Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Dual-purpose Laparoscopy and Bipedicled Anterolateral Thigh Flap for Abdominal Wall Reconstruction After High-voltage Electrical Burn.","authors":"Pattana Ongkasuwan, Chotirot Angkurawaranon","doi":"10.1097/GOX.0000000000008145","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008145","url":null,"abstract":"<p><p>High-voltage electrical burns involving the abdominal wall pose complex management challenges, including delayed bowel perforation, progressive tissue necrosis, and durable reconstruction in compromised tissue. To our knowledge, no standardized approach has been described that combines visceral surveillance with abdominal wall reconstruction in this setting. We report a case of a 43-year-old man who sustained a 22,000-volt electrical injury with 30% total body surface area burns and a full-thickness lower abdominal wall defect (16 × 13 cm) exposing the intact peritoneum. Triple-contrast computed tomography on day 3 excluded bowel perforation. On day 22, diagnostic laparoscopy was performed for delayed visceral surveillance; in the absence of bowel pathology, intraperitoneal onlay mesh reinforcement was performed during the same procedure. On day 27, a bipedicled anterolateral thigh fasciocutaneous flap was elevated; sequential 10-minute bulldog clamp testing of each perforator produced equivalent reductions in perfusion, prompting a 4-day delay for choke-vessel maturation. On day 31, the flap was re-elevated and transposed, with the fascia lata sutured to the anterior rectus sheath as a second reinforcement layer superficial to the intraperitoneal onlay mesh. At the 6-month follow-up, the patient demonstrated complete wound healing, stable abdominal wall integrity without clinical hernia on physical examination or with Valsalva maneuver, independent ambulation with a below-knee prosthesis, and return to modified work duties. This integrated single-stage laparoscopic approach combining delayed visceral surveillance with definitive abdominal wall reinforcement may inform management of similar injuries.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8145"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169977","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":"Nasal Sidewall Propeller Flap for 1-stage Reconstruction of Lateral Nasal Ala Defects.","authors":"Valentine Poissonnet, Gilles Poissonnet, Roxane Elaldi, Brindusa Ciobanu, Alexandre Bozec, Olivier Camuzard, Dorian Culié, Grégoire d'Andréa","doi":"10.1097/GOX.0000000000008154","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008154","url":null,"abstract":"<p><p>Cutaneous carcinomas of the lateral nasal ala, sometimes extending to the upper lip triangle, frequently require superficial or full-thickness resections. Despite their small size, these defects present a significant reconstructive challenge due to the 3-dimensional anatomy and high functional and aesthetic demands of the nasal region. We describe a 1-stage reconstructive technique using a nasal sidewall propeller flap (NSPF), a freestyle perforator flap harvested from the homolateral nasal sidewall, based on perforators from the facial or internal nasal artery. When needed, the NSPF is combined with a transverse jugal advancement flap to restore the continuity of the upper lip aesthetic subunit. Seventeen patients with lateral nasal ala defects were treated using this method: 12 NSPF and 5 melolabial propeller flaps. No flap necrosis occurred. A second-stage aesthetic refinement was necessary in 3 NSPF cases and all 5 melolabial propeller flap cases. The NSPF offers a reliable, easy-to-harvest, single-stage alternative to multistage flaps and free cartilage grafts. The technique provides excellent color and texture match and minimizes donor site morbidity. Its versatility and reproducibility make it an effective option for lateral nasal ala reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8154"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166678","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":"Pneumothorax Following Botulinum Neurotoxin Injection for Trapezius Hypertrophy.","authors":"Shiqi Nong, Yuhao Wang, Jiajie Li, Shuo Liu, Hang Wang","doi":"10.1097/GOX.0000000000008151","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008151","url":null,"abstract":"<p><p>Botulinum neurotoxin (BoNT) injection into the trapezius muscle is increasingly performed for aesthetic contouring. However, iatrogenic pneumothorax has not been previously documented for this cosmetic indication, despite the inherent anatomical risks. We report a 26-year-old woman who developed immediate severe radiating pain during bilateral trapezius BoNT type A (BoNT-A) injections using a 4.8-cm, 25-gauge needle. During the injection, the patient experienced immediate severe radiating pain, followed by pleuritic chest pain and dyspnea within 30 minutes. Computed tomography confirmed a 30% left pneumothorax, effectively ruling out systemic botulism. Subsequent ultrasound revealed a skin-to-pleura distance of only 2.27 cm at the injection site, highlighting the stark mismatch with the 4.8-cm needle used. The patient was managed conservatively with high-flow oxygen, achieving complete clinical and radiographic resolution within 1 month. This case underscores that pneumothorax is a real risk with blind injection techniques and overly long needles. To minimize harm, practitioners should adhere to anatomically defined safe zones, select conservative needle lengths, and utilize ultrasound assistance when necessary, particularly for thin patients.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8151"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166612","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":"Surgeons in Humanitarian Alliance for Reconstruction, Research, and Education Call to Modernize American Society of Plastic Surgeons Photography Guidelines.","authors":"Mollie B Smith, Anna Bogursky, Imraan Sherman, Decontee Wonokay, Amaka Ehighibe, Peter M Nthumba, Joyce K McIntyre","doi":"10.1097/GOX.0000000000008152","DOIUrl":"10.1097/GOX.0000000000008152","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8152"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113780","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":"Efficacy of Manual Lymphatic Drainage in Reducing Postoperative Complications After Cosmetic Plastic Surgery: A Systematic Review.","authors":"Sood Alsairefi, Nagi Alqallaf, Sara Ali, Jana Mohammad, Butti Albutti, Retaj Alawadhi, Husain Alzaidi, Fahad Almukaimi, Ahmad Alqallaf, Ahmed Alsaleh, Husain Alqattan","doi":"10.1097/GOX.0000000000008139","DOIUrl":"10.1097/GOX.0000000000008139","url":null,"abstract":"<p><strong>Background: </strong>Cosmetic plastic surgical procedures, such as liposuction and abdominoplasty, often disrupt the lymphatic system, leading to complications, including swelling, pain, fibrosis, and seromas. Manual lymphatic drainage (MLD) is commonly recommended postoperatively to enhance lymphatic flow and accelerate healing. However, evidence regarding its efficacy remains inconsistent, particularly in cosmetic procedures. This study aims to evaluate the effectiveness of MLD in reducing postoperative swelling, pain, fibrosis, seromas, and recovery time compared with standard care following cosmetic procedures and assess secondary outcomes, including bruising, patient satisfaction, and adverse effects.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, the Cochrane Library, Embase, CINAHL, Web of Science, and Scopus were searched from inception to September 2025 for studies involving adults undergoing cosmetic surgery. Eligible studies included randomized controlled trials (RCTs), cohort studies, and case series. Risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I tools. Owing to heterogeneity among the studies, findings were narratively synthesized.</p><p><strong>Results: </strong>Seven studies were included, primarily RCTs and prospective trials involving cosmetic procedures such as liposuction and abdominoplasty. MLD, alone or with other therapies, reduced swelling, showed variable pain relief, and indicated potential fibrosis mitigation. Efficacy varied by procedure, with better outcomes when initiated early (days 2-5) and delivered in 6-12 sessions. Adverse events were minimal.</p><p><strong>Conclusions: </strong>MLD provides moderate benefits for postoperative swelling reduction after cosmetic surgery, with inconsistent effects on pain and fibrosis. High-quality RCTs are needed to refine protocols and confirm long-term efficacy.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8139"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113679","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":"Upper-extremity Injuries from Side-by-side All-terrain Vehicle Accidents: Experience and Outcomes in over 200 Patients.","authors":"Benjamin Watzig, Leeann Qubain, Clayton Hui, Michael McKee, Joshua Mirrer","doi":"10.1097/GOX.0000000000008156","DOIUrl":"10.1097/GOX.0000000000008156","url":null,"abstract":"<p><strong>Background: </strong>Side-by-side all-terrain vehicle (ATV) crashes produce high-energy upper-extremity trauma requiring complex reconstruction. Despite the increasing prevalence of these injuries, characterization of injury patterns, management, and outcomes remains limited.</p><p><strong>Methods: </strong>A multicenter retrospective review was performed across 9 level I trauma centers from 2019 to 2023. Adult patients with upper-extremity injuries from side-by-side ATV crashes who were evaluated by the hand surgery service were identified through a trauma registry and manual chart review. Demographics, injury characteristics, operative interventions, and outcomes were collected. A minimum of 6 weeks of follow-up was required for inclusion in the outcome analysis.</p><p><strong>Results: </strong>Among 207 patients (mean age, 32 ± 17 y; 70.5% male), the hand was the most frequently injured region (76.8%), followed by the wrist (30.4%) and forearm (26.6%). Open fractures occurred in 66.7% of patients, including 28% with Gustilo type IIIB or IIIC injuries. Patients underwent a mean of 1.5 operations during the index hospitalization; reconstruction included rotation flaps (10%), free flaps (4%), and dermal substitute placement (27%). Early amputation occurred in 18.4%. At a mean follow-up of 31 weeks (n = 158, 76.3%), patients underwent a mean of 2.6 ± 2.3 total operations; infection occurred in 19.6%; 15.2% required operative debridement; and late amputation occurred in 9.5%, yielding an overall amputation rate of 25.6%.</p><p><strong>Conclusions: </strong>Side-by-side ATV crashes cause severe, often contaminated, multitissue upper-extremity injuries with high rates of infection and amputation despite aggressive surgical management.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8156"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113730","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":"From Failure to Flow: Indocyanine Green Improves Preoperative Mapping for Lymphaticovenular Anastomosis After Negative Contrast-enhanced Ultrasonography.","authors":"Xinyu Lou, Johnson Boey, Longbiao Yu, Jingjing Wen, Songhua Liu, Pengzhou Huang, Zhiying Chen, Qing Xie, Zhegang Zhou","doi":"10.1097/GOX.0000000000008146","DOIUrl":"10.1097/GOX.0000000000008146","url":null,"abstract":"<p><p>Accurate identification of functional lymphatic vessels is essential for lymphaticovenular anastomosis (LVA) but it remains challenging. Contrast-enhanced ultrasound (CEUS) is increasingly used for preoperative mapping; however, failure to detect vessels of adequate caliber often leads to deferral of LVA. We report a case where CEUS indicated no suitable lymphatic vessels intraoperatively, yet a high-quality LVA was successfully performed using preoperative indocyanine green (ICG) lymphography-guided exploration. Preoperative ICG mapping revealed limited linear channels and dermal backflow, guiding targeted incisions. Intraoperatively, functional lymphatic vessels and suitable venules (0.3-0.4 mm) were identified despite failed CEUS-guided localization, and end-to-end anastomosis was completed. Postoperatively, maximal interlimb circumference difference decreased from 2.5 to 1.7 cm, with symptomatic relief. This is the first case demonstrating that when CEUS-guided intraoperative localization fails, individualized ICG findings can guide empirical incisions to identify better lymphatic vessels for LVA. A multimodal approach may improve patient outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8146"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113676","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":"Keystone Flap, a Versatile Option for Salvaging Infected Spinal Instrumentation Associated to Soft-tissue Defects: A Novel Option.","authors":"David Montoya González, Natalia López Montoya, Carlos Armando Yepes Porras, Juan David Hoyos Restrepo","doi":"10.1097/GOX.0000000000008165","DOIUrl":"10.1097/GOX.0000000000008165","url":null,"abstract":"<p><p>Keystone design perforator island flaps (KDPIFs) are fasciocutaneous flaps based on multiple perforators that provide reliable perfusion to large tissue segments. Their design incorporates elements of advancement, rotation, interpolation, and transposition, allowing recruitment of surrounding lax tissue to achieve durable coverage with minimal tension. These characteristics make them particularly useful for reconstruction of complex posterior trunk defects. We present the case of a 23-year-old man with severe neuromuscular scoliosis who underwent posterior spinal instrumentation from T3 to L5 and subsequently developed vertebral osteomyelitis caused by multidrug-resistant organisms. Following serial debridements, negative pressure wound therapy, and targeted antibiotic therapy, a 40 × 15 cm dorsal midline defect with exposed spinal instrumentation remained. Given the substantial mechanical and deformity-related risks associated with hardware removal, a strategy focused on implant preservation was pursued. Reconstruction was performed using a subtype IIA KDPIF, achieving tension-free closure, effective dead-space obliteration, and stable soft-tissue coverage over the instrumentation. At 2-year follow-up, there was no evidence of recurrent infection or hardware exposure, with preservation of implant stability and satisfactory functional and aesthetic outcomes. In this case, hardware salvage combined with KDPIF reconstruction provided durable soft-tissue coverage while avoiding the mechanical instability and deformity risks associated with implant removal. KDPIFs may represent a useful reconstructive option for selected patients with complex spinal defects and exposed instrumentation.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8165"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113696","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":"Artificial Intelligence for Prediction of Breast Cancer-Related Lymphedema: A Systematic Review.","authors":"Hatan Mortada, Mustafa Qais Muhsin Al-Khafaji, Zainalabden E Jefri, Faris Sultan, Saad Alrobaiea, Feras Alshomer","doi":"10.1097/GOX.0000000000008132","DOIUrl":"10.1097/GOX.0000000000008132","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer-related lymphedema (BCRL) impairs quality of life and function, and early detection is crucial for preventive intervention. AI models, particularly machine learning and deep learning, hold promise for improving BCRL prediction and personalized risk stratification. This systematic review evaluates AI applications for predicting BCRL and, where available, summarizes how their reported performance compared with traditional diagnostic or non-AI methods.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search in MEDLINE, EMBASE, Cochrane Library, and Google Scholar was conducted in July 2024 using keywords related to breast cancer, lymphedema, and AI. Relevant studies were screened and selected based on predefined inclusion and exclusion criteria, with performance metrics such as accuracy, sensitivity, and specificity extracted for analysis.</p><p><strong>Results: </strong>Seven studies from 2018 to 2024 were included, with 5284 patients. Among the 5 studies reporting BCRL classification performance, AI models achieved accuracies of 81%-93.75% (mean 87.2%), mean sensitivity 85.5%, and mean specificity 87.6%. Commonly reported predictors included higher body mass index, greater lymph node burden, and receipt of chemotherapy or radiotherapy. Younger age and neoadjuvant chemotherapy were associated with higher predicted risk in some studies.</p><p><strong>Conclusions: </strong>AI shows promise for early detection and risk stratification in BCRL, but current models remain exploratory rather than clinically established. Small sample sizes, data heterogeneity, absent external validation, and inconsistent calibration highlight the need for larger, multi-institutional datasets, standardized evaluation, and prospective validation before clinical integration.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8132"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113615","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":"Obese Patients Undergoing Implant-based Breast Reconstruction: A Propensity Score-Matched Analysis.","authors":"Ron Skorochod, Yitzhak Skorochod, Yoav Gronovich","doi":"10.1097/GOX.0000000000008135","DOIUrl":"10.1097/GOX.0000000000008135","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction following oncologic mastectomy is an integral component of comprehensive breast cancer care, with implant-based reconstruction consistently being reported to be the most commonly performed worldwide. Although immediate reconstruction offers the clear benefit of reducing the number of necessary surgical procedures and providing immediate aesthetic results, concerns persist regarding its feasibility in high-risk patient populations. Obesity has been suggested to be a potential contributor to lymphatic dysfunction and impaired lymphatic vasculature; both mechanisms can predispose patients to the development of postmastectomy lymphedema. Postmastectomy lymphedema is a chronic, debilitating condition with significant implications on quality of life, functional capacity, and healthcare utilization. Established risk factors include axillary lymph node dissection, radiation therapy, and the extent of mastectomy resection. Timing of reconstruction, however, especially in obese patients undergoing implant-based reconstruction, has not been clearly delineated.</p><p><strong>Methods: </strong>Retrospective TriNetX cohort of obese adults undergoing implant-based breast reconstruction compared immediate versus delayed timing using propensity matching, assessing short- and long-term complications, including lymphedema, via risk ratios and survival analyses.</p><p><strong>Results: </strong>Among 6082 obese patients, 1944 matched pairs underwent immediate or delayed implant-based reconstruction. Immediate reconstruction showed higher 90-day complications and a persistently increased risk of lymphedema through 5 years, confirmed by Kaplan-Meier and Cox regression analyses.</p><p><strong>Conclusions: </strong>Among obese patients undergoing implant-based breast reconstruction, immediate reconstruction is associated with higher rates of early postoperative complications and a persistent increase in postmastectomy lymphedema risk compared with delayed reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8135"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113793","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}