World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Vascular Control-Focused Surgical Strategy for Pterygopalatine and Infratemporal Fossa Tumors Using Multimodal Image Fusion Reconstruction.","authors":"Zi-Cheng He, Nian-Zhen Zheng, Yong-Quan Wang, Jia-Rui Jiang, Chun-Wei Li, Jian Li","doi":"10.1002/wjo2.70163","DOIUrl":"10.1002/wjo2.70163","url":null,"abstract":"<p><strong>Objective: </strong>To classify tumor-internal maxillary artery (IMA) spatial relationships in pterygopalatine and infratemporal fossa (PPF/ITF) tumors, develop a 3D fusion-guided vascular control-focused surgical strategy, and evaluate its clinical impact.</p><p><strong>Methods: </strong>Seventeen patients were prospectively enrolled in the 3D fusion-guided vascular control-focused strategy (VCFS) group, while 41 patients were retrospectively enrolled in the conventional strategy group. Multimodal imaging data were used to generate patient-specific 3D models to classify tumor-IMA spatial relationships and guide surgical planning under the VCFS framework. Surgical outcomes were compared using stabilized inverse probability of treatment weighting (sIPTW).</p><p><strong>Results: </strong>Compared to the conventional strategy, the VCFS significantly reduced blood loss (200 vs. 800 mL; <i>p</i> = 0.037), decreased complications (33.8% vs. 74.3%; <i>p</i> = 0.017), improved complete resection rates (94.7% vs. 32.7%; <i>p</i> < 0.001), but prolonged operative time (4.5 h vs. 3.0 h; <i>p</i> = 0.005). Hospital stay was similar.</p><p><strong>Conclusions: </strong>Multimodal imaging-based classification of tumor-IMA relationships and application of the VCFS were associated with improved short-term surgical outcomes in patients with PPF/ITF tumors.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841437","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":"Generative AI and Clinicians Show Comparable Prognostic Reasoning From Clinical Narratives in Biologic-Treated CRSwNP.","authors":"Sholem Hack, Chase Kahn, Ainhoa Garcia-Lliberos, Cristina Rodriguez-Prado, Ameen Biadsee, Maxime Fieux, Mark Liu, Eran Glikson, Masayoshi Takashima, Omar G Ahmed, Raj Sindwani, Dennis M Tang, Christopher R Roxbury","doi":"10.1002/wjo2.70164","DOIUrl":"10.1002/wjo2.70164","url":null,"abstract":"<p><strong>Objective: </strong>To compare the ability of large language models (LLMs) and otolaryngologists to identify prognostic signals from brief clinical vignettes in CRSwNP.</p><p><strong>Methods: </strong>In this blinded study, 68 adults initiating biologic therapy for CRSwNP (≥ 36 months follow-up) were represented by standardized vignettes derived from documentation immediately before biologic initiation. Vignettes summarized symptoms, prior surgery, comorbidities, and medications. Biomarkers, imaging scores, smell testing, and follow-up data were excluded to isolate text-based prognostic reasoning under identical constraints. Five attending otolaryngologists, one rhinology fellow, and two residents independently predicted four 5-year outcomes: subsequent endoscopic sinus surgery, recurrent systemic steroid bursts, biologic switch, and a composite endpoint. Multiple LLMs were queried in identical zero-shot format across three sessions to assess stability. Predictions were compared with verified outcomes using accuracy, sensitivity, specificity, F1 score, Cohen's κ, and Matthews correlation coefficient.</p><p><strong>Results: </strong>Five-year outcome prevalences were 38.2% (26 of 68) for subsequent sinus surgery, 26.5% (18 of 68) for steroid bursts, 14.7% (10 of 68) for biologic switch, and 58.8% (40 of 68) for composite failure. Macro-averaged LLM accuracies ranged from 65.0% to 76.1%, compared with 65.7% ± 7.4% for human raters. The best-performing LLM achieved accuracy comparable to the top attending. Both groups showed higher negative than positive predictive values, indicating better discrimination for patients without adverse events. Agreement between LLMs and clinicians was moderate and within the range of inter-clinician variability.</p><p><strong>Conclusion: </strong>When restricted to short pretreatment text, LLMs produced prognostic judgments within the range of clinician variability for severe, biologic-treated CRSwNP outcomes. These findings suggest that in information-limited settings, LLMs may provide an auxiliary reasoning signal rather than a standalone decision tool.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841426","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":"Immune Clues to Sinus Blues: Linking Biomarkers to Radiologic Score of Rhinosinusitis.","authors":"Lubna Khreesha, Amer Sawalha, Mohammad Darweesh, Qusai Elfadel, Mohammad Alzoubi, Saif Alhawadi, Faris Alsawair, Fares Habboub, Bashar Alsmady, Mohammad Aljarboa, Hashim Alhammouri","doi":"10.1002/wjo2.70141","DOIUrl":"10.1002/wjo2.70141","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a prolonged inflammatory condition of the nasal and paranasal sinuses that significantly affects quality of life. This study examines the relationship between CRS severity (based on Lund-Mackay [LM] scores), osteitis, and systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), eosinophil-to-lymphocyte ratio (ELR), and the systemic immune inflammation index (SII).</p><p><strong>Methods: </strong>A retrospective analysis of 208 CRS patients (with or without nasal polyps) who underwent FESS at Jordan University Hospital was performed. Patients were stratified by LM scores into three groups from lowest to highest scores. Inflammatory markers were compared using non-parametric statistical tests.</p><p><strong>Results: </strong>ELR showed the strongest correlation with radiological CRS severity (<i>p</i> < 0.0001) overall. BLR (<i>p</i> = 0.0043) and MLR (<i>p</i> = 0.0199) also showed significant differences, while NLR and PLR did not. ELR was significantly higher in group 3 with the highest Lund-MacKay score for CRS and posterior ethmoid and sphenoid sinus involvement. In patients without nasal polyposis, all markers except MLR showed significant differences with <i>p</i> < 0.05.</p><p><strong>Conclusions: </strong>ELR is a promising, non-invasive biomarker for assessing CRS severity, especially in patients without nasal polyps. It may help evaluate disease burden when imaging is unavailable, offering a cost-effective tool in clinical practice and a valuable addition to the current management protocol for chronic rhinosinusitis treatment guidelines in low- and middle-income countries.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833241","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":"Letter to the Editor in Regards to \"The Characteristics of Sinonasal Inverted Papilloma and Recurrence Factors: An Analysis of 207 Cases\".","authors":"Valli Rajasekaran, Preethi Ekambaram","doi":"10.1002/wjo2.70117","DOIUrl":"10.1002/wjo2.70117","url":null,"abstract":"","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814392","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":"Personalized Surgery for Allergic Fungal Rhinosinusitis.","authors":"Erin E Briggs, Zachary M Soler, Asher T Ripp, Ryan A Durgham, Shabih H Jafri, Alexander N Duffy, Vinay K Rathi, Rodney J Schlosser","doi":"10.1002/wjo2.70161","DOIUrl":"10.1002/wjo2.70161","url":null,"abstract":"<p><strong>Background: </strong>Allergic fungal rhinosinusitis (AFRS) frequently presents as unilateral or asymmetric disease. In cases with minimal disease on one side, the question remains as to the necessary extent of surgery.</p><p><strong>Objective: </strong>To determine the relationship between symmetry and clinical characteristics in AFRS patients, with a focus on implications for surgical management.</p><p><strong>Methods: </strong>Patients with AFRS managed surgically at the Medical University of South Carolina from 2012 to 2024 were reviewed. Disease severity was categorized by Lund-Mackay (LM) scoring system, as no/mild (LM < 4) or moderate/severe (LM ≥ 4) per side. Asymmetry was defined as a LM score difference of > 2 between sides. Extent of surgery was categorized as no/limited (< 2 sinuses) or extensive/full (> 2 sinuses) per side. Revision rates were compared by severity and extent of operation.</p><p><strong>Results: </strong>There were 112 patients (224 sides) included in the study. The overall revision surgery rate was 16.9% (38/224), with no significant difference in recurrence between limited and extensive surgery among patients with no or mild disease (19.1% vs. 22.2%). Similarly, recurrence rates did not differ significantly between mild and moderate-severe disease in patients who underwent extensive surgery. Notably, recurrence was rare in sinuses without initial disease, and time to revision was longer following extensive surgery, though not statistically significant.</p><p><strong>Conclusion: </strong>Our analysis supports a stratified surgical approach, with conservative management appropriate for mild disease and extensive surgery yielding low recurrence in moderate-severe cases.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814403","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":"Alterations in Nasal Function Following Total Laryngectomy and Their Clinical Correlates.","authors":"Kajornpan Sermwittayawong, Paraya Assanasen, Phawin Keskool, Dichapong Kanjanawasee","doi":"10.1002/wjo2.70142","DOIUrl":"10.1002/wjo2.70142","url":null,"abstract":"<p><strong>Introduction: </strong>Although nasal structural and functional changes after total laryngectomy (TL) have been documented, the influence of clinical variables and symptoms remains underexplored. This study compared nasal structure and function between TL patients and healthy controls and identified clinical factors associated with these changes.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on male patients with laryngeal cancer post-TL and healthy male volunteers. Objective nasal assessments included the saccharin test for mucociliary clearance time (MCT), acoustic rhinometry for nasal volume and minimal cross-sectional area (MCA), and contractility index calculated from changes pre- and post-decongestant. Nasal symptom scores were also collected.</p><p><strong>Results: </strong>Forty participants were enrolled (20 per group). Mean MCT was significantly longer in the TL group (10.99 ± 8.41 min) than in controls (6.69 ± 3.72 min; <i>p</i> = 0.047). Mean nasal volume and MCA were comparable between groups (<i>p</i> = 0.77 and 0.31, respectively), as were contractility indices (<i>p</i> = 0.13 and 0.64). Multiple linear regression revealed postoperative duration and smoking amount as significant predictors of increased MCA. Nasal symptoms were reported by 70% of TL patients. Dry nose was negatively correlated with changes in nasal volume and contractility index (<i>r</i> = -0.44 and -0.46, respectively).</p><p><strong>Conclusion: </strong>TL patients exhibited prolonged MCT despite no significant morphometric differences. Postoperative duration and smoking exposure were associated with increased MCA, suggesting potential confounding. Reduced nasal contractility was associated with dry nose symptoms. Overall, these findings suggest an effect of nasal airflow deprivation on nasal physiology and may inform future targeted interventions.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814405","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":"Change in Vocal Resonance Following Sinonasal Surgery.","authors":"Meha G Fox, Sarah L Blumhardt, Lauren McCray, K Kelly Gallagher, Julina Ongkasuwan, Tran B Locke","doi":"10.1002/wjo2.70143","DOIUrl":"10.1002/wjo2.70143","url":null,"abstract":"<p><strong>Objectives: </strong>Delineate objective and clinician-perceived subjective changes in voice quality following sinonasal surgery.</p><p><strong>Methods: </strong>Prospective cohort study of six adults who completed pre- and post-operative voice recordings which were analyzed for jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), formant and anti-formant changes. Consensus auditory-perceptual evaluation of voice (CAPE-V) assessment was completed by two independent reviewers. Wilcoxon signed-rank test was used to analyze the pre- and post-operative voice measures and CAPE-V scores.</p><p><strong>Results: </strong>Four males underwent endoscopic sinus surgery, including two with concurrent septoplasty, and two females underwent septoplasty with inferior turbinate reduction. There was a statistically significant difference between pre- and post-operative formants 2 (F2) and 3 (F3) for the nasal consonant/n/. There was no statistically significant difference in pre- and post-operative formants 1-4 (F1-F4) for the nasal sounds /m/, /Ɛ/, and /i/, or in F1 and F4 for the sound /n/. However, the change in mean for F2-4/m/, F4/a/, F1-4/n/, and F2-4/i/ was greater than 50 Hz, which is clinically significant. There was no statistically significant difference in pre- and post-operative jitter, shimmer, CPP, NHR, or CAPE-V scores.</p><p><strong>Conclusion: </strong>Prior studies demonstrate variable changes in voice following sinonasal surgery. Our study revealed a clinically significant difference in formants. Lack of statistical significance is likely due to a small study population. Larger scale studies assessing objective and subjective measures of voice are planned to better define voice changes following sinonasal surgery.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814414","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":"Endoscopic Total Thyroidectomy via a Single-Port Subclavian Approach Versus Open Surgery for Papillary Thyroid Carcinoma.","authors":"Pei-Liang Lin, Fa-Ya Liang, Lan-Lan Deng, Ping Han, Ren-Hui Chen, Xi-Jun Lin, Jing-Yi Wang, Xiao-Ming Huang","doi":"10.1002/wjo2.70159","DOIUrl":"10.1002/wjo2.70159","url":null,"abstract":"<p><strong>Objective: </strong>Historically, performing contralateral thyroid lobectomy and lymph node dissection via the subclavian approach has been considered challenging. This study evaluated the safety and feasibility of gasless endoscopic total thyroidectomy and central compartment neck dissection via the single-port subclavian approach (SpSCA) in comparison with conventional open surgery for the treatment of papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>Between January 2019 and June 2023, 120 patients diagnosed with PTC were retrospectively enrolled into this study, with 26 undergoing the SpSCA procedure and 94 receiving conventional surgery. Propensity score full matching was used to balance baseline characteristics between the groups. Subsequently, weighted regression analyses (adjusted for age) were used to compare perioperative outcomes, complications, survival, and esthetic results between the groups.</p><p><strong>Results: </strong>After matching, the SpSCA procedure was associated with a significantly longer operative time than open surgery (adjusted difference: 37.3 min, 95% confidence interval [CI]: 16.5-58.2). However, no significant differences were noted in postoperative hospital stay, bleeding volume, drainage volume, or major complications between the groups. During the median follow-up period of 34-36 months, biologic events occurred in six patients who underwent open surgery and one patient who underwent SpSCA; no structural events were observed. Disease-free survival curves were similar between the groups. The SpSCA group exhibited significantly higher esthetic satisfaction scores (adjusted difference: 2.26, 95% CI: 1.56-2.96).</p><p><strong>Conclusion: </strong>The SpSCA approach is a safe and feasible alternative to conventional surgery for selected patients with PTC, offering superior esthetic results and comparable clinical outcomes.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798773","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":"Extramedullary Plasmacytoma of Base of Tongue: A Systematic Review.","authors":"Ori Cohen Michael, Ameen Biadsee, Firas Kassem, Matan Katz, Osnat Jarchowsky-Dolberg, Benny Nageris, Tomer Boldes","doi":"10.1002/wjo2.70156","DOIUrl":"10.1002/wjo2.70156","url":null,"abstract":"<p><strong>Objective: </strong>Identifying extramedullary plasmacytoma originating from the base-of-tongue, in order to evaluate its prevalence, characteristics, management, and treatment within the broader spectrum of head and neck extramedullary plasmacytoma.</p><p><strong>Data sources: </strong>A systematic review was conducted in PubMed, Web of Science, and Cochrane Library for publications up to August 2025.</p><p><strong>Methods: </strong>Eligible studies were in English, verified by two reviewers independently. Articles were excluded if they lacked a diagnosis of extramedullary plasmacytoma, and localization to the base-of-tongue.</p><p><strong>Results: </strong>Twenty-five studies (case reports and case series) comprising of 30 individual cases were identified. The mean age was 63.6 years, with a male-to-female ratio of 5.25:1. Common symptoms included odynophagia, dysphagia, and sore throat. Tumors were confined to the base of tongue in 44% of cases, with others involving cervical lymph nodes or adjacent sites. All specimens showed plasma cell histology; bone marrow, Bence-Jones, and skeletal surveys were negative. Imaging (CT, PET-CT, MRI) revealed additional sites in a minority. Radiotherapy was the main treatment (23 patients, mean dose 45 Gy), often combined with surgery or chemotherapy. Mean follow‑up was 47.7 months, with generally favorable survival, though four cases had recurrence or partial control.</p><p><strong>Conclusions: </strong>In this review, 30 cases were identified, all meeting accepted diagnostic criteria for extramedullary plasmacytoma with exclusion of other plasma cell disorders. Radiotherapy was the most frequent treatment modality with survival among described cases as generally favorable. Extramedullary plasmacytoma should be included in the differential diagnosis of lesions arising in the base of tongue.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798795","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/wjo2.70136","DOIUrl":"https://doi.org/10.1002/wjo2.70136","url":null,"abstract":"","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"12 4","pages":"509-518"},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798544","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}