Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Simplified Transnasal Canthal Fixation of Naso-orbito-ethmoidal Fractures.","authors":"Andrés Ferro Morales, Sofia Martínez Gil, Andreina Zannin Ferrero","doi":"10.1097/GOX.0000000000006774","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006774","url":null,"abstract":"<p><p>The naso-orbito-ethmoidal (NOE) region is formed by the confluence of the frontal sinuses, ethmoidal sinuses, anterior cranial fossa, orbits, and frontal and nasal bones. Fractures involving this area correspond to 9%-10% of facial fractures, with a higher prevalence in male patients between 20 and 30 years of age. In 1991, Dr. Markowitz and Dr. Manson classified these types of fractures based on the following characteristics: the state of the central bone fragments, the position of the medial canthal tendon, and whether they are unilateral or bilateral fractures. NOE fractures can be associated with a number of complications, with traumatic telecanthus and nasolacrimal duct obstruction being the most frequent complications. The authors report a case of a bilateral NOE type II fracture, in which transnasal canthal fixation was performed using nonabsorbable sutures and the support base of a 1-mL syringe plunger, for the correction of traumatic telecanthus and restoration of the nasal dorsum projection. Transnasal canthal fixation is a simple and reproducible technique that reduces operative time and uses frequently used materials without the need for additional equipment. This technique not only presents few complications but also offers aesthetic results by improving traumatic telecanthus while restoring nasal dorsum projection.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6774"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326615","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":"Osteopathic Graduates in Plastic Surgery: How Can We Improve the Pipeline?","authors":"Kristof S Gutowski, Irene Yau, Ariel E Figueroa, Alice Yau, Marina A Lentskevich, Kristyn N Kraus, Jordan E Wiebe, Gregory A Greco, Arun K Gosain","doi":"10.1097/GOX.0000000000006907","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006907","url":null,"abstract":"<p><strong>Background: </strong>Integrated plastic surgery residency is one of the most competitive specialties for medical students to match into. This study was performed to identify trends in osteopathic applicants to plastic surgery and current osteopathic trainees within the field. Furthermore, we explore osteopathic students' perception of plastic surgery and identify methods that our national societies can utilize to foster exposure to the field.</p><p><strong>Methods: </strong>All integrated and independent plastic surgery training programs were identified from the Accreditation Council for Graduate Medical Education. Trainees' medical education was obtained via program websites and public profiles. An anonymous survey was distributed to Student Affairs directors of all 43 osteopathic medical schools, who were asked to forward the survey to their respective student bodies. The survey consisted of 35 questions, inquiring about exposure and barriers to surgical education opportunities, and overall perception of plastic surgery.</p><p><strong>Results: </strong>A total of 1245 plastic surgery trainees were included in analysis. Within integrated programs, osteopathic graduates account for 1.2% of current postgraduate year 1-5 residents. Our survey gauging osteopathic students' perception of plastic surgery received 252 responses from 7 osteopathic schools; 87.4% of students believed that exposure is lacking at their institution and 92.6% of students interested in subinternships experienced barriers arranging these experiences.</p><p><strong>Conclusions: </strong>Osteopathic graduates represent a minority of plastic surgery trainees, which may be attributed to barriers encountered by osteopathic students when seeking exposure to plastic surgery during their undergraduate medical education. Early exposure and increased opportunities for mentorship and away rotations may encourage more osteopathic students to pursue plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6907"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326614","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":"Critical Review of a Series of 78 Surgical Facial Rejuvenation Procedures With Deep-plane Technique.","authors":"Giuseppe Colombo, Andrea Dotto, Antonio Distefano","doi":"10.1097/GOX.0000000000006897","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006897","url":null,"abstract":"<p><strong>Background: </strong>The deep-plane face lift is a widely used surgical technique for improving the appearance of the face and neck. But is it truly effective in providing optimal, reliable, and long-lasting results?</p><p><strong>Methods: </strong>The aim of this study was to analyze the outcomes of deep-plane face lift procedures. A retrospective study was conducted on 78 patients who underwent deep-plane face lift surgery. The follow-up period ranged from 0 to 24 months after surgery, during which the timing of recurrences in ptosis of the nasolabial fold, jowls along the jawline, marionette lines, and the central-lateral aspect of the neck was analyzed.</p><p><strong>Results: </strong>Early recurrences of these parameters were documented in all cases, occurring between 6 and 12 months during follow-up.</p><p><strong>Conclusions: </strong>The deep-plane face lift is a surgical technique that is not suitable for all face types and should be limited to very specific and more restrictive indications than previously imagined.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6897"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326613","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":"The Impact of Hormonal Therapy on Autologous Microvascular Breast Reconstruction: A Systematic Review and Meta-analysis.","authors":"Miroslava Verbat, Gauthier Zinner, Edward T C Dong, Carlo M Oranges","doi":"10.1097/GOX.0000000000006868","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006868","url":null,"abstract":"<p><strong>Background: </strong>Hormonal therapy (HT) is pivotal in managing hormone receptor-positive breast cancer. However, in autologous microvascular breast reconstructions (AMBRs), HT raises concerns, particularly regarding venous thromboembolic (VTE) risk and its potential impact on flap viability. This systematic review and meta-analysis aimed to evaluate the impact of HT on complications of AMBR.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of all comparative studies reporting postoperative complications of AMBR in patients receiving HT in comparison with a control group. All types of free flaps were included. Complications were categorized and compared. Odds ratios and 95% confidence intervals were calculated using a random-effects model.</p><p><strong>Results: </strong>Eight studies, encompassing 4776 flaps performed on 3796 patients undergoing AMBR with or without HT, were included. Patients undergoing HT were treated with either selective estrogen receptor modulators (SERMs) or aromatase inhibitors. Five studies compared both treatments to a control group, whereas 3 studies focused on tamoxifen. Only studies with retrospective design could be included. There was no statistically significant difference between the 2 groups in terms of overall flap complication rates, partial and total flap loss, flap fat necrosis, flap pedicle arterial and/or venous thrombosis, or systemic VTE. Subgroup analysis revealed a significantly higher risk of systemic VTE in the SERMs group compared with controls, while other complications were not significant.</p><p><strong>Conclusions: </strong>Our results show that HT does not increase the risk of flap complications in the context of AMBR, whereas SERMs increase the risk of systemic VTE. Further research with prospective studies is warranted to confirm these findings.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6868"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326630","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":"Perceptions of Achievability, Representation, and Access to Plastic Surgery Training and Mentorship Among Medical Students.","authors":"Jaina C Lane, Maheen F Akhter, Christopher S Crowe, Shane D Morrison, Joseph Lopez","doi":"10.1097/GOX.0000000000006889","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006889","url":null,"abstract":"<p><strong>Background: </strong>As the path to pursuing a career in plastic surgery becomes increasingly competitive, the intentional promotion of the success of medical students from all backgrounds is critical. This study investigated medical students' perceptions of the field of plastic surgery and beliefs on their ability to pursue a career within it.</p><p><strong>Methods: </strong>A survey was distributed through the Recruitment of Accomplished & Diverse Medical Student Applicants into Plastic Surgery program, inquiring of medical students' demographics, metrics of academic achievement, and perceptions of the field of plastic surgery using the Likert scale.</p><p><strong>Results: </strong>Among 178 medical students, White and high-income respondents reported greater familiarity with the field of plastic surgery (<i>P</i> = 0.001, <i>P</i> = 0.0262), had less of a perceived challenge in pursuing the field (<i>P</i> = 0.0481, <i>P</i> = 0.0307), and believed the field to be more diverse (<i>P</i> < 0.0001, <i>P</i> = 0.0017) than minority and lower income respondents. Students from allopathic medical schools and those without an affiliated integrated plastic surgery program perceived the field of plastic surgery as more challenging to enter (<i>P</i> = 0.0002, <i>P</i> = 0.0084). There were no statistically significant differences in the number of research projects, mentors, leadership and volunteer experiences, or the decision to pursue a research year between demographic groups.</p><p><strong>Conclusions: </strong>Medical students' demographic and educational backgrounds are associated with their perceptions of achievability of, representation in, and access to plastic surgery. This provides insight into the perceived barriers and potential areas of intervention to enable students from all backgrounds to achieve their goal of becoming plastic surgeons.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6889"},"PeriodicalIF":1.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317649","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":"Utilizing Intercostal Nerve Autografts for Nipple Neurotization: A Novel Approach to Restore Sensation.","authors":"Elena Millesi, Christin A Harless, Vahe Fahradyan, Tina J Hieken, Mara A Piltin, Aparna Vijayasekaran","doi":"10.1097/GOX.0000000000006898","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006898","url":null,"abstract":"<p><p>Breast cancer is a common malignancy, and treatment often involves mastectomy. For oncological safety, the anterior and lateral cutaneous branches of the third through fifth intercostal nerves are routinely resected during nipple-sparing mastectomies, leading to loss of nipple sensation. The current gold standard for nipple neurotization uses nerve allografts to connect the nipple with a remaining stump of an intercostal nerve. Despite the convenience of off-the-shelf solutions, this study explored a novel approach using intercostal nerves as autografts or for direct repair to restore nipple sensation. Six patients underwent nipple-sparing mastectomy and opted for nipple neurotization. Three patients underwent neurotization with an intercostal nerve autograft, whereas in 3 patients, long intercostal nerves allowed nipple neurotization directly without the need for an autograft. Meticulous dissection of the intercostal nerves enabled a length of approximately 9 cm (±1.5) per nerve. The acquired nerve length allowed tension-free coaptation of direct nipple neurotization in 3 patients and utilization as an autograft in the other 3 patients. No postoperative complications were observed, whereas sensory outcomes are yet to be evaluated. The study highlighted the feasibility of using intercostal nerves either as autologous intercostal nerve grafts or for direct neurotization. Using an intercostal nerve as an autograft is a cost-effective and time-efficient strategy to avoid the need for an allograft without additional donor-site morbidity. This technique offers a practical and globally accessible solution for improving patient access to state-of-the-art postmastectomy breast reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6898"},"PeriodicalIF":1.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317657","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":"Clinical Case-control Study of Postoperative Ocular Microbiota Colonization Using Microbial Analysis in Patients Undergoing Blepharoplasty.","authors":"Hejia Zhao, Yanjun Chen, Huamin Mao, Junpu Ye, Min Fu, Jinhao Qiu, Yunhan Zhang, Er Pan, Ke Xiong","doi":"10.1097/GOX.0000000000006876","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006876","url":null,"abstract":"<p><strong>Background: </strong>Blepharoplasty is the third most common plastic surgical procedure worldwide. However, its impact on the ocular surface microbiota remains unclear. This study aimed to investigate microbial changes before and after blepharoplasty.</p><p><strong>Methods: </strong>A clinical case-control study was conducted involving 30 blepharoplasty patients and 23 controls. Ocular surface swabs were collected, and 16S rRNA sequencing was used to identify bacterial species and abundance. Bioinformatics analysis was performed to annotate and visualize microbial composition.</p><p><strong>Results: </strong>Comparison between groups revealed that patients who underwent blepharoplasty had increased colonization by pathogenic bacteria, whereas controls were primarily colonized by neutral bacteria. Alpha diversity analysis showed a significantly higher bacterial abundance in the surgical group. Beta diversity analysis indicated significant differences in microbial community structure between the 2 groups. Subgroup analysis based on age and sex in the surgical group revealed no significant effects of these factors on microbial composition and abundance.</p><p><strong>Conclusions: </strong>Blepharoplasty may disrupt the ocular mucosal barrier, altering the ocular microenvironment and promoting colonization by pathogenic bacteria. This microbial imbalance may contribute to postoperative ocular discomfort or dysfunction. Notably, age, sex, and surgery frequency did not influence the microbial profile in blepharoplasty patients.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6876"},"PeriodicalIF":1.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317648","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":"Use of Thulium Fiber Laser for Precise Dissection in Facial Rejuvenation Surgery.","authors":"Anastasiya S Borisenko, Valentin I Sharobaro, Alexey E Avdeev, Yousif M Ahmed Alsheikh","doi":"10.1097/GOX.0000000000006880","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006880","url":null,"abstract":"<p><p>In the current era of advanced surgical technologies, new methods are being used in all aspects of surgery that enhance safety and improve dissection and patient outcomes by minimizing tissue trauma, ensuring hemostasis, and reducing the postoperation rehabilitation period. In this article, we discuss the use of Urolase+ surgical thulium fiber laser device within the context of plastic surgery for the dissection of soft tissues in a female patient, undergoing face lift, brow lift, blepharoplasty, and cheiloplasty operations, which, according to our knowledge, has never been done before.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6880"},"PeriodicalIF":1.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317650","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":"Closed Expander Salvage With Dual-port Tissue Expander in Implant-based Breast Reconstruction for High Body Mass Index and Ptotic Patients.","authors":"Alexander R Gibstein, Aneeq S Chaudhry, Rita Loureiro, Charo Thomas, Harry Salinas, Matthew Treiser, Miguel A Medina","doi":"10.1097/GOX.0000000000006845","DOIUrl":"10.1097/GOX.0000000000006845","url":null,"abstract":"<p><strong>Background: </strong>Implant-based (IB) breast reconstruction is efficient and predictable but poses infection risks, especially in patients with high body mass index and/or macromastia. Postoperative infection management lacks standardized protocols for device salvage.</p><p><strong>Methods: </strong>We conducted a 1-year retrospective study on 59 high-risk patients (91 breasts) using dual-port tissue expanders for breast reconstruction. A Wise-pattern skin envelope reduction closed over an inferiorly based adipodermal lining flap was used. Using the dual port, a closed washout protocol with a Betadine solution was initiated for suspected infections. Patient characteristics, infection profiles, and outcomes were recorded. A control cohort of 54 patients (98 breasts) without dual-port expanders was analyzed for infection rates and outcomes.</p><p><strong>Results: </strong>In the experimental cohort, 18% of breasts had postoperative infections, with 38% successfully salvaged using oral antibiotics and the closed washout alone. The overall salvage rate was 75%, and the infectious reconstructive failure rate was 3.3%. Gram-positive bacteria were predominant. The control cohort had a 23.5% infection rate, with only 5% successful salvage and 19 explantations. No statistically significant differences in demographics or infection rates were observed.</p><p><strong>Conclusions: </strong>The study demonstrated the efficacy of a closed wash protocol with dual-port tissue expanders in high-risk IB breast reconstruction. This approach reduces surgical washouts, improves salvage rates, and minimizes reconstruction losses. The dual-port expander shows promise in enhancing salvage outcomes and decreasing reoperations for postoperative infections, providing a valuable addition to IB breast reconstruction strategies. The results suggest potential benefits of the dual-port expander in infection treatment.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6845"},"PeriodicalIF":1.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310304","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":"Addition of Erector Spinae Nerve Block Effect on Opioid Use and Pain Levels in Reduction Mammoplasty.","authors":"Chandler S Hinson, Hallie Masters, MengJie Hu, Benjamin Michaels, Matthew Beyers, Ronald M Brooks","doi":"10.1097/GOX.0000000000006900","DOIUrl":"10.1097/GOX.0000000000006900","url":null,"abstract":"<p><strong>Background: </strong>Macromastia causes significant physical and emotional distress. Reduction mammoplasty often requires opioid analgesia. This study compared the efficacy of combining an erector spinae plane (ESP) block with a field block of long-acting bupivacaine (LLAB) versus LLAB alone in managing pain and opioid use during breast reduction surgery.</p><p><strong>Methods: </strong>We conducted a retrospective review of breast reduction patients from March 2021 to March 2022 at an academic center. The variables included specimen weights, liposuction volume, opioid use (standardized to morphine milligram equivalents [MME]), and pain scores (0-10 scale). Two-sample <i>z</i> tests were used to assess significance.</p><p><strong>Results: </strong>Ninety-eight patients were analyzed: 50 received ESP blocks with LLAB, and 48 received LLAB alone. The ESP block group had significantly lower perioperative opioid use (33.5 versus 89.8 MME, <i>P</i> < 0.001). Preoperative opioid use was similar (27.8 versus 31.5 MME, <i>P</i> = 0.16). Postoperative opioid use trended lower in the ESP block group (22.5 versus 31.4 MME, <i>P</i> = 0.06). ESP block patients also reported lower postanesthesia care unit pain scores (4.3 versus 6.0, <i>P</i> < 0.001) and fewer postdischarge pain medication refills (12.0% versus 20.8%, <i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>ESP blocks with LLAB reduced perioperative opioid use, immediate postoperative pain, and the need for postdischarge refills compared with LLAB alone. Although postoperative opioid reduction was not statistically significant, a clear trend was observed. These findings support further evaluation and potential adoption of the ESP block in breast reduction procedures.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6900"},"PeriodicalIF":1.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310292","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}