Scandinavian Journal of Surgery最新文献

{"title":"Survival of patients with complete metabolic response on [¹⁸F]FDG PET/CT after chemotherapy prior to transplantation for colorectal liver metastases.","authors":"Nadide Mutlukoca Stern, Svein Dueland, Pål-Dag Line, Trygve Syversveen, Harald Grut","doi":"10.1177/14574969261438696","DOIUrl":"https://doi.org/10.1177/14574969261438696","url":null,"abstract":"<p><strong>Background and aims: </strong>The primary aim was to compare disease-free survival (DFS), overall survival (OS), and post relapse survival (PRS) in patients undergoing transplantation for colorectal liver metastases (CRLM) who achieved complete metabolic response (CMR) on pre-transplant [¹⁸F]FDG PET/CT after chemotherapy, with patients presenting with low or high metabolic tumor volume (MTV).</p><p><strong>Methods: </strong>Pre-operative [¹⁸F]FDG PET/CT and diagnostic CT scans from 45 patients included in the Secondary Cancer (SECA) 1 and 2 studies were evaluated. MTV was derived from the [¹⁸F]FDG PET/CT, and patients with CMR (MTV = 0) were identified. Patients were stratified into three subgroups: MTV 0, MTV low, and MTV high. DFS, OS, and PRS were compared using the Kaplan-Meier method and the log-rank test. Baseline characteristics and CT reassessment data were analyzed using the Mann-Whitney U test for continuous variables and Fisher's exact test for categorical variables.</p><p><strong>Results: </strong>Thirteen patients with CMR had significantly longer DFS and OS than patients in the MTV high group (<i>p</i> = 0.033 and 0.030), but significantly shorter DFS and OS than those in the MTV low group (<i>p</i> = 0.042 and 0.018). PRS did not differ significantly between patients with CMR and those with low or high MTV (<i>p</i> = 0.121 and 0.130). Imaging findings of extensive growth along the liver capsule and/or possible tumor extension beyond the liver capsule on CT had significantly shorter OS (<i>p</i> = 0.010 and <0.001), including after exclusion of the MTV high group (0.034 and <0.001).</p><p><strong>Conclusion: </strong>Patients with CMR on [¹⁸F]FDG PET/CT after chemotherapy prior to liver transplantation for CRLM had intermediate DFS, OS, and PRS compared with patients with low and high MTV.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969261438696"},"PeriodicalIF":1.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to move beyond BMI alone in predicting arthroplasty infections: A large single-center retrospective cohort study.","authors":"Elisa Kosonen, Rasmus Liukkonen, Aleksi Reito, Eerik Skyttä, Antti Eskelinen","doi":"10.1177/14574969261438911","DOIUrl":"https://doi.org/10.1177/14574969261438911","url":null,"abstract":"<p><strong>Background and aims: </strong>A high body mass index (BMI) has traditionally been a strict criterion for surgical eligibility for arthroplasty based on the increased risk for periprosthetic joint infection (PJI). Individuals with obesity are two to four times more likely to undergo joint arthroplasty. There are limited data on how well BMI predicts PJI risk and whether strict BMI-based surgical criteria are justified.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included all primary total hip arthroplasties (THAs) and total knee arthroplasties (TKAs) performed at our institution between 1 January 2008 and 28 November 2023. Survival was analyzed using the Kaplan-Meier method, with PJI as the primary outcome. The association between BMI and PJI was assessed using logistic regression and Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 54,879 arthroplasties (23,544 hip and 31,335 knee arthroplasties) were included. The median age was 68 years (interquartile range (IQR): 60-75), and 60.0% of patients were female. The risk for PJI was highest in patients with a BMI >45. After THA, the lowest risk for PJI was seen with a BMI <25 (1.0%) and between 25 and 30 (1.1%) after TKA. After THA, a J-shaped association between BMI and PJI was observed in logistic regression analysis, as the risk for PJI increased in patients with both low and high BMIs. A J-shaped association between BMI and PJI was also observed in Cox regression analysis after both TKA and THA. Men had a higher risk for PJI after THA than women, whereas no sex variation was observed after TKA.</p><p><strong>Conclusion: </strong>The risk for PJI does not increase linearly with BMI and the risk differs between women and men. When BMI exceeds 45, risk levels become notably high. Otherwise, the absolute risk differences between different BMI categories are relatively low. Emphasis should be placed on individualized risk assessment and shared decision-making rather than focusing solely on BMI.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969261438911"},"PeriodicalIF":1.8,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative expectations and quality of life after breast reconstruction: Finnish validation of the BREAST-Q Reconstruction Expectations module.","authors":"Charlotta Kuhlefelt, Jussi P Repo, Tiina Jahkola, Susanna Kauhanen, Pauliina Homsy","doi":"10.1177/14574969261428789","DOIUrl":"https://doi.org/10.1177/14574969261428789","url":null,"abstract":"<p><strong>Background and aims: </strong>Patient expectations can influence satisfaction and health-related quality of life (HRQL) after breast reconstruction. The aim of this study was to evaluate both patient expectations before breast reconstruction and HRQL after a 1-year follow-up.</p><p><strong>Methods: </strong>A cohort study was performed on patients awaiting delayed breast reconstruction at Helsinki University Hospital in April 2020. The BREAST-Q Reconstruction Expectations module was translated into Finnish following accepted guidelines for preoperative assessment of expectations. One-year outcomes were assessed using the BREAST-Q Reconstruction module. Correlation analyses were performed to evaluate associations between expectations and postoperative HRQL.</p><p><strong>Results: </strong>Of 145 patients approached, 57 patients (39%) participated. Median preoperative age was 54 years (interquartile range (IQR) = 47-63). Expectations for coping were high (median = 100, IQR = 68-100). At 1 year, appearance, shape, and clothing fit were expected to return to near normal (median = 69, IQR = 53-91), and donor site appearance and function were expected to normalize (median = 6, IQR = 5-7). At 1 year, 38 patients (67%) completed follow-up. Median scores (IQR) were psychosocial well-being 62 (48-80), satisfaction with breasts 60 (47-76), physical well-being of the chest 85 (64-92), and physical well-being of the abdomen 72 (62-81), indicating generally favorable outcomes. High expectations for coping were associated with better psychosocial well-being postoperatively. In addition, patients expecting more pain reported lower physical well-being of the chest at 1 year.</p><p><strong>Conclusions: </strong>Breast cancer patients reported high expectations regarding the upcoming breast reconstruction, and the HRQL after a 1-year follow-up reflected attainment of these goals.</p><p><strong>Clinical trial registration: </strong>N/A.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969261428789"},"PeriodicalIF":1.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced recovery after surgery in diverticular disease: A multicenter comparison with colorectal cancer.","authors":"Mahmood Wael Mahmood, Mirna Abraham-Nordling, Anna Löf-Granström, Ali Kiasat, Fredrik Hjern, Ulf O Gustafsson","doi":"10.1177/14574969261431953","DOIUrl":"https://doi.org/10.1177/14574969261431953","url":null,"abstract":"<p><strong>Background and aims: </strong>ERAS protocols are widely used in colorectal surgery, yet their impact on outcomes in diverticular disease (DD) is unclear. The primary aim of this study was to compare postoperative complication rates after left-sided colon resections for either DD or left-sided colonic cancer within an ERAS pathway, the secondary aim was to assess ERAS protocol compliance.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study used data from the Swedish ERAS® Interactive Audit System (EIAS) from 2010 to 2020. All participating centers consecutively register elective colorectal procedures in patients aged ⩾ 18 years. We included all adult patients undergoing elective left-sided colonic or sigmoid resection at participating centers, where all procedures are mandatorily registered within a standardized ERAS pathway, with no additional exclusions. ERAS protocol compliance (pre- and intraoperative items), postoperative symptoms, and postoperative complications were assessed according to ERAS® guidelines and compared between diagnostic groups. Associations between variables and outcomes were evaluated using logistic regression.</p><p><strong>Results: </strong>A total of 3774 patients were included (879 with DD and 2895 with cancer). Patients in the DD group were younger and had fewer comorbidities. ERAS compliance was similar between groups (86.3% for DD vs 86.7% for cancer). In multivariable analysis, there was no statistically significant difference in severe complications (Clavien-Dindo grade III-IV) between the DD and cancer groups (11.8% vs 13.1%; OR = 0.97, 95% CI = 0.87-1.09). However, DD was associated with a higher rate of overall complications (39.2% vs 36.5%; OR = 1.27, 95% CI = 1.07-1.52), particularly infectious complications (17.0% vs 12.1%; OR = 1.55, 95% CI = 1.23-1.97), including intra-abdominal abscesses (3.5% vs 2.3%; OR = 1.62, 95% CI = 1.01-2.60). In addition, DD patients were more likely to experience postoperative pain that delayed hospital discharge (5.2% vs 2.4%, OR = 1.78, 95% CI = 1.17-2.70).</p><p><strong>Conclusions: </strong>Despite similar adherence to the ERAS protocol, surgery for DD was associated with a higher overall rate of postoperative complications and similar rates of severe complications as surgery for colonic cancer. The considerable risk of complications should be carefully considered when counseling patients with DD for elective surgery.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969261431953"},"PeriodicalIF":1.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholecystectomy or non-operative management for cholecystitis in elderly patients: An analysis based on hospital practice patterns.","authors":"Maria Söderström, Olov Norlén, Fredrik Linder, Erik Osterman","doi":"10.1177/14574969261431971","DOIUrl":"https://doi.org/10.1177/14574969261431971","url":null,"abstract":"<p><strong>Background and aims: </strong>Early cholecystectomy improves outcomes in acute cholecystitis, yet surgeons often hesitate to operate on elderly and multimorbid patients, and prospective data in this group are lacking. This cohort study compared outcomes across hospitals with differing operative policies to estimate the effect of surgery among the elderly.</p><p><strong>Methods: </strong>Retrospective data using the Swedish National Inpatient Register, including 12,481 patients aged ⩾ 70 years treated for cholecystitis between 2015 and 2019, were analyzed. Outcomes included all-cause and gallstone-related mortality, length of stay related to gallstone disease during the index admission, and within 1 and 3 years. Hospitals and counties were categorized into quartiles based on cholecystectomy rates (Q1 = lowest, Q4 = highest). Survival was assessed using Cox proportional hazards regression. Length of stay was analyzed with linear regression.</p><p><strong>Results: </strong>Patients treated at Q1 hospitals were slightly older but had similar comorbidity burdens compared to Q4 hospitals. Surgical rates ranged from 25% to 60%. Overall mortality was lower in Q4 counties, but not significantly different at hospital level (hazard ratio (HR) = 0.86 95% confidence interval (CI) = 0.77-0.96). Gallstone-related mortality did not differ across quartiles. Although the index admission length of stay was similar, cumulative length of stay at 1 and 3 years was shorter for patients treated at Q4 hospitals compared to Q1 (0.87 fewer days at 3 years; 95% CI = 0.39-1.34).</p><p><strong>Conclusions: </strong>Hospitals with higher cholecystectomy rates did not demonstrate lower mortality, but regions with higher surgical rates showed improved survival. Higher operative rates were associated with fewer recurrences and reduced cumulative length of stay, suggesting that increased use of cholecystectomy benefits both patients and healthcare systems.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969261431971"},"PeriodicalIF":1.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of extracervical recurrence following total parathyroidectomy and autotransplantation for renal hyperparathyroidism.","authors":"Dan Cortes, Sujith Wijerethne, James Lee, Ralph V Yap, Ngiam K Yuan, Rajeev Parameswaran","doi":"10.1177/14574969251363333","DOIUrl":"10.1177/14574969251363333","url":null,"abstract":"<p><strong>Background: </strong>In patients with renal hyperparathyroidism the choice of surgery varies between total parathyroidectomy with autotransplantation (TPTx + AT) and subtotal parathyroidectomy (SPT) with variable outcomes. The present study investigated the risk of extracervical recurrences in patients who underwent total parathyroidectomy with autotransplantation for dialysis patients with renal hyperparathyroidism.</p><p><strong>Methods: </strong>A retrospective cohort analysis of patients who underwent TPTx + AT for renal hyperparathyroidism between the years 2000 and 2023 at a tertiary referral hospital. Patient demographic profiles, biochemical and surgical data, incidence of recurrence and outcomes of intervention were collected.</p><p><strong>Results: </strong>Some 142 (71M:71 F) patients with a mean age of 58.6 ± 11.2 years underwent total parathyroidectomy and autotransplantation during the study period. The mean dialysis vintage was 6.3 ± 3.2 years. Extracervical recurrence was seen in 25 (17.6%) of 142 patients, after a mean follow-up of 9 (±4.2) years, with the common sites of recurrence being the deltoid autotransplant site (73.1%) and the mediastinum (11.5%), while 7.7% of recurrences were biochemical with no localized site. Of the recurrences, 19 of 25 (76%) underwent explant of the deltoid autotransplant, and two in the mediastinum underwent minimally invasive excision (one video assisted thoracic surgery and one robotic excision) of the parathyroid lesion. The median parathyroid hormone level at the time of recurrence was 109.4 pg/ml compared with 17.2 ng/L postexcision or explantation. The only factor predictive for recurrences in the cohort on multivariable analysis was postoperative serum PTH (<i>p</i> = 0.001). Log-rank test showed no statistically significant difference in survival between the two groups (<i>p</i> = 0.355).</p><p><strong>Conclusion: </strong>Extracervical recurrences in the autotransplant are not uncommon in the long-term following total parathyroidectomy and autotransplantation for patients with renal hyperparathyroidism. These recurrences need explantation or excision to reduce the PTH burden in patients who cannot avail a renal transplant.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"97-105"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GallRiks registry: Twenty years of improving the safety and quality of gallstone surgery and ERCP in Sweden.","authors":"Gabriel Sandblom, My Blohm, Carl Johan Drott, Lars Enochsson, Ioannis Gkekas, Erik Haraldsson, Linda Lundgren, Gunnar Persson, Lise-Lott Prebner, Stefan Redéen, Peder Rogmark, Eva-Lena Syrén, Johanna Österberg, Greger Olsson","doi":"10.1177/14574969251387506","DOIUrl":"10.1177/14574969251387506","url":null,"abstract":"<p><p>Gallstone disease is common in the Western world, and approximately 15,000 cholecystectomies and 9000 endoscopic retrograde cholangiopancreatographies (ERCPs) are performed each year in Sweden. While being safe, the high frequency of these procedures has a significant cumulative impact on health in the community, exceeding those of many complex procedures for malignant conditions. Compliance with established guidelines for gallstone disease management varies and the strength of supporting evidence remains inconsistent. The Swedish National Register for Gallstone Surgery and ERCP (GallRiks) was launched in May 2005 to monitor outcomes nationwide, to enhance quality of care, and to facilitate population-based research. Continuous feedback to participating units has contributed to improvement in patient care. Since its introduction, laparoscopic procedures have become more prevalent than open cholecystectomies, antibiotic prophylaxis is used more selectively, and the proportion of procedures performed on a day-case basis has increased: all of this despite unchanged healthcare resources. Register-based studies have highlighted the benefits of intraoperative cholangiography, the advantages of centralizing care to high-volume surgeons, endoscopists and units, as well as the impact of surgeon gender on outcomes. Now in its 20th year, GallRiks remains a cornerstone of quality assurance in Swedish gallstone surgery. Research based on register data continues to improve gallstone disease management and shape clinical guidelines and healthcare practice.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"131-133"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancies: How, to whom, and is centralization needed?","authors":"Ebbe B Thorgersen, Vegar J Dagenborg, Johannes K Schultz","doi":"10.1177/14574969261418796","DOIUrl":"10.1177/14574969261418796","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"129-130"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-affirming healthcare in the Nordic countries: An overview.","authors":"Isak Gran, Cecilia Dhejne, Antti Mikkola, Martin Sollie, Pehr Sommar, Rikke Holmgaard, Kaisu Ojala, Hannes Sigurjonsson, Louise Frisén, Jenny Löfgren, Helena Sackey","doi":"10.1177/14574969251371862","DOIUrl":"10.1177/14574969251371862","url":null,"abstract":"<p><p>This narrative review examines gender-affirming healthcare in the Nordic countries, highlighting historical developments, legal frameworks, epidemiological trends, and current clinical practices. Transgender healthcare dates back to the early 20th century and gained international attention in the early 1950s following one of the first widely publicized gender-affirming surgeries performed in Denmark. Since then, care models have evolved, supported by policy, research, and clinical practice across Europe and North America.All Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden, provide publicly funded gender-affirming healthcare, although service structures differ. Legal gender recognition has shifted toward self-identification in Denmark, Finland, Iceland, Norway, and from July 2025, also Sweden by removing medical or psychiatric prerequisites.In parallel, epidemiological data reveal an increased healthcare utilization, particularly among youth assigned female at birth. Elevated rates of mental health challenges highlight the need for integrated psychosocial support. Clinical care typically follows a multidisciplinary model including psychiatric and medical assessment, hormone therapy, and surgery when indicated. Access to chest and genital surgery requires a formal diagnosis and is with few exceptions restricted to adults. Evidence supports the positive impact of gender-affirming treatment on gender congruence and health-related quality of life. Regret after gender-affirming surgery is rare but does occur, underscoring the importance of individualized care and thorough informed consent.Ongoing challenges include long wait times, unequal access for non-binary individuals, and a growing number of individuals seeking private or cross-border care. Future efforts should focus on expanding public services, strengthening research, and promoting equitable, evidence-based care that reflects the diversity of gender identities.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"5-14"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year survival outcomes following perioperative hydrocortisone versus pasireotide in patients with high risk of pancreatic fistula: Secondary analysis of the HYPAR randomized clinical trial.","authors":"Timo Tarvainen, Jukka Sirén, Arto Kokkola, Ville Sallinen","doi":"10.1177/14574969251387503","DOIUrl":"10.1177/14574969251387503","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"116-118"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}