Annals of Medicine and Surgery最新文献

{"title":"Virtual reality as a transformative tool in pain management.","authors":"Rahmah Zafar Masood, Muneeba Ali, Syeda Faiqa Manzoor, Emad Uddin Sajid, Humaira Kalam","doi":"10.1097/MS9.0000000000003630","DOIUrl":"10.1097/MS9.0000000000003630","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5368-5369"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991376","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 prognostic values of monitoring changes in coagulative, inflammatory, and blood chemistry markers in COVID-19 patient's before and during admission to ICU: a retrospective cohort study.","authors":"Amer Hashim Al Ani, Gabriel Andrade, Yara Elsherbiny, Afiya Walid Zaynob, Mesk Alhammadi, Kowthar Forsat, Vidya Jakapure","doi":"10.1097/MS9.0000000000003600","DOIUrl":"10.1097/MS9.0000000000003600","url":null,"abstract":"<p><strong>Introduction: </strong>The infection caused by the COVID-19 virus is associated with thromboembolic events and severe inflammatory reactions, significantly impacting the prognosis of infected patients. Numerous studies have indicated that COVID-19 patients often exhibit a hypercoagulable state, disseminated intravascular coagulation, and overwhelming inflammation, particularly in critically ill patients with multiple comorbidities requiring admission to the ICU. This study aims to assess the prognostic significance of alterations in coagulation, inflammatory, and blood chemistry markers in COVID-19 patients both before and during admission to the ICU.</p><p><strong>Methods: </strong>Study design and population: This retrospective observational cohort study was conducted from March 2020 to July 2021 at a single center, including 90 adult patients with confirmed COVID-19 infection requiring ICU admission. Patients were divided into two groups: survivors (<i>n</i> = 42) and non-survivors (<i>n</i> = 48). The median age of non-survivors was 48.5 years (BMI 26-40), while survivors had a median age of 54 years (BMI 23-35). All participants received uniform supportive therapy comprising endotracheal intubation, anticoagulation (low molecular weight heparin or unfractionated heparin), aspirin, and steroids. No antiviral therapy was administered. Inclusion criteria encompassed adult COVID-19-positive patients requiring ICU admission. Exclusion criteria included pediatric patients, adult COVID-19 patients not admitted to the ICU, and Intensive Care Unit (ICU) patients without COVID-19 infection. Data collection: Demographic data (age, gender, comorbidities) and laboratory parameters (D-dimer, lactate dehydrogenase [LDH], procalcitonin, prothrombin time, platelet count, ferritin, C-reactive protein [CRP], glucose, and creatinine) were extracted from electronic medical records at three time points: ICU admission, shortly after treatment initiation, and at discharge or death. Statistical analysis: A total of 94 patients were initially assessed; three were excluded due to incomplete data, yielding a final cohort of 91 patients. Missing data for certain variables were imputed using the median of respective variables. Given the non-normal distribution of most laboratory markers, non-parametric statistical tests were applied. Paired Wilcoxon signed-rank tests were used to compare biomarker medians between admission and subsequent time points. Mann-Whitney <i>U</i> tests were employed to evaluate differences between survivors and non-survivors. All tests were two-tailed with a significance threshold set at <i>P</i> ≤ 0.05. Analyses were performed using Jamovi software.</p><p><strong>Results: </strong>Baseline characteristics: A total of 91 patients were included in the final analysis, comprising 42 survivors (36 males [83.7%], 6 females [16.3%]; median age 54 years [Interquartile Range (IQR): 49-59]; Body Mass Index (BMI) range 23-35) and 48 non-survivo","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5401-5408"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991164","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":"Cyclosporine eye drops in lattice corneal dystrophy type 1: case report.","authors":"Hasan Al-Hawasli, Raghid Tarbouche","doi":"10.1097/MS9.0000000000003625","DOIUrl":"10.1097/MS9.0000000000003625","url":null,"abstract":"<p><strong>Introduction and importance: </strong>To report a successful treatment of lattice corneal dystrophy type 1 (LCD1) using topical cyclosporine (CsA) eye drop emulsion 0.05%.</p><p><strong>Case presentation: </strong>A 48-year-old female patient presented with bilateral LCD1characterized by corneal stromal lattice lines and visual symptoms. The patient was treated with topical CsA 0.05% twice daily for 3 months, followed by once daily for another 3 months.</p><p><strong>Clinical discussion: </strong>Following treatment, the patient experienced a significant improvement in symptoms and resolution of corneal opacities in the treated eye.</p><p><strong>Conclusion: </strong>This case report demonstrates the potential efficacy of topical CsA as a novel treatment option for LCD1, offering a noninvasive approach to manage symptoms and improve visual function. Further studies are needed to confirm these findings.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6127-6130"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990959","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 17-year-old female with Down syndrome and Crohn's disease: a rare case report from Syria.","authors":"Muhammed Khaled Al Hamad, Mohammad Abdullah Kokash, Samah Khirou Ismaeil, Abdulrahman Ahmad Othman, Raneem Alrehani, Hussein Fares Hussein, Bassam Abdul Muttalib ALHameed, Alhareth Hassan Alghabra, Baraa Mustafa Boulad, Eyas Issam Idrees, Bilal Sleiay, Mouhammed Sleiay","doi":"10.1097/MS9.0000000000003627","DOIUrl":"10.1097/MS9.0000000000003627","url":null,"abstract":"<p><strong>Introduction: </strong>Down syndrome (DS) affects 1 in 787 live births, linked to congenital anomalies and intellectual impairment. Colorectal Crohn's disease is prevalent in DS patients, presenting with fatigue, abdominal pain, and strictures, often treated with surgery, immunomodulators, and biotherapy for management.</p><p><strong>Case presentation: </strong>The patient presented with symptoms of abdominal pain, cramping, and significant bowel sounds, along with weight loss and a decreased appetite. Histopathological examination and upper endoscopy were used to diagnose the condition, and a gluten-free dietary treatment was implemented.</p><p><strong>Clinical discussion: </strong>Crohn's disease can be diagnosed by several methods, including histopathology, and its treatment can involve various approaches, including dietary management. There is a connection with genetic diseases, and it is not necessary for all symptoms and signs of the disease to appear, as they often vary.</p><p><strong>Conclusion: </strong>DS with Crohn's disease is considered a very rare condition, especially in low-income countries and at a young age. It should be taken into account when differentiating diagnoses in autoimmune and intestinal diseases.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6057-6060"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991245","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":"Dandy-Walker spectrum with bilateral optic atrophy and seizure disorder: a case report and literature review.","authors":"Bipesh Kumar Shah, Karun Bhattarai","doi":"10.1097/MS9.0000000000003554","DOIUrl":"10.1097/MS9.0000000000003554","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Dandy-Walker syndrome (DWS) is a rare congenital posterior fossa malformation, affecting 1 in 25 000-30 000 live births. Prenatal diagnosis is possible via ultrasound and MRI. This case highlights a rare Dandy-Walker variant with bilateral optic atrophy and status epilepticus, emphasizing the need for awareness of progressive neurological and visual impairment in Dandy-Walker spectrum disorders. The case adds to the evolving knowledge on the diverse phenotypic presentations of the Dandy-Walker variant, particularly in resource-limited settings where diagnostic and therapeutic interventions may be constrained.</p><p><strong>Case presentation: </strong>A 27-month-old female with recurrent seizures since infancy presented with generalized tonic-clonic movements, ocular deviation, and frothing, lasting 2 h. Examination revealed fever, tachycardia, tachypnea, and hypertonia. MRI at 5 months confirmed Dandy-Walker spectrum disorder with cerebellar vermis hypoplasia, a posterior fossa cyst, and fourth ventricle malformation. Electroencephalogram at 14 months showed diffuse encephalopathy with multifocal seizures, and fundoscopy revealed bilateral optic atrophy. TORCH (toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV) screening was unremarkable. Despite antiseizure therapy with levetiracetam and phenytoin, persistent seizures required pediatric intensive care unit admission. Valproate (15 mg/kg/day, titrated to 20 mg/kg/day) achieved seizure control.</p><p><strong>Clinical discussion: </strong>This case underscores the complexity of Dandy-Walker spectrum disorder with status epilepticus in a 27-month-old female. No infectious source was identified, and lumbar puncture was declined. Seizure control required escalation of antiseizure therapy. Long-term neurodevelopmental, genetic, and neurometabolic evaluation is crucial for comprehensive management.</p><p><strong>Conclusion: </strong>This case highlights the need for long-term neurodevelopmental, genetic, and neurometabolic evaluation for comprehensive management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"5283-5287"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815630","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":"Comment on the use of bronchoscopy in the postoperative management of lung cancer patients.","authors":"Syed Ibraheem Ul Hassan Ramzi, Syed Hameed-Ul-Hassan Shah, Hooria Ahmad Qureshi, Huzafa Ali, Ajay Pandeya","doi":"10.1097/MS9.0000000000003632","DOIUrl":"10.1097/MS9.0000000000003632","url":null,"abstract":"<p><p>Zhang <i>et al</i>. explore \"Effectiveness of bronchoscopy-assisted postoperative respiratory management in patients with lung cancer and impaired cough strength\" in a high-risk population. The study is clinically relevant, but its sample size and lack of standardized objective assessments decrease its generalizability and reproducibility. The study discusses different interventions for respiratory clearance. The study discusses various interventions for respiratory clearance. However, the inclusion of noninvasive airway clearance techniques (e.g., physiotherapy or mechanical exsufflation) and bronchoscopy, guided by standard clinical guidelines and protocols, particularly for patients with neuromuscular conditions such as post-polio syndrome, could improve its clinical effectiveness. The study reported that 25% of patients had atelectasis because they did not get effective respiratory rehabilitation, which questions the effectiveness of the intervention on its own. These are gaps and limitations; thus, further studies that use standard guidelines and well-compared approaches are needed to benefitclinical practice.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6226-6227"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991254","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":"Effect of Sheng Xuexiaoban capsules on Tregs in an ITP mouse model.","authors":"Jianqiang Liu, Xiaoyan Li, Shenggui Hou, Aixia Dou","doi":"10.1097/MS9.0000000000003572","DOIUrl":"10.1097/MS9.0000000000003572","url":null,"abstract":"<p><strong>Objectives: </strong>To study the effect of Sheng Xuexiaoban capsules (SXXCs) on restoring immune dysfunction in ITP model mice.</p><p><strong>Methods: </strong>We assessed changes in platelet counts, megakaryocyte counts, Treg functions, interleukin-2 expression, and other indicators to investigate the effect of SXXCs in the ITP mouse model.</p><p><strong>Results: </strong>After treatment of the ITP mouse model with SXXCs, we found increases in platelets (577.35 ± 76.94 vs. 123.33 ± 16.24, <i>P</i> < 0.05) and the Treg number (7.35 ± 1.94 vs. 1.33 ± 1.24), and Foxp3 mRNA expression (2^-ΔCt: 0.2493 ± 0.03102 vs. 0.683 ± 0.05774, <i>P</i> = 0.0027). Decreased interleukin-2 produced by effector T cells was detected (2^-ΔCt: 0.6119 ± 0.01173 vs. 2.838 ± 0.1004, <i>P</i> < 0.001). SXXCs treatment significantly improved the proportion and function of Tregs. By increasing Foxp3 mRNA expression and decreasing interleukin-2, we restored immune tolerance to achieve a good therapeutic effect in ITP model mice.</p><p><strong>Conclusions: </strong>We confirmed that SXXCs have a good therapeutic effect on ITP. Simultaneously we verified the important role of Tregs in ITP pathogenesis.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 8","pages":"4848-4852"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815636","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":"Efficacy and safety of tafolecimab in Chinese patients with familial hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials.","authors":"Alaa Ramadan, Ravindra Reddy Gangavarapu, Hina Aziz, Akshat Sinha, Shubh Mehta, Nathan Ezie Kengo","doi":"10.1097/MS9.0000000000003623","DOIUrl":"10.1097/MS9.0000000000003623","url":null,"abstract":"<p><strong>Background: </strong>Familial hypercholesterolemia (FH) is a prevalent inherited disorder marked by elevated low-density lipoprotein cholesterol (LDL-C) levels, predisposing individuals to premature cardiovascular disease and related morbidities. Traditional treatments often fail to achieve target LDL-C levels in many patients, necessitating novel therapies. Tafolecimab, a monoclonal antibody targeting PCSK9, shows promise in managing HeFH by enhancing LDL receptor recycling and LDL-C clearance.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of tafolecimab in Chinese patients with FH through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>This meta-analysis followed PRISMA guidelines and was registered in Prospective Register of Systematic Reviews. A comprehensive search was conducted across PubMed/MEDLINE, Web of Science, Scopus, and Embase databases. Inclusion criteria focused on randomized controlled trials (RCTs) involving patients aged 18-75 with hypercholesterolemia and high cardiovascular risk. Data extraction and quality assessment were performed independently by two reviewers. Statistical analyses were conducted using random-effects models.</p><p><strong>Results: </strong>Four RCTs involving 841 Chinese patients were included. Tafolecimab significantly reduced LDL-C (mean difference [MD]: -2.05; 95% CI: -2.19 to -1.90), apolipoprotein levels (MD: -0.53; 95% CI: -0.56 to -0.50), non-HDL-C (MD: -2.19; 95% CI: -2.32 to -2.06), and lipoprotein(a) levels (MD: -0.09; 95% CI: -0.11 to -0.07). The incidence of adverse events was higher in the tafolecimab group (risk ratio: 0.68; 95% CI: 0.61, 0.75), but no significant differences were found in serious adverse events, treatment discontinuation due to adverse events, deaths, hypersensitivity, muscle-related problems, upper respiratory issues, or liver damage compared to placebo.</p><p><strong>Conclusion: </strong>Tafolecimab effectively reduces various lipid parameters, suggesting its potential in managing hypercholesterolemia and reducing cardiovascular risk. Although adverse events were more frequent, their severity did not significantly differ from placebo. The generalizability of these findings is limited to Chinese populations, highlighting the need for further research in diverse cohorts.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5990-5998"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991151","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":"Artificial intelligence in mental health: integrating opportunities and challenges of multimodal deep learning for mental disorder prevention and treatment.","authors":"Mohammad Narimani, Mahdi Naeim","doi":"10.1097/MS9.0000000000003624","DOIUrl":"10.1097/MS9.0000000000003624","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI), through multimodal deep learning and predictive analytics, holds transformative potential in the prevention and treatment of mental disorders. This study explores the opportunities and challenges of these technologies.</p><p><strong>Objective: </strong>To present a conceptual framework for the responsible application of AI in mental health care.</p><p><strong>Methods: </strong>This integrative review analyzed selected sources from Google Scholar up to June 2025. Both qualitative and quantitative analyses were conducted to identify opportunities and challenges.</p><p><strong>Results: </strong>Key opportunities include early detection, personalized treatment, and enhanced access to mental health services. Major challenges involve ethical concerns, algorithmic bias, and data quality issues.</p><p><strong>Conclusion: </strong>AI can revolutionize mental health care, but it requires standardization and regulatory oversight. Future research should focus on addressing ethical dilemmas and improving data quality.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5757-5761"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991239","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 regulatory T cells in infant HIV pathogenesis: therapeutic strategies.","authors":"Emmanuel Ifeanyi Obeagu, Raajasiri Iyengar","doi":"10.1097/MS9.0000000000003631","DOIUrl":"10.1097/MS9.0000000000003631","url":null,"abstract":"<p><p>Regulatory T cells (Tregs) are pivotal in maintaining immune homeostasis by suppressing excessive immune responses, thereby preventing immunopathology. In the context of infant human immunodeficiency virus (HIV) infection, Tregs exhibit a dualistic role: while they mitigate immune activation, they may also impede effective antiviral immunity, facilitating viral persistence. Recent studies have illuminated the nuanced involvement of Tregs in infant HIV pathogenesis. For instance, research has demonstrated that HIV-exposed uninfected infants exhibit lower frequencies of peripheral blood Tregs at birth compared to unexposed infants, leading to a delayed expansion of these cells over the first 36 weeks of life. This disruption in Treg development is associated with gut epithelial damage, suggesting that compromised mucosal integrity may influence Treg dynamics in early life. Tregs influence HIV pathogenesis in infants through several mechanisms. They suppress the activation and proliferation of effector T cells, including HIV-specific CD8+ cytotoxic T lymphocytes, which are crucial for controlling viral replication. This suppression can lead to inadequate immune responses against HIV, allowing the virus to persist and replicate. Additionally, Tregs can modulate the function of dendritic cells, leading to suboptimal antigen presentation and further dampening the adaptive immune response. Moreover, an imbalance between Tregs and Th17 cells, another subset of CD4+ T cells involved in mucosal immunity, has been observed in HIV-infected individuals. The loss of Th17 cells, coupled with an increase in Tregs, can compromise mucosal barriers, facilitating microbial translocation and chronic immune activation, which are hallmarks of HIV disease progression.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5807-5813"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991278","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}