Advances in respiratory medicine最新文献

{"title":"<i>RSPH4A-PCDx</i>: An Index to Predict Lung Function Decline in Primary Ciliary Dyskinesia.","authors":"Gabriel Román-Ríos, Gabriel Rosario-Ortiz, Marcos J Ramos-Benitez, Ricardo A Mosquera, Wilfredo De Jesús-Rojas","doi":"10.3390/arm93040027","DOIUrl":"https://doi.org/10.3390/arm93040027","url":null,"abstract":"<p><p>Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder that impairs mucociliary clearance and leads to progressive lung disease. This study aimed to characterize lung function decline in a genetically homogeneous cohort of Puerto Rican patients with <i>RSPH4A</i>-associated PCD and to develop a clinical tool to predict lung function decline and support transplant referral decisions. We conducted a retrospective chart review of patients (<i>n</i> = 25) with a confirmed <i>RSPH4A</i> [c.921+3_6delAAGT] genetic variant, collecting longitudinal spirometry data and applying linear regressions to calculate each patient's individual FEV₁ decline. The median FEV₁ at diagnosis was 55%, with a median annual decline of -0.75% predicted. Adults exhibited significantly lower lung function compared to pediatric patients, while no difference was seen between males and females. Based on this observed decline, we developed the Predicted Capacity Decline Index (<i>PCDx</i>), an index that estimates the age and time until a patient reaches the 30% FEV₁ threshold, the point at which lung transplant referral is typically considered. Our findings underscore the need for early intervention and suggest that genotype-specific tools like the <i>PCDx</i> may enhance clinical decision-making in managing progressive lung disease in PCD.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938520","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":"Investigation of Individual Variability and Temporal Fluctuations in Exhaled Nitric Oxide (FeNO) Levels in Healthy Individuals.","authors":"Emi Yuda, Tomoki Ando, Yukihiro Ishida, Hiroyuki Sakano, Yutaka Yoshida","doi":"10.3390/arm93040026","DOIUrl":"10.3390/arm93040026","url":null,"abstract":"<p><p>Measurement of nitric oxide (NO) concentration in exhaled breath (FeNO) is a quantitative, non-invasive, simple, and safe method for assessing airway inflammation. It serves as a complementary tool to other methods for evaluating airway diseases. However, little is known about the typical NO levels in healthy individuals, including individual differences and the influence of measurement timing. Therefore, this study classified measurement times into four periods and statistically analyzed NO levels in healthy individuals. The mean values among groups were compared using repeated measures ANOVA on six participants. The analysis showed large individual variations in NO levels, resulting in no significant difference (<i>p</i> = 0.29). Notably, greater fluctuations were observed in the morning. These findings align with previous studies suggesting the influence of circadian rhythms and the redundancy of repeated measurements. This study highlights the need to consider timing and individual variability when using FeNO as a physiological marker in healthy populations.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697356","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":"Pharmacological Immunomodulation via Collagen-Polyvinylpyrrolidone or Pirfenidone Plays a Role in the Recovery of Patients with Severe COVID-19 Through Similar Mechanisms of Action Involving the JAK/STAT Signalling Pathway: A Pilot Study.","authors":"Hugo Mendieta-Zerón, Esteban Cruz-Arenas, Salvador Díaz-Meza, Alejandro Cabrera-Wrooman, Edna Ayerim Mandujano-Tinoco, Rosa M Salgado, Hugo Tovar, Daniel Muñiz-García, Laura Julieta Orozco-Castañeda, Sonia Hernández-Enríquez, Miriam Deyanira Rodríguez-Piña, Ana Sarahí Mulia-Soto, José Meneses-Calderón, Paul Mondragón-Terán, Edgar Krötzsch","doi":"10.3390/arm93040024","DOIUrl":"10.3390/arm93040024","url":null,"abstract":"<p><p>The therapeutic target of COVID-19 is focused on controlling inflammation and preventing fibrosis. Collagen-polyvinylpyrrolidone (collagen-PVP) and pirfenidone both have the ability to control the cytokine storm observed in rheumatic and fibrotic disorders. In this work, our aim was to understand the benefits of treatment with each of these drugs in patients with severe COVID-19. In total, 36 patients were treated with dexamethasone and enoxaparin, but 26 were allocated collagen-PVP or pirfenidone (<i>n</i> = 15 and 11, respectively); the clinical and metabolic effects were compared among them. Since pirfenidone works via transcriptional mechanisms, we performed a human genome microarray assay using RNA isolated from fibroblast and monocyte cultures treated with the biodrug, with the aim of hypothesising a possible mechanism of action for collagen-PVP. Our results showed that hospital stay duration, quick COVID-19 severity index (qCSI), and admission to the intensive care unit were statistically significantly lower (<i>p</i> < 0.02) in patients treated with collagen-PVP or pirfenidone when compared with the control group, and that only collagen-PVP normalised serum glucose at discharge. Ingenuity Pathway Analysis showed that the cell cycle, inflammation, and cell surface-extracellular matrix interactions could be regulated with collagen-PVP via the downmodulation of proinflammatory cytokines, while Th2 anti-inflammatory response signalling could be upregulated. Furthermore, the downregulation of some of the genes involved in nitric oxide production showed a possible control for JAK in the IFN-γ pathway, allowing for the possibility of controlling inflammation through the JAK/STAT pathway, as has been observed for pirfenidone and other immunomodulators, such as ruxolitinib.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697357","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":"A Comparison of Impulse Oscillometry and Spirometry by Percent Predicted in Identifying Uncontrolled Asthma.","authors":"Chalerm Liwsrisakun, Chaicharn Pothirat, Athavudh Deesomchok, Pilaiporn Duangjit, Warawut Chaiwong","doi":"10.3390/arm93040025","DOIUrl":"10.3390/arm93040025","url":null,"abstract":"<p><strong>Background: </strong>The role of impulse oscillometry (IOS) in evaluating asthma control remains a challenge because the interpretation varies by many factors, including ethnicity. We aimed to assess the diagnostic contribution of spirometry and IOS, established from reference equations, in the detection of uncontrolled asthma.</p><p><strong>Methods: </strong>This retrospective study was conducted in adult asthma subjects with normal spirometry. Uncontrolled asthma was defined as an Asthma Control Test (ACT) score ≤ 19. Receiver operating characteristic (ROC) curves were plotted to compare the diagnostic abilities of the %-predicted of heterogeneity of resistance at 5 Hz and 20 Hz (R5-R20) and the %-predicted of forced expiratory volume in the first second (FEV₁) in detecting uncontrolled asthma. Multivariable risk regressions were performed to identify the %-predicted of R5-R20 as a predictor for uncontrolled asthma.</p><p><strong>Results: </strong>The %-predicted of R5-R20 demonstrated a superior diagnostic ability for detecting uncontrolled asthma compared to the %-predicted FEV₁, with the area under the ROC curves (AuROC) = 0.939 vs. 0.712, respectively, <i>p</i> < 0.001. The %-predicted R5R20 of ≥200 showed the highest AuROC for detecting uncontrolled asthma with an adjusted risk ratio of 10.86 (95%CI; 3.77, 31.29; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>IOS demonstrated better diagnostic ability for detecting uncontrolled asthma than spirometry.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697353","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":"Imaging and Laboratory Results as Predictors of the Course of COVID-19.","authors":"Ewelina Tobiczyk, Hanna Maria Winiarska, Daria Springer, Aleksandra Ludziejewska, Ewa Wysocka, Szymon Skoczyński, Szczepan Cofta","doi":"10.3390/arm93040022","DOIUrl":"10.3390/arm93040022","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 most often affects the respiratory system and may manifest as acute respiratory failure requiring the use of non-invasive respiratory support (NIRS). The aim of this study was to find predictors based on laboratory results and chest computed tomography (CT) scans performed on admission to the hospital indicating the need for NIRS and predicting mortality after hospital discharge.</p><p><strong>Methods: </strong>We retrospectively analysed data from consecutive patients hospitalised in the Pulmonology Department of the Temporary COVID Hospital in Poznan from 1 February 2021 to 31 March 2022. Upon admission to the department, the patients underwent a series of laboratory blood tests and high-resolution chest CT scan.</p><p><strong>Results: </strong>The study group included 282 patients, with an average age of 60.0 ± 15.0 years. In total, 54 (53%) patients of 101 requiring NIRS died from various causes or required intubation. Patients who required NIRS were significantly older and had more severe changes in the lung parenchyma. They had higher white blood cell and neutrophil counts and lower lymphocyte counts, as well as higher concentrations of D-dimer, CRP, PCT, and IL-6 and greater activities of LDH and AST.</p><p><strong>Conclusions: </strong>Laboratory tests and chest CT performed on hospital admission may be useful to rapidly identify patients at higher risk for severe disease.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Invasive Mechanical Ventilation on the Lung Microbiome.","authors":"Jose Luis Estela-Zape, Valeria Sanclemente-Cardoza, Maria Alejandra Espinosa-Cifuentes, Leidy Tatiana Ordoñez-Mora","doi":"10.3390/arm93040023","DOIUrl":"10.3390/arm93040023","url":null,"abstract":"<p><p>The lung microbiota is integral to maintaining microenvironmental homeostasis, influencing immune regulation, host defense against pathogens, and overall respiratory health. The dynamic interplay among the lung microbiota emphasizes their significance in shaping the respiratory milieu and potential impact on diverse pulmonary affections. This investigation aimed to identify the effects of invasive mechanical ventilation on the lung microbiome. <i>Materials and Methods</i>: A systematic review was conducted with registration number CRD42023461618, based on a search of PubMed, SCOPUS, and Web of Science databases, in line with the PRISMA guidelines. To achieve this, \"(mechanical ventilation) AND (microbiota)\" was used as the search term, replicable across all databases. The closing date of the search was 12 March 2025, and the evidence was scored using the MINORS scale. <i>Results</i>: A total of 16 studies were included, with patients aged 13.6 months to 76 years, predominantly male (64.2%). Common ICU admission diagnoses requiring invasive mechanical ventilation (IMV) included pneumonia, acute respiratory failure, and COVID-19. IMV was associated with reduced lung microbiota diversity and an increased prevalence of pathogenic bacteria, including <i>Prevotella</i>, <i>Streptococcus</i>, <i>Staphylococcus</i>, <i>Pseudomonas</i>, and <i>Acinetobacter</i>. The most frequently used antibiotics were cephalosporins, aminoglycosides, and penicillins. IMV-induced pulmonary dysbiosis correlated with higher infection risk and mortality, particularly in pneumonia and COVID-19 cases. Factors such as antimicrobial therapy, enteral nutrition, and systemic inflammation contributed to these alterations. <i>Conclusions</i>: Invasive mechanical ventilation has been associated with the development of alterations in the respiratory microbiome, resulting in reduced diversity of lung microorganisms.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697355","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":"The Comparative Effectiveness of Mepolizumab and Benralizumab in the Treatment of Eosinophilic Asthma.","authors":"Aleksandra Niemiec-Górska, Olga Branicka, Paula Olszewska, Sylwia Mielcarska, Joanna Glück, Barbara Rymarczyk, Radosław Gawlik","doi":"10.3390/arm93040021","DOIUrl":"https://doi.org/10.3390/arm93040021","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma is associated with significant morbidity and risk of complications. Some patients, suffering from eosinophilic asthma, may benefit from biological therapies, especially anti IL-5 (anti-interleukin-5). The purpose of the study was to compare the efficacy evaluation of mepolizumab and benralizumab in the treatment of eosinophilic asthma.</p><p><strong>Methods: </strong>A retrospective, single-centre study including 59 patients with severe eosinophilic asthma treated with biologics (mepolizumab and benralizumab). Clinical outcomes, including peripheral blood morphotic characteristics, spirometry parameters, asthma control questionnaire (ACQ), mini-Asthma Quality of Life Questionnaire (mini-AQLQ) scores, daily oral corticosteroid use, body mass index, exacerbation rate, and exercise tolerance, were examined at the beginning and after 6 months of biological treatment.</p><p><strong>Results: </strong>A total of 38 patients were treated with mepolizumab and 21 with benralizumab. Significant improvements (<i>p</i> < 0.05) in eosinophil count, required daily dose of glucocorticoids, ACQ, mini-AQLQ scores, and exacerbation rate were observed in both groups after six months of treatment. There was no statistical difference (<i>p</i> < 0.05) in the abovementioned parameters between the groups.</p><p><strong>Conclusions: </strong>In patients with severe eosinophilic asthma, mepolizumab and benralizumab were associated with significant improvements in clinical state. Patients with type 2 asthma will benefit from the therapy with both anti-IL5 biologic drugs.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938743","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":"Evaluating Obstructive Sleep Apnea Utilizing Arterial Tonometry in Individuals with Cystic Fibrosis.","authors":"Michelle Chiu, Bethany Bartley, Elizabeth Gootkind, Salma Batool-Anwar, Donald G Keamy, Thomas Bernard Kinane, Lael M Yonker, Kevin S Gipson","doi":"10.3390/arm93030020","DOIUrl":"10.3390/arm93030020","url":null,"abstract":"<p><p>Poor sleep quality and excessive daytime sleepiness are commonly reported by individuals with cystic fibrosis. The potential impact of comorbid sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), has not been extensively studied in the CF population. At present, there are no specific recommendations available to help clinicians identify patients with CF who are at increased risk of sleep disorders. Home sleep apnea testing using a validated peripheral arterial tonometry (PAT) device may offer an accurate diagnosis of OSA in a more convenient and low-cost method than in-lab polysomnography. In this single-center study of 19 adults with CF, we found an increased prevalence of OSA among individuals with CF compared to general population estimates. Although associations with an FEV < 70% predicted and a modified Mallampati score ≥ 3 were observed, these odds ratios did not reach statistical significance, likely reflecting limited power in this small pilot sample. There was no association found between the self-reported presence of nocturnal cough or snoring and OSA. We also found no association between OSA and abnormal scores on commonly used, validated sleep questionnaires, suggesting that CF-specific scales may be needed for effective screening in the CF clinic.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12189706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482878","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":"Harnessing Natural Product Compounds to Target Dormancy Survival Regulator (DosR) in Latent Tuberculosis Infection (LTBI): An In Silico Strategy Against Dormancy.","authors":"Mandeep Chouhan, Mukesh Kumar, Vivek Dhar Dwivedi, Vivek Kumar Kashyap, Himanshu Narayan Singh, Sanjay Kumar","doi":"10.3390/arm93030019","DOIUrl":"10.3390/arm93030019","url":null,"abstract":"<p><p>Dormancy occurs when <i>Mycobacterium tuberculosis</i> (Mtb) enters a non-replicating and metabolically inactive state in response to hostile environment. During this state, it is highly resistant to conventional antibiotics, which increase the urgency to develop new potential drugs against dormant bacilli. In view of this, the dormancy survival regulator (DosR) protein is thought to be an essential component that plays a key role in bacterial adaptation to dormancy during hypoxic conditions. Herein, the NP-lib database containing natural product compounds was screened virtually against the binding site of the DosR protein using the MTiopen screen web server. A series of computational analyses were performed, including redocking, intermolecular interaction analysis, and MDS, followed by binding free energy analysis. Through screening, 1000 natural product compounds were obtained with docking energy ranging from -8.5 to -4.1 kcal/mol. The top four lead compounds were then selected for further investigation. On comparative analysis of intermolecular interaction, dynamics simulation and MM/GBSA calculation revealed that M3 docked with the DosR protein (docking score = -8.1 kcal/mol, RMSD = ~7 Å and ΔG Bind = -53.51 kcal/mol) exhibited stronger stability than reference compound Ursolic acid (docking score = -6.2 kcal/mol, RMSD = ~13.5 Å and ΔG Bind = -44.51 kcal/mol). Hence, M3 is recommended for further validation through in vitro and in vivo studies against latent tuberculosis infection.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482879","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":"Medication Recommendation, Counseling, and Pricing for Nasal Sprays in German Community Pharmacies: A Simulated Patient Investigation.","authors":"Bernhard Langer, Christian Kunow, Tim Dethloff, Sarah George","doi":"10.3390/arm93030018","DOIUrl":"10.3390/arm93030018","url":null,"abstract":"<p><p>For the self-medication of nasal congestion following a common cold, decongestant nasal sprays can be recommended according to the medicine guidelines. In Germany, these are only available in community pharmacies (CPs) with free pricing. The aim was to analyze the medication recommendation, counseling, and pricing. A covert simulated patient study, internationally recognized as the \"gold standard\", was conducted in all CPs of two medium-sized cities in north-eastern Germany. Each CP was visited twice (86 visits) with the identical scenario by one female and one male simulated patient. At the beginning, they asked for a nasal spray and, when asked, stated that they had had nasal congestion for three days. Slightly more than half (54.7%, 47/86) of the recommended nasal sprays were free of preservatives. The median counseling score was 2.0 out of 8 points, with a significantly higher score observed for the female SP (<i>p</i> = 0.004). Information on the maximum intake duration of five days recommended in the German pharmacy guideline was not provided during any visits. The prices varied in total from EUR 1.95 to EUR 6.22. Therefore, measures by the legislator and the chambers of pharmacists are necessary to sustainably improve the medication recommendation, the counseling, and the price transparency.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482783","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}