Cureus最新文献

{"title":"Cerebral Amyloid Angiopathy With Progressive Cortical Superficial Siderosis and Convexity Subarachnoid Hemorrhage in an Apolipoprotein E (APOE) ε2/ε2 Homozygous Patient: A Case Report and Literature Review.","authors":"Masahiro Hayashi, Mayumi Ikeda, Katsuji Kobayashi","doi":"10.7759/cureus.87007","DOIUrl":"10.7759/cureus.87007","url":null,"abstract":"<p><p>Sporadic cerebral amyloid angiopathy (CAA) is characterized by progressive amyloid β-protein (Aβ) deposition in small cortical and leptomeningeal vessels. It is associated with intracerebral hemorrhage (ICH), cognitive decline, and gait disturbance. Among its hemorrhagic manifestations, cortical superficial siderosis (cSS) and convexity subarachnoid hemorrhage (cSAH) are gaining increasing attention, particularly in individuals carrying the apolipoprotein E (APOE) ε2 allele. A cSAH typically represents an acute-phase lesion caused by blood leakage into the subarachnoid space, often presenting as a single linear hypointensity on MRI. In contrast, cSS is a chronic-phase lesion characterized by hemosiderin deposition in the superficial cortex, typically appearing as a double-line hypointensity. Both lesions are believed to originate from the rupture or leakage of structurally fragile small vessels in the leptomeninges and superficial cortex. The accumulation of iron-containing blood products may trigger inflammatory responses and secondary damage to vessels and brain parenchyma, promoting recurrent hemorrhage and cognitive decline. The APOE ε2 allele is hypothesized to exacerbate vascular fragility through Aβ-mediated mechanisms and to increase the severity of hemorrhagic complications in CAA. Homozygosity for APOE ε2 is rare in the general population and has been associated with an elevated risk of hemorrhage in CAA, making this case particularly noteworthy. We report the case of a probable CAA in a man in his 60s who was homozygous for APOE ε2. Over a 10-month period, he experienced progression from mild cognitive impairment and subtle gait abnormality to severe dementia and marked limping. Imaging revealed recurrent cSAH and progressive cSS, along with simultaneous ICH and cSAH in opposite hemispheres. In particular, atypical cSAH-characterized by larger volume or prolonged blood retention-was followed by more extensive cSS in the same regions. Brain perfusion single-photon emission computed tomography (SPECT) showed hypoperfusion in cortical areas affected by these lesions, particularly in the bilateral frontal lobes, more pronounced on the left, and in the bilateral parietal lobes. This case highlights the aggressive course of CAA in a patient with APOE ε2/ε2 homozygote, where repeated hemorrhagic events and iron accumulation may result in both vascular injury and parenchymal dysfunction. We discuss imaging, clinical progression, and pathophysiological implications, with a focus on the role of APOE ε2 in exacerbating hemorrhagic lesions and promoting cognitive and motor decline.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e87007"},"PeriodicalIF":1.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531918","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 Fatal Cascade Following Endoscopic Retrograde Cholangiopancreaticography (ERCP) Complicated by Pancreatitis, Duodenal Perforation, Gastrointestinal Hemorrhage, and Multi-organ Failure.","authors":"Sharath Rajagopalan, Vikash Kumar, Bharath P Bhushan, Leonard R Maier, Eric Huang","doi":"10.7759/cureus.86983","DOIUrl":"10.7759/cureus.86983","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable diagnostic and therapeutic procedure that carries inherent risks, with pancreatitis being a significant complication. While most cases resolve without major sequelae, severe complications can occur. A 65-year-old female with a history of pancreatitis developed post-ERCP pancreatitis following stent placement. The patient subsequently presented with walled-off fluid collections and experienced a catastrophic course complicated by duodenal perforation, severe hemorrhage, and multi-organ dysfunction, ultimately resulting in mortality. This case emphasizes the potential for life-threatening complications following post-ERCP pancreatitis and underscores the importance of vigilant monitoring and prompt intervention in managing these patients.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86983"},"PeriodicalIF":1.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531915","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":"Global Research Trends in Anticoagulation and Mechanical Thrombectomy for Iliofemoral Deep Vein Thrombosis: A Bibliometric Analysis (2000-2024).","authors":"Anas Alhur, Ghaidaa Abdulrahman S Alqahtani, Abdulelah Nasser S Alghaeb","doi":"10.7759/cureus.86924","DOIUrl":"10.7759/cureus.86924","url":null,"abstract":"<p><p>This bibliometric study provides the first comprehensive analysis of global research trends, collaborative networks, and citation metrics related to anticoagulation and mechanical thrombectomy in iliofemoral deep vein thrombosis (DVT). Using Dimensions AI, 234 articles published between 2000 and 2025 were identified through a targeted search of terms including \"iliofemoral DVT,\" \"anticoagulation,\" and \"mechanical thrombectomy.\" Data extracted included publication year, citation count, research category, author affiliation, country of origin, and co-authorship. The study presents an overview of recent global research activity related to anticoagulation and mechanical thrombectomy in the context of iliofemoral deep vein thrombosis (DVT). It highlights key publication trends, leading contributors, and thematic focus areas within the literature. The analysis also outlines the collaborative nature of research efforts and shifts in scientific emphasis over time. Keyword trends indicated a shift from anticoagulation to mechanical thrombectomy as a research focus. Visual mapping using VOSviewer revealed strong institutional and international collaborations and distinct co-citation clusters. These findings highlight evolving priorities in iliofemoral DVT research and provide a foundation for future studies and collaborative efforts in vascular interventions.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86924"},"PeriodicalIF":1.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531922","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 Unusual Cause of Knee Pain Identified by Point-of-Care Ultrasound in the Emergency Department.","authors":"Miguel F Agrait Gonzalez, Nehemesis Rivera Ortiz, Jenniffer Santiago, Glen Malaret Hernandez","doi":"10.7759/cureus.86934","DOIUrl":"10.7759/cureus.86934","url":null,"abstract":"<p><p>Morel-Lavallée lesions (MLLs) are closed degloving injuries that typically result from shearing forces separating the subcutaneous tissue from the underlying fascia, creating a potential space that becomes filled with blood, lymphatic fluid, and necrotic tissue. These lesions are frequently missed on initial evaluation, especially in the context of blunt injury without obvious shearing trauma. Here, we present the case of a 28-year-old male who sustained trauma to his right thigh and knee while attempting to move a refrigerator. Initially diagnosed with a knee contusion after X-rays showed no fracture, the patient experienced worsening pain and swelling, prompting a visit to our emergency department (ED). Upon evaluation in the ED, the sonographic evaluation revealed a large fluid collection overlying the distal lateral thigh and lateral femoral condyle without any associated intraarticular effusion. Findings were consistent with an MLL, which was managed in the ED with ultrasound-guided drainage and compression therapy. This case highlights the importance of recognizing MLLs in the ED, as these injuries are frequently missed on initial evaluation. Early identification and appropriate management of MLL are crucial to preventing complications such as infection, chronic pain, loss of function, and delayed healing.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86934"},"PeriodicalIF":1.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531917","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":"Vaccination Coverage and Associated Factors of Hepatitis B, Measles-Mumps-Rubella, Varicella, and Tetanus-Diphtheria-Acellular Pertussis Among Primary Health Care Workers in Qatar: A Retrospective Study (2020-2024).","authors":"Sameera Alhajri, Anees A Alyafei, Sandy Semaan, Maryam Al Muslemani, Asma Al Nuaimi","doi":"10.7759/cureus.86901","DOIUrl":"10.7759/cureus.86901","url":null,"abstract":"<p><p>Background Healthcare workers (HCWs) are at an increased risk of exposure to infectious diseases, making vaccination a cornerstone of occupational health and patient safety. Despite clear recommendations, vaccination coverage among HCWs remains suboptimal worldwide, with significant disparities influenced by sociodemographic and professional factors. There is a lack of published data on vaccine uptake among HCWs in Qatar, particularly within the Primary Health Care Corporation (PHCC). This study aimed to assess the vaccination coverage rates for hepatitis B virus (HBV), measles, mumps, and rubella (MMR), varicella, and tetanus, diphtheria, and acellular pertussis (Tdap) among HCWs at PHCC in Qatar from 2020 to 2024 and to identify factors associated with vaccination status. Methods A quantitative, retrospective analysis was conducted using data from the Electronic Medical Records System and Human Resources Database across 31 PHCC health centers. All HCWs employed for at least three months were included. Sociodemographic and career-related variables were extracted. Vaccination status for HBV, MMR, varicella, and Tdap was determined. Descriptive statistics summarized coverage rates, and chi-square tests assessed the associations between vaccination status and sociodemographic variables. A p-value was considered statistically significant at <0.005. Results Among 7,463 PHCC employees, the mean age was 40.82 ± 9.00 years, with 65.06% females and 72.18% non-Qatari nationals. Clinical HCWs comprised 64.24% of the workforce. Vaccination coverage was 16.75% for HBV, 5.86% for MMR, 1.76% for varicella, and 12.87% for Tdap. Coverage rates were significantly higher among younger age groups, females, non-Qatari nationals, and those with fewer years of service (p < 0.001 for most comparisons). Non-clinical HCWs had higher HBV coverage, while clinical HCWs had higher Varicella coverage. Educational qualification was associated with HBV and MMR coverage but not with varicella or Tdap. Conclusions Vaccination coverage among PHCC HCWs in Qatar is considerably lower than international targets, with significant disparities across age, gender, nationality, job role, years of service, and education. These findings underscore the need for targeted interventions to enhance vaccine uptake and address barriers among specific HCW subgroups, thereby improving occupational and patient safety.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86901"},"PeriodicalIF":1.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531853","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":"Unmasking Amoebiasis: An Unexpected Cause of Colitis in a Non-endemic Region.","authors":"Vikash S Sagar, Nauman Nauman, Gayathri Jayakumar, Bismah Kazi","doi":"10.7759/cureus.86877","DOIUrl":"10.7759/cureus.86877","url":null,"abstract":"<p><p>Amoebic colitis is a common mimic of inflammatory bowel disease (IBD), primarily encountered in developing countries. We present a case of a 73-year-old British male with no travel history to any amoebic endemic regions, who presented with a three-month history of per rectal (PR) bleeding, diarrhoea, and a positive faecal immunochemical test (FIT). Prior to this, he reported no history of experiencing any gastrointestinal symptoms. Colonoscopy revealed patchy pan-colitis, most marked in the ascending colon, and histology confirmed chronic inflammation. A diagnosis of IBD was made, and the patient was started on corticosteroids and 5-aminosalicylates (5-ASA). He subsequently presented to the emergency department (ED) with worsening symptoms and rising inflammatory markers. Flexible sigmoidoscopy showed progression of inflammation, and despite treatment with intravenous corticosteroids and infliximab, a tumour necrosis factor-alpha (TNF-α) inhibitor, there was no improvement. Cross-sectional imaging performed due to new-onset breathlessness during this admission identified multiple hepatic abscesses and a superior mesenteric vein thrombus. Immunosuppression was stopped, and broad-spectrum antibiotics were initiated. Liver biopsy showed inflammatory cells, but no microorganisms were seen on cultures. Due to treatment-refractory colitis and contraindications to further immunosuppression, the patient underwent a laparoscopic subtotal colectomy with end ileostomy. Histology of the resected bowel was not in keeping with IBD, prompting re-evaluation of the initial biopsies taken from the colonoscopy at first presentation. On re-examination, amoebic-like trophozoites were seen, and the diagnosis of amoebic colitis was confirmed following review by a tertiary centre for specialist infectious disease and gastrointestinal pathology. This case highlights the need for a broad differential when managing treatment-refractory colitis, particularly in non-endemic regions, where the index of suspicion for amoebic colitis is low, and the risk of misdiagnosis is high.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86877"},"PeriodicalIF":1.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531929","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":"Gastrointestinal Complications of Systemic Sclerosis: A Case Report.","authors":"Mason Arbabi, Bella Garg, Saviz Saghari, Paryus Patel","doi":"10.7759/cureus.86844","DOIUrl":"10.7759/cureus.86844","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is a rare, chronic systemic rheumatic disease. Gastrointestinal (GI) involvement is highly prevalent in SSc and any part of the GI tract may be affected. This can range from mild symptoms like heartburn and dysphagia to severe issues like abdominal distention, malnutrition, and fecal incontinence. In SSc patients, GI tract dysfunction significantly impacts the quality of life and is a major contributor to both morbidity and mortality. This case report highlights an 80-year-old female patient with SSc/CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia) syndrome experiencing severe GI involvement who presented to the emergency department with hypoxic respiratory failure and acute kidney injury. The patient and her family finally made the decision to transition to inpatient hospice care, focusing on comfort and dignity, leading to the patient's peaceful passing.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86844"},"PeriodicalIF":1.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531921","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":"Silent Killer in the Liver: A Rare Case of Primary Hepatic Angiosarcoma Presenting With Acute Liver Failure.","authors":"Ahmed Ali Aziz, Muhammad Ali Aziz, Rida Zahid, Muhammad Amir, Rehan Shah, Ijlal Akbar Ali","doi":"10.7759/cureus.86875","DOIUrl":"10.7759/cureus.86875","url":null,"abstract":"<p><p>Primary hepatic angiosarcoma (PHA) is a rare malignant tumor of the liver with an extremely poor prognosis even after diagnosis and treatment. It is difficult to diagnose due to a lack of disease-specific clinical features, tumor markers, or imaging findings. Due to its rarity of occurrence, treatment protocols are not yet clear. We present a rare case of PHA in a 39-year-old female who presented with right upper quadrant abdominal pain and was found to have acute liver failure and a non-resectable liver mass. She underwent a liver transplant (LT) as PHA could not be diagnosed before the transplant. She received chemotherapy and had done well for 12 months until her carcinoma relapsed. She underwent a repeat cycle of chemotherapy; however, her tumor continued to progress and is now undergoing a trial of immunotherapy.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86875"},"PeriodicalIF":1.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531925","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":"Forecasting Youth Tobacco Use With the National Youth Tobacco Survey Data (2021-2024): Implications for Dental Public Health and Cessation Counseling in the United States.","authors":"Bugude Shiva Shankar","doi":"10.7759/cureus.86851","DOIUrl":"10.7759/cureus.86851","url":null,"abstract":"<p><p>Background Youth tobacco use, particularly e-cigarette use, remains a critical public health issue in the United States, with significant implications for oral and systemic health. Although recent regulatory interventions, such as age restrictions and limitations on flavored tobacco products, have been implemented, significant disparities in usage patterns persist across gender and racial/ethnic groups. This study analyzes trends in youth tobacco use to project future patterns and inform targeted dental public health strategies and cessation interventions. Materials and methods Data spanning 2021-2024 from a national survey of youth were analyzed to assess overall tobacco use, gender-specific patterns, e-cigarette use by gender, and variations across racial/ethnic groups (non-Hispanic White and Hispanic students). Statistical methods, including chi-square tests, z-tests for proportions, and linear regression, were applied to identify trends. Forecasting models, including simple linear regression and Holt's exponential smoothing, were applied to estimate tobacco use for 2025 and 2026. To enhance the reliability of the projections, the forecasts generated by both models were averaged using equal weights. Results Overall tobacco use decreased from 9.3% in 2021 to 7.7% in 2024, with a statistically significant drop between 2023 and 2024 (p < 0.01). Gender disparities were evident, with females showing higher use in 2023 (11.2% vs. 8.9% in males, p < 0.001), though convergence occurred by 2024. E-cigarette use mirrored this trend, with gender differences diminishing over time. Racial/ethnic analysis revealed higher initial use among non-Hispanic White students in 2021, aligning with Hispanic students by 2024. Forecasts indicate sustained declines, projecting overall use at 6.95% in 2025 and 6.2% in 2026 (p < 0.05). Conclusion The consistent reduction in youth tobacco use, including e-cigarette consumption, suggests the potential efficacy of ongoing interventions. However, persistent gender and racial/ethnic differences underscore the necessity for tailored approaches. These findings highlight opportunities for dental professionals to incorporate cessation counseling into practice, mitigating tobacco-related oral health risks, and provide a foundation for proactive public health strategies to further decrease youth tobacco use.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86851"},"PeriodicalIF":1.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531920","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":"Preoperative Transcatheter Arterial Embolization and Modified Hepatorrhaphy for Severe Liver Trauma: An Emerging Damage-Control Strategy.","authors":"Teppei Tokumaru, Hideaki Kurata, Jin Mitsui, Joji Tomioka","doi":"10.7759/cureus.86812","DOIUrl":"10.7759/cureus.86812","url":null,"abstract":"<p><p>The efficacy of hepatorrhaphy in managing severe hepatic trauma remains uncertain. Although perihepatic packing (PHP) is widely employed, it is associated with risks such as infection and abdominal compartment syndrome. These concerns underscore the need for safer and more effective damage-control strategies. We report the case of a 16-year-old female patient who sustained blunt abdominal trauma following a motorcycle collision and presented with hemodynamic instability due to severe hepatic and renal injuries. Preoperative transcatheter arterial embolization (TAE) enabled hepatorrhaphy without the need for PHP. An absorbable oxidized regenerated cellulose hemostat (Surgicel NU-KNIT, Ethicon, Raritan, NJ) was used in place of conventional non-absorbable pledgets. A right nephrectomy was concurrently performed due to extensive hilar avulsion. The postoperative course was uneventful, and no further interventions were required. This case highlights two potential innovations: the integration of preoperative TAE with hepatorrhaphy and the use of an absorbable hemostatic agent. These approaches may enhance hemostatic efficacy and reduce reliance on PHP in selected trauma cases.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 6","pages":"e86812"},"PeriodicalIF":1.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510008","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}