Case Reports in Obstetrics and Gynecology最新文献

{"title":"A Novel Pathogenic Variant in <i>PAX2</i>-Related Renal Coloboma Syndrome Identified by Prenatal Diagnosis: A Case Report and Literature Review.","authors":"Gang Wang, Jie Wang, Lichun Zhang, Dongxia Hou, Yan Huang, Hong Wang, Xueyuan Zhou, Xiaoyan Pang, Lu Li, Yuexin Song, Xiaohua Wang","doi":"10.1155/crog/5112963","DOIUrl":"10.1155/crog/5112963","url":null,"abstract":"<p><strong>Introduction: </strong>Renal coloboma syndrome (RCS) is an autosomal dominant disorder caused by pathogenic variants in the <i>PAX2</i> gene, primarily affecting renal and optic nerve development. However, the presentation of RCS is highly heterogeneous, ranging from mild renal anomalies to severe multi-organ involvement. This phenotypic variability often poses significant challenges for accurate clinical diagnosis.</p><p><strong>Case presentation: </strong>In this study, a novel heterozygous <i>PAX2</i> missense mutation (NM_000278.5: c.404 T > G, p.Ile135Ser) was identified via whole-exome sequencing (WES) in a 31-year-old pregnant woman and her fetus. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, this mutation is classified as likely pathogenic. The phenotypic divergence observed between the mother and neonate underscores the syndrome's variable penetrance. While the mother exhibited relatively mild renal and optic nerve anomalies, the neonate presented with severe multi-organ involvement, including renal structural defects, hearing impairment, and extensive pulmonary, cardiac, and cerebral lesions, culminating in fatal intracranial hemorrhage and multi-organ failure at 2 months of age.</p><p><strong>Discussion: </strong>The present case identified a previously unreported pathogenic variant in the <i>PAX2</i> gene, thereby expanding the mutational spectrum of <i>PAX2</i>-related RCS. It also further underscores the phenotypic heterogeneity of this disorder, even among members of the same family. Additionally, the genotype-phenotype spectrum of <i>PAX2</i>-related cases was also reviewed to facilitate early diagnosis, management, and genetic counseling for RCS.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5112963"},"PeriodicalIF":0.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403738","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":"Bilateral Tubo-Ovarian Abscess as an Unusual Trigger of Diabetic Ketoacidosis in a Woman With Type 2 Diabetes: A Rare Case Report.","authors":"Hala O Abdallah, Bara J Abufara, Hobab J Odeh, Ansam Nafah, Reem Shihab, Mua Weah Shroof","doi":"10.1155/crog/4323528","DOIUrl":"10.1155/crog/4323528","url":null,"abstract":"<p><strong>Background: </strong>Tubo-ovarian abscess is a serious complication of pelvic inflammatory disease that often requires surgical management. Diabetic ketoacidosis is a life-threatening metabolic emergency most seen in Type 1 diabetes but can rarely occur in Type 2 diabetes. The simultaneous occurrence of TOA and DKA is extremely rare, highlighting a clinically important association.</p><p><strong>Case presentation: </strong>We report a 37-year-old woman with poorly controlled Type 2 diabetes mellitus who presented with severe abdominal pain, fever, and metabolic decompensation diagnosed as DKA. On workup, CT scan revealed bilateral tubo-ovarian abscesses. She was admitted to the intensive care unit and managed appropriately. Persistent fever with elevated CRP prompted laparoscopic drainage of both abscesses, resulting in clinical improvement.</p><p><strong>Conclusion: </strong>Bilateral tubo-ovarian abscess can precipitate diabetic ketoacidosis in women with Type 2 diabetes mellitus. Recognizing gynecologic sepsis as a potential precipitant is crucial for timely management.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"4323528"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367035","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":"Laterally Implanted Pregnancy With Placenta Accreta Spectrum in a Nulliparous Patient: A Diagnostic Challenge.","authors":"Kristen Warncke, Paola Méndez-Ruiz, Rebecca Pedersen, Steven Blaine Holloway, Shivani Patel","doi":"10.1155/crog/5675416","DOIUrl":"10.1155/crog/5675416","url":null,"abstract":"<p><strong>Background: </strong>Laterally implanted pregnancies-including angular, interstitial, and cornual pregnancies-are rare and diagnostically challenging due to overlapping clinical and imaging features. They may mimic a normal intrauterine pregnancy but are associated with significant maternal morbidity. This case describes a prenatally undiagnosed suspected angular pregnancy complicated by placenta accreta spectrum (PAS).</p><p><strong>Case: </strong>A 39-year-old G1P0 woman underwent induction of labor at 37 weeks for fetal growth restriction and gestational hypertension. Postdelivery, retained placenta was noted. Intraoperative evaluation revealed placental tissue in the left cornua concerning for PAS. Placental removal was unsuccessful, and peripartum hysterectomy was performed.</p><p><strong>Conclusion: </strong>Laterally implanted pregnancies are rare and may be diagnosed only at delivery. Early recognition of abnormal implantation and multidisciplinary management are essential to reduce maternal morbidity.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5675416"},"PeriodicalIF":0.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359789","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":"Pyoderma Gangrenosum Following Cesarean Section: A Case Report With Individualized Management.","authors":"Zepeng Zheng, Shilian Xu, Xiaomiao Zeng, Xiaojun Chen, Xiaoli Liu, Shuning Zhang, Shuai Fu","doi":"10.1155/crog/2579304","DOIUrl":"10.1155/crog/2579304","url":null,"abstract":"<p><strong>Introduction: </strong>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive necrotizing skin ulcers. PG following cesarean section (CS) is extremely rare and frequently misdiagnosed as surgical site infection, leading to inappropriate debridement and disease exacerbation. We report a case of severe postcesarean PG successfully managed with early immunosuppressive therapy.</p><p><strong>Case presentation: </strong>A 24-year-old primiparous woman at 29 + 4 weeks gestation underwent emergency CS due to umbilical cord prolapse. On postoperative day (POD) 7, she developed painful ulcers with undermined violaceous borders around the incision. Despite broad-spectrum antibiotics, lesions progressed rapidly. Pathergy occurred following surgical debridement on POD 9 (wound enlarged to 21.5 × 11.0 cm). PG was diagnosed on POD 11 based on clinical features, sterile cultures, and neutrophilic infiltrate on histopathology. Treatment included methylprednisolone pulse therapy (500 mg intravenously daily for 3 days), followed by tapering to 60 mg/day with concurrent initiation of cyclosporine (75 mg oral twice daily) and etanercept (25 mg subcutaneously twice weekly). The patient was discharged on POD 30. Complete epithelialization was achieved by the 4th postoperative month without recurrence or adverse drug reactions.</p><p><strong>Discussion: </strong>This case highlights the diagnostic challenges of postcesarean PG, which requires high clinical suspicion to distinguish from infectious complications. Triple immunosuppressive therapy (high-dose corticosteroids, calcineurin inhibitor, and TNF-<i>α</i> antagonist) represents an effective strategy for severe, rapidly progressive disease, allowing rapid disease control while facilitating corticosteroid tapering. Long-term follow-up confirmed sustained remission despite extensive initial ulceration.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"2579304"},"PeriodicalIF":0.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343931","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 Case of Ovarian Teratoma-Associated Anti-NMDA Receptor Encephalitis in the Presence of Group A Streptococcus Infection.","authors":"Anna Blach, Shannon Kiss, Alexandra Fontaine, Robert Graebe","doi":"10.1155/crog/1359794","DOIUrl":"10.1155/crog/1359794","url":null,"abstract":"<p><strong>Background and aims: </strong>Anti-NMDAR encephalitis is a severe autoimmune encephalitis that is frequently associated with ovarian teratomas, whereas infectious triggers remain incompletely understood. We report a case of ovarian teratoma-associated anti-NMDAR encephalitis in a young woman with concurrent Group A Streptococcus infection presenting with prominent psychiatric symptoms and subsequent neurologic decline.</p><p><strong>Methods: </strong>We describe the clinical course, diagnostic evaluation, and multidisciplinary management of a 25-year-old African American woman with acute-onset neuropsychiatric symptoms, confirmed anti-NMDAR encephalitis, bilateral ovarian teratomas, and concurrent Group A Streptococcus infection. Verbal informed consent was obtained from the patient for publication of this case report and any accompanying images.</p><p><strong>Results: </strong>The patient initially presented with acute psychiatric symptoms and was treated for suspected schizoaffective disorder. Further evaluation following clinical deterioration revealed anti-NMDAR antibodies in the cerebrospinal fluid and bilateral ovarian teratomas on imaging. She was treated with IVIG, high-dose corticosteroids, bilateral ovarian cystectomy, and plasma exchange, with subsequent clinical improvement and discharge after prolonged hospitalization.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering anti-NMDAR encephalitis in young women presenting with acute psychiatric symptoms and neurologic decline. It also highlights the importance of pelvic imaging for ovarian teratoma and careful infectious evaluation, including for streptococcal infection when clinically indicated. The observed association between Group A Streptococcus infection preceding symptom onset suggests a possible infectious trigger leading to an immunologic response and subsequent anti-NMDAR encephalitis; however, there is limited evidence of a causal relationship in the literature.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"1359794"},"PeriodicalIF":0.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315879","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":"Embolic Stroke Following an Amniotic Fluid Embolism in the Setting of Patent Foramen Ovale.","authors":"Osamah Khan, Michael DeRosa, Lydia Holden, Jason Hoppe, Alton Hallum, Michael Krew","doi":"10.1155/crog/7954851","DOIUrl":"10.1155/crog/7954851","url":null,"abstract":"<p><p>Amniotic fluid embolism (AFE) is a rare but devastating complication during pregnancy. We present an instance of an embolic stroke following an AFE in labor with a concurrent patent foramen ovale (PFO). The patient was a 34-year-old G4P2 who had an acute seizure event intrapartum. She was taken for an emergent cesarean delivery during which she was noted to have cardiopulmonary compromise. A cesarean hysterectomy was performed due to ongoing DIC and hemorrhage. Postoperatively, she was found to have evidence of thrombotic emboli as well as a PFO. She had a good neurologic recovery with supportive measures even prior to discharge from the hospital and has continued to do well. When more common etiologies of intrapartum seizures have been excluded, providers should maintain a high index of suspicion for embolic stroke.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7954851"},"PeriodicalIF":0.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315935","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":"From Hope to Infection: Tubo-Ovarian Abscess After Frozen Embryo Transfer-A Case Report and Review of the Literature.","authors":"Ali El Safadi, Lara Nahouli, Macram Wakim, Antoine Hannoun","doi":"10.1155/crog/5330571","DOIUrl":"10.1155/crog/5330571","url":null,"abstract":"<p><p>Tubo-ovarian abscess is a rare but serious complication of assisted reproductive technologies, typically following oocyte retrieval. We report a case of a 41-year-old woman with endometriosis who developed a tubo-ovarian abscess 2 weeks after a hormonally prepared frozen embryo transfer. The procedure was uneventful and performed under sterile conditions with antibiotic prophylaxis. She later presented with pelvic pain and fever; imaging confirmed a right-sided multiloculated adnexal abscess. Given the patient's stable condition and abscess location, conservative management was chosen. Broad-spectrum intravenous and oral antibiotics led to complete resolution without the need for drainage or surgery. This case highlights that tubo-ovarian abscesses can occur even in low-risk frozen embryo transfer cycles and in the absence of procedural complications. A review of the literature suggests that underlying pelvic pathology, including endometriosis, may predispose patients to infection. Considerate post-transfer monitoring and individualized management strategies are essential to ensure favorable outcomes.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5330571"},"PeriodicalIF":0.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307058","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":"Severe Sepsis After Vaginal Delivery: A Case Report.","authors":"Maryam Dehghan","doi":"10.1155/crog/9666897","DOIUrl":"10.1155/crog/9666897","url":null,"abstract":"<p><strong>Background: </strong>Complications of pregnancy and childbearing are one of the most important public health concerns worldwide. Postpartum sepsis remains a leading cause of maternal morbidity and mortality. Early recognition and timely intervention, including surgical source control, when necessary, are critical for improving outcomes.</p><p><strong>Case presentation: </strong>We report a 29-year-old gravida 2 woman with a history of opioid use, malnutrition, and very low socioeconomic status. She presented 10 days after a preterm vaginal delivery at 24 weeks' gestation with severe sepsis. She developed refractory septic shock, with evidence of endometritis, salpingitis, empyema, and renal microabscesses. Blood cultures grew methicillin-resistant <i>Staphylococcus aureus</i> (MRSA). Despite aggressive fluid resuscitation and broad-spectrum antibiotics, her condition deteriorated, necessitating a total abdominal hysterectomy with bilateral salpingectomy and chest tube insertion on postpartum Day 14. The patient improved postoperatively and was discharged 14 days after surgery.</p><p><strong>Discussion: </strong>This case highlights the importance of early recognition of postpartum sepsis, rapid initiation of empiric broad-spectrum antibiotics, and multidisciplinary management. Risk factors such as comorbidities, malnutrition, and low socioeconomic status may increase disease severity and complicate management. In cases unresponsive to medical therapy, surgical source control can be lifesaving, even following vaginal delivery.</p><p><strong>Conclusion: </strong>Clinicians should maintain a low threshold for aggressive intervention in high-risk postpartum patients. Early diagnosis, multidisciplinary care, and timely surgical intervention are key to reducing maternal morbidity and mortality.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"9666897"},"PeriodicalIF":0.8,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293501","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":"Primary Hyperparathyroidism in a Pregnant Immigrant Facing Healthcare Hurdles: A Case Report.","authors":"Racquel McCrary, Tina Huang, Miranda Worley, Rebecca Daugherty, Amanda Stisher","doi":"10.1155/crog/7503619","DOIUrl":"10.1155/crog/7503619","url":null,"abstract":"<p><strong>Introduction: </strong>PHPT in pregnancy is a rare condition that may be difficult to recognize due to nonspecific symptoms and physiologic changes that can mask hypercalcemia. Delayed diagnosis is associated with significant maternal and fetal morbidity.</p><p><strong>Case presentation: </strong>A 36-year-old Spanish-speaking gravida 5 para 3 woman at 30 weeks gestation presented with decreased fetal movement in the setting of absent prenatal care. Evaluation revealed severe polyhydramnios, fetal growth restriction, and nonimmune fetal hydrops. Laboratory studies demonstrated hypercalcemia with elevated parathyroid hormone levels, consistent with PHPT, with preserved renal function and concurrent vitamin D insufficiency. Ultrasound identified a parathyroid adenoma. Initial management with intravenous hydration and calcitonin resulted in only partial improvement in calcium levels. Ongoing management was complicated by competing priorities between treatment of maternal hypercalcemia and obstetric concerns, as escalation of fluid therapy was limited by the risk of fluid overload in the setting of severe polyhydramnios. Despite medical management, worsening fetal status, including abnormal umbilical artery Doppler findings, necessitated preterm cesarean delivery. The neonate required intubation and admission to the neonatal intensive care unit for management of hydrops fetalis. Following delivery, the patient underwent definitive surgical management with parathyroidectomy, resulting in normalization of calcium and parathyroid hormone levels and confirming biochemical cure.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of PHPT in pregnancy and the complexity of management when standard treatment pathways are limited. It also demonstrates how delayed access to prenatal care and language discordance may contribute to more advanced disease at presentation. Early recognition and coordinated multidisciplinary care may improve maternal and fetal outcomes. This case supports consideration of PHPT in pregnant patients with hypercalcemia and informs clinical approaches to management in complex presentations.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7503619"},"PeriodicalIF":0.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263362","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":"Cavernous Hemangioma of the Uterine Cervix Revealed by Induction Failure: A Rare Case Report.","authors":"Aurélie Buffetau, Hugo Madar, Claire Rozes, Jean Luc Brun, Loïc Sentilhes","doi":"10.1155/crog/1758571","DOIUrl":"10.1155/crog/1758571","url":null,"abstract":"<p><p>Hemangiomas of the uterine cervix are rare benign vascular tumors, with fewer than a hundred cases described in the literature. Their clinical presentation is variable, most often involving abnormal genital bleeding, but they may also be discovered incidentally. Association with pregnancy is reported in a subset of cases, likely reflecting hormonal and hemodynamic influences.</p><p><strong>Case presentation: </strong>We report the case of a 29-year-old woman with no prior medical history, admitted for induction of labor following intrauterine fetal death at 21 weeks of gestation. Despite multiple attempts with both pharmacologic and mechanical methods of induction, adequate cervical dilation could not be achieved-even under general anesthesia-because the cervix was unusually firm and friable, ultimately necessitating cesarean delivery. Postpartum pelvic MRI and colposcopy revealed a suspicious cervical lesion. Conization with endocervical curettage was performed, and histopathological examination confirmed the diagnosis of cavernous hemangioma of the cervix.</p><p><strong>Conclusion: </strong>Cervical cavernous hemangiomas are rare and often overlooked in the differential diagnosis of cervical lesions. This case is remarkable because the lesion was revealed by repeated failure of labor induction. Awareness of such unusual presentations may help gynecologists consider vascular tumors in selected obstetric or gynecologic contexts and guide conservative, fertility-preserving management.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"1758571"},"PeriodicalIF":0.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270520","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}