{"title":"CT imaging analysis of the C7 pedicle and lateral mass in children aged 0–14 years","authors":"","doi":"10.1016/j.aanat.2024.152349","DOIUrl":"10.1016/j.aanat.2024.152349","url":null,"abstract":"<div><h3>Background and objective</h3><div>There is currently a lack of anatomical research on the C7 pedicle and lateral mass in children aged 0–14 years, and experience with pediatric lower cervical spine surgeries remains limited. This study aims to investigate the anatomical structure of the C7 pedicle and lateral mass in a large pediatric sample to understand their growth patterns, providing imaging and anatomical references for pediatric lower cervical spine surgeries and the design of pediatric C7 screws.</div></div><div><h3>Methods</h3><div>We measured 12 parameters, including the width, length, height, and angles of the C7 pedicle and lateral mass in children aged 0–14 years. The t-test was used to analyze bilateral and gender differences, and least squares regression was applied for curve fitting analysis.</div></div><div><h3>Results</h3><div>The size parameters of the C7 pedicle and lateral mass generally increased with age, while angular parameters fluctuated within specific ranges. The average values for each parameter between ages 0–14 were as follows: D1: 2.78–5.28 mm, D2: 18.15–30.54 mm, D3: 2.44–6.01 mm, angle A: 38.05–44.48°; D4: 6.81–10.94 mm, D5: 5.37–11.23 mm, D6: 8.07–13.28 mm, D7: 1.94–4.88 mm, D8: 5.67–9.39 mm, angle C: 18.50–28.80°, angle D: 43.23–52.01°, angle E: 33.74–44.96°. Bilateral analysis showed no significant differences for most parameters across most age groups, with differences mainly observed in angle A, angle C, D6, and D8. Gender differences were primarily noted in length parameters across different age groups, especially in the 3–4, 6–7, 9–11, and 13–14 age groups. Regression analysis indicated that most parameters followed cubic function curves, while a few followed power or quadratic function curves.</div></div><div><h3>Conclusion</h3><div>This study provides detailed CT imaging anatomy of the C7 pedicle and lateral mass in children aged 0–14 years. Preoperative thin-slice CT scans and careful measurements of key parameters are essential for pediatric lower cervical spine surgeries. The findings offer valuable imaging and anatomical references for pediatric posterior cervical fixation surgery and screw design.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549491","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":"The effect of Scheuermann's kyphosis on rib cage morphology: A skeletal study","authors":"","doi":"10.1016/j.aanat.2024.152348","DOIUrl":"10.1016/j.aanat.2024.152348","url":null,"abstract":"<div><h3>Background</h3><div>Evolutionary changes in human rib cage morphology rendered it prone to pathologies like Scheuermann's kyphosis (SK). However, the impact of SK on rib cage morphology is unclear.</div></div><div><h3>Purpose</h3><div>This study aimed to examine differences in rib cage morphology (e.g., ribs and sternum) between SK patients and a control group.</div></div><div><h3>Methods</h3><div>Measurements of the vertebral body, transverse process angle, sternum, and rib size were taken from the skeletons of SK patients (76) and a control group (96). Statistical tests were carried out to examine differences between the study and control groups and between the right and left sides. Correlations were obtained to examine the associations between the extent of the kyphosis (kyphosis angle) and rib cage variables.</div></div><div><h3>Results</h3><div>The SK group yielded significantly longer and flatter ribs than the control group in both sexes. However, males had the largest differences in the 9th rib and females in the upper ribs (5−7). Inconsistency in symmetry results was found between the sexes. In summary, SK patients had a larger anteroposterior diameter in relation to the transverse diameter than the control group.</div></div><div><h3>Discussion and Conclusions</h3><div>SK affects the morphology of the entire thorax and changes rib proportions similarly in males and females. These changes might have a role in bipedal stability and locomotion efficiency. Moreover, understanding the unique anatomy of SK patients is essential when performing an anterior release and anterior fusion operative approach. Finally, it provides insights into respiratory complications and poor prognosis related to individuals suffering from severe hyperkyphosis.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514489","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":"Caspase-12 affects chondrogenesis in mice","authors":"","doi":"10.1016/j.aanat.2024.152347","DOIUrl":"10.1016/j.aanat.2024.152347","url":null,"abstract":"<div><div>Caspase-12 is a molecule whose functions are still not well understood. Although its expression has been found in various tissues, specific roles have been described in only a few cases. These include the effect of caspase-12 on murine bone cell differentiation during craniofacial development. This work focused on the development of the limbs taking place through endochondral ossification, which precedes the formation of the cartilaginous growth plate. Caspase-12 was described here for the first time in growth plate chondrocytes during physiological development. Using pharmacological inhibition, caspase-12 was found to affect chondrogenesis. Limb-derived micromass cultures showed a significantly increased area of chondrogenic nodules after caspase-12 inhibition and there were changes in gene expression, the most significant of which was the reduction of <em>Mmp9</em>. These data point to potential new functions of caspase-12 in chondrogenesis.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514488","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":"3D digital anatomical measurements for clinical application of minimally invasive lumbar foraminal surgery in adolescents aged 12–21 years","authors":"","doi":"10.1016/j.aanat.2024.152344","DOIUrl":"10.1016/j.aanat.2024.152344","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to establish an anatomical foundation for minimally invasive lumbar spine surgery in adolescents by assessing the 3D anatomical parameters of the lumbar vertebrae in the age group of 12–21 years.</div></div><div><h3>Methods</h3><div>We collected CT data from 90 adolescents and performed 3D reconstructions using Mimics 16.0 software. The dimensions assessed included the height and sagittal diameter of the intervertebral foramen, as well as the length and widths of the transverse and spinous processes.</div></div><div><h3>Results</h3><div>The intervertebral foramen height exhibited variation corresponding to the vertebral level, being smallest at L5/S1 and largest at L3/4. The sagittal diameter of the intervertebral foramen increased with age, reaching a minimum at L1/2 and a maximum at L4/5. Significant gender differences were observed in the 12–14 age group, with females exhibiting larger measurements than males. The length and width of the transverse processes were maximal at L3 and L5, respectively. The spinous process length was greatest at L3 and smallest at L5, with notable gender differences present in the 12–14 and 19–21 age groups.</div></div><div><h3>Conclusion</h3><div>The study reveals that gender and age are significant factors influencing the anatomy of the adolescent lumbar spine, which is essential for the development of minimally invasive surgical techniques. Our findings contribute valuable insights for the design and surgical planning of spinal devices tailored to adolescents.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482807","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":"Surgical anatomy of the cystic artery: A systematic review with meta-analysis","authors":"","doi":"10.1016/j.aanat.2024.152343","DOIUrl":"10.1016/j.aanat.2024.152343","url":null,"abstract":"<div><h3>Background</h3><div>The current evidence-based systematic review with meta-analysis presents a detailed overview of the cystic artery (CA) surgical anatomy, including its origin, number, topography, and morphometry. Moreover, the surgical implications of these variants are further discussed.</div></div><div><h3>Methods</h3><div>According to the Evidence-Based Anatomy Workgroup and PRISMA 2020 guidelines, the systematic review was performed using four online databases. The Anatomical Quality Assurance Tool was used to evaluate the risk of bias. Meta-analysis was performed with the R programming software. The pooled prevalence and pooled mean of different CA parameters were calculated.</div></div><div><h3>Results</h3><div>The CA most commonly originated from the right hepatic artery (a pooled prevalence of 85.75 %). Other described origins (in order of frequency) were the aberrant right hepatic artery, the common hepatic, the left hepatic, the gastroduodenal, the superior mesenteric, and the middle hepatic arteries. The CA was single in 88.59 %, while it can be identified as double, triple, or absent. Most commonly, it was located inside the cystohepatic triangle in 83.83 %. Most commonly, it was superomedially to the cystic duct (77.80 %) and posteriorly to the common hepatic duct (35.08 %). The CA pooled mean length was 21.34 mm, and its diameter was more commonly over 1 mm.</div></div><div><h3>Conclusion</h3><div>The CA surgical anatomy is paramount when operating on the gallbladder. The CA's altered anatomy and adjacent area could lead to confusion, iatrogenic injury, and prolonged surgical time. The CA depicts high morphological variability; therefore, surgeons should consider the typical anatomy and possible (usual and unusual) variants.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382719","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":"Revisiting the anatomy of the pectoral nerves and nerve loops of the brachial plexus in the goat (Capra hircus)","authors":"","doi":"10.1016/j.aanat.2024.152340","DOIUrl":"10.1016/j.aanat.2024.152340","url":null,"abstract":"<div><h3>Background</h3><div>The anatomy of the pectoral nerves and the two nerve loops on the course of the axillary artery was revisited to complement current general descriptions as well as to argue whether the nerves contributing to the formation of the pectoral loop are the cranial pectoral nerves. Besides, the positional relationship between the scalene muscles and the nerve roots of the brachial plexus, which contribute to the nerves aimed in this study, was also examined at the same time as the dissection.</div></div><div><h3>Methods</h3><div>Twenty brachial plexuses of 10 domestic adult goats (8 females and 2 males) were examined using gross dissection in this study.</div></div><div><h3>Results</h3><div>In many dissections (95 %), the last bundle of scalenus ventralis muscle was found to pass between the roots of C7 and C8, dividing the brachial plexus into the cranial (ventral) and caudal (dorsal) parts. Two pectoral nerves were noted to contribute to the formation of the first nerve loop around the axillary artery. The first pectoral nerve arose predominantly from the ventral branches of C6 and C7 in company with the n. musculocutaneus, while the second pectoral nerve arose directly from C8 in 70 % of the dissections or as the first branch of the n. thoracicus lateralis (C8, T1) in the remaining 30 %. After the nerve loop, the second pectoral nerve branched off to innervate the superficial surface of the m. pectoralis profundus toward its insertion. The m. subclavius was found to receive its innervation from several sources, including the ventral branches of the brachial plexus. Interestingly, in 4 of the 14 dissections a communication between the n. subclavius and the n. phrenicus heretofore not found in the animal anatomy literature was found. In 16 of the 20 dissections (60 %), the ramus muscularis proximalis of the n. musculocutaneus received the communicating branch(s) from the n. medianus at the site of the second nerve loop, <em>ansa axillaris</em>.</div></div><div><h3>Conclusion</h3><div>The second pectoral nerve contributing to the pectoral loop would be better described as the caudal pectoral nerve rather than the cranial pectoral nerve. Besides the evolutionary perspectives, understanding the findings of this study would be helpful for teaching veterinary anatomy.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334178","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":"Τhe styloid process length and the stylohyoid chain ossification affect its relationship with the carotid arteries","authors":"","doi":"10.1016/j.aanat.2024.152342","DOIUrl":"10.1016/j.aanat.2024.152342","url":null,"abstract":"<div><h3>Purpose</h3><div>The elongated styloid process (SP) is associated with internal carotid artery (ICA) dissection, due to its close relationship with the vessel. However, the relationship with the variable ossified stylohyoid chain (SHC) has been scarcely studied. The current study investigated the relationship between the temporal bone's SP and the external and internal carotid arteries (ECA and ICA). The hypothesis was that the morphological variants of the SP influence this relationship.</div></div><div><h3>Methods</h3><div>Sixty multidetector computed tomography angiographies (120 heminecks) were randomly selected and retrospectively analyzed. SP elongation and the degree of SHC ossification were assessed. The distances (mm) between the SP and the carotid arteries (CAs) were measured.</div></div><div><h3>Results</h3><div>Elongated SPs were present in 21 patients (35 %), while 18 patients (30 %) exhibited variable degrees of SHC ossification. The mean distance from the SP tip and ECA was 5.45 ± 3.01 mm from the ECA and 6.16 ± 3.11 mm to the ICA. The minimum distance between SP and ECA was 3.96 ± 2.74 mm, and between SP and ICA was 4.72 ± 2.73 mm. A statistically significant reduction in SP-ICA distance was observed in cases with elongated SP and SHC ossification, while the SP-ECA distance was statistically significantly shorter in cases of SP elongation. Additionally, three novel topographical patterns between the SP and surrounding vascular structures were identified.</div></div><div><h3>Conclusions</h3><div>SP elongation and variable SHC ossification may impact the spatial relationship between the SP and the ICA/ECA. The proximity of the SP to the carotid arteries, particularly the ICA, holds clinical significance, as a reduced distance may predispose patients to carotid artery dissection, increasing the risk of stroke.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326637","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":"B-learning in human anatomy: Comparative analysis of academic achievement between face-to-face and e-learning modalities","authors":"","doi":"10.1016/j.aanat.2024.152339","DOIUrl":"10.1016/j.aanat.2024.152339","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, modern technologies have become established in most educational fields. Thus, e-learning tends to be an integral part of the learner-centered learning process, with the teacher acting as a facilitator. However, the methodologies used to study the impact of e-learning have been varied and imprecise, making comparison and meta-analysis difficult. This study attempts to overcome these obstacles with a large and homogeneous sample to compare (1) the academic outcomes obtained with face-to-face and e-learning in a blended module of human anatomy and (2) the response attempts (response index) of each student in answering questions specific to each learning modality.</div></div><div><h3>Material and methods</h3><div>The results of the multiple-choice exams under study were collected. All students (n=1160) were from four consecutive academic years following the same teaching program with a b-learning method: 13 topics were presented face to face by the same lecturers, and six via e-learning with the same online resources. Two variables were compared: (1) the academic grade, based on the score for correct answers and the penalty for incorrect ones, and (2) the response index, based on the number of correct and incorrect answers.</div></div><div><h3>Results</h3><div>(1) 73.45 % of the examinees passed the test. In the sample as a whole, results were better in face-to-face than in e-learning. In the quartiles ordered by overall academic performance, this superiority was limited to the top half of the higher-performing students. In contrast, lower-scoring students performed better in e-learning. However, these differences were modest (≤ 0.54 points). (2) In proportion, the questions on topics learned face-to-face were the most frequently answered. A strong correlation was observed between the variables in the whole sample and the students with the highest academic scores (first quartile) on the global exam and the questions on topics learned in each modality. In the remaining quartiles, the correlation was also strong in the e-learning content.</div></div><div><h3>Conclusions</h3><div>(1) Both modalities included in b-learning are academically effective. (2) Proportionally, students take more risks when answering content questions learned in face-to-face classes, and there is a strong correlation between response attempts and academic grades, especially, on the brightest exams and e-learning content.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unveiling proteomic targets in the hypothalamus of ovariectomized and estradiol-treated rats: Insights into menopausal syndrome mechanisms","authors":"","doi":"10.1016/j.aanat.2024.152341","DOIUrl":"10.1016/j.aanat.2024.152341","url":null,"abstract":"<div><h3>Background</h3><div>Menopausal syndrome profoundly affects the physical and mental health of many women, drawing increasing attention from the medical community. However, its pathogenesis remains unclear. These symptoms are primarily driven by hormonal fluctuation. The hypothalamus, a key regulator of hormonal balance, potentially playing a critical role in the manifestation of menopausal syndrome.</div></div><div><h3>Methods</h3><div>We simulated the low-estrogen menopausal state using ovariectomized rats, confirmed the success of ovariectomy via histological analysis of the uterus and vagina, followed by estrogen treatment. TMT-labeled quantitative proteomics, RT<img>qPCR, targeted proteomics and Western blotting were used to identify differentially expressed proteins and their functions in the hypothalamus under low-estrogen conditions.</div></div><div><h3>Results</h3><div>One-way ANOVA (p < 0.05) identified 295 differentially expressed proteins across the sham, ovariectomized and estrogen-treated groups. Post-ovariectomy, 103 differentially expressed proteins were upregulated and 93 were downregulated. Among these, 50 proteins were involved in hormones and neurotransmitters, immunity, metabolism and cardiovascular function. Notably, four proteins—Prkcg, Hsp90ab1, Ywhae, and Gad2—were identified as crucial regulators.</div></div><div><h3>Conclusions</h3><div>This study elucidates the central molecular mechanism of menopausal syndrome through bioinformatics analysis of differentially expressed proteins in the hypothalamus under low-estrogen conditions, providing novel targets for the treatment of related symptoms.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326806","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":"Stereological study of cerebellar morphology in feline fetuses: Insights from the final gestational stage","authors":"","doi":"10.1016/j.aanat.2024.152338","DOIUrl":"10.1016/j.aanat.2024.152338","url":null,"abstract":"<div><div>This study aimed to conduct a morphoquantitative and stereological evaluation, analyzing the cerebellum of domestic cat fetuses in the latter third of the gestational period. Fetal samples were obtained from a neutering campaign conducted in the municipality of Guarulhos, São Paulo, Brazil. The procedures and protocols used in this work adhere to the guidelines established by the ethics committee of the School of Veterinary Medicine and Animal Science at the University of São Paulo (FMVZ/USP), under the number CEUA 1935251121. The five selected fetuses were fixed in 4 % formaldehyde, and their gestational age was determined by Crown Rump (CR) measurements, followed by an assessment of external characteristics. The cerebella were subjected to the evaluation of morphometric parameters and histological processing using stereology techniques. The obtained means for the cerebellar parameters were as follows: length: 1.0-centimeter, width: 0.54 centimeters, thickness: 0.44 centimeters, and weight: 0.84 g. Using stereology, the following parameters were determined: cerebellar volume, averaging 0.847 cm³; volume density of the cortex: 0.496 or 49 % (molecular layer), 0.0314 or 3.14 % (Purkinje cell layer), 0.232 or 23 % (granular layer), and 0.234 or 23 % (medullary white center). Consequently, the average total volume of the cerebellar cortex is 0.419 cm³ for the molecular layer, 0.026 cm³ for the Purkinje cell layer, 0.196 cm³ for the granular layer, and 0.196 cm³ for the medullary white center. The findings presented here have contributed to an in-depth discussion of the neuro-motor development and cerebellum of domestic cats.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0940960224001304/pdfft?md5=dd2536bab68964b7041882857bc19b92&pid=1-s2.0-S0940960224001304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}