Case Reports in Psychiatry最新文献

{"title":"Menstrual Psychosis in a Patient With Premenstrual Dysphoric Disorder Repeatedly Triggered by Minimal Alcohol Consumption: A Case Report.","authors":"Haruka Tagusari, Kohei Nishimura, Masashi Mizutani, Kumi Moriwaki","doi":"10.1155/crps/4861191","DOIUrl":"10.1155/crps/4861191","url":null,"abstract":"<p><p>Menstrual psychosis, a condition characterized by acute onset, brief duration with full recovery, and psychotic or manic symptoms aligned with the menstrual cycle, has been described in the literature. However, it is not recognized as an independent diagnostic entity in either the International Classification of Diseases, 11th Revision (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and treatment options and comorbidities associated with this condition remain poorly understood. We report the case of a 26-year-old woman who repeatedly developed acute psychotic symptoms, including catatonia, which was in synchrony with her menstrual cycle, with the first two episodes triggered by minimal alcohol intake. Retrospective assessment revealed the presence of premenstrual dysphoric disorder (PMDD) as a comorbidity. Although antipsychotic treatment initially improved her symptoms, relapses occurred until low-dose estrogen-progestin (LEP) therapy was introduced, resulting in sustained remission. This case highlights the potential efficacy of hormonal intervention, the overlap between menstrual psychosis and PMDD, and the possible role of alcohol as a trigger. It emphasizes the need for a rigorous approach to diagnosis and the development of evidence-based treatment strategies.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"4861191"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599344","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":"Atomoxetine-Associated Bilateral Testicular Pain and Priapism in a Patient Taking Aripiprazole: A Case Report.","authors":"Anoop Narahari, Kavita Kothari","doi":"10.1155/crps/6645625","DOIUrl":"10.1155/crps/6645625","url":null,"abstract":"<p><p>Priapism, a urologic emergency, is defined as a penile erection persisting longer than 4 h independent of sexual stimulation. While psychotropic medication-associated priapism is well documented, atomoxetine-associated priapism remains extremely rare. Atomoxetine is a norepinephrine reuptake inhibitor used in the management of attention-deficit/hyperactivity disorder (ADHD). We report the case of an Asian male in his late 20s with bipolar I disorder who had been treated with aripiprazole 7.5 mg daily for 6 months and developed sudden bilateral testicular pain, followed by a painful erection lasting more than 4 h, beginning 5 days after starting atomoxetine. He had no history of genitourinary trauma, malignancy, or concurrent medication or substance use. Clinical and laboratory evaluation were unremarkable, and detumescence occurred approximately 6 h after symptom onset without invasive intervention. Atomoxetine was discontinued the next day and no recurrence was reported at 4-week follow-up. Causality assessment using the Naranjo Adverse Drug Reaction Probability Scale yielded a score of 4 (possible) for atomoxetine. This case underscores the importance of counseling patients prescribed atomoxetine and other psychotropics about priapism and the need for urgent evaluation when erections persist for ≥4 h.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"6645625"},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577095","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":"Acute Laryngeal Dystonia Mimicking Anaphylaxis Following Antipsychotic Initiation: A Case Report.","authors":"Devina Wadhwa","doi":"10.1155/crps/9856544","DOIUrl":"10.1155/crps/9856544","url":null,"abstract":"<p><p>Acute laryngeal dystonia (ALD) is an uncommon but potentially life-threatening adverse effect of dopamine D2 receptor-blocking agents. Because airway symptoms predominate, it may be misdiagnosed as anaphylaxis. A 24-year-old woman developed recurrent episodes of throat tightness, dysphonia and stridor within days of antipsychotic initiation and subsequent dose escalation. Initial episodes were treated as anaphylaxis based on airway symptoms and mild tachycardia. Serum tryptase was mildly elevated, further contributing to diagnostic uncertainty. However, the absence of cutaneous findings or hypotension, recurrence after dose escalation and temporal association with antipsychotic therapy prompted reconsideration of the diagnosis. Rapid resolution following intramuscular benztropine supported the diagnosis of ALD as the most likely diagnosis. This case highlights the importance of medication history, temporal pattern recognition and therapeutic response in distinguishing dystonia from allergic reactions. It also illustrates how anchoring bias and diagnostic momentum may contribute to recurrent misclassification. Early recognition of laryngeal dystonia can prevent unnecessary treatment, reduce the risk of airway compromise, and improve diagnostic accuracy.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"9856544"},"PeriodicalIF":0.0,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418990","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":"Limits to the \"Medical Clearance\" of Patients Presenting With Psychiatric Changes: A Case Report and Review of the Literature.","authors":"Jordan Pelc, Gregory Chandler, Riley Rose","doi":"10.1155/crps/7070787","DOIUrl":"10.1155/crps/7070787","url":null,"abstract":"<p><p>We discuss a case of a 54-year-old woman with a history of schizoaffective disorder and Parkinson's disease who presented with altered mental status, including weakness, falls, medication refusal, and paranoia, heralding medical deterioration. The treating teams initially suspected that this presentation was medically driven, and she had multiple admissions to general medicine to look for an \"organic\" explanation of her clinical status. Despite this, no medical driver was identified, and she was diagnosed with progression of her primary psychiatric disease. After she was \"medically cleared\" and was admitted to the inpatient psychiatry unit for 10 days, she was found to be medically unstable, with progressive dysphagia and decreased responsiveness. She was then admitted to the intensive care unit (ICU), where was found to have dysphagia, aspiration pneumonia, lung abscess, severe hypernatremia, and associated diabetes insipidus, and ultimately died of her medical illness. This case illustrates important limitations of the \"medical clearance\" of patients with psychiatric presentations, including limited literature and clinical guidance in this area, and risks of the term \"medical clearance\" itself, which may inappropriately discourage medical reassessments when indicated. We review practices that can help reduce these risks.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"7070787"},"PeriodicalIF":0.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390041","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":"Persistent Delirium in the Elderly: A Case Report and Review of Multifactorial Contributors and Management Challenges.","authors":"Troy Salisbury","doi":"10.1155/crps/9751488","DOIUrl":"10.1155/crps/9751488","url":null,"abstract":"<p><strong>Introduction: </strong>This case describes persistent delirium exceeding 18 months with prominent paranoid delusions in a 72-year-old woman with chronic hyponatremia, poststroke epilepsy, and alcohol use disorder. It highlights diagnostic and pharmacologic management challenges when standard agents carry prohibitive risks.</p><p><strong>Patient’s main concerns and important clinical findings: </strong>A 72-year-old woman with a history of left hemispheric hemorrhagic stroke, poststroke epilepsy, and chronic alcohol use presented with acute confusion. Laboratory evaluation revealed severe hyponatremia (Na 122 mmol/L). Clinical findings included persecutory delusions, severe agitation with dangerous behaviors (attempting to leave moving vehicles, stabbing attempt), anxiety, insomnia, and fluctuating cognitive status with return to baseline between episodes. EEG demonstrated epileptiform discharges and generalized encephalopathy. Divalproex sodium levels at presentation were supratherapeutic (up to 127 mcg/mL). There was no evidence of prior dementia or progressive cognitive decline.</p><p><strong>Primary diagnoses interventions and outcomes: </strong>The primary diagnosis was persistent delirium with multifactorial etiology. Interventions included hyponatremia correction, transition from divalproex to lacosamide, and initiation of mirtazapine, which was selected for its lower hyponatremia risk compared to other antidepressants, lower seizure risk compared to antipsychotics, and low deliriogenic potential. Sleep and anxiety improved with partial agitation reduction, though delirium persisted. Over 18 months, paranoid delusions evolved from episodic to continuous, creating treatment adherence barriers.</p><p><strong>Conclusion: </strong>This case underscores the potential for exceptionally prolonged delirium in medically complex older adults, diagnostic complexity in differentiating persistent delirium from ictal-related psychosis and other conditions, and individualized pharmacotherapy considerations. Early multidisciplinary intervention, capacity assessments, and caregiver support are critical.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"9751488"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344001","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":"Seronegative Autoimmune Encephalitis Presenting With Severe Neuropsychiatric Symptoms in an Older Adult: A Case of Diagnostic Complexity.","authors":"Christopher E Potts, Akbar Ali, James Issa, Usman Alizai, Dakota May","doi":"10.1155/crps/7669338","DOIUrl":"10.1155/crps/7669338","url":null,"abstract":"<p><p>Autoimmune encephalitis (AE) represents a potentially reversible cause of subacute cognitive and psychiatric decline. When no autoantibodies are detected, seronegative AE remains diagnostically challenging, particularly among older adults presenting with new-onset neuropsychiatric symptoms. This report describes an older adult with recurrent episodes of confusion, aphasia, and psychosis whose diagnostic studies-including magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis-were unremarkable. The individual had previously demonstrated substantial improvement after corticosteroid therapy and was again treated empirically with immunotherapy following psychiatric consultation. This case highlights the importance of maintaining a high index of suspicion for AE when standard serologic markers are absent and underscores the collaborative role of psychiatry and neurology in evaluating rapidly progressive cognitive and behavioral syndromes, which may present initially as primary psychiatric illness. Early consideration of autoimmune etiologies and prompt initiation of immunotherapy can significantly improve outcomes in patients with otherwise unexplained, rapidly progressive cognitive or behavioral syndromes.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"7669338"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343961","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":"Unexpected Improvement of Obsessive-Compulsive Disorder Symptoms Following the Mistaken Prescription of Clomiphene: A Novel Perspective on Hormonal Influences in OCD.","authors":"Seyed Hamzeh Hosseini, Behnam Abbasi, Fatemeh Abedian Kenari","doi":"10.1155/crps/4931083","DOIUrl":"10.1155/crps/4931083","url":null,"abstract":"<p><strong>Background: </strong>Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder commonly treated with selective serotonin reuptake inhibitors (SSRIs) and, in more severe or resistant cases, clomipramine. Clomiphene citrate, a selective estrogen receptor (ER) modulator primarily used for infertility, is not indicated for psychiatric disorders but may influence neuroendocrine and serotonergic pathways. This case describes an unexpected improvement in OCD symptoms following the accidental prescription of clomiphene instead of clomipramine.</p><p><strong>Case presentation: </strong>A 50-year-old woman with a longstanding history of anxiety and recurrent major depressive disorder (MDD) developed OCD symptoms after childbirth during her second pregnancy. Her symptoms previously responded well to sertraline, clonazepam, and clomipramine. After ~15 years of relative stability, clomipramine was discontinued because of anticholinergic side effects, resulting in relapse of obsessive-compulsive symptoms. A 3-month trial of sertraline 200 mg/day was ineffective. When clomipramine was intended to be restarted, a prescribing error led to clomiphene 25 mg/day being dispensed instead. The patient took clomiphene together with sertraline 100 mg/day and clonazepam 2 mg/night for 12 weeks. During this period, she experienced a dramatic and complete remission of her obsessive-compulsive symptoms, with an estimated reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score from 23 to ~7. No adverse effects were identified. After the error was recognized, clomiphene was discontinued, the incident was reported, and clomipramine was reintroduced, although the same degree of improvement was not reproduced.</p><p><strong>Conclusion: </strong>This case raises a speculative but clinically important hypothesis regarding the possible role of hormonal modulation in a subgroup of hormonally sensitive patients with OCD. However, causality cannot be established because hormonal measurements were unavailable and alternative explanations, including placebo effects, spontaneous symptom fluctuation, and concomitant medication effects, remain possible. Future studies should longitudinally assess OCD symptom changes during hormonally sensitive periods, ideally in conjunction with standardized clinical measures and hormonal biomarkers. The case also underscores the ethical and patient-safety importance of preventing medication errors.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"4931083"},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263342","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":"Unraveling Protracted Neuropsychiatric Symptoms in a Patient With Altered Post-Bariatric Pharmacokinetics: A Diagnostic Puzzle.","authors":"Akbar Ali, Christopher E Potts, Dakota May","doi":"10.1155/crps/8340699","DOIUrl":"10.1155/crps/8340699","url":null,"abstract":"<p><strong>Objective: </strong>To report a complex case of serotonin toxicity that evolved into a persistent neuropsychiatric syndrome, complicating the differential diagnosis between protracted toxicity, prolonged SSRI discontinuation syndrome, acute hepatic porphyria, and functional neurological disorder (FND).</p><p><strong>Method: </strong>We present the case of a 61-year-old male with a history of gastric sleeve surgery and major depressive disorder (MDD) who developed acute serotonin syndrome (SS) following the concomitant use of fluoxetine, buspirone, and linezolid.</p><p><strong>Results: </strong>While acute autonomic instability resolved upon cessation of serotonergic agents, the patient developed subacute, evolving neurological deficits. Workup revealed an <i>SLC6A4</i> polymorphism and elevated urinary porphyrins, initially prompting Hemin therapy, though genetic testing for porphyria was negative. Tertiary evaluation at the Cleveland Clinic ultimately confirmed a diagnosis of FND, psychogenic non-epileptic seizures (PNES), and chronic migraine. Management remains challenging due to medication sensitivity, including recent parasomnias during a cautious trial of vilazodone.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic complexity following SS in patients with altered gastrointestinal anatomy and genetic variances. It emphasizes how an acute organic insult-whether serotonin toxicity, prolonged SSRI discontinuation, or a combination of both-can serve as a physiological trigger for complex FND and PNES, requiring multidisciplinary management. The limitations inherent in single-case observations are discussed.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"8340699"},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263322","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":"Obsessive-Compulsive Symptoms Associated With Bupropion Treatment: A Case Series.","authors":"Jose Alfonso Ontiveros Y Sánchez de la Barquera, Luis Alberto De La Garza García, Guillermo Sánchez-Torres, Pablo Patricio Zárate Garza, Diego José Vázquez Ramos","doi":"10.1155/crps/8097103","DOIUrl":"10.1155/crps/8097103","url":null,"abstract":"<p><strong>Background: </strong>Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) and nicotinic antagonist. It belongs to the class of aminoketones and is commonly used to treat major depressive disorder (MDD) and to aid in smoking cessation. There is scarce literature on the sudden appearance of obsessive-compulsive symptoms (OCSs) in depressed patients that could be related to bupropion treatment.</p><p><strong>Case series: </strong>We present four cases of bupropion associated with OCSs in patients with affective disorders. Patients reported no previous history of obsessive ideation or compulsion. Symptoms appeared after the start of bupropion treatment with a progressive increase in intensity. Upon discontinuation of the drug, there was a notable reduction in symptoms with a complete remission over time. Evaluation of obsessive and compulsive symptoms and evolution were assessed using the Yale-Brown obsessive-compulsive scale (YBOCS) and clinical global impression-severity (CGI-S) scale.</p><p><strong>Conclusions: </strong>The neurobiological basis for the development of OCSs associated with bupropion treatment is not yet fully understood; clinicians need to take these symptoms into account when prescribing bupropion. Further studies with a larger sample of patients with depression who are undergoing bupropion treatment are required to confirm this phenomenon.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"8097103"},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249327","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":"Naltrexone for Acute Management of Compulsive Sexual and Obsessive Symptoms in a Patient With a Neurodevelopmental Disorder.","authors":"Eric Constantin, Moonpreet S Deol, Jeffrey Yaun, Hardeep Singh, Oliver M Glass","doi":"10.1155/crps/9442957","DOIUrl":"10.1155/crps/9442957","url":null,"abstract":"<p><p>Compulsive sexual behavior disorder (CSBD) is characterized by persistent difficulty controlling sexual urges and behaviors associated with marked distress or impairment. Population-based data indicate that ~8.6% of US adults experience distress related to difficulty controlling sexual urges, feelings, and behaviors, while large international screening studies suggest that ~5% of individuals may be at high risk for CSBD, yet only a minority seek treatment. Diagnostic classification remains challenging in early or evolving presentations and in patients with complex psychiatric and neurodevelopmental comorbidities. The International Classification of Diseases, 11^th Revision (ICD-11) requires a 6-month symptom duration for formal diagnosis and specifies exclusion when symptoms are better explained by another mental disorder, substance use, or medication effects. Here we describe a man in his 20 s with bipolar I disorder, attention-deficit/hyperactivity disorder, anxiety, and intellectual developmental disorder (IDD), along with medical comorbidities, who was hospitalized for severe intrusive sexual thoughts associated with distress and safety concerns. Phenomenology suggested overlap between obsessive-compulsive disorder (OCD) with sexual obsessions and an emerging CSBD-like syndrome, with ego-dystonic intrusive cognitions alongside strong gratification-driven urges and restraint primarily driven by anticipated negative consequences. Given symptom severity and imminent risk of behavioral enactment, the presentation was conceptualized as an early CSBD-like syndrome despite not meeting the ICD-11 duration criterion. Symptoms remained acutely refractory despite multiple psychotropic optimizations; the most temporally associated improvement occurred after initiation of naltrexone, with marked improvement within 5 days and resolution of intrusive sexual thoughts by hospital day 16. Although concurrent medication changes preclude attribution to naltrexone monotherapy, the rapid response supports further investigation of reward- and impulse-targeted interventions for severe subthreshold presentations and highlights the need for clearer diagnostic frameworks and evidence-based guidance for acute management of diagnostically ambiguous compulsive sexual and sexual obsessive syndromes.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"9442957"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216551","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}