Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery最新文献

{"title":"Role of choroid plexus cauterization in augmenting the success rate of endoscopic third ventriculostomy in Chiari II-associated hydrocephalus.","authors":"Mohamed Mohsen Amen, Mohamed Badran, Ahmed Zaher, Mostafa Shahein","doi":"10.1007/s00381-026-07414-6","DOIUrl":"10.1007/s00381-026-07414-6","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the efficacy and outcomes of endoscopic third ventriculostomy combined with choroid plexus cauterization (ETV + CPC) as a primary treatment for hydrocephalus associated with Chiari II malformation in infants.</p><p><strong>Methods: </strong>This retrospective study analyzed 53 infants, all under 12 months of age and post-myelomeningocele repair, who presented with hydrocephalus (Evans' Index > 0.3 or Frontal occipital horn ratio (FOHR) > 0.4). All patients underwent Endoscopic third ventriculostomy (ETV) and bilateral choroid plexus cauterization (CPC) using a rigid endoscope. Success was defined as shunt-free survival with clinical and radiological improvement over a 12-month follow-up period.</p><p><strong>Results: </strong>The cohort of 53 infants (28 males, 25 females) had a mean age of 3.4 months, with 36% consanguinity. Patients were stratified into three age groups: < 3 months (n = 13), 3-6 months (n = 19), and 6-12 months (n = 21). The ETV + CPC success rate showed a positive correlation with age: 54% in the youngest group, 63% in the middle group, and 67% in the oldest group. Of the 20 failures, 14 required ventriculoperitoneal shunts (VPS), and 6 were managed with re-endoscopy for stoma closure. Meningitis was the most common complication (15%), with all affected patients eventually requiring a VP shunt.</p><p><strong>Conclusion: </strong>ETV + CPC offers an effective, safe, and durable alternative to traditional VPS for infants with Chiari II-associated hydrocephalus. It significantly reduces shunt dependency and its associated long-term complications. Success rates improve with advancing age, making it a viable first-line surgical option in pediatric neurosurgery, particularly in resource-limited settings.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671847","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":"Time to adjuvant treatment for newly diagnosed pediatric brain tumors in the molecular era: a single center retrospective study.","authors":"Kenneth L Virgin, Michael Fletcher, Jinan Ayub, Hannah Harmsen, Laurie L Ackerman, Jignesh K Tailor","doi":"10.1007/s00381-026-07419-1","DOIUrl":"10.1007/s00381-026-07419-1","url":null,"abstract":"<p><strong>Purpose: </strong>Molecular testing has become a cornerstone in pediatric neuro-oncology but relies on time intensive workflows at specialized centers. We hypothesized that time to adjuvant therapy has increased since the incorporation of molecular testing.</p><p><strong>Methods: </strong>In this retrospective case series, data were collected from Riley Hospital for Children in Indianapolis from the pre-molecular era (2007-2009) and the molecular era (2023-2025). Patients aged ≤ 21 years who received initial surgery for a primary brain tumor were included. The primary outcome of interest was the time from initial surgery to initiation of adjuvant treatment.</p><p><strong>Results: </strong>A total of 140 patients met inclusion criteria, including 83 who received adjuvant therapy as part of the initial postoperative treatment plan. Time to adjuvant treatment was significantly shorter in the pre-molecular cohort (24.5 vs 34.2 days). Multivariate analysis demonstrated that this prolonged time to treatment was associated with the use of targeted therapies that rely on molecular testing for diagnosis, and increased patient referrals to external institutions during the molecular era. The most cited reasons for delay in adjuvant treatment were final pathology report pending, family decision making, and shunt-related factors.</p><p><strong>Conclusion: </strong>Time to adjuvant therapy was longer in the molecular era, and this effect was attributable to evolving treatment paradigms, specifically the adoption of targeted therapies related to molecular diagnosis and increased reliance on external treatment centers. These results underscore modifiable, system-level barriers in the delivery of precision oncology which represent key opportunities to improve timeliness of care and, ultimately, patient outcomes.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671895","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":"Unilateral hemilaminectomy for pediatric intradural spinal tumors: a consecutive case series.","authors":"Serdar Kahraman, Mehmet Alpay Çal","doi":"10.1007/s00381-026-07424-4","DOIUrl":"10.1007/s00381-026-07424-4","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the perioperative, oncologic, and structural outcomes of unilateral hemilaminectomy for pediatric intradural spinal tumors.</p><p><strong>Methods: </strong>We retrospectively reviewed all children aged ≤ 16 years who underwent unilateral hemilaminectomy for an intradural spinal tumor at a single tertiary center between 2018 and 2023. Clinical records, operative data, early postoperative contrast-enhanced MRI, and subsequent surveillance imaging were evaluated. Primary outcomes were 30-day complications and clinically detected postoperative deformity or instability requiring further evaluation or treatment.</p><p><strong>Results: </strong>Among 246 spinal tumor operations across all age groups, 11 involved children; six extradural tumors were excluded, and all five pediatric intradural tumors underwent unilateral hemilaminectomy. Four patients were aged 13-16 years. Early postoperative MRI demonstrated gross-total resection in three patients, near-total resection in one, and subtotal resection in one. In the latter patient, a greater than 80% reduction in motor-evoked potential amplitude prompted termination of the index procedure without tumor resection. An unplanned second operation was performed 7 days later, but similar monitoring deterioration limited resection to subtotal removal. The child experienced transient quadriparesis after both procedures; both episodes resolved before discharge. Stereotactic radiotherapy was subsequently administered. During a median follow-up of 26 months (range, 18-84 months), no tumor-related reoperation or clinically detected deformity or instability requiring bracing, referral, or fusion was documented.</p><p><strong>Conclusion: </strong>Unilateral hemilaminectomy provided surgical access for pediatric intradural tumors while preserving the contralateral posterior elements. However, the small, predominantly adolescent cohort, absence of systematic standing radiographs, and limited follow-up preclude conclusions regarding subtle or late deformity or comparative superiority.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671904","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":"Successful pre-operative endovascular intraventricular meningioma embolization: a systematic review and pediatric case analysis.","authors":"Adam M Abdallah, Atef F Hulliel, Dana Saleh, Mohammad Mukahal, Deema Qassim, Mouness Obeidat","doi":"10.1007/s00381-026-07422-6","DOIUrl":"10.1007/s00381-026-07422-6","url":null,"abstract":"<p><strong>Background: </strong>Intraventricular meningiomas are rare tumors accounting for a small fraction of intracranial meningiomas and are often associated with significant surgical challenges due to their deep location and rich vascular supply. Pre-operative endovascular embolization has been proposed as an adjunct to reduce intraoperative bleeding and facilitate safer resection; however, its role in intraventricular lesions remains poorly defined.</p><p><strong>Method: </strong>We present a case of a 9.5-year-old boy with a highly vascular intraventricular meningioma who underwent pre-operative endovascular embolization followed by surgical resection. Additionally, a systematic review was conducted in accordance with PRISMA guidelines, searching PubMed and Scopus for studies reporting embolization of intraventricular meningiomas.</p><p><strong>Results: </strong>In the presented case, selective embolization of the posterior choroidal artery using a glue-lipiodol mixture was successfully performed without complications, leading to reduced tumor vascularity and enabling gross total resection with minimal blood loss (< 300 mL). The systematic review identified seven cases from six studies. Embolization was successful in six cases, with varying degrees of devascularization. Gross total resection was achieved in all surgically treated patients. Reported intraoperative blood loss ranged from 150 to 1850 mL. Complications occurred in two of seven cases, including postoperative epidural hematoma.</p><p><strong>Conclusion: </strong>Pre-operative endovascular embolization appears to be a technically feasible adjunct in selected cases of intraventricular meningiomas. However, current evidence is limited to case reports and small case series, precluding definitive conclusions regarding its safety or clinical benefit.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665545","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":"Intraoperative diagnosis of myxoid glioneuronal tumor guiding safe limited resection: a case report.","authors":"Kazuya Morita, Yoshio Nakashima, Nozomu Kurose, Atsuhiro Kawashima, Akihiro Nishiyama, Hironori Fujisawa","doi":"10.1007/s00381-026-07421-7","DOIUrl":"10.1007/s00381-026-07421-7","url":null,"abstract":"<p><p>Myxoid glioneuronal tumor (MGT) is a newly delineated CNS WHO grade 1 neoplasm genetically characterized by PDGFRA p.K385L/I mutation. We describe a 14-year-old boy presenting with gelastic seizures caused by an intraventricular MGT. Intraoperative frozen section allowed minimal resection, preserving surrounding eloquent structures. Histology showed oligodendrocyte-like cells within myxoid stroma and scattered floating neurons, while molecular analysis revealed the canonical PDGFRA p.K385L mutation. At 13-month follow-up, the residual tumor remained stable without any further neurological dysfunction. This case highlights the importance of intraoperative diagnosis for surgical safety in MGT.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655576","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":"An unusual cranial manifestation of B-cell precursor lymphoblastic lymphoma in 10-year-old girl.","authors":"Dominika Bardońska, Tymon Skadorwa, Łukasz Hutnik","doi":"10.1007/s00381-026-07420-8","DOIUrl":"10.1007/s00381-026-07420-8","url":null,"abstract":"<p><p>Pediatric B-cell precursor lymphoblastic lymphoma (BCP-LBL) is a rare subtype of non-Hodgkin lymphoma with a predominantly extramedullary presentation. Cutaneous and subcutaneous involvement, particularly in the head region, is a recognized manifestation; however, presentation as a solitary scalp mass mimicking a benign surgical lesion remains diagnostically challenging. A 10-year-old female patient presented to the Neurosurgery Department for a growing mass in the right frontal region of the scalp for the past 4 months. After excision, the mass was diagnosed as BCP-LBL and the patient was referred to oncologic treatment. This report aims to increase awareness among surgeons and physicians that persistent or progressive pediatric scalp lesions, even when clinically benign-appearing, may represent an underlying malignant hematologic disease requiring prompt histopathological verification and specialist referral.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655574","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":"Prolonged puncturing decreases ventriculoperitoneal shunt insertion rate in neonates with posthemorrhagic ventricular dilatation.","authors":"Dino Gačević, Gerbrich E van den Bosch, Ronny Knol, Liesbeth S Smit, Jochem K H Spoor","doi":"10.1007/s00381-026-07408-4","DOIUrl":"10.1007/s00381-026-07408-4","url":null,"abstract":"<p><strong>Purpose: </strong>Posthemorrhagic ventricular dilatation (PHVD) is a frequent complication of intraventricular hemorrhage (IVH) in preterm infants and is associated with increased neurodevelopmental morbidity. Following national Dutch guidelines, infants with PHVD are generally punctured for up to 28 days via a ventricular access device (VAD), before a ventriculoperitoneal shunt (VPS) is inserted. We aimed to investigate retrospectively whether performing VAD punctures for longer than 28 days decreased the final VPS insertion rate.</p><p><strong>Methods: </strong>Retrospective single-center cohort study at the Erasmus MC-Sophia Children's hospital in Rotterdam, the Netherlands. Patients were included if they were born between 2010 and 2020 and treated for PHVD.</p><p><strong>Results: </strong>Out of 55 included patients, 23 were punctured in low frequency longer than 28 days via their VAD because of improved but persistent ventricular dilatation. Only 14 of them ultimately did require VPS insertion, resulting in a significant reduction of 15% in the final VPS insertion rate (p < 0.001).</p><p><strong>Conclusion: </strong>Puncturing infants with PHVD with a beneficial clinical course via a VAD for longer than 28 days decreases the ventriculoperitoneal shunt insertion rate. Further research on prolonging temporizing punctures and its impact is warranted.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650543","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":"Non-operative management of traumatic occipitocervical distraction injuries in children: a systematic review.","authors":"Luiz Carlos Almeida da Silva, Brynn Rankin, Markus J Bookland, David S Hersh, Richard C E Anderson, Jonathan E Martin","doi":"10.1007/s00381-026-07395-6","DOIUrl":"10.1007/s00381-026-07395-6","url":null,"abstract":"<p><strong>Purpose: </strong>Existing guidelines for the management of atlanto-occipital dislocation (AOD) recommend occipitocervical fusion (OCF) for these low frequency, high-consequence injuries. Recent literature has questioned this guidance and provided case examples of successful non-operative management of a more inclusive and broadly defined spectrum of injuries to the occipitocervical junction (OCJ) termed occipitocervical distraction injuries (OCDI). A systematic review of existing literature on this topic would inform efforts to investigate the safety and efficacy of non-operative management of these injuries.</p><p><strong>Methods: </strong>We performed a systematic review based on preferred reporting items for systematic reviews (PRISMA) guidelines of English language publications to define and map literature related to non-operative management of pediatric traumatic OCDI.</p><p><strong>Results: </strong>We identified 40 patients in 21 manuscripts meeting defined inclusion and exclusion criteria. 82.5% of patients were successfully managed with non-operative management alone. No patient declined neurologically during orthotic treatment or in relation to crossover to surgical management through a minimum of 3-month follow-up.</p><p><strong>Conclusions: </strong>This review supports the contention that non-operative management is both safe and effective in the management of OCDI. Further research to develop standardized diagnostic and treatment protocols for non-operative management of OCDI through registries and multi-center research efforts is needed.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623732","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":"Telemetric sensors for intracranial pressure monitoring in children with CSF shunts: a systematic review and narrative synthesis.","authors":"Jagraj Thandi, Hannah Redpath, Abdullah Alazzawi, Nithish Jayakumar, Christopher J A Cowie, Ian Coulter","doi":"10.1007/s00381-026-07405-7","DOIUrl":"10.1007/s00381-026-07405-7","url":null,"abstract":"<p><strong>Purpose: </strong>Telemetric sensors are optionally inserted for intracranial pressure monitoring in paediatric hydrocephalus management. Children with shunted hydrocephalus may undergo multiple surgeries to investigate shunt function throughout their childhood. Understanding whether telemetric sensor use in the paediatric population improves surgical outcomes and has an economic benefit is vital.</p><p><strong>Methods: </strong>A systematic review was performed utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles included were from the OVID Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database. Reports from 1st September 2000 to 31st August 2025 for patients under 18 years old with hydrocephalus were included.</p><p><strong>Results: </strong>From 1190 studies identified, 7 were included in the systematic review. A narrative synthesis was feasible, however due to the limited number of heterogeneous articles, a quantitative meta-analysis was not possible. Five overarching themes which support telemetric sensor implementation were identified. These include (i) evidence of technical feasibility and reliability of ICP measurements, (ii) no identified significant safety concerns, (iii) meaningful valve adjustment data, (iv) the benefit of objective ICP readings over symptom-driven ICP management, and (v) evidence that telemetric sensors and appropriate protocols facilitate outpatient management.</p><p><strong>Conclusion: </strong>Implementing the use of telemetric sensors in the paediatric population is safe, technically feasible, clinically informative, and potentially valuable in some paediatric patients with shunted hydrocephalus.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612100","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":"Paediatric sellar mature teratoma with isolated growth hormone deficiency - A case-based review.","authors":"Urvashi Singh, Shruti Venkitachalam, Ambika R S, Rayappa Chinnusamy, Siddhartha Ghosh","doi":"10.1007/s00381-026-07416-4","DOIUrl":"10.1007/s00381-026-07416-4","url":null,"abstract":"<p><strong>Purpose: </strong>Intracranial germ cell tumours (IGCTs) are rare, accounting for only 0.5-3% of central nervous system tumours in children, with teratomas representing a minority. Sellar teratomas are exceptionally rare, with fewer than 50 reported cases, often mimicking craniopharyngioma on imaging.</p><p><strong>Methods: </strong>We report a case of a 7-year-old boy with isolated growth hormone deficiency and no visual or neurological deficit. MRI showed a heterogeneous sellar-suprasellar mass, while CT demonstrated multiple ossified components within the lesion. PubMed was searched through July 2026 for reports of paediatric sellar teratomas, and the reference lists of retrieved articles were screened for additional cases.</p><p><strong>Results: </strong>Endoscopic transnasal transsphenoidal surgery achieved gross total resection of the lesion, including 11 fully formed teeth embedded in keratinised tissue; histology confirmed a mature teratoma. Recovery was uneventful, and the child remains recurrence-free at 1-year follow-up while receiving hormone replacement therapy. Seven paediatric mature sellar teratomas, including the present case, were reviewed. Visual symptoms and endocrine dysfunction were common presentations, whereas isolated growth hormone deficiency was unusual.</p><p><strong>Conclusion: </strong>Preoperative identification of teeth or fat on CT should raise suspicion of teratoma over other sellar lesions, while high-resolution imaging may assist surgical planning. For mature teratomas, complete resection may provide disease control, while chemotherapy and radiotherapy have limited role. In our case, the endoscopic transnasal transsphenoidal approach allowed gross total resection despite poor sphenoid pneumatization. Continued follow-up is appropriate to monitor persistent endocrine dysfunction and detect rare metachronous germ cell tumours.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623754","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}