René Haugk, Holger Rohde, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Emmanuel Acheamfour-Akowuah, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Tafese Beyene Tufa, Torsten Feldt, Hagen Frickmann, Kirsten Alexandra Eberhardt
{"title":"Associations of HIV status and the abundance of blaCTX-M and vanB resistance genes in stool samples of Ghanaian individuals.","authors":"René Haugk, Holger Rohde, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Emmanuel Acheamfour-Akowuah, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Tafese Beyene Tufa, Torsten Feldt, Hagen Frickmann, Kirsten Alexandra Eberhardt","doi":"10.1556/1886.2025.00061","DOIUrl":"https://doi.org/10.1556/1886.2025.00061","url":null,"abstract":"<p><strong>Background: </strong>A cross-sectional study was performed to investigate associations of enteric colonization with resistant bacteria in Ghanaian individuals who were tested positive and negative for the human immunodeficiency virus (HIV).</p><p><strong>Methods: </strong>Abundance of the ESBL-(extended spectrum beta-lactamase-)type resistance-mediating gene blaCTX-M and the vancomycin resistant enterococci-(VRE-)associated genes vanA and vanB genes was associated with available clinical and epidemiological data on the study participants.</p><p><strong>Results: </strong>In terms of enteric carriage of ESBL-positive bacteria with CTX-M-type beta-lactam resistance genes, being HIV-positive (93.3% vs. 83.3%, P = 0.003) and having low CD4+ T-lymphocyte counts <200 cells/µL (microliter) (96.8% vs. 91.2%, P = 0.009) were identified as risk factors. Enteric carriage of ESBL-positive bacteria with CTX-M-type resistance genes was associated with poor immunological status in terms of lower CD4+ T-leukocyte counts, lower CD4+/CD8+ ratios, higher viral replication, as well as with immune activation. For VRE, a non-significant trend for more VRE in control individuals without known HIV infection (6% vs. 2.5%, P = 0.089) was observed.</p><p><strong>Conclusions: </strong>An association of ESBL colonization and immunological status was recorded. No such association was detected for VRE, suggesting different determinants of local VRE epidemiology.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305061","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}
Anina Lange, Soraya Mousavi, Stefan Bereswill, Markus M Heimesaat
{"title":"Old germs, novel approaches - A systematic review on pathogen distribution and therapeutic intervention strategies in periprosthetic joint infections.","authors":"Anina Lange, Soraya Mousavi, Stefan Bereswill, Markus M Heimesaat","doi":"10.1556/1886.2025.00057","DOIUrl":"https://doi.org/10.1556/1886.2025.00057","url":null,"abstract":"<p><p>Chronic degenerative diseases including osteoarthritis are on the rise leading to a growing demand for joint replacement surgery in elderly and often multimorbid patients. Periprosthetic joint infections (PJIs) constitute serious complications following endoprosthetic surgery. Increasing prevalences of PJIs by multi-drug resistant and/or biofilm-producing bacteria hinder sufficient anti-infectious treatment especially in vulnerable patients. Hence, alternative and/or adjunct therapeutic approaches appear crucial in the combat of difficult-to-treat PJIs. In our review we summarize recent evidence for changes in the spectrum of PJI-associated pathogens over time and elucidate treatment concepts beyond established standard therapies. Our literature search revealed that the spectrum of bacterial pathogens can vary considerably depending on the time course post-surgery, the geographical region, and the patient population. While standard antibiotic therapy besides surgical revision remains the corner stone of treatment, alternative/adjunct antibiotics-independent methods are increasingly coming to the fore. These include the targeted dissolution of bacterial biofilms, enzyme-based approaches, and enhanced infection prevention measures upon risk assessment of the patient. Despite promising methodological approaches clinical evidence of their therapeutic value in everyday care is scarce. Hence, optimized early pathogen detection measures, individually tailored treatment concepts and their application in interdisciplinary settings will be important in the combat of difficult-to-treat PJIs.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245306","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":"Ethnic disparities in prevalence and screening rates of sexually transmitted infections.","authors":"Perla Schmidt Henriquez, Markus M Heimesaat","doi":"10.1556/1886.2025.00052","DOIUrl":"10.1556/1886.2025.00052","url":null,"abstract":"<p><p>Sexually transmitted infections (STIs) represent a major global health concern, with certain ethnic communities being disproportionately affected. This review summarizes recent evidence of ethnic disparities in STI prevalence and screening rates, with most data originating from the United States. The findings confirm the fact that certain ethnic communities such as Black and Hispanic display higher prevalence rates of STIs. Yet the data on screening behavior reveal a striking contradiction. While some studies report lower testing rates among these communities, others demonstrate that Black and Hispanic individuals reported the highest testing engagement compared to other ethnic groups. If testing behavior alone explained these disparities, a clearer correlation between screening and infection rates would be expected. Instead, that paradox might suggest a complex interplay with additional factors included in this review such as, for example, institutional racism, socioeconomic inequalities, differences in sexual and healthcare-seeking behavior, traumatic experiences, and limited access to healthcare. In conclusion, given the global burden caused by STIs, the ongoing health disparities in many parts of the world indicate an urgent need for further investigations into the mechanisms behind these disparities and to identify factors that yet may have been overlooked.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"164-171"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226573","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":"Relevance in question: A rare case of Actinomyces radicidentis bacteremia.","authors":"Hagen Frickmann, Frauke Theis, Philipp Warnke","doi":"10.1556/1886.2025.00048","DOIUrl":"10.1556/1886.2025.00048","url":null,"abstract":"<p><strong>Background: </strong>Actinomyces spp.-associated bloodstream infections have been infrequently described and repeatedly but not exclusively associated with intra-oral infections. For Actinomyces radicidentis, which has been shown to cause biofilm-forming endodontic infections, bacteremia has only once been reported so far. To elaborate on the scarcely available information on potential etiological relevance of A. radicidentis as a cause of bloodstream infection, we describe another case of A. radicidentis bacteremia.</p><p><strong>Case report: </strong>A. radicidentis confirmed by 16S rRNA gene sequencing was detected in the bloodstream of an 81-year-old male multimorbid patient with diffuse large B-cell lymphoma of non-germinal center type under chemotherapy as the most critical medical condition. A specific focal infection was not recorded. A concomitantly diagnosed Pseudomonas aeruginosa-associated urinary tract infection was treated with piperacillin/tazobactam for 1 day and meropenem for additional 9 days. While the course of the infection was considered as favorable by the clinicians in charge, an unfavorable course of the underlying malignant disease let to demission of the patients for palliative care at home.</p><p><strong>Discussion: </strong>Although A. radicidentis bacteremia was not specifically addressed, negative effects on the clinical course were not confirmed.</p><p><strong>Conclusions: </strong>The etiological relevance of A. radicidentis bacteremia in patients without specific infectious foci remains uncertain.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"157-163"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070754","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}
Sven Jungblut, Sebastian Aland, Jens-Uwe Erk, Julia Aland, Hagen Frickmann
{"title":"Gall bladder sludge and biliary pseudolithiasis as rare complications of ceftriaxone therapy in adult patients - A case report including sonographic workup.","authors":"Sven Jungblut, Sebastian Aland, Jens-Uwe Erk, Julia Aland, Hagen Frickmann","doi":"10.1556/1886.2025.00041","DOIUrl":"10.1556/1886.2025.00041","url":null,"abstract":"<p><strong>Background: </strong>Ceftriaxone-induced biliary pseudolithiasis is a disease entity frequently observed in children, while it is rarely seen in adult patients. We provide a thorough sonographic workup of the case to guide sonographers confronted with it.</p><p><strong>Case report: </strong>A 41-years-old male patient with sonographically confirmed, culture-negative endocarditis accompanied by repeated fever episodes received 4g ceftriaxone per day next to ampicillin and gentamicin as an element of his antibiotic therapy. At day 4 of treatment, signs of gall bladder sludge and biliary pseudolithiasis were first seen in sonography. At day 17, abdominal pain over 30 min and increased liver and pancreatic enzymes pointed towards temporal duct obstruction as a complication and ceftriaxone therapy had to be preterm cancelled. A sonographic work-up of the stepwise improvement of the sonographic findings after the end of the ceftriaxone therapy is provided, a reemergence of endocarditis was not observed.</p><p><strong>Discussion: </strong>The case reminds of a rarely recognized, usually reversible side effect of high-dose ceftriaxone therapy and its complications. The sonographic work-up may serve as guidance for clinicians during follow-up assessments.</p><p><strong>Conclusions: </strong>Although ceftriaxone allows usually well-tolerated antimicrobial therapies, biliary pseudolithiasis should be kept in mind as a rare but sometimes non-ignorable side effect.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"150-156"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884605","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}
Philipp Warnke, Moritz Jansson, Ina Antonenko, Hagen Frickmann, Andreas Podbielski
{"title":"Negligible influence of limescale deposits on faucet aerators on measured microorganism loads.","authors":"Philipp Warnke, Moritz Jansson, Ina Antonenko, Hagen Frickmann, Andreas Podbielski","doi":"10.1556/1886.2025.00027","DOIUrl":"10.1556/1886.2025.00027","url":null,"abstract":"<p><strong>Introduction: </strong>The study was conducted to assess the effects of limescale deposits on faucet aerators on the qualitative and quantitative detection of microorganisms from swabbing and first jet water samples.</p><p><strong>Methods: </strong>Limescale deposits on faucet aerators were categorized into three groups: not / slightly calcified, moderately calcified and heavily calcified. Colonization was assessed by isolating microorganisms from standardized swabbing and water samples. Microorganisms isolated from the aerators were compared with clinical isolates from the same year.</p><p><strong>Results: </strong>Regardless of the degree of calcification on the faucet aerators, similar numbers and types of microorganisms were found. Except for Staphylococcus epidermidis and the rare occurrence of Staphylococcus aureus and Nacaseomyces glabratus on the aerators, there were no matches between the microorganisms isolated from the aerators and the top ten clinical isolates. Microorganisms frequently isolated from aerators, such as Sphingomonas paucimobilis, were extremely rare in clinical samples. No differences in species were observed based on the degree of calcification of the aerators.</p><p><strong>Conclusions: </strong>The study did not demonstrate a significant effect of the degree of calcification on the colonization of aerators. Although calcification of aerators as a risk factor for increased microbial transmission cannot be entirely dismissed, its importance appears to be secondary.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"103-112"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510053","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}
Hagen Frickmann, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Martin Kofi Agyei, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Ulrike Loderstädt, Tafese Beyene Tufa, Torsten Feldt, Kirsten Alexandra Eberhardt
{"title":"Epidemiological, clinical and immunological features of Schistosoma spp., Stronglyoides stercoralis and Taenia spp. infections in Ghanaian HIV patients.","authors":"Hagen Frickmann, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Martin Kofi Agyei, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Ulrike Loderstädt, Tafese Beyene Tufa, Torsten Feldt, Kirsten Alexandra Eberhardt","doi":"10.1556/1886.2025.00031","DOIUrl":"10.1556/1886.2025.00031","url":null,"abstract":"<p><strong>Background: </strong>Interactions of helminth infections and human immunodeficiency virus (HIV) remain incompletely understood. This study aimed to assess the clinical, epidemiological, and immunological characteristics of co-infections involving HIV and selected nematode, trematode and cestode species commonly detected in stool samples.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among people-living-with-HIV (PLWH) with and without anti-retroviral therapy and HIV-negative controls at a tertiary hospital in Kumasi, Ghana. Stool samples were analyzed by real-time PCR for the presence of Strongyloides stercoralis, Schistosoma spp. as well as Taenia spp. Diagnostic findings were compared with clinical, demographic, socioeconomic and immunological data.</p><p><strong>Results: </strong>Low prevalences of helminth infections were observed across the study population, ranging from 1.9% for S. stercoralis to 2.8% for Schistosoma spp. Only weak and infrequent associations were found between helminth infections and HIV status or immunosuppression. Identified risk factors included male sex, younger age, shorter duration since HIV diagnosis, and poor food hygiene in the case of taeniasis.</p><p><strong>Conclusions: </strong>In this Ghanaian population, co-infections of HIV and helminths were infrequent and showed limited immunological associations. These findings suggest that helminth detection in PLWH is more likely to reflect local endemicity than HIV-related immunosuppression.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"113-124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499917","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}
Valea Pötschke, Stefan Bereswill, Markus M Heimesaat
{"title":"Antibacterial effects of sulforaphane - A phytonutrient derived from broccoli as promising candidate in the combat of bacterial infections.","authors":"Valea Pötschke, Stefan Bereswill, Markus M Heimesaat","doi":"10.1556/1886.2025.00028","DOIUrl":"10.1556/1886.2025.00028","url":null,"abstract":"<p><p>Bacterial pathogens, particularly antibiotic-resistant strains may constitute major challenges for the successful treatment of infected patients. Therefore, novel antibiotics or alternative, antibiotics-independent compounds with antimicrobial properties such as phytonutrients are needed. Our systematic literature review summarizes current knowledge on antibacterial effects of sulforaphane (SFN) in vitro and in vivo, including human studies. The isothiocyanate SFN is abundant in plants from the Brassicaceae family including broccoli. The 28 reports reviewed herein revealed that SFN i.) exerted antimicrobial effects against a variety of Gram-positive and Gram-negative bacteria; ii.) counteracted distinct virulence factors such as biofilm formation and toxin production (e.g. Shiga toxin); iii.) enhanced antibacterial immune cell responses mounting in anti-oxidant and anti-inflammatory actions thereby supporting bacterial killing and dampening inflammatory cell and tissue damage; iv.) prevented from aspirin-induced small intestinal cell injury; and v.) alleviated Helicobacter pylori-induced gastritis. In conclusion, given its antibacterial, immune-modulatory, and disease-alleviating effects, SFN constitutes a promising alternative antibiotic-independent candidate for the treatment of bacterial infections, warranting further consideration in clinical trials.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"139-149"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487491","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}
Andreas Erich Zautner, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Tafese Beyene Tufa, Torsten Feldt, Sascha Kahlfuß, Hagen Frickmann, Kirsten Alexandra Eberhardt
{"title":"Comparative epidemiology of Ghanaian individuals with molecular proof of Entamoeba histolytica with and without concomitant human immunodeficiency virus infection.","authors":"Andreas Erich Zautner, Fred Stephen Sarfo, Betty Roberta Norman, Albert Dompreh, Shadrack Osei Asibey, Richard Boateng, Edmund Osei Kuffour, Veronica Di Cristanziano, Tafese Beyene Tufa, Torsten Feldt, Sascha Kahlfuß, Hagen Frickmann, Kirsten Alexandra Eberhardt","doi":"10.1556/1886.2025.00030","DOIUrl":"10.1556/1886.2025.00030","url":null,"abstract":"<p><strong>Introduction: </strong>Entamoeba histolytica is the causative agent of enteric amebiasis in human patients. Partly controversial hypotheses have been proposed regarding the potential impact of the immunological status of patients as well as HIV (human immunodeficiency virus) positivity on the prevalence and clinical course of amebiasis.</p><p><strong>Methods: </strong>To investigate a potential interplay between the epidemiology of E. histolytica and immunological markers of Ghanaian HIV patients, real-time PCR targeting E. histolytica DNA in stool samples was conducted on a cohort of 595 clinically and immunologically well-characterized adult Ghanaian HIV patients, along with 82 HIV negative control-individuals.</p><p><strong>Results: </strong>E. histolytica DNA was more prevalent in the HIV-negative control group (12.2%, n = 10/82) compared to the HIV-positive subpopulation (3.5%, n = 21/595, P = 0.001). Among HIV-positive individuals, the prevalence of E. histolytica DNA was 4.2% in subjects with CD4+ T cell counts above 200 cells/µL, 3.3% in case of 50 and 200 cells/µL, and 0% in case of less than 50 cells/µL. In the group of ART-exposed HIV-positive individuals, E. histolytica positivity was associated to lower CD4+/CD8+ cell ratios.</p><p><strong>Conclusions: </strong>The study suggested a negative association of E. histolytica DNA detections with HIV-positivity and with the degree of HIV infection-associated immunosuppression.</p>","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"94-102"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277046","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}
Araceli Perez-Lopez, Gabriela Hernandez-Galicia, Luis Uriel Lopez-Bailon, Ana D Gonzalez-Telona, Roberto Rosales-Reyes, Celia M Alpuche-Aranda, Jose I Santos-Preciado, Vianney Ortiz-Navarrete
{"title":"Corrigendum to: Pro-inflammatory and anti-inflammatory responses in B cells during Salmonella infection.","authors":"Araceli Perez-Lopez, Gabriela Hernandez-Galicia, Luis Uriel Lopez-Bailon, Ana D Gonzalez-Telona, Roberto Rosales-Reyes, Celia M Alpuche-Aranda, Jose I Santos-Preciado, Vianney Ortiz-Navarrete","doi":"10.1556/1886.2024.11188","DOIUrl":"10.1556/1886.2024.11188","url":null,"abstract":"","PeriodicalId":93998,"journal":{"name":"European journal of microbiology & immunology","volume":" ","pages":"137"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121797","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}