Paul Asadourian, Alyssa B Valenti, Alexandra Michalowski, Albert Y Truong, Nell Borys, Myles LaValley, Vikash Modi, Thomas A Imahiyerobo
{"title":"Estimated Time of Arrival: Impact of Healthcare Disparities on Access to and Outcomes of Multidisciplinary Cleft Lip and Palate Care.","authors":"Paul Asadourian, Alyssa B Valenti, Alexandra Michalowski, Albert Y Truong, Nell Borys, Myles LaValley, Vikash Modi, Thomas A Imahiyerobo","doi":"10.1177/10556656241259890","DOIUrl":"10.1177/10556656241259890","url":null,"abstract":"<p><p>ObjectiveTo determine the impact of sociodemographic and clinical factors on patient presentation into the cleft care pathway and determine how delayed interventions may affect post-surgical outcomes.DesignRetrospective study.SettingMultidisciplinary craniofacial clinics of two university hospitals.Patients, Participant135 patients with cleft lip and/or palate.InterventionsPrimary cheiloplasty, primary palatoplasty.Main Outcome MeasuresAge at initial presentation, age at first surgery, lag time, delayed surgery, rate of return to the emergency department (ED), readmission rate, reoperations, and oronasal fistula development.ResultsPatients referred by OBGYN who underwent cheiloplasty had an earlier age at initial presentation (p < 0.01), earlier age at first surgery (p = 0.01), and a shorter lag time (p < 0.01) compared to children from other referral pathways. African American children had an older age at first surgery (p = 0.01) and a longer lag time (p = 0.02) when compared to non-African American children. Children with syndromes had an older age at first surgery (p < 0.01) and a longer lag time (p < 0.01) than children without syndromes. Patient race, cleft type, and syndromic status increased the odds of receiving delayed surgery. Patients who received delayed palatoplasty returned to the ED at a higher rate than patients who received non-delayed palatoplasty (p = 0.02).ConclusionsOur data suggest that referral source, race, and syndromic status influence the timeliness of cleft care. Surgeons should develop strong referral networks with local OBGYNs and hospitals to allow for an early entry into the cleft care pathway.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1461-1468"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osseous Outcomes of Cleft Alveolar Bone Grafting with Allograft and Platelet-Rich Fibrin: Preliminary Study with Radiological Outcome.","authors":"Julie Chauvel-Picard, Camille Lambert, Dominique Gaget, Marc Asselborn, Edouard Lange, Arnaud Gleizal","doi":"10.1177/10556656241271663","DOIUrl":"10.1177/10556656241271663","url":null,"abstract":"<p><p>ObjectiveCleft lip and palate are the most common craniofacial malformations worldwide. The alveolar cleft is treated with a bone graft, between 4 and 7 years of age in mixed dentition. This is an important step because it provides good quality jawbone and a better support of the lip and the alar cartilage on the side of the cleft. Bone autografting with iliac harvesting remains the most commonly used technique, but it is not without risks. Allograft techniques have therefore been described to reduce this morbidity (pain, infectious risk, hemorrhagic risk, fracture risk). The aim of this study was to evaluate, one year after allografting, the efficiency and consolidation of the bone allograft in the alveolar cleft.SettingA retrospective study was conducted in the department of pediatric craniomaxillofacial surgery in the Woman-Mother-Child Hospital in Lyon, France.PatientsThis series includes 22 patients or 25 alveolar cleft bone grafts, including 16 boys and 6 girls, with an average age of 6.1 years.Main Outcome MeasuresQuantify the residual bone allograft by evaluating the ratio between the volume of the bone graft and the volume of the initial space on pre- and post-operative cone beam computed tomography.ResultsThe residual bone allograft percentage at 1 year was 58.5% (± 22.3).ConclusionsAlveolar cleft bone graft with bone allograft is an alternative to iliac autografting to reduce donor site morbidity.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1549-1554"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Can Kocabalkanli, Regina Fenton, Susan Gaetani, Fereshteh Aalamifar, Marius George Linguraru, Reza Seifabadi
{"title":"Accuracy of Cranial Shape Measurements Using Smartphones: A Prospective Study.","authors":"Can Kocabalkanli, Regina Fenton, Susan Gaetani, Fereshteh Aalamifar, Marius George Linguraru, Reza Seifabadi","doi":"10.1177/10556656241271681","DOIUrl":"10.1177/10556656241271681","url":null,"abstract":"<p><p>ObjectiveProspectively validate the accuracy of smartphone-based digital cranial measurements for the diagnosis and treatment of deformational plagiocephaly and/or brachycephaly (DPB), compared with calipers used in the standard of care.Design/MethodsBird's-eye-view head photos were captured via smartphone, and their heads were measured with hand calipers by an expert user. CI/CVAI/CVA were calculated from photos and caliper measurements, and from 3D photogrammetry of the head as ground truth. Digital and caliper measurements were compared against 3D-based ground truth using mean absolute error, Spearman correlation coefficient, and Bland-Altman method. Statistical significance between methods was assessed using Wilcoxon Rank-Sum test.Participants71 infants aged 2-11 months (20 female, 51 male) with DPBResultsThe mean absolute errors for CI, CVAI, CVA were 1.63 ± 1.44, 1.45 ± 1.29, 2.38 ± 1.86 mm for smartphone, and 2.60 ± 1.96, 1.43 ± 1.22, 2.04 ± 1.81 mm for calipers, respectively. The correlation coefficients for CI, CVAI, CVA between smartphone and ground truth were 0.90, 0.94, 0.80 (p < 0.001), and 0.87, 0.93, 0.84 (p < 0.001) between calipers and ground truth, respectively. Bland-Altman results were (0.08, [-4.18, 4.34]), (-0.05, [-3.85, 3.76]), (-0.82, [-6.52, 4.87]) for smartphone, and (1.41, [-4.34, 7.15]), (0.28, [-3.37, 3.94]), (0.16, [-5.18, 5.49]) for caliper measurements respectively. Digital and caliper measurements were similar (p = 0.12) except for CI, where digital measurements were more accurate (p = 0.04).ConclusionSmartphone-based cranial measurements have very high correlation with 3D-based ground truth, and they are comparable or superior to caliper measurements. Digital measurements can be performed in pediatric offices or from home to help with the early detection and treatment of DPB.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1592-1597"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eugene E Zheng, Lauren Gates-Tanzer, Sai Cherukuri, Samir Mardini, M Hassan Murad, Uldis Bite, Waleed Gibreel
{"title":"What Free Flaps Are Surgeons Using for Palatal Fistula Repair in Patients with Cleft Palate? A Systematic Review.","authors":"Eugene E Zheng, Lauren Gates-Tanzer, Sai Cherukuri, Samir Mardini, M Hassan Murad, Uldis Bite, Waleed Gibreel","doi":"10.1177/10556656241266243","DOIUrl":"10.1177/10556656241266243","url":null,"abstract":"<p><p>ObjectiveRecalcitrant palatal fistulas in patients with cleft palate history sometimes require free flap reconstruction. This study reviews the literature on described flaps and outcomes.DesignA systematic review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.SettingAll study designs were included. Non-English articles were excluded.Patients and ParticipantsPatients with a history of cleft palate who underwent free flap reconstruction for a oronasal fistula.InterventionsFree tissue transfer for a palatal fistula repair.Main outcomee measuresInformation regarding defect and flap characteristics were reviewed. Surgical outcomes such as flap loss rates, rates of recurrent fistula formation, and speech outcomes were also obtained.ResultsOur search returned 894 articles, of which 23 were included. All studies were retrospective case series and reports. A total of 65 patients were described with an average age of 19.3 (range 3-55) years and a median fistula size of 8.00 cm<sup>2</sup> (range 2.54 cm<sup>2</sup> - 24 cm<sup>2</sup>). The most common flap was the radial forearm flap (n = 37). Nine patients (13.8%) had recurrent fistula formation with surgical revision successful in all cases in which the patient returned to the operating room. There were two partial flap losses and no total flap losses. Speech outcomes showed improvement in 27 patients across 10 studies.ConclusionsPalatal fistula repair with free tissue transfer is safe with an acceptable risk profile and low flap loss rate. Early recurrence due to partial flap necrosis and dehiscence are successfully managed with flap readvancement.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1568-1577"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Profiling the Roles and Responsibilities of Professionals and Non-Professionals Providing Speech Language Services for Individuals with CLP in Resource-Limited Regions.","authors":"B Subramaniyan, Debbie Sell, Valerie Pereira, Triona Sweeney, Roopa Nagarajan, Erika Bostock, Selena Ee-Li Young, Karen Goldschmied, Benjamas Prathanee, Malka Jayathilake, Yoshiko Takei, Nargis Jahan, Veronica Yu","doi":"10.1177/10556656241271640","DOIUrl":"10.1177/10556656241271640","url":null,"abstract":"<p><p>Fourteen Speech and Language Therapists/Pathologists (SLT/Ps) from 13 countries across 5 continents made up the International Confederation of Cleft Lip and Palate and Related Craniofacial Anomalies (ICCPCA) CLEFT 2022 Speech Taskforce. Following a group consensus activity led by an external facilitator using Lightning Design Thinking principles, \"task-shifting\" was identified as the topic for this Taskforce. Absence and scarcity of SLT/Ps in many parts of the world have led to non-SLT/Ps delivering speech and language therapy services to individuals with cleft lip +/- palate. This narrative is the first known attempt to develop a framework, describing the different types of providers and their scope of practice.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1605-1615"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shweta Gupta Batra, Manish Khatri, Mansi Bansal, Puneet Batra, Ayush Khatri, Sana Bint Aziz
{"title":"Oral Health Assessment in Cleft Lip & Palate Patients During Orthodontic Treatment for Maxillary Protraction: A Periodontal & Microbiological Study.","authors":"Shweta Gupta Batra, Manish Khatri, Mansi Bansal, Puneet Batra, Ayush Khatri, Sana Bint Aziz","doi":"10.1177/10556656241263442","DOIUrl":"10.1177/10556656241263442","url":null,"abstract":"<p><p>ObjectiveTo assess the oral health status and microbiota of subgingival plaque in patients with surgically repaired cleft lip and palate (CLP) during orthodontic treatment for maxillary protraction with two different orthodontic appliances.DesignRandomized controlled trialSettingInstitutional.ParticipantsA total of 90 patients with surgically repaired Unilateral Cleft Lip and Palate, out of initially enrolled 120 patients, were divided into 3 groups: experimental group I, experimental group II and control group, with 30 subjects each. Patients with a history of oral prophylaxis in last 6 months or antibiotic therapy within 3 months were excluded from the study.InterventionsBone Anchored Maxillary Protraction was done in experimental group I, while facemask with acrylic occlusal splint was used for maxillary protraction in experimental group II and no orthodontic intervention in control group.Mean Outcome MeasuresPlaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), Probing Depth (PD), and microbiota of subgingival plaque (<i>P. gingivalis</i>, <i>P. intermedia</i>, <i>Veillonella</i> and <i>Capnocytophaga</i>) were compared at baseline (T<sub>0</sub>) and after 8 months (T<sub>1</sub>).ResultsThe PI, GI, GBI and PD were observed to be significantly higher in experimental group II followed by experimental group I as compared to control group at 8 months interval (<i>P</i> < .001). The microbiota counts increased significantly in experimental group II and experimental group I (<i>P</i> < .001), as compared to control group.ConclusionMaxillary protraction with facemask and bone plates was found to be a better alternative than facemask with occlusal splint, considering the overall oral health of patients with CLP.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1523-1534"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krystof Stanek, Alice T Wang, Anne F Hseu, Roseanne E Clark, John G Meara, Roger C Nuss, Ingrid M Ganske, Carolyn R Rogers-Vizena
{"title":"Multidisciplinary Velopharyngeal Dysfunction Evaluation Helps Detect Non-classic Cases of 22q11.2 Deletion.","authors":"Krystof Stanek, Alice T Wang, Anne F Hseu, Roseanne E Clark, John G Meara, Roger C Nuss, Ingrid M Ganske, Carolyn R Rogers-Vizena","doi":"10.1177/10556656241266464","DOIUrl":"10.1177/10556656241266464","url":null,"abstract":"<p><p>ObjectiveTo explore the role of multidisciplinary velopharyngeal dysfunction (VPD) assessment in diagnosing 22q11.2 deletion syndrome (22q) in children.DesignRetrospective cohort study.SettingMultidisciplinary VPD clinic at a tertiary pediatric hospital.Patients, ParticipantsSeventy-five children with genetically confirmed 22q evaluated at the VPD clinic between February 2007 and February 2023, including both previously diagnosed patients and those newly diagnosed as a result of VPD evaluation.InterventionsComprehensive review of medical records, utilizing ICD-10 codes and an institutional tool for keyword searches, to identify patients and collect data on clinical variables and outcomes.Main Outcome MeasuresCharacteristics of children with 22q, pathways to diagnosis, and clinical presentations that led to genetic testing for 22q.ResultsOf the 75 children, 9 were newly diagnosed with 22q following VPD evaluation. Non-cleft VPI was a significant indicator for 22q in children not previously diagnosed, occurring in 100% of newly diagnosed cases compared to 52% of cases with existing 22q diagnosis (<i>P</i> = .008). Additional clinical findings leading to diagnosis included congenital heart disease, craniofacial abnormalities, and developmental delays.ConclusionsVPD evaluations, particularly the presence of non-cleft VPI, play a crucial role in identifying undiagnosed cases of 22q. This underscores the need for clinicians, including plastic surgeons, otolaryngologists, and speech-language pathologists, to maintain a high degree of suspicion for 22q in children presenting with VPI without a clear etiology. Multidisciplinary approaches are essential for early diagnosis and management of this complex condition.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1588-1591"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jagmeet S Arora, Nima Khoshab, Megan Donnelly, Sharon Vargas, Touran Zadeh, Raj M Vyas
{"title":"Interactive iPad-Based Education for Parents of Patients with Cleft Lip and Palate.","authors":"Jagmeet S Arora, Nima Khoshab, Megan Donnelly, Sharon Vargas, Touran Zadeh, Raj M Vyas","doi":"10.1177/10556656241275534","DOIUrl":"10.1177/10556656241275534","url":null,"abstract":"<p><p>ObjectiveTo assess the effectiveness of an interactive iPad-based educational module (cleft iBook) in enhancing parent/caregiver education related to cleft lip and/or cleft palate (CL/P) care.DesignA prospective study involving pre- and post-intervention surveys.SettingThe study was conducted at a craniofacial clinic in a dedicated children's hospital specifically during initial consultations for CL/P care.ParticipantsThirty-two participants (parents/legal guardians/caregivers) ≥18 years of age, English and/or Spanish-speaking, and attending with a child with CL/P.InterventionsParticipants were provided with iPads and engaged with the interactive iPad-based educational module. Pre- and post-intervention surveys were administered.Main Outcome Measure(s)The survey assessed the understanding of a CL/P diagnosis and management and usability of the iBook. Survey responses were graded on a 5-point Likert scale. Total scores for pre- and post-intervention surveys were compared.ResultsUtilizing the cleft iBook module before consultation significantly enhanced comprehension in multiple domains: prenatal development of CL/P, dento-facial molding, surgical techniques, steps after the initial consultation, postoperative care, and the necessity of long-term care for affected children (<i>P </i>< .01). Cumulative survey scores increased by 10.2 points, reflecting significantly improved responses regarding overall comprehension (<i>P </i>< .001).ConclusionsThe interactive, iPad-based cleft educational module emerges as a viable, digital strategy for providing education and empowerment to parents and caregivers navigating the challenges of caring for a child with CL/P. The cleft iBook serves as a readily accessible resource, fostering connections among the child, caregivers, and care team.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1581-1587"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica L Williams, Jamie L Perry, Davinder J Singh, Thomas J Sitzman
{"title":"Do Palatoplasty Procedures Resolve Hypernasality as Effectively as Pharyngoplasty Procedures in Patients with 22q11.2 Deletion Syndrome?","authors":"Jessica L Williams, Jamie L Perry, Davinder J Singh, Thomas J Sitzman","doi":"10.1177/10556656241266365","DOIUrl":"10.1177/10556656241266365","url":null,"abstract":"<p><p>ObjectiveCompare the effectiveness of palatoplasty and pharyngoplasty procedures at resolving hypernasality in patients with 22q11.2 deletion syndrome (22q).DesignRetrospective cohort study.SettingMetropolitan children's hospital.PatientsFourteen patients with 22q presenting for management of velopharyngeal insufficiency.InterventionsPalatoplasty or pharyngoplasty procedure.Main Outcome MeasureResolution of hypernasality 12 months postoperatively.ResultsBoth procedure groups had a mean preoperative velopharyngeal gap of 6.2 mm during phonation. No patient who underwent palatoplasty achieved resolution of hypernasality; 1/7 patients had worse hypernasality, 4/7 had no change, and 2/7 had improved hypernasality. In contrast, hypernasality was resolved in 6/7 patients in the pharyngoplasty group, which was significantly (<i>P</i> = .03) higher than the palatoplasty group.ConclusionsIn patients with 22q, palatoplasty procedures may be less effective than pharyngoplasty procedures at resolving hypernasality. This may be due to underlying anatomic or physiologic differences, such as increased pharyngeal depth and hypodynamic muscles.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1616-1624"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Invited Review: \"I've Just Seen a Face\".","authors":"Kenny Ardouin","doi":"10.1177/10556656241259885","DOIUrl":"10.1177/10556656241259885","url":null,"abstract":"<p><p>I've Just Seen a Face is a new resource produced by author Amy Mendillo and is designed for parents of children with cleft lip and/or palate to help them to navigate the first year of life. In this invited article, Kenny Ardouin provides an overview of the book, and offers perspective on the content contained within, including potential issues for professionals working with cleft to consider. The review ends with recommendations for likely beneficiaries of the book, as well as considerations for additional future versions of the book.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1578-1580"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}