World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Chinese Guidelines for the Diagnosis and Surgical Treatment of Adult Obstructive Sleep Apnea (2024).","authors":"","doi":"10.1002/wjo2.70070","DOIUrl":"10.1002/wjo2.70070","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a common chronic disorder characterized by abnormal breathing during sleeping. OSA can damage various organs throughout the body and is burdensome, both socially and economically. Moreover, as OSA has been increasingly studied in recent years, new evidence-based guidelines for its diagnosis and surgical treatment are needed. A working group responsible for establishing Guidelines for the Diagnosis and Surgical Treatment of Adult OSA, the Otolaryngology Branch of the Chinese Medical Association (Subspecialty Group of Laryngopharyngology and Voice) and the Editorial Board of the Chinese Journal of Otorhinolaryngology Head and Neck Surgery partnered to formulate the \"Chinese Guidelines for the Diagnosis and Surgical Treatment of Adult Obstructive Sleep Apnea (2024)\" to ultimately standardize clinical decision-making. We searched or performed systematic reviews of currently available evidence and graded the evidence to provide recommendations for 10 important clinical issues. The aim of these guidelines was to improve the diagnosis and surgical treatment of adult OSA in China and therefore reduce the social and economic burden of OSA.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"12 3","pages":"265-297"},"PeriodicalIF":1.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13205930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044139","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":"Active Emergency Management of Adult Acute Epiglottitis: An Analysis of 570 Cases.","authors":"Bo-Jun Shen, Xu-Lan Tang, Chun-Yan Li, Yang-Jun Liu, Hong-Liang Yi, Shan-Kai Yin, Kai-Ming Su, Su-Ru Liu","doi":"10.1002/wjo2.70082","DOIUrl":"10.1002/wjo2.70082","url":null,"abstract":"<p><strong>Objective: </strong>Acute epiglottitis, which is primarily caused by bacterial infection, can quickly progress to life-threatening airway obstruction. The first 24 h after symptom onset is a critical window for management. However, few studies have evaluated the effect of emergency management during this period or have identified the factors that influence treatment outcomes.</p><p><strong>Subjects and methods: </strong>This retrospective study includes a cohort of patients diagnosed with acute epiglottitis between December 2012 and December 2022. Patients are categorized based on whether they received improved emergency management. Medical records are systematically reviewed to assess the effect of emergency management and inflammatory markers on prognosis and length of hospitalization, as well as the risk factors for airway intervention.</p><p><strong>Results: </strong>In total, 570 patients are included. The number of acute epiglottitis cases each year keeps stable from 2012 to 2022. After implementation of improved emergency management, both mortality and hospital stay significantly decreased (<i>p</i> = 0.020 and <i>p</i> < 0.005, respectively). Hypertension (<i>p</i> = 0.041), diabetes (<i>p</i> = 0.009), epiglottic cysts (<i>p</i> = 0.015), and inflammatory markers are associated with longer hospital stay. Hypertension, diabetes, alcoholism, and high inflammatory marker levels are associated with airway intervention (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The implementation of improved emergency management significantly reduces mortality and hospital stay duration in acute epiglottitis. The presence of epiglottic cysts is associated with a poorer patient prognosis. This study underscores the critical role of optimized emergency care in managing this condition.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585371","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":"ANGPT2 Drives Thyroid Cancer Progression Through PI3K/AKT Signaling and Correlates With Poor Prognosis and Immune Infiltration.","authors":"Han Chen, Lin Wang, Ji-Sheng Zhang, Xu-Dong Yan, Long-Gang Yu, Yan Jiang","doi":"10.1002/wjo2.70089","DOIUrl":"10.1002/wjo2.70089","url":null,"abstract":"<p><strong>Objectives: </strong>Angiopoietin-2 (ANGPT2) is known to participate in tumor progression and immune modulation across multiple malignancies. Nevertheless, its expression pattern, prognostic value, and biological function in thyroid cancer (THCA) have not been comprehensively investigated.</p><p><strong>Methods: </strong>An integrative analysis using multiple public databases was conducted to evaluate the expression pattern, prognostic value, and potential functional pathways associated with ANGPT2 in THCA. Experimental validation was performed using human THCA tissues and TPC-1 cell lines. Quantitative PCR, Western blotting, and multiplex immunofluorescence were used to assess ANGPT2 expression and its correlation with immune infiltration. Stable ANGPT2-overexpressing TPC-1 cells were constructed, and functional assays, including CCK-8, wound healing assay, and Western blotting, were employed to evaluate proliferation and migration.</p><p><strong>Results: </strong>ANGPT2 was significantly upregulated in THCA tissues compared with normal thyroid tissues (median transcript per million: 3.29 vs 3.13, <i>p</i> < 0.001) and associated with poor overall survival (HR = 5.37, 95% CI: 1.22-23.63, <i>p</i> = 0.013) and relapse-free survival (HR = 2.76, 95% CI: 1.11-6.87, <i>p</i> = 0.023). Bioinformatics analysis suggested involvement in immune regulation and PI3K/AKT signaling. Experimental validation confirmed a positive correlation between ANGPT2 expression and CD4⁺ T cells infiltration (<i>r</i> = 0.69, <i>p</i> = 0.03). Functional studies revealed that ANGPT2 overexpression significantly enhanced THCA cell proliferation and migration, accompanied by upregulation of MMP2 and MMP9. These effects were partially reversed by the PI3K phosphorylation inhibitor Pilaralisib, indicating that ANGPT2 may promote tumor progression through PI3K/AKT-dependent mechanisms.</p><p><strong>Conclusions: </strong>ANGPT2 promoted thyroid cancer cell proliferation and migration through activation of the PI3K/AKT signaling pathway, and was closely linked to altered immune cell infiltration. Its overexpression was associated with unfavorable prognosis, underscoring its potential as both a prognostic biomarker and a therapeutic target in thyroid cancer.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585408","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":"Extensive Subcutaneous Emphysema and Pneumomediastinum Following Eustachian Tube Dilation and PET Insertion: A Rare Complication.","authors":"Mihai A Bentan, Nam K Lee, Scott E Mann, Emily Ambrose","doi":"10.1002/wjo2.70086","DOIUrl":"10.1002/wjo2.70086","url":null,"abstract":"<p><strong>Introduction: </strong>Eustachian tube dilation (ETD) is an increasingly popular and seemingly safe method of treating ETD. We present a rare case of subcutaneous emphysema and pneumomediastinum following ETD.</p><p><strong>Methods: </strong>Retrospective chart review. Patient consent was obtained for data collection, analysis, drafting, and publication of information.</p><p><strong>Results: </strong>A 33-year-old male presented to the emergency department with acute facial swelling 1 day after treatment for bilateral eustachian tube dysfunction with bilateral ETD and pressure equalization tube (PET) insertion by an otolaryngologist at an outside facility. Symptoms began after he tried to pop his ears. He had extensive crepitus throughout his face, neck, and chest bilaterally with intact and patent PETs. Flexible laryngoscopy revealed a patent airway and no evidence of mucosal injury. Computed tomography demonstrated extensive subcutaneous emphysema extending from the chest to the skull base along with pneumomediastinum. The patient was admitted for observation given these findings and ultimately discharged without requiring any surgical intervention. No recurrent symptoms were noted in the subsequent post-operative period.</p><p><strong>Discussion: </strong>This case illustrates a rare but important complication of ETD, where mucosal injury within the Eustachian tube likely facilitated air dissection into deep cervical and mediastinal fascial planes. While subcutaneous emphysema and pneumomediastinum are typically self-limiting, awareness of anatomical pathways, appropriate imaging, and conservative management strategies are essential for optimal patient care. As ETD gains wider acceptance, further research is needed to characterize risk factors and preventative measures for these complications.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585438","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":"Morphological Sinus Features and Chronic Rhinosinusitis Risk: A Radiomics Study.","authors":"Song Luo, Xiang-Hai Hu, Min Yin, Song Li, Lei Cheng","doi":"10.1002/wjo2.70081","DOIUrl":"10.1002/wjo2.70081","url":null,"abstract":"<p><strong>Objectives: </strong>Anatomical factors of the sinuses significantly impact the progression of chronic rhinosinusitis (CRS). This study aims to investigate the correlation between morphological sinus features and the risk of CRS onset to provide evidence-based support for clinical management.</p><p><strong>Methods: </strong>This multicenter study enrolled 716 CRS patients and 115 healthy individuals from January 2019 to December 2023. CRS patients were categorized into eosinophilic CRS (eCRS) and non-eosinophilic CRS (NeCRS) based on pathological results. The deep learning model nnU-Net v2 was trained for automated segmentation of sinuses. Morphological features were extracted and then screened using PyRadiomics. Subsequently, logistic regression, random forest, and multi-layer perceptron (MLP) were used to build CRS risk and subgroup evaluation models.</p><p><strong>Results: </strong>CRS patients exhibited larger sinus volumes, surface areas, and multiple 2D/3D diameters compared to healthy individuals, while sphericity of maxillary and sphenoid sinuses was lower. A CRS risk prediction model was built using 20 morphological indicators. In the test cohort, the AUC values for the logistic regression, random forest, and MLP models were 0.884 (95% CI: 0.818-0.938), 0.890 (95% CI: 0.819-0.963), and 0.888 (95% CI: 0.822-0.952), respectively. Subgroup analysis showed that, although 18 indicators were selected for predicting the risk of CRS subtypes, the performance of all three models was relatively poor.</p><p><strong>Conclusions: </strong>Multiple morphological sinus features are closely associated with the risk of CRS and could serve as significant indicators for assessing CRS risk. However, there are no significant differences in sinus morphology between eCRS and NeCRS patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585365","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 BMI on the Differences Between Drug-Induced Sleep Endoscopy and Müller Maneuver.","authors":"Jun-Fang Xue, Hong-Guang Guo, Su-Jeong Lee, Xue-Sheng Li, Kun-Peng Liu, Li-Bin Suo, Jian-Jun Sun","doi":"10.1002/wjo2.70085","DOIUrl":"10.1002/wjo2.70085","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the differences in drug-induced sleep endoscopy (DISE) and Müller Maneuver (MM) results and study the impact of body mass index (BMI) on these differences.</p><p><strong>Study design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>Forty patients with OSAHS were included in this study. All enrolled patients were evaluated for MM and DISE using the Velum, Oropharynx lateral walls, Tongue Base, and Epiglottis (VOTE) classification to describe the type, site, and degree of upper airway collapse.</p><p><strong>Results: </strong>The differences between MM and DISE were statistically significant at the tongue base (<i>p</i> < 0.001) and epiglottis levels (<i>p</i> < 0.001). At the epiglottis level, the differences of identifying severe obstruction between DISE and MM were statistically significant in the BMI < 25 kg/m² (<i>p</i> = 0.033) and BMI 25-30 kg/m² groups (<i>p</i> = 0.049). But for the BMI ≥ 30 kg/m² group, the difference was not statistically significant (<i>p</i> = 0.077).</p><p><strong>Conclusion: </strong>DISE is more sensitive in detecting obstructions of OSAHS at the tongue base and epiglottis levels, especially in non-obese patients. MM could be a reasonable alternative in obese OSAHS patients when DISE is not available.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585501","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":"Decreased Production of Tissue Plasminogen Activator in Endothelial Cells From Nasal Polyps.","authors":"Qian-Qian Zhang, Chen Zhang, Jia-Ni Chen, Fu-Ying Cheng, Yi-Zhang Wang, Shi-Rui Xue, Huan Wang, De-Hui Wang, Xi-Cai Sun, Li Hu","doi":"10.1002/wjo2.70072","DOIUrl":"10.1002/wjo2.70072","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have demonstrated that chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by excessive fibrin deposition which is related to impaired production of tissue plasminogen activator(t-PA) by epithelial cells. This study aims to evaluate whether t-PA expression in endothelial cells is also decreased under the inflammatory milieu of CRSwNP.</p><p><strong>Methods: </strong>Vascularity and proangiogenic genes expression in polyp tissues from eosinophilic CRSwNP (eCRSwNP) and non-eosinophilic CRSwNP (neCRSwNP) were assessed by immunohistochemistry and real-time PCR. Single-cell RNA sequencing data set of CRS, Immunohistochemistry were used. Human primary nasal endothelial cells were stimulated by IL-13 and IFN-γ with or without retinoic acid.</p><p><strong>Results: </strong>We observed the increased expression of proangiogenic genes and vascularity in both eCRSwNP and neCRSwNP. Single-cell RNA sequencing and immunostaining revealed that t-PA expression was decreased in endothelial cells of polyp tissues. In vitro study, IL-13 and IFN-γ could significantly attenuate t-PA expression in endothelial cells, which can be rescued by retinoic acid.</p><p><strong>Conclusions: </strong>Our findings showed a significant contribution of endothelial cells in the production of t-PA in sinonasal tissues. Furthermore, the levels of t-PA in endothelial cells could also be impaired in the inflammatory environment of CRSwNP. Retinoic acid could restore t-PA expression in endothelial cells impaired by inflammatory cytokines (including IL-13 and IFN- γ), thus degrading the deposited fibrin in polyp tissue.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585369","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":"Research Progress on Upper Airway Cough Syndrome.","authors":"Wan-Ting Huang, Jia Chen","doi":"10.1002/wjo2.70073","DOIUrl":"10.1002/wjo2.70073","url":null,"abstract":"<p><p>Upper airway cough syndrome (UACS) has been identified as a significant contributor to chronic cough in various national guidelines. However, the complexity of its pathogenesis, the lack of clarity surrounding its diagnostic criteria, and its overlap with other etiologies of chronic cough present considerable challenges in both diagnosis and treatment. The utilization of nasal and laryngeal endoscopy is crucial in the diagnostic process, and the implementation of a multidisciplinary collaborative approach can markedly enhance diagnostic accuracy and treatment outcomes. This article provides a comprehensive review of the clinical characteristics, diagnostic and therapeutic approaches, and pathophysiological mechanisms associated with UACS, aiming to equip clinicians with a deeper understanding for improved management of this condition.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585416","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":"Distinct Nasal Microbiome Profiles and Prediction Model for Allergic Rhinitis, Nonallergic Rhinitis, and Healthy Children.","authors":"Kantima Kanchanapoomi, Iyarit Thaipisuttikul, Perapon Nitayanon, Witchaya Srisuwatchari, Punchama Pacharn, Nualanong Visitsunthorn, Orathai Jirapongsananuruk","doi":"10.1002/wjo2.70080","DOIUrl":"10.1002/wjo2.70080","url":null,"abstract":"<p><strong>Objectives: </strong>Adult studies reported differences in nasal microbiota composition among patients with allergic rhinitis (AR), nonallergic rhinitis (NAR), and healthy controls (HCs), whereas pediatric data remain limited. This study compared the nasal microbiomes of children with AR, NAR, and HC, investigated factors influencing these microbiomes, and developed a predictive model to differentiate these conditions based on microbiome data.</p><p><strong>Methods: </strong>Nasal swab samples were collected from children with AR, NAR, and HC. Microbial characterization was performed using 16S rDNA sequencing to analyze bacterial composition. Relevant demographic data and influencing factors were collected.</p><p><strong>Results: </strong>Sixty participants (median age 6.3 [4.3-8.4] years, 51.6% males) were categorized into AR (<i>n</i> = 24), NAR (<i>n</i> = 14), and HC (<i>n</i> = 22). Significant differences in alpha and beta diversity were observed among groups (<i>p</i> < 0.01 and <i>p</i> < 0.05, respectively). The AR and NAR groups exhibited lower Pielou's evenness than HC (FDR-adjusted <i>p</i> < 0.01 and <i>p</i> = 0.02, respectively). Compared to HC, the AR group showed a higher abundance of <i>Escherichia-Shigella</i>, <i>Negativicoccus</i>, and <i>Campylobacter</i>. In contrast, <i>Dolosigranulum</i> was enriched while the Enterobacteriaceae family was depleted in the NAR group. Household pets and breastfeeding duration significantly influenced nasal microbiome diversity regardless of the disease groups. A prediction model of nasal microbial distribution for AR, NAR, and HC identified 14 taxa critical for distinguishing these groups (accuracy of 0.83).</p><p><strong>Conclusion: </strong>This pilot study identified preliminary differences in nasal microbiome diversity and composition among children with AR, NAR, and HC. Differential microbial abundances may reflect distinct rhinitis phenotypes. However, these findings are hypothesis-generating and require validation in larger, independent cohorts.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585356","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":"Author Guidelines.","authors":"","doi":"10.1002/wjo2.70083","DOIUrl":"https://doi.org/10.1002/wjo2.70083","url":null,"abstract":"","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 4","pages":"610-617"},"PeriodicalIF":1.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879270","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}