Frontiers in reproductive health最新文献

{"title":"Spatial distribution and determinants of children ever born among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 mini Ethiopian demographic health survey.","authors":"Ahmed Fentaw Ahmed, Bezawit Adane, Tilahun Degu Tsega, Mekides Nigusu, Kalaab Esubalew Sharew, Abebaw Molla, Mulugeta Tesfa","doi":"10.3389/frph.2025.1389932","DOIUrl":"10.3389/frph.2025.1389932","url":null,"abstract":"<p><strong>Background: </strong>Understanding population dynamics is essential since the number of children ever born (CEB) affects the growth, composition, and structure of a nation's population. The number of CEB has increased significantly, contributing to the world's rapid population growth. The spatial distribution of CEB in Ethiopia lacks recent information. Therefore, this study aimed to assess spatial distribution, and associated factors of CEB among reproductive age women in Ethiopia.</p><p><strong>Method: </strong>Mini Ethiopian Demographic and Health Survey (MEDHS) 2019 data were used in this study. The study comprised 5527 (weighted) women's between the ages of 15 and 49. STATA and Aeronautical Reconnaissance Coverage Geographic Information System (ArcGIS) 10.8 software was used. The primary outcome, CEB, was categorized as \"low\" if fewer than five children were born and \"high\" if five or more children were born. Global and local Moran's Index methods were used to assess the extent of clustering. Multi-level (two-level) logistic regression analysis was used and variables with a <i>P</i> value less than 0.05 were considered statistical significance. Adjusted odds ratio AOR) with a 95% confidence interval (CI) was used to show the strength and direction of the association respectively.</p><p><strong>Results: </strong>High number of CEB in Ethiopia was 37.46%, 95% CI (0.39-0.56) and it was spatially clustered (Moran's index = 0.59 <i>P</i> value <0.0001). Significant hotspots of high CEB were found in the Eastern Somali, Hadiya, Sidama, and Welayta zones. From individual-Level variables: women who were married [AOR = 3.23, 95% CI (1.48, 6.62)] were positively associated with high number of CEB. Whereas, women who were primary educated [AOR = 0.18, 95% CI (0.12, 0.27)], women who were secondary educated [AOR = 0.0.05, 95% CI (0.02, 0.13)], women's whose age at first birth after 20 year [AOR = 0.38, 95% CI (0.27, 0.51)] and women's who were using contraceptive [AOR = 0.59, 95% CI (0.44-0.78) were negatively associated with high number of CEB. From community level variables: a community with high proportion of contraceptive non user [AOR = 1.38, 95% CI (1.94-2.04)] were positively associated with high number of CEB.</p><p><strong>Conclusion: </strong>Both individual and community-level factors were significantly linked to a high number of children born. The government is advised to prioritize interventions that promote women's education, delay first births, and provide access to a range of contraceptive options, ensuring informed, voluntary choices. Empowering women to exercise reproductive autonomy, free from coercion, is key to influencing fertility outcomes effectively.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1389932"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494634","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":"Women's experiences and acceptability of self-administered, home delivered, intravaginal 5-Fluorouracil cream for cervical precancer treatment in Kenya.","authors":"Konyin Adewumi, Aparna Ghosh Kachoria, Everlyn Adoyo, Mercy Rop, Antony Owaya, Jennifer H Tang, Lisa Rahangdale, Chemtai Mungo","doi":"10.3389/frph.2025.1487264","DOIUrl":"10.3389/frph.2025.1487264","url":null,"abstract":"<p><strong>Background: </strong>Innovative strategies are essential to meet the World Health Organization's 90/70/90 cervical cancer elimination targets, aiming for 90% access to precancer treatment globally by 2030. In low-and middle-income countries (LMICs) where most cervical cancer cases occur, access to precancer treatment is severely limited. Scalable solutions like self-administered topical therapies can help close this gap. In a recent Phase I trial (ClinicalTrials.gov NCT05362955), we demonstrated safety and adherence to self-administered intravaginal 5% 5-Fluorouracil (5FU) cream as an adjuvant therapy for cervical precancer among women living with HIV (WLWH) in rural Kenya. To understand women's experiences with self-administered 5FU, we evaluated the acceptability of this intervention among trial participants.</p><p><strong>Methods: </strong>All 12 participants from the Phase I trial completed a structured questionnaire and in-depth semi-structured interviews in their preferred language, focusing on their experiences with 5FU self-administration, challenges faced, and overall acceptability of the intervention, including whether they would use it again or recommend it to someone who needed it. Quantitative data were analyzed using descriptive statistics. In the qualitative study, acceptability was defined as \"the perception that a given treatment is agreeable, palatable, or satisfactory.\" A thematic analysis was conducted using five dimensions of acceptability: content, complexity, comfort, delivery, and credibility.</p><p><strong>Results: </strong>The mean age was 43.9 years (SD 4.4), and seven (58%) had primary education or less. While some participants reported feelings of uncertainty when they started using 5FU, at the end of the study, all 12 participants strongly agreed that the cream was safe and were confident they used it correctly. Most participants (91.7%) experienced no discomfort with the vaginal applicator, and most reported using tampons overnight after 5FU use, as recommended. Qualitative findings revealed that favorable perceptions of self-administered 5FU were driven by its ease of use, the discrete nature of the treatment, and the comfort of home application. The main challenges included correctly measuring the study drug, finding a private place at home to self-administer, and the need to use condoms during treatment. Compared to their previous ablation or excision treatments, participants found 5FU to be less painful, and all would prefer a self-administered treatment instead of a procedure if it were an option.</p><p><strong>Conclusion: </strong>Self-administered intravaginal 5FU as an adjuvant treatment for cervical precancer among women living with HIV in Kenya was highly acceptable. Randomized studies of 5FU and other topical therapies in LMICs are needed to evaluate their use in closing the current precancer treatment gaps in these settings.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1487264"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470178","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":"Tackling somatic DNA contamination in sperm epigenetic studies.","authors":"Anamika Kumari, Rajender Singh","doi":"10.3389/frph.2025.1506117","DOIUrl":"10.3389/frph.2025.1506117","url":null,"abstract":"<p><strong>Introduction: </strong>Recent interest in sperm epigenetics has stemmed from its implication in sperm DNA quality, sperm fertility, environmental toxicity, and transgenerational inheritance. Sperm epigenetic data may be significantly affected by somatic DNA contamination, resulting in misleading conclusions. However, detecting and dealing with somatic DNA contamination in semen samples can be a challenging task.</p><p><strong>Methods: </strong>In the present study, we worked out a detailed and robust plan to deal with somatic cell DNA contamination in sperm epigenetic studies in order to draw error-free scientific conclusions. Apart from incorporating simple quality checks, such as microscopic examination and somatic cell lysis buffer (SCLB) treatment, we compared the Infinium Human Methylation 450K BeadChip data for sperm and blood samples to identify the CpG sites that were highly methylated in blood samples in comparison to sperm, but were unrelated to infertility.</p><p><strong>Results and discussion: </strong>The comparison of Infinium Human Methylation 450K BeadChip data for sperm and blood samples identified 9564 CpG sites that can be used as markers for analyzing somatic DNA contamination. We have put together a comprehensive plan including evaluation under a microscope, SCLB treatment, inclusion of CpG biomarkers for sample quality evaluation, and applying a 15% cut off at the time of data analysis to completely eliminate the influence of somatic DNA contamination in sperm epigenetic studies. We conclude that if this comprehensive plan is followed, the influence of somatic DNA contamination in sperm epigenetic studies can be completely eliminated.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1506117"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460969","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":"Determinant of unmet need for family planning among adolescent and young women in Kenya: multilevel analysis using recent Kenyan demographic health survey.","authors":"Beyene Sisay Damtew, Hinsermu Bayu Abdi, Beker Ahemed Hussien, Getahun Tiruye, Nafyad Tolossa Urgie, Beniam Worku Yigezu, Sifan Ahmed Mohammed, Bezawit Melak Fente","doi":"10.3389/frph.2025.1511606","DOIUrl":"10.3389/frph.2025.1511606","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for family planning (FP) refers to the proportion of women who are fecund, sexually active, and wish to delay or limit childbearing but are not using any effective contraceptive method. Unmet need for FP remains a significant public health concern, particularly among young women aged 15-24 years. This study explores the determinants of unmet need for FP among young women.</p><p><strong>Method and material: </strong>This study used data from the 2022 Kenyan Demography and Health Survey to investigate the relationship between various factors and a binary outcome variable of unmet need for family planning among adolescent young age group. A multilevel binary logistic regression model was used to analyze the data, accounting for the clustering effects of the survey data. The statistical significance of the relationships was assessed using adjusted odds ratios with 95% confidence intervals. The model with the lowest deviance was considered the best fit for the data.</p><p><strong>Result: </strong>Magnitude of unmet need family planning among adolescent young age in Kenya is 25% (95% CI: 24.5%-26%). Determinants of Unmet need for family planning are age 15-19 (AOR: 3.4, 95%CI (1.3-11), undecided desire number of children (AOR: 2.3, 95%CI: 1.4-2.1), age at first sex 15-29 (AOR: 2.7, 95%CI: 1.2-6.2), rural residency (AOR: 3.9, 95%CI: 1.1-14), high community level poverty (AOR: 2.1, 95%CI: 1.1-4.5).</p><p><strong>Conclusion: </strong>The study finds that 25% of young women in Kenya lack access to family planning. Factors like age, desired family size, early sex, rural life, and poverty contribute to this. These factors create barriers that hinder women's ability to plan their pregnancies and access necessary resources. Younger women, those in rural areas, and those living in poverty are particularly affected. Addressing this issue requires a comprehensive approach that considers the specific circumstances of these vulnerable populations.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1511606"},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451163","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":"Trends in infections detected in women with cervicitis over a decade.","authors":"Lenka A Vodstrcil, Erica L Plummer, Thuy Vy Nguyen, Christopher K Fairley, Eric P F Chow, Tiffany R Phillips, Catriona S Bradshaw","doi":"10.3389/frph.2025.1539186","DOIUrl":"10.3389/frph.2025.1539186","url":null,"abstract":"<p><strong>Objectives: </strong>There is a growing body of evidence that in the absence of <i>Chlamydia trachomatis</i> and/or <i>Neisseria gonorrhoeae, Mycoplasma genitalium</i> and bacterial vaginosis (BV) are associated with cervicitis. We aimed to describe infections detected among cervicitis cases over a decade and establish how commonly <i>M. genitalium</i> and BV were detected among non-chlamydial/non-gonococcal cases to inform testing and treatment practices.</p><p><strong>Methods: </strong>We conducted a retrospective case-series to determine the number of cervicitis cases diagnosed with genital infections (<i>C. trachomatis</i>, <i>N. gonorrhoeae, M. genitalium</i> and BV) among women attending the largest public sexual health service in Australia from 2011 to 2021. We determined the proportion of cervicitis cases with one or more genital infections detected, and trends in testing and detection of each infection over time.</p><p><strong>Results: </strong>Over a decade 813 cervicitis cases were diagnosed; 421 (52%, 95%CI: 48%-55%) had no infection detected; 226/729 (31%, 95%CI: 28%-35%) had BV, 163/809 (20%, 95%CI: 17%-23%) <i>C. trachomatis</i>, 48/747 (6%, 95%CI: 5%-8%) <i>M. genitalium</i>, and 13/793 (2%, 95%CI: 1%-3%) <i>N. gonorrhoeae</i>. Of the 665 (82%) cases tested for all four infections, 268 (40%) had one infection and 73 (11%) had >1 infection detected. Of the 517/665 (78%) non-chlamydial/non-gonococcal cases<i>,</i> 164 (32%) had BV and 16 (3%) had <i>M. genitalium</i> as the sole infections detected; a further 13 cases (3%) were co-infected with BV and <i>M. genitalium</i>. The proportion of cases tested for BV (90%) did not change overtime, but detection increased from 32% to 45% (P_trend < 0.001). The proportion of cases tested for <i>M. genitalium</i> increased from 84% in 2011 to 96% in 2019 (P_trend = 0.006), with <i>M. genitalium</i>-detection in cervicitis increasing from 3% to 7% (P_trend = 0.046).</p><p><strong>Conclusions: </strong>In our study population, chlamydia or gonorrhoea were not detected in ∼75% of cervicitis cases; 1 in 3 of these cases had BV and/or <i>M. genitalium</i>, and both increased in prevalence over time. These data highlight the need for clinicians to consider BV and <i>M. genitalium</i> when assessing and managing cervicitis.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1539186"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442730","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":"Editorial: Weighing the impact of being overweight on female reproductive function and fertility.","authors":"Theocharis Koufakis, Dimitrios Patoulias, Kulvinder Kochar Kaur, Djordje S Popovic","doi":"10.3389/frph.2025.1554284","DOIUrl":"10.3389/frph.2025.1554284","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1554284"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442725","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":"Exploring drivers and prevention strategies for sexual violence among adolescent girls and young women in Kicukiro, Rwanda.","authors":"Wongani Patricia Kawonga, Sam M Livingstone, Augustine Ndaimani, Jean Pierre Sibomana, Tsion Yohannes Waka, Maxwell Mhlanga, Andrew Mclellan","doi":"10.3389/frph.2025.1420947","DOIUrl":"10.3389/frph.2025.1420947","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual violence against adolescent girls and young women (AGYW) is a pervasive issue globally, with particularly high prevalence in sub-Saharan Africa. This study explores the drivers and prevention strategies for sexual violence among AGYW in Kicukiro, Rwanda.</p><p><strong>Methods: </strong>A descriptive exploratory design guided by the socioecological model and feminist standpoint theory was employed. In-depth interviews were conducted with 13 AGYW participating in a mentorship program and 5 male community members. Data was analyzed using thematic analysis to identify key drivers and potential prevention strategies.</p><p><strong>Results: </strong>Four themes emerged: (1) empowering mentorship programs, (2) tiered drivers of sexual violence, (3) optimizing violence-mitigating resources, and (4) interference with judicial processes. Key drivers of sexual violence included substance use, transactional sexual relationships, inadequate family protection, entrenched gender stereotypes, and limited legal literacy.</p><p><strong>Conclusion: </strong>Findings underscore the need for multifaceted interventions that address systemic and cultural barriers, strengthen legal frameworks, and expand community-based programs. Addressing sexual violence requires a holistic approach, integrating empowerment initiatives, robust community engagement, and legal reforms to create safer environments for AGYW. The mentorship program's success suggests scalability across other settings.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1420947"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411825","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":"Corrigendum: Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livingston, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2025.1561341","DOIUrl":"https://doi.org/10.3389/frph.2025.1561341","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1473354.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1561341"},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392611","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":"Corrigendum: Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livingston, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2025.1560111","DOIUrl":"https://doi.org/10.3389/frph.2025.1560111","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1473354.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1560111"},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383579","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":"Assessing factors influencing adolescent sexual debut in Nigeria: a multi-cluster survival analysis approach.","authors":"Fabio Mathias Correa, Peter Enesi Omaku, Joseph Odunayo Braimah","doi":"10.3389/frph.2025.1475421","DOIUrl":"10.3389/frph.2025.1475421","url":null,"abstract":"<p><strong>Introduction: </strong>Early sexual debut is an area of concern in Nigeria with implications for reproductive health.</p><p><strong>Methods: </strong>This study addresses this by proposing a more effective survival model-one that incorporates both independent and identically distributed (IID) and Besag intrinsically conditional auto-regressive (ICAR) random effect priors, using a generalised additive model that accounts for both individual and spatial influences on age at first sex. We analyse data from the 2018 Nigerian NDHS survey and compare our model with existing models: a model without the cluster frailty effect, a model that ignores the Besag ICAR and includes the IID, and a model that ignores the IID and includes only the Besag ICAR.</p><p><strong>Results: </strong>Our approach, which combines independent and spatial random effects, outperforms others based on statistical criteria (Deviation Information Criterion and the Widely Applicable Information Criterion).</p><p><strong>Discussion: </strong>As shown in this study, the proposed model effectively captures the complexity of age at first sex. In addition, visualisations reveal significant geographic and social clusters with high rates of early sexual debut in Nigeria. These findings highlight the importance of considering multi-level clustering to better understand and promote healthy sexual behaviour among young Nigerians through targeted interventions.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1475421"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383524","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}