Cardiology and cardiovascular medicine最新文献

{"title":"Promoting Exercise as a Therapeutic Intervention in Multiple Sclerosis: Barriers, Efficacy, and Social Prescribing Strategies.","authors":"Kristen Mittl, Devendra K Agrawal","doi":"10.26502/fccm.92920478","DOIUrl":"10.26502/fccm.92920478","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a chronic neurologic disease associated with significant physical, cognitive and social burden. Substantial evidence supports the safety and benefits of aerobic exercise for people with MS (pwMS), including improvements in fatigue, mobility, cognition, mood and quality of life. While exercise is recommended across all disability levels in clinical guidelines, real-world adherence remains low. This narrative review summarizes the benefits of aerobic exercise in MS and examines the symptom-related, psychosocial, socioeconomic, and healthcare system barriers that limits its implementation. These barriers reflect the broader influence of social determinants of health, which play a critical role in MS outcomes yet remain under-addressed in intervention research. We highlight social prescribing, a patient-centered approach that connects individuals to non-medical, community-based resources to address social needs, as a strategy to reduce barriers to exercise participation for pwMS. Future research should focus on developing and evaluating MS-specific interventions to improve exercise adherence and promote equitable access to physical activity to improve health outcomes.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"10 1","pages":"6-15"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328317","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":"Novel Missense Variants in <i>TRIM37</i> Associated with Mulibrey Nanism and Complex Congenital Heart Disease.","authors":"Gloria K E Zodanu, Angela C Zeigler, Jordan Mudery, Charlotte Wolf, John H Hwang, Xuedong Kang, Amy Speirs, Lee-Kai Wang, Reshma Biniwale, Ming-Sing Si, Nancy Halnon, Gary M Satou, Wayne W Grody, Glen S Van Arsdell, Stanly F Nelson, Marlin Touma","doi":"10.26502/fccm.92920481","DOIUrl":"10.26502/fccm.92920481","url":null,"abstract":"<p><strong>Background: </strong>Mulibrey nanism is a rare autosomal recessive genetic disorder caused by homozygous or compound heterozygous mutations in the tripartite motif protein 37 (<i>TRIM37</i> gene), which codes for a RING finger E3 ubiquitin ligase. Affected individuals present with prenatal-onset growth failure, abnormalities in multiple organs, and heart disorders, including constrictive pericarditis and restrictive cardiomyopathy.</p><p><strong>Methods and results: </strong>We performed phenotypic-genotypic analyses in a 32-week gestation preterm infant presenting with a complex congenital heart disease, including interrupted aortic arch type B, persistent left-sided superior vena cava (SVC), septal defects, and valvular disease, in addition to other congenital malformations. Initial genetic screenings, including whole genome chromosomal microarray, were negative. Whole exome sequencing (WES) of DNA samples from the proband/mother duo revealed two novel heterozygous missense variants [c.199C>T (p.Arg67Cys)] and [c.2041C>G (p.Gln681Glu)] in the <i>TRIM37</i> gene, which has been associated with Mulibrey nanism. The c.199C>T variant was inherited from the mother; however, the mode of inheritance of the c.2041C>G could not be ascertained. Whether the two variants are present on the same allele could not be determined either, due to the unavailability of the father or any family member for additional genetic analysis. However, <i>in silico</i> analysis predicted that both variants are damaging, and both amino acid positions are fairly well conserved.</p><p><strong>Conclusion: </strong>These findings highlight the critical role of the <i>TRIM37</i> genetic variants in complex congenital heart defect phenotypes associated with Mulibrey nanism and emphasize the importance of comprehensive triobased WES for antenatal care and early diagnosis.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"10 2","pages":"22-33"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13026078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576741","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":"Testosterone and Cardiovascular Health: Physiology, Pharmacokinetics and Clinical Implications.","authors":"Gaithrri Shanmuganathan, Nora Lyang, Sandeep Gill, Devendra K Agrawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is becoming increasingly prevalent in the United States, prompting an interest in biological and hormonal contributors to risk. Although testosterone has long been implicated in cardiovascular risk, the nature of this relationship is complex and is not fully understood. Furthermore, the use of testosterone replacement therapy has increased over the years, especially in male hypogonadism. Like endogenous testosterone, the influence of testosterone replacement therapy on CVD risk remains unclear as findings from multiple studies have been inconsistent. Some studies proposed that testosterone replacement therapy-induced erythrocytosis may contribute to an increased risk of CVD, however, this association remains unconfirmed. Building on this proposed mechanism, some studies have found certain testosterone replacement therapy formulations to have increased rates of erythrocytosis while other studies found similar effects across all formulations. In this review, we outline the physiology of endogenous testosterone, its role in cardiovascular health and the current evidence surrounding testosterone replacement therapy and its relationship with CVD. We will then review the different testosterone replacement therapy formulations and evaluate their potential influence on CVD risk.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"10 2","pages":"57-70"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824278","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":"Mortality Trends in the United States due to Concurrent Heart Failure, Atrial Fibrillation/Flutter and Sepsis.","authors":"Gaithrri Shanmuganathan, Nicole Jeongha Lee, Devendra K Agrawal","doi":"10.26502/fccm.92920482","DOIUrl":"10.26502/fccm.92920482","url":null,"abstract":"<p><p>Heart failure (HF), atrial fibrillation (AF)/atrial flutter (AFL) and sepsis commonly co-occur in hospitalized patients. This study determines temporal mortality trends associated with concurrent HF, AF/AFL, and sepsis among adults across demographic and geographic groups in the United States. The CDC Wonder database was utilized to extract age-adjusted mortality rates (AAMR) per 100,000 for deaths listing HF, AF/AFL, and sepsis. Trends were analyzed by age, race/ethnicity, region, and sex. Joinpoint regression calculated the annual percent change (APC) and average annual percent change (AAPC) for AAMR with 95% CI. From 1999 to 2023, there were 1,749,565 deaths involving HF, AF/AFL, and sepsis. AAMR doubled (1999: 11.79 vs. 2020: 23.87 per 100,000), with a critical 2012 inflection point accelerating mortality from 1.29% to 6.42% annually. White individuals had steepest post-2012 acceleration (6.67%), surpassing Black individuals by 2020 (24.88 vs. 20.80 per 100,000). Males had higher AAMRs than females (28.69 vs 20.19 per 100,000 in 2020). Middle-aged adults (45-64 years) showed highest acceleration (9.98-10.30%), nearly double those aged ≥85 years (5.82%). The Midwest and South had steepest increases (7.07% and 7.11%). During 2018-2023, mortality continued increasing at 6.11% annually without stabilization. Mortality involving HF, AF/AFL and sepsis doubled from 1999-2023 with sustained acceleration and no post-pandemic stabilization. Targeted interventions should focus on males, middle-aged adults, and high-risk regions with enhanced post-discharge care.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"10 2","pages":"34-48"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596304","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":"Most Effective Interventions for Improving Upper Extremity Function in Patients with Hemiparesis.","authors":"Andre Aabedi, Daniel Mashiach, Marcel P Fraix, Devendra K Agrawal","doi":"10.26502/fccm.92920475","DOIUrl":"https://doi.org/10.26502/fccm.92920475","url":null,"abstract":"<p><p>Hemiparesis, commonly resulting from stroke, leads to significant impairments in upper extremity function, limiting daily activities and reducing quality of life. Effective rehabilitation strategies are essential to enhance motor recovery and restore functional independence. This review evaluates the most effective interventions for improving upper extremity function in patients with hemiparesis. A comprehensive literature review was conducted, analyzing systematic reviews, randomized controlled trials, and clinical guidelines. The efficacy of various interventions, including task-specific training, constraint-induced movement therapy (CIMT), neuromuscular electrical stimulation (NMES), mirror therapy, virtual reality, bilateral arm training, pharmacological approaches, and robotic-assisted rehabilitation, was assessed based on their impact on motor function and daily activities. The review highlights the role of neuroplasticity in motor recovery, emphasizing interventions that promote cortical reorganization. Task-specific training, CIMT, and NMES demonstrate strong evidence in enhancing motor function. Emerging technologies, such as brain-computer interfaces and robotics, show promise in optimizing rehabilitation outcomes. Factors influencing recovery, including stroke severity, time since onset, and patient motivation, are discussed. Studies consistently support the effectiveness of CIMT and task-specific training in improving upper extremity function. NMES and mirror therapy are beneficial adjunct therapies, particularly for patients with moderate impairment. Virtual reality and robotics enhance engagement and motor learning, while pharmacological and stem cell therapies are emerging areas with potential but require further research. A multimodal rehabilitation approach combining task-oriented therapies, neuromodulation, and emerging technologies yields the best outcomes for upper extremity recovery in hemiparesis patients. Future research should focus on optimizing individualized treatment plans and integrating novel therapeutic modalities to maximize functional gains.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 6","pages":"504-511"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790685","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":"Pulse Oximetry Screening for Critical Congenital Heart Defects: Effectiveness and Implementation across Clinical Settings.","authors":"Gauri Gurumurthy, Devendra K Agrawal","doi":"10.26502/fccm.92920468","DOIUrl":"10.26502/fccm.92920468","url":null,"abstract":"<p><p>Congenital heart defects are the most prevalent congenital anomalies, occurring in approximately 1% of live births and accounting for nearly one-third of all major congenital disorders worldwide. Within this spectrum, critical congenital heart defects (CCHDs) represent the most severe forms, often necessitating surgical or catheter-based intervention within the first year of life. Delayed or missed diagnosis of CCHDs remains a major cause of preventable neonatal morbidity and mortality, underscoring the importance of timely detection. Pulse oximetry screening has emerged as a noninvasive, inexpensive, and highly specific method to identify hypoxemia, particularly in duct-dependent lesions that may otherwise escape early clinical recognition. Since its universal adoption in the United States in 2011, pulse oximetry screening has consistently demonstrated value as a complementary tool to prenatal ultrasound and physical examination, improving detection rates, reducing emergency hospitalizations, and lowering infant mortality. Despite its proven clinical impact, important challenges remain. Screening sensitivity is limited, especially for conditions such as coarctation of the aorta that may not produce early hypoxemia. Variability in protocols, including timing of screening, pre- versus post-ductal measurement, and thresholds for repeat testing, contributes to inconsistent performance across hospitals. Moreover, recent evidence of racial bias in pulse oximetry accuracy, along with persistent disparities in early detection across demographic groups, highlights the need for inclusive device validation and standardized protocols. In low- and middle-income countries, pilot studies from Rwanda, Nigeria, and India demonstrate feasibility and dual benefits for detecting both cardiac and non-cardiac hypoxemic conditions, but widespread implementation is hindered by resource constraints, inadequate referral pathways, and limited access to confirmatory echocardiography. Emerging strategies, including integration with electronic medical records, computerized clinical decision support systems, and mobile health technologies, hold promise for standardizing workflows, improving compliance, and extending reach to resource-limited settings. This article presents a synthesisis of current evidence on the effectiveness, limitations, and global implementation of pulse oximetry screening for the detection of congenital heart defect detection, highlighting both its established role in neonatal care and the urgent need for innovations to address disparities, optimize protocols, and ensure equitable access to screening worldwide.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 5","pages":"444-456"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679504","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":"Immunomodulation and Thrombolytic Approaches in the Management of Deep Vein Thrombosis and Pulmonary Embolism.","authors":"Angelie Pathak, Laura Roberts, Devendra K Agrawal","doi":"10.26502/fccm.92920456","DOIUrl":"10.26502/fccm.92920456","url":null,"abstract":"<p><p>Deep vein thrombosis (DVT) and pulmonary embolism (PE) are key initiating events in the development of venous thromboembolism (VTE), a condition associated with significant morbidity, mortality, and long-term complications. While traditional therapies have focused on anticoagulation and thrombolysis, current evidence describes the pivotal role of immune pathways in the pathogenesis and progression of thrombosis. This review explores the multifaceted mechanisms underlying DVT and PE, emphasizing the contribution of inflammation, leukocyte activation, and immuno-thrombosis to thrombus formation and embolization. Key immune players such as neutrophil extracellular traps (NETs), inflammasomes, antibodies, and the STING pathway act in concert with coagulation cascades, highlighting potential targets for therapeutic modulation. We critically evaluated and discussed the efficacy and risks associated with thrombolytic agents such as alteplase, reteplase, and tenecteplase, particularly in severe or hemodynamically unstable cases. In addition, we reviewed new and innovative approaches including immune-targeted therapies and nanoparticle-based drug delivery systems, which provide the promise of more precise, safer, and cost-effective interventions. By integrating immunologic insights with evolving thrombolytic strategies, this paper supports a more tailored approach to managing DVT and PE, with the goal of reducing recurrence, minimizing complications, and enhancing long-term patient outcomes.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 4","pages":"322-333"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016701","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":"Atrial fibrillation in Retinal Artery Occlusions.","authors":"Shreyas Melanahalli, Tommy Tran, Clement Ng, Devendra K Agrawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Retinal artery occlusions, encompassing central retinal artery occlusion and branch retinal artery occlusion, are acute vascular events that can result in significant and often irreversible vision loss. These ocular emergencies are closely associated with systemic vascular risk factors, including hypertension, diabetes mellitus, advanced age, and cardiovascular comorbidities. Atrial fibrillation (AFib), the most common sustained cardiac arrhythmia, has emerged as a notable contributor to the risk of retinal artery occlusions. The prevalence of AFib is rising, particularly among older adults, paralleling the age-dependent increase in retinal artery occlusion incidence. Recent studies indicate a significant association between AFib and retinal artery occlusions, with AFib conferring an elevated risk for both retinal and cerebral ischemic events. Notably, Patients with retinal artery occlusion exhibit a heightened risk of subsequent AFib, stroke, and thromboembolic complications. The pathophysiological interplay involves embolic phenomena originating from cardiac or carotid sources, with AFib facilitating thrombus formation and embolization to the retinal circulation. Diagnostic advances, including prolonged cardiac monitoring and optical coherence tomography, have improved detection of both AFib and retinal ischemic changes. Despite the lack of a universally accepted treatment for retinal artery occlusions, early interventions such as thrombolysis and hyperbaric oxygen therapy may improve visual outcomes if administered promptly. This manuscript underscores the importance of comprehensive cardiovascular evaluation in patients with retinal artery occlusion, particularly for AFib, to optimize risk stratification, guide management, and reduce the likelihood of recurrent vascular events. Enhanced awareness and interdisciplinary collaboration are critical to improving prognosis and preventing further morbidity in this high-risk population.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 4","pages":"234-247"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786076","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":"Interaction between Perivascular and Luminal Factors in Arteriovenous Fistula in Yucatan Miniswine.","authors":"Fanya Xia, Jacob Smith, Vikrant Rai, Devendra K Agrawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Arteriovenous fistula (AVF) is created in end-stage renal disease patients for hemodialysis. AVF maturation failure is a common complication due to thrombosis and stenosis of the vessels involved in AVF. Chronic inflammation along with perivascular cuffing plays a critical role in AVF maturation failure. Luminal as well as periluminal factors with the involvement of transcription and epigenetic factors play a critical role in AVF maturation failure. Our previous study reported MYOD1, a factor associated with muscle regeneration and increased with muscle injury, as a significantly increased transcription factor in AVF arteries compared to control. This study aims to characterize the perivascular and vascular AVF tissues for the expression of MYOD1, mediators of inflammation, immune cell markers, and apoptosis markers with the hypothesis that muscle injury mediates the recruitment of immune cells and activation of apoptosis leading to increased apoptosis and vascular thrombosis and fibrosis of perivascular structures. Previously collected tissues from Yucatan miniswine were stained and analyzed, and the results revealed increased expression of mediators of inflammation, immune cell markers, and apoptosis markers in association with increased MYOD1 expression. The findings suggest an interaction between the expression of perivascular factors and luminal factors, but further investigations using in-vitro studies are needed to establish this relationship.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 2","pages":"82-88"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556042","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":"Nutrition, Gut Microbiota, and Epigenetics in the Modulation of Immune Response and Metabolic Health.","authors":"Sabrin Bacaloni, Devendra K Agrawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Immune system function is intricately shaped by nutritional status, dietary patterns, and gut microbiota composition. Micronutrients such as vitamins A, C, D, E, B-complex, zinc, selenium, iron, and magnesium are critical for maintaining physical barriers, supporting immune cell proliferation, and regulating inflammation. Macronutrients-including proteins, fats, and carbohydrates-also modulate immune responses through their impact on immune metabolism and the gut-immune axis. Epigenetic mechanisms, including DNA methylation, histone modifications, and microRNA expression, mediate the long-term effects of diet on immune function and tolerance. Diet-induced alterations in gut microbiota further influence immune homeostasis via microbial metabolites like short-chain fatty acids. Imbalanced diets, particularly the Western diet, contribute to immune dysregulation, chronic inflammation, and the development of metabolic disorders such as obesity and type 2 diabetes. While plant-based and Mediterranean dietary patterns have shown anti-inflammatory and immunoregulatory benefits, gaps remain in understanding the long-term epigenetic impacts of these diets. This review integrates current knowledge on how nutrition and the microbiome regulate immunity, highlighting future directions for personalized dietary strategies in preventing chronic immune-related conditions.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"9 3","pages":"111-124"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183477","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}