Turkish Journal of Surgery最新文献

{"title":"Examination of the effects of virtual reality glasses and stress ball applications on pain, vital signs, anxiety, fear, satisfaction, and comfort levels during the dressing changes in patients who underwent abdominal surgery.","authors":"Zehra Yanık, Altun Baksi","doi":"10.47717/turkjsurg.2026.2025-10-24","DOIUrl":"10.47717/turkjsurg.2026.2025-10-24","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effects of virtual reality glasses and stress-ball use on pain, vital signs, anxiety, fear, satisfaction, and comfort during dressing changes in patients undergoing abdominal surgery.</p><p><strong>Material and methods: </strong>This research is a randomized experimental study with pretest-posttest control group design. The study was conducted from 8 August to 20 November 2024 in general surgery unit 1 of a city hospital in the Mediterranean Region of Türkiye. A total of 156 patients who underwent abdominal surgery and met the sampling criteria were included in the study: 52 in the virtual reality group, 52 in the stress ball group, and 52 in the control group. Data were collected using the socio-demographic and clinical characteristics form, state-trait anxiety inventory, and visual analog scale.</p><p><strong>Results: </strong>Patients who were given virtual reality glasses and a stress ball during dressing changes reported higher levels of comfort and relaxation than those in the control group. Fear levels during dressing changes were also higher in the virtual reality group than in the other groups. Anxiety levels were lower in the intervention groups (virtual reality and stress ball) compared to the control group. No statistically significant differences were found among the groups with respect to pain, vital signs, or satisfaction.</p><p><strong>Conclusion: </strong>The use of virtual reality glasses and stress balls during dressing changes in patients appears to be effective in enhancing comfort and reducing anxiety.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"42 1","pages":"73-84"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356681","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":"Step-by-step single-port retroperitoneal right hemicolectomy with D3-lymph node dissection for right colon cancer.","authors":"Sergey K Efetov, Polina D Panova, Yaroslav P Krasnov, Alexandra Y Koziy, Yu Cao","doi":"10.47717/turkjsurg.2026.2025-10-29","DOIUrl":"10.47717/turkjsurg.2026.2025-10-29","url":null,"abstract":"<p><p>Minimally invasive right hemicolectomy for colon cancer has demonstrated better outcomes than those of open surgery. However, in certain patients, high body mass index, abdominal adhesions, and concomitant cardiopulmonary disease may limit the use of conventional laparoscopy. The use of the retroperitoneal approach preserves the benefits of the minimally invasive approach and expands the range of surgical options. All major steps were performed without access to the abdominal cavity: mobilization, D3 lymph node dissection and vessels ligation. Supplementary video demonstrates a retroperitoneal approach for right hemicolectomy with D3 lymph node dissection that can solve these challenges.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"140-141"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012318","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":"Potential use of bioresorbable poly-D-L-lactic acid (PDLLA) plates in rhinoseptoplasty.","authors":"Andrey Makarov, Natalya Korableva, Pavel Pavlov, Mikhail Dokhov","doi":"10.47717/turkjsurg.2025.2025-8-19","DOIUrl":"10.47717/turkjsurg.2025.2025-8-19","url":null,"abstract":"<p><strong>Objective: </strong>Bioresorbable poly-D-L-lactic acid (PDLLA) plates are increasingly used in rhinoseptoplasty due to their biocompatibility, adequate initial mechanical strength, and complete resorption over time. These properties may offer advantages over permanent implants, particularly in complex cases involving post-traumatic nasal deformity. To evaluate the clinical efficacy and safety of PDLLA plates in achieving functional and aesthetic outcomes in primary and reconstructive rhinoseptoplasty.</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted on 37 consecutive patients [23 men, 14 women; median age 37 years, interquartile range (IQR) 30-44] who underwent rhinoseptoplasty between January 2022 and December 2024. The minimum follow-up was 3 months. Primary endpoints included septal stability, complication profile (e.g., infection, extrusion, resorption issues), and patient-reported outcomes. Subjective nasal appearance and symptom burden were assessed using the validated Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). In select cases requiring revision, histopathological evaluation of implantation sites was performed at 12 and 24 months.</p><p><strong>Results: </strong>He use of pure PDLLA plates provided reliable septal stabilization and facilitated precise dorsal alignment, eliminating the need for autologous graft harvesting in 83.8% of cases. No plate-related infections, extrusions, or delayed resorption events were observed. Patient-reported symptom burden, as measured by the SCHNOS score, improved markedly from a median of 21 (IQR: 15-26) preoperatively to 1 (IQR: 0-1) postoperatively. Histology confirmed complete material resorption by 24 months, with mature collagenous remodeling and an absence of chronic inflammatory infiltrate.</p><p><strong>Conclusion: </strong>In carefully selected patients, PDLLA plates appear to be a biocompatible and technically feasible adjunct in rhinoseptoplasty, facilitating septal reconstruction, eliminating donor-site morbidity, and yielding improvements in both patient-reported nasal function and aesthetic outcomes. These preliminary findings support further investigation in larger, controlled studies.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"131-139"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913256","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":"Early-onset colorectal cancer in pediatric patient.","authors":"Sarp Tunalı, Kamil Erözkan, Yiğit Türk, Ülgen Çeltik, Osman Bozbıyık","doi":"10.47717/turkjsurg.2026.2025-11-4","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2025-11-4","url":null,"abstract":"<p><p>The incidence of early-onset colorectal cancer is rising, largely driven by underlying genetic mutations. While many countries have implemented screening programs for individuals under 45 years of age, colorectal cancer in pediatric patients remains exceedingly rare and often unexpected. As a result, children diagnosed with colorectal cancer frequently present with advanced-stage disease, commonly due to obstructive symptoms. In this case report, we describe the clinical presentation and management of a 17-year-old female patient who was admitted with an obstructing tumor at the splenic flexure.A 17-year-old girl with cerebral palsy was referred to our center with a 10-day history of obstructive symptoms. She had a four-month history of constipation with multiple hospital admissions. Following an evaluation by the pediatric surgery team in the emergency department, a computed tomography scan was performed, revealing a 4 cm tumor at the splenic flexure with signs of obstruction and suspected metastatic mesenteric lymphadenopathy. Once the diagnosis was confirmed, the pediatric surgery team referred the patient to the colorectal surgery team. The colorectal surgeons recommended laparotomy, which was performed through a midline incision. An extended left hemicolectomy with a Mikulicz colostomy was carried out. The patient was discharged on postoperative day 7 without complications. Histopathological analysis revealed mucinous adenocarcinoma with 17 metastatic lymph nodes out of 42 harvested. No BRAF, KRAS, or NRAS mutations were detected; mismatch repair protein expression was intact. Genetic counseling identified a variant of uncertain significance in the <i>ATM</i> gene. The patient was subsequently referred for adjuvant chemotherapy. Pediatric-onset colorectal cancer should be considered in the differential diagnosis of children presenting with persistent gastrointestinal symptoms, as delayed recognition may lead to advanced disease. Genetic counseling plays a crucial role in management, underscoring the need for surgeon awareness and multidisciplinary collaboration.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early endoscopic evaluation of the ileal pouch after ulcerative colitis surgery.","authors":"Gürel Neşşar","doi":"10.47717/turkjsurg.2026.2025-10-5","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2025-10-5","url":null,"abstract":"<p><p>Surgical treatment of the ulcerative colitis is abdominal procto-colectomy and ileal pouch anal anastomosis. A J-shaped pouch is created from the terminal ileum to serve as a reservoir function of the rectum. Early endoscopic evaluation of the pouch can predict surgical complications and the long-term pouch outcome. The owl's eyes image in the proximal part of the pouch is an indicator that it is technically well constructed.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed gastric emptying associated with <i>Strongyloides stercoralis</i> infection and pancreatic adenocarcinoma.","authors":"Özgür Aktaş, Gizem Yasa, Oğuz Usta, Sidar Çöpür, Burcu Saka, Yeşim Beşli, Duygu Karahacıoğlu, Gürkan Tellioğlu, Önder Ergönül","doi":"10.47717/turkjsurg.2025.2025-4-39","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-4-39","url":null,"abstract":"<p><p>We present a rare case of co-occurrence of <i>Strongyloides stercoralis</i> (<i>S. stercoralis</i>) infection and newly diagnosed pancreatic adenocarcinoma in a 71-year-old female who presented with new-onset jaundice and right upper quadrant abdominal pain. The patient had eosinophilia, recurrent Escherichia coli cholangitis, and a strong family history of jaundice in an endemic region. <i>S. stercoralis</i> larvae were identified on histopathological examination following pancreaticoduodenectomy. Notably, ivermectin treatment attenuated the delayed postoperative gastric emptying that had not responded to conventional management, including nasogastric decompression or drainage of a perigastric collection. While <i>S. stercoralis</i> can cause obstructive jaundice and pancreatic masses, this case highlights the importance of considering parasitic infections in patients from endemic areas or with immunosuppressive conditions who present with abdominal symptoms, particularly to avoid unnecessary interventions and prevent clinical deterioration.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic profiling and pathway analysis in bladder carcinoma: Implications for therapeutic targeting.","authors":"Sampara Vasishta, Usha Sachidananda Adiga, Alfred J Augustine","doi":"10.47717/turkjsurg.2025.2025-3-33","DOIUrl":"10.47717/turkjsurg.2025.2025-3-33","url":null,"abstract":"<p><strong>Objective: </strong>Bladder carcinoma represents a significant challenge in oncology due to its heterogeneous molecular nature. This study aimed to identify key genetic factors and molecular pathways involved in bladder carcinoma pathogenesis to facilitate the development of targeted therapies.</p><p><strong>Material and methods: </strong>The top 30 genes associated with bladder carcinoma were retrieved from the disease gene network database. Comprehensive bioinformatic analysis was performed using various enrichment tools, including gene ontology biological process, cellular component, molecular function analyses, and pathway mapping through WikiPathways and metabolite associations through human metabolome database. Drug interactions were evaluated using DrugMatrix data.</p><p><strong>Results: </strong>Gene ontology analysis revealed significant enrichment of cancer-related biological processes, cellular components, and molecular functions. Pathway analysis identified strong associations with head and neck squamous cell carcinoma, cancer pathways, pleural mesothelioma, endometrial cancer, and bladder cancer pathways. Key genes including <i>CDKN2A, PTEN, EGFR, PIK3CA, HRAS, FGFR3</i>, and <i>TP53</i> were implicated across multiple pathways. Metabolite analysis showed significant associations with phosphatidylinositol derivatives, highlighting the importance of the PI3K pathway. Drug interaction analysis revealed potential modulatory effects of several compounds including sertraline, valproic acid, and hydroxyurea on gene expression patterns in bladder carcinoma.</p><p><strong>Conclusion: </strong>This study provides comprehensive insights into the molecular underpinnings of bladder carcinoma, highlighting interconnected pathways and potential therapeutic targets. The significant overlap with other cancer types suggests common oncogenic mechanisms that could be exploited for therapeutic intervention. Further validation of these findings in clinical samples may facilitate the development of personalized treatment approaches for bladder carcinoma patients.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"437-447"},"PeriodicalIF":0.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733476","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":"<i>De novo</i> malignancy development following kidney transplantation: Managing risks and outcomes in clinical practice.","authors":"Amil Huseynov, Sevim Nuran Kuşlu Çiçek","doi":"10.47717/turkjsurg.2025.2025-4-34","DOIUrl":"10.47717/turkjsurg.2025.2025-4-34","url":null,"abstract":"<p><strong>Objective: </strong><i>De novo</i> malignancy is a significant complication following kidney transplantation, attributed to prolonged immunosuppression. This study evaluates the incidence, risk factors, and clinical outcomes of <i>de novo</i> malignancies in kidney transplant recipients.</p><p><strong>Material and methods: </strong>A retrospective cohort analysis was conducted on 1200 kidney transplant recipients between 2016 and 2023. Patients were categorized based on the presence or absence of <i>de novo</i> malignancies. Statistical analyses were performed to identify risk factors, including age, sex, comorbidities, and immunosuppressive regimens. Patient and graft survival were assessed using Kaplan-Meier analysis and the log-rank test.</p><p><strong>Results: </strong>Among the study population, 43 patients (3.6%) developed <i>de novo</i> malignancies. The most frequent malignancy types were non-melanoma skin cancers (27.9%) and post-transplant lymphoproliferative disorders (18.6%). Patients with malignancies exhibited a lower three-year survival rate (83.7%) compared to those without malignancies (91.4%), though the difference was not statistically significant (p=0.067). Graft survival at three years was slightly lower in the malignancy group (84.0% vs. 88.7%, p=0.146). Older recipient age was identified as a significant risk factor (hazard ratio=1.03 per year, p=0.025).</p><p><strong>Conclusion: </strong><i>De novo</i> malignancy remains a concern in kidney transplant recipients, particularly among older patients. Regular screening protocols, lifestyle interventions, and individualized immunosuppressive regimens are essential to mitigate risk and improve outcomes.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 4","pages":"369-373"},"PeriodicalIF":0.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702002","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 impact of the COVID-19 pandemic on the diagnosis and surgical treatment processes of gastric cancer.","authors":"Ekin Ulusoy, Volkan Sayur, Sarp Tunalı, Bahadır Emre Baki, Bekir Çetin, Özgür Fırat, Muhtar Sinan Ersin, Taylan Özgür Sezer","doi":"10.47717/turkjsurg.2025.2025-4-9","DOIUrl":"10.47717/turkjsurg.2025.2025-4-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of the coronavirus disease-2019 (COVID-19) pandemic on the diagnostic and surgical treatment processes of gastric cancer. Three-year periods before and after the pandemic were compared to examine differences in the diagnostic process, disease stage, surgical extent, and survival.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 395 patients who underwent resection surgery for gastric cancer between March 11, 2017, and March 11, 2023. Patients with incomplete data regarding the diagnostic and treatment processes, those deemed inoperable following exploratory surgery and subsequently referred for alternative treatment, and patients operated on at external centers were excluded. A total of 197 patients were analyzed and divided into two groups: pre-pandemic (PP, n=137) and post-pandemic (PS, n=60).</p><p><strong>Results: </strong>A significant decrease in the number of surgeries was observed in the PS group compared to the PP group. Significant differences were found between the two groups regarding locally advanced disease at diagnosis (T4/N+), the application rate of cytoreductive surgery+hyperthermic intraperitoneal chemotherapy, and follow-up mortality (p=0.031, p=0.028, and p=0.005). The overall mean survival was 50.02±2.78 months in the PP group and 32.52±2.24 months in the PS group (p=0.765). No significant differences were observed between the groups regarding the diagnostic process and pathological stages.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic may have reduced both the referral rates for surgery and the extent of surgical interventions for advanced-stage gastric cancer. It is believed that both surgeons and patients adopted more conservative approaches during the pandemic.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 4","pages":"391-397"},"PeriodicalIF":0.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701972","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":"Transfusion requirements as a surrogate marker of mortality and morbidity in adults with severe burns: A retrospective cohort study.","authors":"Ayten Saraçoğlu, Sezer Yakupoğlu, Mariah Arif, Ezgi Hatip Ünlü, Nouran El Tantawi, Amgad M Elshoeibi, Tahsin Şimşek, Gaye Filinte, Kemal T Saraçoğlu","doi":"10.47717/turkjsurg.2025.2025-6-29","DOIUrl":"10.47717/turkjsurg.2025.2025-6-29","url":null,"abstract":"<p><strong>Objective: </strong>Although blood transfusion is necessary for addressing anemia, coagulopathy, and systemic inflammation, transfusions also carry risks that may influence morbidity and mortality. This study, of patients with burns treated at a tertiary care centre, was conducted from October 2024 to May 2025. It aimed to investigate the association between blood and blood product transfusion requirements and clinical outcomes in adult patients with severe burns. Additionally, the study identified other predictors of mortality, and examined the prognostic role of common biochemical markers and complications in determining patient outcomes.</p><p><strong>Material and methods: </strong>This retrospective cohort study analyzed 82 eligible adult patients with burns. Patients were considered eligible if they were 18 years of age or older, were admitted for acute burn injury and had complete clinical and laboratory data. Demographic, clinical, laboratory, and transfusion data were retrieved from electronic medical records. Cox proportional hazards regression was used to identify independent predictors of mortality, while Kaplan-Meier analysis assessed survival trends.</p><p><strong>Results: </strong>Participants were grouped into survivors (n=33) and non-survivors (n=49). Non-survivors required higher total volume of red blood cells (11 vs. 6 units), fresh frozen plasma (11 vs. 5 units), and platelets (4 vs. 0 units), particularly in the intensive care unit (ICU) setting. Compared to survivors, non-survivors also had elevated creatinine levels, lower platelet counts, and higher rates of complications such as pneumonia and dialysis. Cox regression confirmed total body surface area burned as the strongest independent predictor of mortality.</p><p><strong>Conclusion: </strong>High transfusion requirements in the ICU are associated with increased mortality in patients with severe burns and may serve as a surrogate marker for disease severity. These findings support the need for restrictive, individualized transfusion strategies and underscore the importance of integrating transfusion parameters into early risk assessment and prognostic models in burn care.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"355-362"},"PeriodicalIF":0.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303538","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}