European Archives of Oto-Rhino-Laryngology最新文献

{"title":"What should otolaryngologists know about dural venous sinus stenting?","authors":"Bulent Mamikoglu, Jared Cooper, Katrina R Stidham, Fawaz Al-Muhti, Chirag D Gandhi","doi":"10.1007/s00405-024-08806-7","DOIUrl":"10.1007/s00405-024-08806-7","url":null,"abstract":"<p><p>Dural venous sinus stenting is an emerging and exciting area in otolaryngology in collaboration with neurosurgeons and neuroradiologists. The first cases were reported 20 years ago. It is now considered part of the routine treatment of increased intracranial pressure due to transverse sinus stenosis. ENT doctors are the first to see these patients in their clinics, as sinus headaches, pulsating tinnitus, and dizziness are the most common symptoms. Previously, with limited success, high-dose diuretics and intracranial shunts had been the only options for treating these patients. Other methods, such as covering the sigmoid sinuses with graft material, appear to cause a sudden increase in intracranial pressure that can lead to blindness and even death. This overview summarizes the clinical and imaging characteristics of patients who will benefit from endovascular sinus stenting for elevated intracranial pressure.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic repair of nasal septal perforation with anterior ethmoidal artery flap using tunnel technique.","authors":"Aeshah J Almahbub, Muath I Alsabih, Mona N Solaim, Wafaa M Alwihaibi, Yazeed A Alsuliman, Fahad S Alfawwaz, Abdulaziz A AlQahtani","doi":"10.1007/s00405-024-08843-2","DOIUrl":"10.1007/s00405-024-08843-2","url":null,"abstract":"<p><strong>Purpose: </strong>Septal perforations (SPs) present a distinct challenge. There are many described surgical approaches with variable success rates. The goal of this study is to describe a new technique in repairing SP.</p><p><strong>Methods: </strong>A case series of eighteen patients with anterior septal perforation who underwent endoscopic repair with the \"tunnel technique\" based on anterior ethmoid artery flap (AEA) were analyzed. Demographic data, etiology, size of perforation, and success rate were collected.</p><p><strong>Results: </strong>Eighteen cases with male predominance (67%) were enrolled from 2019 to 2022. The average perforation size was 1.5 cm (0.5- 3.6 cm). The success rate of complete SP closure was 94% (n = 17/18) with no complications after surgery. The patients were followed up for 7 ± 5.2 months.</p><p><strong>Conclusions: </strong>AEA flap reconstruction with the tunnel technique is associated with favorable outcomes in SP closure. The tunnel technique provides a useful flap bolster and minimizes the use of other supportive measures. This technique offers an addition to other techniques for septal perforation repair.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic segmentation of the maxillary sinus on cone beam computed tomographic images with U-Net deep learning model.","authors":"Busra Ozturk, Yavuz Selim Taspinar, Murat Koklu, Melek Tassoker","doi":"10.1007/s00405-024-08870-z","DOIUrl":"10.1007/s00405-024-08870-z","url":null,"abstract":"<p><strong>Background: </strong>Medical imaging segmentation is the use of image processing techniques to expand specific structures or areas in medical images. This technique is used to separate and display different textures or shapes in an image. The aim of this study is to develop a deep learning-based method to perform maxillary sinus segmentation using cone beam computed tomography (CBCT) images. The proposed segmentation method aims to provide better image guidance to surgeons and specialists by determining the boundaries of the maxillary sinus cavities. In this way, more accurate diagnoses can be made and surgical interventions can be performed more successfully.</p><p><strong>Methods: </strong>In the study, axial CBCT images of 100 patients (200 maxillary sinuses) were used. These images were marked to identify the maxillary sinus walls. The marked regions are masked for use in the maxillary sinus segmentation model. U-Net, one of the deep learning methods, was used for segmentation. The training process was carried out for 10 epochs and 100 iterations per epoch. The epoch and iteration numbers in which the model showed maximum success were determined using the early stopping method.</p><p><strong>Results: </strong>After the segmentation operations performed with the U-Net model trained using CBCT images, both visual and numerical results were obtained. In order to measure the performance of the U-Net model, IoU (Intersection over Union) and F1 Score metrics were used. As a result of the tests of the model, the IoU value was found to be 0.9275 and the F1 Score value was 0.9784.</p><p><strong>Conclusion: </strong>The U-Net model has shown high success in maxillary sinus segmentation. In this way, fast and highly accurate evaluations are possible, saving time by reducing the workload of clinicians and eliminating subjective errors.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of endoscopic and microscopic stapedotomy in the same patients: a prospective randomized controlled trial.","authors":"İsa Kaya, Fetih Furkan Şahin, Hasan Tanrıverdi, Süleyman Eroğlu, Tayfun Kirazli","doi":"10.1007/s00405-024-08823-6","DOIUrl":"10.1007/s00405-024-08823-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to conduct a comparative analysis of audiological and postoperative clinical outcomes between the endoscopic and microscopic stapedotomy approaches.</p><p><strong>Methods: </strong>This study employed a randomized, controlled design. Twenty-seven patients with bilateral otosclerosis underwent stapedotomy in both ears, with randomized allocation of the surgical technique (endoscopic vs. microscopic) for the first operated ear. Air-bone gap (ABG) and ABG gain were measured at least 12 months postoperatively. Postoperative outcomes including pain (Visual Analog Scale-VAS), dizziness, early-term (day 1) and late-term (6 months) dysgeusia were evaluated. The Glasgow Benefit Inventory (GBI) assessed health-related quality of life at one month postoperatively, and operative time was measured.</p><p><strong>Results: </strong>This study compared endoscopic (n = 27 ears) and microscopic (n = 27 ears) stapedotomy for otosclerosis. Both groups achieved similar hearing improvement with no significant differences in pre-operative and post-operative bone/air conduction thresholds, ABG, and ABG gain (all p > 0.05). The endoscopic stapedotomy group demonstrated reduced postoperative pain (lower VAS scores, p < 0.001), lower early dysgeusia (3.7% vs. 33.3%, p = 0.005), shorter operative time (47.3 vs. 75.4 min, p < 0.001) and improved patient-reported outcomes (higher GBI score, p = 0.014) when compared to microscopic stapedotomy group. No significant differences were observed in postoperative dizziness or late-term dysgeusia between groups.</p><p><strong>Conclusion: </strong>This study found similar hearing improvement with both endoscopic and microscopic stapedotomy for otosclerosis. However, the endoscopic approach showed advantages in reduced postoperative pain, early dysgeusia, and operative time, with improved patient-reported quality of life. These findings suggest endoscopic stapedotomy as a valuable alternative to the conventional microscopic approach.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of ChatGPT responses on tracheotomy for patient education.","authors":"Amina Khaldi, Shahram Machayekhi, Michele Salvagno, Antonino Maniaci, Luigi A Vaira, Luigi La Via, Fabio S Taccone, Jerome R Lechien","doi":"10.1007/s00405-024-08859-8","DOIUrl":"10.1007/s00405-024-08859-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the accuracy of information provided by ChatGPT-4o to patients about tracheotomy.</p><p><strong>Methods: </strong>Twenty common questions of patients about tracheotomy were presented to ChatGPT-4o twice (7-day intervals). The accuracy, clarity, relevance, completeness, referencing, and usefulness of responses were assessed by a board-certified otolaryngologist and a board-certified intensive care unit practitioner with the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool. The interrater reliability and the stability of the ChatGPT-4o responses were evaluated with intraclass correlation coefficient (ICC) and Pearson correlation analysis.</p><p><strong>Results: </strong>The total scores of QAMAI were 22.85 ± 4.75 for the intensive care practitioner and 21.45 ± 3.95 for the otolaryngologist, which consists of moderate-to-high accuracy. The otolaryngologist and the ICU practitioner reported high ICC (0.807; 95%CI: 0.655-0.911). The highest QAMAI scores have been found for clarity and completeness of explanations. The QAMAI scores for the accuracy of the information and the referencing were the lowest. The information related to the post-laryngectomy tracheostomy remains incomplete or erroneous. ChatGPT-4o did not provide references for their responses. The stability analysis reported high stability in regenerated questions.</p><p><strong>Conclusion: </strong>The accuracy of ChatGPT-4o is moderate-to-high in providing information related to the tracheotomy. However, patients using ChatGPT-4o need to be cautious about the information related to tracheotomy care, steps, and the differences between temporary and permanent tracheotomies.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of underlying diseases on pneumonia risk in patients with neurogenic or tumor-related dysphagia: a retrospective cohort study.","authors":"Almut C Niessen, Jana Zang, Ferkhunda Tinat, Julie C Nienstedt, Frank Müller, Till Flügel, Julia Glinzer, Christina Pflug","doi":"10.1007/s00405-024-08815-6","DOIUrl":"10.1007/s00405-024-08815-6","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the association of neurological disorders (ND) and head and neck cancer (HNC) with dysphagia severity and aspiration pneumonia occurrence.</p><p><strong>Method: </strong>Retrospective cohort study conducted at a university dysphagia center) for two consecutive years. Patients with ND or HNC were included if they had undergone a flexible endoscopic swallowing evaluation (FEES) at the dysphagia center, and at least one food consistency had been sampled and recorded. Outcomes of interest were swallowing safety, highest penetration-aspiration-score (PAS_max), way of food intake, presence of a tracheal tube, and occurrence of pneumonia within the past two years.</p><p><strong>Results: </strong>Of 257 consecutive patients, 199 were enrolled in the study and classified according to their underlying diagnosis into ND (120 patients) or HNC (79 patients). Forty-three HNC patients (54.4%) and 54 ND patients (45%) showed critical dysphagia in FEES (PAS ≥ 6). Binary logistic regression comparing both groups showed patients with ND to be 2.31 times more likely to develop pneumonia. However, if the 32 stroke patients were excluded from the calculation, PAS_max remains the only significant variable affecting pneumonia risk in both groups. Liquids were the main challenge for ND patients, while aspirating HNC patients struggled with all consistencies.</p><p><strong>Conclusions: </strong>The study shows that patients with HNC and ND differ in pneumonia risk only if stroke patients are included in the ND group. If they are excluded, the PAS score is the only remaining risk factor for pneumonia. Thickening liquids may not be suitable for all dysphagic patients; individually tailored measures might be more helpful, especially for HNC patients.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsy of the facial nerve in slow-onset facial palsy.","authors":"Gianluca Sistori, Michael Götting, Cornelia Radke, Markus Jungehülsing","doi":"10.1007/s00405-024-08826-3","DOIUrl":"10.1007/s00405-024-08826-3","url":null,"abstract":"<p><strong>Introduction: </strong>Primary squamous cell carcinoma of the parotid gland typically presents as a palpable, often painless mass. Peripheral facial palsy as the only sign of malignant neoplasia is rare. In these cases, the diagnosis is regularly confirmed by radiological imaging followed by surgical exploration and biopsy. However, if there is no detection of malignant lesions and no evidence of a tumor, the reluctance to take a biopsy of an unremarkable nerve can lead to misdiagnoses.</p><p><strong>Case report: </strong>A 40-year-old female patient without medical history presented to our clinic with a complete right-sided peripheral facial palsy that had slowly progressed for 2.5 years. All other otorhinolaryngological examination findings were within normal limits. Magnetic resonance imaging examination of the head and neck and 18-fluorodeoxyglucose positron emission tomography showed unremarkable results. We proceeded with surgical exploration, which revealed no evidence of a tumor and an externally completely unremarkable facial nerve. A biopsy from the main trunk area of the nerve revealed an infiltration by a squamous cell carcinoma. Total parotidectomy with resection and reconstruction of the facial nerve and neck dissection was performed. Considering the absence of a primary tumor and other tumor formations the diagnosis of a completely regressive primary squamous cell carcinoma of the parotid gland was confirmed.</p><p><strong>Conclusion: </strong>In conclusion, in the case of slow-onset peripheral facial palsy that persists without signs of recovery, a gadolinium-enhanced MRI should be performed. If imaging is unremarkable and there is no primary tumor detection along the course of the facial nerve, a surgical exploration with biopsy of the facial nerve is necessary.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-generated text in otolaryngology publications: a comparative analysis before and after the release of ChatGPT.","authors":"Jonathan M Carnino, Nicholas Y K Chong, Henry Bayly, Lindsay R Salvati, Hardeep S Tiwana, Jessica R Levi","doi":"10.1007/s00405-024-08834-3","DOIUrl":"10.1007/s00405-024-08834-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study delves into the broader implications of artificial intelligence (AI) text generation technologies, including large language models (LLMs) and chatbots, on the scientific literature of otolaryngology. By observing trends in AI-generated text within published otolaryngology studies, this investigation aims to contextualize the impact of AI-driven tools that are reshaping scientific writing and communication.</p><p><strong>Methods: </strong>Text from 143 original articles published in JAMA Otolaryngology - Head and Neck Surgery was collected, representing periods before and after ChatGPT's release in November 2022. The text from each article's abstract, introduction, methods, results, and discussion were entered into ZeroGPT.com to estimate the percentage of AI-generated content. Statistical analyses, including T-Tests and Fligner-Killeen's tests, were conducted using R.</p><p><strong>Results: </strong>A significant increase was observed in the mean percentage of AI-generated text post-ChatGPT release, especially in the abstract (from 34.36 to 46.53%, p = 0.004), introduction (from 32.43 to 45.08%, p = 0.010), and discussion sections (from 15.73 to 25.03%, p = 0.015). Publications of authors from non-English speaking countries demonstrated a higher percentage of AI-generated text.</p><p><strong>Conclusion: </strong>This study found that the advent of ChatGPT has significantly impacted writing practices among researchers publishing in JAMA Otolaryngology - Head and Neck Surgery, raising concerns over the accuracy of AI-created content and potential misinformation risks. This manuscript highlights the evolving dynamics between AI technologies, scientific communication, and publication integrity, emphasizing the urgent need for continued research in this dynamic field. The findings also suggest an increasing reliance on AI tools like ChatGPT, raising questions about their broader implications for scientific publishing.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional vs. diode laser stapedotomy.","authors":"Jia-Peng Zhang, Guan-Jiang Huang","doi":"10.1007/s00405-024-08833-4","DOIUrl":"10.1007/s00405-024-08833-4","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neck-Persistency-Net: a three-dimensional, convolution, deep neural network aids in distinguishing vital from non-vital persistent cervical lymph nodes in advanced head and neck squamous cell carcinoma after primary concurrent radiochemotherapy.","authors":"Matthias Santer, Philipp Zelger, Joachim Schmutzhard, Wolfgang Freysinger, Annette Runge, Timo Maria Gottfried, Andrea Tröger, Samuel Vorbach, Julian Mangesius, Gerlig Widmann, Simone Graf, Benedikt Gabriel Hofauer, Daniel Dejaco","doi":"10.1007/s00405-024-08842-3","DOIUrl":"10.1007/s00405-024-08842-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance (DP) of the high-resolution contrast computed tomography (HR-contrast-CT) based Neck-Persistency-Net in distinguishing vital from non-vital persistent cervical lymph nodes (pcLNs) in patients with advanced head and neck squamous cell carcinoma (HNSCC) following primary concurrent chemoradiotherapy (CRT) with [18F]-fluorodeoxyglucose positron emission tomography and high-resolution contrast-enhanced computed tomography ([18F]FDG-PET-CT). Furthermore, the Neck-Persistency-Net's potential to justify omitting post-CRT neck dissection (ND) without risking treatment delays or preventing unnecessary surgery was explored.</p><p><strong>Methods: </strong>All HNSCC patients undergoing primary CRT followed by post-CRT-ND for pcLNs recorded in the institutional HNSCC registry were analyzed. The Neck-Persistency-Net DP was explored for three scenarios: balanced performance (BalPerf), optimized sensitivity (OptSens), and optimized specificity (OptSpec). Histopathology of post-CRT-ND served as a reference.</p><p><strong>Results: </strong>Among 68 included patients, 11 were female and 32 had vital pcLNs. The Neck-Persistency-Net demonstrated good DP with an area under the curve of 0.82. For BalPerf, both sensitivity and specificity were 78%; for OptSens (90%), specificity was 62%; for OptSpec (95%), sensitivity was 54%. Limiting post-CRT-ND to negative results would have delayed treatment in 27%, 40%, and 7% for BalPerf, OptSens and OptSpec, respectively, versus 23% for [18F]FDG-PET-CT. Conversely, restricting post-CRT-ND to positive results would have prevented unnecessary post-CRT-ND in 78%, 60%, and 95% for BalPerf, OptSens and OptSpec, respectively, versus 55% for [18F]FDG-PET-CT.</p><p><strong>Conclusion: </strong>The DP of the Neck-Persistency-Net was comparable to [18F]-FDG-PET-CT. Depending on the chosen decision boundary, the potential to justify the omission of post-CRT-ND without risking treatment delays in false negative findings or reliably prevent unnecessary surgery in false positive findings outperforms the [18F]-FDG-PET-CT.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}