Archives of rheumatology最新文献

{"title":"Regional variations in psoriatic arthritis: Insights from a nationwide multicenter analysis in Türkiye.","authors":"Erkan Kılıç, Gamze Kılıç, İbrahim Tekeoğlu, Betül Sargın, Sevtap Acer Kasman, Hakan Alkan, Nilay Şahin, Gizem Cengiz, Nihan Cüzdan, İlknur Albayrak Gezer, Dilek Keskin, Cevriye Mülkoğlu, Hatice Reşorlu, İsmihan Sunar, Ajda Bal, Mehmet Tuncay Duruöz, Okan Küçükakkaş, Ozan Volkan Yurdakul, Meltem Alkan Melikoğlu, Yıldıray Aydın, Fikriye Figen Ayhan, Hatice Bodur, Mustafa Çalış, Erhan Çapkın, Gül Devrimsel, Kevser Orhan, Sami Hizmetli, Ayhan Kamanlı, Yaşar Keskin, Hilal Ecesoy, Öznur Kutluk, Nesrin Şen, Ömer Faruk Şendur, Sena Tolu, Murat Toprak, Tiraje Tuncer, Kemal Nas","doi":"10.46497/ArchRheumatol.2024.10591","DOIUrl":"10.46497/ArchRheumatol.2024.10591","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to investigate and compare clinical features, disease activity, and the overall disease burden among psoriatic arthritis (PsA) patients across seven distinct geographic regions in Türkiye.</p><p><strong>Patients and methods: </strong>A multicenter cross-sectional study involving 1,134 PsA patients from 25 referral centers across seven regions was conducted. Demographic and clinical characteristics, comorbidities, joint involvement, extra-articular manifestations, and disease activity measures were evaluated across regions.</p><p><strong>Results: </strong>A total of 1134 PsA patients from seven different geographic regions in Türkiye participated in this study. The highest number of participants was from the Marmara region (n=409), with subsequent representation from Central Anatolia (n=370), Aegean (n=139), Mediterranean (n=60), Black Sea (n=60), Eastern Anatolia (n=60), and Southeastern Anatolia (n=36) regions. There were significant variations in demographic profile, including age, body mass index, age of disease onset, educational status, comorbidities, and family history of both psoriasis and PsA. Clinical features, such as enthesitis, dactylitis, uveitis, and joint involvement, demonstrated significant variation across regions. Additionally, disease activity measures, including pain, patient and physician global assessments, acute phase reactants, disease activity indices, quality of life, and functional status, displayed considerable regional differences.</p><p><strong>Conclusion: </strong>This nationwide study revealed substantial regional diversity in demographic data, clinical characteristics, disease activity, and quality of life among PsA patients in Türkiye. These findings stress the need to customize treatment approaches to address regional needs and to conduct further research to uncover reasons for disparities. It is crucial to enhance region-specific approaches to improve patient care and outcomes for PsA.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"339-349"},"PeriodicalIF":1.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592363","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":"Acquired Madelung's deformity as a cause of recurrent monoarthritis in a young patient.","authors":"Georges El Hasbani, Ali Jawad, Imad Uthman","doi":"10.46497/ArchRheumatol.2024.10548","DOIUrl":"10.46497/ArchRheumatol.2024.10548","url":null,"abstract":"","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"467-470"},"PeriodicalIF":1.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592320","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 impact of ex vivo ozone injection into the synovial fluid in patients with knee osteoarthritis: A controlled clinical trial.","authors":"Emre Ata, Semiha Özgüç, Mustafa Hüseyin Temel, Hakan Beyaztaş, Selman Aktaş, Eray Metin Güler","doi":"10.46497/ArchRheumatol.2024.10375","DOIUrl":"10.46497/ArchRheumatol.2024.10375","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the effect of varying ozone doses on proinflammatory cytokine levels in the synovial fluid collected from individuals with knee osteoarthritis.</p><p><strong>Patients and methods: </strong>The controlled clinical trial was conducted with 82 patients (61 females, 21 males; mean age: 63.1±10.0 years; range, 40 to 73 years) between 21 April 2023 and 20 May 2023. Synovial fluid samples were collected from the patients under ultrasound guidance and divided into three tubes, one of which was not injected with ozone, and the other two were injected with 10 and 30 gamma (γ) ozone, respectively. The total antioxidant status, total oxidant status, oxidative stress index, interleukin (IL)-1 beta (β), IL-6, and tumor necrosis factor-alpha (TNF-α) in the joint fluids were measured.</p><p><strong>Results: </strong>The oxidative stress index and IL-1 β, IL-6, and TNF-α levels in the synovial fluid were lower at 10 and 30 γ compared to 0 and 10 γ, respectively. <i>In vitro</i> ozone injection at 30 gamma was more effective in reducing proinflammatory cytokines in the synovial fluid than that at 10 and 0 γ. Ozone injection into the pathological joint fluid was more effective in terms of total antioxidant status at 10 and 30 γ compared to 0 and 10 γ, respectively. No significant difference in total oxidant status was observed between the groups.</p><p><strong>Conclusion: </strong>This study showed that <i>in vitro</i> ozone injection at 30 γ was more effective in reducing proinflammatory cytokines in the synovial fluid and in improving total antioxidant status than that at 10 and 0 γ. The results showed the potential significance of the ozone injection dosage in treating knee osteoarthritis.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"459-466"},"PeriodicalIF":1.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592377","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":"Gout and erectile dysfunction: Increased carotid intima-media thickness is independently associated with greater likelihood for erectile dysfunction.","authors":"Ece Yigit, Serdar Yasar, Meryem Can, Zeki Bayraktar","doi":"10.46497/ArchRheumatol.2024.10486","DOIUrl":"10.46497/ArchRheumatol.2024.10486","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to compare gout patients and healthy subjects in terms of erectile dysfunction, carotid intima-media thickness (CIMT), and other variables and to investigate the relationship between CIMT and erectile dysfunction.</p><p><strong>Patients and methods: </strong>This cross-sectional study was conducted with 134 male gout patients (median age: 56 years; range, 48 to 62 years) and 104 healthy males (median age: 47 years; range, 40.5 to 54.5 years) between September 2022 and June 2023. Age, comorbidities, height, weight, laboratory results, gout treatment data, insulin resistance evaluated by the homeostatic model assessment for insulin resistance, presence and severity of erectile dysfunction evaluated by the six-item International Index of Erectile Function erectile function domain (IIEF-EF), and CIMT measured by ultrasound were assessed.</p><p><strong>Results: </strong>Hypertension, hyperlipidemia, greater insulin resistance, erectile dysfunction, and bilaterally increased CIMT were significantly more common in the gout group. The mean IIEF-EF score of gout patients was significantly lower than that of controls. Multivariable logistic regression revealed increased CIMT as the sole parameter independently associated with erectile dysfunction (p=0.010). When both groups were categorized into CIMT-based subsets, erectile dysfunction was present in 97.9% of patients with coexistence of gout and increased CIMT (≥0.9 mm), a significantly higher proportion compared to the other three subsets (p<0.001).</p><p><strong>Conclusion: </strong>Increased CIMT was the only factor independently associated with a greater likelihood of erectile dysfunction in patients with and without gout; however, coexistence of gout and increased CIMT appears to result in a significantly elevated risk for erectile dysfunction.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"393-403"},"PeriodicalIF":1.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592330","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":"Proprotein convertase subtilisin/kexin type 9 and apelin in fibromyalgia syndrome.","authors":"Nevsun Pihtili Taş, Rabia Aydogan Baykara, Ayhan Kamanli, Ali Gürbüz, Erkan Cure, Medine Cumhur Cüre, Mehmet Erdem, Tugce Tasar Yildirim","doi":"10.46497/ArchRheumatol.2024.10462","DOIUrl":"10.46497/ArchRheumatol.2024.10462","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the potential roles of proprotein convertase subtilisin/ kexin type 9 (PCSK9) and apelin in the etiology of fibromyalgia syndrome (FS).</p><p><strong>Patients and methods: </strong>The retrospective study was conducted between May 2022 and February 2023. Fifty-eight female FS patients (mean age: 45.2±9.9 years; range, 25 to 66 years) and 30 age- and body mass index-matched control subjects (mean age: 43.1±9.9 years; range, 26 to 67 years) were included in the study. Apelin and PCSK9 levels of all individuals were measured using appropriate methods.</p><p><strong>Results: </strong>The levels of PCSK9 (173.2±62.2 <i>vs.</i> 75.1±44.1, p<0.001) and apelin (354.6±195.5 <i>vs.</i> 229.0±83.2, p<0.001) were significantly higher in patients with FS compared to the control group. A positive correlation was found between PCSK9 and apelin levels and various measures, including the Fibromyalgia Impact Questionnaire (FIQ), Symptom Severity Scale (SSS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI). Additionally, there was a positive correlation between apelin levels and FIQ, SSS, PSQI, Beck Anxiety Inventory, and BDI scores. The optimal cutoff value for PCSK9 in predicting FS was 110.0 ng/mL, with a sensitivity of 84.5% and specificity of 83.9% (area under the curve [AUC]=0.920, 95% confidence interval [CI]: 0.852-0.987, p<0.001). For apelin, the optimal cutoff value for predicting FS was 258.8 ng/L, with a sensitivity of 63.8% and specificity of 64.5% (AUC=0.732, 95% CI: 0.623-0.840, p<0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that PCSK9 may play a role in FS etiology and potentially contribute to oxidative stress. Increased apelin levels may be a compensatory response to high oxidative stress, possibly leading to hyperalgesia. Both PCSK9 and apelin can be predictive markers for FS.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"375-383"},"PeriodicalIF":1.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592359","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":"Prevalence and characteristics of juvenile fibromyalgia syndrome in pediatric rheumatic diseases: A comparative study.","authors":"Gülcan Özomay Baykal, Duygu Kurtuluş, Serap Ata, Betül Sözeri","doi":"10.46497/ArchRheumatol.2024.10562","DOIUrl":"10.46497/ArchRheumatol.2024.10562","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to evaluate the frequency of juvenile fibromyalgia syndrome (JFMS) in patients diagnosed with juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) with joint symptoms and compare them with a healthy control group.</p><p><strong>Patients and methods: </strong>This retrospective study was conducted with 181 participants between January and April 2023. One hundred twenty-one patients with JIA or FMF diagnoses (71 females, 50 males; mean age: 15.6±2.1 years; range, 12 to 23 years) and 60 healthy individuals (36 females, 24 males; mean age: 14.5±1.6 years; range, 12 to 17 years) were included in the patient group and the control group, respectively. The pain and symptom assessment scale was applied for the JFMS diagnosis, and the output data were analyzed with the widespread pain index and symptom severity scale.</p><p><strong>Results: </strong>Of the patient group, 57% (n=69) were diagnosed with FMF, and 43% (n=52) were diagnosed with JIA. When the two groups were compared with those diagnosed with JFMS, statistical significance was detected (p<0.05). Thirteen (87%) of those diagnosed with JFMS were female, and two (13%) were male, with a statistically significant difference.</p><p><strong>Conclusion: </strong>In patients with JIA and FMF who complain of chronic musculoskeletal pain, tiredness, and weakness, JFMS diagnosis should always be considered in the clinical evaluation.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 3","pages":"384-392"},"PeriodicalIF":1.1,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592354","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":"Unmet needs in psoriatic arthritis, a narrative review.","authors":"Clementina Lopez-Medina, Umut Kalyoncu, Laure Gossec","doi":"10.46497/ArchRheumatol.2024.10710","DOIUrl":"10.46497/ArchRheumatol.2024.10710","url":null,"abstract":"<p><p>Psoriatic arthritis is a chronic rheumatic disease that poses challenges in its diagnosis, evaluation, and management. The heterogeneity in the manifestations and the absence of definitive diagnosis biomarkers often complicates the process of accurate diagnosis. Furthermore, the involvement of multiple disease domains poses difficulties in assessing disease activity and defining the concept of remission. Despite therapeutic advancements, a subset of patients remains refractory to treatment, leading to the emergence of the concept of \"difficult-to-treat\" patients and the necessity for novel therapeutic approaches (e.g., drugs with novel mechanisms of action; combinations of treatments). This review addresses key unmet needs in psoriatic arthritis, in terms of diagnosis, classification, evaluation, comorbidities and treatment.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 2","pages":"159-171"},"PeriodicalIF":1.1,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461227","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":"Predictive risk factors for one-year mortality in idiopathic inflammatory myopathy patients with interstitial lung disease: A retrospective, single-center cohort study.","authors":"Minna Jiang, Xiaohong Wen, Sisi Xia, Yiqun Guo, Yu Bai","doi":"10.46497/ArchRheumatol.2024.10418","DOIUrl":"10.46497/ArchRheumatol.2024.10418","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyze the risk factors for mortality of idiopathic inflammatory myopathy (IIM) patients admitted with interstitial lung disease (ILD) to guide rapid and accurate judgment of clinical prognosis.</p><p><strong>Patients and methods: </strong>This retrospective, single-center cohort study was conducted with 135 participants (37 males, 98 females; mean age: 54.8±11.1 years; range, 24 to 85 years) between June 1, 2016, and June 30, 2021. The participants were categorized into the survival group (n=111) and nonsurvivors (n=24) according to whether they survived during the one-year follow-up. The independent risk factors for mortality in one year after discharge were analyzed. Receiver operating characteristic curve analysis was used to determine the accuracy of oxygenation index at baseline combined with pulmonary infection (PI) at follow-up to indicate death in IIM-ILD patients.</p><p><strong>Results: </strong>Compared to the survival group, nonsurvivors were older (p=0.006) and had a higher proportion of anti-MDA5 (melanoma differentiation-associated protein 5) positivity (p<0.001). The ILD duration was shorter (p=0.006), the oxygenation index was lower (p<0.001), and the intensive care unit occupancy rate (p<0.001) and ventilator utilization rate (p<0.001) were elevated in nonsurvivors compared to the survival group. Oxygenation index at baseline (odds ratio [OR]=1.021, 95% confidence interval [CI]: 1.001-1.023, p=0.040) and PI (clinical judgment) at follow-up (OR=16.471, 95% CI: 1.565-173.365, p=0.020) were found as independent risk factors for death in the year after discharge in IIM inpatients with ILD. An oxygenation index ≤279 mmHg at baseline combined with PI at follow-up exhibited a promising predictive value for all-cause death in IIM-ILD patients within one year.</p><p><strong>Conclusion: </strong>Oxygenation index at baseline and PI during follow-up were independent risk factors for death of IIM-ILD patients within one year after discharge. Patients with an oxygenation index ≤279 mmHg at baseline had an increased risk of death once they developed PI during the one-year follow-up.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 2","pages":"213-220"},"PeriodicalIF":1.1,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461282","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":"Tertiary adrenal insufficiency in a patient with familial Mediterranean fever: Association or coincidence?","authors":"Nozomi Harai, Shunichiro Hanai, Tadatsugu Hosokawa, Kyoichiro Tsuchiya, Daiki Nakagomi","doi":"10.46497/ArchRheumatol.2024.10400","DOIUrl":"10.46497/ArchRheumatol.2024.10400","url":null,"abstract":"","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 2","pages":"314-316"},"PeriodicalIF":1.1,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461284","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":"Rituximab for rheumatoid arthritis-related interstitial lung disease: A systematic review and meta-analysis.","authors":"Tarun Krishna Boppana, Saurabh Mittal, Karan Madan, Anant Mohan, Vijay Hadda, Randeep Guleria","doi":"10.46497/ArchRheumatol.2024.10199","DOIUrl":"10.46497/ArchRheumatol.2024.10199","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review and meta-analysis aimed at summarizing the evidence of efficacy and safety of rituximab in rheumatoid arthritis-related interstitial lung disease (RA-ILD).</p><p><strong>Materials and methods: </strong>PubMed and Embase databases were searched until June 22, 2022, to identify studies on RA-ILD treated with rituximab, confined to predefined inclusion and exclusion criteria. A systematic review and meta-analysis were performed on the included studies to assess the overall stabilization or improvement in ILD, changes in percent-predicted (%-predicted) forced vital capacity (FVC), and %-predicted diffusion capacity of lungs for carbon monoxide (DLCO) following rituximab therapy.</p><p><strong>Results: </strong>A total of 15 studies (4 prospective and 11 retrospective studies) were included, with a total of 314 patients. There were 105 (60.7%) females out of 173 subjects for whom sex details were available from seven studies. The overall pooled proportion of patients with stabilization or improvement in ILD was 0.88 [95% confidence interval (CI): 0.76-0.96, p=0.02]. Rituximab improved FVC from baseline by 7.50% (95% CI: 1.35-13.65; p=0.02, fixed effect). Similarly, rituximab improved DLCO by 6.39% (95% CI: 1.366-14.43; p=0.12, random-effect). Two retrospective studies reported reduced mortality with rituximab therapy compared to tumor necrosis factor-alpha inhibitors.</p><p><strong>Conclusion: </strong>Treatment with rituximab in RA-ILD was associated with a significant improvement in %-predicted FVC, as well as stabilization or improvement in ILD after one year of treatment.</p>","PeriodicalId":93884,"journal":{"name":"Archives of rheumatology","volume":"39 2","pages":"317-329"},"PeriodicalIF":1.1,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461283","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}