European Spine Journal最新文献

{"title":"SCaRES - scoliosis caregiver response and emotional scale: a Rasch-validated questionnaire to measure the psychological impact of children's scoliosis on their parents.","authors":"Fabio Zaina, Irene Ferrario, Hadeel R Bakhsh, Sabrina Donzelli, Stefano Negrini","doi":"10.1007/s00586-025-08983-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08983-x","url":null,"abstract":"<p><strong>Purpose: </strong>Having a child diagnosed with Idiopathic Scoliosis (IS) can be stressful for parents who report higher rates of mood disturbances, anxiety, and diminished quality of life (QoL). Currently, there are no questionnaires to assess the QoL of this population. This study aimed to develop a Rasch-validated questionnaire to measure the impact of their children's pathology and treatment on the QoL of parents of IS patients.</p><p><strong>Methods: </strong>We designed a cross-sectional psychometric study; we used a conventional approach for content analysis on an online blog addressed to patients and families with scoliosis to identify parents' self-reported problems affecting their QoL. Progressively refined versions of the questionnaire were administered to parents caring for a child with IS. Rasch analysis was performed.</p><p><strong>Results: </strong>The final version of the questionnaire consisted of 18 items rated on a 4-point Likert scale. The variance explained was 14.39 eigenvalue (44.4%). The variance in 1st contrast was 2.56 eigenvalue (7.9%). All the 18 items fit the Rasch model. The questionnaire targeting was satisfactory. The Person's ability spanned 6.99 logits from - 5.17 to 1.82 with an ability mean measure of -1.41 logits (SD = 1.14 logits). Item difficulty spanned 2.07 logits from - 1.17 to 0.90. Reliability was 0.83, allowing for the distinction of the 3.32 strata participant's mean. No DIF was noted for parents' age, sex, or the child's age and sex.</p><p><strong>Conclusion: </strong>The questionnaire reliably measures the QoL of parents of children with IS. These findings support its validity and possible implementation in clinical settings.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340077","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":"Anterior transarticular crossing screw fixation for reducible atlantoaxial dislocation with basilar invagination: a radiological feasibility study.","authors":"Jianying Zheng, Yu Wang, Jiahao Xie, Hang Xiao, Panjie Xu, Zhongmin Zhang, Wei Ji","doi":"10.1007/s00586-025-09072-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09072-9","url":null,"abstract":"<p><strong>Purpose: </strong>The primary focus of surgical treatment for reducible atlantoaxial dislocation with basilar invagination (RADB) is reducing and fixing the atlantoaxial joint. While established anterior, posterior, or combined approaches are effective, they can be associated with significant risks and surgical trauma. Our prior research suggests that anterior transarticular crossing screw (ATCS) fixation via a unilateral anterior cervical minimally invasive approach allows for bilateral screw placement and offers superior stability. However, the anatomical feasibility of ATCS for RADB has not been systematically evaluated. Therefore, this study aimed to radiologically assess the potential trajectories and anatomical feasibility of ATCS fixation in RADB patients.</p><p><strong>Methods: </strong>A retrospective radiological study was conducted involving 94 patients with RADB, who were categorized into group 1 (with C2-C3 block vertebrae) and group 2 (without C2-C3 block vertebrae). All patients had undergone prior successful reduction and posterior occipitocervical fixation, ensuring a stable post-reduction anatomy for precise measurements. Anatomical parameters for both hypothetical ATCS and anterior transarticular screw (ATS) trajectories were measured from multiplanar computed tomography reconstruction images and flexion-extension radiographs. These included the mandible occlusion angle (MOA), sternum occlusion angle (SOA), screw lateral angles (LAs), screw lengths, screw incline angles (IAs), and screw entry angles on ideal trajectory (EAs). Statistical comparisons were performed to evaluate differences between ATCS and ATS parameters.</p><p><strong>Results: </strong>In both group 1 and group 2, the MOA of the ATCS was greater than that of the ATS (Group 1: 68.0 ± 12.2° vs. 56.9 ± 10.6°, P < 0.001; Group 2: 61.0 ± 16.4° vs. 57.5 ± 14.7°, P < 0.001), while the SOA of the ATCS was less than that of the ATS (Group 1: -9.8 ± 10.8° vs. -6.3 ± 9.3°, P < 0.001; Group 2: -8.2 ± 13.1° vs. -5.8 ± 12.3°, P < 0.001). Additionally, ATCS demonstrated greater ideal screw lengths (Group 1: 50.5 ± 3.7 mm vs. 24.9 ± 3.0 mm for ATS, P < 0.05; Group 2: 42.4 ± 4.6 mm vs. 27.3 ± 4.1 mm for ATS, P < 0.05) and different angular characteristics compared to ATS. Detailed measurements provided potential optimal screw insertion angles and lengths, indicating radiological feasibility. And the EAs of both ATCS and ATS were between their MOA and SOA.</p><p><strong>Conclusions: </strong>Anterior transarticular crossing screw placement is radiological feasible for the patients with RADB, especially for the ones with C2-C3 block vertebrae, involving a longer screw.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340073","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":"‌Spike-shaped ossification of the posterior longitudinal ligament combined with dural ossification: a case report and literature review on imaging diagnosis and pathogenesis.","authors":"Kaishuai Zhao, Zhan Peng, Jin Li, Pu Wang, Zukun Song, Zhuobin Liu, Guangye Wang","doi":"10.1007/s00586-025-09080-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09080-9","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340072","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":"Unilateral sacral fragility fractures: a comparative study of unilateral vs. bilateral minimally invasive osteosynthesis.","authors":"Martin Naisan, Mohamad Joumah, Marco Brenneis, Marcus Richter, Philipp Drees, Philipp Hartung","doi":"10.1007/s00586-025-09081-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09081-8","url":null,"abstract":"<p><strong>Purpose: </strong>Unilateral sacral fragility fractures are frequently managed with unilateral percutaneous iliosacral screw fixation, which may increase stress on the contralateral sacrum and lead to secondary fractures. This study compared complication rates between unilateral and bilateral screw osteosynthesis and evaluated risk factors for contralateral fracture following unilateral treatment.</p><p><strong>Methods: </strong>This retrospective study included patients with unilateral sacral fragility fractures treated between 2018 and 2024. Patients were categorized into two groups: Group 1 (unilateral fixation) and Group 2 (bilateral fixation). Demographics, fracture morphology, and outcomes at 3 and 12 months postoperatively were assessed. Potential risk factors included comminution, sacral zone involvement, and concomitant anterior pelvic ring fractures.</p><p><strong>Results: </strong>A total of 119 patients were analyzed (44 unilateral, 75 bilateral). The complication rate was significantly higher in the unilateral group (26% vs. 7.1%; p = 0.03). Contralateral fractures occurred more frequently in the unilateral group, particularly in the presence of anterior pelvic ring fractures, although this association was not statistically significant (p = 0.2).</p><p><strong>Conclusions: </strong>Bilateral screw osteosynthesis significantly reduces complication rates compared to unilateral fixation in the treatment of unilateral sacral fragility fractures. These findings support the routine consideration of bilateral fixation, particularly in patients with concomitant anterior pelvic ring injuries, to minimize the risk of contralateral sacral failure.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340079","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":"Correlation/Compatibility of DIERS postural analysis data with radiographic findings in patients with idiopathic scoliosis.","authors":"Fatma Kumbara, Aslı Turan, Elif Yalçın","doi":"10.1007/s00586-025-09076-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09076-5","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate patients with idiopathic scoliosis separately using radiological imaging and the DIERS posture analysis system; to assess the applicability of the radiation-free DIERS system in follow-up, with the goal of reducing radiation exposure and determining the reliability of the device.</p><p><strong>Materials and methods: </strong>A total of 85 patients with previously performed synchronous double-plane radiographs and DIERS scans were retrospectively included in the study. Parameters were measured in both radiographs and DIERS including pelvic parameters (pelvic obliquity, pelvic tilt), sagittal plane (thoracic kyphosis, lumbar lordosis, sagittal imbalance), coronal plane (Cobb angle, midline apical deviation), and horizontal plane (degree of rotation). Data distribution was assessed with the Kolmogorov-Smirnov test. Measurement differences were evaluated using parametric and non-parametric tests, and agreement between methods was analyzed using Bland-Altman analysis.</p><p><strong>Results: </strong>Statistically significant differences were found between DIERS and X-ray measurements for Cobb angle, vertebral rotation, pelvic obliquity, torsion, and apical deviation (p < 0.001). Notably, substantial discrepancies were observed in rotation angle (X-ray: 11.06°; DIERS: 4.15°) and apical deviation (X-ray: 12.81°; DIERS: 4.60°). Bland-Altman analysis indicated a systematic difference between the two methods. The correlation between X-ray and DIERS measurements varied across parameters. The strongest correlation was observed in pelvic obliquity (r = 0.96, p < 0.001), while the weakest correlation was found in apical deviation (r = 0.77, p < 0.001). Overall, DIERS measurements systematically differed from those obtained by X-ray, and this difference was statistically significant in both paired t-tests and Wilcoxon signed-rank tests.</p><p><strong>Conclusion: </strong>The DIERS system offers an advantage in the follow-up of scoliosis patients due to its radiation-free nature. However, the detection of different values compared to X-ray, especially in rotational and pelvic deformities, indicates that the system should be interpreted with caution in treatment planning. The DIERS system may be used as a complementary tool to radiographic evaluation.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340074","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 intrathecal morphine analgesia for full endoscopic lumbar discectomy: a prospective dose-finding study.","authors":"Yue Lei, Zhang Feng, Wang Ziqi, Huang Changsheng, Zhang Jianming, Su Xueyuan, Wang Shijun, Li Chao, Yu Zhengrong, Lin Zengmao, Sun Haolin","doi":"10.1007/s00586-025-09047-w","DOIUrl":"https://doi.org/10.1007/s00586-025-09047-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Anesthesia for full endoscopic lumbar discectomy (FELD), typically administered locally or regionally, often fails to provide adequate analgesia, necessitating additional analgesics or even sedation. Our previous work has shown that intrathecal morphine (ITM) administration is considered an effective adjuvant approach for managing peri-operative pain for FELD, but the adverse events (AEs) for ITM remain concerns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to determine the effective dose of intrathecal morphine required to eliminate intraoperative pain in 90% of patients (ED&lt;sub&gt;90&lt;/sub&gt;) undergoing FELD under spinal anesthesia and to evaluate the safety profile of ITM within 100 µg.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A prospective, double-blind, sequential allocation dose-finding study was conducted using the biased coin up-down method. Patients undergoing single-segment FELD received ITM through the same route as spinal anesthesia. The ITM dose was adjusted using a 1/9 probability of dose reduction following an effective response, or increased for the subsequent patient if the response was ineffective. Sample size for drug dose-finding studies typically ranges between 20 and 40 participants; this study included 30 participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;The ED&lt;sub&gt;90&lt;/sub&gt; and its 95% confidence intervals were estimated by isotonic regression. The primary outcome was intraoperative pain intensity measured by visual analogue scale (VAS), while secondary outcomes included postoperative pain at various time points and AEs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All patients underwent single-segment interlaminar or transforaminal FELD under spinal anesthesia. The ITM dosage range was established at 25, 50, 75, and 100 µg. An effective response was defined as an intraoperative VAS score of 0 with no need for additional analgesics. The dose was adjusted using a biased coin up-down method, with a 1/9 probability of dose reduction after an effective response. If an ineffective response occurred-defined as an intraoperative VAS score &gt; 0 or the requirement for supplemental analgesics-the ITM dose was upgraded for the next patient. The study was registered in the Chinese Clinical Trial Registry (ChiCTR2200067060).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty patients were enrolled and completed the study between November 2022 and August 2024. The ED&lt;sub&gt;90&lt;/sub&gt; of ITM for FELD was 90.89 µg (95% CI 80.05-149.23 µg). Satisfactory analgesia (VAS = 0) was achieved in 15/16 patients at 100 µg, 11/13 patients at 75 µg, and none at 50 µg. ITM-related AEs occurred in 22/30 patients, with no significant difference in overall AE incidence between the 100 µg high-dose and lower doses. Nausea or vomiting was the most common AE during the operation and 1 h postoperatively, while pruritus was most frequent at 12 and 24 h postoperatively. More participants receiving 100 µg ITM reported pruritus compared to those receivi","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340078","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":"In memoriam dr. Margareta Nordin (1945-2025): A leader in spine research, rehabilitation and a global health advocate.","authors":"Dino Samartzis, Bjorn Rydevik","doi":"10.1007/s00586-025-09057-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09057-8","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340076","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":"Digital tomosynthesis enhances cervicothoracic sagittal alignment assessment: are cervicothoracic sagittal parameters correlated with the occurrence of cervical spondylotic myelopathy?","authors":"Shengbiao Ma, Xuechen Ding, Zhenhai Zhou, Mengxu Wang, Xiaodong Tang, Peng Zhang","doi":"10.1007/s00586-025-09074-7","DOIUrl":"https://doi.org/10.1007/s00586-025-09074-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the availability of digital tomosynthesis (DTS) in assessing cervicothoracic junction sagittal alignment, and investigate the correlation between cervicothoracic sagittal parameters and the occurrence of cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>A cohort of 160 participants-80 healthy controls (Group A) and 80 CSM patients (Group B)-underwent cervical lateral radiography and DTS imaging in our center. Sagittal parameters (occiput-C2 angle [O-C2], cervical lordosis [CL], C2-7 sagittal vertical axis [C2-7 SVA], neck tilt [NT], T1 slope [T1S], thoracic inlet angle [TIA], cervical tilt, and cranial tilt) were measured using both modalities. Inter-class correlation coefficients (ICCs) were calculated to assessed measurement reliability. Group comparisons and multivariate logistic regression analyses were performed to identify CSM-related parameters.</p><p><strong>Results: </strong>DTS demonstrated excellent reliability across all parameters (ICCs: 0.885-0.987), surpassing radiography (ICCs: 0.714-0.932; rated good-to-excellent). While O-C2, CL, C2-7 SVA, and NT showed no significant differences (P > 0.05), DTS yielded significantly larger measurements for T1S, TIA, cervical tilt, and cranial tilt (P < 0.05). Between groups, for CSM patients, DTS-derived CL, T1S, and cervical tilt were significantly smaller (P < 0.05), but C2-7 SVA and NT were significantly larger (P < 0.05). Multivariate analysis identified diminished CL (B = 0.120, OR = 1.128, P < 0.001) and lower T1S (B =-0.150, OR = 0.861, P < 0.001) as independent CSM risk factors.</p><p><strong>Conclusion: </strong>DTS surpasses conventional radiography in precision for cervicothoracic sagittal evaluation. Reduced CL and diminished T1S are independently associated with CSM pathogenesis, highlighting their utility in clinical risk stratification.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340075","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":"Intraoperative neurophysiological monitoring and patient-related outcomes in thoracic spinal meningiomas surgery: a single-center retrospective cohort study.","authors":"Giovanni Grasso, Tito Petralia, Fabio Torregrossa, Luigi Basile, Luigi Cusumano, Alessandro Rodolico, Domenico Iacopino","doi":"10.1007/s00586-025-09064-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09064-9","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the relationships between changes in intraoperative neurophysiological monitoring (IONM) and patient-related outcomes (PROs), by Brief Pain Inventory (BPI) questionnaire and the MD Anderson Symptom Inventory (MDASI) questionnaire, in a cohort of patients operated on for thoracic spinal meningioma (SM).</p><p><strong>Methods: </strong>This is a retrospective study on patients operated on for thoracic SMs in whom IONM was used. BPI and the MDASI were recorded preoperatively, at 1-month, 6- and 12-month follow-up. The Wilcoxon signed-rank test was used to evaluate significant differences between preoperative and postoperative individual items from the MDASI, BPI, and neurological dysfunction through the modified McCormick scale (mMCS). To compare differences in outcome measures, repeated measures ANOVA were performed. Spearman's rank-order correlation was used to analyze the degree of association between the variables after surgery. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>A total of 183 patients operated on for thoracic SM were included. Of these, 95 (52%) had no change in IONMs during surgery, 30 (16%) had a worsening in motor, sensory, or mixed recordings, and 58 (32%) had an improvement in intraoperative recordings. Both the MDASI and BPI showed a statistically significant improvement from the baseline to the first follow-up (p > 0.001), remaining stable over time.</p><p><strong>Conclusions: </strong>In our series, we observed statistical significance differences between favorable IONM, neurological outcome, and PROs. Further studies with a larger sample size and a longer follow-up may provide more conclusive results.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316286","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":"Does disc consistency matter? a comparative series on calcified and soft thoracic disc herniations.","authors":"Chinedu Egu, R M Prasanna S Ratnayake, Ibrahim M Alrabi, Nalinda S Jayalath, Neel Badhe, Eduardo Muscogliati, Weronika Nocun, Nasir A Quraishi, Elie Najjar","doi":"10.1007/s00586-025-09069-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09069-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316284","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}