Journal of Hand Surgery-American Volume最新文献

{"title":"Assessing the Effect of Time From Injection of Collagenase to Manipulation on Success Rates in Dupuytren Disease","authors":"Purushottam Nagarkar MD ,&nbsp;Nirbhay S. Jain MD ,&nbsp;Meaghan L. Barr MD ,&nbsp;Cathy Tang MD ,&nbsp;Dong Lee BS ,&nbsp;Irene Chang BA ,&nbsp;Michael R. Delong MD ,&nbsp;Prosper Benhaim MD","doi":"10.1016/j.jhsa.2023.07.015","DOIUrl":"10.1016/j.jhsa.2023.07.015","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Dupuytren disease<span> can be managed with an injection of collagenase </span></span><em>Clostridium histolyticum</em> enzyme followed by manual manipulation. Although the recommended time from injection to manipulation is 24–72 hours, patient and physician schedules may not accommodate this time frame. Therefore, we sought to study the impact of time from injection to manipulation on outcomes and complications of collagenase injection.</div></div><div><h3>Methods</h3><div>We performed a review of 309 patients who underwent an injection of collagenase <em>Clostridium histolyticum</em><span> for Dupuytren disease with manipulation at two, five, or seven days after injection. We compared preinjection and postinjection contracture angles as well as frequency of skin tears and tendon ruptures.</span></div></div><div><h3>Results</h3><div>Of the 309 patients, 207 underwent manipulation at two days, 32 at five days, and 70 at seven days. Patients had similar preinjection contracture angles. All patients demonstrated improvement in contracture after manipulation. Rates of skin tears and tendon ruptures were similar in all three groups. Significant predictors of complications included number of cords injected and history of previous collagenase injection, but not history of previous Dupuytren diagnosis.</div></div><div><h3>Conclusions</h3><div>Although collagenase injection for Dupuytren disease is typically performed with plans for manipulation at 24–72 hours, postinjection manipulation could be performed as late as seven days without adversely affecting the frequency of skin and tendon complications.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 376.e1-376.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10426939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Elbow Flexion On Valgus Carrying Angle","authors":"Tyler John Wilps MD ,&nbsp;Calvin K. Chan MS ,&nbsp;Satoshi Yamakawa PhD ,&nbsp;Keishi Takaba MD ,&nbsp;Satoshi Takeuchi MD ,&nbsp;Robert A. Kaufmann MD ,&nbsp;Richard E. Debski PhD","doi":"10.1016/j.jhsa.2023.07.010","DOIUrl":"10.1016/j.jhsa.2023.07.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to examine the effect of flexion on valgus carrying angle in the human elbow using a dynamic elbow testing apparatus.</div></div><div><h3>Methods</h3><div>Active elbow motion was simulated in seven cadaveric upper extremities. Six electromechanical actuators simulated muscle action, while 6 degrees-of-freedom joint<span> motion was measured with an optical tracking system to quantify the kinematics of the ulna<span> with respect to the humerus as the elbow was flexed at the side position. Repeatability of the testing apparatus was assessed in a single elbow over five flexion-extension cycles. The varus angle change of each elbow was compared at different flexion angles with the arm at 0° of humerothoracic abduction or dependent arm position.</span></span></div></div><div><h3>Results</h3><div>The testing apparatus achieved excellent kinematic repeatability (intraclass correlation coefficient, &gt;0.95) throughout flexion and extension. All elbows decreased their valgus carrying angle during flexion from 0° to 90° when the arm was maintained at 0° of humerothoracic abduction. Elbows underwent significant total varus angle change from full extension of 3.9° ± 3.4° (<em>P</em> = .007), 7.3° ± 5.2° (<em>P</em> = .01), and 8.9° ± 7.1° (<em>P</em> = .02) at 60°, 90°, and 120° of flexion, respectively. No significant varus angle change was observed between 0° and 30° of flexion (<em>P</em> = .66), 60° and 120° of flexion (<em>P</em> = .06), and 90° and 120° of flexion (<em>P</em> = .19).</div></div><div><h3>Conclusions</h3><div>The dynamic elbow testing apparatus characterized a decrease of valgus carrying angle during elbow flexion and found that most varus angle changes occurred between 30° and 90° of flexion. All specimens underwent varus angle change until at least 90° of flexion.</div></div><div><h3>Clinical relevance</h3><div>Our model establishes the anatomic decrease in valgus angle by flexion angle <em>in vitro</em><span> and can serve as a baseline for testing motion profiles of arthroplasty designs and ligamentous reconstruction in the dependent arm position. Future investigations should focus on characterizing motion profile change as the arm is abducted away from the body.</span></div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 373.e1-373.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10014344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational Health Data Science and Informatics and Hand Surgery Research: Past, Present, and Future","authors":"Richard Hum MS ,&nbsp;Jennifer CE. Lane DPhil, FRCS (T&O) ,&nbsp;Gongliang Zhang PhD, MS ,&nbsp;Ruud W. Selles PhD ,&nbsp;Aviram M. Giladi MD, MS","doi":"10.1016/j.jhsa.2024.09.009","DOIUrl":"10.1016/j.jhsa.2024.09.009","url":null,"abstract":"<div><div>Single center studies are limited by bias, lack of generalizability and variability, and inability to study rare conditions. Multicenter observational research could address many of those concerns, especially in hand surgery where multicenter research is currently quite limited; however, there are numerous barriers including regulatory issues, lack of common terminology, and variable data set structures. The Observational Health Data Sciences and Informatics (OHDSI) program aims to surmount these limitations by enabling large-scale, collaborative research across multiple institutions. The OHDSI uses the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) to standardize health care data into a common language, enabling consistent and reliable analysis. The OMOP CDM has been transformative in converting multiple databases into a standardized code with a single vocabulary, allowing for coherent analysis across multiple data sets. Building upon the OMOP CDM, OHDSI provides an extensive suite of open-source tools for all research stages, from data extraction to statistical modeling. By keeping sensitive data local and only sharing summary statistics, OHDSI ensures compliance with privacy regulations while allowing for large-scale analyses. For hand surgery, OHDSI can enhance research depth, understanding of outcomes, risk factors, complications, and device performance, ultimately leading to better patient care.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 363-367"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Radiolunate Imbrication Neutralization (MIRLIN) Procedure","authors":"Sanjeev Kakar MD, FAOA ,&nbsp;Sean Cantwell MD ,&nbsp;Greg Couzens MD ,&nbsp;Nick Smith MD ,&nbsp;Mark Ross MD","doi":"10.1016/j.jhsa.2024.10.019","DOIUrl":"10.1016/j.jhsa.2024.10.019","url":null,"abstract":"<div><div>Debate persists about the optimal surgical management of scapholunate dissociation. Many contemporary techniques address both the injured scapholunate ligament as well as the capsuloligamentous stabilizers necessary to prevent carpal instability and collapse. Here, we present a technique to reinforce or plicate the long radiolunate ligament, a critical stabilizer to the carpus. Arthroscopic-assisted long radiolunate ligament capsulodesis may be considered in the treatment algorithm for scapholunate dissociation.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 385.e1-385.e8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Results of Hook Plate Fixation for Palmar Fracture Dislocation of the Proximal Interphalangeal Joint","authors":"Tatsuya Hara PhD ,&nbsp;Toshikazu Kurahashi PhD ,&nbsp;Yutaro Kuwahara MD ,&nbsp;Masahiro Tatebe PhD ,&nbsp;Takeshi Oguchi PhD ,&nbsp;Shrio Urata MD","doi":"10.1016/j.jhsa.2023.09.004","DOIUrl":"10.1016/j.jhsa.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to present the clinical outcomes of the dorsal plating technique for palmar fracture dislocations of the proximal interphalangeal (PIP) joint. This plating technique minimizes dissection and interference with the finger extensor mechanism.</div></div><div><h3>Methods</h3><div>We treated seven patients (with a mean age of 39.1 years) with dorsal hook plates for palmar fracture dislocations of the PIP joint between April 2018 and August 2022. The little finger was affected in five patients, and ring finger was affected in two. The mean time to surgery was 5.6 days, and the postoperative follow-up period was seven months. On the second postoperative day, all patients were allowed active motion of both the PIP and the distal interphalangeal (DIP) joints. Simultaneously, DIP blocking exercises were started to prevent adhesion of the extensor mechanism.</div></div><div><h3>Results</h3><div>The mean active flexion and extension of the PIP joint was 105° and −4°, respectively, whereas those of the DIP joint were 65° and 4°. No patient experienced extension lag in the DIP joint. The mean total active motion (TAM) was 273°, and the %TAM was 96%. The grip strength of the affected hand averaged 90% of that of the unaffected hand. The mean numerical rating scale for pain was 0.3 points, and the mean Hand20 score was 5.1 points. No complications were observed; two patients underwent implant removal at their request.</div></div><div><h3>Conclusions</h3><div>The present study suggests that this hook plate technique, which minimizes interference with the finger extension mechanism, is an effective surgical procedure that allows patients to tolerate early range of motion exercises and obtain satisfactory clinical outcomes in both the PIP and DIP joints.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic V.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 381.e1-381.e6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scapholunate Kinematics After Combined Palmar and Dorsal Ligament Reconstruction: A Quantitative Evaluation Using Four-Dimensional Computed Tomography","authors":"Merel J.-L. Berkhout MD, MA ,&nbsp;Johannes G.G. Dobbe PhD ,&nbsp;Paul W.M. Wilmer MD ,&nbsp;Geert J. Streekstra PhD, MEng ,&nbsp;Marco J.P.F. Ritt MD, PhD","doi":"10.1016/j.jhsa.2024.11.014","DOIUrl":"10.1016/j.jhsa.2024.11.014","url":null,"abstract":"<div><h3>Purpose</h3><div>This observational pilot study investigated (1) carpal positioning in the neutral wrist pose, (2) the scapholunate (SL) rotation axis, (3) physiological SL motion, and (4) the SL distance after combined palmar and dorsal SL ligament reconstruction using quantitative four-dimensional computed tomography (4D-CT) imaging.</div></div><div><h3>Methods</h3><div>Six subjects were included, and 4D-CT images of both wrists were obtained. Kinematic parameters of the treated side were compared to those of the healthy contralateral side, which was used as the normal reference.</div></div><div><h3>Results</h3><div>Average follow-up was 18.3 months (range, 8–35). After surgery, an average residual rotational deviation of the scaphoid (10.0° flexion, 8.1° radial deviation, 7.1° pronation) and lunate (17.5° extension) at neutral position of the wrist was observed compared with the contralateral side. Scapholunate motion followed that of the healthy wrists, whereas SL motion of one untreated affected wrist deviated from normal. Scapholunate distance was on average 1.3 mm larger than in the healthy wrists during flexion-extension and radioulnar deviation.</div></div><div><h3>Conclusions</h3><div>Combined palmar and dorsal SL ligament reconstruction seems to restore wrist kinematics, although the neutral position of the scaphoid and lunate are not restored to normal.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic V.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 320-330"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Concerns the Day After Office Hand Surgery","authors":"Abraham Bankole MD ,&nbsp;Raul Tejada BSA ,&nbsp;David Ring MD, PhD ,&nbsp;Sina Ramtin MD","doi":"10.1016/j.jhsa.2023.09.006","DOIUrl":"10.1016/j.jhsa.2023.09.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Pain after minor hand surgery can be misinterpreted as a problem. The sense that something may be wrong intensifies the pain. Some surgeons anticipate these feelings and call patients the evening or day after surgery to guide them through the recovery process. A study of routine, next day, postoperative phone calls can help determine the frequency of concerns and associated factors. We asked: 1) What factors are associated with concern the day after office hand surgery? 2) What factors are associated with pain intensity, satisfaction with care, and patient’s perceived recovery trajectory the day after office hand surgery?</div></div><div><h3>Methods</h3><div>In a cross-sectional study, 82 patients who had office hand and upper extremity surgery completed a survey recording age, gender, insurance, income level, measures of symptoms of depression and anxiety, a measure of catastrophic thinking regarding pain, 10-point ordinal ratings of pain intensity and satisfaction with care, whether the patient was concerned about their hand (yes or no) and whether they felt their recovery was on track (yes or no).</div></div><div><h3>Results</h3><div>Ten patients (12%) were concerned about their hand. In bivariate analysis, concern the day after surgery was associated with greater catastrophic thinking and male gender. Greater pain intensity was associated with greater catastrophic thinking. There was insufficient variation in satisfaction or a sense that recovery was on track for a meaningful analysis.</div></div><div><h3>Conclusions</h3><div>The finding that concerns were common the day after minor office hand surgery supports the practice of contacting patients for support and helping to reorient unhelpful catastrophic thoughts.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 383.e1-383.e5"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Thumb Basal Joint Arthritis: From Eaton’s Tendon Interposition to Denervation","authors":"Scott D. Lifchez MD, FACS","doi":"10.1016/j.jhsa.2024.12.002","DOIUrl":"10.1016/j.jhsa.2024.12.002","url":null,"abstract":"","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 350-351"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Ultrasound and Electrodiagnostic Studies in Patients Evaluated for Ulnar Neuropathy","authors":"Soun Sheen MD ,&nbsp;David Speach MD ,&nbsp;Courtney M.C. Jones MPH, PhD ,&nbsp;Mattie E. Raiford MD ,&nbsp;Warren C. Hammert MD","doi":"10.1016/j.jhsa.2024.12.004","DOIUrl":"10.1016/j.jhsa.2024.12.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Our goal was to determine the association between the severity of electrodiagnostic (EDX) studies with the cross-sectional area (CSA) of the ulnar nerve at the cubital tunnel using diagnostic ultrasound. Based on our clinical experience, we hypothesized there would not be a positive correlation between the severity of EDX and ulnar nerve CSA.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of patients 18 years or older evaluated from May 1, 2020, to June 31, 2021, referred for an upper limb EDX and neuromuscular ultrasound to evaluate for an upper limb neuropathy. History, physical examination, ultrasound imaging (ulnar nerve at elbow), and EDX were reviewed. Patients were excluded for age under 18 years or concomitant upper limb radiculopathy. Baseline sample characteristics were analyzed, including age, race, sex, ethnicity, body mass index (normal, overweight, obese, or morbid obesity), and smoking status.</div></div><div><h3>Results</h3><div>Of 1,043 patients, there were more females than males (634 vs 409) with an average age (SD) of 54.0 (15.5). Most of the patients were White (863) compared to Black (113) and other races (67). The average CSA of the ulnar nerve at the elbow increased with increased severity based on EDX results. There was a significant association between increasing severity on EDX and the increased nerve CSA at the elbow.</div></div><div><h3>Conclusions</h3><div>We found a positive association between the EDX severity and the CSA of the ulnar nerve on diagnostic ultrasound at the cubital tunnel. As the severity of ulnar neuropathy at the elbow increases, the CSA of the ulnar nerve correspondingly increases at the elbow.</div></div><div><h3>Type of study/level of evidence</h3><div>Prognostic II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 259-264"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison Between Volar Locking Plates and Percutaneous Pinning in the Treatment of Distal Radius Fractures: A Systematic Review","authors":"Nikhil Gopal MBBS ,&nbsp;Abhijith Anil MBBS, MS ,&nbsp;Meera Gopal MBBS ,&nbsp;Anil K. Bhat MBBS, MS","doi":"10.1016/j.jhsa.2024.08.016","DOIUrl":"10.1016/j.jhsa.2024.08.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Percutaneous fixation with Kirschner wires and open reduction and internal fixation with volar locking plates are the most common surgical techniques for managing distal radius fractures (DRFs). As the superiority of either technique is yet to be established, we aimed to conduct an updated systematic review to compare these techniques for the optimal management of unstable DRFs.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search to identify studies comparing fixation outcomes for DRFs between groups treated with Kirschner wires and those treated with volar locking plates. Only randomized controlled trials (RCTs) were included. The revised Cochrane risk-of-bias tool was used to assess the methodological quality of RCTs. Meta-analyses were performed only on outcome measures that were reported at the same time points using the same metrics across three or more RCTs. Evaluated outcomes included the Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, wrist range of motion, and radiological outcomes. We also assessed the Patient-Rated Wrist Evaluation (PRWE) score and incidence of complications.</div></div><div><h3>Results</h3><div>Fourteen RCTs with 2,226 patients were included in the meta-analysis. DASH scores were significantly lower in the plating group at all time points. PRWE outcomes favored the plating group at follow-ups greater than 1 year. There were no significant differences in radiological outcomes or incidence of complications between the two groups.</div></div><div><h3>Conclusions</h3><div>Although the plating group provided marginally better functional outcomes at 1 year after surgery, the K-wire group remained a viable alternative. The reported differences should be interpreted cautiously because of the inherent variability of the included RCTs. High-quality RCTs with strict inclusion criteria and standard postoperative protocols are essential to generalize our results across all age groups and fracture types to overcome our study’s limitations.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapy/Prevention, Etiology/Harm II.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 265-273"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}