Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Correlation of Ultrasound and Electrodiagnostic Evaluation in Ballistic Peripheral Nerve Injuries.","authors":"Mitchell S Mologne, Zachary D Randall, Nathan P Olafsen, David M Brogan, Christopher J Dy","doi":"10.1097/GOX.0000000000006846","DOIUrl":"10.1097/GOX.0000000000006846","url":null,"abstract":"<p><strong>Background: </strong>Evaluation and management of ballistic peripheral nerve injuries remain controversial, and recent series have suggested higher rates of nerve discontinuity than previously appreciated. Ultrasound (US) may aid clinicians in the management of ballistic injuries. The goal of this study was to compare US findings to electrodiagnostic and intraoperative findings to assess its accuracy in ballistic injuries.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients with the following criteria: (1) ballistic injury to the upper or lower extremity with suspected mixed or motor peripheral nerve injury; (2) underwent electrodiagnostic studies (EDX) and peripheral nerve ultrasound. US findings were categorized as normal, enlarged, neuroma-in-continuity, partial transection, or complete transection. EDX were reviewed for abnormalities in compound motor action potential amplitudes.</p><p><strong>Results: </strong>Sixteen patients met our inclusion criteria, of whom 14 had US abnormalities: 8 neuromas-in-continuity, 2 complete transections/discontinuity, 1 partial transection, 2 enlargements, and 1 hypoechoic/fascicular irregularity. US detected 14 of 16 neurapraxic, axonotmetic, or neurotmetic peripheral nerve injuries after ballistic trauma. US had 88% sensitivity, with 0 false positives and 2 false negatives (negative on ultrasound, positive on electrodiagnostic testing) compared with electrodiagnostic testing.</p><p><strong>Conclusions: </strong>Our findings suggest that US is an accurate way to evaluate peripheral nerve injuries after ballistic trauma. US may play a role in early diagnostics, especially when EDX are of little value. Future work should focus on the accuracy of early US in ballistic injuries and determining the effects of US and EDX at varying time intervals.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6846"},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234809","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":"Role of Superficial Thoracoepigastric Vein in Delay Procedure of Deep Inferior Epigastric Artery Perforator Flap.","authors":"Sara L Ma, Mihaela-Elena Rapolti","doi":"10.1097/GOX.0000000000006851","DOIUrl":"10.1097/GOX.0000000000006851","url":null,"abstract":"<p><p>Deep inferior epigastric perforator (DIEP) flaps are the current gold standard for autologous breast reconstruction. A delay technique for single-perforator DIEP flap reconstruction had been previously described to improve tissue transfer reliability. However, the importance of the thoracoepigastric system in this procedure is unknown. We describe a case of 2-stage bilateral DIEP flap breast reconstruction in a 49-year-old obese woman, wherein unilateral (left) interruption of the thoracoepigastric vein during stage 1 delay unexpectedly yielded markedly improved outcomes compared with the opposing (right) side with an intact thoracoepigastric vein. Slight transient venous congestion was noticed immediately in the left hemiabdomen after interruption of the ipsilateral thoracoepigastric vein concomitant with ligation of the superficial inferior epigastric vein, venae comitantes of the superficial inferior epigastric artery, and superior epigastric veins. The left hemiabdominal DIEP flap was uneventfully harvested and transferred 3 weeks later. On the right side with an intact thoracoepigastric system, complete elevation of the hemiabdomen tissue during stage 2 resulted in extensive venous congestion in situ, which improved after an intraflap anastomosis between the dilated stump of the right superficial inferior epigastric vein and a branch of the right deep inferior epigastric vein. Preservation of the thoracoepigastric system as part of the previously described DIEP delay protocol may cause insufficient flap delay, as the intact superficial system prevents maturation of venous drainage through the pedicle pathway. We propose thoracoepigastric vein interruption as a critical step in optimizing the delay of DIEP flap reliability, particularly in patients with dominant superficial venous systems.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6851"},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234811","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 Efficacy of Combined Exosome (Exodew) and Microneedling Treatment for Facial Pore Reduction and Skin Texture Improvement.","authors":"Jovian Wan, Song Eun Yoon, Kyu-Ho Yi","doi":"10.1097/GOX.0000000000006849","DOIUrl":"10.1097/GOX.0000000000006849","url":null,"abstract":"<p><strong>Background: </strong>Enlarged facial pores are a common aesthetic concern that worsens with age due to increased sebum production, reduced skin elasticity, and photoaging. Although microneedling is known to stimulate collagen production, the combined use of stem cell-derived exosome therapy for pore reduction has not been thoroughly investigated.</p><p><strong>Methods: </strong>A case series was conducted at a private aesthetic clinic between January and June 2024. Three patients (1 man and 2 women; 32-55 y of age; Fitzpatrick skin type IV) underwent 3 sessions of microneedling combined with topical exosome application (Exodew, Hyundae Meditech) at 4-week intervals. Standardized photographs were obtained at baseline and posttreatment. Clinical outcomes were evaluated using the Global Aesthetic Improvement Scale by 2 independent dermatologists and patient satisfaction scores at 12 and 22 weeks.</p><p><strong>Results: </strong>All patients exhibited visible reductions in pore size and improvements in skin texture and overall appearance. Global Aesthetic Improvement Scale scores ranged from 4 to 5, indicating \"very much improved\" outcomes. Patient satisfaction was high at both 12- and 22-week follow-ups. No adverse events were reported, and improvements were sustained through week 22.</p><p><strong>Conclusions: </strong>Microneedling combined with stem cell-derived exosome therapy seems to be a safe and effective treatment for facial pore reduction and skin texture enhancement. Larger, controlled studies are needed to confirm these preliminary results.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6849"},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234812","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":"Comprehensive Review of Surgical Techniques for Correcting Cephalic Malposition of the Lower Lateral Cartilages in Rhinoplasty.","authors":"Aref Nassar, Joy Naba","doi":"10.1097/GOX.0000000000006808","DOIUrl":"10.1097/GOX.0000000000006808","url":null,"abstract":"<p><strong>Background: </strong>Lateral crural malposition, characterized by lower lateral cartilages diverging less than 30 degrees from the midline toward the ipsilateral medial canthus, presents both functional and aesthetic challenges in rhinoplasty. Various surgical techniques have been described for correction, but no comprehensive review has compared their efficacy.</p><p><strong>Methods: </strong>A literature review was conducted to categorize and evaluate surgical techniques for correcting cephalic malposition. Techniques were grouped into flaps, grafts, lateral crura transection, and suture-based methods. Functional and aesthetic outcomes, as well as factors influencing technique selection, were analyzed.</p><p><strong>Results: </strong>The selection of a surgical technique depends on factors such as surgeon expertise, cartilage availability, and patient-specific anatomical considerations. Although multiple techniques have demonstrated favorable outcomes, long-term data on complications and structural stability remain limited, highlighting the need for further research.</p><p><strong>Conclusions: </strong>This article is the first to comprehensively describe and compare surgical techniques for cephalic malposition correction. Further research is needed to establish evidence-based guidelines for technique selection and to assess long-term functional and aesthetic outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6808"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226222","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":"Dynamic Eyelid Reanimation in Facial Paralysis: A Systematic Review of Techniques and Outcomes.","authors":"Ghanem Aljassem, Zaki Alyazji, Rami Misk, Bara Shraim, Mohamed Badie Ahmed, Salim Al Lahham, Abeer Alsherawi","doi":"10.1097/GOX.0000000000006827","DOIUrl":"10.1097/GOX.0000000000006827","url":null,"abstract":"<p><strong>Background: </strong>Facial nerve palsy has severe morbidity, stemming from the loss of facial animation. Earlier attempts to restore eyelid function relied on static procedures. With the advancement in microsurgery techniques in recent years, dynamic eyelid reconstruction has gained more popularity. The goal is to maximize functional and aesthetic outcomes. This article aimed to highlight the current techniques and outcomes of dynamic eyelid reanimation.</p><p><strong>Methods: </strong>MEDLINE, PubMed, PubMed Central, and Cochrane databases were searched. The included articles were reviewed. The techniques, methods of assessment, and associated outcomes were extracted and compared.</p><p><strong>Results: </strong>Seventeen articles were included in the study. Tools used for assessment were diverse, including specific scales, questionnaires, and clinical examination. Techniques used were classified as nerve and muscle transfers. Nerve transfers included cross-facial nerve graft, nerve to masseter, and hypoglossal nerve transfer. Better results and lower morbidity were achieved with the combination of methods. Muscle transfers included free platysma muscle transfer as a free flap or graft, differentiated innervated gracilis muscle transfer, contralateral orbicularis oculi muscle, and temporalis muscle transfer. Better results were achieved with platysma-free functional muscle transfer.</p><p><strong>Conclusions: </strong>Dynamic reanimation has better results than static procedures, and a combination of dynamic and static procedures might have the best results. The chosen method must be individualized, with the choice mainly affected by denervation time and the age of the patient.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6827"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226225","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 Continued Value of the Independent Training Pathway and Impact on Career Trajectory.","authors":"Skyler K Palmer, Ansley N Wallace, Jun Bai Park Chang, Zain Aryanpour, Joseph N Carey, Mark A Greyson, David W Mathes, Phuong D Nguyen","doi":"10.1097/GOX.0000000000006835","DOIUrl":"10.1097/GOX.0000000000006835","url":null,"abstract":"<p><strong>Background: </strong>The independent pathway is the traditional model for plastic surgery training. Although previous studies have compared independent and integrated training pathways, none have controlled for institutional influence on outcomes. This study evaluates the continued value of the independent pathway by examining fellowship matriculation and academic practice rates of independent graduates and comparing these rates with integrated graduates from these same programs.</p><p><strong>Methods: </strong>A retrospective review was performed on all independent plastic surgery programs with residents graduating from 2018 to 2024. Independent graduate year, training pathway, fellowship matriculation, fellowship type, and academic practice status were collected from publicly available data. The same data collection was performed for programs that also had integrated graduates during this time. Standard statistical analyses were performed.</p><p><strong>Results: </strong>A total of 34 independent programs were included, 21 of which also had an integrated program. The overall independent graduate fellowship matriculation rate was 42.6%. Among programs that produced both independent and integrated graduates, integrated graduates were more likely to pursue a fellowship (70.6%, <i>P</i> < 0.001). There was no significant difference in academic practice between independent (24.0%) and integrated graduates (33.0%) within these programs (<i>P</i> = 0.13).</p><p><strong>Conclusions: </strong>This study evaluated fellowship matriculation and academic practice rates of graduates from independent plastic surgery programs. Although integrated graduates from these programs were more likely to matriculate into fellowship, they were not more likely to enter academic practice. As discussions around the future of independent programs evolve, it is important to acknowledge their continued contributions to academic plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6835"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226241","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":"Treatment of Intercostal Neuralgia Following Cough-induced Rib Fractures With Targeted Muscle Reinnervation.","authors":"Madi El Haj, Muhannad Abu Arafeh, Yechiel N Gellman, Sofia A Vorobeitchik, Yusef Azraq, Shaul Beyth","doi":"10.1097/GOX.0000000000006839","DOIUrl":"10.1097/GOX.0000000000006839","url":null,"abstract":"<p><p>Intercostal neuralgia is a rare yet debilitating condition that can be caused by thoracotomy, herpes zoster infection, or traumatic rib fractures. This case report describes a 48-year-old woman who developed persistent intercostal neuralgia after sustaining bilateral multiple rib fractures from a violent coughing episode. Initial surgical decompression and subsequent neurectomy of the affected intercostal nerve temporarily alleviated her symptoms. A third surgical intervention involving targeted muscle reinnervation with intercostal to thoracodorsal nerve transfer provided long-lasting pain relief. This case highlights the importance of considering nerve entrapment as a cause of posttraumatic intercostal neuralgia and suggests the targeted muscle reinnervation as a reliable procedure for obtaining persistent pain relief.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6839"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226243","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":"Layered Repair in Extensive Sacral Defects with Bilaminar Gluteal Flaps: Demirdover Flaps.","authors":"Cenk Demirdover, Alper Geyik, Safa Eren Atalmis","doi":"10.1097/GOX.0000000000006828","DOIUrl":"10.1097/GOX.0000000000006828","url":null,"abstract":"<p><strong>Background: </strong>The reconstruction of extensive sacral defects following the resection of chordomas and malignant tumors poses a significant challenge. Local flaps are often preferred over free flaps due to the challenging vascular anatomy of the region. However, many local flaps lack the necessary volume and vascularity to adequately fill the defect.</p><p><strong>Methods: </strong>Twelve patients with extensive sacral defects who underwent reconstruction with the bilaminar gluteal flap, named the Demirdover flap (DF), were included in the study. The following variables were evaluated: patient demographics, tumor type, defect size, resection and reconstruction details, complications, and follow-up time. The DF is a viable alternative to regional or free flaps for reconstructing extensive sacral defects.</p><p><strong>Results: </strong>All patients were men, and the mean age was 63.2 years. Most of the patients had chordoma (58.3%). The body mass index of all patients was recorded, and they were either normal or overweight. All patients received adjuvant radiotherapy. None of the patients experienced severe complications during the follow-up period.</p><p><strong>Conclusions: </strong>The DF flap is a promising option for reconstructing extensive sacral defects. The DF flap offers adequate volume as a result of the 2-layer design, ensuring sufficient tissue volume to fill the defect. Furthermore, preserving the muscle's neurovascular structures enhances blood supply, and the flap's design minimizes muscle disruption, promoting better function.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6828"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226228","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 Site Infection Owing to <i>Mycobacterium mageritense</i> After Immediate Breast Reconstruction Using a Deep Inferior Epigastric Perforator Flap.","authors":"Anna Suzuki, Takako Komiya, Hiroaki Fujita, Kazuki Shimada, Masahito Nonaka, Mai Hanano, Meisei Takeishi, Takashi Ishikawa, Hajime Matsumura","doi":"10.1097/GOX.0000000000006823","DOIUrl":"10.1097/GOX.0000000000006823","url":null,"abstract":"<p><p><i>Mycobacterium mageritense</i> is a rare, rapidly growing, nontuberculosis mycobacterium that belongs to type IV of the rapidly growing mycobacteria. These bacteria are found in soil and water, and cause localized skin and soft tissue infections; however, they are challenging to culture, leading to diagnostic delays. To our knowledge, there have been 12 reported cases of surgical site infections (SSIs) caused by <i>M. mageritense</i>, with only 2 cases following breast reconstruction. A 51-year-old woman underwent nipple-sparing mastectomy and immediate breast reconstruction using a deep inferior epigastric perforator flap for invasive ductal carcinoma of the left breast. One month after surgery, she developed an SSI caused by <i>M. mageritense</i>. Despite initial outpatient treatment, the infection persisted, requiring multiple hospitalizations, administration of intravenous antibiotics, and several debridements under general anesthesia. Negative pressure wound therapy and a coordinated approach among various medical specialties are essential for managing infections. The patient experienced side effects from prolonged antibiotic use but eventually exhibited no signs of infection recurrence. This case highlights the challenges in diagnosing and treating <i>M. mageritense</i> SSIs, emphasizing the need for comprehensive surgical and medical management, together with patient-centered care, to effectively manage long-term treatment.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6823"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226240","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 Efficacy of Combined Microneedling and Topical Poly-d,l-lactic Acid (Juvelook) Application for Facial Pore Reduction and Skin Texture Improvement.","authors":"Jovian Wan, Suk Bae Seo, Song Eun Yoon, Kyu-Ho Yi","doi":"10.1097/GOX.0000000000006838","DOIUrl":"10.1097/GOX.0000000000006838","url":null,"abstract":"<p><strong>Background: </strong>Enlarged facial pores are a common cosmetic concern influenced by factors such as age, genetics, and increased sebaceous activity. Despite the availability of numerous treatment modalities, results are often variable, and many methods involve significant discomfort or a high number of sessions. This case series evaluated the efficacy of combining microneedling with the topical application of poly-d,l-lactic acid (PDLLA, Juvelook, VAIM Inc., Seoul, Korea) in reducing pore size and improving skin texture.</p><p><strong>Methods: </strong>Fifteen patients with enlarged facial pores underwent 3 sessions of microneedling with intradermal PDLLA injections spaced 3 weeks apart. Pore size was evaluated using a standardized visual grading scale, and improvements in skin texture were assessed through clinical photography. Patient satisfaction was measured using a 4-point Likert scale.</p><p><strong>Results: </strong>All patients demonstrated significant improvements, with pore size scores decreasing from an average of 6 (baseline) to 3 at 12 weeks (<i>P</i> < 0.001) and results maintained through 22 weeks. Skin texture showed noticeable enhancement, and 80% of patients reported high satisfaction levels. Mild transient erythema and edema were observed in some patients, resolving within 48 hours.</p><p><strong>Conclusions: </strong>Microneedling combined with topical PDLLA is a minimally invasive, effective treatment for pore reduction and skin texture improvement. Further research, including larger randomized controlled trials and advanced imaging technologies, is warranted to validate these findings and refine the treatment protocol.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6838"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226242","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}