Spinal Cord Series and Cases最新文献

{"title":"Skin and tissue changes after spinal cord injury-A scoping review.","authors":"Leander G Melin, Knaerke Soegaard, Fin Biering-Soerensen, Dimitri Beeckman, Jens A Soerensen","doi":"10.1038/s41394-026-00746-0","DOIUrl":"10.1038/s41394-026-00746-0","url":null,"abstract":"<p><strong>Study design: </strong>Scoping review.</p><p><strong>Objectives: </strong>Spinal cord injury causes complex and severe changes in affected skin and underlying tissues, increasing the risk of pressure ulcer development and impeding wound healing. This scoping review provides an updated overview on skin and tissue changes after spinal cord injury. Given the complexity and inconsistent evidence of the topic, this review outlines current knowledge and highlights research gaps.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in Medline, Embase, Cochrane Library, and SCOPUS databases. Studies written in English addressing skin and tissue changes after spinal cord injury were included, with no restrictions on study type or publication year. Two reviewers independently screened the studies, and eligible articles were organized into the following six subgroups: 1) histopathology, 2) ultrasonography, 3) biomechanical properties, 4) skin perfusion, 5) sebum- and sweat gland excretion, and 6) microbiota.</p><p><strong>Results: </strong>Out of 5387 articles screened, twenty-three met the inclusion criteria. Findings revealed epidermal atrophy characterized by progressive thinning over time, while the dermal layer demonstrated fibrosis and reduced collagen synthesis. Results on skin thickness were inconsistent, though increased tissue stiffness was consistently reported. Skin perfusion was compromised, with diminished reactive hyperemia, impaired vascular autoregulation, and reduced spontaneous skin oxygenation.</p><p><strong>Conclusion: </strong>Skin and tissue affected by spinal cord injury exhibit compromised quality with characteristics of aged and injured skin. Consequently, the skin is less able to resist pressure, shear stress, and ischemia. The reviewed literature reveals substantial gaps in knowledge, underscoring the need for further research to improve clinical care and management.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764983","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":"Contextual determinants of long-term home use of powered exoskeletons: commentary on Cutti et al.","authors":"Abhimanyu Vasudeva, Pratikshya Lenka, Susmita Sarkar","doi":"10.1038/s41394-026-00747-z","DOIUrl":"10.1038/s41394-026-00747-z","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765643","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":"Giant vaginal lithiasis in spinal cord injury related neurogenic lower urinary tract dysfunction: diagnostic pitfall with upper urinary tract deterioration.","authors":"Tudor-Mihai Magdaș, Bogdan Adrian Buhas, Sofia Anamaria Ferțadi, Dan Vasile Stanca","doi":"10.1038/s41394-026-00745-1","DOIUrl":"10.1038/s41394-026-00745-1","url":null,"abstract":"<p><strong>Introduction: </strong>Vaginal lithiasis is exceptionally rare and may mimic vesical lithiasis on imaging, particularly in women with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (nLUTD). Delayed recognition may cause recurrent infection, obstructive uropathy and upper urinary tract deterioration.</p><p><strong>Case presentation: </strong>A 38-year-old woman with a T6 ASIA Impairment Scale (AIS) grade A SCI and nLUTD after epidural abscess drainage presented with continuous urinary leakage, recurrent febrile urinary tract infections and progressive renal impairment. Urine culture grew Pseudomonas aeruginosa. Non-contrast-enhanced computed tomography showed a 10 × 5.7 cm midline pelvic calculus with bilateral grade II-III ureterohydronephrosis, initially read as a giant intravesical stone. Persistent incontinence was inconsistent with presumed detrusor-sphincter dyssynergia, prompting clinical reassessment. Cystoscopy revealed an empty bladder and a midline vesico-vaginal fistula; colposcopy confirmed a giant vaginal calculus occupying the vaginal vault. The calculus was removed transvaginally using Kielland obstetric forceps. Hydronephrosis resolved and renal function improved; fistula repair was deferred per patient preference.</p><p><strong>Discussion: </strong>A focused review identified fewer than 20 reported cases of primary vaginal lithiasis, most associated with nLUTD, neurological impairment, anatomical abnormalities, urinary fistulas or chronic urinary stasis. This case emphasizes that imaging alone may mislocalize pelvic calculi. In SCI patients with nLUTD, clinical and pelvic examination are essential and may establish the diagnosis while assessing for fistula. After risk stratification, structured long-term surveillance of the upper urinary tract and awareness among spinal cord-injured individuals and physicians are crucial to prevent complications and recurrence.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713628","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":"Retrospective safety evaluation of the atalante exoskeleton in a clinical setting in patients with tetraplegia and high paraplegia.","authors":"Jean-Gabriel Previnaire, Héloise Baillet, Jean-François Bel, Vincent Péan, Céline Cuenot","doi":"10.1038/s41394-026-00744-2","DOIUrl":"10.1038/s41394-026-00744-2","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To evaluate the safety of the Atalante exoskeleton in patients with tetraplegia and high paraplegia.</p><p><strong>Setting: </strong>Three inpatient rehabilitation centers in France.</p><p><strong>Methods: </strong>Data from thirty-three inpatients with tetraplegia (12 motor complete (American Spinal Injury Association Impairment Scale (AIS) grade A or B), 10 motor incomplete (AIS C or D)) and high paraplegia (at or above T4 level; 10 motor complete and 1 motor incomplete) and an average time since Spinal Cord Injury (SCI) of 2.6 years (19 individuals < 12 months after injury), who completed at least one session of training with the Atalante exoskeleton, were analyzed. The primary outcome was the safety assessment through reported device-related adverse effects (AE). Secondary outcomes included pain (Numeric Pain Rating Scale), spasticity (Ashworth scale), walking ability (WISCI-II), and exoskeleton session data.</p><p><strong>Results: </strong>Participants underwent a median of 7.5 (IQR: 3-22.8) exoskeleton training sessions, with a median verticalization duration of 22.4 min (IQR: 18-26.9) and 583.0 steps (IQR: 347.0-854.0) performed. The estimated rate of AEs per session across all sessions was 0.63%, with a 95% confidence interval ranging from -0.56 to 1.81%. One minor AE occurred in one patient, involving hypotension, fatigue and dizziness, leading to session discontinuation. No therapy-related pain or fracture was reported. Regarding secondary outcomes, spasticity remained unchanged while positive changes were observed in WISCI-II scores in 11 patients with incomplete SCI.</p><p><strong>Conclusions: </strong>After individual benefit-risk assessment, the Atalante exoskeleton can be safely used in a clinical setting for high SCI patients.</p><p><strong>Sponsorship: </strong>Wandercraft.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670722","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":"Evaluation of corticosteroid treatment in patients with post-traumatic ascending myelopathy and spinal cord injury: three case reports and review of the literature.","authors":"Ariadna Marcé-Rotger, David Farkas Reinhardt, Carles Tortajada Bustelo, Xurxo Segura Navarro, Irene Corral López, Lluïsa Montesinos-Magraner","doi":"10.1038/s41394-026-00743-3","DOIUrl":"10.1038/s41394-026-00743-3","url":null,"abstract":"<p><strong>Introduction: </strong>Subacute post-traumatic ascending myelopathy (SPAM) is defined as a neurological deterioration extending several levels above the initial spinal cord injury (SCI) within the first few weeks post-injury, without associated mechanical instability or syringomyelia. This report details three cases of SPAM to highlight this condition.</p><p><strong>Cases presentation: </strong>We present three case reports who sustained SPAM over the last 7 years at the Hospital Universitari Vall d'Hebron in Barcelona (Spain). The first patient was a 41-year-old male with a traumatic C5 SCI (AIS A), diagnosed of SPAM 35 days post-injury with a C3 SCI (AIS A) and treated with descending taper of dexamethasone (Dx). The second patient was a 45-year-old female with a traumatic C7 SCI (AIS A), diagnosed of SPAM 39 days post-injury with a C4 SCI (AIS A) and treated with a 3-day methylprednisolone (MP) bolus. The third patient was a 40-year-old male with a traumatic T7 SCI (AIS B), diagnosed of SPAM 11 days post-injury with a T5 SCI (AIS A) and treated with a 7-day MP bolus. The third patient showed improvement in AIS classification. A literature review of identification and treatment of SPAM was conducted.</p><p><strong>Discussion: </strong>SPAM is a severe and rare complication that should be considered within weeks following an acute traumatic SCI. There is no consensus in the literature regarding the treatment of corticosteroids related to SPAM. In the three cases presented, methylprednisolone was associated with better outcomes than dexamethasone; however, given the small sample size, this observation remains preliminary and hypothesis-generating.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449347","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":"Knowledge, attitudes, and practices of Lebanese healthcare professionals toward multidisciplinary spinal cord injury rehabilitation.","authors":"Nour El Hoda Saleh, Ali Orabi, Linda Abou-Abbas, Dalia Khachman, Ibrahim Naim, Salem Hannoun, Samar Rachidi","doi":"10.1038/s41394-026-00742-4","DOIUrl":"10.1038/s41394-026-00742-4","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Objectives: </strong>To assess the knowledge, attitudes, and practices (KAP) of Lebanese healthcare professionals toward multidisciplinary spinal cord injury (SCI) rehabilitation.</p><p><strong>Setting: </strong>Lebanon.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between April and June 2024 among physicians, nurses, and rehabilitation professionals involved in SCI care in Lebanon. Participants completed an anonymous online questionnaire assessing sociodemographic characteristics and KAP related to SCI rehabilitation. Data were analyzed using descriptive statistics, bivariate analyses, and multiple linear regression.</p><p><strong>Results: </strong>A total of 110 healthcare professionals participated; 61.8% were aged ≤35 years and 62.7% held postgraduate degrees. The mean knowledge score was 58.5 (SD 13.0), with 88.1% scoring below the adequate threshold. Attitudes were generally positive, with a mean score of 70.1 (SD 19.5), and 68.8% scored above the threshold. Practice scores were low (mean 42.5, SD 23.2), with only 32.1% demonstrating adequate practices. Higher knowledge and practice scores were associated with postgraduate education, longer experience, and working in rehabilitation settings. Lower attitude scores were observed among males and professionals managing acute referrals.</p><p><strong>Conclusion: </strong>Lebanese healthcare professionals demonstrated positive attitudes but insufficient knowledge and practices regarding multidisciplinary SCI rehabilitation, highlighting the need for targeted training and stronger interdisciplinary rehabilitation systems.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406048","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":"Reconstruction with muscle flaps after hip joint heterotopic ossification resection in spinal cord injured patients: a case series.","authors":"Luca Negosanti, Luca Gaiani, Silvia Campagnoni, Siriana Landi, Francesca Bettini, Pamela Salucci, Rossella Sgarzani","doi":"10.1038/s41394-026-00740-6","DOIUrl":"10.1038/s41394-026-00740-6","url":null,"abstract":"<p><strong>Introduction: </strong>Heterotopic ossification (HO) is a frequent complication in persons with spinal cord injury (SCI). This condition leads to limitations in movement and to abnormal posture, which can impair sitting and bed positioning and may result in pressure ulcers. Surgery is considered when HO causes severe limitations due to joint obstruction caused by the ossification. However, the defect left after resection is often extensive and may create significant dead spaces that can lead to seroma or hematoma formation if not adequately filled, increasing the risk of infection and prolonged hospitalization, and extended antibiotic therapy.</p><p><strong>Case presentation: </strong>We report five cases of large HO treated with resection followed by muscle flap reconstruction to eliminate all dead spaces. All patients were male, with a median age of 44 years old; 3 patients were paraplegic and 2 tetraplegics; 3 patients presented with AIS A and 2 with AIS B. All HOs were in the trochanteric region and involve the hip joint, with a mean defect size of 9,6 × 39,7 × 9,4 cm. After HO resection the defects were filled with a rectus femoris muscle flap. In two cases we observed a seroma that was drained, and the defect was filled with another muscle flap (vastus lateralis and semimembranosus).</p><p><strong>Discussion: </strong>In all reported cases, following muscle flap positioning, no seromas or hematomas were observed. We believe that this reconstructive technique can be beneficial in such cases and may become part of our standard approach to HO resection.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382403","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":"Long-term availability of powered exoskeleton for ambulation in domestic context: A cross-sectional study to assess safety, usage pattern, and satisfaction after long-term use.","authors":"Andrea Giovanni Cutti, Federico Morosato, Valeria Gazzotti, Gregorio Teti, Antonella Miccio, Patrizio Rossi, Emanuele Gruppioni","doi":"10.1038/s41394-026-00739-z","DOIUrl":"10.1038/s41394-026-00739-z","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Objective: </strong>To quantify the safety, usage pattern, and satisfaction of seven subjects with paraplegia after prolonged home use of a commercial powered overground exoskeleton.</p><p><strong>Setting: </strong>Centro Protesi Inail, the prosthetic centre of the Italian workers' compensation authority.</p><p><strong>Methods: </strong>The participants were recalled for a single-day assessment. Five domains were investigated: i.</p><p><strong>Safety: </strong>occurrences of adverse events. ii. Active use, usability, and satisfaction: Number of gait steps and stair steps with exoskeleton, System Usability Scale (SUS), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). iii. Health status and independence: Short Form-36 (SF-36), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder Scale (GAD-7), VO2 consumption associated to a sub-maximal arm crank ergometer test, Modified Ashworth Scale (MAS), Jobe's test and Speed's test, Spinal Cord Injury Measure (SCIM). iv. Perceived benefits: Self-perceived pain severity (VAS scale), Self-perceived bowel and bladder management (5-Likert scale). v. Performance: 6 min Walking Test (6MWT), 10 Meters Walking Test (10MWT).</p><p><strong>Results: </strong>Most recruited subjects were able to use the exoskeleton actively and safely throughout the observation period, experiencing an overall improvement across all domains of investigation. In one case, the ambulation time was lower due to the unavailability of the caregiver.</p><p><strong>Conclusions: </strong>Home supply of powered exoskeleton for ambulation could be part of a rehabilitation program to support individuals with paraplegia in their daily life. However, the presence of a qualified caregiver emerged as dominant factor for technology abandonment.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340416","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":"War, spinal cord injuries and rehabilitation: A revisited perspective.","authors":"Raktim Swarnakar","doi":"10.1038/s41394-026-00738-0","DOIUrl":"10.1038/s41394-026-00738-0","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212498","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":"Acute tetraplegia in a healthy patient: cryptogenic cervical ischaemic-venous myelopathy.","authors":"Francesco Perrotta, Federica Vitale, Ludovica De Marco, Andrea Sparascio, Pierluigi Morciano, Francesca De Salvo, Gaetano Iosa, Daniela Rizzo, Donato Piscopiello, Daniele Gemma","doi":"10.1038/s41394-026-00737-1","DOIUrl":"10.1038/s41394-026-00737-1","url":null,"abstract":"<p><strong>Background: </strong>Cervical spinal cord infarction is a rare condition, accounting for approximately 1-2% of all ischaemic events of the central nervous system (1,2). Diagnosis is often challenging due to clinical overlap with inflammatory, autoimmune, or compressive myelopathies (3). Early recognition is crucial to initiate appropriate treatment and avoid unnecessary or potentially harmful therapies.</p><p><strong>Case presentation: </strong>We report the case of a 65-year-old previously healthy man who developed acute cervical pain and paraesthesia in the hands while exposed to sunlight, followed within one hour by complete tetraplegia and respiratory failure, with preserved sensation. Brain imaging was unremarkable, while cervical MRI revealed a T2 hyperintensity from C2 to C4, predominantly involving the anterior and paramedian columns (\"H-sign\") (4,5), without critical canal stenosis but with minimal disc indentations at C4-C6. CSF analysis was normal. Spinal angiography and transoesophageal echocardiography excluded arteriovenous fistulae, dissections, or embolic sources. A mild hyperhomocysteinaemia (15 µmol/L) was found, with positive anti-recoverin antibodies; anti-AQP4 was negative. The patient received corticosteroids and intravenous immunoglobulins, later discontinued when an ischaemic aetiology was suspected. Antiplatelet and prophylactic anticoagulation therapy were continued. The clinical course was complicated by ventilator-associated pneumonia due to Klebsiella aerogenes, successfully treated with cefepime. Partial motor recovery in the hands and feet was observed from day five onwards.</p><p><strong>Conclusions: </strong>The clinical and radiological findings, combined with the negative work-up for inflammatory, embolic, or compressive causes, support a diagnosis of cryptogenic ischaemic cervical myelopathy, probably of acute ischaemic-venous origin favoured by minimal disc indentations. This case highlights the diagnostic complexity of acute non-traumatic myelopathies and the crucial role of early multidisciplinary evaluation to establish the aetiology and initiate timely functional rehabilitation (6-8).</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034824","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}