ASM case reports最新文献

{"title":"Reactive infectious mucocutaneous eruption: an increasingly encountered complication during periods of increased <i>Mycoplasma pneumoniae</i> transmission-a case report.","authors":"Andrew E Clark, Lakshmi Marimuthu, Anna Sick-Samuels, Heba H Mostafa","doi":"10.1128/asmcr.00107-25","DOIUrl":"10.1128/asmcr.00107-25","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma pneumoniae</i> is a common cause of community-acquired pneumonia among children and young adults. Surveillance within the United States has identified increased levels of <i>M. pneumoniae</i>-mediated respiratory disease following a multi-year period of minimal detection during the COVID-19 pandemic. A wide spectrum of extrapulmonary complications can be associated with <i>M. pneumoniae</i> infections, including dermatological disease. Reactive infectious mucocutaneous eruption (RIME) is a constellation of immune-mediated extrapulmonary manifestations causing ulceration of multiple mucous membranes that occurs in up to 25% <i>M</i>. <i>pneumoniae</i> cases.</p><p><strong>Case summary: </strong>An adolescent patient presenting with acute hypoxic respiratory failure and an eight-day history of conjunctivitis and oral ulcers tested positive for <i>M. pneumoniae</i> from a nasopharyngeal specimen and was diagnosed with RIME. A retrospective review of increased <i>M. pneumoniae</i> test positivity and hospitalizations at our institution was undertaken, which mirrored national trends.</p><p><strong>Conclusion: </strong>As dedicated <i>M. pneumoniae</i> testing may not be available in all settings, clinicians should consider a diagnosis of RIME for patients presenting with similar para- or post-infectious mucositis, even in the absence of traditional respiratory symptoms. RIME incidence is expected to increase in the setting of a higher prevalence of <i>M. pneumoniae</i> disease. As RIME can be associated with significant morbidity including dehydration and weight loss as well as disease recurrence, proper management of patient symptomatology is essential.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544973","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":"Rapid acquisition of daptomycin resistance in a <i>Corynebacterium striatum</i> osteoarticular infection: case report and discussion on antimicrobial resistance.","authors":"Ines Rezzoug, Emmanuel Zamparini, Charles Court, Assaf Mizrahi, Laurent Dortet, Cécile Emeraud","doi":"10.1128/asmcr.00106-25","DOIUrl":"10.1128/asmcr.00106-25","url":null,"abstract":"<p><strong>Background: </strong><i>Corynebacterium striatum</i>, a commensal of the skin microbiota, can cause invasive osteoarticular infections that are challenging to diagnose and treat due to biofilm formation. Daptomycin, owing to its potent activity against gram-positive bacteria and favorable toxicity profile, is frequently used as empirical therapy in the management of postoperative bone and joint infections. However, cases of acquired resistance remain rare and poorly understood.</p><p><strong>Case summary: </strong>We describe a case of chronic T11-T12 spondylodiscitis in a paraplegic patient. During the first surgical intervention, a daptomycin-susceptible <i>C. striatum</i> isolate (CORY-1) was recovered. The patient received 14 days of daptomycin monotherapy (10 mg/kg). At the time of the second surgery, a daptomycin-resistant <i>C. striatum</i> strain (CORY-2) was isolated. Whole-genome sequencing revealed only 13 single nucleotide polymorphisms between the two isolates, including a nonsense mutation in <i>pgsA</i>, likely responsible for resistance. Additional mutations in <i>mltG</i> and <i>ftsI</i> genes may contribute to the modest increases observed in β-lactam minimum inhibitory concentrations.</p><p><strong>Conclusion: </strong>This case highlights the risk of rapid daptomycin resistance emergence in <i>C. striatum</i> under selective pressure. Daptomycin should be used with caution for long-term infections caused by this species. Alternative agents such as vancomycin or oxazolidinones may offer more reliable therapeutic options.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544970","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":"<i>Stenotrophomonas maltophilia</i>: the need for randomized controlled trials to evaluate treatment options.","authors":"Ya-Ting Chang, Luca Mezzadri, David L Paterson","doi":"10.1128/asmcr.00127-25","DOIUrl":"10.1128/asmcr.00127-25","url":null,"abstract":"<p><p>The most optimal treatment for serious <i>Stenotrophomonas maltophilia</i> infections remains undetermined based on current evidence. The evolution of Infectious Diseases Society of America (IDSA) guidance from 2022 to 2024 reflects growing support for combination therapy and a shift away from agents with unfavorable pharmacokinetic/pharmacodynamic profiles, such as tigecycline. No randomized controlled trials (RCTs) have been conducted to date, and existing observational comparative studies have yielded heterogeneous results. Despite efforts to adjust for bias and confounders, definitive conclusions remain elusive, largely due to methodological limitations inherent in retrospective designs, such as immortal time bias. For serious <i>S. maltophilia</i> infections, a multi-arm trial is likely necessary to generate robust evidence; however, challenges, such as large sample size requirements, difficult patient recruitment, and high implementation costs remain significant barriers. To overcome these obstacles, innovative trial designs and analytic approaches have emerged. Target trial emulation, for instance, seeks to approximate RCT-level evidence using observational data. Several other designs aim to improve the flexibility and efficiency of clinical trials, including: multi-arm, multi-stage (MAMS) trial designs; embedding a multi-arm trial within a larger platform trial; an analysis method known as PRACTical method composed of personalized randomization treatment options relevant to individuals; and Bayesian analytic frameworks, enabling simultaneous comparison across multiple treatment arms. As we seek answers to complex clinical dilemmas, such as the life-threatening <i>S. maltophilia</i> infection reported by Qadabashi and colleagues in a recent article in <i>ASM Case Reports</i> (ASM Case Rep 1:e00005-25, 2025, https://doi.org/10.1128/asmcr.00005-25), these forward-looking trial designs and analytic methodologies will be critical in shaping the future of evidence-based treatment strategies.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544857","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":"Infective endocarditis due to <i>C. fetus</i>: an opportunistic infection in a patient with AIDS.","authors":"Cole T Bredehoeft, Ryan D Carroll","doi":"10.1128/asmcr.00102-25","DOIUrl":"10.1128/asmcr.00102-25","url":null,"abstract":"<p><strong>Background: </strong><i>Campylobacter fetus</i> is a rare zoonotic cause of infective endocarditis (IE) that occurs most commonly in persons with predisposing conditions, such as immunodeficiencies and/or structural heart disease.</p><p><strong>Case summary: </strong>This case highlights native tricuspid valve IE due to <i>C. fetus</i> occurring in a patient with concomitant diagnosis of acquired immunodeficiency syndrome (AIDS) treated with combination beta-lactam antimicrobial therapy without immediate surgical candidacy following initial presentation with prolonged constitutional symptoms.</p><p><strong>Conclusion: </strong>Patients with AIDS are at-risk for opportunistic infections, including those that are less commonly investigated and potentially without obvious epidemiologic risk factors, such as <i>C. fetus</i>. However, despite being a fastidious organism, <i>C. fetus</i> bacteremia can be diagnosed using widely available blood culture methods. Treatment requires rapid initiation of effective antimicrobial therapy and surgical evaluation in most cases of IE.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544945","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":"Molecular methods to diagnose pertussis: a case of confusion with <i>Bordetella bronchiseptica</i>.","authors":"Christopher M Zarbock, Esse M Evbuomwan, Melissa Shenep, Gautam Dantas, Rebekah E Dumm","doi":"10.1128/asmcr.00084-24","DOIUrl":"10.1128/asmcr.00084-24","url":null,"abstract":"<p><strong>Background: </strong>Prompt identification of clinically relevant <i>Bordetella</i> (e.g., <i>B. pertussis</i> and <i>B. parapertussis</i>) is critical for both treatment and isolation decisions to mitigate transmission among close contacts. Due to the organisms' fastidious growth requirements, nucleic acid amplification tests (NAATs) have become a mainstay for identification and differentiation of <i>B. pertussis</i> and <i>B. parapertussis</i>. For NAATs detecting these closely related species, the nucleic acid target dictates assay sensitivity and specificity and varies between commercially available platforms.</p><p><strong>Case summary: </strong>This case report describes a child's course of cough and post-tussive emesis following bone marrow transplant for an underlying immunodeficiency. While an initial BioFire Respiratory Panel 2.1 (BioFire Diagnostics, LLC, Salt Lake City, UT, USA) detected <i>B. pertussis</i> DNA, a subsequent maxillary sinus culture grew <i>B. bronchiseptica</i>, identified by MALDI-TOF MS and whole-genome sequencing. Furthermore, on two subsequent occasions, nasopharyngeal specimens were positive for <i>B. pertussis</i> on the BioFire RP2.1; however, they were negative for <i>B. pertussis</i> on the DiaSorin Molecular Simplexa Bordetella Direct (DiaSorin Molecular LLC, Cypress, CA, USA). These seemingly disparate results can be explained by molecular target differences on the respective platforms and a rare instance of cross-reactivity with the genetic target for <i>B. pertussis</i> (<i>ptxP</i>) in an isolate of <i>B. bronchiseptica</i>.</p><p><strong>Conclusion: </strong>This case, where the presence of <i>ptxP</i> was confirmed by whole genome sequencing in an isolate of <i>B. bronchiseptica</i>, highlights a caveat to the molecular diagnosis of pertussis and emphasizes the importance of understanding gene targets to interpret results when false positive detections are suspected.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544947","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":"Expedited diagnosis of disseminated <i>Mycobacterium kansasii</i> infection using targeted (amplicon-based) next-generation sequencing in an immunocompromised patient.","authors":"Risa Fuller, Bruce E Petersen, Shafinaz Hussein, Christian Salib, Amy Duffield, Rebecca Gaglia, Janice L Gabrilove, Carolina Hernández, Juan David Ramirez, Samantha E Jacobs, Alberto Paniz-Mondolfi","doi":"10.1128/asmcr.00110-24","DOIUrl":"10.1128/asmcr.00110-24","url":null,"abstract":"<p><strong>Background: </strong><i>Mycobacterium kansasii</i> is typically associated with pulmonary disease and is an uncommon cause of disseminated infection and thus can be challenging to diagnose and treat.</p><p><strong>Case summary: </strong>We present a 59-year-old female with a history of renal cell carcinoma (RCC) and T-cell large granular lymphocytic leukemia (T-LGLL) who developed disseminated <i>Mycobacterium kansasii</i> infection. Targeted next-generation sequencing (tNGS) facilitated the rapid detection of <i>M. kansasii</i> from formalin-fixed, paraffin-embedded (FFPE) tissue, aiding in clinical decision-making prior to culture confirmation.</p><p><strong>Conclusion: </strong>The case highlights the diagnostic challenges posed by overlapping clinical features and chronic granulomatous inflammation in immunocompromised patients, as well as the utility of amplicon-based sequencing in expediting diagnostic turnaround and guiding therapeutic interventions.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544986","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":"Lymphatic filariasis remained silent until presentation with huge abdominal mass mimicking malignancy: a case report.","authors":"S Kafle, B Panthi","doi":"10.1128/asmcr.00073-25","DOIUrl":"10.1128/asmcr.00073-25","url":null,"abstract":"<p><strong>Background: </strong>Lymphatic filariasis (LF) is an endemic infection seen in the tropical and subtropical regions of the world, including Nepal. It is a mosquito-borne neglected tropical disease and is caused by a nematode parasite.</p><p><strong>Case summary: </strong>We reported an unusual case of LF in a 50-year-old male who presented to a tertiary hospital in Kathmandu with a complaint of a palpable abdominal mass mimicking malignancy. A CT scan revealed a large mesenteric cystic mass measuring approximately 23 × 15 cm. These findings initially directed the clinicians toward a diagnosis of malignancy, leading to blood tests for cancer markers, for example, carcinoembryonic antigen, which showed slight elevation supportive of this suspicion. Given the cystic nature of the mass and intestinal obstruction, surgical intervention was performed to place a pigtail catheter for drainage, and a fluid sample was sent for cytopathological evaluation for malignancy as well as biochemical and microbiological evaluation. Initially, biochemical and microbiological findings were reported as normal. Cytopathological study on stained slides (Giemsa and Papanicolaou) revealed multiple threadlike microfilaria larvae, the morphology of which resembled <i>Wuchereria bancrofti</i>, confirming the diagnosis of LF. This was further supported by the microbiological studies confirming the presence of sheathed microfilaria larvae in the cyst fluid. The patient's condition significantly improved after initiation of diethylcarbamazine. No further surgical intervention was required.</p><p><strong>Conclusion: </strong>LF may remain asymptomatic for decades. This case highlights that LF may present with an abdominal mass mimicking malignancy.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544949","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":"Severe <i>Saprochaete capitata</i> fungemia presenting as micafungin breakthrough hepatosplenic lesions in an immunocompromised patient: case report.","authors":"Hannakate Lichota, Eric Bhaimia, Graeme Forrest, Nicholas M Moore","doi":"10.1128/asmcr.00071-25","DOIUrl":"10.1128/asmcr.00071-25","url":null,"abstract":"<p><strong>Background: </strong><i>Saprochaete capitata</i> (<i>S. capitata</i>, also known as <i>Magnusiomyces capitatus</i>), a yeast-like fungus commonly isolated from soil, is an emerging infection capable of disseminated infection in immunocompromised hosts, including those with hematologic malignancy.</p><p><strong>Case summary: </strong>A 70-year-old female admitted for induction therapy for myelodysplastic syndrome (MDS) developed persistent neutropenic fever while on antibacterial and micafungin prophylaxis. Blood cultures revealed high-grade <i>S. capitata</i> fungemia with imaging findings of hepatosplenic involvement in the setting of a central venous catheter and interatrial shunt. The patient was successfully treated with a combination of voriconazole, amphotericin B 3 mg/kg daily, and flucytosine. She was transitioned to voriconazole monotherapy after blood culture clearance and resolution of fever.</p><p><strong>Conclusion: </strong><i>S. capitata</i> may be associated with severe, disseminated infection in patients with hematologic malignancy. While there is a lack of evidence to guide optimal treatment, the organism appears to exhibit resistance to echinocandins. Expert opinion favors voriconazole as empiric treatment with the addition of intravenous liposomal amphotericin B for severe infections.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544984","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":"What you see is not always what you get: the influence of epidemiology on ordering practices for herpes simplex virus and varicella zoster virus.","authors":"Blake W Buchan, Preeti Pancholi","doi":"10.1128/asmcr.00112-25","DOIUrl":"10.1128/asmcr.00112-25","url":null,"abstract":"<p><strong>Background: </strong>Herpes simplex virus (HSV) and varicella zoster virus (VZV) are common causes of clinically indistinguishable lesions. The epidemiology and clinical presentation, including anatomic site of lesion and patient age, differ between these viruses, which may influence physician ordering practices. Importantly, atypical presentation of either HSV or VZV can result in the potential for misdiagnosis or missed diagnosis.</p><p><strong>Case summary: </strong>Two cases are presented illustrating atypical anatomic location and presentation of HSV-1 and VZV lesions that resulted in failure to consider the virus when placing orders for laboratory testing, leading to missed or misdiagnosis.</p><p><strong>Conclusion: </strong>Atypical presentation of HSV or VZV resulting in failure to order the appropriate laboratory test impacts a significant minority of cases, which can lead to failure to prescribe appropriate therapy, extended symptoms, and additional interaction with the healthcare system.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919589","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":"First report of <i>Escherichia albertii</i> in Iran: a case study highlighting diagnostic challenges in pediatric gastroenteritis.","authors":"Ali Dadvar, Ali Nemati, Maryam Hafiz, Zahra Khammar, Ute Römling, Mahdi Askari Badouei, Gholamreza Hashemi Tabar","doi":"10.1128/asmcr.00046-25","DOIUrl":"10.1128/asmcr.00046-25","url":null,"abstract":"<p><strong>Background: </strong><i>Escherichia albertii</i> is a gram-negative, facultative anaerobic bacillus in the order Enterobacterales, family Enterobacteriaceae, increasingly recognized as an emerging enteropathogen. Initially isolated in 1991 from a child with diarrhea in Bangladesh and misclassified as <i>Hafnia alvei</i>, it was reclassified in 2003 and is now acknowledged as the second pathogenic species of the <i>Escherichia</i> genus, following <i>Escherichia coli</i>.</p><p><strong>Case summary: </strong>This article reports the first documented case of <i>E. albertii</i> in Iran, infecting a 5-year-old girl who presented with profuse watery diarrhea. During a 7-month surveillance study at Akbar Children's Hospital in Mashhad, stool samples from 231 children with diarrhea were analyzed, with this single case demonstrating infection by <i>E. albertii</i>. The strain was identified through pentaplex PCR but exhibited phenotypic traits highly similar to other enteropathogens and showed resistance to antibiotics, such as ampicillin and amoxicillin-clavulanate.</p><p><strong>Conclusion: </strong>The study highlights the diagnostic challenges associated with the discrimination between <i>E. coli</i> and <i>E. albertii</i>, which is often misidentified when solely biochemical tests are used. Our findings and literature data suggest that <i>E. albertii</i> should be considered a significant cause of pediatric gastroenteritis, akin to <i>Shigella</i> and enteroinvasive <i>E. coli</i>. These observations emphasize the need for adequate diagnostic protocols, including PCR testing, to accurately identify <i>E. albertii</i> and inform appropriate clinical management strategies. Further research is necessary to deepen our understanding of this emerging pathogen and its implications for human health.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12584167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544958","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}