Mymensingh medical journal : MMJ最新文献

{"title":"Relationship between Functional Dyspepsia and Gastric Eosinophilia: A Single Centre Cross-Sectional Study.","authors":"I Mahbub, B C Shil, A N M Saifullah, A Islam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Functional dyspepsia is one of the most common gastrointestinal disorders. Immune activation by eosinophils is thought to be one of the important mechanisms behind the pathogenesis of functional dyspepsia. The study aimed to evaluate the association of gastric eosinophilia with functional dyspepsia. This cross-sectional study was conducted in the Department of Gastroenterology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh from July 2019 to June 2020. Forty-six (46) adult patients with functional dyspepsia diagnosed by Rome-III criteria were enrolled. Forty patients not fulfilling the criteria of functional dyspepsia and also patients attending the department for endoscopy (evaluation of anemia, pre-ERCP screening, evaluation of chronic diarrhea, etc.) and having normal endoscopic features subsequently were taken as comparison group. After endoscopy, a biopsy was taken from the gastric body and antrum of each participant. Counting of eosinophil and histopathology was done by an expert senior histopathologist. It was expressed in per HPF. Statistical analysis was done by SPSS 22.0 and p<0.05 was set as statistically significant. Mean±SD age was 40.34±16.22 and 40.15±13.96 in functional dyspepsia patients and patients taken for comparison respectively. Females were slightly predominant with a female-male ratio of 1.2:1. Lower middle-class families were found to be the most vulnerable group suffering from functional dyspepsia. The mean eosinophil count of gastric body and antrum in functional dyspepsia patients was higher than that of the comparison group. The difference between the two groups was statistically significant (p<0.001). A statistically significant relation was found between gastric eosinophilia (p=0.015, 0.016) with functional dyspepsia (p<0.001). Eosinophil count of gastric mucosa was significantly higher in functional dyspepsia patients and had an association with it. However, further study with a large sample size could explain this precisely.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"453-460"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756865","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":"Evaluation of Asymmetry between the Maximum Length of Right and Left Humerus of Bangladeshi Population.","authors":"S M A Haque, T Mehataz, F Afros, D Debnath, M R Alam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The humerus is the typical long bone of the superior extremity. It consists of three parts- upper end, lower end and intervening shaft. The aim of this study was to evaluation of the asymmetry of maximum length between the right and left-sided humerus. For the study 100 human humerus, 43 on the right side and 57 on the left side were elaborated. Samples were selected through the purposive sampling technique for this cross-sectional descriptive study in the Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh from July 2021 to June 2022. Any damaged, unossified bones or fractured bones were excluded. Data were tabulated and statistically analyzed using Microsoft Excel and SPSS software. In this study, the mean±SD maximum length of the humerus was 304.139±17.652 mm and 300.42±20.779 mm on the right and left sides respectively. These studies confirmed that the right-sided humeral dimension was more prominent than the left side. So, the asymmetry between the maximum length of right and left humerus is established. We hope that this study of the maximum length of humerus among the Bangladeshi population may be very helpful for anatomists, police, forensic experts, anthropologists and radiologists.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"307-311"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757070","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":"Hearing Impairment among the High-Risk Neonates: Findings from a Hospital-Based Targeted Screening.","authors":"A L Halder, M A H Mollah, M A Baki, S Khan, J Nahar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hearing impairment in early life can have deleterious effects on speech and language development and so as in communication. As hearing impairment in the infant is an invisible disability, screening is one of the most important methods of early identification. In this study, we screened the hospitalized high-risk neonates to estimate the prevalence of hearing impairment and to identify the risk factors in our settings. This cross-sectional study was conducted on 282 high-risk neonates admitted to the Special Care Baby Unit (SCABU), BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital-2, Dhaka, Bangladesh, from January 2019 to December 2019. The screening was done by distortion product otoacoustic emissions (DPOAE); first, by the age of 30 days, and second, two weeks after the first screening. Hearing impairment was confirmed by auditory brain stem response audiometry (ABR), which was performed at the age of three months. The prevalence of hearing impairment was found to be 9.5%. Among them, 7.4% had unilateral (right or left ear) and 2.1% had a bilateral hearing impairment. There was no gender predominance (p=0.92). The most prevalent risk factors were the use of ototoxic drugs (amikacin/ gentamycin ± furosemide) for more than 5 days or multiple courses (n=107, 37.9%) and birth weight less than 1500gm (n=30, 10.6%). The family history of hearing loss (OR=10.924, CI: 1.609-74.150, p= 0.014), craniofacial anomalies involving pinna and ear canal (OR=12.214, CI: 1.294-85.268, p=0.029), Hyperbilirubinemia at a serum level requiring exchange transfusion (OR=8.689, CI: 2.044-36.931, p=0.003) and needing mechanical ventilation for more than 5 days (OR=4.695, CI: 1.075-20.506, p=0.040) were detected as independent risk factors for hearing impairment in these high-risk neonates. The prevalence of hearing impairment among the high-risk neonates was 9.5%. The family history of hearing loss, craniofacial anomalies involving the pinna and ear canal, hyperbilirubinemia at the exchange level, and needing mechanical ventilation for more than 5 days was independent risk factors for hearing impairment in high-risk neonates.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"400-407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757076","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":"Prescription Pattern of Analgesics and Adjuvant Drugs in Cancer Patients Attending Outpatient Department of Radiotherapy in a Tertiary Level Hospital.","authors":"M Sharmin, S K Saha, S Mostaqim, M K Hasan, T Salam, F Nargis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To assess the pattern of analgesics used for pain among the cancer patients attending outpatient department in a tertiary level hospital in Bangladesh. During the one year study period between July 2018 and June 2019, a cross sectional study was conducted in the Department of Pharmacology and Therapeutics with the collaboration of Department of Radiotherapy, Mymensingh Medical College Hospital, Mymensingh. A total of 323 patients were selected. Data were collected by interviewing the patients and their prescription. After completion of data collection, data analysis was done using SPSS version 24.0. Out of 323 patients, Step 1 analgesics (Paracetamol or other NSAIDs) were prescribed to 61.9% patients; 21.4% and 7.1% patients were treated with Step 2 (Tramadol) and Step 3 (Morphine) analgesics. Step 1 and 2 combined analgesics were prescribed to 9.6% patients. Among the adjuvant drugs, 22.9% prescribed drugs were antidepressants, corticosteroids (16.7%), anticonvulsants (14.9%), antispasmodics (9.6%), antianxiety (3.7%) and antipsychotics (2.2%). This study showed that using of WHO analgesic (pain relief) ladder; it is capable of controlling pain in more than 90.0% of patients.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"408-411"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757081","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":"Prevalence, Variants and Presentation of Anomalous Aortostial Origin of Coronary Arteries: A Registry Based Analysis of Ten Cases.","authors":"K A Siddika, B Dutta, M W Rahman, M B Rashid, M A Alam, G K Paul, A B M Kawsar, K Ahmed, A A Javed, M Sultana, A Jahangir, K K Karmoker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The study was aimed at determining the prevalence, different patterns of origin of coronary arteries and their clinical presentation in patients who underwent coronary angiography. In this cross-sectional study, initially 2000 patients who underwent coronary angiogram (CAG) for chronic stable angina or acute coronary syndrome or required CAG as pre-operative evaluation for other surgery in the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from July 2019 to December 2020 were enrolled after taking informed consent. The prevalence of anomalous aorto ostial origin among 2000 study population was 0.5%. Among 10 patients, males were predominant 8(80.0%) with a mean age of 51.0±3.0 years. The coronary artery anomalies were more common in the right coronary artery (RCA) than the left coronary artery. Out of 10 patients, RCA arouse from the left coronary sinus (3) and the separate origin of left anterior descending and left circumflex artery (3) were equal. The next common anomaly was the left coronary artery arising from the right coronary sinus (2) followed by the left circumflex artery arising from the right coronary sinus (1) and double right coronary artery (1). Twenty percent (20.0%) of the patients were asymptomatic and diagnosed during coronary angiogram for other surgery. Thirty percent (30.0%) of the cases presented with chronic stable angina and 50.0% of the total cases presented with acute coronary syndrome. Anomalous origin of coronary arteries may present as an isolated defect or as a part of complex congenital heart disease. Presentation and prognosis varies widely from asymptomatic to sudden cardiac death according to the type of various anomalies. So, congenital coronary artery anomalies pattern should be sorted out for risk stratification and proper management.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"381-387"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756831","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":"Raised Inflammatory Markers as Predictors of Acute Kidney Injury in Hospitalized Covid-19 Patients: A Retrospective Cohort Study.","authors":"S Rahman, A Wazib, T Bahar, M Yesmin, P Saha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Covid-19 infection can affect the multiple-organ system. Acute kidney injury (AKI) is one of the complications and is associated with poor outcomes. Of many potential risk factors for the development of AKI, raised inflammatory markers are postulated to be responsible. A retrospective cohort study was conducted on 135 patients who were admitted in the ward and intensive care unit (ICU) from June 2020 to September 2020 in Enam Medical College and Hospital, Savar, Dhaka, Bangladesh. Patients aged ≥18 years with positive RT-PCR Covid-19 were included. AKI was defined and staged according to KDIGO criteria. We evaluated the incidence of AKI, the demographic and laboratory markers associated with AKI in Covid-19 patients and the outcome. Univariate and multivariate analyses were performed. The incidence of AKI was 27.0% (36). Most of them were in stage 1(75.0%). The mean age of the cohort was 52.19±15.55 years and 68.0% were male (n=92). Of the comorbidities, diabetes mellitus was the commonest (46.0%). On progressive multivariate logistic regression, severe/critical Covid-19 (aOR 3.1, 95% CI: 1.09-8.93, p-value 0.033), requiring mechanical ventilation (aOR 2.7, 95% CI: 1.13-6.51, p-value 0.026) and raised D-dimer (aOR 3, 95% CI: 1.07-8.22, p-value 0.036) were identified as independent risk factors associated with AKI. A higher proportion of patients who developed AKI required ICU (50.0% versus 14.1%, p<0.0001) and were intubated (39% versus 13.0%, p=0.003). Overall, in-hospital mortality was 22(16.0%). In-hospital mortality was higher in patients with AKI (39 versus 8.0%, p<0.0001). Severe Covid-19, requiring mechanical ventilation and raised d-dimer are associated with AKI in Covid-19. Early identification of risk factors can reduce the incidence of AKI and death.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"447-452"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756860","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":"Correlation between Serum CA 15-3 and Nodal Involvement in Carcinoma of the Breast.","authors":"M Asaduzzaman, M R I Emon, M I Siddique, A Habib","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Elevated preoperative CA 15-3 level is directly related to tumor burden and independent prognostic factors for breast cancer. The importance of elevated CA 15-3 level is very significant in evaluating a case of breast tumor. To evaluate the correlation between elevated serum CA 15-3 level with axillary nodal involvement this cross-sectional study was done in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2019 to June 2019. In this study total 50 women of diagnosed carcinoma of the breast were enrolled according to the inclusion and exclusion criteria. Serum CA 15-3 was measured in the morning of operation and all patients underwent MRM by single surgeon and involvement of axillary lymph node on histology was recorded. Among the sample most of the patients were between 41-50 years of ages and ductal carcinoma was the most prevalent type. Axillary nodal involvement was 72.0% and average number of lymph node involved was 5.25±5.96. Serum CA15-3 levels was significantly higher in nodal involved patients than those without lymph node involvement, which was statistically significant (p<0.05). But higher number of patient with normal CA15-3 level are found to have lymph node metastasis, and this data was not statistically significant (p>0.05). So, elevated CA 15-3 level has significant positive predictive value but it has no significant negative predictive value for nodal involvement.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"395-399"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756961","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":"Validation of Clinical RGA Score in Diagnosis of Scrub Typhus at 2nd Tier Hospital of West Bengal, India.","authors":"V Mali, P Tripathi, M Maiti, S Mukhida","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Scrub typhus is caused by arthropod-borne gram-negative obligately intracellular bacillus Orientia tsutsugamushi bite by bitten by an infected vector, a Leptotrombidium mite. An eschar at the site of chigger feeding is a classic clinical feature of scrub typhus. Scrub typhus had severe complications including jaundice, acute renal failure, acute respiratory distress syndrome etc. Laboratory investigation is the gold standard test for the diagnosis but it is not available at all point of care centers. Rathi Goodman Score (RGA) was introduced and validated to diagnose the disease at the resource-limited center. The main aim of this study is to Validation of Clinical RGA score in the diagnosis of scrub typhus at 2nd tier hospital in West Bengal. The prospective cross-sectional observational study was conducted at a tertiary care hospital from March 2021 to February 2022 on 102 pediatric patients. All the relevant clinical features and tests were done for all patients. RGA scoring system was validated with the available standard IgM ELISA test. Pets and tick exposure were found in the majority of patients. Scrub typhus was diagnosed in 69.80% of patients by IgM ELISA. Sensitivity and specificity of the scoring system with the standard test were reported at 87.32% and 64.52% in comparison with IgM ELISA in children with a cut-off of 14 respectively. Diagnostic accuracy was reported at 80.39%. We conclude that this RGA scoring system might be useful for early detection, treatment, and prevention of child mortality and morbidity from scrub typhus-type Rickettsial disease.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"562-570"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756833","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":"Magnitude, Pattern and Predictors of Maternal Near Miss Cases Admitted in a Tertiary Care Hospital.","authors":"N Islam, T T Mirza, S Shamsi, N Islam, D Roy, T Jahan, N Begum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Maternal Near Miss is a serious antagonistic event that leads to harm and morbidity in the mother, but from which she survives. Maternal mortality rate in Bangladesh has declined by 66.0% over last few decades, valued at a rate of 5.5% every year. Aim of the study was to determine the magnitude, pattern and predictors of Maternal Near Miss cases. This cross-sectional descriptive type of observational study was conducted at the Department of Obstetrics and Gynecology in Mymensingh Medical College Hospital, Bangladesh from January 2018 to December 2018. A total of 69 patients were included for the study. Patients were evaluated for cardiac arrest, jaundice, gasping, shock coagulation disorders, cerebrovascular accident and total paralysis. Serum lactate >5mmol/L, paO₂/ FiO₂ <200mm of Hg, pH <7.1 and statistical analysis was performed using computer- based software, statistical package for social science (SPSS) version 20.0. Maximum number was found 44.93% in the age groups 20-29 years, maximum were rural patients (84.05%), no formal education (55.07%) of couple were significantly higher in case of maternal near miss case. Rate of maternal near miss case among the admitted patients was 4.86%. Among the maternal near miss case pregnancy induced hypertension were most common (44.9%). Most of the patients of the maternal near miss case presented with excessive P/V bleeding (37.7%). Among the medical management most common interventions were infusion of MgSO₄ (31.9%). Regarding neonatal outcome, live birth was 47.82%. Common causes of maternal near miss case are pregnancy induced hypertension, obstetric hemorrhage, ruptured uterus and ruptured ectopic pregnancy, prolonged/obstructed labor, impending uterine rupture and infections.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"438-446"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757078","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":"The Pool of Beta-lactamase Present in Extended Drug Resistant Klebsiella pneumoniae Isolated from Clinical Settings in Dhaka, Bangladesh.","authors":"S Akter, T Tabassum, M Khaleque, M F Islam, H Akhter, A Begum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recently bacterial infections caused by antibiotic resistant bacteria are becoming a threat to the health care system of many countries. Extensively-drug-resistant (XDR) Klebsiella pneumoniae are resistant to almost all classes of antibiotics and only a few are for clinical use. Recent emergence, worldwide dissemination and clinical impact of carbapenemase positive isolates persuade us to characterize the clinical K. pneumoniae isolates. We tested 647 K. pneumoniae that was isolated from different specimens of hospitalized patients in Dhaka, Bangladesh. Various phenotypic characterization, plasmid profiling and PCR assays followed by sequencing were performed. Round the year, 4.33% (n=28) K. pneumoniae isolates were found as XDR in addition to carbapenem resistant. Among the XDR isolates, 82.0% (n=23) showed Metallo-beta-lactamase (MBL) phenotype. Only two isolates showed MBL with KPC (K. pneumoniae carbapenemase) phenotype. By double disc synergy test, 12 isolates (43.0%) showed extended-spectrum beta-lactamase (ESBL) phenotype in addition. Among the isolates, 60.0% (n=17) were blaTEM positive, 82.0% (n=23) were blaSHV positive and 46.0% (n=13) were blaOXA positive determined by multiplex PCR. BlaCTX-M were present in 43.0% (n=12) isolates, which were of type-15 as revealed by sequencing. More than 60.0% (n=17) isolates were positive for blaNDM-1. Multiple genes coexisted in nearly all isolates. None of those were found to carry blaVIM or blaKPC. Twenty-six isolates were found to be strong biofilm former. Among the isolates, 16 harbored multiple plasmids ranging from 19 to 91 KDa; however, correlation between plasmid profile and antibiotic resistance pattern was not evident. Prevalence of carbapenem resistant and ESBL isolates have been previously reported in Bangladesh. Therefore, this study will expand our knowledge about XDR disseminated in Bangladesh and could assist in future therapeutic management.</p>","PeriodicalId":94148,"journal":{"name":"Mymensingh medical journal : MMJ","volume":"34 2","pages":"428-437"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756912","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}