European journal of breast health最新文献

{"title":"Advances in Breast Cancer Care: The Role of Artificial Intelligence and Digital Pathology in Precision Medicine.","authors":"Ayşe Hümeyra Dur Karasayar, İbrahim Kulaç, Nilgün Kapucuoğlu","doi":"10.4274/ejbh.galenos.2025.2024-12-8","DOIUrl":"10.4274/ejbh.galenos.2025.2024-12-8","url":null,"abstract":"<p><p>Artificial intelligence (AI) and digital pathology are transforming breast cancer management by addressing the limitations inherent in traditional histopathological methods. The application of machine learning algorithms has enhanced the ability of AI systems to classify breast cancer subtypes, grade tumors, and quantify key biomarkers, thereby improving diagnostic accuracy and prognostic precision. Furthermore, AI-powered image analysis has demonstrated superiority in detecting lymph node metastases, contributing to more precise staging, treatment planning, and reduced evaluation time. The ability of AI to predict molecular markers, including human epidermal growth factor receptor 2 status, BRCA mutations and homologus recombination deficiency, offers substantial potential for the development of personalized treatment strategies. A collaborative approach between pathologists and AI systems is essential to fully harness the potential of this technology. Although AI provides automation and objective analysis, human expertise remains indispensable for the interpretation of results and clinical decision-making. This partnership is anticipated to transform breast cancer care by enhancing patient outcomes and optimizing treatment approaches.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":"93-100"},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545246","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":"Vitamin D Deficiency and Mastalgia: A Prospective Controlled Study on Prevalence and the Therapeutic Impact of Supplementation.","authors":"Goranta Navya Sree, Sanjay Kumar Yadav, Deepti Bala Sharma, Dhananjaya Sharma, Saket Shekhar","doi":"10.4274/ejbh.galenos.2025.2025-1-6","DOIUrl":"10.4274/ejbh.galenos.2025.2025-1-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between vitamin D deficiency and mastalgia and assess the effectiveness of vitamin D supplementation in alleviating mastalgia symptoms.</p><p><strong>Materials and methods: </strong>A prospective investigational study conducted in an Indian tertiary teaching centre. Participants were included if the presented with mastalgia and controls without mastalgia were also were recruited. Exclusion criteria were malignant pathology; fibroadenoma; other benign breast diseases; or recent therapeutic vitamin D supplementation. Vitamin D deficiency was classified as <20 ng/mL. Women in the mastalgia group with deficiency received 60,000 IU weekly oral vitamin D for eight weeks. Symptom severity was evaluated using a visual analog scale (VAS) at baseline and follow-up intervals of 4, 8, and 12 weeks. Difference in serum vitamin D levels between groups and changes in VAS scores post-supplementation was assessed.</p><p><strong>Results: </strong>A total of 200 women, including 100 with mastalgia and 100 without (control group), were recruited over two years.The mean serum vitamin D level was significantly lower in the mastalgia group (25.29±7.7 ng/mL) compared to controls (31.46±8.5 ng/mL, <i>p</i><0.0001). Vitamin D deficiency was more prevalent in the mastalgia group (26% vs. 9%, <i>p</i> = 0.001). Post-supplementation, 46% of deficient patients in the mastalgia group reported symptom improvement, with 21% achieving complete resolution. However, 54% reported persistent symptoms despite achieving sufficient vitamin D levels.</p><p><strong>Conclusion: </strong>Vitamin D deficiency is more prevalent in Indian women with mastalgia, and supplementation provides symptomatic relief for some patients. However, a significant proportion of patients continue to experience symptoms, suggesting other underlying factors contributing to mastalgia. Further research is needed to explore these factors and optimize management strategies.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":"137-140"},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607417","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":"Male Breast Cancer in Portugal: A Descriptive Analysis of a 20-Year Cohort.","authors":"Maria Alexandra Montenegro, Tiago Dias Domingues, Teresa Mota Garcia, Rita Quaresma Ferreira, Ivánia Tavares Furtado, Rui Escaleira, Filipa R Verdasca, Diana Cardoso Simão, Leonor Fernandes, Sónia Duarte Oliveira","doi":"10.4274/ejbh.galenos.2025.2025-2-2","DOIUrl":"10.4274/ejbh.galenos.2025.2025-2-2","url":null,"abstract":"<p><strong>Objective: </strong>Male breast cancer (MBC) is a rare malignancy, representing less than 1% of all breast cancer cases. Despite the rising incidence, MBC research remains limited, with most data extrapolated from female breast cancer (FBC). This study evaluated the clinicopathological features, treatment strategies, and survival outcomes of MBC patients in Portugal over two decades.</p><p><strong>Materials and methods: </strong>A retrospective analysis of MBC cases from the Portuguese National Oncology registry (2001-2021) was conducted. Clinicopathological features, therapeutic strategies, and overall survival (OS) were assessed across three disease categories: localized, locally advanced, and metastatic. Hormone receptor status, human epidermal growth factor receptor 2 (HER2) expression, and Ki-67 index were recorded, and survival was estimated using Kaplan-Meier methods.</p><p><strong>Results: </strong>A total of 620 MBC cases were included with median age at diagnosis 68 years (interquartile range: 60-77). Localized disease accounted for 60.3% of the cases, locally advanced for 24.5%, and metastatic 15.2%. Most tumours were invasive carcinoma of no special type (86%), and hormone receptor-positive (estrogen receptor: 96.6%; progesterone receptor: 85.6%). HER2 -disease was noted in 11.6% of cases and triple-negative in 1.6%. Mastectomy was the primary surgical intervention while tamoxifen was the most widely used adjuvant endocrine therapy-exemestane therapy (A-ET). ET was the most prescribed first-line therapy. Median OS was 86 months for localized, 70 months for locally advanced, and 41 months for metastatic disease.</p><p><strong>Conclusion: </strong>This study highlights the unique challenges of MBC, including late-stage diagnoses and reliance on FBC-derived protocols. Findings suggest an urgent need for male-specific clinical trials and molecular research to optimise treatment and outcome. In Portugal increased awareness and early detection initiatives will be important to advance MBC care.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":"154-161"},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627190","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":"Aromatase Inhibitor-Related Lower Limb Tendinopathies: Ultrasound is on the Agenda.","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Sercan Aksoy, Murat Kara, Levent Özçakar","doi":"10.4274/ejbh.galenos.2025.2024-12-7","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2025.2024-12-7","url":null,"abstract":"","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Diagnostic Potential of Platelet-to-Lymphocyte Ratio and HALP Score in Newly Diagnosed Breast Cancer: A Step Toward Early Detection.","authors":"Durmuş Ayan, Ergül Bayram, Hakan Sakallı, Umut Karabay, Fatih Yay","doi":"10.4274/ejbh.galenos.2025.2024-12-9","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2025.2024-12-9","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer (BC) is a global concern due to its high incidence worldwide. The alarming increase in BC cases highlights the need for careful management of the disease at multiple levels. This study investigated the diagnostic value of hemoglobin, albumin, lymphocyte and platelet counts (HALP score), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in newly diagnosed BC patients.</p><p><strong>Materials and methods: </strong>A total of 84 individuals, including 42 healthy volunteers (group I) and 42 patients newly diagnosed with BC (group II), were included. Serum albumin levels were determined using spectrophotometry. The levels of tumor-markers carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3) in serum were analyzed by electrochemiluminescence immunoassay. Hemogram parameters were analyzed using fluorescence flow cytometry.</p><p><strong>Results: </strong>The median PLR was significantly lower in group II than group I (<i>p</i> = 0.014). There were no statistical differences in HALP score, NLR, LMR, and prognostic nutrition index between the two groups (<i>p</i> = 0.133, <i>p</i> = 0.993, <i>p</i> = 0.591, and <i>p</i> = 0.294, respectively). The sensitivity and specificity of PLR in predicting BC were 61.90% and 64.29%, respectively, with an area under the curve of 0.665 (<i>p</i> = 0.009, 95% confidence interval: 0.5480 to 0.7819, cut-off value ≤124). PLR, CEA and CA 15-3 were independent risk factors for BC (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>The findings suggest that PLR may serve as a potential biomarker for the early diagnosis of BC; however, further validation is required. Conversely, the HALP score and other parameters did not demonstrate a significant association with early BC diagnosis. These results warrant corroboration through regional and community-based studies.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Plasmacytoma to Rib Tuberculosis: The Case of A Breast Mass With An Unexpected Diagnosis.","authors":"Hafedh Abbassi, Badra Bannour, Sarra Yacoub, Ekram Guerbej, Imen Bannour, Samir Hidar, Moncef Mokni","doi":"10.4274/ejbh.galenos.2024.2024-10-6","DOIUrl":"10.4274/ejbh.galenos.2024.2024-10-6","url":null,"abstract":"<p><p>Tuberculosis (TB) of the rib is an uncommon manifestation of extrapulmonary TB that can pose significant diagnostic challenges, especially when presenting as a breast mass. We report the case of a 74-year-old woman who presented with a left breast lump, initially suspected to be a plasmacytoma due to its imaging characteristics and clinical history. The mass was surgically excised, and histopathological analysis revealed granulomatous inflammation with caseous necrosis, suggesting TB. TB-polymerase chain reaction confirmed the diagnosis, despite negative Ziehl-Neelsen staining. The patient was treated with anti-tubercular therapy for twelve months, resulting in a favorable clinical outcome. This case highlights the importance of considering rib TB in the differential diagnosis of breast masses, particularly in endemic areas, and underscores the role of comprehensive diagnostic evaluations for timely and effective treatment.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"21 1","pages":"85-89"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916664","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":"Carbonic Anhydrase IX Enzyme in Triple Negative Breast Carcinoma: Relationship With Prognostic Factors and Response to Neoadjuvant Chemotherapy.","authors":"Özgen Arslan Solmaz, Nizamettin Kutluer, Mehmet Buğra Bozan","doi":"10.4274/ejbh.galenos.2024.2024-6-1","DOIUrl":"10.4274/ejbh.galenos.2024.2024-6-1","url":null,"abstract":"<p><strong>Objective: </strong>Triple negative breast carcinoma (TNBC) is characterized by the absence of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 receptor expression. Carbonic anhydrase IX (CA IX) is a tumor-associated cell surface glycoprotein that is involved in adaptation to hypoxia-induced acidosis and plays a role in cancer progression. The aim of this study was to investigate CA IX expression in TNBC and its relationship with treatment effect.</p><p><strong>Materials and methods: </strong>Immunohistochemical staining was performed on tru-cut biopsy materials with CA IX antibody. Positive staining was graded as low (<10%) and high (>10%). In addition, the relationship between tumor diameter, histological grade and the treatment effect on mastectomy materials performed after neoadjuvant treatment was evaluated.</p><p><strong>Results: </strong>TNBCs with positive staining for CA IX exhibited higher histological grade, and higher Ki-67 index compared to TNBCs with negative staining (<i>p</i> < 0.05). The response to treatment decreased as the degree of CA IX staining increased. There was no significant difference between the high staining group and low staining group in terms of patient age, tumor diameter and breast localisation.</p><p><strong>Conclusion: </strong>CA IX enzyme is a poor prognostic marker in TNBC cases. However, overexpression of CA IX was associated with reduced response to treatment.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"21 1","pages":"57-62"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916661","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 Investigation into Psychological Aspects of Patients Diagnosed with Breast Cancer: A Review Study of Postgraduate Theses Prepared in Turkey.","authors":"Umut Çıvgın","doi":"10.4274/ejbh.galenos.2024.2024-9-1","DOIUrl":"10.4274/ejbh.galenos.2024.2024-9-1","url":null,"abstract":"<p><p>A significant number of scientific data concerning breast cancer is generated in Turkey. The present research reviewed postgraduate theses examining the psychological evaluation of breast cancer patients conducted in Turkey. The objective of the review study was to ascertain the focal topics of the theses, identify commonly examined psychological variables, determine research gaps, compare the frequency of experimental and intervention studies with other kinds of research, and provide recommendations for literature. A retrospective descriptive study was designed by performing a search on the YÖK Thesis Center website with the keywords \"breast cancer\" and \"psychology\" (in Turkish and English) between 2000 and 2024. The criteria for inclusion in the review study required that the dissertation be a master's or doctoral thesis in psychology, involve breast cancer patients as participants, focus on patients who are not in remission, and be available as open access. Twenty-seven postgraduate theses were selected. Of the theses 88.9% were classified as master's theses, while 11.1% were categorized as doctoral theses. Although the variables included in the these studies were numerous, some were investigated more often. \"Post-traumatic growth\" was evaluated by 12 theses, \"perceived social support\" by 6, \"depression-anxiety-stress\" by 15, and \"coping\" by 8. more frequently observed factors include metacognition, ruminative thinking, schemas, body perception/image, and self-esteem. Most of the studies were relational and non-interventional. Only three studies used psychological intervention. It is suggested that thesis studies should include more participant characteristics, control for them in analyses, and be more experimental and effectiveness focused.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"21 1","pages":"16-32"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916732","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":"Bioinformatics Based Drug Repurposing Approach for Breast and Gynecological Cancers: <i>RECQL4/FAM13C</i> Genes Address Common Hub Genes and Drugs.","authors":"Gizem Ayna Duran","doi":"10.4274/ejbh.galenos.2024.2024-11-2","DOIUrl":"10.4274/ejbh.galenos.2024.2024-11-2","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of breast cancer and gynaecological cancers is high, and these cancer types can occur consecutively as secondary cancers. The aim of our study is to determine the genes commonly expressed in these cancers and to identify the common hub genes and drug components.</p><p><strong>Materials and methods: </strong>Gene intensity values of breast cancer, gynaecological cancers such as cervical, ovarian and endometrial cancers were used from the Gene Expression Omnibus database Affymetrix Human Genome U133 Plus 2.0 Array project. Using the linear modelling method included in the R LIMMA package, genes that differ between healthy individuals and cancer patients were identified. Hub genes were determined using cytoHubba in Cytoscape program. \"ShinyGo 0.80\" tool was used to determine the disease-specific biological KEGG pathways. Drug.MATADOR from the ShinyGo 0.80 tool was used to predict drug-target relationships.</p><p><strong>Results: </strong>The RecQ Like Helicase 4 and <i>Family with Sequence Similarity 13 Member C</i> genes were found to be similarly expressed in breast cancer and gynaecological cancers. Upon KEGG pathway analyses with hub genes, Drug.MATADOR analysis with hub genes related to cancer related pathways was performed. We have determined these gene/drug interactions: NBN (targeted by Hydroxyurea), EP300 (targeted by Acetylcarnitine) and MAPK14 (targeted by Salicylate and Dibutyryl cyclic AMP).</p><p><strong>Conclusion: </strong>The drugs associated with hub genes determined in our study are not routinely used in cancer treatment. Our study offers the opportunity to identify the target genes of drugs used in breast and gynaecological cancers with the drug repurposing approach.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"21 1","pages":"63-73"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916660","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":"Evaluation of Long-Term Lymphedema Rate in Patients With Subclinical Lymphedema Diagnosed in the Preoperative Period via Bioimpedance.","authors":"Zeynep Erdoğan İyigün, Tolga Ozmen, Serkan İlgün, Cansu Nakipoğlu, Enver Özkurt, Filiz Çelebi, Çağlar Ünal, Alper Öztürk, Gül Alço, Çetin Ordu, Gürsel Soybir","doi":"10.4274/ejbh.galenos.2024.2024-9-5","DOIUrl":"10.4274/ejbh.galenos.2024.2024-9-5","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the relationship between subclinical lymphedema identified prior to surgical intervention and clinical lymphedema observed in the late period, the incidence of lymphedema in our cohort, and the associated risk factors.</p><p><strong>Materials and methods: </strong>This prospective study was conducted with early-stage breast cancer patients who had been enrolled in a previous study. For diagnosing lymphedema, physical examination, L-Dex® score, and circumferential measurement was used. The L-Dex^® score was used as a screening test for preoperative, subclinical lymphedema since there were no clinical findings. Patients with subclinical lymphedema were provided with education and followed up more frequently with regular monitoring.</p><p><strong>Results: </strong>The mean age of the 217 participants was 56.7±12.7 years (range 29-90), and the mean body mass index was 27.7±3.3 kg/m² (range 19.3-36.9). Among the 217 patients, lymphedema was detected in 31 (14.7%) at a median follow-up period of 89 months (range 73-108 months). Multivariable analysis of factors associated with late-stage lymphedema revealed positive lymph node count and capsular invasion as significant factors (<i>p</i> = 0.001 for both). Forty (18.4%) had preoperative subclinical lymphedema. At the end of the follow-up period, lymphedema persisted in 11 patients (27.5%) and resolved in 29 patients (72.5%). In multivariable analysis, the positive lymph node count was identified as an independent variable in these patients.</p><p><strong>Conclusion: </strong>Identifying high-risk patients, regular monitoring, and early intervention can significantly reduce the risk of clinical lymphedema through timely treatment.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"21 1","pages":"40-45"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916663","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}