Maedica最新文献

{"title":"Gastric Juice Biomarkers in Gastric Cancer: New Trends?","authors":"Georgios D Lianos, Gerasimia D Kyrochristou, Aikaterini D Lianou, Vasileios Tatsis, Dimitrios Schizas, Konstantinos Vlachos, Michail Mitsis","doi":"10.26574/maedica.2024.19.4.775","DOIUrl":"10.26574/maedica.2024.19.4.775","url":null,"abstract":"<p><p>As gastric cancer represents the fifth most common cancer diagnosis and the third leading cause of cancer death worldwide, it remains a current social and health issue. A variety of genetic, epigenetic and environmental factors contribute to the development of gastric cancer, although the etiology remains unclear. Timely diagnosis and appropriate treatment play the most crucial role not only in the containment of morbidity and mortality but also in the prognosis. The establishment of novel non-invasive biomarkers into patient management protocols represents a very promising and challenging approach. In this article, we focus on gastric cancer biomarkers with a special interest in gastric juice that may represent a novel, non-invasive, cost-effective 'liquid biopsy'.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"775-779"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461105","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":"Early Prediction of ABO HDN Using Immuno-Hematological and Biochemical Tests.","authors":"Dnyaneshwar Patale, Jayashree Sharma, Charusmita Modi, Swarupa Bhagwat","doi":"10.26574/maedica.2024.19.4.711","DOIUrl":"10.26574/maedica.2024.19.4.711","url":null,"abstract":"<p><strong>Objective: </strong>ABO hemolytic disease of the newborn (ABO HDN) is the most common cause of neonatal jaundice due to feto-maternal incompatibility. The objective of this study is to evaluate early predictors of ABO HDN using immuno-hematological and biochemical tests.</p><p><strong>Materials and methods: </strong>Newborns with blood group A/B born to group O mothers were prospectively enrolled in the present study. Direct antiglobulin test (DAT) and cord blood bilirubin (CBB) were performed. Total serum bilirubin (TSB) was measured at 72 hours of life. Serum anti-A/B IgG titers of maternal samples were measured. For the statistical analysis, Microsoft Excel 2013 (Microsoft Corporation, NY, USA) and SPSS statistical computer software (version 22) were used. To find the efficacy and cut-off values for various predictors of neonatal jaundice, receiver operating characteristic (ROC) curve analysis was performed. To evaluate the relative importance of predictors for phototherapy (PT), logistic regression was used.</p><p><strong>Results: </strong>A total of 200 ABO incompatible mother-neonate pairs were included in the present study. The incidence of ABO HDN was 10% (n=20). The number of DAT positive cases was 38 (19%). Regression analysis showed a significant influence of antibody titre, CBB and DAT on probability of phototherapy. Antibody titers ≥512 predicted severe hyperbilirubinemia with 80% sensitivity and 83% specificity; CBB ≥2.75 mg/dL had 85% sensitivity and 83% specificity.</p><p><strong>Conclusion: </strong>High risk ABO-incompatible neonates could be identified at birth using maternal antibody titers, DAT and CBB. Early diagnosis with enhanced surveillance will help in optimum utilization of healthcare.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"711-717"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461114","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":"Psychosomatic Dimensions of Rhinoplasty and Their Role in Quality of Life and Self-Care.","authors":"Aikaterini D Lianou, Elena Dragioti, Stefanos Mantzoukas, Mary Gouva","doi":"10.26574/maedica.2024.19.4.836","DOIUrl":"10.26574/maedica.2024.19.4.836","url":null,"abstract":"<p><p>Rhinoplasty, one of the most prevalent facial plastic surgeries, bears both functional and aesthetic import. This literature review examined the psychosomatic dimensions of rhinoplasty and their influence on patients' quality of life and self-care. Rhinoplasty, whether undertaken alone or in conjunction with septoplasty, is intricate and technically demanding, with success being largely contingent upon psychosomatic factors. The popularity of rhinoplasty has burgeoned due to augmented social acceptance and media exposure. Postoperative psychological outcomes vary, with dissatisfaction being frequently linked to pre-existing psychopathology. Men often exhibit higher levels of psychopathology and are less satisfied after surgery comparatively to women. Prudent patient selection, realistic expectations and psychological screening are imperative for successful outcomes. Rhinoplasty affects individuals of all ages, from adolescents to the elderly, with involving unique concerns and benefits. Patient satisfaction hinges on factors such as gender, age, education, culture, ethnicity, occupation, economic profile, psychological profile and expectations. The use of patient reported outcome measures (PROMs) is indispensable for evaluating the health-related quality of life and psychosocial changes following rhinoplasty. Comprehending these dimensions is crucial for enhancing patient satisfaction and ensuring successful outcomes.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"836-841"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460886","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":"Updates in Head and Neck Oncology - Current Knowledge and Future Horizons.","authors":"Camil Ciprian Mirestean, Roxana Irina Iancu, Dragos Petru Teodor Iancu","doi":"10.26574/maedica.2024.19.4.796","DOIUrl":"10.26574/maedica.2024.19.4.796","url":null,"abstract":"<p><p>Treatment for head and neck recurrent/metastatic squamous cell carcinoma (HNSCC) with immune checkpoint inhibitors has now become the new therapeutic standard, primarily replacing the EXTREME and TPex protocols that included the EGFR inhibitor Cetuximab and chemotherapy. Even if there are considerable advances in therapeutic results, less than 20% of patients with this stage of the disease survive more than four years. These results demonstrate the need to identify more effective therapies beyond simple PD1/PD-L1 blockade. Antibody-drug conjugates (ADC), vaccines, bispecific kinase inhibitors and fusion proteins involving the modulation of the tumor microenvironment are strategies to be exploited in the future. Also, in locally advanced cancers, the results of combining immunotherapy with chemoradiation treatment did not give the expected results. The use of other therapeutic sequences, including immunotherapy in association with neo-adjuvant chemotherapy, but also the association with mTOR inhibitors are also evaluated in clinical trials. We propose to present some new directions in the therapies of locally advanced relapsed or metastatic HNSCC.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"796-800"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460974","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":"Pregnancy Outcomes in Women with Multiple Sclerosis Who Had Exposure to Ocrelizumab: a Systematic Review of the Literature.","authors":"Zahra Shahraki, Ali Zarrinnia, Fariba Askari, Mohsen Rastkar, Mahsa Ghajarzadeh","doi":"10.26574/maedica.2024.19.4.823","DOIUrl":"10.26574/maedica.2024.19.4.823","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the pooled prevalence of pregnancy-related issues in women who were exposed to Ocrelizumab before or during pregnancy.</p><p><strong>Methods: </strong>PubMed, Scopus, EMBASE, Web of Science, Google Scholar, references and conference abstracts were comprehensively searched by two independent researchers. The search was conducted on 1 June 2023.</p><p><strong>Results: </strong>A literature search revealed 320 records, of which 44 full-texts were evaluated and only five studies remained for the systematic review, among which one study was conducted in Australia, one in the United States, one in Canada and one in the United Kingdom. All eligible studies were conducted between 2017 and 2022. They included a number of patients ranging from 12 to 608, and totalized 1 305 participants and 1 306 pregnancies. The pooled prevalence of term delivery was 46% (95% CI 31-61%) (I²=94.5%, P<0.001). The pooled prevalence of abortion was 9% (95% CI 4-14%) (I²=80%, P<0.001). Three studies reported on the number of ectopic pregnancies. The pooled prevalence of ectopic pregnancies was 5% (95% CI 2-4%) (I²=60%, P<0.001). The pooled prevalence of major congenital malformations was 2% (95% CI 1-3%) (I²=0).</p><p><strong>Conclusions: </strong>The results of this systematic review show that exposure to Ocrelizumab during conception is not associated with a higher frequency of preterm deliveries or major malformations.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"823-828"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460697","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 Investigation of Hearing Loss in Patients with Thalassemia Major Referred to Hazrat Ali Asghar (AS) Hospital in Sistan and Baluchistan Province (Iran).","authors":"Gholam-Ali Dashti Khavidaki, Reza Gharibi, Majd Naderi, Hossein Sedaghatkia","doi":"10.26574/maedica.2024.19.4.731","DOIUrl":"10.26574/maedica.2024.19.4.731","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing disorders are one of the major complications in patients with thalassemia major. Therefore, the purpose of this research is to investigate hearing loss in patients with thalassemia major referred to Hazrat Ali Asghar Hospital in Sistan and Baluchistan province, Iran.</p><p><strong>Methods: </strong>This cross-sectional descriptive study was conducted on 56 patients with thalassemia major who were referred to Ali Asghar Hospital in 2021-2022 and met the inclusion criteria into the present research. After obtaining the written consent of all participants, they underwent an audiometry test and were further examined. All information was collected in the researcher-made questionnaire and was analyzed using SPSS version 24 software.</p><p><strong>Results: </strong>Among the 56 eligible patients, 11 subjects (19.6%) had hearing loss. In terms of age, there was no statistically significant difference in hearing loss (P<0.05). Among the 11 patients with hearing loss, one patient (9.1%) had conductive hearing loss, three patients (27.3%) had sensorineural hearing loss, one patient (9.1%) had mixed hearing loss and six patients (54.5%) had hearing loss at frequencies above 5000 Hz. In terms of gender, there was no statistically significant difference in hearing loss. The average duration of Desferal in patients with hearing loss was significantly longer than other subjects (P<0.05).</p><p><strong>Conclusion: </strong>To prevent and treat hearing complications caused by thalassemia, regular and periodic hearing screening of all thalassemia patients is recommended.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"731-735"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460965","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":"Relationship of Right and Left Bundle Branch Blocks to Mortality in COVID-19 Patients Hospitalized in the Intensive Care Unit: a Descriptive-Analytical Retrospective Study.","authors":"Seyed Ahmad Raza Salim Bahrami, Bassam Alshargabi, Mohammad Mehdi Monajem, Nasrin Jiryaei, Behrouz Karkhanei","doi":"10.26574/maedica.2024.19.4.726","DOIUrl":"10.26574/maedica.2024.19.4.726","url":null,"abstract":"<p><strong>Background: </strong>COVID-19, in addition to affecting the respiratory system, exerts an impact on various extrapulmonary organs, including the cardiovascular system. This influence may lead to hospitalization in the intensive care unit (ICU) and even mortality. This study aimed to investigate the relationship of right and left bundle branch blocks (RBBB and LBBB) to mortality in COVID-19 patients admitted to the ICU.</p><p><strong>Methods: </strong>This descriptive-analytical retrospective study examined 650 COVID-19 patients hospitalized in the ICU of Sina Hospital in Hamadan, Iran, during the fifth peak of the pandemic. Patients were initially categorized into two groups. Data were collected using a researcher-designed checklist that included demographic and clinical information, such as age, gender, smoking history, underlying medical conditions, initial electrocardiogram findings on admission (specifically the presence of RBBB or LBBB) and final outcomes (survival or mortality). Data analysis was conducted using SPSS software, at a significance level of 0.05.</p><p><strong>Results: </strong>Among the 650 COVID-19 patients with a mean age of 60.55 ± 17.22 years, 24 subjects had RBBB and 20, LBBB. Among the 161 subjects who did not survive, 11 (6.8%) had RBBB and six (3.7%) LBBB. A significant association between RBBB and mortality in COVID-19 patients was found (P=0.049). Right bundle branch blocks were also significantly associated with underlying medical conditions (P=0.034) and smoking history (P=0.031).</p><p><strong>Conclusion: </strong>Electrocardiography (ECG) is a valuable tool in predicting the severity of COVID-19 and patient mortality. The presence of RBBB is associated with higher mortality rates in COVID-19 patients. Therefore, ECG can serve as a valuable diagnostic tool both upon admission and during hospitalization.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"726-730"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460893","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 Role of Self-Esteem in the Adherence of Patients with Obstructive Sleep Apnea Syndrome to Continuous Positive Airway Pressure Therapy.","authors":"Romica Burcea, Florin Dumitru Mihaltan","doi":"10.26574/maedica.2024.19.4.704","DOIUrl":"10.26574/maedica.2024.19.4.704","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous positive airway pressure therapy (CPAP) is the gold standard for the treatment of obstructive sleep apnea syndrome (OSAS). This therapy eliminates daytime sleepiness and prevents cardiovascular complications of OSAS. Given that CPAP is a chronic therapy and that in most cases it must be used for life, good adherence to treatment is essential for the patient to feel its benefits. Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Self-esteem (SE) can be defined as a person's positive or negative attitude toward the self in totality.</p><p><strong>Materials and methods: </strong>We conducted a prospective, observational, non-randomized study on an essay of 380 observations with 95 patients. After the evaluation period, based on the average time of CPAP used, the patients were divided into two groups: a first group consisting of 50 patients who were considered adherent to the instituted therapy and a second group comprising 45 patients who were considered non-adherent to the instituted therapy. The aim of this article is to assess the role of self-esteem in the adherence of patients with OSAS to CPAP therapy. Determinants of self-esteem at the beginning of treatment (To) were evaluated. The secondary objectives of the study consisted of investigating the existence of other predictors for the evolution of OSA such as self-esteem and clinical/demographic/paraclinical parameters.</p><p><strong>Results: </strong>In the present study, the adherence of patients with OSAS to CPAP therapy was 52.63%. The self-esteem score was higher in adherent patients than non-adherent ones. The main factors associated with increased self-esteem levels included good adherence to therapy, education, patient income, absence of alcohol and tobacco consumption, absence of nocturnal symptoms, use of Auto-CPAP, use of nasal mask, absence of other pulmonary pathology, absence of psychological type D.</p><p><strong>Conclusions: </strong>Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Along with other factors, self-esteem may be one of the predictive factors for patients' adherence to CPAP therapy.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"704-710"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460971","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":"Assessment of the Attitude, Anxiety Episodes and Perceived Psychological Impact of the Pandemic on Medical Undergraduate Students - a Retrospective Study.","authors":"Priti Chaudhary, Apurba Patra, Anjali Singal, Kamal Kumar Arora","doi":"10.26574/maedica.2024.19.4.750","DOIUrl":"10.26574/maedica.2024.19.4.750","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has caused widespread public concern and stress, particularly among medical undergraduates, who faced heightened anxiety due to the uncertainty of the disease resurgence. This study aimed to assess the knowledge, attitudes, anxiety experiences and perceived mental healthcare needs of undergraduate medical students in India through an online multicentric survey.</p><p><strong>Methods: </strong>A semi-structured pilot-tested questionnaire was administered online via Google Forms and distributed through social media platforms. The survey was carried out over a period of three months during the pandemic (2020-2021). Students were given five days to respond and incomplete or late submissions were excluded. Data were collected and analyzed using MS Excel and appropriate statistical tests, with a significance level of 0.05.</p><p><strong>Results: </strong>Out of all respondents to the survey, 55.3% reported frequently thinking about the pandemic, while 5.9% were always paranoid about infection. Social contact avoidance was common, with 40.5% of respondents always avoiding contact and 36.3% avoiding large gatherings. Sleep disturbances were reported by 16.9% occasionally and 3.8% regularly. Social media posts about COVID-19 affected 56.1% of participants. Notably, 62.4% expressed a desire to discuss pandemic-related worries and 85.2% acknowledged the need for mental health support during periods of heightened panic. Most respondents (86.5%) agreed that mental health professionals should assist in managing pandemic-related stress.</p><p><strong>Conclusion: </strong>The study highlights significant psychological impacts of COVID-19 on medical students, with emphasizing the need for targeted mental health interventions. Raising awareness and providing accessible mental health resources are crucial to addressing their needs, particularly as the threat of new COVID-19 variants persists. Studying mental health impacts across diverse populations will aid in planning effective strategies for broader pandemic-related mental health challenges.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"750-755"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461010","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":"Evaluation of Clinicopathological Features in Breast Cancer Patients Using Cytonuclear Morphometry.","authors":"Simona Alina Duca-Barbu, Alexandru Adrian Bratei, Daniel Cristi Nicu Banica, Maria Sajin, Florinel Pop, Tiberiu Augustin Georgescu, Antonia Carmen Georgescu","doi":"10.26574/maedica.2024.19.4.677","DOIUrl":"10.26574/maedica.2024.19.4.677","url":null,"abstract":"<p><p>As breast cancer is one of the leading causes of death worldwide, we aim to correlate cytonuclear morphometric parameters with clinicopathological features in order to emphasize their importance to prognostication. Following the pathological processing of tumor specimens, representative areas throughout the tumor mass were selected. These areas have been scanned using an Olympus VS200 slide scanner and analyzed using QuPath v0.4.4. Nine cytonuclear morphometric parameters have been calculated and correlated with clinicopathological features. P values were determined through regression analysis and a p-value <0.05 was considered significant. Many significant correlations have been obtained between cytonuclear morphometric parameters and clinicopathological features. There have been elaborated mathematical criteria-based algorithms by selecting cut-off values for tubular differentiation score, nuclear pleomorphism score, mitotic rate score, Nottingham score, lymph node status, lymphovascular invasions, perineural invasion, presence of necrosis, presence of in situ carcinoma and presence of microcalcifications. The cytonuclear morphometric parameters show great promise for prognostication in breast cancer patients, as many of them were significantly correlated with clinicopathological features. The values of these parameters have allowed the development of algorithms to predict these features.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"677-683"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461020","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}