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

{"title":"Psychotropic prescribing patterns during pregnancy in two South African mental health clinics.","authors":"Catherine Farmer, Elsa du Toit, Ulla Botha, Dana Niehaus, Liezl Koen","doi":"10.4102/jcmsa.v3i1.188","DOIUrl":"10.4102/jcmsa.v3i1.188","url":null,"abstract":"<p><strong>Background: </strong>Given that there is a significant burden of mental illness during pregnancy, psychotropic polypharmacy during this period is commonly found in clinical practice. In South Africa, however, there is a paucity of data on the use of psychotropics during pregnancy.</p><p><strong>Methods: </strong>This was a retrospective descriptive study of 303 pregnant women attending two specialised maternal mental health clinics from presentation to six weeks postpartum. Demographic data, psychiatric history, medical comorbidity, pregnancy-related, and prescription data were collected and tabulated at treatment-as-usual visits. Polypharmacy prevalence was defined as the prescription of two or more psychotropics for at least 90 days.</p><p><strong>Results: </strong>A majority of the study group was diagnosed with major depressive disorder (<i>n</i> = 161, 53.1%), and non-tricyclic antidepressants were the most prescribed medication class (<i>n</i> = 195, 64.4%). One-third of the participants received prescriptions in all three trimesters. Polypharmacy criteria were met in 18.8% (<i>n</i> = 57) of the sample population.</p><p><strong>Conclusion: </strong>The prescription patterns in the study sample appeared to be in line with current international protocols. Prescribing psychotropics during pregnancy remains challenging because of the need to weigh up the potential risks of medication-related effects on the mother and baby against those of discontinuing treatment.</p><p><strong>Contribution: </strong>This study may raise awareness and assist medical professionals regarding the rational use of psychotropic medication during pregnancy.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"188"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461166","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":"More than semantics: Language, power, and epistemic justice in South African scholarship.","authors":"Clint Hendrikse","doi":"10.4102/jcmsa.v3i1.283","DOIUrl":"10.4102/jcmsa.v3i1.283","url":null,"abstract":"","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"283"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260561","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":"Anaesthetists' knowledge and awareness of diathermy use in a department of anaesthesiology.","authors":"Harrilene Apleni, Juan Scribante, Helen Perrie, Zainub Jooma","doi":"10.4102/jcmsa.v3i1.225","DOIUrl":"10.4102/jcmsa.v3i1.225","url":null,"abstract":"<p><strong>Background: </strong>Anaesthetists are expected to have a basic understanding of diathermy use. The aim of this study is to evaluate anaesthetists' knowledge and awareness of diathermy use in the Department of Anaesthesiology at the University of the Witwatersrand, Johannesburg, South Africa.</p><p><strong>Methods: </strong>A prospective, descriptive and contextual study was conducted utilising an anonymous self-administered questionnaire distributed to anaesthetists during academic meetings, and convenience sampling was used. A minimum sample size of 96 anaesthetists was estimated. Using the modified Angoff Method, a score of 62% was determined for adequate knowledge.</p><p><strong>Results: </strong>One hundred and one questionnaires met the criteria for analysis. The overall mean score obtained for knowledge was 44.7%; 47.7% for junior anaesthetists <i>versus</i> 42.7% for senior anaesthetists (<i>p</i> = 0.20). The total number of anaesthetists achieving an adequate score was 13 (12.9%). Of those, 10 (76.9%) were junior anaesthetists with a mean score of 71.0%, and 3 (23.1%) were senior anaesthetists with a mean score of 67.0% (<i>p</i> = 0.72). There was no significant difference in the knowledge between anaesthetists with Fellowship of the College of Anaesthesia Part 1 examinations and those without (<i>p</i> = 0.34). In a comparison of knowledge between junior and senior anaesthetists, junior anaesthetists scored significantly better in the category of precautions and appropriate use (<i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>The University of the Witwatersrand (Wits) anaesthetists demonstrated poor overall knowledge of diathermy. While anaesthetists do not apply diathermy pads or use diathermy themselves, they are responsible for patients' safety in the operating theatre and diathermy may interfere with anaesthetic equipment or patient devices.</p><p><strong>Contribution: </strong>This study investigated anaesthetists' knowledge and awareness pertaining to diathermy use in the operating theatre. It has highlighted the need for ongoing education pertaining to diathermy safety for anaesthetists.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"225"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260478","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":"Medical practitioners' confidence in performing paediatric critical procedures in the emergency department.","authors":"Shivanthra Ramdass, Matthew Zoghby, Nicholas Dufourq","doi":"10.4102/jcmsa.v3i1.209","DOIUrl":"10.4102/jcmsa.v3i1.209","url":null,"abstract":"<p><strong>Background: </strong>Paediatric patients make up a significant portion of emergency department (ED) visits, and critically ill children require timely, life-saving procedures. While medical practitioners (MPs) may have the necessary skills, a lack of confidence can prevent them from applying these skills effectively, potentially impacting patient outcomes. This study aimed to assess MPs' confidence in performing critical procedures for paediatric patients and to identify factors influencing it.</p><p><strong>Methods: </strong>This is a cross-sectional descriptive study, conducted in four EDs in KwaZulu-Natal between 07 July 2023 and 11 November 2023. A questionnaire completed by MPs with confidence levels ranked on a five point Likert Scale was used.</p><p><strong>Results: </strong>With a 68% response rate the mean level of confidence was 3 [s.d. = 12.5]. Emergency medicine specialists when compared to non-specialists had a higher level of confidence being 3.99 (<i>P</i> = 0.02). The amount of time spent treating paediatric patients did not affect confidence levels. Performing a procedure more frequently generally resulted in a higher level of confidence apart from that of newborn cardiopulmonary resuscitation and cardioversion.</p><p><strong>Conclusion: </strong>The confidence of MPs (translating to 60% confident) was significantly less than their perceived importance of the procedure. This could suggest motivation to improve their ability to perform these skills. The rank of doctor and frequency of procedures performed can affect an MP's confidence. Medical practitioners being confident when performing critical procedures in paediatric patients can possibly improve outcomes, which needs to be researched further.</p><p><strong>Contribution: </strong>MPs may require ongoing practical medical training or simulations to boost their confidence during paediatric procedures.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260556","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":"Emergency specialists' perceptions of climate-related health and education in South Africa.","authors":"Elzarie Theron, Gina Ziervogel, Willem Stassen","doi":"10.4102/jcmsa.v3i1.214","DOIUrl":"10.4102/jcmsa.v3i1.214","url":null,"abstract":"<p><strong>Background: </strong>Climate change exacerbates existing social inequalities, placing a disproportionate burden on already vulnerable populations. As emergency care often functions as the initial point of contact for affected patients, it is crucial that these specialists understand the impacts and are appropriately trained to respond. However, it is unclear whether specialists in South Africa are equipped with the knowledge and preparedness to do so in clinical practice.</p><p><strong>Methods: </strong>This study followed a quantitative survey design to describe emergency medicine registrars' and physicians' perceptions about climate change and health, climate-related health education, and self-perceived preparedness to respond to these impacts.</p><p><strong>Results: </strong>The majority (80%, <i>n</i> = 16) of 20 participants (combining 'probably' and 'definitely') recognised climate-related health impacts; 70% (<i>n</i> = 14) believed that it would impact their own health, and 95% (<i>n</i> = 19) felt that it would impact their patients' health (combining 'agree' and 'strongly agree'). However, none of the participants had received any formal training on the topic, and only 3 participants (15%) indicated that they 'probably' have enough information to prepare and respond to the health impacts of climate change. When asked about key priorities to improve preparedness, 65% (<i>n</i> = 13) highlighted the importance of education and information.</p><p><strong>Conclusion: </strong>The findings suggest a gap in preparedness and underscore the need for a climate-responsive emergency care education.</p><p><strong>Contribution: </strong>This is the first study in South Africa to describe emergency medicine specialists' perceptions and preparedness in relation to climate change and health, establishing a foundation for future curriculum development.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"214"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of delayed specialist presentation in head and neck cancer to Tygerberg Hospital, Western Cape.","authors":"Petrus J Vermeulen, Johan Grobbelaar","doi":"10.4102/jcmsa.v3i1.215","DOIUrl":"10.4102/jcmsa.v3i1.215","url":null,"abstract":"<p><strong>Background: </strong>Delayed presentation of head and neck cancers at Tygerberg Hospital often results in tumour progression and clinical upstaging - frequently marking the difference between curative and palliative care. This study aimed to identify factors contributing to prolonged time intervals before specialist consultation in South Africa's public healthcare sector, and to inform potential interventions to address these delays.</p><p><strong>Methods: </strong>A cross-sectional, survey-based study was conducted. Patients were recruited weekly, and data were collected through individual interviews. Descriptive statistics were used to analyse responses.</p><p><strong>Results: </strong>At initial specialist presentation, 58.9% of patients were diagnosed with stage III/IV disease, with oral cavity malignancies being most common. Nearly half (47.06%) experienced delays because of inappropriate antibiotic prescriptions and misdiagnoses. The median time from symptom onset to specialist review was 135 days. The most frequently cited patient-related barrier was poor health literacy (57.84%).</p><p><strong>Conclusion: </strong>The majority of patients presented with advanced-stage head and neck cancer. Delays were attributed to both clinician-related factors - such as misdiagnosis and unwarranted antibiotic use - and patient-related factors, primarily limited health literacy. The observed median delay exceeds international benchmarks, underscoring the need for targeted interventions.</p><p><strong>Contribution: </strong>This study highlights the urgent need for earlier referral and specialist assessment of head and neck cancer patients. Findings support the implementation of clinician education, patient awareness initiatives and policy development aimed at reducing diagnostic and referral delays within South Africa's public healthcare system.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"215"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260570","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":"Perimesencephalic subarachnoid haemorrhage: A case study.","authors":"Esaias C C Koller, Joubert C Steynberg, Zainub Jooma","doi":"10.4102/jcmsa.v3i1.245","DOIUrl":"10.4102/jcmsa.v3i1.245","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous subarachnoid haemorrhage (SAH) is caused by a ruptured aneurysm in most cases. In 15% of cases, no vascular abnormality can be found. This subset is classified according to blood distribution, which can be perimesencephalic or non-perimesencephalic. Perimesencephalic subarachnoid haemorrhage (PM-SAH) is the least common phenomenon. It has a favourable prognosis with negligible long-term complications. A high index of suspicion is needed to identify this group of patients. This report highlighted the current consensus for managing these patients. It also highlighted the need for further research as no cause has been identified.</p><p><strong>Patient presentation: </strong>A 35-year-old male developed PM-SAH during physical exertion. He had no risk factors and was well below the described age of being in the 6th decade of life.</p><p><strong>Management and outcome: </strong>The patient was admitted to an intensive care unit and had digital subtraction angiography performed within the prescribed 24 h-48 h. This modality digitally subtracts radiopaque structures such as bones to enhance the visibility of blood vessels. Treatment was symptomatic, and a course of nimodipine was completed. The clinical course was uncomplicated, and the patient recovered fully.</p><p><strong>Conclusion: </strong>Perimesencephalic subarachnoid haemorrhage is a benign condition once aneurysmal causes have been excluded. As PM-SAH follows a diagnosis of exclusion, the initial monitoring and management follow the same principles of an aneurysmal SAH.</p><p><strong>Contribution: </strong>In this uncommon phenomenon of PM-SAH described in this case, an even more uncommon anatomical variant, namely a superior cerebellar artery fenestration, has been identified. This possibly highlights the role that vascular anatomical variants play in this condition, where no cause has been identified.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"245"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260563","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":"Beyond the textbook: Unveiling medical students' voices on public health education.","authors":"Tladi D Ledibane, Marietjie de Villiers","doi":"10.4102/jcmsa.v3i1.180","DOIUrl":"10.4102/jcmsa.v3i1.180","url":null,"abstract":"<p><strong>Background: </strong>Training medical students in public health (PH) is crucial for shaping their future practices as healthcare professionals. This study aimed to explore the knowledge, attitudes and perceptions of fifth-year medical students at a South African university regarding their PH training to inform curriculum development and enhance the learning experience.</p><p><strong>Methods: </strong>A mixed-methods study with a convergent design was conducted. The questionnaire was distributed electronically to 248 fifth-year medical students using a 5-point Likert scale. A total of 85 students participated in the survey (34% response rate). Qualitative data were obtained through a single focus group discussion with five participants, all of whom were former class representatives from the same cohort and eligible survey participants. Descriptive statistics were used for quantitative data analysis, whereas thematic analysis was employed for qualitative data.</p><p><strong>Results: </strong>The study revealed appreciation for PH among students. However, concerns were raised about late exposure to PH in medical training and, predominantly, didactic teaching methods. Most students agreed on the integral role of PH in clinical medicine. The study also highlighted a need for more research opportunities in the undergraduate programme.</p><p><strong>Conclusions: </strong>The findings underscore the need for early exposure to PH, more engaging teaching methods and increased research training opportunities in PH. These insights can guide the revision and improvement of PH curricula in medical schools, potentially enhancing students' preparedness for future roles in healthcare and research.</p><p><strong>Contribution: </strong>This study provides evidence from medical students' perspectives to inform curriculum renewal in public health education, underscoring the need for earlier exposure, more engaging pedagogy, and integrated research training.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"180"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260533","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":"Outcomes of hysterectomy for puerperal sepsis at an Academic Hospital: A retrospective study.","authors":"Esther Olusola, Admire Chikandiwa, Evelyn Ngwa Lumngwena, Poovangela Naidoo","doi":"10.4102/jcmsa.v3i1.216","DOIUrl":"10.4102/jcmsa.v3i1.216","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy-related sepsis contributes significantly to maternal mortality. While there is substantial information on postpartum hysterectomy, information on outcomes of hysterectomy as source control for puerperal sepsis is limited. Knowledge of the common causative organisms and their antimicrobial sensitivity may assist with targeted antibiotic therapy to improve patient outcomes. This study described the indications and outcomes of surgery in patients following hysterectomy as source control for puerperal sepsis.</p><p><strong>Methods: </strong>In a retrospective study, we analysed the intra-operative and histological findings and the results of microbial culture and antibiotic sensitivity of women who underwent a hysterectomy for puerperal sepsis at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, from January 2019 to December 2019.</p><p><strong>Results: </strong>Twenty-nine (88%) of the 33 women with hysterectomy for puerperal sepsis studied had a caesarean section (CS), 14 (48%) of whom had a CS performed for foetal distress. Eight of these 33 women (24%) had hypertensive-related disorders. The most common organisms cultured in the intra-abdominal fluid were <i>Acinetobacter baumannii</i> (<i>n</i> = 11, 26%), <i>E. coli</i> (<i>n</i> = 8, 19%), <i>Klebsiella</i> species (<i>n</i> = 6, 14%) and <i>Enterococcus faecalis</i> (<i>n</i> = 6, 14%) of a total of 42 organisms were identified from all sites. Puerperal sepsis was confirmed in 28 (85%) of the uterine histology samples, with a mortality rate of 6% in this study.</p><p><strong>Conclusion: </strong>Hysterectomy for puerperal sepsis was most frequently associated with CS, with hypertensive-related disorders the most common indication. Histological confirmation of sepsis is required, as the histological findings differed by 15% with surgical diagnosis.</p><p><strong>Contribution: </strong><i>A. baumannii</i> was the most common species isolated as the cause of infection.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"216"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067619","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":"Audit of a retinopathy of prematurity screening programme in the Limpopo province, South Africa.","authors":"Ntsakisi Bandi, Christopher Sutton, Tshilidzi van der Lecq","doi":"10.4102/jcmsa.v3i1.220","DOIUrl":"10.4102/jcmsa.v3i1.220","url":null,"abstract":"<p><strong>Background: </strong>Retinopathy of prematurity (ROP) is a potentially blinding disorder. South Africa (SA) has national ROP screening guidelines to aid the timely diagnosis of infants requiring treatment. Several tertiary units in SA have published data on the prevalence of ROP; however, data from some provinces are lacking. An audit of ROP screening programmes, especially in these areas, is important to determine the ROP prevalence and whether screening is based on the national criteria.</p><p><strong>Methods: </strong>This retrospective audit included infants screened between 01 January 2019 and 30 June 2021 at a single tertiary unit in the Limpopo province, SA. The following criteria were used to identify eligible infants: birth weight (BW) < 1500 g or gestational age (GA) < 32 weeks.</p><p><strong>Results: </strong>A total of 203 infants were screened. The mean BW and GA were 1250 grams (s.d. 239.0) and 30.4 weeks (s.d. 2.43), respectively. Nine (4.4%) infants were diagnosed with ROP and 2 (1.0%) infants required treatment. Most (95.1%,193) infants met the screening criteria. Screening was completed in 158 (77.8%) infants and 44 (22.0%) were lost to follow-up (LTFU).</p><p><strong>Conclusion: </strong>Although eligible infants were identified based on the national criteria, a low prevalence of ROP was found among screened infants. This is likely because of lack of screening, late screening and high LTFU.</p><p><strong>Contribution: </strong>This study shows the value and importance of auditing ROP screening programmes even in countries with national screening guidelines to identify areas for improvement.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"3 1","pages":"220"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067668","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}