Plastic and Reconstructive Surgery Global Open最新文献

{"title":"The Freestyle Multiperforator Island Flap: Beyond the Keystone Flap.","authors":"Oswaldo J Gómez, Daniel Alejandro Espinel Pinzón, David F Duque, Harold D Moreno, Paloma Beltrán Pachón","doi":"10.1097/GOX.0000000000006503","DOIUrl":"10.1097/GOX.0000000000006503","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to introduce freestyle multiperforator island flaps as a technical advancement beyond keystone perforator flaps. These flaps represent a fully free-design approach, supplied by multiperforators in small subcutaneous pedicles randomly located, allowing for customized designs tailored to anatomical regions of diverse complexity.</p><p><strong>Methods: </strong>We present a retrospective cohort study of 150 patients with coverage defects, without distinction of anatomical location or age, treated between 2012 and 2021. The study assessed the clinical presentation, flap characteristics, additional procedures, and postoperative outcomes. We used the chi-square test to assess the relationship between pedicle area size and the incidence of partial or complete necrosis.</p><p><strong>Results: </strong>We performed 211 flaps on 184 defects, with a mean follow-up of 8.7 months. Tumors (30.4%) and trauma (23.3%) were the most common etiologies. Most flaps were performed on the head and neck (31%) and lower limbs (30.4%). The mean pedicle area was 33%, and the flap-to-defect size ratio was between 1:1 and 3:1 in 82% of cases. Complications occurred in 29.8% of the flaps, with only 8.1% needing surgical reintervention. The most common occurrences were dehiscence (18.5%), partial necrosis (9%), and total necrosis (1.9%). The pedicle area of the flap did not demonstrate a statistically significant relationship with the necrosis outcome (<i>P</i> = 0.813; 95% confidence interval, 0.17-0.926).</p><p><strong>Conclusions: </strong>Freestyle multiperforator island flaps are a safe and versatile tool with low necrosis rates, excellent aesthetic results, and unmatched cost-effectiveness.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6503"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391538","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":"Breast Cancer Occurrence After Risk-reducing Mastectomies in 274 Cases: A Single Center With More Than 42 Years of Experience.","authors":"Matej Patzelt, Tereza Livancova, Xuan Le Thanh, Kristyna Rosetzka, Jan Drozd, Andrej Sukop","doi":"10.1097/GOX.0000000000006526","DOIUrl":"10.1097/GOX.0000000000006526","url":null,"abstract":"<p><strong>Introduction: </strong>Carriers of genetic mutations with a high risk of developing breast cancer have a lifetime risk of this cancer of up to 70%. To reduce the risk, patients have the option of a risk-reducing mastectomy. There is limited data with only short follow-ups on its safety. The aim of the study was to determine the long-term incidence of breast cancer in healthy patients with no previous surgery, who underwent bilateral risk-reducing mastectomies (BRRMs).</p><p><strong>Methods: </strong>We retrospectively reviewed 274 patients from our facility with no previous breast surgery, who underwent BRRM from 1981 to 2022, due to genetic mutations, a strong family history, or having very dense mammary glands. We approached these patients during their checkups, by phone call or email, and we asked them if they had developed breast cancer after their procedures. We recorded the patients' demographic factors, their genetic mutation types, and the mastectomy methods carried out.</p><p><strong>Results: </strong>A total of 274 patients had BRRMs with a mean follow-up after 76 months; 208 patients had undergone nipple-sparing mastectomies, 39 patients had undergone skin-sparing mastectomies, and 27 patients had skin-reducing mastectomies. One BRCA1+ patient developed breast cancer 21 months after undergoing the risk-reducing skin-sparing mastectomy procedure. None of the patients died of breast cancer.</p><p><strong>Conclusions: </strong>The incidence of breast cancer in the monitored patients is comparable to the results of the other related studies. The study result confirms that risk-reducing mastectomies reduce the risk of breast cancer in high-risk populations, regardless of the type of mastectomy performed.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6526"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391509","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":"Enhancing Acute Reconstructive Skills in Burn Surgery Through Virtual Simulation.","authors":"John Warner-Levy, Zeeshan Sheikh, Baljit Dheansa, Karl Walsh","doi":"10.1097/GOX.0000000000006527","DOIUrl":"10.1097/GOX.0000000000006527","url":null,"abstract":"<p><p>Medical simulation has progressed to using sophisticated computerized systems such as virtual and augmented reality. Despite its widespread adoption across various specialties, its adoption in burn surgery remains limited. Consequently, we wish to report on the \"Excision of an Unhealed Burn Wound\" module on the Touch Surgery mobile application that simulates the tangential excision and reconstruction of a burn wound with a split-thickness skin graft. To ascertain their knowledge of the surgical management of an unhealed burn wound, 38 regional senior house officer trainees currently on a plastic surgery placement completed a multiple-choice test. The trainees then viewed a full demonstration of the \"Excision of an Unhealed Burn Wound\" burn surgery module, before repeating the multiple-choice test after 1 hour. The self-assessed knowledge of participants regarding the excision of a burn and skin graft procedure improved in 90% of cases. Similarly, knowledge of the different types of equipment used for burn surgery saw an improvement in 89.5% of cases. Additionally, 84.3% of participants reported improvement in their understanding of the principles of preparing and applying a split-thickness skin graft. All but one participant agreed that simulation is beneficial in teaching surgical procedures, with the lone participant providing no rationale. Despite the relative inability to provide trainees with hands-on experience using surgical instruments and the risk of constraining the user to a single, preferred operating technique, we feel that digital simulation offers a novel tool for educating trainees in burn surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6527"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391510","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":"Hand Surgery in Lebanon 2024: Excellence Despite Existing Gaps.","authors":"Joseph Y Bakhach, Jana H Doghman, Paul T Beaineh, Kareem W Makkawi","doi":"10.1097/GOX.0000000000006512","DOIUrl":"10.1097/GOX.0000000000006512","url":null,"abstract":"<p><strong>Background: </strong>Lebanon has always offered advanced hand surgery services in the Middle East. However, the acknowledgment of hand surgery as an independent entity is yet to be recognized, impacting the hand care services provided. This article analyzes the landscape of hand surgery in Lebanon in 2024.</p><p><strong>Methods: </strong>A list of registered plastic and orthopedic surgeons was obtained from the Lebanese Order of Physicians. Data on registered surgeons' work settings and hand surgery subspecialty focus were obtained from the Lebanese Society of Plastic, Reconstructive, and Aesthetic Surgery, and the Lebanese Orthopaedic Society. Data on hand surgeons worldwide were extracted through direct contact with society presidents and from the most recent published records.</p><p><strong>Results: </strong>The work environment of the active surgeons fell into 3 categories: working full time in Lebanon, splitting work between Lebanon and abroad, and exclusively working abroad. The ratio of Lebanese surgeons practicing basic hand surgery is 3.28 per 100,000 people compared with a ratio of 0.1 per 100,000 people for specialized hand surgeons-well below the recommended ratio of 0.8. Seven other countries also experience a shortage in hand surgeons, 5 have a nearly adequate supply, and 5 have an oversupply.</p><p><strong>Conclusions: </strong>There is a shortage of specialized hand surgeons in Lebanon, compounded by a lack of recognition of this specialty at the public and private levels of the country. Implementation of strategies is needed to bridge this gap and add to the already offered contributions by existing expertise.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6512"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391531","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":"Factors Limiting the Lifetime Impact of Surgical Training.","authors":"Lionel Dumont, Anne Zeidan, Pierre Quinodoz","doi":"10.1097/GOX.0000000000006518","DOIUrl":"10.1097/GOX.0000000000006518","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6518"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391529","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":"Surgical Outcomes Following Distal Nerve Decompression in Patients With Trigeminal Neuralgia.","authors":"Merel H J Hazewinkel, Leonard Knoedler, Katya Remy, Sierra Tseng, William G Austen, Lisa Gfrerer","doi":"10.1097/GOX.0000000000006507","DOIUrl":"10.1097/GOX.0000000000006507","url":null,"abstract":"<p><strong>Background: </strong>Patients with headache disorders may present with compression of distal trigeminal nerve branches as well as other head and neck nerve branches such as the occipital nerves. In addition, a coexisting diagnosis of trigeminal neuralgia of proximal origin may be present. This overlap in diagnoses complicates treatment. Therefore, this study aimed to investigate the therapeutic effects of distal nerve decompression surgery in patients with coexisting trigeminal neuralgia from a proximal origin.</p><p><strong>Methods: </strong>The charts of 1112 patients who underwent screening for nerve decompression surgery were retrospectively reviewed. Patients with trigeminal neuralgia who underwent nerve decompression surgery were included. Data regarding preoperative and postoperative pain characteristics were collected.</p><p><strong>Results: </strong>Seventeen (1.5%) patients met the inclusion criteria and underwent nerve decompression. Fifteen patients (56%) underwent occipital decompression (13 greater occipital nerve decompressions, and 10 lesser occipital nerve decompressions), 5 patients (19%) underwent frontal decompression (supraorbital nerve/supratrochlear nerve decompression), and 6 patients (22%) underwent temporal decompression (4 zygomaticotemporal decompressions and 2 auriculotemporal nerve decompressions). Among the patients who underwent occipital decompression, 11 (73%) patients reported ≥80% pain relief, 1 (6.7%) patient reported ≥50% pain relief, and 3 (20%) patients reported ≤20% pain relief. For frontal and/or temporal decompression, only 2 (28%) patients achieved substantial pain relief (100% and 50%), whereas 5 (71%) patients experienced ≤20% pain relief.</p><p><strong>Conclusions: </strong>Our results demonstrate that occipital nerve decompression is an effective treatment for alleviating occipital neuralgia in individuals with coexisting proximal trigeminal neuralgia. However, the outcomes of frontal and temporal decompression were less favorable.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6507"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391537","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":"Identifying Contextual Workplace Stressors in a Division of Plastic and Reconstructive Surgery.","authors":"Viola Goodacre, Karthik Adapa, Elizabeth Kwong, Lisa M Vizer, Chao-Chin Liu, Nadia Charguia, Caprice Greenberg, Lynn A Damitz, Damian McHugh, Lukasz M Mazur","doi":"10.1097/GOX.0000000000006525","DOIUrl":"10.1097/GOX.0000000000006525","url":null,"abstract":"<p><strong>Background: </strong>Healthcare professionals in plastic and reconstructive surgery (PRS) face unique stressors that contribute to burnout, increasing the risk of errors and compromising patient care. Despite this, there is limited research on PRS burnout in the United States. This study aimed to measure burnout rates and identify high-impact improvement targets within a PRS division at a US academic medical center.</p><p><strong>Methods: </strong>A sequential mixed-methods study was conducted, involving systems analysis and contextual design methods. All surgeons (n = 5) and nonsurgeons (n = 9) were invited to participate (total n = 14). Burnout rates were measured, and workplace stressors were identified using surveys, focus groups, and contextual inquiries. High-impact, low-effort improvement targets were determined through impact-effort matrices.</p><p><strong>Results: </strong>Survey data from 13 respondents revealed an 85% burnout rate. Three focus groups and 14 contextual inquiries were conducted. After 13 participants validated and prioritized 2 affinity diagrams and provided 24 high-priority stressors, 8 respondents completed 2 surveys that yielded 6 high-impact/low-effort targets for organizational improvement efforts.</p><p><strong>Conclusions: </strong>This study highlights the high prevalence of burnout in PRS and identifies specific improvement targets for both surgeons and nonsurgeons. Findings suggest strategies such as improving respect and recognition for surgeons and streamlining clinic flow for nonsurgeons. Implementing these targeted improvements can enhance the well-being of healthcare professionals and ultimately improve patient care. The study's methods can be replicated by other healthcare organizations to identify and address burnout-related issues effectively.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6525"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391533","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":"Prospective Qualitative Study on Impact of Headache Surgery on Quality of Life: Are We Ready for Headache Surgery Outcome Measures?","authors":"Ahmed M Afifi, Sarah Lyon, Diana Gutierrez-Meza, Esra Alagoz, Armin Edalatpour, Jacqueline S Israel","doi":"10.1097/GOX.0000000000006500","DOIUrl":"10.1097/GOX.0000000000006500","url":null,"abstract":"<p><strong>Background: </strong>Migraines are common and are associated with significant morbidity to patients and cost to the healthcare system. Headache surgery (HS) has emerged as a treatment option for patients with symptoms refractory to medical management, but its impact on patients' quality of life is incompletely understood. This study analyzed, via in-depth prospective patient interviews, patient perceptions of and experience with HS.</p><p><strong>Methods: </strong>Patients with history of migraines who were scheduled for HS were invited to participate in this study. Semistructured interviews were conducted by trained qualitative interviewers in the pre/postoperative periods. Interviews were transcribed verbatim, coded utilizing NVivo 12 Software, and queried to assess the impact of surgery on domains such as work, relationships, headache severity, and medication use. Predominant themes were identified and compared among subjects in the preoperative/postoperative periods. Subjects were recruited until thematic saturation was achieved.</p><p><strong>Results: </strong>Eleven patients were enrolled in this study. Nine patients completed preoperative/postoperative interviews an average of 1 month before and 33 months following surgery. Compared with the preoperative interview, postoperative transcript analysis revealed reduced migraine severity, greater ability to participate in work and personal relationships, improved medication efficacy, and better ability to control headaches. These shifting domains facilitated a transition in patient cognitive allocation with reduced migraine predominance in the postoperative setting.</p><p><strong>Conclusions: </strong>This novel study assessed the impact of HS on the quality of life in a prospective, qualitative manner. Our results suggest that HS may reduce migraine severity, improve patients' ability to work and engage in relationships, and improve patients' mental health overall.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6500"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391534","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":"Improved Outcomes in Lower Eyelid Reconstruction With Biodegradable Implant: A Comparative Study.","authors":"Eldor Jonnazarov, Maria Cervatiuc, Igor V Reshetov, Svetlana V Saakyan, Natalia D Chuchueva","doi":"10.1097/GOX.0000000000006524","DOIUrl":"10.1097/GOX.0000000000006524","url":null,"abstract":"<p><strong>Background: </strong>Eyelid reconstruction is essential for patients who have undergone radical surgery to treat eyelid malignancies. The primary goal of this surgery is to restore both the functional and aesthetic aspects of the eyelid. Traditionally, various grafts from other parts of the body have been used for reconstruction. However, these methods may be limited by the availability of donor sites and the potential for associated complications.</p><p><strong>Methods: </strong>The study included 61 patients 58-91 years of age who underwent lower eyelid reconstruction. The patients were divided into 2 groups: a treatment group of 31 patients who received the biodegradable implant in addition to standard surgical techniques and a control group of 30 patients who underwent reconstruction without the implant. All patients were followed up for 1 year.</p><p><strong>Results: </strong>The study demonstrated that the use of the biodegradable membrane offered several advantages over the traditional approach without an implant. These advantages included faster healing times, as evidenced by cytological analysis; improved blood flow to the reconstructed eyelid, as measured by laser Doppler flowmetry; and a reduced incidence of eyelid complications, such as ectropion (outward turning of the eyelid). There were no statistically significant differences in tear osmolarity or pH between the 2 groups.</p><p><strong>Conclusions: </strong>The findings of this study suggest that the use of a biodegradable implant for lower eyelid reconstruction following malignant tumor surgery is a safe and effective method. It may lead to faster healing, improved blood flow, and fewer complications compared with traditional techniques.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6524"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383233","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":"Demographic Data of Orbital Fat Removal for Dark Circles Under Eyes in Nationwide Cosmetic Surgery Group.","authors":"Takahiko Tamura, Yusuke Funakoshi, Hiromichi Okuma, Yoshimasa Furuichi, Taichi Tamura, Takashi Fuse, Miku Toma, Koki Okumura, Hiroo Teranishi","doi":"10.1097/GOX.0000000000006528","DOIUrl":"10.1097/GOX.0000000000006528","url":null,"abstract":"<p><strong>Background: </strong>Transconjunctival orbital fat removal has exhibited an increasing trend in Japan. This study, conducted in more than 100 clinics in Japan, aimed to contribute to the evolving body of evidence guiding surgical procedures.</p><p><strong>Methods: </strong>We analyzed data from our institutional database of 127,505 patients who underwent orbital fat removal for dark circles under the eyes at our clinic. Parameters evaluated included age, sex, occupation, number of debridement sites, medications, and comorbidities.</p><p><strong>Results: </strong>The number of procedures has been increasing annually, surpassing 70,000 in 2023. A total of 86.5% of patients were women and 13% were men. The top 3 occupations of patients included company employees (46.2%), housewives (10.4%), and others (9.9%). The median age of patients was 43 (range 33-51) years, showing a trend toward older age. Nearly all excess orbital fatty areas were removed via total resection. Patients undergoing total resection were significantly older on average compared with those undergoing partial resection. Comorbidities, including hypertension, glaucoma, and retinal disease, tended to increase annually. Both steroids and antiplatelet/anticoagulant medications were increasingly used, with the former accounting for 26.5 patients per month and the latter for 10.8 patients per month in the last year.</p><p><strong>Conclusions: </strong>The number of middle-aged and older patients is increasing, suggesting a future increase in procedures. The aging demographic will likely lead to a higher prevalence of comorbidities and high-risk medications in the patient population. Surgeons must be aware of these risk factors and possess the skills to manage them safely and effectively.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6528"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383231","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}