World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Expanding the Limits of Robotic Thyroidectomy: Management of a Rare Presentation of Thyroid Carcinoma With Supraglottic Extension.","authors":"Surender Dabas, Shivya Chopra, Reetesh Ranjan, Bikas Gurung, Nandini Menon, Sukirti Tiwari, Daksh Goel, Shivani Rewari","doi":"10.1002/wjo2.70146","DOIUrl":"https://doi.org/10.1002/wjo2.70146","url":null,"abstract":"<p><p>Thyroid carcinoma ranks as the seventh most common malignancy globally by incidence, though its mortality remains relatively low. We present a rare case of papillary thyroid carcinoma in a 32-year-old male, with supraglottic extension of the right thyroid lobe, managed successfully using a robotic-assisted bilateral axillo-breast approach (BABA). The total operative duration was 4 h, and the postoperative course was uneventful, with early recovery and excellent cosmetic outcome. Histopathology confirmed multifocal papillary thyroid carcinoma (mpT2N1b) with central and right selective neck node metastases. This case expands the boundaries of robotic thyroidectomy, demonstrating its feasibility and safety even in anatomically challenging scenarios. It emphasizes the potential need to revise current selection criteria as surgical expertise and robotic precision continue to evolve.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798768","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":"Effects of Obstructive Sleep Apnea on Personality and Temperament: A Cohort and Mendelian Randomization Study.","authors":"Jian-Hong Liao, Yun-Han Shi, Xin-Peng Xu, Yan-Ru Li, De-Min Han","doi":"10.1002/wjo2.70139","DOIUrl":"https://doi.org/10.1002/wjo2.70139","url":null,"abstract":"<p><strong>Objective: </strong>Obstructive sleep apnea (OSA) is associated with neurocognitive impairment, but its causal relationship with personality traits remains poorly understood. This study investigates the association and causality between OSA and personality using both cohort and genetic data.</p><p><strong>Method: </strong>This study included adults undergoing full-night polysomnography (PSG). Personality traits were assessed using the Eysenck Personality Questionnaire (EPQ), which assesses extraversion, neuroticism, psychoticism, and lie scales. Based on Eysenck's theory, participants were classified into melancholic, choleric, phlegmatic, and sanguine temperaments. Bidirectional Mendelian randomization (MR) analysis was conducted using GWAS data from the FinnGen database to infer causality. The inverse-variance weighted (IVW) method was used as the primary analysis. Sensitivity, pleiotropy, and heterogeneity analyses were conducted to validate the results.</p><p><strong>Results: </strong>A total of 233 participants were included. OSA was associated with significantly reduced neuroticism (<i>p</i> = 0.020) and psychoticism (<i>p</i> = 0.047). No significant differences were found in extraversion or lie scores. MR analysis indicated a modest causal effect of OSA on reduced neuroticism (<i>p</i> = 0.023-0.030), while cohort data showed temperament shifts from melancholic to choleric/sanguine types with OSA severity (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>OSA may contribute to reduced neuroticism and altered temperament, highlighting the need for psychological screening in OSA management. Caution is warranted in interpreting causality due to modest MR effect sizes and potential heterogeneity.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798812","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":"Vibratory Characteristics and Quantitative Parameters of Laryngeal Dystonia: A Scoping Review of High-Speed Videoendoscopy Studies.","authors":"Yuan-Jia Hu, Jia Song, Sen-Nian Zheng, Lu Xing, Yu-Jie Feng, Sheng-Tao Wu, Shu-Yi Zeng, Ying-Shan Tan, Qiu-Tong Chen, Pei-Yun Zhuang","doi":"10.1002/wjo2.70155","DOIUrl":"10.1002/wjo2.70155","url":null,"abstract":"<p><strong>Objective: </strong>To review the clinical application and quantitative parameters of high-speed videoendoscopy (HSV) in evaluating vocal fold kinematics in patients with laryngeal dystonia (LD), to summarize the limitations of existing studies, and to provide a reference for future clinical standardization.</p><p><strong>Method: </strong>A comprehensive search of eight databases, including PubMed, Embase, and the Web of Science Core Collection (WoSCC), was conducted from inception to December 2025. Three independent investigators performed the literature screening and data extraction. A scoping review and visual analysis were subsequently conducted on the included studies.</p><p><strong>Results: </strong>Across the included studies, HSV captured several LD-related abnormalities, including oscillatory breaks, micromotions, motion irregularities, supraglottic compression, altered open quotient (OQ), speed quotient (SQ), glottal area change index (GACI), vocal vibration opening onset position (VVOOP), and prolonged or more variable glottal attack time (GAT) and glottal offset time (GOT). These findings were organized into five parameter domains, covering abnormal movements and configuration, micro-vibratory dynamics and kinematics, onset/offset temporal dynamics, image-field usability, and automated analysis metrics. Recent studies further incorporated artificial intelligence (AI)-assisted approaches, including automated obstruction detection and glottal segmentation.</p><p><strong>Conclusions: </strong>HSV provides multidimensional, objective, and quantitative metrics for LD assessment, reducing reliance on subjective evaluation. Future studies should employ multicenter designs with larger cohorts to standardize parameter definitions and further validate the reliability of AI-assisted analytical approaches, ultimately promoting more objective and standardized diagnosis of LD.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798546","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":"Performance of Large Language Models in Answering Otolaryngology Clinical Questions in Non-English Languages.","authors":"Eugene Oh, Arthur W Wu, Laura Garcia-Rodriguez, Zhen-Xiao Huang, Wei-Chung Hsu, Jeongkyou Kim, Young Chul Kim, Yi-Tsen Lin, Hae Chan Park, Hector Andres Perez, Juan San Juan, Gene Liu, Matthew Lee, Dennis M Tang","doi":"10.1002/wjo2.70153","DOIUrl":"https://doi.org/10.1002/wjo2.70153","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) such as ChatGPT are being explored for various medical applications, but their performance across languages is not established. Despite the promising results in English from previous studies, it is unclear how ChatGPT performs in other languages. We assessed the ability of ChatGPT-4 to answer common otolaryngology-related frequently asked questions in Chinese, Korean, and Spanish in this study.</p><p><strong>Methods: </strong>Eighteen clinical questions were selected from the American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines and ENT Health across six subspecialties. Bilingual clinicians translated the questions to Chinese, Korean, or Spanish and input them into ChatGPT-4 (OpenAI, San Francisco, USA). The responses were rated on a five-point Likert scale for accuracy, completeness, and similarity to English reference answers. A linear mixed-effects model with language as a fixed effect and random intercepts for question and rater was used to compare performance across languages. Inter-rater reliability was assessed using intraclass correlation coefficients and Krippendorff's <i>α</i>. Subjective evaluations were also collected.</p><p><strong>Results: </strong>ChatGPT-4's performance differed significantly by language in all assessment domains. Responses in Spanish scored highest throughout and most frequently were characterized as clear and organized. Korean answers were generally accurate but tended to be more conservative and less detailed. Chinese answers showed greater variability, with reviewers noting a mix of clear and less accurate outputs.</p><p><strong>Conclusion: </strong>The clinical performance of ChatGPT-4 differed across Chinese, Korean, and Spanish. These findings underscore the importance of ongoing evaluation and refinement of LLMs to ensure they provide reliable multilingual support in clinical practice.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798270","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":"A Recurrent Tympanicum Paraganglioma With a SDHD Pathogenic Variant: First Reported Case.","authors":"Alex Z Graboyes, Kevin Wong, Yonghong Huan, Jason A Brant","doi":"10.1002/wjo2.70133","DOIUrl":"10.1002/wjo2.70133","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to describe a clinical case of a <i>SDHD</i> germline mutation associated tympanic paraganglioma (TPGL).</p><p><strong>Patients: </strong>A female patient seen in the otology clinic at a tertiary care center with a diagnosis of tympanic paraganglioma and significant family history of head and neck paragangliomas.</p><p><strong>Intervention: </strong>Surgery and genetic management.</p><p><strong>Main outcome measurements: </strong>We describe the patient's clinical course and discuss the implications of genetic result on management.</p><p><strong>Results: </strong>The patient was diagnosed with a pathogenic variant of <i>SDHD</i> gene before the presentation of a tympanic paraganglioma. Her clinical course was complicated by locally aggressive and recurrent disease including ossicular erosion, tympanic membrane perforation, and cholesteatoma.</p><p><strong>Conclusion: </strong>This is a case of a SDHD associated tympanic paraganglioma, and the SDHD TPGL case to demonstrate recurrence. Such cases require multidisciplinary care for active surveillance of tumor development.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798750","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":"Vocal Cord Dysfunction: Evaluating the Utility of AI Large Language Models for Patient Education.","authors":"Kyle Cook, Phil Tseng, David Ahmadian, Natalie Demirjian, Vicki Liu, Troy Weinstein, Helena Yip","doi":"10.1002/wjo2.70158","DOIUrl":"10.1002/wjo2.70158","url":null,"abstract":"<p><strong>Objective: </strong>To compare provider preferences for patient education materials generated by OpenEvidence, ChatGPT 5 Extended Thinking, and a laryngologist with fellowship training in response to common patient questions about vocal cord dysfunction (VCD).</p><p><strong>Study design: </strong>Cross-sectional survey study.</p><p><strong>Methods: </strong>A laryngologist compiled four common patient questions about VCD and authored expert responses. Equivalent responses for patients were generated using OpenEvidence and ChatGPT 5 Extended Thinking with a standardized role prompt, each in a new chat session, and all outputs were limited to four sentences. Responses were de-identified and presented in a REDCap survey. Forty-five healthcare providers ranked responses based on perceived medical accuracy, clarity, and ability to address patient concerns. Preferences were analyzed using chi-square goodness-of-fit and Friedman testing with post hoc pairwise comparisons.</p><p><strong>Results: </strong>Among the 45 respondents, the most represented specialties were otolaryngology (<i>n</i> = 17) and allergy/immunology (<i>n</i> = 12), and most were attending physicians (<i>n</i> = 31). ChatGPT 5 Extended Thinking received the most first choice selections for three of the four questions, whereas OpenEvidence and ChatGPT performed similarly on the definition question. Analyses of full rankings confirmed significant differences among sources for all four questions (all Friedman <i>p</i> ≤ 0.001): responses generated by AI were preferred over the laryngologist response for the definition, diagnosis, and treatment process questions, while ChatGPT was preferred over both comparators for the etiology question. Otolaryngology respondents were more likely than non-otolaryngology respondents to rank the laryngologist response first for the definition question only.</p><p><strong>Conclusion: </strong>Responses generated by AI were frequently preferred over a single expert comparator for common VCD questions, with ChatGPT 5 Extended Thinking performing best overall and OpenEvidence showing similar performance on several items. These findings support further evaluation of LLMs as adjunctive tools in laryngology patient education, while highlighting the need for clinician oversight, assessment of individual model performance, and studies of patient outcomes.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798569","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":"Salivary Pepsin Test in the Diagnosis of Laryngopharyngeal Reflux Disease: Reality or Fallacy?","authors":"Jin-Rang Li, Jacqueline E Allen, Jerome R Lechien","doi":"10.1002/wjo2.70147","DOIUrl":"https://doi.org/10.1002/wjo2.70147","url":null,"abstract":"","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798540","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":"Importance of Global Health Opportunities in Residency Selection Among Otolaryngology Applicants.","authors":"Eric K Kim, Sarah Nuss, Leyda S Marrero Morales, Patrick J Barba, Lia K Jacobson, Andrew N Goldberg, Mary Jue Xu","doi":"10.1002/wjo2.70150","DOIUrl":"https://doi.org/10.1002/wjo2.70150","url":null,"abstract":"<p><strong>Introduction: </strong>Global health has become an increasing priority in medical training. In this cross-sectional study, we seek to evaluate the importance of a residency program's global health opportunities on otolaryngology-head and neck surgery (OHNS) applicants' residency selection.</p><p><strong>Methods: </strong>The questionnaire was distributed via snowball sampling and an electronic residency professional forum to 2023 and 2024 United States OHNS residency applicants.</p><p><strong>Results: </strong>Of 52 complete responses, the mean participant age was 28.67 years (SD 2.40). The average rating of global health importance in residency selection was 2.45 on a 1-4 scale (SD 0.86). Among the most influential factors in residency selection were faculty mentorship (88.5%), prior resident involvement in global health activities (73.1%), and funding opportunities (71.2%). Motivations for engagement in global health included opportunities to learn about new cultures (75%), career interest in working in a domestic resource-constrained setting (59.6%), and career interest in working internationally (53.8%). 63.5% of respondents reported prior engagement in global health activities.</p><p><strong>Conclusion: </strong>Global health opportunities can be an important factor in OHNS applicants' residency selection. Mentorship, funding, and institutional support for global health may attract applicants with an interest in working in resource-limited settings.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798308","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":"Treatment of Severe Obstructive Sleep Apnea With a Domestic Implantable Hypoglossal Nerve Stimulator: A Case Report.","authors":"Su-Ru Liu, En-Hui Zhou, Xin-Yi Li, Hua-Jun Xu, Jian Guan, Hong-Liang Yi, Shan-Kai Yin","doi":"10.1002/wjo2.70140","DOIUrl":"https://doi.org/10.1002/wjo2.70140","url":null,"abstract":"<p><strong>Background: </strong>Implantable hypoglossal nerve stimulation (HNS) is an established neuromodulatory therapy for obstructive sleep apnea (OSA) in patients intolerant to continuous positive airway pressure (CPAP). However, no domestically developed HNS system has been clinically implemented in China to date.</p><p><strong>Methods: </strong>We report the first clinical implantation of a novel, Chinese-developed HNS system in a patient with severe OSA. The patient was a 39-year-old man with a 20-year history of nocturnal snoring and apnea. Preoperative polysomnography (PSG) demonstrated an apnea-hypopnea index (AHI) of 46.3 events per hour and a lowest oxygen saturation of 83%. The device selectively activates the medial branch of the hypoglossal nerve, which induces genioglossus contraction and anterior tongue displacement, thereby stabilizing the upper airway during sleep.</p><p><strong>Results: </strong>The procedure was successfully performed. At short-term follow-up, the patient showed marked improvements: AHI decreased from 46.3 to 11.8 events/hour, LSaO₂ increased from 83% to 86%, and the Epworth Sleepiness Scale Score improved from 1 to 0. No adverse events occurred.</p><p><strong>Conclusions: </strong>This first‑in‑human experience confirms that the domestic HNS system is feasible, safe, and clinically effective in patient with severe OSA who is intolerant to CPAP. These preliminary results support further clinical development and validation of this domestically manufactured HNS technology for broader application in China.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798559","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":"Herpesvirus and Adenotonsillar Hypertrophy in Chinese Children: An Epidemiological and Clinical Analysis.","authors":"Ting-Ting Ji, Miao Fan, Dan Yu, Xin Ni, Xiao-Dan Li, Xin-Yu Wang, Lu Lu, Wen Su, Li-Xing Tang, Wei Zhang, Xiao Xiao, Yang Han, Lin Mei, Sheng-Cai Wang","doi":"10.1002/wjo2.70148","DOIUrl":"10.1002/wjo2.70148","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the possible association between adenotonsillar hypertrophy (ATH) and herpesviral infections in children, and to examine correlations between specific viral detection and clinical characteristics.</p><p><strong>Methods: </strong>We enrolled 43 children aged 3-14 years with ATH (mean age 76.56 ± 25.65 months; 31 boys). Paired tonsil and adenoid specimens were collected during non-acute infection periods, defined as the absence of fever (body temperature < 37.3°C), purulent tonsillar exudate, or new-onset respiratory symptoms within 2 weeks before surgery. Eight human herpesviruses (HHVs) were detected by qualitative real-time polymerase chain reaction (qPCR), and associations with demographic, clinical, and polysomnographic variables were explored.</p><p><strong>Results: </strong>The overall HHV detection rate was 97.7% (42/43). Epstein-Barr virus (EBV), HHV-6, and HHV-7 were the most prevalent in both tissues, with detection rates of 44.2%, 74.4%-79.0%, and 65.1%-67.5%, respectively. EBV DNA positivity in both tissue types was associated with older age, longer disease duration, and a lower arousal index (AI) (all <i>p</i> < 0.05). HHV-6 DNA positivity in tonsils was correlated with longer disease duration (<i>p</i> = 0.006), whereas HHV-7 DNA positivity in adenoids was associated with larger adenoid size (<i>p</i> = 0.012). No significant differences were identified between monoviral and multiviral groups.</p><p><strong>Conclusion: </strong>EBV, HHV-6, and HHV-7 are highly prevalent in pediatric ATH tissues and associate with select clinical parameters, yet viral positivity did not correlate with disease severity. These findings do not support routine viral screening or changes in clinical management for ATH. The role of herpesviruses in ATH pathogenesis warrants further investigation through controlled, longitudinal studies.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798316","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}