世界移植杂志最新文献

{"title":"Endothelial dysfunction in the kidney transplant population: Current evidence and management strategies.","authors":"Arun Prabhahar, Akshey Batta, Juniali Hatwal, Vivek Kumar, Raja Ramachandran, Akash Batta","doi":"10.5500/wjt.v15.i1.97458","DOIUrl":"10.5500/wjt.v15.i1.97458","url":null,"abstract":"<p><p>The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators. Endothelial dysfunction (ED), characterized by impaired vasodilation, inflammation, and thrombosis, triggers future cardiovascular (CV) diseases. Chronic kidney disease, a state of chronic inflammation caused by oxidative stress, metabolic abnormalities, infection, and uremic toxins damages the endothelium. ED is also associated with a decline in estimated glomerular filtration rate. After kidney transplantation, endothelial functions undergo immediate but partial restoration, promising graft longevity and enhanced CV health. However, the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED, culminating in poor CV health and graft survival. ED in kidney transplant recipients is an under-recognized and poorly studied entity. CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts. ED contributes to the pathogenesis of many of the CV diseases. Various biomarkers and vasoreactivity tests are available to study endothelial functions. With an increasing number of transplants happening every year, and improved graft rejection rates due to the availability of effective immunosuppressants, the focus has now shifted to endothelial protection for the prevention, early recognition, and treatment of CV diseases.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"97458"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659859","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":"Global transplantation: Lessons from organ transplantation organizations worldwide.","authors":"Solonas Symeou, Eleni Avramidou, Vassilios Papalois, Georgios Tsoulfas","doi":"10.5500/wjt.v15.i1.99683","DOIUrl":"10.5500/wjt.v15.i1.99683","url":null,"abstract":"<p><p>Although national transplant organizations share common visions and goals, the creation of a unified global organization remains impractical. Differences in ethnicity, culture, religion, and education shape local practices and infrastructure, making the establishment of a single global entity unfeasible. Even with these social disparities aside, logistical factors such as time and distance between organ procurement and transplantation sites pose significant challenges. While technological advancements have extended organ preservation times, they have yet to support the demands of transcontinental transplantations effectively. This review presents a comparative analysis of the structures, operational frameworks, policies, and legislation governing various transplant organizations around the world. Key differences pertain to the administration of these organizations, trends in organ donation, and organ allocation policies, which reflect the financial, cultural, and religious diversity across different regions. While a global transplant organization may be out of reach, agreeing on best practices for the benefit of patients is essential.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"99683"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659869","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":"King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever.","authors":"Bruno da Silva Athanasio, Antonio Marcio de Faria Andrade, Vivian Vasconcelos Costa, Juliano Felix Castro, Silverio Leonardo Macedo Garcia, Mauro Martins Teixeira, Daniele da Gloria Souza, Paula Vieira Teixeira Vidigal, Cristiano Xavier Lima","doi":"10.5500/wjt.v15.i1.100413","DOIUrl":"10.5500/wjt.v15.i1.100413","url":null,"abstract":"<p><strong>Background: </strong>Acute liver failure (ALF) is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease. Liver transplantation (LT) is the most impactful treatment. Yellow fever (YF) is an infectious disease that primarily affects the liver and has a high mortality rate. However, LT can be a viable option for treating rare cases with extensive liver involvement. However, the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.</p><p><strong>Aim: </strong>To present necessary adjustments to established scoring systems for ALF secondary to YF.</p><p><strong>Methods: </strong>This was an observational, retrospective, single-center study. Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil. During hospitalization, general supportive therapeutic measures were implemented, and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure. LT is considered a viable measure for patients with signs of end-stage liver failure.</p><p><strong>Results: </strong>Eight of 14 (57%) patients developed severe neurological alterations within the first 96 hours after hospital admission. Four patients underwent emergency LT, and despite a moderate viral infection of the graft after transplantation, the 5-year survival rate was 50%. Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF, they are insufficient for predicting the risk of mortality in this context, primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.</p><p><strong>Conclusion: </strong>To ensure good applicability in cases of YF-induced ALF, the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"100413"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659876","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":"Efficacy of antimicrobials in preventing resistance in solid organ transplant recipients: A systematic review of clinical trials.","authors":"Carlos M Ardila, Pradeep K Yadalam, Jaime Ramírez-Arbelaez","doi":"10.5500/wjt.v15.i1.98003","DOIUrl":"10.5500/wjt.v15.i1.98003","url":null,"abstract":"<p><strong>Background: </strong>In the absence of effective antimicrobials, transplant surgery is not viable, and antirejection immunosuppressants cannot be administered, as resistant infections compromise the life-saving goal of organ transplantation.</p><p><strong>Aim: </strong>To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.</p><p><strong>Methods: </strong>A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses. This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents (prophylactic or therapeutic) aimed at preventing antimicrobial resistance. The search strategy involved analyzing multiple databases, including PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO, as well as examining gray literature sources on Google Scholar. A comprehensive electronic database search was conducted from the databases' inception until May 2024, with no language restrictions.</p><p><strong>Results: </strong>After the final phase of the eligibility assessment, this systematic review ultimately included 7 articles. A total of 2318 patients were studied. The most studied microorganisms were cytomegalovirus, although vancomycin-resistant enterococci, <i>Clostridioides difficile</i>, and multidrug-resistant <i>Enterobacterales</i> were also analyzed. The antimicrobials used in the interventions were mainly maribavir, valganciclovir, ganciclovir, and colistin-neomycin. Of concern, all clinical trials showed significant proportions of resistant microorganisms after the interventions, with no statistically significant differences between the groups (mean resistance 13.47% <i>vs</i> 14.39%), except for two studies that demonstrated greater efficacy of maribavir and valganciclovir (mean resistance 22.2% <i>vs</i> 41.1% in the control group; <i>P</i> < 0.05). The total reported deaths in three clinical trials were 75, and there were 24 graft rejections in two studies.</p><p><strong>Conclusion: </strong>All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions. More high-quality randomized clinical trials are needed to corroborate these results.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"98003"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659856","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":"Patients admitted in the intensive care unit after solid organ or bone marrow transplantation: Retrospective cohort study.","authors":"Ana Vujaklija Brajkovic, Iva Kosuta, Lucija Batur, Sara Sundalic, Marijana Medic, Andro Vujevic, Luka Bielen, Jaksa Babel","doi":"10.5500/wjt.v15.i1.98975","DOIUrl":"10.5500/wjt.v15.i1.98975","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) revolutionized the survival and quality of life of patients with malignant diseases, various immunologic, and metabolic disorders or those associated with a significant impairment in a patient's quality of life.</p><p><strong>Aim: </strong>To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit (ICU).</p><p><strong>Methods: </strong>We conducted a single-center, retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb, Croatia covering the period from January 1, 2018 to December 31, 2023.</p><p><strong>Results: </strong>The study included 91 patients with either SOT [28 patients (30.8%)] or HSCT [63 patients (69.2%)]. The median age was 56 (43.2-64.7) years, and 60.4% of the patients were male. Patients with SOT had more comorbidities than patients after HSCT [<i>χ²</i> (5, <i>n</i> = 141) = 18.513, <i>P</i> < 0.001]. Sepsis and septic shock were the most frequent reasons for admission, followed by acute respiratory insufficiency in patients following HSCT. Survival rate significantly differed between SOT and HSCT [<i>χ²</i> (1, <i>n</i> = 91) = 21.767, <i>P</i> < 0.001]. ICU survival was 57% in the SOT and 12.7 % in the HSCT group. The need for mechanical ventilation [<i>χ²</i> (1, <i>n</i> = 91) = 17.081, <i>P</i> < 0.001] and vasopressor therapy [<i>χ²</i> (1, <i>n</i> = 91) = 36.803, <i>P</i> < 0.001] was associated with survival. The necessity for acute renal replacement therapy did not influence patients' survival [<i>χ²</i> (1, <i>n</i> = 91) = 0.376, <i>P</i> = 0.54]. In the subgroup of patients with infection, 90% had septic shock, and the majority had positive microbiological samples, mostly Gram-negative bacteria. The ICU survival of patients with sepsis/septic shock cumulatively was 15%. The survival of SOT patients with sepsis/shock was 45%.</p><p><strong>Conclusion: </strong>Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic shock. Despite advancements in critical care, the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely high. Early recognition and timely ICU admittance might improve the outcome of patients, especially after HSCT.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"98975"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659948","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":"Challenges related to clinical decision-making in hepatocellular carcinoma recurrence post-liver transplantation: Is there a hope?","authors":"Nourhan Badwei","doi":"10.5500/wjt.v14.i3.96637","DOIUrl":"https://doi.org/10.5500/wjt.v14.i3.96637","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a common liver malignancy and represents a serious cause of cancer-related mortality and morbidity. One of the favourable curative surgical therapeutic options for HCC is liver transplantation (LT) in selected patients fulfilling the known standard Milan/University of California San Francisco criteria which have shown better outcomes and longer-term survival. Despite careful adherence to the strict HCC selection criteria for LT in different transplant centres, the recurrence rate still occurs which could negatively affect HCC patients' survival. Hence HCC recurrence post-LT could predict patients' survival and prognosis, depending on the exact timing of recurrence after LT (early or late), and whether intra/extrahepatic HCC recurrence. Several factors may aid in such a complication, particularly tumour-related criteria including larger sizes, higher grades or poor tumour differentiation, microvascular invasion, and elevated serum alpha-fetoprotein. Therefore, managing such cases is challenging, different therapeutic options have been proposed, including curative surgical and ablative treatments that have shown better outcomes, compared to the palliative locoregional and systemic therapies, which may be helpful in those with unresectable tumour burden. To handle all these issues in our review.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"14 3","pages":"96637"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302156","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":"Disorders of potassium homeostasis after kidney transplantation.","authors":"Abdelhamid Aboghanem, G V Ramesh Prasad","doi":"10.5500/wjt.v14.i3.95905","DOIUrl":"https://doi.org/10.5500/wjt.v14.i3.95905","url":null,"abstract":"<p><p>Disturbances of potassium balance are often encountered when managing kidney transplant recipients (KTR). Both hyperkalemia and hypokalemia may present either as medical emergencies or chronic outpatient abnormalities. Despite the high incidence of hyperkalemia and its potential life-threatening implications, consensus on its management in KTR is lacking. Hypokalemia in KTR is also well-described, although it is given less attention by clinicians compared to hyperkalemia. This article discusses the etiology, pathophysiology and management of both types of potassium disorders in KTR. Once any emergent situation has been corrected, treatment approaches include correcting insulin deficiency if present, adjusting non-immunosuppressive and immunosuppressive medications, eliminating or supplementing potassium as needed, and dietary counselling. Although commonly of multifactorial etiology, ascertaining the specific cause in a particular patient will help guide successful management. Monitoring KTR through regular laboratory testing is essential to detect serious disturbances in potassium balance since patients are often asymptomatic.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"14 3","pages":"95905"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302157","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":"Management of cytomegalovirus infection after liver transplantation.","authors":"Zeynep Burcin Yilmaz, Funda Memisoglu, Sami Akbulut","doi":"10.5500/wjt.v14.i3.93209","DOIUrl":"https://doi.org/10.5500/wjt.v14.i3.93209","url":null,"abstract":"<p><p>Cytomegalovirus (CMV) infection is one of the primary causes of morbidity and mortality following liver transplantation (LT). Based on current worldwide guidelines, the most effective strategies for avoiding post-transplant CMV infection are antiviral prophylaxis and pre-emptive treatment. CMV- IgG serology is the established technique for pretransplant screening of both donors and recipients. The clinical presentation of CMV infection and disease exhibits variability, prompting clinicians to consistently consider this possibility, particularly within the first year post-transplantation or subsequent to heightened immunosuppression. At annual symposia to discuss CMV prevention and how treatment outcomes can be improved, evidence on the incorporation of immune functional tests into clinical practice is presented, and the results of studies with new antiviral treatments are evaluated. Although there are ongoing studies on the use of letermovir and maribavir in solid organ transplantation, a consensus reflected in the guidelines has not been formed. Determining the most appropriate strategy at the individual level appears to be the key to enhancing outcomes. Although prevention strategies reduce the risk of CMV disease, the disease can still occur in up to 50% of high-risk patients. A balance between the risk of infection and disease development and the use of immunosuppressants must be considered when talking about the proper management of CMV in solid organ transplant recipients. The objective of this study was to establish a comprehensive framework for the management of CMV in patients who have had LT.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"14 3","pages":"93209"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302177","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":"Impact of bisphosphonate treatment on bone mineral density after kidney transplant.","authors":"Georgia Andriana Georgopoulou, Marios Papasotiriou, Theodoros Ntrinias, Eirini Savvidaki, Dimitrios S Goumenos, Evangelos Papachristou","doi":"10.5500/wjt.v14.i3.92335","DOIUrl":"https://doi.org/10.5500/wjt.v14.i3.92335","url":null,"abstract":"<p><strong>Background: </strong>Mineral bone disease is associated with chronic kidney disease and persists after kidney transplantation. Immunosuppressive treatment contributes to the pathogenesis of this disease. Bisphosphonate treatments have shown positive but indefinite results.</p><p><strong>Aim: </strong>To evaluate the effectiveness and safety of bisphosphonate treatment on post kidney transplantation bone mineral density (BMD).</p><p><strong>Methods: </strong>We included kidney transplant recipients (KTRs) whose BMD was measured after the operation but before the initiation of treatment and their BMD was measured at least one year later. We also evaluated the BMD of KTRs using two valid measurements after transplantation who received no treatment (control group).</p><p><strong>Results: </strong>Out of 254 KTRs, 62 (39 men) were included in the study. Bisphosphonates were initiated in 35 KTRs in total (20 men), 1.1 ± 2.4 years after operation and for a period of 3.9 ± 2.3 years while 27 (19 men) received no treatment. BMD improved significantly in KTRs who received bisphosphonate treatments (from -2.29 ± 1.07 to -1.66 ± 1.09, <i>P</i> < 0.0001). The control group showed a non-significant decrease in BMD after 4.2 ± 1.4 years of follow-up after surgery. Kidney function was not affected by bisphosphonate treatment. In KTRs with established osteoporosis, active treatment had a similar and significant effect on those with osteopenia or normal bone mass.</p><p><strong>Conclusion: </strong>In this retrospective study of KTRs receiving bisphosphonate treatment, we showed that active treatment is effective in preventing bone loss irrespective of baseline BMD.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"14 3","pages":"92335"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302173","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":"Evolution of heart transplant donor characteristics in the 21^st century: A United States single center's experience.","authors":"Alexander M Spring, Christiana Gjelaj, Shivank Madan, Snehal R Patel, Omar Saeed, Sandhya Murthy, Yogita Rochlani, Daniel B Sims, Sasha Vukelic, Stephen J Forest, Jamil F Borgi, Daniel J Goldstein, Ulrich P Jorde","doi":"10.5500/wjt.v14.i3.92721","DOIUrl":"https://doi.org/10.5500/wjt.v14.i3.92721","url":null,"abstract":"<p><p>Despite a record setting number of heart transplants performed annually, the national donor shortage continues to plague transplant teams across the United States. Here we describe the barriers to adaptation of numerous \"non-traditional\" orthotopic heart transplant donor characteristics including donors with hepatitis C virus, those meeting criteria for donation after cardiac death, donors with coronavirus disease 19 infection, donors with the human immunodeficiency virus, and grafts with left ventricular systolic dysfunction. Our center's objective was to increase our transplant volume by expanding our donor pool from \"traditional\" donors to these \"non-traditional\" donors. We detail how medical advances such as certain laboratory studies, pharmacologic interventions, and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"14 3","pages":"92721"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302159","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}