Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring最新文献

{"title":"Loneliness, social isolation, and effects on cognitive decline in patients with dementia: A retrospective cohort study using natural language processing.","authors":"James A C Myers, Tom Stafford, Ivan Koychev, Robert Perneczky, Oliver Bandmann, Nemanja Vaci","doi":"10.1002/dad2.70149","DOIUrl":"10.1002/dad2.70149","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to compare cognitive trajectories between patients with reports of social isolation and loneliness and those without.</p><p><strong>Methods: </strong>Reports of social isolation, loneliness, and Montreal Cognitive Assessment (MoCA) scores were extracted from dementia patients' medical records using natural language processing models and analyed using mixed-effects models.</p><p><strong>Results: </strong>Lonely patients (<i>n</i> = 382), compared to controls (<i>n</i> = 3912), showed an average MoCA score that was 0.83 points lower at diagnosis (<i>P</i> = 0.008) and throughout the disease. Socially isolated patients (<i>n</i> = 523) experienced a 0.21 MoCA point per year faster rate of cognitive decline in the 6 months before diagnosis (<i>P</i> = 0.029), but were comparable to controls before this period. This led to average MoCA scores that were 0.69 MoCA points lower at diagnosis (<i>P</i> = 0.011).</p><p><strong>Discussion: </strong>Lower cognitive levels in lonely and socially isolated patients suggest that these factors may contribute to dementia progression.</p><p><strong>Highlights: </strong>Developed Natural Language Processing model to detect social isolation and loneliness in electronic health records.Patients with loneliness reports have lower Montreal Cognitive Assessment (MoCA) scores than other patients.Social isolation was related to the faster decline in MoCA scores before diagnosis.Social isolation and loneliness are promising targets for slowing cognitive decline.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70149"},"PeriodicalIF":4.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735260","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, evaluation, and management of cognitive disorders in Parkinson's disease: Consensus recommendations from a modified Delphi process.","authors":"Dana Pourzinal, Deborah Brooks, Deepa Sriram, Leander K Mitchell, Nancy A Pachana, Kirstine Shrubsole, Brian Wood, John D O'Sullivan, Rodney Marsh, Alexander Lehn, Jacki Liddle, Edwin C K Tan, W Kim Halford, Neil Page, Nadeeka N Dissanayaka","doi":"10.1002/dad2.70152","DOIUrl":"10.1002/dad2.70152","url":null,"abstract":"<p><strong>Introduction: </strong>Variations in clinical management of cognitive disorders in Parkinson's disease (PD) can delay diagnosis, treatment, and care. To harmonize clinical practice, we aimed to gain consensus on best practice recommendations for the diagnosis, evaluation, and management of cognitive disorders in PD.</p><p><strong>Method: </strong>Fifty-eight evidence-based recommendations were presented to an expert panel (<i>N</i> = 29) of Australian PD clinicians and researchers using a modified Delphi approach to gauge agreement. A 5-point Likert scale was used, with a median score > 4 and inter-quartile range < 1, indicating satisfactory agreement. Optional written feedback was also collected. A steering committee of clinicians, researchers, and lived experience experts (<i>N</i> = 13) revised recommendations based on panel feedback.</p><p><strong>Results: </strong>Fifty-one evidence-based and expert-endorsed recommendations for the diagnosis, evaluation, and management of cognitive disorders in PD were produced.</p><p><strong>Discussion: </strong>The recommendations serve as a foundational framework to guide clinical practice for cognitive disorders in PD and improve the provision of care.</p><p><strong>Highlights: </strong>Recommendations for cognitive disorders in Parkinson's disease were developed.Diagnosis, evaluation, and management of cognitive disorders were explored.A modified Delphi approach was used.A panel of 29 Australian clinician and/or research experts provided input.Fifty-one evidence-based and expert-backed recommendations were developed.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70152"},"PeriodicalIF":4.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709883","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":"Underlying brain and genetic mechanisms linking historic phone use patterns, visual decline, and dementia risk in middle-aged and older adults.","authors":"Xiayin Zhang, Yuling Xu, Shan Wang, Ishith Seth, Yu Huang, Xueli Zhang, Zijing Du, Dongli Zhuang, Shunming Liu, Yijun Hu, Xianwen Shang, Mingguang He, Zhuoting Zhu, Honghua Yu","doi":"10.1002/dad2.70117","DOIUrl":"10.1002/dad2.70117","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate associations between historic phone use, visual decline, and risk of dementia, as well as underlying biological mechanisms.</p><p><strong>Methods: </strong><b>A total of</b> 494,359 participants from UK Biobank were included in the prospective study. Historic phone use, visual acuity, brain imaging, and leukocyte telomere lengths (LTLs) were assessed. Incident dementia was tracked via hospital episode records and mortality data.</p><p><strong>Results: </strong>Over a median follow-up of 12.2 years, participants with better visual acuity were associated with longer use of mobile phone. Longer historic phone use was associated with a 31% lower risk of dementia. Both hippocampal gray matter volumes and LTLs were associated with historic phone use length and significantly mediated the relationship between historic phone use and dementia. Mediation still exists in participants with visual decline.</p><p><strong>Conclusion: </strong>Our findings suggest mobile phone use may serve as a modifiable factor to prevent dementia, even in older adults with visual decline.</p><p><strong>Highlights: </strong>A strong inverse association was observed between longer mobile phone use and lower dementia incidence, potentially mediated by changes in hippocampal gray matter volume and LTL.Mobile phone use may benefit individuals with age-related visual decline by reducing dementia risk, given the well-established link between vision impairment and increased dementia risk.Middle-aged and older adults should be encouraged to use mobile phones as a means to enhance social connectivity.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70117"},"PeriodicalIF":4.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700279","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":"Cognitive function correlates with retinal structural and vascular imaging parameters in Chinese older adults.","authors":"Manqiao Wang, Limei Chen, Yi Gong, Emmanuel Eric Pazo, Fei Gao, Liying Hu, Chen Chen, Yan Shao, Juping Liu, Xiaorong Li","doi":"10.1002/dad2.70147","DOIUrl":"10.1002/dad2.70147","url":null,"abstract":"<p><strong>Aim: </strong>To investigate associations between cognitive status and retinal parameters in older adults.</p><p><strong>Methods: </strong>The population-based Beichen Eye Study (BCES) recruited 5840 older adults from Tianjin, China. Retinal thickness and vessel density (VD) were measured using optical coherence tomography angiography (OCT/OCTA). Cognitive function was assessed via the Mini-Mental State Examination (MMSE). Participants with gradable images and valid MMSE scores (<i>n</i> = 3606) were analyzed.</p><p><strong>Results: </strong>Cognitive impairment (CI) was identified in 32.7% of participants. Compared to non-CI individuals, those with CI exhibited reduced average retinal thickness (<i>p</i> = 0.007) and choroid thickness (<i>p</i> < 0.001). Superficial VD (VD_SVP) was significantly higher in moderate to severe CI compared to mild CI (<i>p</i> = 0.030). Linear mixed-effects regression demonstrated positive correlations between MMSE scores and retinal parameters (<i>r</i> = 0.518 to 0.530).</p><p><strong>Conclusion: </strong>Retinal thinning may occur in mild CI, with VD changes as CI progresses. Choroidal thinning is a potential cognitive indicator. OCT/OCTA, as a non-invasive tool, offers potential for early cognitive disorder screening in aging populations.</p><p><strong>Highlights: </strong>Retinal thinning (average retinal thickness: <i>p</i> = 0.007) and choroidal thinning (<i>p</i> < 0.001) are significantly associated with CI in older adults.A paradoxical increase in VD_SVP was observed in moderate to severe CI (<i>p</i> = 0.030), suggesting compensatory vascular remodeling.Choroidal thickness emerges as a robust biomarker for cognitive decline (correlation coefficient range: 0.518 to 0.530).The large-scale population-based study (<i>n</i> = 5840) was conducted integrating OCT/OCTA imaging with MMSE cognitive assessments.The study supports OCT/OCTA as a noninvasive, cost-effective screening tool for early detection of cognitive disorders in resource-limited settings.The study highlights vascular risk management (e.g., glycemic control, smoking cessation) as a dual target for retinal and cognitive health.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70147"},"PeriodicalIF":4.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700278","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":"Correction to \"The prognosis of mild cognitive impairment: A systematic review and meta-analysis\".","authors":"","doi":"10.1002/dad2.70150","DOIUrl":"10.1002/dad2.70150","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1002/dad2.70074.].</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70150"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676588","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":"Dysregulation of cerebral perfusion dynamics is associated with Alzheimer's disease.","authors":"Vasilis Marmarelis, Sandy Billinger, Elizabeth Joe, Dae Shin, Suhaib Hashem, Jasmin Rizko, Emily Hazen, Danilo Cardim, Jeff Burns, Rong Zhang, Helena C Chui","doi":"10.1002/dad2.70134","DOIUrl":"10.1002/dad2.70134","url":null,"abstract":"<p><strong>Introduction: </strong>A novel physio-marker, termed \"cerebrovascular dynamics index\" (CDI), was developed and evaluated in a multi-center National Institutes of Health (NIH)-funded study for improved diagnosis of mild cognitive impairment (MCI) and its transition to Alzheimer's disease (AD).</p><p><strong>Methods: </strong>The CDI quantifies the regulation dynamics of cerebral perfusion and oxygenation (which adjust autonomously blood flow and oxygen delivery over time) through predictive dynamic modeling using relevant time-series data.</p><p><strong>Results: </strong>Cross-sectional results demonstrated excellent diagnostic performance of CDI in differentiating 90 MCI/AD patients from 77 controls (area under the curve (AUC) =  0.96), which surpassed the commonly used biomarker of amyloid positron emission tomography-standardized uptake value ratio (PET-SUVR) (AUC = 0.78) or cognitive screening tests of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) (AUC = 0.91 and 0.92, respectively). The CDI can also be used for disease staging because it differentiated 56 MCI from 34 mild AD participants (AUC = 0.98).</p><p><strong>Conclusion: </strong>These findings offer the promise of a high-performance diagnostic physio-marker for MCI and AD, which can be obtained in a comfortable, rapid, and automated manner in clinical settings.</p><p><strong>Highlights: </strong>Novel physio-marker (cerebrovascular dynamics index [CDI]) quantifies the regulation dynamics of cerebral perfusion.The CDI was shown to improve mild cognitive impairment/Alzheimer's disease (MCI/AD) diagnosis (area under the curve [AUC] >0.95) relative to existing markers.The CDI is obtained non-invasively, objectively, rapidly, and inexpensively.The CDI performance supports the key role of cerebrovascular dysfunction in AD.The CDI is obtained via dynamic modeling of hemodynamic/oxygenation time-series data.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70134"},"PeriodicalIF":4.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676589","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":"It is time to share Alzheimer biomarker results in dementia with Lewy bodies.","authors":"Melissa J Armstrong, Joshua D Grill, Thomas F Tropea","doi":"10.1002/dad2.70144","DOIUrl":"10.1002/dad2.70144","url":null,"abstract":"<p><p>There are increasing calls for sharing individual biomarker results with participants in dementia research. No studies investigate returning Alzheimer's disease (AD) biomarker results to individuals with syndromic dementia with Lewy bodies (DLB) even though most of these individuals have both pathologies. This perspective argues that AD biomarkers are valid, interpretable, and actionable, particularly relating to expected prognosis and treatment effects, in people with DLB. Thus, there is an ethical imperative to study AD biomarker result sharing in these patients. This will require revising current disclosure practices. Areas of need include unique pre- and post-test education and careful assessment of the readiness to receive results and post-result responses in people with DLB given the frequency of neuropsychiatric symptoms in this group. Studying responses to sharing AD biomarkers in people with DLB will also inform other dementia settings (e.g., returning synuclein results to individuals with syndromic AD) and neurodegenerative diseases more broadly.</p><p><strong>Highlights: </strong>There are increasing calls for biomarker result sharing in dementia research.No processes exist to guide result sharing in dementia with Lewy bodies (DLB).Alzheimer biomarker results in DLB are valid, interpretable, and actionable.Research is needed on the methods and effects of sharing with people with DLB.Research is needed for sharing evidence of co-pathology across neurodegenerations.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70144"},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602195","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":"Commentary on \"It is time to share Alzheimer biomarker results in dementia with Lewy bodies\".","authors":"John T O'Brien","doi":"10.1002/dad2.70145","DOIUrl":"10.1002/dad2.70145","url":null,"abstract":"<p><p>Many people with dementia with Lewy bodies (DLB) have evidence of Alzheimer's disease (AD) co-pathology, which can be assessed in vivo using biomarkers. In this issue, Armstrong and colleagues argue that it is now timely to disclose such AD biomarker results to people with DLB. They provide logical and powerful arguments, including the right for people to know and the value of this information in informing outcome and management. However, there are also important caveats to consider and a careful balance needs to be maintained between, on the one hand, the right to know and convey clinically useful information and, on the other, acknowledging the real uncertainty that exists regarding the true diagnostic and management implications of AD biomarkers in an individual with a DLB rather than an AD clinico-pathological syndrome.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70145"},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602193","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":"Comparing retrospective informant assessments to prospectively collected cognitive measures in the Health and Retirement Study.","authors":"Ali G Hamedani, Dylan Thibault, Katya Rascovsky, Allison W Willis, Kenneth M Langa","doi":"10.1002/dad2.70138","DOIUrl":"10.1002/dad2.70138","url":null,"abstract":"<p><strong>Introduction: </strong>Clinicians and researchers frequently ask informants about changes in a person's cognition, but whether informant assessments correspond to objectively measured change is unclear.</p><p><strong>Methods: </strong>A subset (<i>n</i> = 2710) of US Health and Retirement Study participants and their informants completed the Harmonized Cognitive Assessment Protocol (HCAP). Using generalized estimating equations, we compared informant-reported change in memory and daily functioning to prospectively collected delayed word recall and instrumental activities of daily living (iADL) in the 10 years preceding HCAP.</p><p><strong>Results: </strong>Informant reports of worsened memory were associated with declining word recall, and informant-reported iADL loss was associated with declining iADLs. Informant-reported memory impairment was more strongly associated with declining word recall when informants saw the respondent weekly or more compared to one to three times monthly or less (<i>p</i> < 0.0001 for interaction).</p><p><strong>Discussion: </strong>Informant assessments of memory and iADLs are generally consistent with prospective measurements, but this relationship depends significantly on frequency of informant contact.</p><p><strong>Highlights: </strong>Informant ratings of a person's memory and daily functioning are generally reliable.Quality of reporting depends on frequency of informant contact.Knowing an informant's characteristics is important for interpreting responses.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70138"},"PeriodicalIF":4.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602194","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":"Effects of obesity on plasma biomarker and amyloid PET trajectories in Alzheimer's disease.","authors":"Soheil Mohammadi, Farzaneh Rahmani, Mahsa Dolatshahi, Suzanne E Schindler, Cyrus A Raji","doi":"10.1002/dad2.70143","DOIUrl":"10.1002/dad2.70143","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a risk factor for Alzheimer's disease (AD), but its impact on AD blood biomarker (BBM) and amyloid positron emission tomography (PET) trajectories is unknown.</p><p><strong>Methods: </strong>One thousand two hundred twenty-eight plasma samples from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were assessed using six leading commercial tests (C2N, Fujirebio, Janssen, ALZpath, Roche, and Quanterix). Amyloid PET scans were used to assess amyloid burden in Centiloids (CLs). Spearman partial correlations assessed cross-sectional associations, while linear mixed-effects models examined the longitudinal impact of obesity status on BBMs and CLs.</p><p><strong>Results: </strong>Higher body mass index at baseline was correlated with lower levels of plasma phosphorylated tau (p-tau)217, p-tau217 ratio, neurofilament light chain (NfL), glial fibrillary acidic protein, and CLs. However, baseline obesity predicted higher rate of increase in p-tau217, p-tau217 ratio, Roche NfL, and amyloid PET burden over time.</p><p><strong>Discussion: </strong>This study provides insights for longitudinal changes in AD pathologies, as measured by BBM levels and CLs, in association with obesity.</p><p><strong>Highlights: </strong>Higher body mass index was related to lower baseline plasma tau phosphorylated at threonine 217 (p-tau217), p-tau217, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) and amyloid positron emission tomography (PET) burden.Obesity predicts a faster increase in p-tau217, p-tau217 ratio, and NfL.Obesity predicts a faster increase in amyloid PET burden.Changes in GFAP over time are not linked with obesity.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70143"},"PeriodicalIF":4.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576951","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}