Cancer prevention research (Philadelphia, Pa.)最新文献

{"title":"Epigenetic Changes Induced by Carcinogenic Agents or Occupational Exposure with Sufficient Evidence for Bladder Cancer.","authors":"Edyta Kasperczyk, Kateryna Tarhonska, Ewa Jablonska","doi":"10.1158/1940-6207.CAPR-24-0450","DOIUrl":"10.1158/1940-6207.CAPR-24-0450","url":null,"abstract":"<p><p>Extensive evidence highlights the role of epigenetic alterations in chemically induced carcinogenesis. Accordingly, this review focuses on the importance of epigenetics and exposure in bladder cancer. Specifically, we examined publications reporting epigenetic alterations associated with exposure to agents and occupations classified by the International Agency for Research on Cancer as having sufficient evidence for bladder cancer. This systematic review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of the PubMed database was performed for studies published up to March 2024. The inclusion criteria required the use of epigenetic studies in healthy populations exposed to carcinogenic agents or occupational exposures with sufficient evidence for bladder cancer, as classified by the International Agency for Research on Cancer, and was limited to articles written in English. We identified 23 studies examining epigenetic changes in healthy individuals exposed to 16 carcinogens or occupational exposures with established evidence of increased bladder cancer risk. These studies particularly emphasized DNA methylation analysis. Epigenetic responses associated with these exposures have been extensively studied and characterized. Although epigenetic disorders are increasingly considered critical in cancer assessments, there remain gaps in research addressing the epigenetic effects of many potential carcinogens in the human epithelium. Consequently, data on bladder cancer induction through epigenetic mechanisms are especially valuable.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"439-451"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059541","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":"Editors' Selections from Relevant Scientific Publications.","authors":"","doi":"10.1158/1940-6207.CAPR-18-8-HFL","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-18-8-HFL","url":null,"abstract":"","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"18 8","pages":"435"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Loss Reverses the Effects of Aging and Obesity on Mammary Tumor Immunosuppression and Progression.","authors":"Laura A Smith, Dalton M Craven, Alyssa N Ho, Elaine M Glenny, Erika T Rezeli, Meredith S Carson, Evan M Paules, Magdalena Fay, Alyssa J Cozzo, Stephen D Hursting, Michael F Coleman","doi":"10.1158/1940-6207.CAPR-24-0514","DOIUrl":"10.1158/1940-6207.CAPR-24-0514","url":null,"abstract":"<p><p>Advanced age and obesity are major risk factors for breast cancer progression, including triple-negative breast cancer (TNBC). In this study, we interrogated (i) whether these factors interact to promote TNBC progression and (ii) whether weight loss mitigates the separate and combined effects of aging and obesity on TNBC. We demonstrate that aging and diet-induced obesity interact to promote TNBC growth in mice. Transcriptomic analysis revealed the suppression of antitumor immunity in tumors from aged and/or obese mice. Weight loss via intermittent calorie restriction reduced tumor growth and restored immune-related gene signatures to reverse the protumor effects of aging and/or obesity. Using publicly available genomic datasets from murine studies of obesity, weight loss, and TNBC, we identified a consensus transcriptomic signature of obesity-driven immunosuppression that predicted the survival of patients with breast cancer. This consensus signature was also suppressed by aging, obesity, and their combination. Intermittent calorie restriction reversed the effects of aging and/or obesity on the consensus signature. We conclude that aging and obesity interact to limit antitumor immunity and enhance TNBC progression and that these adverse effects can be disrupted by weight loss.</p><p><strong>Prevention relevance: </strong>Advanced age and obesity are important risk factors for the development and progression of breast cancers, including TNBC. We demonstrate that the suppression of signatures of antitumor immunity is a common feature of accelerated tumor progression in TNBC. We show that weight loss achieved through calorie restriction can restore such markers. See related Spotlight, p. 437.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"453-463"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036733","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":"Association of Elevated Serum Triglycerides with Colorectal Cancer Risk: Findings from a Large-Scale Prospective Cohort of Korean Adults.","authors":"Sukhong Min, Hyobin Lee, Sinyoung Cho, Seung-Yong Jeong, Aesun Shin, Daehee Kang","doi":"10.1158/1940-6207.CAPR-25-0058","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0058","url":null,"abstract":"<p><p>Colorectal cancer (CRC) incidence is rising in Korea, emphasizing the need to identify its risk factors. Serum lipids may influence CRC risk, but evidence is conflicting. We examined the associations between serum lipids and CRC risk in Koreans. Using data from Korean Genome and Epidemiology Study Health Examinee study, we assessed serum low-density lipoproteins (LDL), high-density lipoproteins (HDL), triglycerides (TG) and total cholesterol (TC) among those who did not use lipid-lowering drugs. Dyslipidemia and its subcategories were defined using established clinical thresholds. Cancer cases were identified via the national cancer registry. Associations between lipids and cancers were evaluated using Cox regression. Subgroup analyses were conducted by sex, age, diabetes, and prior screening experience, along with sensitivity analyses based on follow-up duration. During a median follow-up of 9.1-years, 821 new CRC cases occurred among 111,330 participants aged 40-69 years (38,455 men and 72,875 women). For CRC, elevated TG (Q4 vs. Q1 HR 1.32, 95% CI: 1.07-1.62; P-trend = 0.02) and TC (Q4 vs. Q1 HR 1.22, 95% CI: 1.00-1.51) increased risk. For colon cancer, high TG increased risk (Q4 vs. Q1 HR 1.42, 95% CI: 1.08-1.86, P-trend=0.01). Those with hyper-triglyceridemia, compared those without, showed increased risk (HR 1.42, 95% CI: 1.07-1.87) for rectal cancer, whereas other lipids showed no significant associations. Similar but attenuated results were found in the subgroup analyses among participants aged ≥50 years. TG was associated with colorectal, colon, and rectal cancer in Koreans. Findings suggest that lipid levels may be relevant to CRC prevention strategies.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an mHealth intervention to increase participation in breast cancer screening (Breast Cancer ATICA Study): a pragmatic randomized controlled trial.","authors":"Melisa Paolino, Victoria Sánchez Antelo, Liliana Orellana, Silvina Correa, Juan David Mazzadi, Anabel Furia, María Eugenia Strochero, Graciela López De Degani, Silvina Arrossi","doi":"10.1158/1940-6207.CAPR-25-0225","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0225","url":null,"abstract":"<p><p>Implementation of invitation systems has been shown to increase breast cancer (BC) screening rates. However, implementation of active outreach strategies in Latin American programs is limited. We conducted a pragmatic randomized controlled trial -the BC ATICA Study- to evaluate the effectiveness and implementation of a digital messaging-based intervention to increase BC screening. A total of 248 Argentinian women aged 50 + years were recruited from ten health care centers in Santa Fe, Argentina, and randomly assigned (1:1) to the intervention (n=123) or control group (n=125). The intervention included up to four SMS messages inviting participants to schedule an appointment for mammography through WhatsApp or the usual care control group (n=125). Effectiveness outcomes were the proportion of women who underwent mammography within 105 or 45 days of enrollment. The RE-AIM framework was used to evaluate the implementation of the intervention. Our results showed that women in the intervention group (n=123) were significantly more likely than women in the control group (n=125) to undergo a mammography within 105 days (23.6% vs. 6.4%, difference 17%, 95%CI: 7.7% to 27.0%) and within 45 days (15.4% vs. 3.2%; difference 12%, 95%CI:4.3% to 20.0%, p=0.02). Our results also showed high acceptability and appropriateness of the intervention. Our study demonstrates that sending consecutive SMS messages, including a WhatsApp number to ask for an appointment, effectively increased BC screening. This mHealth intervention could be an excellent option to improve access to breast cancer screening in low- and middle-resource settings where active invitation systems are challenging to implement.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer Screening among Adults Older than Medicare's Upper Age Eligibility Criteria.","authors":"Monica Hernandez, Kristin G Maki, Hui Zhao, Iakovos Toumazis, Robert J Volk","doi":"10.1158/1940-6207.CAPR-24-0544","DOIUrl":"10.1158/1940-6207.CAPR-24-0544","url":null,"abstract":"<p><p>Implications on the loss of lung cancer screening (LCS) coverage among Medicare recipients aged 77+ have not been explored. We use a 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine LCS patterns of screen-eligible adults across three age groups: 65-70, 71-77, 78-79 years. In descriptive analyses, LCS-eligible respondents are compared by screening status across each age category. In regression analyses, we explore various sociodemographic and health-related factors that may help explain age-related differences between these groups. Less than a third of our sample reported LCS in the last year (26.3%). Among eligible respondents, adults aged 78-79 reported the highest LCS rates (32.0%) followed by adults aged 71-77 years (28.3%) and 65-70 years (24.2%). Respondents aged 78-79 and 65-70 years with COPD indicated significantly increased LCS odds (respectively, OR=3.37 [1.12-10.11]; OR=2.91 [1.98-4.27]). Respondents aged 78-79 years with history of a heart attack or kidney disease indicated significantly decreased LCS odds (respectively, OR=0.08 [0.01-0.62]; OR=0.06 [0.01-0.56]). Respondents aged 71-77 years with coronary heart disease indicated a significantly decreased LCS odds (OR=0.54 [0.30-0.96]). Although loss of CMS coverage for LCS is not associated with lower screening among BRFSS adults aged 78-79 years, clinicians should continue to consider the appropriateness of treatment for older LCS eligible adults with chronic health conditions.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585756","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":"Implementing a Tribally Engaged Lung Cancer Screening Pilot Program in Rural Oklahoma.","authors":"Zsolt Nagykaldi, Mark Doescher, Dorothy A Rhoades, Kathleen Dwyer, Ann Chou, Michele Gibson","doi":"10.1158/1940-6207.CAPR-24-0348","DOIUrl":"10.1158/1940-6207.CAPR-24-0348","url":null,"abstract":"<p><p>The Tribally Engaged Approaches to Lung Cancer Screening study aimed to codesign and test a community-based lung cancer screening (LCS) program within a large, tribally operated health system. In 2020 to 2021, we conducted a pre-post quasi-experimental pilot implementation study of a tailored and comprehensive LCS program in two Choctaw Nation of Oklahoma primary care clinics in rural Oklahoma. The program included screening quality assessment, academic detailing, practice facilitation, health system enhancements, technology support, centralized LCS coordination, and community outreach. Eligibility for LCS was based on the 2013 U.S. Preventive Services Task Force guidelines. Participants completed pre- and post-intervention surveys on their knowledge, attitudes, and experiences regarding LCS. All participant charts were extracted to determine LCS completion. Postimplementation semi-structured interviews of patients and clinicians were conducted, and practice facilitator notes were analyzed. Participants (N = 57) averaged 67 years, and 66% were current smokers. The proportion of participants who were up-to-date with LCS increased from 39% to 58% (P < 0.01). About 18% of patients reported improvement in general care choice and treatment discussions with their doctor, and about 40% reported an improvement in their awareness or understanding of lung cancer and receipt of LCS. We also identified several key facilitators and barriers to LCS implementation at the practice and health system levels. LCS acceptance and uptake improved significantly in this community-engaged pilot intervention which informed a subsequent cluster-randomized trial. Comprehensive and community-engaged LCS programs may have the potential to improve the delivery of LCS in underserved community settings.</p><p><strong>Prevention relevance: </strong>Our community-engaged, multicomponent, and multilevel pilot implementation study significantly improved lung cancer screening rates in a rural, tribal health system. A key feature of this pilot study was a centralized screening coordination service supported by a population screening registry. We believe that our study is replicable in other settings. See related Spotlight, p. 381.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"423-430"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525217","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":"Evidence-Based Lung Cancer Screening in a Tailored Package.","authors":"Abbie Begnaud, Frank G Ondrey","doi":"10.1158/1940-6207.CAPR-25-0114","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0114","url":null,"abstract":"<p><p>Cancer screening practices are amalgamated into the entire spectrum of cancer prevention efforts that range from primary prevention (e.g., avoiding tobacco and limiting sun exposure) to screening measures after risk assessment (mammography, colonoscopy, pap smears, etc.) and tertiary measures (e.g., lesion ablation after identification and cancer follow-up examinations for secondary primaries). Marginalized groups often have difficulty gaining access to screening, and improving screening rates is challenging. The Tribally Engaged Approaches to Lung Screening (TEALS) study for lung cancer screening in the American Indian/Alaska Native population in Oklahoma represents a comprehensive effort that has significantly improved lung cancer screening for high-risk individuals on the Choctaw Nation. See related article by Nagykaldi et al., p. 423.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"18 7","pages":"381-382"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Study of Metformin and Intensive Lifestyle Intervention on Cancer Incidence over 21 Years of Follow-up in the Diabetes Prevention Program.","authors":"Brandy M Heckman-Stoddard, Jill P Crandall, Sharon L Edelstein, Philip C Prorok, Dana Dabelea, Richard Hamman, Helen P Hazuda, Edward Horton, Mary A Hoskin, Marjorie Perloff, Anna Bowers, William C Knowler, Leslie G Ford, Marinella Temprosa","doi":"10.1158/1940-6207.CAPR-23-0461","DOIUrl":"10.1158/1940-6207.CAPR-23-0461","url":null,"abstract":"<p><p>Meta-analyses have reported a decrease in overall cancer incidence of approximately 10% to 40% with metformin use among individuals with diabetes. Lifestyle change could potentially reduce cancer incidence. The objective was to determine whether metformin or intensive lifestyle (ILS) intervention reduces the risk of cancer among adults at high risk of diabetes. The Diabetes Prevention Program (1996-2001) randomized 3,234 participants to ILS, metformin (850 mg twice daily), or blinded placebo. During follow-up through the Diabetes Prevention Program Outcomes Study, all participants were offered a modified lifestyle intervention, and metformin continued in an open-label metformin group. Participants reported cancer cases annually. Medical records were adjudicated for all reported events. The primary endpoint was total cancer incidence, comparing metformin versus placebo, with ILS versus placebo as a secondary objective. After a median follow-up of 21 years, 546 participants (173 metformin, 182 ILS, and 191 placebo) were diagnosed with a first incident cancer. Incidence rates of cancer were 9.8, 10.5, and 10.8 per 1,000 person-years in metformin, ILS, and placebo, respectively, with a HR of 0.90 (95% confidence interval, 0.73-1.10) for metformin compared with placebo and 0.96 (95% confidence interval, 0.79-1.18) for ILS compared with placebo. There were no differences between any treatment groups for obesity-related cancer or in sex-specific analyses. Neither assignment to metformin nor ILS reduced cancer incidence among adults at high risk of diabetes. These results may be impacted by increased nonstudy metformin usage over time due to the development of diabetes and reduced intensity of the ILS intervention over time.</p><p><strong>Prevention relevance: </strong>This study examines both metformin and ILS intervention as primary cancer prevention interventions in people at high risk for type 2 diabetes.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"401-411"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060319","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":"Cancer Incidence and Survival after Emergency Department Care in the U.S. Midwest: An Opportunity for Cancer Interception.","authors":"Mark E Sherman, Michael G Heckman, Christopher C DeStephano, Launia J White, Jennifer L St Sauver, Ruth M Pfeiffer","doi":"10.1158/1940-6207.CAPR-24-0426","DOIUrl":"10.1158/1940-6207.CAPR-24-0426","url":null,"abstract":"<p><p>Historically, cancers diagnosed via the emergency department (ED) portend a poor prognosis. Recent data from the United States are sparse, and analyses of cancers detected in the years following ED visits are lacking. Thus, we analyzed data from nine rural U.S. Midwest counties included within the population-based Rochester Epidemiology Project (2015-2021). Participants without a history of cancer (N = 42,074) who did not receive ED care were matched 1:1 to ED participants on the date of ED visit, age, sex, race, ethnicity, and county of residence. Analyses were restricted to participants with records ≤2 years prior to ED or index visit and ≥30 days after. HRs and 95% confidence intervals (CI) comparing cancer incidence and deaths among ED and non-ED participants were estimated from Cox proportional hazards regression models, either unadjusted or adjusted for covariates. Cumulative cancer incidence curves accounting for competing risks of death and survival (all cause and cancer-specific) were estimated. The median follow-up was 6.3 years, with 2,719 (6.46%) cancers diagnosed among ED participants and 3,139 (7.46%) among non-ED participants. ED participants experienced lower cancer risk overall (HRAdjusted = 0.70; 95% CI, 0.66-0.74; P = 8.89 × 10-31), specifically for breast cancer, prostate cancer, melanoma, and secondary cancers. Cancer-specific mortality was higher among ED participants (HRAdjusted = 1.76; 95% CI, 1.49-2.08; P = 3.62 × 10-11). Compared with non-ED participants, ED participants experienced a lower incidence of cancer but higher overall cancer-specific mortality, suggesting that subsets of ED patients may benefit from postvisit preventive interventions.</p><p><strong>Prevention relevance: </strong>This cohort analysis shows that cancer incidence over 6 years was lower among participants after an ED visit than among matched non-ED participants, whereas cancer-specific mortality was higher in the ED group (HRAdjusted = 1.76; 95% CI, 1.49-2.08; P = 3.62 × 10-11), suggesting the potential benefit of preventive interventions.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"413-421"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796436","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}