HAND最新文献

{"title":"Goal Concordant Care: A Cross-Sectional Study Evaluating Correlates of Concordant Care and Association With Satisfaction and Outcomes.","authors":"Kaitlyn R Julian, Jeffrey W Kwong, Chelsea Leversedge, Thompson Zhuang, Nicole Schroeder, Robin N Kamal, Lauren M Shapiro","doi":"10.1177/15589447241279458","DOIUrl":"10.1177/15589447241279458","url":null,"abstract":"<p><strong>Background: </strong>The concordance between patient and physician goals has been associated with improved outcomes in many chronic diseases. The purpose of this study was to evaluate the association between goal concordant care, patient satisfaction, and patient experience and to analyze factors associated with goal concordant care in hand and upper extremity surgery.</p><p><strong>Methods: </strong>New patients who were 18 years or older were invited to participate. Goal concordant care was defined as the patient's previsit treatment goal matching the primary treatment received. The χ² tests were used to evaluate the association between goal concordant care and patient satisfaction and patient experience. We conducted univariable logistic regression to evaluate variables for their association with concordance and multivariable logistic regression for variables that were significantly associated in the initial analyses to evaluate their aggregate influence on concordance.</p><p><strong>Results: </strong>In total, 169 patients enrolled. The rate of goal concordant care was 62%; concordance was not associated with patient satisfaction or experience. Age, sex, English proficiency, health literacy, education level, employment and relationship status, pain self-efficacy, symptom duration, functional disability, and patient-centered decision-making were not associated with concordant care. Patients with annual income less than $50,000 had significantly higher odds of goal discordant care.</p><p><strong>Conclusion: </strong>Patients with lower income had more than 3 times the odds of receiving discordant care. However, discordant care was not associated with patient satisfaction or experience. Further studies on other pertinent outcomes are needed in orthopedic surgery (eg, treatment adherence). Known care disparities based on socioeconomic status may be mediated through care discordance and should be investigated.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279458"},"PeriodicalIF":16.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345527","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":"Iatrogenic Irreducible Pediatric Salter-Harris II Middle Phalanx Base Fracture With Dorsal Dislocation of the Proximal Interphalangeal Joint: A Case Report.","authors":"Daniel Urness, SeHoon Park, Jordan Miller, David Fadell","doi":"10.1177/15589447241278957","DOIUrl":"10.1177/15589447241278957","url":null,"abstract":"<p><p>Pediatric phalangeal Salter-Harris (SH)-type fracture dislocations are rare injuries that often require open reduction and stabilization. We present a case of a 14-year-old male who sustained an iatrogenic irreducible SH II dorsal fracture dislocation of the small-finger proximal interphalangeal joint (PIPJ) after an attempted closed reduction of a small-finger PIPJ dislocation by a community emergency medicine physician. Following the reduction attempt, the epiphysis was noted on radiographs to be rotated approximately 90° with persistent dorsal dislocation and an associated SH II fracture of the base of the middle phalanx. The patient was sent to our trauma center for further evaluation by our on-call hand surgeon and required open reduction and pinning of the fracture dislocation. To our knowledge, this pattern of iatrogenic PIPJ fracture dislocation has not been previously described in the literature. We outline the case presentation, treatment method, and learning points for both the on-call hand surgeon as well as the community emergency medicine physicians in this report.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241278957"},"PeriodicalIF":16.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345528","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":"Radiocarpal Fracture Dislocations: A Retrospective Review on Operative Fixation and Postoperative Range of Motion.","authors":"Victor E Greco, Matthew Akelman, Morgan Childress, Taylor R Wood, Fiesky Nunez, Zhongyu J Li","doi":"10.1177/15589447241279451","DOIUrl":"10.1177/15589447241279451","url":null,"abstract":"<p><strong>Background: </strong>Radiocarpal dislocation (RCD) and radiocarpal fracture dislocation (RCFD) are rare but severe injury patterns with multiple types of fixation techniques described. The purpose of this study was to determine the outcomes of RCD and RCDF treated at our institution.</p><p><strong>Methods: </strong>Patients were identified using our institution's electronic medical records between 2013 and 2022. Seventeen patients met criteria who suffered either RCD or RCFD. Patient charts were reviewed retrospectively with a focus on demographics, mechanism of injury, smoking status, open injury, direction of dislocation, Moneim and Dumontier classification, procedures, complications, final range of motion and subsequent surgeries.</p><p><strong>Results: </strong>Seventeen patients met criteria with an average age of 38.5 years. Thirteen patients sustained dorsal dislocations while 4 sustained volar dislocations. Four were Dumontier type I and 13 were type II. Twelve were Moneim type I and 5 were type II. Fourteen of the 17 patients had at least 6-month follow-up. The average flexion and extension at time of last follow-up was 33.6° and 39.5°, respectively. Average pronation and supination was 80.6° and 63.1°, respectively. Fourteen patients underwent subsequent surgeries, mainly hardware removal, and 5 had complications resulting in unplanned return to the operating room. There was no significant difference in post operative range of motion, complications, or subsequent surgeries based on Moneim or Dumontier classification (<i>P</i> > 0.11).</p><p><strong>Conclusions: </strong>Radiocarpal dislocation and RCFD are challenging and rare injuries with multiple patterns and variance. With proper fixation and recognition of associated injuries, patients with these injuries can expect to return to work and achieve functional range of motion.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279451"},"PeriodicalIF":16.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345531","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":"Diagnostic Accuracy of Neuromuscular Ultrasound vs. Electrodiagnostic Studies for Carpal Tunnel Syndrome: Systematic Review and Meta-analysis of Paired Accuracy Studies.","authors":"Larry E Miller, Warren C Hammert, Mark S Rekant, John R Fowler","doi":"10.1177/15589447241278972","DOIUrl":"10.1177/15589447241278972","url":null,"abstract":"<p><p>This systematic review with meta-analysis compared the diagnostic accuracy of neuromuscular ultrasound (NMUS) and electrodiagnostic studies (EDX) as confirmatory tests for carpal tunnel syndrome (CTS) diagnosis. We used bivariate random-effects models to estimate pooled sensitivity and specificity and generate hierarchical summary receiver-operating characteristic curves to assess diagnostic test accuracy. Nine paired accuracy studies were included, representing 1751 hands (743 clinically diagnosed CTS; 1008 without CTS) that underwent NMUS and EDX. Compared to the clinical diagnosis reference standard, the pooled sensitivity was 86.4% for NMUS and 91.6% for EDX. Pooled specificity was 79.3% for NMUS and 81.9% for EDX. The positive likelihood ratios were 4.2 and 5.1 for NMUS and EDX, respectively, and the negative likelihood ratios were 0.17 and 0.10, respectively. The diagnostic odds ratio was 24 for NMUS and 49 for EDX. No statistically significant differences were identified between NMUS and EDX for sensitivity, specificity, or overall diagnostic accuracy. Overall, the diagnostic accuracy of NMUS is similar to that of EDX for CTS diagnosis, with high sensitivity and moderate specificity for each. The choice between these confirmatory diagnostic tests should incorporate shared decision-making between patients and providers that weighs diagnostic accuracy as well as factors such as patient preferences, test availability, cost, and tolerability.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241278972"},"PeriodicalIF":16.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345526","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":"Pain Sensitization and Association With Baseline Factors in Elderly Patients With Distal Radius Fracture: A Cross-Sectional Study.","authors":"Héctor Gutiérrez-Espinoza, Felipe Araya-Quintanilla, Rodrigo Gutiérrez-Monclus, Juan Valenzuela-Fuenzalida, Elisabet Hagert, Susanne Rein","doi":"10.1177/15589447241279596","DOIUrl":"10.1177/15589447241279596","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to describe the presence of pain sensitization (PS) and its association with baseline factors after cast removal in patients older than 60 years with distal radius fracture (DRF) treated conservatively.</p><p><strong>Methods: </strong>This cross-sectional study included 220 patients older than 60 years with extra-articular DRF who completed the Pain Sensitivity Questionnaire (PSQ). Patients with PSQ score > 7 points were considered positive for PS. In addition, sociodemographic, anthropometrics, clinical, radiological, lifestyle behaviors, pain-related psychological factors, and functional outcomes were analyzed as baseline predictors, all measured were performed 2 weeks after cast removal.</p><p><strong>Results: </strong>A total of 159 patients (72.3%) showed PS. The results showed an association between higher values of PSQ-total with the affected dominant hand (β = 1.1; <i>P</i> = 0.04), high energy of injury (β = 3.5; <i>P</i> < .001), extra-articular comminuted metaphyseal DRFs (β = 1.8; <i>P</i> < .001), lower values of Rapid Assessment of Physical Activity questionnaire (β = 3.1; <i>P</i> < .001), higher values of Pittsburgh Sleep Quality Index (β = 2.5; <i>P</i> < .001), higher values of Tampa Scale of Kinesiophobia (β = 1.9; <i>P</i> < .001), higher values of Pain Catastrophizing Scale (β = 1.8; <i>P</i> < .001), higher values of Disabilities of the Arm, Shoulder and Hand questionnaire (β = 1.6; <i>P</i> < .001), lower values of grip strength (β = 1.4; <i>P</i> < .001) and higher values of Visual analog scale (β = 4.2; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>A high percentage of patients older than 60 years with extra-articular DRFs present PS at 2 weeks after cast removal. Our results may help physicians and physiotherapists identify risk and/or prognostic baseline factors for the occurrence of PS after DRF, and the need for a therapeutic approach that incorporates the clinical management of this condition in these patients.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279596"},"PeriodicalIF":16.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345530","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":"Arthrodesis as Salvage for Failed Metacarpophalangeal Arthroplasty.","authors":"Matthew M Rode, Kitty Y Wu, Benjamin D Welling, Marco Rizzo","doi":"10.1177/15589447241279589","DOIUrl":"10.1177/15589447241279589","url":null,"abstract":"<p><strong>Background: </strong>Surgical management of failed metacarpophalangeal (MCP) arthroplasties includes revision arthroplasty and arthrodesis. The purpose of this study was to review the indications and outcomes of arthrodesis as a salvage procedure for failed MCP arthroplasties.</p><p><strong>Methods: </strong>This was a retrospective cohort study of all patients undergoing salvage MCP arthrodesis at a single institution from 1990 to 2020. Patient charts were reviewed for patient demographics, indication for salvage, surgical technique, revision rate, and time to radiographic union. Patient-reported outcomes, including the Michigan Hand Outcomes Questionnaire and an MCP-specific questionnaire detailing pain, functional, appearance, and patient satisfaction, were also collected.</p><p><strong>Results: </strong>Eleven digits in 9 patients (6 women, 3 men, median age of 66) with median 36-month follow-up were included. The majority (91%) of patients also had concomitant soft tissue deformities, including joint contractures, extension lag, and collateral ligament insufficiency. The overall revision rate following arthrodesis was 45% with 3 digits requiring one revision each, and 2 digits undergoing 3 revisions. The overall union rate was 91% with median time to union of 4 months from most recent arthrodesis. Patient-reported outcomes obtained from 4 patients demonstrated improvements in pain and function.</p><p><strong>Conclusion: </strong>Despite a high revision rate of 45%, salvage MCP arthrodesis following arthroplasty has a high eventual union rate of 91% and is associated with improved pain and function based on 4 patients' experiences. Arthrodesis as a salvage procedure for failed MCP arthroplasties should be considered in patients with persistent joint instability and functionally limiting soft tissue deformities.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279589"},"PeriodicalIF":16.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285853","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":"Individual Joint Distractions Using Ilizarov Mini-Fixator Device for Chronic Simultaneous Dislocation of the Distal and Proximal Interphalangeal Joints in the Same Finger.","authors":"Satoshi Usami, Kentaro Sonoki, Sanshiro Kawahara","doi":"10.1177/15589447241279598","DOIUrl":"10.1177/15589447241279598","url":null,"abstract":"<p><p>Simultaneous dislocation of the distal and proximal interphalangeal joints is an uncommon injury. Treating chronic cases proves challenging due to severe contractures affecting both joints and surrounding soft tissues. Here, we report an unusual chronic contracture case in a 46-year-old man who suffered a dorsal dislocation of the distal and proximal interphalangeal joints of the little finger. The patient underwent primary joint distraction followed by open reduction, leading to stable radiographic restoration and a functional range of motion in the affected finger 6 months postoperatively. Joint distraction was a reliable approach for the treatment of chronic joint dislocation with severe soft tissue contracture, especially for multiple joint contractures. In addition, the Ilizarov mini-fixator device was effective in enabling individualized traction on both the distal and proximal interphalangeal joints.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279598"},"PeriodicalIF":16.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285858","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":"Coverage of Soft-Tissue Defects of the Palm of the Hand: Introduction of a New Flap Design.","authors":"Mohamed Fareed, Abdelrahman Awadeen, Ali Mohamed Elameen","doi":"10.1177/15589447241277845","DOIUrl":"10.1177/15589447241277845","url":null,"abstract":"<p><p>The palm is of great importance for maintaining a functioning hand. The reconstructive demands of thickness, texture, color matching, pliability, and sensation for palmar defects represent a unique challenge for plastic surgeons. This study introduced a novel versatile design for the ulnar palmar artery perforator flap (UPAPF) to cover large palmar soft-tissue defects of the hand. The fifth metacarpophalangeal joint was identified as a landmark where the perforator was nearly 1 to 1.5 cm proximal. A template of the defect was outlined after adequate debridement. Meticulous dissection was executed under loupe magnification to trace the perforator until an adequate length of the pedicle was obtained for rotation. The harvested type B fasciocutaneous flap was rotated nearly 90° to be insetting on the palmar defect. Two patients were presented with a soft-tissue defect of the palm measuring 4.8 × 5.5 cm² and 3.8 × 5 cm², respectively. The flap was harvested and positioned at the defects. The flaps survived in the 2 cases with minimal donor site complications. The patients acquired protective sensations within the flap at the end of the follow-up period. The UPAPF provides a stable coverage for palmar soft-tissue defects with satisfactory aesthetic and functional results. It is a convenient addition to the armamentarium for reconstructing palmar soft-tissue defects of the hand.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241277845"},"PeriodicalIF":16.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285855","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":"Comparison Between Surgical Techniques for Correction of Congenital Syndactyly: A Systematic Review and Meta Analysis.","authors":"João Matheus Schirlo, André Saad Cleto, Danilo Beltrame, Mayara Beltrame, Thais Scortegagna, Camila Marinelli Martins","doi":"10.1177/15589447241279456","DOIUrl":"10.1177/15589447241279456","url":null,"abstract":"<p><p>This review aimed to assess which surgical technique has better outcomes to correct one of the most common congenital anomalies of the upper limb: syndactyly. The following databases were used in the search: PubMed, Embase, Cochrane (CENTRAL), LILACS, SciELO, Scopus and Web of Science, on October 27, 2022. Studies that described a surgical technique for correcting syndactyly and evaluated surgical complications were included. Studies about noncongenital or foot syndactyly were excluded. The risk of bias was assessed using a specific method for case reports. For synthesis of results, the characteristics of the studies and techniques were demonstrated by a qualitative analysis. Meta-analysis models were applied for complications, functionality, and aesthetic. 73 studies were included, of which 70 were series or case reports, 27 studies did not use skin grafts and 7 studies used external fixators. To evaluate functional results, 42 studies used only the surgeon's opinion. Meta-analyses showed a higher incidence of scar defects when using skin grafts and of infection when using external fixators. There was no difference for web creep and readmission. Few studies evaluated results using the VSS scale, showing worse scar pigmentation when skin grafts were used, but there was no difference in other parameters (PROSPERO CRD42022368930).</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241279456"},"PeriodicalIF":16.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285854","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":"Diagnostic Capability of Ultrasonography in Evaluating Peripheral Nerve Injuries of the Brachial Plexus.","authors":"Madeline C Rocks, Victoria Comunale, Gerardo E Sanchez-Navarro, Rebecca S Nicholas, Jacques H Hacquebord, Ronald S Adler","doi":"10.1177/15589447241277844","DOIUrl":"10.1177/15589447241277844","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to determine the diagnostic capability of ultrasonography (US) in patients with suspected brachial plexus injury (BPI) to the terminal nerves by comparing physical examination (PE) findings with US, electromyography (EMG), and magnetic resonance imaging (MRI) reports.</p><p><strong>Methods: </strong>All patients at a single institution who underwent US for peripheral nerve injury of the brachial plexus and terminal nerves resulting in sensory-motor deficits from October 1, 2017 to October 31, 2023 were identified. A retrospective chart review was performed. Each PE, US, EMG, and MRI reports were given an overall rating: \"normal\" or \"abnormal.\" Terminal nerves (musculocutaneous, axillary, radial, ulnar, medial) were individually assessed as \"normal\" or \"abnormal.\" The interobserver agreement between reports was calculated using Cohen kappa. Specificity and sensitivity analyses were performed to determine diagnostic accuracy and were reported with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 120 patients were included. Most injuries were traumatic in nature (78.8%) and were low-energy (53.8%). When each imaging modality was compared with the PE findings, EMG had the highest interobserver agreement (Cohen kappa = 0.18), followed by US (Cohen kappa = 0.10), and last MRI (Cohen kappa = 0.07). The US had the highest sensitivity (0.92, CI = 0.85, 0.96) among the 3 imaging modalities (Table 2). On US, the ulnar nerve was most commonly abnormal (n = 84, 70.0%).</p><p><strong>Discussion: </strong>Ultrasonography serves as a useful adjunct in the workup of patients with suspected peripheral BPI and is reliable in localizing the pathology of injured terminal nerves in the brachial plexus.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447241277844"},"PeriodicalIF":16.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285856","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}