Brain tumor research and treatment最新文献

{"title":"The Dual Impact of Glioma Resection on Survival and Health-Related Quality of Life: Resect More, Live Better.","authors":"Miguel Esquivel-Miranda, Dessiré Gutiérrez-Gutiérrez, Emmanuelle Vargas-Valenciano, Allan Ramos-Esquivel, Javeth Calvo-Molina, Juan Sahuquillo-Barris","doi":"10.14791/btrt.2025.0015","DOIUrl":"10.14791/btrt.2025.0015","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HR-QoL) is a critical consideration in glioma surgery, alongside improving patient survival. Current evidence highlights maximal surgical resection as a key independent prognostic factor for enhancing HR-QoL and survivability. This study aimed to compare the impact on HR-QoL and survival rates in glioma patients before and after surgery with varying degrees of tumor resection (<10%, 10%-90%, >90%) and residual tumor volumes (≤2 cm³, >2 cm³).</p><p><strong>Methods: </strong>This single-institution prospective study analyzed 117 patients with newly diagnosed gliomas (2009-2015). HR-QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) (global quality of life status [GQLS], physical, emotional, role, cognitive, and social function, as well as insomnia and fatigue). We compared survival rates and HR-QoL outcomes based on extent of resection and residual tumor volume. Clinically meaningful thresholds and statistical significance were used to evaluate HR-QoL changes.</p><p><strong>Results: </strong>In grade 4 gliomas, resections >90% and residual tumor volumes ≤2 cm³ significantly improved median survival compared to lesser resections. For HR-QoL, resections >90% led to clinically and statistically significant improvements in GQLS, emotional, role, and cognitive function, as well as insomnia. Residual volumes ≤2 cm³ significantly enhanced emotional and role function, with statistical improvements in GQLS, cognitive function, social function, insomnia, and fatigue. Lower resection rates and higher residual volumes resulted in significant HR-QoL declines. When stratified by tumor grade, high- and low-grade gliomas showed clinically significant improvements in different HR-QoL domains.</p><p><strong>Conclusion: </strong>Resections greater than 90% and residual volumes ≤2 cm³ significantly improve HR-QoL and overall survival. Conversely, partial resections and larger residual tumor volumes are associated with worse HR-QoL outcomes.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"20-28"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151297","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":"Outcome of an Elderly Female With Diffuse Large B-cell Lymphoma With Central Nervous System and Orbital Involvement Treated With Modified Methotrexate and R-CHOP Therapy: A Case Report.","authors":"Fallen Grace E de la Paz, Paul Vincent A Opinaldo, Maria Angelica Liza V Imperial","doi":"10.14791/btrt.2025.0004","DOIUrl":"10.14791/btrt.2025.0004","url":null,"abstract":"<p><p>The National Comprehensive Cancer Network (NCCN) recommends a regimen of rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHOP) with methotrexate (MTX) given at ≥3 g/m² for stage IV diffuse large B-cell lymphoma with parenchymal involvement. Tumor lysis syndrome (TLS) may occur after initiation of treatment. MTX, though beneficial, may induce toxicity, especially in elderly patients with comorbidities. This paper discusses a case of 74-year-old female with secondary central nervous system lymphoma with multiple comorbidities and high risk for TLS given a modified schedule of R-CHOP and a lower dose of MTX at 2-2.5 g/m² with a good treatment response. This paper aims to contribute additional information on optimal treatment for this disease.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"47-51"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151390","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":"Facial Nerve Outcomes Following Microsurgical Resection of Large Cerebellopontine Angle Tumors: Experience From a Tertiary Care Center in Pakistan.","authors":"Shah Khalid, Salaar Ahmed, Komal Naeem, Ahmad Hassan, Mehar Masroor, Altaf Ali Laghari, Syed Ather Enam","doi":"10.14791/btrt.2025.0005","DOIUrl":"10.14791/btrt.2025.0005","url":null,"abstract":"<p><strong>Background: </strong>Cerebellopontine angle (CPA) tumors present surgical challenges due to their proximity to the facial nerve. Despite preservation efforts, facial nerve paresis is a major issue. This study aims to identify key factors affecting facial nerve preservation during microsurgical resection of large CPA tumors in a low- and middle-income countries (LMIC) setting.</p><p><strong>Methods: </strong>This retrospective cross-sectional study, conducted at Aga Khan University, included patients who underwent microsurgical resection of large (>3 cm) CPA tumors with House-Brackmann (HB) grades 1-4. Postoperative facial nerve function was assessed using the HB grading system. Data was extracted from medical records and analyzed using SPSS 22.</p><p><strong>Results: </strong>This study analyzed 95 patients (M:F=1:1.16, mean age 44.24±13.71 years) with CPA tumors who underwent microsurgical resection. Common presenting complaints included a complete hearing loss (57.9%), headache (52.6%), and abnormal gait (40%). Preoperative facial nerve function was normal (HB grade I) in 75%, with 19%, 7%, and 2% having HB grades II, III, and IV, respectively. Schwannoma (69.5%), meningioma (16.8%), and epidermoid cyst (10.5%) were the most common diagnoses. Postoperative preservation of facial nerve function was achieved in 73.7% of patients. At six months, HB grades I and II were observed in 64% and 11.5%, respectively, while none had complete facial nerve palsy. On univariate analysis, larger tumor size and higher HB grade correlated with worse facial nerve outcomes (<i>p</i>=0.02). Complications were more frequent in patients with worsened outcomes (72% vs. 38.6%, <i>p</i>=0.004). However, in multivariate analysis, only preoperative HB grade was identified as a predictor.</p><p><strong>Conclusion: </strong>Facial nerve preservation during CPA tumor resection is influenced by intrinsic tumor characteristics, surgical complexity, and patient-specific factors. Detailed preoperative counseling is crucial to set realistic expectations.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150081","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":"Multi-Layered Dysregulation of NRCAM in Lower-Grade Gliomas: Insights From TCGA Copy Number and Epigenetic Analyses.","authors":"Steven Lehrer, Peter H Rheinstein","doi":"10.14791/btrt.2025.0033","DOIUrl":"10.14791/btrt.2025.0033","url":null,"abstract":"<p><strong>Background: </strong>Neuronal cell adhesion molecule (NRCAM) has been implicated in glioma biology through splicing alterations reported by prior studies. However, the relative contributions of genomic and epigenetic mechanisms to NRCAM dysregulation in gliomas remain unclear.</p><p><strong>Methods: </strong>We analyzed data from The Cancer Genome Atlas (TCGA) Lower-Grade Glioma (LGG) cohort using UCSC Xena and cBioPortal. Copy number variation (CNV), DNA methylation (Illumina HumanMethylation450 BeadChip arrays), and mutation profiles were assessed for NRCAM. Kaplan-Meier survival analyses were performed with Xena, stratifying patients by copy number status and methylation state. Correlations between mutation burden and fraction of genome altered (FGA) were evaluated using Spearman and Pearson methods.</p><p><strong>Results: </strong>Somatic mutations in NRCAM were rare in the TCGA-LGG cohort. In contrast, CNV and methylation changes were frequent and clinically relevant. Copy number gains at the NRCAM locus were associated with significantly shorter overall survival, while higher methylation of NRCAM correlated with improved survival outcomes. NRCAM mutation count did not show a linear correlation with FGA, suggesting these alterations are largely independent of overall genomic instability. The findings highlight copy number imbalance and epigenetic regulation as predominant mechanisms of NRCAM dysregulation.</p><p><strong>Conclusion: </strong>NRCAM is recurrently dysregulated in lower-grade gliomas through CNVs and DNA methylation, both of which stratify patient survival. Together with previously reported splicing deregulation, these data suggest that NRCAM functions as a multilayered regulator of glioma progression. NRCAM methylation may represent a potential prognostic biomarker, while therapeutic modulation of NRCAM warrants further investigation.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151093","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":"Current Perspectives on Pediatric Low-Grade Gliomas: Focus on BRAF and MEK Inhibition.","authors":"Jin Kyung Suh, Kyung-Nam Koh","doi":"10.14791/btrt.2025.0026","DOIUrl":"10.14791/btrt.2025.0026","url":null,"abstract":"<p><p>Pediatric low-grade gliomas (pLGGs) are the most common childhood central nervous system tumors and are frequently driven by alterations in the RAS/mitogen-activated protein kinase (RAS/MAPK) signaling pathway. Advances in molecular profiling have revealed key genetic drivers, including BRAF mutations, BRAF fusions, and other kinase gene rearrangements, enabling the development of genotype-guided targeted therapies. First-generation BRAF inhibitors and mitogen-activated protein kinase kinase (MEK) inhibitors have demonstrated significant clinical benefit in molecularly selected patient subgroups, prompting FDA approvals and a paradigm shift away from traditional chemotherapy. However, challenges such as resistance mechanisms, treatment durability, and long-term toxicities persist. This review summarizes the molecular landscape of pLGG, highlights current and emerging targeted therapies, and discusses unresolved issues including optimal treatment duration, toxicity management, and future directions for individualized care.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150078","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":"Fate of Brain Metastasis With Cerebrospinal Fluid Space Invasion Based on MRI Findings: Clinical Features and Factors Affecting Progression to Overt Leptomeningeal Metastasis.","authors":"Yoontae Hong, Haechan Song, Ho-Shin Gwak, Yun-Sik Dho, Sang Hoon Shin, Heon Yoo, Kyu-Chang Wang","doi":"10.14791/btrt.2026.0001","DOIUrl":"10.14791/btrt.2026.0001","url":null,"abstract":"<p><strong>Background: </strong>Parenchymal brain metastasis (BM) and its extended growth into cerebrospinal fluid (CSF) pathways or surgical spillage could result in leptomeningeal metastasis (LM). We defined BM with epipial spread or dural attachment on MRI as BM with CSF space invasion (BM-CSFi), regardless of CSF cytology results, and evaluated its clinical course after BM resection.</p><p><strong>Methods: </strong>We retrospectively reviewed 297 patients who underwent craniotomy for BM excluding patients followed for <6 months or without follow-up MRI. Primary outcomes were proportion of patients progressing to overt LM and time to progression. We also evaluated clinical and radiologic variables to identify risk factors for LM progression.</p><p><strong>Results: </strong>A total of 91 patients (30.6%) developed overt LM, with median time to progression of 7.9 months during 18.3 months follow-up after the craniotomy. On multivariable analysis, preoperative MRI evidence of dural attachment with enhancement (hazard ratio [HR], 5.59; <i>p</i>=0.002), primary small cell lung cancer (HR, 4.92; <i>p</i>=0.026), infratentorial BM location (HR, 2.14; <i>p</i>=0.019), and postoperative cumulative CSF cytology positive rate ≥50% (HR, 7.13; <i>p</i>=0.012) were independent risk factors for LM progression. The mode of resection and postoperative radiotherapy or systemic chemotherapy were not significantly associated with LM progression.</p><p><strong>Conclusion: </strong>BM-CSFi, defined by preoperative MRI findings, may represent a clinically important precursor of LM. Our findings highlight the need for close monitoring of patients with BM-CSFi and the development of management protocols to minimize the risk of LM progression.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"35-46"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151066","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":"Cerebral Sparganosis: A Case Report of Rare Parasitic Brain Infection.","authors":"Shin-Hyuck Bang, Hyeong-Joong Yi, Hyoung-Joon Chun, Kyu-Sun Choi, Minkyun Na","doi":"10.14791/btrt.2025.0036","DOIUrl":"10.14791/btrt.2025.0036","url":null,"abstract":"<p><p>Cerebral sparganosis is a rare parasitic infection caused by plerocercoid larvae of <i>Spirometra</i> species. Intracranial involvement is uncommon and may mimic other parasitic or neoplastic diseases. We report the case of a 64-year-old man who presented with dysarthria and dizziness, later diagnosed with cerebellar sparganosis. Retrosigmoid craniotomy was performed, and two intact spargana were removed with the surrounding capsule. Histopathology demonstrated granulomatous inflammation with eosinophilic infiltration and characteristic calcareous corpuscles within degenerated parasitic tissue fragments. Postoperatively, dysarthria and dizziness improved, and the patient was able to ambulate independently. Sparganosis has been continuously reported in Korea for nearly a century, though incidence has declined in recent decades. Parasite invasion into the central nervous system is thought to occur through the foramen magnum, with the brain parenchyma particularly vulnerable due to its soft tissue composition. In our case, prior cerebellar infarction may have provided a structural weakness that facilitated parasite invasion. Differentiation from neurocysticercosis is essential, as imaging findings and clinical implications differ. Surgical excision remains the standard treatment, although recent evidence indicates that long-term, high-dose praziquantel may be effective in selected cases. Cerebral sparganosis should be considered in patients with compatible clinical and radiologic features in endemic regions. Complete surgical removal offers definitive therapy, while high-dose praziquantel may serve as a noninvasive alternative for inoperable cases.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"14 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151559","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":"Spontaneous Regression of Incidental Meningioma in the Posterior Cranial Fossa: A Case Report and Literature Review.","authors":"Min Seok Kim, So Hee Park, Youngbeom Seo","doi":"10.14791/btrt.2025.0012","DOIUrl":"10.14791/btrt.2025.0012","url":null,"abstract":"<p><p>We report a rare case of spontaneous regression of a meningioma located in the posterior cranial fossa. A 60-year-old female patient presented with a headache. Both physical and neurological examinations were normal. Her medical history included type 2 diabetes mellitus. MRI showed a homogeneously enhancing mass in the left cerebellopontine angle. The volume of the tumor was 1.673 cm³. Radiological features, including the dural tail sign and the cerebrospinal fluid cleft sign, suggested the presence of a meningioma. Given these characteristics, we recommended serial follow-up MRI examinations. Unfortunately, the patient was lost to follow-up. Ten years later, she returned with a headache to reevaluate the previously diagnosed tumor. The follow-up MRI revealed significant regression and increased intratumoral calcification, with the tumor now measuring only 0.256 cm³. This report illustrates that meningiomas diagnosed incidentally can undergo spontaneous regression, a phenomenon that clinicians should be aware of.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"13 4","pages":"153-157"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12621765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496845","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":"Resolution of Hyperprolactinemia Caused by Pituitary Stalk Compression After Transsphenoidal Surgery for Pituitary Tumors.","authors":"Myungsuk Oh, Eui Hyun Kim","doi":"10.14791/btrt.2025.0028","DOIUrl":"10.14791/btrt.2025.0028","url":null,"abstract":"<p><strong>Background: </strong>Hyperprolactinemia caused by pituitary stalk compression is common in patients with pituitary tumors. There is a lack of studies investigating the resolution patterns or time course of hyperprolactinemia after surgery. We aimed to demonstrate the time course of changes in prolactin levels following successful surgical decompression of the pituitary stalk.</p><p><strong>Methods: </strong>We retrospectively examined 201 patients with preoperative hyperprolactinemia caused by the pituitary stalk compression effect who underwent transsphenoidal surgery. Postoperative prolactin levels were assessed at the time points of 1 week; 1, 3, and 6 months; and 1 year following the surgery. As a subgroup analysis, 115 individuals underwent serial prolactin level measurements at 6, 12, 18, 24, 48, and 72 hours after surgery.</p><p><strong>Results: </strong>Hyperprolactinemia caused by pituitary stalk compression was resolved in 71.64% of patients 1 week after surgery, 84.84% after 1 month, 89.30% after 3 months, and 92.67% after 6 months, and 92.74% eventually reached normalization 1 year after surgery. Among the 35 patients whose prolactin levels were measured in the immediate postoperative period, 26 patients (72.49%) reached remission status within 72 hours. The immediate postoperative prolactin level was most predictive at 72 hours after surgery, with an optimal cutoff of 23.10 ng/mL.</p><p><strong>Conclusion: </strong>The postoperative resolution of hyperprolactinemia caused by stalk compression was possible in 90% within a year. The decline in serum prolactin levels typically began within the first 72 hours after surgery, indicating that the hormonal response to surgical decompression is very prompt and effective.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"13 4","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12621836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496213","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":"Sonodynamic Therapy With Orally Absorbable Nanomedicine for Brain Tumor.","authors":"Chaerim Yoo, Jihyeon Kim, Dong Yun Lee","doi":"10.14791/btrt.2025.0023","DOIUrl":"10.14791/btrt.2025.0023","url":null,"abstract":"<p><p>Glioblastoma (GBM) is an aggressive and treatment-resistant brain tumor with poor prognosis despite surgery, radiotherapy, and chemotherapy. Sonodynamic therapy (SDT), which combines low-intensity focused ultrasound with systemically or orally administered sonosensitizers, has emerged as a promising non-invasive approach to achieve localized tumor cell killing via reactive oxygen species. Recent advances in nanomedicine have enabled the development of orally absorbable, blood-brain barrier permeable delivery systems that enhance tumor targeting and ultrasound responsiveness. Preclinical studies have demonstrated consistent anti-tumor efficacy and immune activation, while early clinical trials suggest SDT is safe, feasible, and potentially effective in recurrent GBM. This review outlines recent progress in SDT-based strategies for GBM, with emphasis on mechanistic insights, delivery innovations, and clinical translation.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"13 4","pages":"121-129"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12621860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496345","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}