Case Reports in Critical Care最新文献

{"title":"A 16-Year-Old Boy With ARDS and Septic Shock, an Atypical Presentation of Murine Typhus: Case Report and Review of the Literature.","authors":"Pierre H François, Thalia Leclerc, Manon Jaboyedoff, Onya Opota, Gilbert Greub, Guillaume Maitre, Vivianne Chanez","doi":"10.1155/crcc/1267884","DOIUrl":"10.1155/crcc/1267884","url":null,"abstract":"<p><p>Murine typhus is a flea-borne disease caused by the bacteria <i>Rickettsia typhi</i> that occurs worldwide, but predominantly in endemic areas. The clinical presentation of typhus is often nonspecific, leading to delays in diagnosis and treatment. The severity of the disease varies widely. Most cases are relatively mild, but some patients develop a very severe form and may die. We report a case of severe murine typhus complicated by septic shock, alveolar hemorrhage, and acute respiratory distress syndrome in a teenager who was born in Somalia and had immigrated from Kenya to Switzerland. Diagnosis was suspected upon admission in the pediatric intensive care unit and was confirmed by PCR. The patient improved with doxycycline treatment. Rickettsial disease should be considered in the differential diagnosis of patients returning from endemic areas, and anti-rickettsial treatment should be started without delay to ensure rapid recovery and avoid severe complications.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"1267884"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946106","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":"Successful Treatment of Post-pump Chorea With Tiapride in an Adult Cardiac Surgery Patient: A Case Report.","authors":"Nicolas Kaiser, Matthias C Borutta, Martin Regensburger, Larissa Herbst, Lena Rühl, Timo Seitz, Stefan Gerner, Mario Schiffer, Carsten Willam, Kosmas Macha, Karl Bihlmaier","doi":"10.1155/crcc/5776661","DOIUrl":"10.1155/crcc/5776661","url":null,"abstract":"<p><p>Postpump chorea is a rare hyperkinetic movement disorder following cardiac surgery with cardiopulmonary bypass. Although initially described in pediatric patients, postpump chorea is increasingly recognized in adults. We report the case of a 65-year-old woman who developed severe choreiform movements approximately 2 weeks after cardiac surgery. Extensive diagnostic workup including cerebrospinal fluid analysis revealed no alternative etiology. Notably, hypothermia had only been mild during cardiac surgery, and there were no characteristic basal-ganglia MRI abnormalities. Treatment with tiapride, a selective dopamine D2/D3 receptor antagonist with established antichoreic effects was followed by rapid neurological improvement and complete remission of symptoms. This is one of the first reports of tiapride in adult postpump chorea, supporting its role as a potentially useful symptomatic therapeutic option in this rare complication.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"5776661"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957150","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":"Early Disseminated Cryptococcosis Following Orthotopic Heart Transplantation Requiring VA-ECMO: A Case Report.","authors":"Vanessa Petrich, Lucas Deschenes","doi":"10.1155/crcc/5744015","DOIUrl":"10.1155/crcc/5744015","url":null,"abstract":"<p><p>Disseminated cryptococcosis is a rare but serious opportunistic infection following solid organ transplantation and rarely occurs within the first month of transplantation. We report a case of disseminated <i>Cryptococcus neoformans</i> infection occurring 14 days after orthotopic heart transplantation which required mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (VA-ECMO). Management was complicated by alterations in antifungal pharmacokinetics and the inability to perform serial lumbar punctures while anticoagulated. Antifungal therapy with nonliposomal amphotericin B, flucytosine, and fluconazole was administered. A combination of optic nerve sheath diameter measurements, CT scans, and evaluation for papilledema was used as temporizing, noninvasive surrogates for intracranial pressure monitoring until lumbar punctures could be safely performed. The patient was successfully decannulated, weaned from mechanical support, and discharged from the intensive care unit.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"5744015"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921678","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 Diagnosis: A Comprehensive Case Report on Duchenne Muscular Dystrophy.","authors":"Mahmoud Abdel Hameed Shahin, Atheer Ali Asiri, Areej Salah Alotaibi, Huda Majrashi, Saeedah Khubrani, Shorouq Hashel AlQarni, Shomokh Saad Alqurashi, Manal Essa Samti, Zahra Hashel AlQarni","doi":"10.1155/crcc/9969987","DOIUrl":"10.1155/crcc/9969987","url":null,"abstract":"<p><strong>Background: </strong>Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disorder characterized by the absence of dystrophin, leading to progressive muscle degeneration and generalized weakness. It primarily affects males in early childhood and progresses to loss of ambulation and cardiac and respiratory complications.</p><p><strong>Case report: </strong>This case report describes a 26-year-old male with terminal-stage DMD who was admitted to the surgical intensive care unit (SICU) in a critically ill state with multiple-organ failure. He was ventilator-dependent via tracheostomy, hypotensive, anemic, and required cardiovascular support. He also had multiple pressure ulcers, including a Stage IV ulcer with associated edema, acute renal failure managed with continuous renal replacement therapy (CRRT), and sepsis due to mixed bacterial and fungal infections. Broad-spectrum antimicrobial therapy and intensive wound care were provided. This case highlights that advanced-stage DMD is a severe multisystem condition requiring intensive, specialized, and multidisciplinary care.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of a multidisciplinary approach in managing complex patient conditions, emphasizing the prevention of secondary complications such as pressure ulcers and pulmonary infections. Adherence to evidence-based guidelines, coupled with psychosocial and ethical considerations related to quality of life, remains essential. Establishing standardized care protocols, enhancing healthcare team training on the specific needs of these patients, and promoting home-based and palliative care services are strongly recommended to ensure comprehensive, coordinated, and patient-centered management.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"9969987"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908170","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":"Diagnosis of Aortoenteric Fistula in a 65-Year-Old Male With Recently Discovered Dieulafoy Lesion-A Case Report.","authors":"Amira Elsabagh, Mustafa Naveed, Luke Durbin, Thomas S Davis, Mayada Issa, Yousuf M Khan","doi":"10.1155/crcc/1513556","DOIUrl":"10.1155/crcc/1513556","url":null,"abstract":"<p><strong>Background: </strong>Aortoenteric fistulas (AEFs) are an uncommon but often life-threatening cause of gastrointestinal (GI) hemorrhage in patients with a history of abdominal aortic aneurysm (AAA) repair. Dieulafoy lesions are a rare cause of GI bleeding, which can have significant morbidity if not identified promptly.</p><p><strong>Case report: </strong>In this case, we describe a 65-year-old male with a history of AAA repair, complicated by graft infection, who was admitted for GI bleeding. An initial esophagogastroduodenoscopy (EGD) revealed a Dieulafoy lesion in the gastric fundus, which was treated with endoscopic clips. The patient was discharged after clinical improvement. Two weeks later, he returned with recurrent bleeding and hemodynamic instability. Repeat EGD showed no active bleeding but revealed persistent blood in the stomach and duodenum. Subsequent imaging raised concern for AEF; ultimately, emergent surgical exploration confirmed the diagnosis, revealing graft dehiscence and communication into the duodenum.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenge of GI bleeding in patients with a history of AAA repair. AEFs may present with \"herald bleeds\" that mimic other causes of GI bleeding such as Dieulafoy lesions, delaying definitive diagnosis and treatment. Subtle radiologic findings, such as perigraft air, induration, or loss of normal aortic fat planes, should prompt urgent surgical evaluation, particularly in patients with a history of aortic instrumentation, infected grafts, or recurrent bleeding despite endoscopic therapy. High clinical suspicion, early CT angiography, and timely surgical consultation are critical to improving outcomes in these patients.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"1513556"},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898252","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":"Acute Respiratory Failure due to Pulmonary Toxoplasmosis in an Immunocompetent Patient: A Case Report.","authors":"María Jesús Ojeda, María Isabel Domínguez, Leonardo Soto, Rodrigo Kemeny, Pablo Regueira, Guillermo Ávila, Tomas Regueira","doi":"10.1155/crcc/7875906","DOIUrl":"10.1155/crcc/7875906","url":null,"abstract":"<p><p>Pulmonary toxoplasmosis is a rare but potentially life-threatening manifestation of <i>Toxoplasma gondii</i> infection in immunocompetent individuals. Clinical presentation is often nonspecific and may mimic viral or atypical pneumonia, leading to delayed diagnosis. We report the case of a previously healthy 32-year-old man who presented with a mononucleosis-like syndrome complicated by rapidly progressive hypoxemic respiratory failure requiring invasive mechanical ventilation. Initial evaluation revealed marked systemic inflammation, cytopenias, hyperferritinemia, and mixed-pattern hepatitis. Chest computed tomography demonstrated bilateral consolidations, ground-glass opacities, pleural effusions, and interstitial changes. Extensive microbiological and immunological investigations were initially unrevealing. Polymerase chain reaction (PCR) testing for <i>T. gondii</i> was positive in blood despite negative IgG serology and isolated IgM positivity, raising concern for potentially misleading serological findings. The diagnosis of pulmonary toxoplasmosis was subsequently confirmed by PCR detection of <i>T. gondii</i> DNA in bronchoalveolar lavage fluid. Targeted treatment with trimethoprim-sulfamethoxazole led to rapid clinical and biochemical improvement, allowing successful extubation after 6 days of mechanical ventilation and complete radiological resolution prior to discharge. This case highlights the diagnostic challenges of pulmonary toxoplasmosis in immunocompetent hosts and underscores the importance of molecular testing in critically ill patients with severe pneumonia and ambiguous serological findings.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"7875906"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882761","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":"Reviving the Standstill Heart: Multimodal Management of Refractory Cardiac Arrest due to Massive Pulmonary Embolism.","authors":"Jeffrey Valencia Uribe, Mariam Attia, Alfredo Perez Tagle Tejeda, Kyle Seifert, Ramon G Valentin, Daniel Mayer","doi":"10.1155/crcc/6192253","DOIUrl":"10.1155/crcc/6192253","url":null,"abstract":"<p><strong>Introduction: </strong>Massive pulmonary embolism (PE) is a life-threatening condition frequently associated with right ventricular (RV) strain, hypotension, and cardiac arrest. Recommended management includes IV alteplase for high-risk PE. However, evidence guiding higher thrombolytic doses during cardiac arrest remains limited and is rarely reported. We present a case of massive PE requiring an atypically high cumulative tPA dose administered during CPR, resulting in return of spontaneous circulation (ROSC).</p><p><strong>Case description: </strong>A 38-year-old female with prior DVT and PE presented with syncope and left lower extremity edema. Imaging confirmed bilateral PE and DVT. She was found to be hemodynamically unstable and was treated with 100 mg IV tPA. This resulted in transient improvement, but she subsequently suffered a prolonged PEA arrest. During ACLS, there was confirmation of cardiac standstill on POCUS. A second bolus of 50 mg tPA was administered 29 min into the code, which led to sustained ROSC within 2 min. Despite maximal vasopressor and inotropic support, persistent shock and hypoxemia necessitated pulmonary angiography and attempted thrombectomy, which was aborted due to recurrent arrest. Catheter-directed thrombolysis with bilateral EKOS catheters was initiated, and by ICU Day 3, echocardiography revealed normalized RV function.</p><p><strong>Discussion: </strong>Massive PE causes acute RV failure and impaired pulmonary perfusion, which may limit thrombolytic delivery. Repeat tPA dosing during CPR may enhance clot penetration and improve outcomes. When systemic thrombolysis is insufficient, catheter-directed therapies can provide additional hemodynamic benefit. Adjunctive strategies including ventilatory optimization, pulmonary vasodilation, and neuroprotection were critical for the patient to achieving full recovery.</p><p><strong>Conclusion: </strong>Aggressive, multidisciplinary management, including repeat thrombolysis during arrest, can overcome traditionally poor prognostic indicators in massive PE and result in favorable neurologic outcomes.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"6192253"},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841672","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":"Multimodal Monitoring in Eclamptic Intracerebral Hemorrhage Complicated by Reversible Cerebral Vasoconstriction Syndrome (RCVS): A Case Report.","authors":"Giada Cucciolini, Marta Pillitteri, Lara Vegnuti, Francesco De Masi, Baldassare Ferro","doi":"10.1155/crcc/7731993","DOIUrl":"10.1155/crcc/7731993","url":null,"abstract":"<p><strong>Background: </strong>Eclampsia is a rare but severe obstetric condition associated with maternal morbidity and mortality. Neurological complications are rare and often compounded by systemic involvement such as HELLP syndrome and coagulopathy. In this complex setting, multimodal neuromonitoring may support individualized management.</p><p><strong>Case: </strong>A 32-year-old woman at 37 weeks' gestation presented with new-onset tonic-clonic seizures, severe hypertension, and laboratory findings consistent with HELLP syndrome and disseminated intravascular coagulation. Following emergency cesarean section, brain CT revealed a right frontal intracranial hemorrhage (ICH) with mass effect. Given the high surgical risk related to coagulopathy, conservative management was pursued after placement of an invasive intracranial pressure (ICP) monitoring. In the neuro-ICU, a multimodal monitoring strategy combining ICP waveform analysis, continuous electroencephalography, cerebral near-infrared spectroscopy, and transcranial color-coded duplex ultrasound (TCCD) guided therapy. Medical treatment successfully controlled intracranial hypertension and restored cerebral compliance. Daily TCCD examinations revealed progressively increased middle cerebral artery flow velocities, leading to early suspicion and radiological confirmation of reversible cerebral vasoconstriction syndrome (RCVS). Treatment with verapamil and levosimendan resulted in rapid normalization of Doppler velocities without systemic hypotension.</p><p><strong>Outcome: </strong>The patient showed progressive neurological recovery and was discharged to rehabilitation. After 6 months, functional outcome was favorable (modified Rankin Scale = 2).</p><p><strong>Conclusions: </strong>This case underscores the value of bedside TCCD integrated with multimodal neuromonitoring in the management of a complicated eclampsia with ICH and RCVS. Assessment of cerebral hemodynamics and perfusion may support safe conservative management in high-risk neuro-intensive care patients.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"7731993"},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841613","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 Case Report of Tracheobronchomalacia Requiring Stenting and Extracorporeal Membrane Oxygenation Treatment.","authors":"Hiroyuki Tanaka","doi":"10.1155/crcc/6232860","DOIUrl":"10.1155/crcc/6232860","url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchomalacia (TBM) is characterized by the excessive expiratory collapse of the central airway due to structural weakness or membranous redundancy of the tracheal and bronchial cartilages. TBM may present with anatomical and physiological compromise of the airways. Aggressive treatments for severe respiratory failure include mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Interventional approaches include short-term silicone stent trials to predict surgical benefits and definitive procedures, such as tracheobronchoplasty.</p><p><strong>Case presentation: </strong>An Asian male patient in his 60s with a history of COPD receiving home oxygen therapy (HOT) was transferred to our hospital for dyspnea. His baseline symptoms were classified as Hugh-Jones Class III. Upon admission, the partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO₂/FiO₂) ratio was 110. Computed tomography (CT) revealed bilateral narrowing of the trachea and bronchi. Estimated expiratory airway collapse for repeated CT scans was 75%, and limited dynamic 3D airway reconstruction demonstrated expiratory tracheal collapse, supporting the diagnosis of TBM. The patient received high-flow nasal oxygen therapy but gradually deteriorated and required mechanical ventilation. Biopsy revealed expanded submucosal fibrosis. The patient's respiratory status deteriorated on the 11th day after admission with no improvement in any ventilator settings. Venous-venous ECMO was performed. Airway stenting was performed on the 20th day of admission. ECMO was discontinued on the 28th day, and the patient was weaned from the ventilator on the following day (Day 29).</p><p><strong>Conclusions: </strong>This case illustrates that in severe TBM, where both airway patency and gas exchange are compromised, ECMO may serve as a strategic bridge to definitive airway intervention. This case illustrates features of both an anatomically difficult airway (critical central airway collapse) and a physiologically difficult airway (severe hypoxemic respiratory failure), highlighting the importance of managing both airway anatomy and physiology simultaneously. Early extracorporeal support may be considered in carefully selected patients with reversible causes of severe respiratory failure.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"6232860"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801445","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 Case of Suspected Multiple Acyl-CoA Dehydrogenase Deficiency-Induced Encephalopathy.","authors":"Molly Hirsh, Lauren McCroskie, Julia Weaver, Kathryn Humes, Nicola M Zetola","doi":"10.1155/crcc/9093349","DOIUrl":"10.1155/crcc/9093349","url":null,"abstract":"<p><p>Multiple acyl-coenzyme A dehydrogenase deficiency (MADD) is a rare inherited disorder that disrupts fatty acid metabolism. We report a case of a patient who presented with confusion, undifferentiated shock, and rapidly worsening lactic acidosis and hyperammonemia, unexplained in severity by primary liver dysfunction. Metabolic investigations suggested the probable cause was late-onset MADD, likely triggered by pneumonia and exacerbated by early administration of fatty acid-containing sedatives. Early recognition of MADD and other metabolic disorders, whether inherited or acquired, is crucial for timely diagnosis and management. Unexplained hyperammonemia and other metabolic abnormalities should prompt clinicians to consider these rare conditions.</p>","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"9093349"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801486","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}