Cureus最新文献

{"title":"Understanding the Link Between Hormonal Changes and Gingival Health in Women: A Review.","authors":"Sidra Tul Muntaha Jawed, Khadeeja Tul Kubra Jawed","doi":"10.7759/cureus.85270","DOIUrl":"https://doi.org/10.7759/cureus.85270","url":null,"abstract":"<p><p>Sex hormones, particularly estrogen and progesterone, undergo continuous fluctuations throughout a woman's life, beginning at puberty and extending through the menstrual cycle, pregnancy, and menopause. These hormonal variations significantly influence gingival health, leading to various periodontal conditions. During puberty, elevated levels of estrogen and progesterone enhance blood circulation to the gingival tissues, increasing their sensitivity to plaque and resulting in puberty gingivitis. This condition is characterized by gingival enlargement, redness, and bleeding. Throughout the menstrual cycle, hormonal fluctuations can cause menstrual gingivitis, presenting as inflamed and bleeding gums, typically occurring prior to menstruation and subsiding thereafter. Pregnancy induces substantial hormonal changes, with heightened estrogen and progesterone levels exacerbating gingival inflammation. This often leads to pregnancy gingivitis, marked by swelling, bleeding, and tenderness of the gums. In some cases, a localized overgrowth known as a pyogenic granuloma or \"pregnancy tumor\" may develop on the gingiva. The use of oral contraceptives, which alter hormonal levels, has been associated with increased gingival inflammation and exudate, similar to the effects observed during pregnancy. Menopause brings a significant decline in estrogen levels, leading to various oral health issues such as dry mouth (xerostomia), a burning sensation in the mouth, and an increased risk of osteoporosis affecting the alveolar bone supporting the teeth. These changes contribute to a heightened susceptibility to periodontal diseases in post-menopausal women. The influence of estrogen and progesterone on the immune response, oral microbial composition, bone density, and enzymes like collagenase plays a crucial role in modulating gingival inflammation and the risk of periodontal diseases. Understanding these hormonal impacts is essential for developing effective prevention and treatment strategies for maintaining optimal gingival health in women across different life stages.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85270"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217915","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 Protocol for Venous Thromboembolism Prophylaxis in Elective Spine Surgery: A Retrospective Evaluation of a Single-Center Experience.","authors":"Hani Aljohani, Abdulrahman H Alashkar, Ghada K Alkafarnah, Monirh M Almeshigeh, Abdullh A Alsadoon, Amr Alfakhouri","doi":"10.7759/cureus.85297","DOIUrl":"https://doi.org/10.7759/cureus.85297","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolic (VTE) events include deep vein thrombosis (DVT) and pulmonary embolism (PE). In spine surgery, the risk of VTE events should be weighed against the risk of developing epidural hematoma (EDH). This has made the subject of VTE prophylaxis in spine surgery an ongoing matter of debate in the scientific community.</p><p><strong>Objective: </strong>To present our experience with venous thromboembolism prophylaxis in patients undergoing elective spine surgery and discuss it in the light of the literature.</p><p><strong>Methods: </strong>This was a retrospective review done on all patients who underwent elective spine surgery at our institution from 2019 to 2024 and were prescribed a specified VTE prophylaxis protocol (inpatient enoxaparin and a seven-day course of rivaroxaban following discharge). Patients who underwent spine surgery for non-elective indications, were known to have a malignancy, had a history of VTE, were already on anticoagulant therapy, and/or were non-ambulatory, were excluded.</p><p><strong>Results: </strong>A total of 528 patients were included; 284 (53.78%) patients were males, and 354 (67.04%) surgeries were thoraco-lumbar. Of the 174 (32.95%) surgeries performed on the cervical spine, 105 were anterior discectomies and 69 were laminectomies. The mean age (±SD) was 55.06 years (±14.9). The majority of the included patients were overweight/obese; 447 patients (84.65%). Of all the patients, 452 (85.6%) started to ambulate on Day 1, and the mean (±SD) length of hospital stay was comparable for patients undergoing cervical and thoracolumbar spine surgeries, 4.6 (±1.3) and 4.8 (±1.6), respectively. None of the patients experienced VTE events, while three (0.56%) developed EDH.</p><p><strong>Conclusion: </strong>The protocol presented in this report is safe and effective in preventing VTE in ambulatory patients undergoing elective spine surgery. Rivaroxaban is a possible option for VTE prophylaxis in patients undergoing elective spine surgery, including procedures involving the cervical spine.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85297"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217912","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":"Educating Medical Students on Deaf-Hearing Interpreter Teams: A Virtual Patient Panel Experience.","authors":"Benedicta O Olonilua, Natalie Snyder, Julia Croce, Dimitrios Papanagnou","doi":"10.7759/cureus.85290","DOIUrl":"https://doi.org/10.7759/cureus.85290","url":null,"abstract":"<p><p>Communication and cultural differences render d/Deaf patients vulnerable to poorer health outcomes when compared to their hearing peers. Interventions designed to address these inequities are a growing focus in medical education, with virtual platforms (e.g., Zoom) becoming increasingly popular. This article describes the implementation of a one-hour virtual patient panel with an interactive question-and-answer session between a certified Deaf interpreter (CDI) and second-year pre-clerkship medical students at the authors' institution. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using generative artificial intelligence to summarize key themes. There were 41 respondents, with a response rate of 15%. The key themes that emerged are grouped under the following thematic headings: role of interpreters and communication; insights about d/Deaf culture; challenges and experiences; and suggestions for improvement. Students' takeaways emphasized themes of communication, cultural competency, and access to care. Student reflections highlighted the novelty and clinical applicability of lessons learned from the panel for their future practice. Further work in medical education is needed to adequately expose healthcare trainees to Deaf culture, particularly how to work with interpreters and CDIs in the clinical environment.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85290"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217913","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":"Retraction: A Rare Case of Disseminated Varicella Zoster Virus (VZV) Infection Complicated by VZV Pneumonia.","authors":"Suhel A Sabunwala, Tuhina Cornelius","doi":"10.7759/cureus.r185","DOIUrl":"https://doi.org/10.7759/cureus.r185","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.7759/cureus.84630.].</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"r185"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217914","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 of Cardiometabolic Disease in Iowa: A County-Level Analysis of Ethnic Disparities and Screening Gaps.","authors":"Cyril Pedagarla, Anirudh Pradeep, Ramarao Pradeep","doi":"10.7759/cureus.85224","DOIUrl":"https://doi.org/10.7759/cureus.85224","url":null,"abstract":"<p><p>Cardiometabolic conditions - including diabetes, hypertension, and hyperlipidemia - are leading contributors to morbidity, mortality, and health disparities across the United States. In Iowa, the burden of these diseases varies substantially by county, with notable geographic and racial/ethnic inequities. This ecological study analyzed data from all 99 Iowa counties to assess the prevalence of cardiometabolic diseases, evaluate demographic correlations, and identify underserved regions we term \"cardiometabolic screening deserts.\"  We defined screening deserts as counties that lacked at least two of the following preventive services: blood pressure (BP) screening, HbA1c testing, and lipid panel access; had high poverty or uninsured rates (>15%); and were designated Health Professional Shortage Areas (HPSAs). County-level data on disease prevalence, screening availability, race/ethnicity, poverty, and provider access were obtained from state and federal datasets and analyzed descriptively. Nineteen counties (19.2%) met all criteria to be classified as screening deserts. As shown in Centers for Disease Control and Prevention (CDC) national surveillance data, disease prevalence varied widely: diabetes (6.1%-10.9%), hypertension (28.1%-39.0%), and hyperlipidemia (25.2%-39.9%). Screening availability was limited - HbA1c testing was present in only 24 counties, and lipid testing in just 18. Counties with higher proportions of Black, Hispanic, or Native American residents disproportionately lacked screening access and had higher disease burdens.  Our findings emphasize the critical need to align preventive care infrastructure with disease burden. This analysis provides a county-level framework to guide targeted interventions and improve equity in chronic disease prevention across Iowa.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85224"},"PeriodicalIF":1.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210537","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":"Community-Based Double Reflex Screening Reveals Widespread Hepatitis D Viremia Among Hepatitis B Surface Antigen Carriers in Pakistan.","authors":"Minaam Abbas, Zaigham Abbas, Muhammed Y Sharif","doi":"10.7759/cureus.85200","DOIUrl":"https://doi.org/10.7759/cureus.85200","url":null,"abstract":"<p><p>Background Hepatitis D, caused by the hepatitis delta virus (HDV), poses a significant public health concern in many parts of the world. However, HDV screening remains suboptimal in most regions, leading to underdiagnosis of the infection. This study aimed to determine the prevalence of HDV infection through double reflex testing of hepatitis B surface antigen (HBsAg)-positive individuals at screening camps in two high-prevalence towns in the eastern part of Balochistan province, Pakistan. Methods A total of 1,643 individuals were screened for HBsAg and antibodies to the hepatitis C virus (anti-HCV). Those who tested positive for HBsAg were further tested for antibodies to HDV (anti-HDV). Samples positive for anti-HDV were subsequently analyzed for HDV RNA using real-time PCR. Results Of the 1,643 individuals screened, 277 (16.9%) tested positive for HBsAg and 227 (13.8%) for anti-HCV. Among the HBsAg-positive individuals, 186 (67.1%) were positive for anti-HDV antibodies, including 133 men and 53 women, with a mean age of 32.2 ± 11.3 years. HDV RNA was detectable in 108 (58.1%) of the anti-HDV-positive individuals, with mean HDV RNA levels of log₁₀ 6.69 ± 1.35 IU/mL. Of the 277 HBsAg-positive individuals, five also tested positive for anti-HCV; one of these was positive for anti-HDV but negative for HDV RNA. Conclusions Reflex testing of HBsAg-positive individuals in this HDV-endemic area showed that 67% had been exposed to HDV, and 58.1% of those with anti-HDV antibodies had active viremia. These findings underscore the importance of implementing double reflex testing - screening HBsAg-positive individuals for anti-HDV antibodies, followed by HDV RNA testing in those who are anti-HDV positive - in regions with high HDV prevalence.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85200"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210534","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":"Pterygoid Anchorage of Subperiosteal Implants: An Overview and Case Report.","authors":"Antoine Diss, Augustin Lerebours, Cyrille Grébonval, Laurine Birault","doi":"10.7759/cureus.85175","DOIUrl":"https://doi.org/10.7759/cureus.85175","url":null,"abstract":"<p><p>Severely atrophic maxillae (Cawood and Howell Class V-VI) often prevent conventional implant placement in the absence of extensive bone grafting, which carries risks, especially in elderly patients. Modern subperiosteal implants, digitally designed and manufactured in titanium using additive technologies, offer a graftless solution by anchoring the implant to basal bone structures such as the canine pillars and the zygomatic buttress. This case report explores the clinical feasibility of adding pterygoid anchorage to increase subperiosteal implant stability. A 71-year-old edentulous female with extreme maxillary atrophy received two custom subperiosteal implants designed with fixation points in the canine, zygomatic, and pterygoid regions. The digital workflow included cone beam computed tomography (CBCT) imaging, digital smile design, and implant modeling with a triply periodic minimal surface (TPMS)-gyroid structure to promote osseointegration. The implants were manufactured using Direct Metal Laser Sintering in Ti-6Al-4V ELI titanium and loaded immediately with a provisional titanium-reinforced polymethyl methacrylate (PMMA) bridge. Surgical placement included the insertion of bicortical pterygoid screws that penetrated the pterygomaxillary suture, so increasing posterior support and countering the occlusal forces associated with anterior cantilevers. Postoperative results showed excellent implant stability and patient satisfaction. This report confirms that pterygoid anchorage is a viable addition to subperiosteal implant design. It offers improved mechanical stability and expands treatment options for patients with extreme bone loss, without requiring bone grafting. Further biomechanical and long-term studies are recommended to validate these promising findings.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85175"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210538","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":"Distal Femoral Replacement After Distal Femur Periprosthetic Fracture: A Case Report.","authors":"Rayan Jamal, Hatem A Shaqroon, Mohamad A Ali, Sultan H Farsi","doi":"10.7759/cureus.85188","DOIUrl":"https://doi.org/10.7759/cureus.85188","url":null,"abstract":"<p><p>Distal femoral periprosthetic fractures present a complex challenge, particularly in elderly patients with comorbidities and poor bone quality. We report a case of a 62-year-old Saudi female with morbid obesity and a history of bilateral total knee arthroplasty (TKA) who sustained a distal femoral fracture after minor trauma. Due to limited bone stock and fracture proximity to the prosthesis, internal fixation was ruled out. The patient underwent successful revision TKA with distal femoral replacement (DFR). Postoperative recovery was good, and she was discharged on day 4 with a knee range of motion of 0-90°. This case underscores the viability of DFR as a limb-salvaging option, offering immediate weight-bearing and early mobilization.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85188"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210535","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 Prevalence and Associated Risk Factors of Coronary Heart Disease in Patients With Gout: A Cross-Sectional Study.","authors":"Sohaib Asghar, Shoaib Asghar, Summayha Mahbub, Asad Riaz, Shahid Farooq, Imran Khan","doi":"10.7759/cureus.85194","DOIUrl":"https://doi.org/10.7759/cureus.85194","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Background Long-term gout patients have been linked to increased risk of coronary heart disease (CHD) and its associated comorbidities. Therefore, careful evaluations are necessary to examine the prevalence and the causes of CHD in gout patients. The aim of this research was to identify significant factors associated with CHD in patients with gout along with the prevalence rate. Materials and methods A cross-sectional study was performed on 270 gout patients who attended the specialist outpatient clinic and the medicine department of Sheikh Zayed Medical College & Hospital, Rahim Yar Khan, Pakistan. Data about predictor variables was collected through interviews and standard clinical procedures. Blood samples were taken to measure laboratory variables such as fasting blood sugar (FBS), serum creatinine, cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Initially, descriptive statistics along with the chi-square test of association was executed. Finally, logistic regression analysis was performed as a classification method to estimate the odds ratio and confidence interval. Results The findings showed that 108 (40%, n=270) of gout patients experienced CHD with the highest prevalence rate (52; 48%, n1=108) of myocardial infarction (MI). Among all (n=270) patients, 150 (56%) were suffering from gout for more than 10 years, and 161 (60%) were diagnosed with hypertension. Considering p-value&lt;0.05 as significant for the chi-square test, hypertension (p-value=0.001), type 2 diabetes mellitus (T2DM) (p-value=0.004), family history of CHD (p-value=0.001), serum creatinine (p-value=0.02), cholesterol (p-value=0.04), subcutaneous tophi (p-value=0.02), intraosseous tophi (p-value=0.04), and intermittent allopurinol intake (p-value=0.04) were found to be associated with CHD in patients with gout. The logistic regression analysis showed that hypertension (OR=2.70, CI: 1.60-4.58), T2DM (OR=2.08, CI: 1.26-3.42), creatinine (OR=1.77, CI: 1.07-2.93), cholesterol (OR=1.67, CI: 1.02-2.73), HDL-C (OR=0.59, CI: 0.36-0.96), subcutaneous tophi (OR=1.86, CI: 1.09-3.16), intraosseous tophi (OR=2.22, CI: 1.29-3.81), and intermittent allopurinol consumption (OR=1.92, CI: 1.01-3.66) were associated with CHD in patients with gout. Conclusions The study estimated that 40% of patients with chronic gout developed different types of CHD with the highest prevalence of MI, regardless of the duration of gout or treatment of acute attacks. Hypertension, T2DM, obesity, high creatinine, high cholesterol, low HDL-C and presence of intraosseous tophi are found to be significant factors of CHD in gout patients. These findings significantly contributed to medical research to address the risk of CHD among Pakistani patients with gout by controlling these significant associated factors. Gout patients with a positive family history of CHD should also take precautionary measures to avoid heart complications. Nation-w","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85194"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210539","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":"Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection.","authors":"Mohamed I Fahim, Fady Shafeik, Rasha M Allam, Marina Asaad, Mohammad Taher","doi":"10.7759/cureus.85171","DOIUrl":"https://doi.org/10.7759/cureus.85171","url":null,"abstract":"<p><p>Aim This study aimed to evaluate the potential prognostic impact of various clinicopathological factors on survival outcomes in patients with low rectal adenocarcinoma treated with neoadjuvant chemoradiation followed by abdominoperineal resection. Methods This retrospective observational cohort study included 174 patients with low rectal adenocarcinoma who were treated and followed up between 2012 and 2019 at the National Cancer Institute - Cairo University. Results The median follow-up period was 71.2 months. The median disease-free survival (DFS) was 69 months, while the median overall survival (OS) was not reached. Multivariate analysis showed that high tumor grade was significantly associated with reduced OS (95% CI: 1.250-7.280; P = 0.014). Additionally, a circumferential resection margin (CRM) of ≤1 mm was significantly associated with reduced DFS (95% CI: 1.604-17.818; P = 0.006). Conclusions The study found no significant prognostic impact of tumor response to neoadjuvant chemoradiation. However, tumor grade and CRM status emerged as potential prognostic factors for survival in this patient population.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e85171"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210536","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}