is free from commercial influence.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"150"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067632","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":"Assessment of dermatological life quality in patients with cutaneous diseases at Universitas Academic Hospital.","authors":"Navlin Naidoo, Frans Maruma, Edward Ngwenya, Mthobisi N Mazibuko","doi":"10.4102/jcmsa.v3i1.160","DOIUrl":"10.4102/jcmsa.v3i1.160","url":null,"abstract":"<p><strong>Background: </strong>Dermatological conditions significantly impact quality of life (QoL). This cross-sectional study aimed to assess this impact as part of a comprehensive care approach.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted at a tertiary hospital's dermatology outpatient department from January 2023 to March 2023. Eligible patients were recruited, and data on demographics, clinical diagnoses and Dermatological Life Quality Index (DLQI) scores were collected.</p><p><strong>Results: </strong>The study included 200 participants (median age: 39 years, range: 18-86). Females comprised 58%, while males were significantly older (median: 53 vs 35 years, <i>p</i> < 0.001). A significant difference was found between the 10 most common diagnoses and DLQI scores (<i>p</i> < 0.05, Kruskal-Wallis test). The top diagnoses were eczema (21%), cutaneous malignancy (13%) and acne/rosacea (11%). Hidradenitis suppurativa had the highest DLQI scores, followed by lupus and urticaria.</p><p><strong>Conclusion: </strong>This study highlights the significant burden of skin diseases on QoL, with hidradenitis suppurativa showing the greatest impact. Findings underscore the need for patient-centred dermatological care addressing both physical and psychological well-being.</p><p><strong>Contribution: </strong>This study contributes to dermatology research in line with the <i>Journal of the Colleges of Medicine of South Africa</i> (JCMSA) mission to encourage multidisciplinary publications.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"160"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067675","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":"Financial literacy among anaesthetists in an academic department in Johannesburg.","authors":"Ayesha Noor Mohamed, Zainub Jooma","doi":"10.4102/jcmsa.v3i1.111","DOIUrl":"10.4102/jcmsa.v3i1.111","url":null,"abstract":"<p><strong>Background: </strong>Financial literacy is an important skill required to navigate the complex financial landscape. Wealth, income, race, age, geographical location and level of education affect financial literacy levels in South Africa. The aim of this study was to assess financial literacy among anaesthetists at the Department of Anaesthesiology, University of the Witwatersrand (WITS) and to identify factors associated with better financial literacy.</p><p><strong>Methods: </strong>This prospective, cross-sectional study was conducted using an anonymised questionnaire adapted from the South African Social Attitudes Survey. A financial literacy score out of 100 was calculated using four domain scores (financial knowledge, financial planning, financial control and product choice and awareness).</p><p><strong>Results: </strong>A total of 184 anaesthetists were included. The mean financial literacy score was 72. Gender, age, relationship status and years of employment did not influence the mean financial literacy scores. The mean scores for the individual domains were 79 for financial control, 76 for financial planning, 51 for product choice and 82 for financial knowledge. Lower levels of financial preparedness were observed among younger and junior anaesthetists as well as anaesthetists who self-reported as mixed race or black ethnicity.</p><p><strong>Conclusion: </strong>Anaesthetists at the Department of Anaesthesiology, University of the Witwatersrand have high levels of overall financial literacy but do not display adequate preparedness in planning for a secure financial future. We suggest integration of continuous financial education into medical training, from undergraduate studies through to specialisation.</p><p><strong>Contribution: </strong>This study was the first to investigate financial literacy among anaesthetists in South Africa. It has highlighted the need for formal education on financial literacy to be incorporated into medical training.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"111"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067685","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":"#MissingInAction: A review of the social media footprint of South African interventional radiology practitioners.","authors":"Siviwe S Mpateni, Kuhle M Zwakala, Richard D Pitcher, Michelle Da Silva","doi":"10.4102/jcmsa.v3i1.97","DOIUrl":"10.4102/jcmsa.v3i1.97","url":null,"abstract":"<p><strong>Background: </strong>Interventional radiology (IR) is a rapidly developing branch of medicine; however, the general awareness of the subspeciality among patients and medical colleagues is limited. Social media (SM) has become an integral part of information transfer globally, and its utility as an effective communication tool can be leveraged by IRs to bridge this knowledge gap. This study investigated the SM footprint of IR providers in South Africa.</p><p><strong>Methods: </strong>An online analysis of radiology practices (<i>N</i> = 100) registered on the Radiological Society of South Africa (RSSA) website was performed. The SM footprint of practices offering IR services was audited, and statistical analysis was performed to examine the level of SM uptake, the relationship between SM uptake in urban versus non-urban locations and between practice size.</p><p><strong>Results: </strong>There were 38 practices offering IR services with 68% (<i>n</i> = 26) located in major metropolitan areas. A systematic online Google search revealed that 84% (<i>n</i> = 32) had a website and the most widely used SM platform was Facebook. There was a statistically significant correlation between the size of the radiology practices and the total number of SM accounts (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Most South African IR practitioners have a SM presence with larger radiology practices establishing a broad digital presence on SM. Poor SM visibility, particularly from smaller practices, on these platforms may limit their ability to reach their target audience.</p><p><strong>Contribution: </strong>Improving the current usage of SM by IR practitioners may present an opportunity to display their services.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"97"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067579","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":"Cross-sectional study of thyroid associated orbitopathy in a South African thyroid clinic.","authors":"Sandra de Vasconcelos, Hamzah Mustak, Maanda Mabogo, Joel Dave","doi":"10.4102/jcmsa.v3i1.127","DOIUrl":"10.4102/jcmsa.v3i1.127","url":null,"abstract":"<p><strong>Background: </strong>Thyroid-associated ophthalmopathy (TAO) is a common and debilitating manifestation of Graves' disease (GD) associated with poor clinical outcomes including impaired quality-of-life (QoL) and socio-economic status. Data on TAO in Africa is scarce and unavailable in the South African population.</p><p><strong>Methods: </strong>This descriptive cross-sectional study focussed on GD patients attending the thyroid clinic at Groote Schuur Hospital, in Cape Town, South Africa. Participants were evaluated for TAO activity and severity according to the European Group on Graves' Orbitopathy (EUGOGO) criteria. Quality-of-life was assessed using the TED-QoL questionnaire.</p><p><strong>Results: </strong>Thyroid-associated ophthalmopathy prevalence was 59.8%. The majority of TAO patients had mild disease (<i>n</i> = 73; 59.8%). Based on the severity score alone, moderate to severe disease (<i>n</i> = 41; 33.6%) and sight-threatening disease (<i>n</i> = 8; 6.6%) were identified and referred for further ophthalmological intervention. There was a statistically significant increase in the QoL score with an increase in the severity score (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The prevalence of orbitopathy was found to be higher than that reported from other continents, but our severity distribution was similar. This study emphasised the importance of evaluating severity as well as the psychosocial aspect of TAO to allow for the identification of and interdisciplinary management of patients to improve patient outcomes.</p><p><strong>Contribution: </strong>This study was the first to attempt to determine the prevalence and severity of TAO in South Africa. The importance of early TAO detection using both, a clinical and psychosocial tool, is highlighted in this study to reduce the complications associated with TAO.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067686","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":"Vaginal bleeding in early pregnancy at a regional-level emergency department in KwaZulu-Natal.","authors":"Mthunzi Maseko, Seelan Pillay, Jaykumaran Govender","doi":"10.4102/jcmsa.v3i1.162","DOIUrl":"10.4102/jcmsa.v3i1.162","url":null,"abstract":"<p><strong>Background: </strong>Vaginal bleeding in early pregnancy (VBIEP) affects between 15% and 25% of all pregnancies worldwide and it portends life-threatening gynaecological emergencies. One of the core functions of an emergency medicine physician is to recognise critical illness and institute high-quality emergency care. This study aimed to describe the demographics, clinical presentation, management and outcomes of patients with VBIEP presenting to the emergency department (ED).</p><p><strong>Methods: </strong>Retrospective descriptive data were collected on all patients presenting to the ED of General Justice Gizenga Mpanza Regional Hospital (GJGMRH) with VBIEP between 01 January 2022 and 30 April 2022.</p><p><strong>Results: </strong>The most affected group comprised multiparous women, in the first trimester of pregnancy between the ages of 25 and 29 year. Among HIV-positive participants majority (40.9%) were aged 35-39 years of age. Majority (87%) of patients had received no prior antenatal care. Incomplete miscarriage was the most (46.1%) common diagnosis made in the ED. Most (61.7%) patients from the ED required admission to the hospital for further care.</p><p><strong>Conclusion: </strong>This study showed that multiparous women in their first trimester of pregnancy are at highest risk of VBIEP. It also highlighted early antenatal care and early use of point-of-care ultrasound may prevent and improve outcomes with VBIEP. Incomplete miscarriage was the commonest cause. A standardised management protocol for these patients should be developed, however larger studies must be conducted to validate this.</p><p><strong>Contribution: </strong>This study contributes to the limited literature on VBIEP in low to middle-income countries and the findings may influence the department of health's allocation of resources to this condition.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"162"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067649","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":"Factors associated with depression and anxiety among mental healthcare practitioners.","authors":"Cheval Murugas, Carla Kotzé","doi":"10.4102/jcmsa.v3i1.120","DOIUrl":"10.4102/jcmsa.v3i1.120","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression constitute a significant global mental health burden. The extant literature indicates elevated rates of anxiety and depression among mental healthcare practitioners; however, this phenomenon remains understudied within this particular population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using self-administered questionnaires. Participants voluntarily completed an anonymous socio-demographic questionnaire, the General Anxiety Disorder-7 scale and the Patient Health Questionnaire-9.</p><p><strong>Results: </strong>The study included 255 participants from various occupational categories within mental health. High levels of anxiety (<i>N</i> = 56; 22%) and depression (<i>N</i> = 42; 16.5%) were found among mental healthcare practitioners. Participants with a prior history of anxiety and/or depression (21.2%) demonstrated a significant association with anxiety and depression at the time of completion of the questionnaire (<i>p</i> = 0.000).</p><p><strong>Conclusion: </strong>Mental health practitioners with a previous history of anxiety and depression were at a substantially higher risk of experiencing current symptoms, highlighting the need for workplace support mechanisms tailored to this vulnerable group.</p><p><strong>Contribution: </strong>This research identified a specific group of mental health practitioners at elevated risk for anxiety and depression that warrants targeted interventions through occupational assistance initiatives and preventative strategies.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"120"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067666","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":"Precipitating factors and clinical outcomes of diabetic ketoacidosis in Eastern Cape, South Africa.","authors":"Siqhamo Magadla, Chukwuma Ekpebegh, Nomagugu Ndlovu, Thozama Dubula, Sibi Joseph","doi":"10.4102/jcmsa.v3i1.99","DOIUrl":"10.4102/jcmsa.v3i1.99","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) is a common hyperglycaemic emergency in persons living with diabetes (PLWD), and outcomes of treatment depend on the precipitating factor.</p><p><strong>Methods: </strong>A cross-sectional prospective study of patients admitted in the adult high care unit of Nelson Mandela Central Hospital was carried out from 19 February 2022 to 19 January 2023. Patients were assessed for demographic, clinical profiles and outcomes concerning precipitating factors. The outcomes were duration of admission and discharge from the hospital as alive or dead.</p><p><strong>Results: </strong>There were 55 PLWD, all black African, predominantly females, known with diabetes with a mean age of 38 ± 15.8 years. The main precipitants for DKA in descending order were infections (47%), treatment omission (30%) and a new diagnosis of diabetes (19%). The mean duration of admission for all patients was 8.2 ± 5.3 days. The length of hospital stay was 9.5 ± 5.2 days, 5.6 ± 2.2 days, and 8.6 ± 7.6 days, respectively (<i>p</i> = 0.118). The mortality in all patients was 9 (16.4%), and all but one death was associated with sepsis. There were no significant differences in the HbA1c among patients with infection (13.9 ± 3.8), those who omitted treatment (12.6 ± 4.7) and those newly diagnosed (12.2 ± 2.2) (<i>p</i> = 0.620).</p><p><strong>Conclusion: </strong>The high mortality rates in our DKA patients were mainly related to infections. The high HbA1c indicates poor glycaemic control preceding DKA. Improving glycaemic control, preventing infections, and early treatment of infections can reduce DKA-related mortality among patients.</p><p><strong>Contribution: </strong>This study provides a comprehensive analysis of DKA in resource-limited settings, focusing on its precipitating factors, clinical profiles, and outcomes among adults in the Eastern Cape, South Africa. Infections were identified as the leading precipitant, with poor glycaemic control prevalent across all cases and a mortality rate of 16.4%, primarily due to sepsis. The findings highlight the urgent need for strategies to improve glycaemic control, prevent infections, and ensure timely interventions to reduce DKA-related mortality. This research aligns with the <i>Journal of the Colleges of Medicine of South Africa</i>'s mission to advance clinical practice by addressing critical healthcare challenges in underserved communities, offering insights applicable across the region.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067646","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":"Minor salivary gland tumours: Malignant or benign? A 10-year local retrospective review.","authors":"Johan Grobbelaar, Kathryne E Wright, Ann Thomas, Shaun E Adam","doi":"10.4102/jcmsa.v3i1.126","DOIUrl":"10.4102/jcmsa.v3i1.126","url":null,"abstract":"<p><strong>Background: </strong>This study reports on our local incidence of minor salivary gland tumours (MSGT).</p><p><strong>Methods: </strong>This was a retrospective descriptive study including all patients with MSGT treated at Tygerberg Hospital from 2015 to 2024.</p><p><strong>Results: </strong>Benign and malignant tumours' incidence was almost equal at 46.46% and 53.54%, respectively (<i>N</i> = 99). Pleomorphic adenomas were the most common tumour overall (38.38%) and the most common benign tumour. Polymorphous low-grade adenocarcinoma (PLGA) was the most common malignant tumour (15.15%). The palate was the most common site. Primary sites other than lips and palate had a 93.23% malignant incidence. Benign tumours occurred statistically significantly in younger patients than malignant tumours (<i>p</i> < 0.001) (42.74 years versus 56.02 years).</p><p><strong>Conclusion: </strong>We did not see the high malignant incidence that is frequently reported in otorhinolaryngology textbooks. Pleomorphic adenomas remain the most common and occur most commonly in the palate. We did show an unusually high incidence of PLGA. Primary sites other than palate and lips should raise the suspicion of malignant MSGT.</p><p><strong>Contribution: </strong>The study highlights the importance of reporting on local data because disease patterns may vary greatly based on genetic and geographical differences. Further investigation is needed to explain possible local factors contributing to the high incidence of PLGA.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"126"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067651","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}