Baylor University Medical Center Proceedings最新文献

{"title":"Fezolinetant for vasomotor symptoms in postmenopausal women.","authors":"Belinda M Kohl-Thomas, Kelsey R Kelso","doi":"10.1080/08998280.2025.2498841","DOIUrl":"10.1080/08998280.2025.2498841","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"547"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482990","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 single-institution retrospective analysis on the administration of β-lactam antibiotics prior to vancomycin in bacteremic patients.","authors":"John Corbyn Cravero, Collin Telchik, Taylor Yakubik, Lewis Woods, Sharon Park, Lauren Sisco","doi":"10.1080/08998280.2025.2494488","DOIUrl":"10.1080/08998280.2025.2494488","url":null,"abstract":"<p><strong>Background: </strong>The 2021 Surviving Sepsis Guidelines emphasize prompt antibiotic administration as a recommendation for septic patients. Instead of focusing solely on timing, we aimed to investigate whether the sequence of antibiotic administration influences mortality.</p><p><strong>Methods: </strong>This single-institution retrospective study included patients over 18 years old with confirmed bacteremia between January 1, 2021, and July 1, 2023, who received sequential antibiotic administration of intravenous β-lactam and vancomycin within the first 6 hours of admission. Our primary objective was to determine the odds ratio for 30-day mortality based upon antibiotic class administered first.</p><p><strong>Results: </strong>Of 6143 patients generated from an electronic search, 222 patients were included in the β-lactam-first group, and 16 were included in the vancomycin-first group. The most common β-lactam antibiotic administered was piperacillin-tazobactam (58.40%) followed by cefepime (25.47%) and then ceftriaxone (13.03%). For patients with monomicrobial bacteremia, the most common bacterial infections included <i>Escherichia coli</i> (25.21%), methicillin-resistant <i>Staphylococcus aureus</i> (13.45%), methicillin-susceptible <i>S. aureus</i> (11.34%), and <i>Proteus mirabilis</i> (7.56%). The calculated odds ratio for 30-day mortality was 0.40 (95% confidence interval 0.089-1.831), indicating a decreased occurrence of mortality within 30 days for patients who received β-lactam antibiotics first, although this result was not statistically significant due to limited sample size, particularly within the vancomycin-first group.</p><p><strong>Conclusion: </strong>Although not statistically significant, the prompt administration of β-lactam antibiotics before vancomycin may confer a mortality benefit in patients with bacteremia. Further studies are needed to validate this finding.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"421-426"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482933","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":"Primary cutaneous leiomyosarcoma: demographics and survival benefit of surgical management in a US population.","authors":"Asad Ullah, Abdul Qahar Khan Yasinzai, Hannah Chaudhury, Abdullah Chandasir, Tena Nguyen, Katharine Tracy, Agha Wali, Aman Goyal, Bisma Tareen, Hritvik Jain, Abdul Waheed, Asif Iqbal, Marjan Khan, Michelle Tarbox, Amir Humza Sohail","doi":"10.1080/08998280.2025.2491895","DOIUrl":"10.1080/08998280.2025.2491895","url":null,"abstract":"<p><strong>Background: </strong>Leiomyosarcoma of the skin is a rare malignant mesenchymal neoplasm categorized as cutaneous or subcutaneous. This study identified demographic and pathological factors affecting the prognosis and treatment of leiomyosarcoma of the skin.</p><p><strong>Methods: </strong>Data of patients with skin leiomyosarcoma was extracted from 2000 to 2020 using the Surveillance, Epidemiology, and End Results database. Propensity score matching and prognostic nomograms were used to analyze survival rate predictions.</p><p><strong>Results: </strong>Most patients were >65 years of age (50.5%), male (78.8%), and White (88.5%). The overall 5-year survival was 79.9% (95% confidence interval [CI] = 77.4-82.6), and the 5-year cause-specific survival rate was 95.7% (95% CI = 94.2-97.2). Based on treatment, the 5-year cause-specific survival rate was 82.9% (95% CI = 80.3-85.6) for surgery only, 60.2% (95% CI = 47.7-76.0) for both radiation and surgery, and 68.2% (95% CI = 58.9-78.9) for no treatment. Multivariable analysis showed that head and neck tumors were associated with worse mortality.</p><p><strong>Conclusion: </strong>The results provide valuable insights that could shape development of future clinical protocols for skin leiomyosarcoma and impact patient care and treatment efficacy.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"399-406"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483017","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":"Association of patient and clinical characteristics with postoperative opioid consumption following total knee arthroplasty: a single center retrospective study.","authors":"Roxana Farokhnia, Emily H Garmon, Bryce C Allen, Michael R Fettiplace, Michael P Hofkamp","doi":"10.1080/08998280.2025.2494956","DOIUrl":"10.1080/08998280.2025.2494956","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of our study was to determine which patient and clinical characteristics were associated with opioid consumption in phase I recovery following unilateral total knee arthroplasty (TKA) at our hospital.</p><p><strong>Methods: </strong>Our institutional review board approved this study. A total of 600 Black, Hispanic, and White patients who underwent unilateral TKA at Baylor Scott & White Medical Center - Temple from January 1, 2018 to December 31, 2022 were randomly selected for analysis. Patients were excluded from the final analysis if there was incomplete data regarding opioid consumption or body mass index, if the procedure was improperly coded, or if the patient received liposomal bupivacaine as part of their local infiltration analgesia.</p><p><strong>Results: </strong>Among the 534 patients included in the final analysis, 373 and 161 patients did and did not receive opioid medication in phase I recovery, respectively. Preoperative acetaminophen administration (adjusted odds ratio [aOR] 2.17; 95% confidence interval [CI] 1.25, 3.78; <i>P</i> = 0.006) and general anesthesia as primary anesthetic technique (aOR 3.56; 95% CI 1.55, 8.17; <i>P</i> = 0.003) were independently associated with opioid consumption during phase I recovery following TKA.</p><p><strong>Conclusions: </strong>Patients who received opioid medication in phase I recovery following TKA were more likely to have received preoperative acetaminophen and general anesthesia compared to patients who received no opioid medication.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"442-446"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482947","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":"Carvedilol is associated with lower mortality than other nonselective beta-blockers in patients with cirrhosis.","authors":"Michael J Mullarkey, Gerald O Ogola, Sumeet K Asrani, Michael L Volk","doi":"10.1080/08998280.2025.2491220","DOIUrl":"10.1080/08998280.2025.2491220","url":null,"abstract":"<p><strong>Background: </strong>Recent guidelines have suggested that carvedilol should be first-line treatment in patients with cirrhosis and portal hypertension. This recommendation is based on data that rely on clinically impractical surrogates such as hepatic venous pressure gradient measurements. There is limited head-to-head data comparing carvedilol to other nonselective beta-blockers in the real-world setting.</p><p><strong>Methods: </strong>This retrospective case-control study from a large health system compared patients with cirrhosis determined by ICD-10 algorithm and platelet count <150, who were treated with carvedilol versus nadolol or propranolol. Outcomes including hepatic decompensation (ascites, encephalopathy, variceal bleeding) and all-cause mortality were analyzed with adjustment for potential confounding using propensity score matching and time-dependent Cox regression.</p><p><strong>Results: </strong>Among the 2302 cirrhosis patients meeting inclusion criteria, 1629 (70.8%) were on carvedilol and 673 (29.2%) were on nadolol or propranolol. In risk-adjusted analysis, patients on carvedilol had a lower hazard of hepatic decompensation (<i>P</i> < 0.001) and lower hazard of mortality (<i>P</i> = 0.03) compared to patients on propranolol/nadolol. The superiority of carvedilol applied equally to each decompensation type: ascites, encephalopathy, and variceal bleeding.</p><p><strong>Conclusion: </strong>These findings support the use of carvedilol in patients with cirrhosis and clinically apparent portal hypertension, to decrease the risk of hepatic decompensation and improve survival.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"412-418"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482952","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":"Ezetimibe plus statin combination versus double-dose statin in patients with dyslipidemia and atherosclerotic cardiovascular disease risk: a comprehensive systematic review and meta-analysis of 47 randomized controlled trials.","authors":"Abdelrahman Mahmoud, Hazem Mohamed Salamah, Hazem Rezq, Yazan Al-Mohtasib, Ali Ashraf Salah Ahmed, Mohamed R Abdelraouf, Ahmed Mazen Amin, Ahmed A Ibrahim, Yasmine Adel Mohammed, Omar Ahmed Abdelwahab, Majd M AlBarakat, Salem Elshenawy, Husam Abu Suilik, Basel Abdelazeem","doi":"10.1080/08998280.2025.2487966","DOIUrl":"10.1080/08998280.2025.2487966","url":null,"abstract":"<p><strong>Background: </strong>Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). Oral regimens to achieve blood lipid targets include increasing the statin dose or adding ezetimibe to statin therapy. The optimal strategy remains debated. This study evaluated the efficacy and safety of ezetimibe plus statin versus a double dose of the same statin in patients with ASCVD risk.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials from PubMed, Embase, Cochrane, Scopus, and Web of Science through December 2023. A random-effects model was used to analyze outcomes, reporting risk ratio and mean difference with 95% confidence intervals.</p><p><strong>Results: </strong>Forty-seven randomized controlled trials involving 18,592 patients were included. Ezetimibe plus statin significantly reduced low-density lipoprotein (LDL) cholesterol (<i>P</i> < 0.001), triglyceride (<i>P</i> = 0.019), and total cholesterol levels (<i>P</i> < 0.001) and increased target LDL achievement (<i>P</i> < 0.0001) compared to double-dose statin. No significant differences were observed in high-density lipoprotein levels, any adverse events, all-cause mortality, myocardial infarction, angina, or nonfatal stroke. The incidence of severe adverse events was higher with ezetimibe plus statin (<i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>Ezetimibe plus statin therapy demonstrated superior lipid-lowering efficacy compared with double-dose statin therapy, with no additional clinical benefit. There was no difference in overall adverse events. There was a higher incidence of severe adverse events with combination therapy compared to double-dose statin therapy, although these events were rare and not believed to be attributable to medication.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"474-483"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482987","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":"An update on the incidence rates of early onset vs late onset colon cancer among Whites, Blacks, Hispanics, and Asian-American/Pacific Islanders in the United States.","authors":"Renuka Verma, Kamleshun Ramphul, Dhruvkumar Gadhiya, Suma Sri Chennapragada","doi":"10.1080/08998280.2025.2489897","DOIUrl":"10.1080/08998280.2025.2489897","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"579-582"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482934","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 onset gastric cancer: clinical and molecular insights into a rising epidemic among younger adults.","authors":"Maryana Stryelkina, My Nguyen, Priyanka Reddy, Anh Trinh Doan, Michelle Min, Lisa Go, Lucas Wong","doi":"10.1080/08998280.2025.2488592","DOIUrl":"10.1080/08998280.2025.2488592","url":null,"abstract":"<p><strong>Background: </strong>Early onset gastric cancer (EOGC), defined as gastric cancer occurring in individuals aged 49 years or younger, presents distinct clinical and molecular characteristics compared to late-onset gastric cancer (LOGC). Despite the increasing incidence of EOGC, limited data exist regarding its demographic, risk factor, and molecular profiles. This study aimed to compare the clinicopathologic and molecular features of EOGC and LOGC and characterize the demographic, clinical, and molecular characteristics of EOGC in a diverse cohort to elucidate potential risk factors and disease behavior.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 437 gastric carcinoma patients screened at Baylor Scott & White Health (2002-2022). Demographic, clinical, and molecular data, including <i>Helicobacter pylori</i> infection, lifestyle factors, histopathology, and biomarkers (HER2, MSI), were analyzed.</p><p><strong>Results: </strong>Of the 437 gastric carcinoma cases screened, 32 patients had EOGC, while 51 had LOGC with available clinical and molecular data. EOGC was associated with a higher proportion of females (<i>P</i> = 0.001) and greater racial/ethnic diversity, including a higher prevalence of Hispanic (41% vs 13.7%) and African American patients (34.3% vs 13.7%). Modifiable risk factor analysis revealed a significant association between EOGC and <i>H. pylori</i> infection (<i>P</i> = 0.001), whereas alcohol use was more common in LOGC (<i>P</i> = 0.041). EOGC was more frequently diagnosed at advanced stages (<i>P</i> = 0.02) and exhibited a higher prevalence of signet ring cell carcinoma (<i>P</i> = 0.003) and poorly differentiated tumors (<i>P</i> < 0.001). Molecular analysis showed low HER2 positivity (4.2%) and mismatch repair deficiency (8.3%) in EOGC, suggesting distinct molecular features. The overall 5-year survival rate for EOGC was 22.6%, significantly lower in patients diagnosed at advanced stages (III/IV 5.9% vs I/II 63.6%, <i>P</i> = 0.028).</p><p><strong>Conclusion: </strong>This study underscores the aggressive nature of EOGC, highlighting its advanced-stage presentation, poor survival, and distinct molecular pathways. The high prevalence of <i>H. pylori</i> infection, obesity, and smoking reinforces the need for targeted prevention strategies. Given its rising incidence and late-stage diagnosis, risk-based screening, optimized treatment protocols, and novel therapeutic strategies are crucial for improving patient outcomes.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"388-396"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482982","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":"Vonoprazan and amoxicillin dual therapy versus bismuth-based therapy for <i>Helicobacter pylori</i> eradication: a systematic review and meta-analysis of randomized controlled trials.","authors":"Hazem Abosheaishaa, Hesham Elsayed, Omar Abdelhalim, Islam Mohsen El Haddad, Mohamed K Harfoush, Abdallfatah Abdallfatah, Arshia Sethi, Mohammed Abusuliman, Rahul Karna, Mohammad Bilal","doi":"10.1080/08998280.2025.2491964","DOIUrl":"10.1080/08998280.2025.2491964","url":null,"abstract":"<p><strong>Introduction: </strong><i>Helicobacter pylori</i> infection can cause peptic ulcer disease, chronic gastritis, primary gastric lymphoma, and gastric cancer. Treatment with bismuth-based quadruple therapy is typically the first line of treatment but can be challenging due to increased pill burden and adverse effects, leading to nonadherence to therapy. Recent studies have shown that vonoprazan can be used in combination with amoxicillin as a potential treatment option. We conducted a systematic review and meta-analysis to assess the efficacy and tolerability of vonoprazan-based dual therapy as compared to bismuth-based therapy (BBT).</p><p><strong>Methodology: </strong>We conducted a comprehensive search of multiple electronic databases including PubMed, Embase, and Cochrane Library to identify randomized controlled studies assessing vonoprazan and amoxicillin (VA) in comparison to BBT for <i>H. pylori</i> treatment in adults >18 years of age. Studies with pediatric populations, written in languages other than English, or without control groups were excluded.</p><p><strong>Results: </strong>Out of the 1968 citations, 9 studies including 2039 patients were included in the final analysis. There were 463 and 481 men in the VA and the BBT groups, respectively. The mean age ranged from 38.1 to 48.7 years in the VA group and from 38.6 to 46.1 in the BBT group. The VA group had an eradication rate similar to that of the BBT group (odds ratio [OR]: 0.32, 95% confidence interval [CI]: 0.26-0.40; <i>P</i> = 0.08). The VA group had a lower incidence of total adverse events than the BBT group (OR: 0.32, 95% CI: 0.26-0.40; <i>P</i> = 0.0001), including a reduced occurrence of nausea and vomiting (OR: 0.42, 95% CI: 0.28-0.65; <i>P</i> = 0.0001). There was no difference in compliance between the VA and BBT groups (OR: 1.16, 95% CI: 0.76-1.76; <i>P</i> = 0.50).</p><p><strong>Conclusion: </strong>Our study showed a similar eradication rate of <i>H. pylori</i> but a significantly lower incidence of adverse events in the VA group compared with the BBT group. Our analysis suggests that a VA-based regimen is an acceptable treatment option for <i>H. pylori</i> patients who cannot tolerate BBT.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"716-721"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring apremilast in the treatment of lichen planus pemphigoides: a new remedy.","authors":"Hannah Chaudhury, Nicole Remmert, Meredith Pham, Michelle Tarbox","doi":"10.1080/08998280.2025.2489899","DOIUrl":"10.1080/08998280.2025.2489899","url":null,"abstract":"<p><p>Lichen planus pemphigoides (LPP) is an uncommon autoimmune dermatosis characterized by a combination of lichenoid lesions and bullous lesions. While its pathogenesis is often considered idiopathic, some cases have been associated with certain medications and infections. The standard treatment for LPP involves systemic corticosteroids. However, the suboptimal recurrence rate of 20% and the presence of various side effects highlight the need for alternative approaches. Recognizing the role of proinflammatory cytokines in the pathogenesis of LPP and targeting their reduction and related pathways has emerged as a promising therapeutic strategy. This case report details the experience of a 67-year-old woman with a history of LPP, showing disease progression despite undergoing multiple conventional therapies. Faced with the inadequacy of traditional treatments, we achieved successful results by using apremilast as an effective intervention.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 5","pages":"758-761"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871136","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}