World Journal of Orthopedics最新文献

{"title":"Gut microbiome and orthopaedic health: Bridging the divide between digestion and bone integrity.","authors":"Naveen Jeyaraman, Madhan Jeyaraman, Priya Dhanpal, Swaminathan Ramasubramanian, Lavanya Ragavanandam, Sathish Muthu, Gabriel Silva Santos, Lucas Furtado da Fonseca, José Fábio Lana","doi":"10.5312/wjo.v15.i12.1135","DOIUrl":"10.5312/wjo.v15.i12.1135","url":null,"abstract":"<p><p>The gut microbiome, a complex ecosystem of microorganisms in the digestive tract, has emerged as a critical factor in human health, influencing metabolic, immune, and neurological functions. This review explores the connection between the gut microbiome and orthopedic health, examining how gut microbes impact bone density, joint integrity, and skeletal health. It highlights mechanisms linking gut dysbiosis to inflammation in conditions such as rheumatoid arthritis and osteoarthritis, suggesting microbiome modulation as a potential therapeutic strategy. Key findings include the microbiome's role in bone metabolism through hormone regulation and production of short-chain fatty acids, crucial for mineral absorption. The review also considers the effects of diet, probiotics, and fecal microbiota transplantation on gut microbiome composition and their implications for orthopedic health. While promising, challenges in translating microbiome research into clinical practice persist, necessitating further exploration and ethical consideration of microbiome-based therapies. This interdisciplinary research aims to link digestive health with musculoskeletal integrity, offering new insights into the prevention and management of bone and joint diseases.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1135-1145"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915607","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":"Specific approach to total hip arthroplasty in patients with childhood hip disorders sequelae.","authors":"Katarina Barbaric Starcevic, Goran Bicanic, Luka Bicanic","doi":"10.5312/wjo.v15.i12.1118","DOIUrl":"10.5312/wjo.v15.i12.1118","url":null,"abstract":"<p><p>Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons. These patients are typically younger and have greater functional demands. Therefore, achieving optimal biomechanical conditions is crucial, involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length. The altered anatomy in these cases makes total hip arthroplasty more complex, necessitating thorough preoperative imaging and an individualised surgical approach. Various techniques may be employed to optimise biomechanical outcomes. We propose a modified lateral hip approach, offering exceptional visualisation of the acetabulum and femur while preserving the continuity of the abductor muscles without requiring trochanteric osteotomy. To achieve the most biomechanically advantageous acetabular position, cotyloplasty is our preferred method.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1118-1123"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915965","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":"Total hip arthroplasty preoperative planning for childhood hip disorders' sequelae: Focus on developmental dysplasia of the hip.","authors":"Saran S Gill, Valerio Pace","doi":"10.5312/wjo.v15.i12.1112","DOIUrl":"10.5312/wjo.v15.i12.1112","url":null,"abstract":"<p><p>Developmental dysplasia of the hip (DDH) poses significant challenges in both childhood and adulthood, affecting up to 10 per 1000 live births in the United Kingdom and United States. While newborn screening aims to detect DDH early, missed diagnoses can lead to severe complications such as hip dysplasia and early onset osteoarthritis in adults. Treatment options range from less invasive procedures like hip-preserving surgery to more extensive interventions such as total hip arthroplasty (THA), depending on the severity of the condition. Preoperative planning plays a critical role in optimizing surgical outcomes for DDH patients undergoing THA. This includes accurate imaging modalities, precise measurement of acetabular bone stock, assessment of femoral head subluxation, and predicting prosthesis size and leg length discrepancy. Recent advancements artificial intelligence and machine learning offer promising tools to enhance preoperative planning accuracy. However, challenges remain in validating these technologies and integrating them into clinical practice. This editorial highlights the importance of ongoing research to refine preoperative strategies and improve outcomes in DDH management through evidence-based approaches and technological innovations.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1112-1117"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915967","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":"Low back pain in China: Disease burden and bibliometric analysis.","authors":"Wei-Lin Yang, Wen-Cai Jiang, Yan-Hua Peng, Xian-Jie Zhang, Rui Zhou","doi":"10.5312/wjo.v15.i12.1200","DOIUrl":"10.5312/wjo.v15.i12.1200","url":null,"abstract":"<p><strong>Background: </strong>Low back pain has become a global problem. Since many traditional Chinese therapies are helpful for low back pain, the current status of low back pain in China may provide some insights to this issue.</p><p><strong>Aim: </strong>To demonstrate the disease burden of low back pain in China and the response of Chinese scholars to this issue.</p><p><strong>Methods: </strong>The burden of low back pain in China was estimated using the Global Burden of Disease Study 2021 released by the American Institute for Health Metrics and Evaluation. The incidence, prevalence and disability-adjusted life years were analyzed. We also performed a bibliometric analysis to analyzed the publication trend, changes of cooperation models and research topics on low back pain.</p><p><strong>Results: </strong>Prevalence of low back pain increased from 69.61 million in 1990 to 102.96 million in 2021. New cases increased by a stunning 44.50 million in 2021. Low back pain led to an increase of 4.16 per 1000000 population in terms of disability-adjusted life years from 1990 to 2021. But the increase in China was slower than that of world average. As a response, publications of low back pain published by Chinese scholars were stably raised. From 1990 to 2023, domestic cooperation significantly increased, while international cooperation and no cooperation decreased. However, domestic cooperation decreased between 2021 and 2023. The number of studies on prevention and treatment of low back pain reduced from 1990 to 2023, while the mechanism, etiology and other aspects of low back pain augmented.</p><p><strong>Conclusion: </strong>The burden of low back pain in China is heavy. Together with the government, Chinese institutions of medical science should do more in declining the impacts of low back pain.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1200-1207"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915771","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":"Utilization of artificial intelligence in the diagnosis of pes planus and pes cavus with a smartphone camera.","authors":"Samir Ghandour, Anton Lebedev, Wei-Shao Tung, Konstantin Semianov, Artem Semjanow, Christopher W DiGiovanni, Soheil Ashkani-Esfahani, Lorena Bejarano Pineda","doi":"10.5312/wjo.v15.i12.1146","DOIUrl":"10.5312/wjo.v15.i12.1146","url":null,"abstract":"<p><strong>Background: </strong>Pes planus (flatfoot) and pes cavus (high arch foot) are common foot deformities, often requiring clinical and radiographic assessment for diagnosis and potential subsequent management. Traditional diagnostic methods, while effective, pose limitations such as cost, radiation exposure, and accessibility, particularly in underserved areas.</p><p><strong>Aim: </strong>To develop deep learning algorithms that detect and classify such deformities using smartphone cameras.</p><p><strong>Methods: </strong>An algorithm that integrated a deep convolutional neural network (CNN) into a smartphone camera was utilized to detect pes planus and pes cavus deformities. This case control study was conducted at a tertiary hospital with participants recruited from two orthopaedic foot and ankle clinics. The CNN was trained and tested using photographs of the medial aspect of participants' feet, taken under standardized conditions. Participants included subjects with standard foot alignment, pes planus, or pes cavus determined by an expert clinician using the foot posture index. The model's performance was assessed in comparison to clinical assessment and radiographic measurements, specifically lateral tarsal-first metatarsal angle and calcaneal inclination angle.</p><p><strong>Results: </strong>The CNN model demonstrated high accuracy in diagnosing both pes planus and pes cavus, with an optimized area under the curve of 0.90 for pes planus and 0.90 for pes cavus. It showed a specificity and sensitivity of 84% and 87% for pes planus detection, respectively; and 97% and 70% for pes cavus, respectively. The model's prediction correlated moderately with radiographic lateral Meary's angle measurements, indicating the model's excellent reliability in assessing food arch deformity (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the potential of using a smartphone-based CNN model as a screening tool that is reliable and accessible for the detection of pes planus and pes cavus deformities, which is especially beneficial for underserved communities and patients with pain generated by subtle foot arch deformities.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1146-1154"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915969","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":"Construction and validation of a risk prediction model for depressive symptoms in a middle-aged and elderly arthritis population.","authors":"Jun-Wei Shi, Wei Kang, Xin-Hao Wang, Jin-Long Zheng, Wei Xu","doi":"10.5312/wjo.v15.i12.1164","DOIUrl":"10.5312/wjo.v15.i12.1164","url":null,"abstract":"<p><strong>Background: </strong>Arthritis is a prevalent and debilitating condition that affects a significant proportion of middle-aged and older adults worldwide. Characterized by chronic pain, inflammation, and joint dysfunction, arthritis can severely impact physical function, quality of life, and mental health. The overall burden of arthritis is further compounded in this population due to its frequent association with depression. As the global population both the prevalence and severity of arthritis are anticipated to increase.</p><p><strong>Aim: </strong>To investigate depressive symptoms in the middle-aged and elderly arthritic population in China, a risk prediction model was constructed, and its effectiveness was validated.</p><p><strong>Methods: </strong>Using the China Health and Retirement Longitudinal Study 2018 data on middle-aged and elderly arthritic individuals, the population was randomly divided into a training set (<i>n</i> = 4349) and a validation set (<i>n</i> = 1862) at a 7:3 ratio. Based on 10-fold cross-validation, least absolute shrinkage and selection regression was used to screen the model for the best predictor variables. Logistic regression was used to construct the nomogram model. Subject receiver operating characteristic and calibration curves were used to determine model differentiation and accuracy. Decision curve analysis was used to assess the net clinical benefit.</p><p><strong>Results: </strong>The prevalence of depressive symptoms in the middle-aged and elderly arthritis population in China was 47.1%, multifactorial logistic regression analyses revealed that gender, age, number of chronic diseases, number of pain sites, nighttime sleep time, education, audiological status, health status, and place of residence were all predictors of depressive symptoms. The area under the curve values for the training and validation sets were 0.740 (95% confidence interval: 0.726-0.755) and 0.731 (95% confidence interval: 0.709-0.754), respectively, indicating good model differentiation. The calibration curves demonstrated good prediction accuracy, and the decision curve analysis curves demonstrated good clinical utility.</p><p><strong>Conclusion: </strong>The risk prediction model developed in this study has strong predictive performance and is useful for screening and assessing depression symptoms in middle-aged and elderly arthritis patients.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1164-1174"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915998","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":"Prognostic factors in patients with bone metastasis of lung cancer after immune checkpoint inhibitors: A retrospective study.","authors":"Yuki Ishibashi, Hiroshi Kobayashi, Toshihiko Ando, Kouichi Okajima, Takahiro Oki, Yusuke Tsuda, Yusuke Shinoda, Ryoko Sawada, Sakae Tanaka","doi":"10.5312/wjo.v15.i12.1155","DOIUrl":"10.5312/wjo.v15.i12.1155","url":null,"abstract":"<p><strong>Background: </strong>Accurate data on the prognosis of bone metastases are necessary for appropriate treatment. Immune checkpoint inhibitors (ICIs) are widely used in the treatment of gene mutation-negative non-small cell lung cancer (GMN-NSCLC).</p><p><strong>Aim: </strong>To investigate the prognostic factors in patients with bone metastases from GMN-NSCLC following ICI use.</p><p><strong>Methods: </strong>This retrospective cohort study included 45 patients with GMN-NSCLC who were treated for bone metastases from 2017 to 2022 and received chemotherapy after diagnosis. Using Kaplan-Meier curves and Cox proportional hazards models, we evaluated the association between overall survival (OS) and clinical parameters, including serum biochemical concentrations and blood cell count.</p><p><strong>Results: </strong>Univariate analysis showed that Eastern Cooperative Oncology Group performance status ≤ 1 and the use of ICIs and bone-modifying agents after bone metastasis diagnosis were significantly associated with a favorable OS. Multivariate analysis revealed that ICI use after bone metastasis diagnosis was significantly associated with a favorable OS.</p><p><strong>Conclusion: </strong>ICI use after bone metastasis diagnosis may be a favorable prognostic factor in patients with bone metastases of GMN-NSCLC. Consideration of ICI treatment for bone metastasis and GMN-NSCLC is warranted to establish a more accurate predictive nomogram for patients with bone metastasis.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1155-1163"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915708","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":"Cervical spine infection arising from chronic paronychia: A case report and review of literature.","authors":"Dan Zhang, Li-Ying Gan, Wen-Jie Zhang, Ming Shi, Liang Zhang, Yong Zhang, Ming-Wei Liu","doi":"10.5312/wjo.v15.i12.1214","DOIUrl":"10.5312/wjo.v15.i12.1214","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine pyogenic infection (CSPI) is a rare and challenging form of spinal infection that is typically caused by pyogenic bacteria and primarily affects the cervical vertebral bodies and surrounding tissues. Given its nonspecific symptoms, such as fever and neck pain, early diagnosis is crucial to prevent severe complications, including spinal cord injury. We report a previously unreported case of acute CSPI arising from chronic paronychia, exploring its diagnostic and therapeutic challenges through a review of the current literature.</p><p><strong>Case summary: </strong>The presented case involved a 15-year-old man with CSPI caused by <i>Staphylococcus aureus</i>, which led to complications including bacteremia and a paronychia-associated abscess. Acute pyogenic infection was initially diagnosed by typical symptoms and blood culture. Fever improved after antibiotic treatment while developing progressive limbs dysfunction. Six days after admission, the patient underwent anterior cervical debridement + autogenous iliac bone graft fusion + plate internal fixation and received 12 weeks of antibiotic treatment after the operation. Re-examination 3 years postoperatively showed that the patient had stable cervical fixation, no significant neck pain or upper limb abnormalities, and normal urinary function.</p><p><strong>Conclusion: </strong>Early imaging findings, laboratory markers, and timely antibiotic treatment are crucial for CSPI management, preventing complications and facilitating recovery.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1214-1225"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915982","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":"Femoral nerve palsy following Girdlestone resection arthroplasty: An observational cadaveric study.","authors":"Dominik Spuehler, Lukas Kuster, Oliver Ullrich, Karl Grob","doi":"10.5312/wjo.v15.i12.1175","DOIUrl":"10.5312/wjo.v15.i12.1175","url":null,"abstract":"<p><strong>Background: </strong>When patients with a failed hip arthroplasty are unsuitable for reimplantation, Girdlestone resection arthroplasty (GRA) is a viable treatment option. We report on a patient who was treated with a GRA due to a periprosthetic infection. We discovered partial paralysis of the quadriceps muscle in this patient. We investigated the femoral nerve anatomy, particularly the nerve entry points, to better understand this phenomenon.</p><p><strong>Aim: </strong>To reveal the femoral nerve anatomy with respect to severe proximal migration after GRA.</p><p><strong>Methods: </strong>Eight cadaveric hemipelves were investigated. The branches of the femoral nerve were dissected and traced distally. The GRA was performed by the direct anterior approach. Axial stress to the lower extremity was applied, and the relative movement of the femur was recorded. The femoral nerve and its entry points were assessed.</p><p><strong>Results: </strong>GRA led to a 3.8 cm shift of the femur in vertical direction, a 1.8 cm shift in the dorsal direction, and a 2.3 cm shift in the lateral direction. A 36.5° external shift was observed. This caused stress to the lateral division of the femoral nerve. We observed migration of the femoral nerve entry point at the following locations: (1) Vastus medialis (5.3 mm); (2) The medial part of the vastus intermedius (5.4 mm); (3) The lateral part of the vastus intermedius (16.3 mm); (4) Rectus femoris (23.1 mm); (5) Tensor vastus intermedius (30.8 mm); and (6) Vastus lateralis (28.8 mm).</p><p><strong>Conclusion: </strong>Migration of the femur after GRA altered the anatomy of the femoral nerve. Stress occurred at the lateral nerve division leading to poor functional results.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1175-1182"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915604","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":"Ipsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.","authors":"Abdulrahman Jalwi Korkoman, Abdullah Alhamodi, Saleh Alrusayni, Mohammed Musaed Almalki","doi":"10.5312/wjo.v15.i12.1208","DOIUrl":"10.5312/wjo.v15.i12.1208","url":null,"abstract":"<p><strong>Background: </strong>Clavicle fractures are among the most common fractures seen in the emergency department. While acromioclavicular (AC) joint injuries are much less common. However, ipsilateral combinations of these injuries are quite rare with only a few cases reported in the literature.</p><p><strong>Case summary: </strong>A 29-year-old man who sustained a combination of ipsilateral AC joint dislocation and midshaft clavicle fracture. He underwent open reduction and plate fixation of the clavicle fracture, as well as semi-rigid surgical implants used to restore both the AC ligaments and the coracoclavicular joint. one year follow-up revealed that the patient had a complete range of motion and excellent shoulder scores. This case presents a rare presentation of such combination of injuries, contributing valuable insights to the literature on such rare injuries.</p><p><strong>Conclusion: </strong>Combined midshaft clavicle fractures and AC joint dislocations are considered quite rare. Timely diagnosis of such injuries leads to great functional outcomes. AC joint dislocation should be suspected with midshaft clavicle fractures and should be investigated radiologically and clinically in an appropriate manner. Still, there is no consensus on the optimal management of such injuries.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1208-1213"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915630","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}