Trauma Surgery & Acute Care Open最新文献

{"title":"Poor oral health is associated with social vulnerability in critically ill trauma patients.","authors":"Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Chelsea J Guy-Frank, Gabrielle E Hatton, Kayli A Quinton, Sophia Syed, Erin E Fox, Charles E Wade, Kimberly A Mankiewicz, Lillian S Kao","doi":"10.1136/tsaco-2024-001636","DOIUrl":"10.1136/tsaco-2024-001636","url":null,"abstract":"<p><strong>Background: </strong>Social factors affect oral health status, and poor oral health has been associated with worse health outcomes. Using the Oral Health Risk Assessment Value Index (OHRAVI), a bedside tool for non-dentists to assess oral health, we investigated the interplay of oral health with social drivers of health and social vulnerability, as measured by the Social Vulnerability Index (SVI), in severely injured patients.</p><p><strong>Methods: </strong>Our retrospective study included dentulous critically ill trauma patients who were previously assigned an OHRAVI score (range 0-3; unhealthy score >1). Patient demographics, comorbidities, and self-reported social drivers were obtained from health records. SVI was calculated using census-tract data. Bayesian regression analyses were performed to calculate posterior probabilities of an association between risk factors and poor oral health (PP OR >1).</p><p><strong>Results: </strong>Among 170 patients, 91 (54%) patients had unhealthy OHRAVI scores. Median index OHRAVI score was 1.13 (IQR 0.86-1.43); median SVI was 0.7 (0.5-0.9). Median OHRAVI scores were higher in the high SVI group (SVI >0.7; OHRAVI 1.19) than in the low SVI group (SVI <0.7; OHRAVI 1.06, p=0.026). Social factors associated with poor oral health from Bayesian analysis (PP OR>1) included lack of social support (99%), housing instability (99%), divorced marital status (87%), and non-English primary language (86%). Social vulnerability was also associated with poor oral health (98%).</p><p><strong>Conclusions: </strong>Poor oral health in critically ill injured patients was associated with lack of social support, housing insecurity, divorced marital status, non-English primary language, and increased social vulnerability. OHRAVI may provide quick, objective bedside assessment to help identify socially vulnerable patients and serve as a marker for the presence of social risk factors that may portend poor outcomes. Oral health may be a modifiable risk factor, and early identification of patients may allow them to benefit from oral hygiene regimens, including treatment with antimicrobial agents.</p><p><strong>Level of evidence: </strong>Level II/III, prospective/retrospective cohort study with only one negative criterion.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001636"},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302933","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":"Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries.","authors":"L Erin Miller, Jennifer J Misenhimer, Luke T Sabal, John M Green","doi":"10.1136/tsaco-2025-001765","DOIUrl":"10.1136/tsaco-2025-001765","url":null,"abstract":"<p><p>Cervical spinal cord injuries (SCIs) are accompanied by significant physiologic challenges as well as psychologic burdens. Patient with high cervical SCI face severe physical disability and daily medical needs, which may include long-term mechanical ventilation. Given the substantial change in quality of life, it is crucial to include such patients in early goals of care discussions, when possible. Although there exists a depth of literature considering the medical benefits of early tracheostomy for patients with cervical SCI, there is a paucity of discussion regarding the ethical considerations. With an improved ability to communicate, early tracheostomy may improve subjective quality of life and augment the patient's sense of autonomy. Using a framework guided by the principles of medical ethics, we aim to emphasize the role of early tracheostomy for patients with high cervical SCI with a review of current literature and a case presentation from our institution.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001765"},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302880","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":"Viscoelastic testing in trauma: not all that glitters is a gold standard.","authors":"Andrea Rossetto, Jared M Wohlgemut, Ross Davenport","doi":"10.1136/tsaco-2025-001919","DOIUrl":"10.1136/tsaco-2025-001919","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001919"},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286592","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":"Comorbidity-based risk stratification in emergency general surgery: insights from a low-resource setting.","authors":"Mythri Ambatipudi, Joaquim Michael Havens","doi":"10.1136/tsaco-2025-001922","DOIUrl":"10.1136/tsaco-2025-001922","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001922"},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286590","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":"Gauze-soaked with suction wall: An alternative technique for negative pressure wound therapy.","authors":"Rawan Alshammary, Rashed Alshatti, Hameed Humaid, Rahaf Alsubayti, Faris Sultan, Albadawi Hassan","doi":"10.1136/tsaco-2024-001748","DOIUrl":"10.1136/tsaco-2024-001748","url":null,"abstract":"<p><strong>Background: </strong>Conventional negative pressure wound therapy (NPWT) machines, such as vacuum-assisted closure (VAC) devices, can be prohibitively expensive for healthcare settings with limited resources. This study investigates the effectiveness of a cost-saving alternative-Gauze-Suction Under Continous (GSUC)-in promoting wound healing when standard NPWT devices are unavailable or unaffordable.</p><p><strong>Methods: </strong>Four patients at Prince Mutaib Bin Abdulaziz Hospital in Al-Jouf, Saudi Arabia, underwent GSUC as part of their wound management under the plastic surgery unit. The primary outcome was the amount of granulation tissue generated, assessing wound readiness for skin grafting, primary closure, delayed primary closure, or secondary intention.</p><p><strong>Results: </strong>All four patients achieved more than 75% granulation tissue coverage in an average of 15.4 days. No wound-related or hospitalization-related complications were observed. Ultimately, all wounds were either successfully grafted or closed primarily. Patient satisfaction was high, and the estimated cost savings reached at least 45% compared with using conventional VAC devices.</p><p><strong>Conclusion: </strong>GSUC is a viable, cost-effective alternative to standard VAC NPWT systems, achieving comparable clinical outcomes at significantly reduced expense. Its adoption may be particularly beneficial in resource-constrained settings seeking to optimize wound care.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001748"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286591","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":"Multicenter evaluation of the Quantra with the QStat Cartridge in adult trauma patients.","authors":"Ernest E Moore, Edward A Michelson, Katrina Gabriel-Ramos, Michael W Cripps, Antolin Flores, Kofi Vandyck, Brian Thurston, Meghan Brennan, Francesco Viola, Deborah A Winegar","doi":"10.1136/tsaco-2024-001672","DOIUrl":"10.1136/tsaco-2024-001672","url":null,"abstract":"<p><strong>Background: </strong>Trauma-induced coagulopathy (TIC) occurs in a quarter of trauma patients and is associated with death due to uncontrolled bleeding. Current guidelines recommend viscoelastic testing (VET) to assess coagulopathy and guide transfusions. The Quantra with the QStat Cartridge is a point-of-care (POC) VET device that measures changes in clot stiffness (CS) during coagulation and fibrinolysis using ultrasound detection of resonance. This study aimed to evaluate the performance of the QStat Cartridge in trauma patients compared with rotational thromboelastometry (ROTEM) <i>delta</i> and thromboelastography (TEG) 6s VET devices.</p><p><strong>Methods: </strong>A multicenter prospective observational study was conducted in adult patients meeting criteria for a full trauma team response at eight US level 1 trauma centers. Citrated blood samples drawn on arrival at the hospital or after blood transfusions were analyzed in parallel on QStat, ROTEM or TEG. Correlation between QStat and equivalent VET measurements was assessed by linear regression. Concordance was assessed by agreement of results relative to device-specific normal reference ranges.</p><p><strong>Results: </strong>259 severely injured patients were enrolled, yielding 271 samples for analysis. Moderate to strong correlations between QStat and corresponding ROTEM and TEG measurements were observed (r=0.64-0.88). The concordance between CS results was 84.5% for QStat CS and EXTEM A10 and 83.3% for CS and citrated rapid TEG maximum amplitude. For fibrinogen-related results, concordance was 81.5% for QStat fibrinogen contribution to clot stiffness (FCS) and FIBTEM A10 and 93.8% for FCS and citrated functional fibrinogen maximum amplitude. For fibrinolysis measurements, the overall agreement between QStat clot stability to lysis and EXTEM ML or CK-LY30 was 97.5% and 92.9%, respectively.</p><p><strong>Conclusion: </strong>QStat provides comparable information to the ROTEM <i>delta</i> and TEG 6s in trauma patients and can be useful for diagnosing TIC and guiding treatment. The Quantra's simplicity of use, ability to deploy at the POC, and rapid availability of results may provide clinicians with a faster, more convenient means to assess and manage TIC.</p><p><strong>Level of evidence: </strong>Diagnostic test, level II.</p><p><strong>Trial registration number: </strong>NCT04312958.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001672"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249726","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":"Bite injuries at a level 1 trauma center in Germany.","authors":"Christina Polan, Steffen C Kraus, Monika Herten, Heinz-Lothar Meyer, Bastian Mester, Gero Hilken, Marcel Dudda, Max Daniel Kauther, Manuel Burggraf","doi":"10.1136/tsaco-2024-001613","DOIUrl":"10.1136/tsaco-2024-001613","url":null,"abstract":"<p><strong>Background: </strong>Bite injuries are a common occurrence and may result in significant morbidity. The aim of the study was to investigate bite injuries, their treatment, and consequences in the urban milieu of a European industrialized nation.</p><p><strong>Methods: </strong>A retrospective, monocentric analysis was conducted on data of bite injuries during the study period from 2010 to 2020. Factors such as age, sex, vaccination status, injury pattern, injury location, the duration of treatment in outpatient, inpatient, or intensive care settings were investigated together with radiological, laboratory, and microbiological parameters, as well as the therapies employed.</p><p><strong>Results: </strong>The majority of the included 442 patients were between the ages of 20 and 50, with a mean age of 37.2±18.4 years (0.7-91). The female sex was more frequently affected (59%). Most bite injuries were caused by dogs (49.9%), followed by cats (36.1%) and humans (9.8%) and were often caused by domestic animals (78%). The hand was the most common site of bites (n=251), followed by the forearms (n=75) and lower legs (n=43). In children under the age of 10, the head was the most common site of bites. In only 5% of patients, injuries extended to deeper structures. Wound infection was observed in 14.7% of the bite wounds. The mean number of treatment days for patients with infected bite wounds was significantly higher than that for patients with non-infected wounds, regardless of whether they were outpatients, inpatients, or intensive care patients (p=0.001, p<0.001, and p=0.003, respectively).</p><p><strong>Conclusions: </strong>In accordance with the severity of the injury, a prompt examination, imaging, laboratory diagnostics, and individualized therapy are required. The implementation of an early therapeutic regimen comprising debridement and irrigation, calculated antibiotic therapy, and immobilization can effectively mitigate the risk of developing a fulminant wound infection. Similarly, bite wounds caused by exotic species are to be treated with haste and precision.</p><p><strong>Level of evidence: </strong>Level III study: non-experimental descriptive studies.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001613"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209630","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":"Subdural hematomas and medical malpractice in the USA: an analysis of 314 patients.","authors":"Isabella L Pecorari, Sayak Ghosh, Anne Lally, Vijay Agarwal","doi":"10.1136/tsaco-2024-001462","DOIUrl":"10.1136/tsaco-2024-001462","url":null,"abstract":"<p><strong>Introduction: </strong>Subdural hematomas (SDHs) are a serious condition that can lead to high rates of morbidity and mortality. Given the prevalence of malpractice in healthcare, particularly among physicians who treat patients with high-risk conditions, the aim of this study was to analyze factors that impact litigation outcomes in cases pertaining to SDH.</p><p><strong>Methods: </strong>The online legal database, Westlaw Edge, was used to identify cases related to malpractice and SDH between 1977 to 2023. Plaintiff demographics, geographic location, defendant specialties, reason for litigation, and trial outcomes were obtained.</p><p><strong>Results: </strong>Three hundred and fourteen cases were included in the analysis. The most common reason for litigation was negligent care in a healthcare setting resulting in SDH (55.4%), followed by failure to diagnose (47.1%). Trauma (74.8%) was the most common cause of SDH. The most frequently cited defendants were emergency medicine physicians (76.4%). Most cases ended in a jury verdict in favor of the defense (64.5%). The only factor that was associated with a significantly higher rate of plaintiff compared with defendant verdicts was premature hospital discharge (p=0.007). The mean settlement was $658 741.65, whereas the mean plaintiff verdict payment was $4402 261.63.</p><p><strong>Conclusion: </strong>Emergency medicine physicians are the most likely specialty to be sued in cases of SDH. Failure to diagnose and negligent care resulting in a subdural bleed are the most common reasons for litigation pertaining to this condition. Juries are more likely to return a verdict in favor of the defense. However, settlements are often less costly for defendants in comparison to the payouts of cases that were ruled in favor of the plaintiff.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001462"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209631","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 stabilization of rib fractures in conjunction with veno-venous ECMO for traumatic chest wall injury: a multi-institutional case series from the Chest Wall Injury Society (CWIS).","authors":"John A Farag, Daniel Stoltz, Stephanie Jensen, Sean Dieffenbaugher, Aneyesis D Gonzalez-Suarez, Samuel Ross, Gaurav Sachdev, Amer Afaneh, Jamie Tung, Joseph D Forrester","doi":"10.1136/tsaco-2024-001658","DOIUrl":"10.1136/tsaco-2024-001658","url":null,"abstract":"<p><strong>Introduction: </strong>Rib fractures are prevalent in 10% of blunt injury admissions and contribute significantly to trauma-related mortality. Severe cases, such as flail segments or multiple displaced fractures, frequently necessitate surgical stabilization of rib fractures (SSRF) to mitigate pain and improve outcomes. Pulmonary contusions, present in about 25% of chest wall injuries, can be exacerbated by severe rib fractures, leading to acute respiratory distress syndrome. These cases can lead to a combination of therapies-SSRF and veno-venous extracorporeal membrane oxygenation (VV-ECMO)-that is rarely reported and without guidelines. Here we present the identified cases of patients undergoing SSRF on VV-ECMO highlighting the potential synergy of these two therapies to achieve favorable outcomes.</p><p><strong>Methods: </strong>The Chest Wall Injury Society queried its membership to identify cases where both SSRF and VV-ECMO were used concurrently. Five patients from three trauma centers were identified. Data on patient demographics, injury mechanisms, treatment timelines, and outcomes were collected. Descriptive analysis was planned given the low number of anticipated patients. IRB approval was sought and determined exempt by the Stanford IRB as no identifiable information was presented.</p><p><strong>Results: </strong>The cohort comprised five male patients aged 20-50s, primarily injured in vehicular collisions. Median Injury Severity Score was 34. Median number of fractured ribs was 11 (range: 9-15) and four patients had clinical flail chest. ECMO cannulation occurred on median day 0, and SSRF was performed on median day 4 postinjury. Median duration of ECMO was 19 days, and hospital stay was 49 days. All patients underwent tracheostomy, and four developed pulmonary infections. Despite these complications, all patients survived, with three discharged home and two to skilled nursing facilities. No rib-related readmissions were reported.</p><p><strong>Conclusion: </strong>Integration of SSRF and VV-ECMO presents a viable therapeutic strategy for severely injured trauma patients. Although further research is needed, this approach holds promise for improving outcomes in selected patients.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001658"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209632","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 those at risk: predicting patient factors associated with worse EGS outcomes.","authors":"Komal Abdul Rahim, Namra Qadeer Shaikh, Maryam Pyar Ali Lakhdir, Asma Altaf Hussain Merchant, Noreen Afzal, Saad Bin Zafar Mahmood, Saqib Kamran Bakhshi, Mushyada Ali, Zainab Samad, Adil H Haider","doi":"10.1136/tsaco-2024-001690","DOIUrl":"10.1136/tsaco-2024-001690","url":null,"abstract":"<p><strong>Background: </strong>Comorbidity has a detrimental impact on Emergency General Surgery (EGS) outcomes. In lesser-developed countries with inconsistent documentation of comorbid conditions, undiagnosed and progressively worsening comorbidities can worsen EGS outcomes. We aimed to discern the comorbidity index as a predictor of complications and inpatient mortality in EGS using a large South Asian sample population.</p><p><strong>Materials and methods: </strong>Data of adult patients with AAST-defined EGS diagnoses at primary index admission from 2010 to 2019 were retrieved. Patients were categorized into predefined EGS groups using ICD-9 CM codes. Primary exposure was comorbidity using the Charlson Comorbidity Index (CCI). The primary outcome was inpatient mortality, and the secondary outcome was complication status. Multiple logistic and Cox regression with Weibull distribution was performed.</p><p><strong>Results: </strong>Analysis of 32 280 patients showed a mean age of 40.06±16.87 years. Overall comorbidity, inpatient mortality, and complication rates were 44.6%, 2.42% and 36.37%, respectively. Patients with moderate CCI had the highest complications (AOR 6.61, 95% CI 5.91, 7.37), and severe comorbidity had the highest hazards (AOR 3.79, 95% CI 2.89, 4.98). Male gender, increasing age, emergent admission status, and lack of insurance were associated with moderate and severe CCI, resulting in prolonged length of stay (5.72 and 5.83 days), reduced survival time (20.04 and 21.95 days), and higher mortality rates (10.52% and 9.48%).</p><p><strong>Conclusions: </strong>We identified predictive patient-level factors associated with higher CCI and worse EGS outcomes. Our findings can help stratify population subsets at risk of worse outcomes, provide valuable insight into disease progression, and aid decision-making in EGS patients.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001690"},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180279","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}