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

{"title":"The association between burnout and empathy in intern medical doctors rotating at Steve Biko Academic Hospital in Pretoria, South Africa.","authors":"Quanita N Tatchell, Melissa Fernihough, Gian Lippi","doi":"10.4102/jcmsa.v4i1.323","DOIUrl":"10.4102/jcmsa.v4i1.323","url":null,"abstract":"<p><strong>Background: </strong>Burnout, a state of mental and physical exhaustion from chronic work stress, affects approximately one in three doctors. Burnout is associated with substance use, suicidality and impaired doctor-patient relationships. It also contributes to reduced quality of care, increased medical errors and malpractice claims. Empathy is the cognitive ability to understand and respond to a patient's experiences. This study explored the relationship between burnout and empathy among South African intern doctors.</p><p><strong>Methods: </strong>This cross-sectional quantitative study used consecutive sampling. Self-administered questionnaires were completed by 95 interns. Data were analysed using descriptive statistics, as well as bivariate and multivariable analyses.</p><p><strong>Results: </strong>The median age of interns was 26 years. Over 70% were overextended or burnt out. About one-third (33.68%) of participants had a diagnosed mental illness, and over half reported worsening illness during their internship. Lack of awareness of counselling services (83.16%) was associated with higher burnout (<i>p</i> = 0.020). Age was associated with burnout profile (<i>p</i> < 0.001), with younger interns more likely to be burnt out. Empathy scores were significantly lower in the burnt out, overextended and ineffective interns (<i>p</i> = 0.002), even after adjustment for demographic, clinical and work-related factors.</p><p><strong>Conclusion: </strong>The high prevalence of burnout among intern doctors and its inverse association with empathy underscore the need for systemic, evidence-based interventions to reduce burnout and enhance empathy, supporting the delivery of quality patient care.</p><p><strong>Contribution: </strong>This study offers novel insights into the challenges faced by South African intern doctors, providing a foundation for future research and targeted institutional reform.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"323"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687594","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":"Reflection: AI as a catalyst for change in postgraduate medical education.","authors":"Sumaiya Adam, Vanessa C Burch","doi":"10.4102/jcmsa.v4i1.413","DOIUrl":"10.4102/jcmsa.v4i1.413","url":null,"abstract":"<p><p>Artificial intelligence (AI) presents a timely opportunity to modernise postgraduate medical education, which has remained largely unchanged despite rapid technological advancements. AI can streamline administrative tasks, personalise learning and support critical thinking, allowing educators to refocus on mentorship and bedside teaching. However, if used uncritically or introduced too early as a substitute for clinical reasoning, AI may contribute to the risk of 'never-skilling', where students fail to develop the foundational clinical skills and independent judgement needed for safe practice. Integrating AI and other digital tools into clinical environments fosters authentic, technology-enabled learning while promoting digital professionalism. A collaborative, environmentally conscious approach across disciplines and institutions is essential to ensure equitable, sustainable adoption. The thoughtful use of AI can transform postgraduate medical education into a more efficient, student-centred system, aligned with the realities of modern healthcare.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"413"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428629","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":"Malignant external auditory canal and temporal bone tumours: Clinical outcomes in Cape Town, South Africa.","authors":"Hervin N Heeroo, Tashneem Harris, Matthew White, Sameera Dalvie","doi":"10.4102/jcmsa.v4i1.327","DOIUrl":"10.4102/jcmsa.v4i1.327","url":null,"abstract":"<p><strong>Background: </strong>Temporal bone cancers are associated with high morbidity and poor prognosis. However, no established treatment guidelines currently exist. Information on temporal bone carcinomas in sub-Saharan Africa is almost non-existent in the literature. The aim of the study was to look at the outcomes of temporal bone malignancies in a developing-world setting.</p><p><strong>Methods: </strong>A retrospective chart review was conducted at a tertiary-care hospital in Cape Town, South Africa, of all patients with newly diagnosed temporal bone malignancies from 2008 to 2023. Distant metastases to the temporal bone were excluded.</p><p><strong>Results: </strong>In total, 20 patients were identified, with a mean age of 60.7 years. From the study sample, 40% of the patients were male, and 60% were female. The most common histological diagnosis was squamous cell carcinoma (70%), followed by adenoid cystic carcinoma (15%). Seventy per cent of patients were treated with curative intent; 65% with primary surgery and 5% with primary radiotherapy, respectively. The remaining patients were offered palliative radiotherapy (25%) and best supportive care (5%). Disease recurrence occurred in 25% of patients, with the mean time to recurrence being 5.6 months. The mean overall survival for the cohort was 1.52 ± 1.23 years, while the mean disease-specific survival was 1.68 ± 1.67 years.</p><p><strong>Conclusion: </strong>Early diagnosis of temporal bone cancers is fundamental, and aggressive resection is essential, if indicated, to obtain negative margins and minimise recurrence.</p><p><strong>Contribution: </strong>This study provides valuable insights into temporal cancers in sub-Saharan Africa and paves the way for larger studies on the continent.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"327"},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428632","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":"Preparedness of emergency care providers to manage obstetric haemorrhage in KwaZulu-Natal province, South Africa: A mixed-methods study.","authors":"Shaun Govender, Olive P Khaliq, Tashlen Abel, Jagidesa Moodley","doi":"10.4102/jcmsa.v4i1.349","DOIUrl":"10.4102/jcmsa.v4i1.349","url":null,"abstract":"<p><strong>Background: </strong>Obstetric haemorrhage (OH), particularly postpartum haemorrhage, is a leading cause of maternal mortality in sub-Saharan Africa. Emergency medical services (EMS) play a critical role in early recognition, intervention and transport; however, evidence on EMS preparedness for OH remains limited. This study assessed the system-level preparedness of public-sector emergency care providers in KwaZulu-Natal (KZN) across four domains: administration, resources, training and response capacity.</p><p><strong>Methods: </strong>A concurrent convergent mixed-methods design was used. Quantitative data were collected using structured questionnaires (<i>n</i> = 417) and analysed descriptively. Qualitative data were obtained through semi-structured interviews (<i>n</i> = 10) and thematically analysed. Findings were integrated to identify convergence and divergence across data sources.</p><p><strong>Results: </strong>Key gaps were identified across all four domains. Administrative weaknesses included inconsistent policy implementation and limited supervisory oversight. Resource constraints reflected ambulance shortages and variable access to essential equipment. Training gaps included limited hands-on obstetric exposure and variable practical skills on scene. Response capacity was affected by the absence of maternal-specific surge planning.</p><p><strong>Conclusion: </strong>Emergency medical services in KZN play a central role in the prehospital management of OH but operate within significant system-level constraints. Strengthening governance, improving fleet and equipment availability, expanding practical obstetric training and integrating maternal health into surge and disaster planning may enhance preparedness in KZN and similar resource-limited settings.</p><p><strong>Contribution: </strong>This study provides evidence on EMS preparedness to manage obstetric haemorrhage, informing system strengthening and maternal emergency care planning.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"349"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428649","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":"Private hospital, university-led health sciences teaching and training: A proposal for the University of Limpopo's Faculty of Health Sciences specialist lecturer shortage.","authors":"Marule P Kgagudi","doi":"10.4102/jcmsa.v4i1.332","DOIUrl":"10.4102/jcmsa.v4i1.332","url":null,"abstract":"<p><p>Medical doctor training has largely retained the historical context of biased resource allocation. However, lately, new medical schools have been added to the lot. The University of Limpopo Medical School was established in 2016. Although successful with undergraduate training, to date, the latter struggles with both recruitment and retention of specialist staff numbers for accreditation purposes. The private sector (hospitals and staff) potentially has the resources and human capital to aid in addressing the skills shortage that exists in the province and the university. This review aims to assess the available literature and evidence that supports the role that private doctors and hospitals can play in undergraduate and postgraduate medical teaching and training. A narrative review of the literature was conducted to peruse evidence on the status of private-public partnerships in medical teaching and training. There is growing evidence for private sector teaching both locally and internationally. The government, regulators and end-users seem aligned on private sector involvement in medical training. The medical teaching and training landscape is changing with demands for innovative solutions. Infrastructure, legislation and end-users may be poised for the implementation of the private hospital, university-led health sciences teaching and training (PHUHSTT) programmes. The evidence, therefore, exists as a foundation for further engagement and possible implementation of the latter. Our proposal is not a silver bullet, but a recommendation for tackling the current state of affairs in relation to challenges in medical teaching and training at the University of Limpopo (UL).</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"332"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214198","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 association between perirenal fat volume and nephrolithiasis: A Bloemfontein study.","authors":"Jozanne Voigt, Eugene Loggenberg, Mari Wentzel","doi":"10.4102/jcmsa.v4i1.319","DOIUrl":"10.4102/jcmsa.v4i1.319","url":null,"abstract":"<p><strong>Background: </strong>Nephrolithiasis is a well-recognised global health burden associated with significant morbidity. Recent studies have demonstrated a potential association between perirenal fat volume (PFV) and nephrolithiasis, particularly among males, likely related to sex-related differences in visceral fat distribution. However, this association has not yet been investigated within the South African population. We explored the association between PFV and nephrolithiasis by comparing the PFV surrounding a stone-bearing kidney with the PFV surrounding a non-stone-bearing kidney in the same individual in both male and female patients.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted at Universitas Academic Hospital in South Africa on patients diagnosed with unilateral nephrolithiasis. Manual tracing software was applied to non-contrasted computed tomography abdomen studies to calculate the PFV. The PFV difference surrounding normal and pathological kidneys was calculated and described using the Signed-Rank test for paired data.</p><p><strong>Results: </strong>A total of 140 patients were included, of which 91 were males and 49 were females. The PFV surrounding the stone-bearing kidney was statistically significantly higher than the PFV surrounding the non-stone-bearing kidney (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>A significant association between PFV and nephrolithiasis was found.</p><p><strong>Contribution: </strong>This study provides the first South African evidence of a significant association between perirenal fat volume and unilateral nephrolithiasis. It supports the potential use of perirenal fat thickness as a simpler radiological marker for future nephrolithiasis risk assessment and research in South African clinical practice.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"319"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214217","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":"Surgical outcomes of Ahmed Glaucoma Valve Implantation surgery: With mitomycin C and without mitomycin C.","authors":"Hojatollah Jaldi, Tshilidzi van der Lecq","doi":"10.4102/jcmsa.v4i1.362","DOIUrl":"10.4102/jcmsa.v4i1.362","url":null,"abstract":"<p><strong>Background: </strong>The Ahmed Glaucoma Valve (AGV) is a commonly used glaucoma drainage device (GDD) in the surgical management of glaucoma patients. Adjunctive mitomycin C (MMC) has demonstrated clear benefits in improving the surgical outcomes of trabeculectomy surgery. The effectiveness of MMC in improving the surgical outcomes of GDDs remains uncertain. This study seeks to compare the surgical outcomes of AGV implantation with and without the use of intraoperative MMC in an African cohort.</p><p><strong>Methods: </strong>This retrospective case series analysed 98 eyes in 95 patients who underwent AGV implantation from 01 January 2016 to 31 December 2021 at two units located in Cape Town, South Africa. The postoperative data collected included intraocular pressure (IOP), medication use, and complications.</p><p><strong>Results: </strong>The eyes were categorised into the MMC use (<i>n</i> = 46) or non-MMC use (<i>n</i> = 52) group. In most eyes within the MMC use group (78.3%, <i>n</i> = 36), a concentration of 0.2 mg/mL was used. The mean preoperative IOP in the MMC group and the non-MMC group was 38 and 33, respectively (<i>p</i> = 0.12). At 1 year, the mean IOP in the MMC use group (<i>n</i> = 31) was 18 mmHg and 16 mmHg in the non-MMC group (<i>n</i> = 36) (<i>p</i> = 0.84). The frequency of complications and the hypertensive phase were comparable in the two groups.</p><p><strong>Conclusion: </strong>This study found no difference between the two groups in terms of IOP control, postoperative medication use, and complications. This may be attributed to the low concentration of MMC used in our cohort.</p><p><strong>Contribution: </strong>This study provides insights into the role of MMC use in AGV implantation.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"362"},"PeriodicalIF":0.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214226","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 profile of the Diploma in Anaesthesia in South Africa.","authors":"Nabeelah Moola, Brian Gardner, Moses M Kebalepile","doi":"10.4102/jcmsa.v4i1.333","DOIUrl":"10.4102/jcmsa.v4i1.333","url":null,"abstract":"<p><strong>Background: </strong>South Africa faces a shortage of anaesthetists, particularly in rural areas. The Diploma in Anaesthesia (DA) was created to address this gap, but its role may now serve as a preparatory step for specialist training. This study assessed DA graduates' career paths, perceived value of the diploma, geographical distribution and self-perceived clinical confidence.</p><p><strong>Methods: </strong>This cross-sectional study was conducted via virtual response to a questionnaire using Research Electronic Data Capture (REDCap^®). Data were analysed using descriptive statistics.</p><p><strong>Results: </strong>One hundred and ninety-two diplomates responded. Most DA candidates practised anaesthesia, with 44% working as DA anaesthetists and 41% pursuing the specialist route. Most candidates (60%) practised in urban areas, particularly in Gauteng (49%) and the Western Cape (17%). Eighty-six per cent of respondents viewed the DA as a step within the Fellowship of the College of Anaesthetists (FCA) curriculum. Most respondents felt the DA tested their competence (86.5%), safety (88%) and skills and knowledge (94.8%).</p><p><strong>Conclusion: </strong>Most diplomates practise within the urban setting, potentially limiting the diploma's value in enriching the quality of anaesthesia provided in rural areas. High perceptions of the DA's value in testing competence and safety suggest its continued relevance in anaesthesia training. The view that the DA is a preparatory step within the FCA process indicates a need for ongoing evaluation of the DA curriculum and its alignment with current workforce demands.</p><p><strong>Contribution: </strong>This research will contribute to the optimisation of the DA, enhancing its utility for its intended purpose or improving its structure to better align with its current application.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"333"},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214206","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":"From scribble to scrutiny: The legal risks of poor clinical handwriting.","authors":"Suhayfa Bhamjee","doi":"10.4102/jcmsa.v4i1.311","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.311","url":null,"abstract":"<p><p>Illegible handwritten patient records pose a significant threat to clinical accountability and legal integrity in South Africa's healthcare system. Despite clear guidelines from the Health Professions Council of South Africa (HPCSA), poor documentation remains widespread, particularly in public sector facilities. A black-letter doctrinal analysis was conducted of South African law (<i>Medicines and Related Substances Act</i> General Regulations, HPCSA Booklet 9, and the <i>National Health Act</i>) and the evidentiary treatment of clinical records in case law. A focused comparative reference to a 2025 Punjab & Haryana High Court judgement was used to contextualise the normative stakes of legibility in another common-law system. South African primary law already requires legible prescriptions and legible, understandable clinical records; courts treat hospital notes as hearsay unless properly admitted, with clarity impacting the weight accorded to such documentation. The Indian judgement constitutionally frames legibility as part of the right to health and mandates interim capital-letter prescriptions pending digitisation. Clear documentation is essential for justice, safety and the dignity of patients. The article calls for curriculum reform, digitisation, policy enforcement and legal recognition of legibility as a component of the right to access healthcare. This article may assist legal and medical professionals in recognising legibility as a constitutional obligation, thereby strengthening medico-legal accountability and promoting patient-centred care.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"311"},"PeriodicalIF":0.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871339","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 multifaceted training approach for neurosurgery registrars incorporating cadaver-based simulation.","authors":"Mohammed Z Ebrahim, Rhoda Meyer, Elize Archer","doi":"10.4102/jcmsa.v4i1.287","DOIUrl":"10.4102/jcmsa.v4i1.287","url":null,"abstract":"<p><strong>Background: </strong>Neurosurgical training has historically been grounded in an apprenticeship model. This approach to developing competence relies on authentic learning opportunities presenting themselves in the operating theatre. Recently, aspects such as medical litigation, increasing registrar numbers, reduction in mandatory work hours and the need to prioritise service delivery over training opportunities have led to the incorporation of cadaver-based simulation training to increase surgical exposure. Our study aimed to explore how a structured training package in anterior cervical discectomy and fusion influences a group of neurosurgery registrars' perception of their skills development.</p><p><strong>Methods: </strong>The training package consisted of an interactive lecture, a video and two cadaver-based simulation training sessions. The study population included seven registrars. Data was generated through a questionnaire completed at recruitment and semi-structured interviews conducted after exposure to the training package. Demographic information was captured and summarised, and the interviews were analysed using thematic analysis.</p><p><strong>Results: </strong>Structured training in a basic neurosurgical technique was found to be valuable and preferred to fragmented and opportunistic learning opportunities. It promoted confidence in procedural principles and theatre setup and provided invaluable opportunities for learning. Opportunities to practise basic techniques made the theatre environment less hostile and promoted learning in the workplace.</p><p><strong>Conclusion: </strong>Structured training packages incorporating cadaver-based simulation are a potentially important component of skills development in neurosurgical training.</p><p><strong>Contribution: </strong>Such learning resources are based on neurosurgical core competencies and can form part of a shift towards a more comprehensive competency-based training programme.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"287"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871300","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}