Thoracic research and practice最新文献

{"title":"Validation and Reliability Assessment of the Test of Adherence to Inhalers (TAI) in Turkish Patients with Chronic Obstructive Pulmonary Disease (COPD).","authors":"Aylin Özgen Alpaydın, Elif Şen, Salih Yiğit, Derya Gökmen, Sibel Atış Naycı, Eylem Sercan Özgür, Demet Polat Yuluğ, Ahmet Melih Şahin, Elif Selçuk, Nurdan Köktürk, Ayshan Mammadova, Yelda Varol, Ayşe Baha, Funda Elmas, Alev Gürgün, İpek Çaylı Candemir, Mehmet Polatlı, İrem Şerifoğlu, Gaye Ulubay, Oya Baydar Toprak, Ali Kocabaş","doi":"10.4274/ThoracResPract.2026.2026-1-5","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-5","url":null,"abstract":"<p><strong>Objective: </strong>Accurate assessment of inhaler adherence is essential for optimizing treatment outcomes in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the validity and reliability of the Turkish version of the Test of Adherence to Inhalers (TAI) in a multicentre COPD cohort.</p><p><strong>Material and methods: </strong>A total of 277 patients were included. Sociodemographic characteristics and adherence status [assessed by the Turkish version of the Medication Adherence Report Scale-5 (MARS-5); <i>İlaç Uyumunu Bildirim Ölçeği</i> (İUBÖ)] were recorded. Construct validity was evaluated using confirmatory factor analysis (CFA), criterion validity was evaluated by agreement with İUBÖ using kappa statistics, and known-groups validity was evaluated by comparing the number of inhaler devices used. Reliability was assessed using Cronbach's alpha coefficients and item-total correlations.</p><p><strong>Results: </strong>The mean age was 66.3±8.3 years, 81.9% of participants were male. Most patients (73.6%) used at least two inhaler devices, and 28.9% were classified as non-adherent according to İUBÖ. Based on TAI scores, 43.3% of patients had good adherence, 23.8% had intermediate adherence, and 32.9% had poor adherence. CFA supported the two-factor structure of the TAI (Tucker-Lewis Index: 0.965; Comparative Fit Index: 0.972; Root Mean Square Error of Approximation: 0.114). Criterion validity was demonstrated by good agreement between TAI and İUBÖ (kappa: 0.637, <i>P</i> < 0.001). Patients using more than one inhaler device were more likely to be non-adherent according to the TAI-10 (<i>P</i> = 0.02). Internal consistency was high for both the 10- and 12-item versions (Cronbach's alpha >0.90), with item-total correlations indicating adequate reliability.</p><p><strong>Conclusion: </strong>The Turkish version of the TAI is a valid and reliable tool for assessing inhaler adherence in patients with COPD and is suitable for both clinical practice and research settings in Türkiye.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"280-286"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679303","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":"Reply: Artificial Intelligence in Respiratory Medicine: Epistemic Authority, Trust and Responsibility in Practice and in Training.","authors":"Umur Karan, Osman Elbek","doi":"10.4274/ThoracResPract.2026.2026-8-21","DOIUrl":"10.4274/ThoracResPract.2026.2026-8-21","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"341-342"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889689","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":"Subcutaneous Adipose Tissue Attenuation Change on Chest CT Is Associated with Overall Survival After Allogeneic Hematopoietic Stem Cell Transplantation.","authors":"Zeynep Atçeken, Taner Tan, Yüksel Peker","doi":"10.4274/ThoracResPract.2026.2026-3-7","DOIUrl":"10.4274/ThoracResPract.2026.2026-3-7","url":null,"abstract":"<p><strong>Objective: </strong>Early chest computed tomography (CT) examinations are frequently performed after allogeneic hematopoietic stem cell transplantation (allo-HSCT) due to respiratory symptoms or clinical deterioration. Subcutaneous adipose tissue attenuation (SATA) has recently been proposed as a quantitative imaging marker of systemic tissue alterations related to fluid redistribution and inflammatory processes. This study aimed to evaluate interval changes in SATA after allo-HSCT and to investigate their association with overall survival.</p><p><strong>Material and methods: </strong>In this retrospective single-center study, adult allo-HSCT recipients who underwent non-contrast chest CT both before transplantation and within 30 days after transplantation were included. SATA was measured in Hounsfield units (HU) using standardized circular regions of interest placed in the anterior chest wall. The interval change in attenuation Hounsfield units (ΔHU) was calculated as post-transplant minus pre-transplant values. Cox proportional hazards regression was used to assess the association between ΔHU and survival. Kaplan-Meier analysis was performed after dichotomization according to the median ΔHU value.</p><p><strong>Results: </strong>A total of 104 patients were included. SATA increased on early post-transplant CT compared with baseline (<i>P</i> < 0.001). Higher ΔHU values were associated with worse overall survival (hazard ratio per 5-HU increase: 1.18; 95% confidence interval: 1.03-1.35; <i>P</i> = 0.016). Patients with ΔHU above the median (16-HU) demonstrated significantly poorer survival compared with those below the median (log-rank <i>P</i> = 0.0003).</p><p><strong>Conclusion: </strong>SATA increases after allo-HSCT, and greater interval increases are associated with worse survival outcomes. Quantitative assessment of SATA may provide a simple, non-invasive imaging biomarker for early risk stratification in allo-HSCT recipients.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"287-293"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868345","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":"Clinical Characteristics and Treatment Outcomes After First <i>Achromobacter</i> Isolation in Children with Cystic Fibrosis (Pre-CFTR Modulator Era).","authors":"Şeyda Karabulut, Merve Selçuk Balcı, Mine Yüksel Kalyoncu, Aynur Gulieva, Mürüvvet Yanaz, Cansu Yılmaz Yeğit, Almala Pınar Ergenekon, Burcu Uzunoğlu, Gamze Taştan, Özgenur Demirkol, Ela Erdem Eralp, Yasemin Gökdemir, Ayşegül Karahasan, Fazilet Karakoç, Bülent Karadağ","doi":"10.4274/ThoracResPract.2026.2026-1-8","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-1-8","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to describe the clinical and demographic characteristics of children with cystic fibrosis (cwCF) diagnosed with a first <i>Achromobacter</i> (Ach) isolation, and to evaluate treatment outcomes at our CF center during the pre-modulator era.</p><p><strong>Material and methods: </strong>We retrospectively reviewed children followed at a single CF center (2014-2021) with at least four respiratory cultures per year and ≥12 months of follow-up after first Ach isolation. Eradication was defined as no Ach isolation for 12 months after the first detection; persistent infection was defined as intermittent or chronic isolation according to the Leeds criteria. We compared clinical characteristics and 12-month outcomes between the eradicated and non-eradicated groups.</p><p><strong>Results: </strong>Forty children were included; mean age at first isolation was 10.9±7.0 years, and eradication was achieved in 19/40 (47.5%). The non-eradicated group was older at first isolation (12.7±8.0 vs. 8.5±5.1 years; <i>P</i> = 0.04), had more pulmonary exacerbations (Pex) in the preceding year (median 4 vs. 2; <i>P</i> = 0.01), and more frequent prophylactic azithromycin use (67% vs. 21%; <i>P</i> = 0.01). Airway colonization patterns changed significantly over 12 months in the non-eradicated group (<i>P</i> < 0.001), with increased colonization by <i>Pseudomonas aeruginosa</i> (PA); changes were not significant in the eradicated group. Among those with available spirometry, 12-month forced expiratory volume in one second (FEV₁) z-scores did not differ by eradication status after adjustment for the baseline FEV₁ z-score.</p><p><strong>Conclusion: </strong>In this pre-cystic fibrosis transmembrane conductance regulator modulator study, persistence of Ach was associated with older age, higher Pex burden before first isolation, and clinically relevant shifts in airway microbiology, including increased PA colonization. Our findings suggest that cwCF with frequent exacerbations or a worsening clinical course may warrant closer attention to Ach, and eradication of Ach may be considered at first detection.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Smoking Cessation Clinics Reflect a Country's Tobacco Control Status? Trends in Electronic Cigarette Use Among Individuals Attending a Smoking Cessation Clinic: A Retrospective Analysis (2017-2023).","authors":"Ayşe Turan, Çiğdem Erhan, Pelin Duru Çetinkaya","doi":"10.4274/ThoracResPract.2026.2026-3-2","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-3-2","url":null,"abstract":"<p><strong>Objective: </strong>The increasing use of electronic cigarettes (e-cigarettes) has emerged as a significant challenge for tobacco control efforts. Despite legal restrictions in Türkiye, e-cigarette use is becoming increasingly widespread. This study aimed to assess annual trends in e-cigarette use, motivations for use, and supply patterns among individuals who visited a smoking cessation clinic between 2017 and 2023.</p><p><strong>Material and methods: </strong>This retrospective study included 7,140 individuals who visited a Smoking Cessation Clinic of a public hospital between January 1, 2017, and December 31, 2023. Annual trends in e-cigarette use, reasons for use, dual use characteristics, awareness of product content, and supply sources were analyzed using descriptive frequency analyses.</p><p><strong>Results: </strong>Overall, 13.1% of the participants (n = 935) reported using e-cigarettes before, during, or after their smoking cessation process. The annual prevalence of e-cigarette use has increased significantly over time, rising from 0.2% in 2017 to 39.9% in 2023. While the most frequently reported reason for use in 2017 was \"curiosity,\" the most common motivation in 2023 was \"the intention to quit smoking.\" Between 2017 and 2021, e-cigarettes were predominantly obtained through online shopping, while their availability from physical retail outlets increased in subsequent years. Although applications to smoking cessation clinics decreased over time, e-cigarette use and its use in enclosed spaces steadily increased.</p><p><strong>Conclusion: </strong>The significant increase in e-cigarette use among individuals applying to smoking cessation clinics between 2017 and 2023 indicates a worrying weakening of tobacco control efforts in Türkiye. The findings raise significant concerns about the societal normalization of e-cigarette use, increased accessibility through online and informal markets, and non-compliance with smoke-free environment policies.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Non-contrast Lung CT in Evaluating Pulmonary Cavitary Lesions in Children and Adolescents: With a Specific Focus in Perforated Hydatid Cyst, Necrotizing Pneumonia, and Lung Abscess.","authors":"Shokrollah Hafez Eftekhari, Anahita Azinfar, Masoud Mahdavi Rashed, Mahdi Abdollahi Karizno","doi":"10.4274/ThoracResPract.2026.2025-8-6","DOIUrl":"10.4274/ThoracResPract.2026.2025-8-6","url":null,"abstract":"<p><strong>Objective: </strong>Accurate diagnosis of pulmonary cavitary lesions in children is essential for effective treatment and prevention of complications. While chest X-rays are commonly used, they lack the precision needed for detailed lesion characterization. Non-contrast high-resolution computed tomography (CT) scans offer superior imaging capabilities, particularly for cavitary lesions, though their use in pediatric patients must be balanced against radiation exposure risks. This study evaluates the diagnostic utility of non-contrast CT in distinguishing among hydatid cysts, necrotizing pneumonia, and lung abscesses by incorporating both clinical and imaging data.</p><p><strong>Material and methods: </strong>Conducted as a cross-sectional study at Akbar Hospital (Mashhad University of Medical Sciences) from 2021 to 2023, the study included pediatric patients who presented with pulmonary symptoms and underwent non-contrast lung CT. Statistical analyses involved chi-square tests for categorical variables and t-tests or non-parametric equivalents for continuous data. Diagnostic metrics such as sensitivity, specificity, predictive values, and accuracy were calculated.</p><p><strong>Results: </strong>Key radiological features that identify necrotizing pneumonia with high sensitivity and specificity include irregular lesion borders and fully aerated lesions. Additional indicators, such as pleural effusion heterogeneity and pneumothorax, further enhanced diagnostic accuracy. Hydatid cysts were reliably diagnosed by the presence of floating membranes and associated cystic structures, each demonstrating 100% specificity. In contrast, lung abscesses lacked distinctive imaging features, underscoring the need for further research.</p><p><strong>Conclusion: </strong>Non-contrast CT is a valuable diagnostic tool for pediatric cavitary pulmonary lesions, particularly necrotizing pneumonia and hydatid cysts. The findings support the adoption of standardized imaging protocols to improve diagnostic precision and clinical outcomes.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"200-206"},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564078","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":"Working in Extreme Heat, an Invisible Occupational Risk: Legislation, Risk Management and Policy Recommendations for Türkiye: Turkish Thoracic Society Workshop Report on the Regulation of Working Conditions in Extreme Heat.","authors":"Sebahat Genç, Selin Çakmakcı Karakaya, Sabri Serhan Olcay, Mikdat Kadıoğlu, İstemi Ceysu Dinç Ütükler","doi":"10.4274/ThoracResPract.2026.2026-2-5","DOIUrl":"10.4274/ThoracResPract.2026.2026-2-5","url":null,"abstract":"<p><p>Extreme heat, amplified by climate change, has become a predictable and escalating occupational hazard in Türkiye, increasing the burden of heat-related illnesses, traumatic workplace injuries, and productivity losses among both outdoor and indoor workers, particularly in labor-intensive sectors and among vulnerable populations. This Turkish Thoracic Society workshop report synthesizes interdisciplinary expert input and available evidence to propose a practical, prevention-focused framework for regulating working conditions in extreme temperatures. The recommendations were systematically developed through four thematic interdisciplinary working groups and finalized by plenary consensus. Key recommendations include explicitly defining employers' duties to assess, prevent, and manage extreme weather-related risks within Occupational Health and Safety Law No. 6331; establishing secondary regulations that operationalize temperature/Wet-Bulb Globe Temperature (WBGT)-triggered work-rest schedules, hydration and cooling requirements, and acclimatization protocols; and standardizing objective heat-stress monitoring using the WBGT index (aligned with ISO 7243). The report prioritizes engineering and administrative controls (shading, ventilation/cooling, shift adjustments, rest areas, and \"buddy systems\") over reliance on personal protective equipment, and calls for strengthened labor inspection capacity \"through the lens of climate change.\" Additional policy actions include integrating heat-related outcomes into occupational disease and injury surveillance systems, enhancing inter-institutional coordination for rapid reporting and work-stoppage mechanisms during extreme heat events, and implementing multilingual, sector-specific training and emergency preparedness pathways. Protecting informal and migrant workers, seasonal agricultural laborers, and individuals with chronic cardiopulmonary disease is highlighted as a core priority for equity and climate justice.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"250-260"},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564051","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":"CT Histogram Analysis for Predicting Malignancy in Anterior Mediastinal Masses.","authors":"Nilay Çavuşoğlu Yalçın, Mustafa Yalçın, Okan Karataş","doi":"10.4274/ThoracResPract.2026.2025-11-4","DOIUrl":"10.4274/ThoracResPract.2026.2025-11-4","url":null,"abstract":"<p><strong>Objective: </strong>Anterior mediastinal masses encompass a broad spectrum from benign thymic hyperplasia to malignant thymomas and thymic complementary computed tomography (CT) histogram and texture analysis have emerged as complementary, non-invasive quantitative biomarkers for malignancy prediction. This study investigates whether CT histogram-derived parameters, particularly mean attenuation and first-order metrics, can differentiate benign from malignant anterior mediastinal masses to support preoperative risk stratification.</p><p><strong>Material and methods: </strong>We retrospectively analyzed data from 102 patients who underwent surgical resection of anterior mediastinal masses. Non-contrast CT scans were evaluated, and mean Hounsfield unit (HU), standard deviation, skewness, and kurtosis values were extracted using region-of-interest-based histogram analysis. Histopathological diagnosis is considered the gold standard for classification. Group comparisons were performed using appropriate parametric or non-parametric tests, and the diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Of the 102 patients, 60 (58.8%) had malignant and 42 (41.2%) had benign pathologies. The mean CT attenuation was higher in malignant lesions than in benign lesions (63.3±16.9 HU vs. 48.3±39.0 HU; <i>P</i> = 0.023), whereas the standard deviation was similar between the groups (<i>P</i> = 0.810). Skewness and kurtosis were higher in malignant lesions (<i>P</i> < 0.05), indicating denser and more peaked attenuation distributions. ROC analysis of mean HU demonstrated moderate discriminative performance (area under the curve: 0.64), with high sensitivity (96.7%) and limited specificity (50.0%).</p><p><strong>Conclusion: </strong>CT histogram analysis, particularly mean attenuation, may serve as a complementary biomarker for differentiating benign from malignant anterior mediastinal masses. Given its high sensitivity but limited specificity, it should be used as an adjunct to clinical and morphologic assessment rather than as a determinant of surgical management. Prospective validation incorporating volumetric and advanced radiomic parameters is required.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"229-234"},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438322","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":"Reply Letter to the Editor: Free Large Language Model-based Chatbots Can Help to Align Statistical Tests with the Study Design and Avoid Pseudo-replication.","authors":"Ömer F Karakoyun, Halil E Koyuncuoğlu, Ömer H Sağnıç, Mehmed E Özdemir, Yalçın Gölcük, Birdal Yıldırım","doi":"10.4274/ThoracResPract.2026.2026-6-15","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-15","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 4","pages":"266-267"},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581584","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":"Erratum.","authors":"","doi":"10.4274/ThoracResPract.2026.e001","DOIUrl":"10.4274/ThoracResPract.2026.e001","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 4","pages":"268"},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581576","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}