European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Accuracy of acetabular cup installation angles using two augmented reality navigation systems: computed tomography-based and noninvasive portable systems in total hip arthroplasty.","authors":"Gai Kobayashi, Yohei Naito, Shine Tone, Hironori Unno, Masahiro Hasegawa","doi":"10.1007/s00590-026-04971-z","DOIUrl":"10.1007/s00590-026-04971-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the accuracy of acetabular cup installation angles in total hip arthroplasty (THA) between a CT-based augmented reality (AR) navigation system and a noninvasive AR portable navigation system used simultaneously during surgery. Both navigation systems can be used with acetabular components from multiple manufacturers.</p><p><strong>Methods: </strong>This study included 48 hips across 44 patients who underwent primary cementless THA in the supine position. Acetabular cup placement was guided by the AR CT-based navigation system, whereas the noninvasive AR portable navigation system provided a single static measurement after cup fixation. The cohort consisted of 12 male and 36 female hips, with a mean age of 69 years and a mean body mass index (BMI) of 24 kg/m². The target angles for cup placement were 40° for radiographic inclination (RI) and 15° for radiographic anteversion (RA). Navigation errors were defined as the absolute difference between intraoperative navigation values and postoperative CT measurements and compared between groups.</p><p><strong>Results: </strong>RI navigation errors were similar (CT-based AR group vs. noninvasive AR portable group: 2.4°±2.0° vs. 2.8°±2.4°; not significant). In contrast, RA navigation errors were significantly smaller in the CT-based AR group (2.3°±1.8°) than in the noninvasive AR portable group (3.2°±2.4°; p < 0.05). No significant factors influencing navigation errors were identified in either group.</p><p><strong>Conclusion: </strong>In supine THA, under these static measurement conditions, RI navigation error did not differ significantly between the two systems, whereas RA navigation error was significantly greater with the noninvasive AR portable navigation system than with the AR CT-based navigation system.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding \"Quantitative assessment of pelvic reduction using a pretensioned external fixator in unstable pelvic injuries: a retrospective study\".","authors":"Hao Liu, Qinglai Wang","doi":"10.1007/s00590-026-04979-5","DOIUrl":"10.1007/s00590-026-04979-5","url":null,"abstract":"<p><p>The pretensioned pelvic external fixator (PPEF) is a promising option for unstable pelvic injuries, but its radiological assessment remains unstandardized. Queipo-de-Llano et al. reported favorable reduction in 28 patients, with no significant difference between Tile C and A/B fractures. We highlight three methodological issues: inconsistent labeling of the Matta-Tornetta criteria, reduction CT performed several days after frame application, and inadequate control of baseline balance in subgroup comparisons. Clarifying these points is essential for interpreting the true efficacy of PPEF.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of total knee arthroplasty in patients with posttraumatic versus primary knee osteoarthritis.","authors":"Stefanie Waldburger, Vilijam Zdravkovic, Andreas Ladurner, David Hamilton, Karlmeinrad Giesinger","doi":"10.1007/s00590-026-04960-2","DOIUrl":"10.1007/s00590-026-04960-2","url":null,"abstract":"<p><strong>Introduction: </strong>Posttraumatic osteoarthritis (ptOA) of the knee accounts for 12.5% of all total knee arthroplasties (TKA) and is associated with significantly higher complication and revision rates than in TKA for primary osteoarthritis (pOA). However, the impact of ptOA on patient-reported outcomes is less clear. The purpose of this study is to analyse longitudinal clinical and patient-reported outcomes in these patient groups.</p><p><strong>Materials and methods: </strong>A retrospective analysis of prospectively collected data from an institutional database was performed (time frame 2006-2023). Patients with a history of intraarticular femoral or tibial fractures (ptOA) were identified, and propensity score matched (1:3 ratio) for age, sex and body mass index (BMI) to a comparable cohort receiving TKA for pOA. Outcomes at one year were assessed using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Forgotten Joint Score-12 (FJS-12), EuroQo-5D (EQ-5D), range of motion (ROM) and overall patient satisfaction.</p><p><strong>Results: </strong>72 patients with ptOA were compared to 216 matched pOA patients. There were no statistically significant differences in WOMAC (19.95 vs. 15.61; p = 0.15) or EQ-5D (0.75 vs. 0.80; p = 0.14) between the two groups at 1-year follow-up. FJS-12 showed significantly inferior result 1-year postoperatively in the ptOA group (56.4 vs. 71.3; p = 0.02). Overall patient satisfaction (72.4 vs. 89.6%; p = 0.001) and pre- and post-operative ROM (p < 0.001) were also significantly worse in the ptOA group.</p><p><strong>Conclusions: </strong>There was no difference in traditional joint-specific or general heatlh scores (WOMAC or Eq. 5D scores) between patients with primary or posttraumatic OA. However, patients undergoing TKA for ptOA reported poorer higher-level outcomes (FJS-12 scores), poorer satisfaction rates and poorer knee flexion at 1-year.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early mechanical failure patterns after femoral neck fixation with the femoral neck system and dynamic hip screw.","authors":"Clémence Baetz, Adrien Maupetit, Clément Marc, Louis Rony, Guillaume David","doi":"10.1007/s00590-026-04955-z","DOIUrl":"10.1007/s00590-026-04955-z","url":null,"abstract":"<p><strong>Background: </strong>The Femoral Neck System (FNS) has been introduced as a minimally invasive alternative to the Dynamic Hip Screw (DHS) for intracapsular femoral neck fracture fixation. Comparative data on early mechanical failure patterns remain limited.</p><p><strong>Purpose: </strong>To describe the early mechanical complications observed after FNS and DHS fixation during a period of progressive FNS adoption, without assuming implant-specific causality.</p><p><strong>Methods: </strong>This retrospective single-center cohort included 130 consecutive patients treated between December 2020 and January 2024 (42 DHS, 88 FNS). The primary outcome was mechanical revision within one year. Tip-apex distance (TAD) and postoperative reduction quality using the Garden Alignment Index (GAI) were assessed on immediate postoperative radiographs.</p><p><strong>Results: </strong>Mechanical revision occurred in 3 DHS patients (7.1%; 95% CI 1.5-19.5%) and 8 FNS patients (9.1%; 95% CI 4.0-17.1%; p = 0.25). Reduction was acceptable in 40/42 DHS and 80/88 FNS patients (p = 0.50). Mechanical failure occurred in 5/10 patients with unacceptable reduction versus 6/120 with acceptable reduction (p < 0.001). Mean TAD was similar between groups (18.8 ± 4.8 versus 19.6 ± 5.2 mm; p = 0.34), and all four cut-outs occurred with TAD >25 mm. Observed failure patterns included shortening/medialization and cut-out after DHS, and shortening/medialization, cut-out, and peri-implant fracture after FNS.</p><p><strong>Conclusion: </strong>Different mechanical complications were observed after DHS and FNS fixation, but confounding by indication and the small number of events preclude implant-specific causal conclusions. Reduction quality and implant positioning appear important determinants of early mechanical failure.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture nonunion: classification, evaluation and management strategies-a structured approach for higher orthopaedic examinations.","authors":"Maria Vitenberg, Katie Hutchinson, Pramin Raut, Alex Trompeter","doi":"10.1007/s00590-026-04962-0","DOIUrl":"10.1007/s00590-026-04962-0","url":null,"abstract":"<p><strong>Purpose: </strong>Fracture nonunion is a clinical challenge that can lead to prolonged disability and significantly impaired quality of life. This review summarises current evidence on its evaluation and management, emphasising the principles relevant to higher orthopaedic examinations.</p><p><strong>Methods: </strong>A structured narrative review of relevant literature, focusing on classification, risk factor assessment, diagnosis and surgical management of fracture nonunion, is presented. Systematic reviews, established guidelines and clinically relevant studies are considered, allowing for a practical, principle-based approach to be described.</p><p><strong>Results: </strong>Fracture nonunion is a multifactorial condition that requires comprehensive assessment, including patient- and injury-related risk factors, adequate imaging and laboratory testing. Nonunion management strategies are based on the optimisation of the biological and mechanical environment.</p><p><strong>Conclusion: </strong>Fracture nonunion represents a complex condition that requires multidisciplinary management within specialist centres. Selection of the optimal strategy should be based on an assessment of both biological and mechanical factors contributing to impaired fracture healing. Fracture-related infection should be considered in all cases of nonunion, and appropriate evaluation should be undertaken.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on: \"Formal joint preparation appears to not be necessary for surgical treatment of ankle fractures with tibiotalocalcaneal nailing: a systematic review\".","authors":"Omar Tariq Al Zareeni, Abrar Azzabi","doi":"10.1007/s00590-026-04973-x","DOIUrl":"10.1007/s00590-026-04973-x","url":null,"abstract":"<p><p>This correspondence concerns a systematic review reporting that formal joint preparation is not necessary during tibiotalocalcaneal nailing for ankle fractures. The review's principal outcome is fracture union, whereas joint preparation is undertaken to achieve arthrodesis, and radiographic fusion is reported in only one of the seven included studies, where both joints fused in 18.2% of patients. The conclusion therefore rests on an endpoint the intervention is not intended to influence, a limitation acknowledged in the discussion but not in the title or conclusion. Three discrepancies are also identified from the published tables: the union numerators sum to 127 rather than the reported 114, and reconcile exactly when the unprepped figure given in the Results is substituted for one study entered at its full-cohort value; a rate printed as 88% is 77.8%; and complication and reoperation rates are calculated on denominators from which two patients were removed while their events were retained. The remedies proposed are re-tabulations of existing data rather than new analyses.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on: \"Clinical and logistical determinants of operative timing, surgical approach, and admission in pediatric supracondylar humerus fractures\".","authors":"Abdul Basit Munir, Haider Imran, Nashmia Faraz","doi":"10.1007/s00590-026-04968-8","DOIUrl":"10.1007/s00590-026-04968-8","url":null,"abstract":"<p><p>This letter to the editor examines recent work by Nelson et al. regarding the clinical and logistical determinants of operative timing, surgical approach, and hospital admission in 242 pediatric supracondylar humerus fractures. While acknowledging the study's insights into resource allocation, the author raises several methodological and statistical concerns. These include potential selection bias from differential missing data on weekends, the exclusion of nonoperatively managed patients which limits triage applicability, and the recoding of surgical approaches. Furthermore, the critique highlights limitations regarding multivariable model construction without correction for multiple comparisons, and notes that the evaluated outcomes reflect healthcare utilization rather than direct patient-centered benefits or long-term functional recovery. The author concludes that addressing these methodological factors, alongside multicenter validation and patient-centered outcomes, is vital before implementing such models in clinical triage.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is anterior pelvic ring fixation associated with lower incidence of posterior hardware failure in elderly patients with pelvic ring injuries?","authors":"Andrew P Collins, Benjamin R Caruso, Zachary A Rockov, Conor P Kleweno, Reza Firoozabadi","doi":"10.1007/s00590-026-04976-8","DOIUrl":"10.1007/s00590-026-04976-8","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies assess failure risk of pelvic ring constructs in elderly patients. This study aimed to identify patient, injury, and fixation characteristics associated with implant positional change, altered weightbearing restrictions, and revision surgery in operatively managed geriatric pelvic ring injuries.</p><p><strong>Methods: </strong>This retrospective cohort study at a single academic Level I trauma center included patients aged 65 years or older with operatively treated pelvic ring injuries and a minimum 6 month follow-up. The primary outcome was the incidence of postoperative implant positional change. Secondary outcomes were revision surgery and postoperative weightbearing restriction changes resulting from implant migration.</p><p><strong>Results: </strong>215 patients were included (mean age 74.0 ± 6.9 years; 57% female). Radiographic implant positional change occurred in 23.7% of patients (6.5% anterior, 17.7% posterior). Weightbearing restrictions were altered in 4.2% due to implant loosening, and revision surgery was performed in 4.2% (0.9% hardware removal, 3.3% revision fixation). On multivariate analysis, posterior implant positional change was independently associated with a protective effect from age > 80 years (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1-0.8, p = 0.016) and anterior ring fixation (OR 0.2, 95% CI 0.1-0.4, p < 0.001). Among patients with anterior injuries, anterior pelvic ring fixation was likewise protective against revision surgery or adverse changes in weightbearing status (OR 0.3, 95% CI 0.1-0.9, p = 0.045).</p><p><strong>Conclusions: </strong>In geriatric pelvic ring injuries, anterior pelvic ring stabilization was associated with lower incidence of implant positional change and subsequent revision surgery or weightbearing restriction changes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe definitive surgery in unstable pelvic ring injuries - a retrospective cohort study.","authors":"Carl Vincent Bästlein, Felix Karl-Ludwig Klingebiel, Christian Thomas Hübner, Yannik Kalbas, Olivia Klee, Hans-Christoph Pape, Roman Pfeifer","doi":"10.1007/s00590-026-04972-y","DOIUrl":"10.1007/s00590-026-04972-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Unstable pelvic ring injuries in polytrauma patients remain among the most lethal injury patterns, largely due to hemorrhage and the physiological burden of staged surgical management. While temporary external fixation is widely used as part of damage-control strategies, early definitive posterior stabilization using percutaneous sacroiliac \"rescue screws\" may provide sufficient mechanical stability while reducing cumulative operative stress. However, comparative clinical data supporting this approach remain scarce. This study investigates operative strategies, timing, and early outcomes in a consecutive cohort of severely injured patients with unstable pelvic ring fractures treated at a Level-1 trauma center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a retrospective cohort study including patients aged ≥ 16 years with high-energy unstable pelvic ring injuries (Young and Burgess APC II-III, LC III, combined mechanism, and vertical shear) and an Injury Severity Score (ISS) &gt; 16. Demographic data, injury severity, hemodynamic status on admission, operative strategies, number of surgical procedures, and length of hospital stay were analyzed. Outcomes were compared between early definitive posterior fixation and temporary external fixation. Statistical significance was defined as p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-two patients were included (mean age 43.6 ± 17.3 years; 72.2% male), reflecting a severely injured cohort with a mean ISS of 30.4 ± 10.6; 30.6% presented with hemodynamic shock on admission. Early definitive posterior stabilization without prior temporary external fixation was achieved in n = 63 patients (87.5%). Temporary external fixation was required in n = 9 patients (12.5%), who demonstrated significantly greater injury severity, including higher ISS (41.0 ± 11.3 vs. 28.9 ± 9.8), higher NISS (45.7 ± 12.5 vs. 30.8 ± 10.4), and a higher incidence of shock on admission (44.4 versus. 28.6%). Compared with early definitive fixation, external fixation was associated with a substantially higher operative burden (2.31 ± 0.85 vs. 1.41 ± 0.67 procedures) and prolonged hospitalization (31.9 ± 30.2 vs. 23.4 ± 25.3 days). Radiographic reduction quality did not differ between the groups, with a mean residual sacroiliac joint diastasis of 4.14 ± 1.21 mm in the SDS group and 4.11 ± 0.71 mm in the ExFix group; according to the Matta and Saucedo criteria, all reductions in both groups were graded as anatomic or nearly anatomic. Importantly, early posterior fixation using percutaneous sacroiliac rescue screws was not associated with an increase in early fixation-related complications, even in initially unstable patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In a Level-1 trauma setting, early definitive posterior stabilization using percutaneous sacroiliac rescue screws is feasible and safe in most patients with unstable pelvic ring injuries. Compared with traditional staged management using temporary exte","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Perioperative antihypertensive medication use is associated with no antifibrotic benefit but higher complications and revision rates following shoulder arthroplasty\".","authors":"Hao Liu","doi":"10.1007/s00590-026-04969-7","DOIUrl":"10.1007/s00590-026-04969-7","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the statistical robustness and interpretive framing of a recent retrospective cohort study examining perioperative RAAS inhibitor use and outcomes after total shoulder arthroplasty.</p><p><strong>Methods: </strong>We evaluated the multiplicity of reported outcomes, sample-size implications for statistical significance, absolute risk differences, and the transparency of propensity score matching covariates against accepted observational-study principles.</p><p><strong>Results: </strong>The study reported at least 14 separate outcomes across 90-day and 1-year timepoints in two propensity-matched comparisons (ARB vs control, ACEi vs control), with no correction for multiple comparisons. With cohort sizes of 27,938-30,602 per group, absolute risk differences of less than 0.5% may reach conventional statistical significance, yet the abstract reports only directional findings (\"higher rates\") without absolute risk differences or confidence intervals for individual outcomes. The propensity score matching covariates are not specified in the abstract, and the title and abstract emphasize \"higher complications and revision rates\" while the conclusion acknowledges that findings should be interpreted as associative rather than causal.</p><p><strong>Conclusion: </strong>Clarification of multiplicity correction, absolute risk differences, matching covariates, and consistency between the title/abstract framing and the conclusion's causal caveat would strengthen the interpretability and clinical utility of this study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}