Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"Incidental double duct sign: Should we be worried? Results from a long-term follow-up study.","authors":"Lu Yao, Hoda Amar, Somaiah Aroori","doi":"10.14701/ahbps.23-063","DOIUrl":"10.14701/ahbps.23-063","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Double duct sign (DDS) (dilated common bile and pancreatic duct) is synonymous with pancreatic head/peri-ampullary tumor (PHPAT). There is limited evidence on whether incidental DDS (I-DDS) is associated with an increased risk of malignancy. This study aimed to evaluate 5-year outcomes of I-DDS.</p><p><strong>Methods: </strong>Patients were categorized according to their risk of malignancy. 'Low-risk' patients, including those with I-DDS between 2010 and 2015, were analyzed in this study. The primary outcome was incidence of PHPAT within five years of identification of DDS. Histology results from endoscopic ultrasound-guided biopsy were considered diagnostic. Secondary outcomes were incidence of benign causes, extent of follow-up investigations, and clinical indicators of malignancy in patients with DDS.</p><p><strong>Results: </strong>Among 103 patients with DDS, 20 had I-DDS. Subsequent follow-up of these 20 patients found no patient with PHPAT, two (10%) patients with chronic pancreatitis, and 18 (90%) patients with no cause found. The median follow-up duration for 'low-risk' patients was 7.3 years (range, 6-11 years). The mean number of follow-up investigations per patient was two (range, 0-9). Investigations included computed tomography (n = 27), magnetic resonance cholangiopancreatography (n = 23), endoscopy (n = 16), and ultrasound (n = 14). Patients with jaundice were more likely to have malignancy (<i>p</i> < 0.01). Those with abdominal pain were more likely to have a benign cause (<i>p</i> < 0.01). Hyperbilirubinemia and/or deranged liver enzymes and raised CA19-9 were more likely to be associated with PHPAT (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Patients with I-DDS have a low risk of developing PHPAT within five years.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429746","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":"Corrigendum: Clinicopathological characteristics of extrahepatic biliary neuroendocrine neoplasms in the gallbladder, extrahepatic biliary tract, and ampulla of Vater: A single-center cross-sectional study.","authors":"Young Mok Park, Hyung Il Seo, Byeong Gwan Noh, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Dong Uk Kim, Sung Yong Han","doi":"10.14701/ahbps.28-1_C","DOIUrl":"10.14701/ahbps.28-1_C","url":null,"abstract":"","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"114"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699006","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":"Predictive modeling algorithms for liver metastasis in colorectal cancer: A systematic review of the current literature.","authors":"Isaac Seow-En, Ye Xin Koh, Yun Zhao, Boon Hwee Ang, Ivan En-Howe Tan, Aik Yong Chok, Emile John Kwong Wei Tan, Marianne Kit Har Au","doi":"10.14701/ahbps.23-078","DOIUrl":"10.14701/ahbps.23-078","url":null,"abstract":"<p><p>This study aims to assess the quality and performance of predictive models for colorectal cancer liver metastasis (CRCLM). A systematic review was performed to identify relevant studies from various databases. Studies that described or validated predictive models for CRCLM were included. The methodological quality of the predictive models was assessed. Model performance was evaluated by the reported area under the receiver operating characteristic curve (AUC). Of the 117 articles screened, seven studies comprising 14 predictive models were included. The distribution of included predictive models was as follows: radiomics (n = 3), logistic regression (n = 3), Cox regression (n = 2), nomogram (n = 3), support vector machine (SVM, n = 2), random forest (n = 2), and convolutional neural network (CNN, n = 2). Age, sex, carcinoembryonic antigen, and tumor staging (T and N stage) were the most frequently used clinicopathological predictors for CRCLM. The mean AUCs ranged from 0.697 to 0.870, with 86% of the models demonstrating clear discriminative ability (AUC > 0.70). A hybrid approach combining clinical and radiomic features with SVM provided the best performance, achieving an AUC of 0.870. The overall risk of bias was identified as high in 71% of the included studies. This review highlights the potential of predictive modeling to accurately predict the occurrence of CRCLM. Integrating clinicopathological and radiomic features with machine learning algorithms demonstrates superior predictive capabilities.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"14-24"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833275","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":"Low-cost model for pancreatojejunostomy simulation in minimally invasive pancreatoduodenectomy.","authors":"Hiang Jin Tan, Adrian Kah Heng Chiow, Lip Seng Lee, Suyue Liao, Ying Feng, Nita Thiruchelvam","doi":"10.14701/ahbps.23-040","DOIUrl":"10.14701/ahbps.23-040","url":null,"abstract":"<p><p>Minimally invasive pancreatoduodenectomy (MIS PD) is a well reported technique with several advantages over conventional open pancreatoduodenectomy. In comparison to distal pancreatectomy, the adoption of MIS PD has been slow due to the technical challenges involved, particularly in the reconstruction phase of the pancreatojejunostomy (PJ) anastomosis. Hence, we introduce a low-cost model for PJ anastomosis simulation in MIS PD. We fashioned a model of a cut pancreas and limb of jejunum using economical and easily accessible materials comprising felt fabric and the modelling compound, Play-Doh. Surgeons can practice MIS PJ suturing using this model to help mount their individual learning curve for PJ creation. Our video demonstrates that this model can be utilized in simulation practice mimicking steps during live surgery. Our model is a cost-effective and easily replicable tool for surgeons looking to simulate MIS PJ creation in preparation for MIS PD.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"428-432"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308879","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":"Is aggressive intravenous fluid prescription the answer to reduce mortality in severe pancreatitis? The FLIP study: Fluid resuscitation in pancreatitis.","authors":"Julia McGovern, Samuel J Tingle, Stuart Robinson, John Moir","doi":"10.14701/ahbps.23-044","DOIUrl":"10.14701/ahbps.23-044","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality.</p><p><strong>Methods: </strong>Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality.</p><p><strong>Results: </strong>Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (<i>p</i> = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; <i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"394-402"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221598","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":"Enhancing generation efficiency of liver organoids in a collagen scaffold using human chemically derived hepatic progenitors.","authors":"Myounghoi Kim, Yohan Kim, Elsy Soraya Salas Silva, Michael Adisasmita, Kyeong Sik Kim, Yun Kyung Jung, Kyeong Geun Lee, Ji Hyun Shin, Dongho Choi","doi":"10.14701/ahbps.23-052","DOIUrl":"10.14701/ahbps.23-052","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Liver organoids have emerged as a powerful tool for studying liver biology and disease and for developing new therapies and regenerative medicine approaches. For organoid culture, Matrigel, a type of extracellular matrix, is the most commonly used material. However, Matrigel cannot be used for clinical applications due to the presence of unknown proteins that can cause immune rejection, batch-to-batch variability, and angiogenesis.</p><p><strong>Methods: </strong>To obtain human primary hepatocytes (hPHs), we performed 2 steps collagenase liver perfusion protocol. We treated three small molecules cocktails (A83-01, CHIR99021, and HGF) for reprogramming the hPHs into human chemically derived hepatic progenitors (hCdHs) and used hCdHs to generate liver organoids.</p><p><strong>Results: </strong>In this study, we report the generation of liver organoids in a collagen scaffold using hCdHs. In comparison with adult liver (or primary hepatocyte)-derived organoids with collagen scaffold (hALO_C), hCdH-derived organoids in a collagen scaffold (hCdHO_C) showed a 10-fold increase in organoid generation efficiency with higher expression of liver- or liver progenitor-specific markers. Moreover, we demonstrated that hCdHO_C could differentiate into hepatic organoids (hCdHO_C_DM), indicating the potential of these organoids as a platform for drug screening.</p><p><strong>Conclusions: </strong>Overall, our study highlights the potential of hCdHO_C as a tool for liver research and presents a new approach for generating liver organoids using hCdHs with a collagen scaffold.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"342-349"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10500237","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":"Clinicopathological characteristics of extrahepatic biliary neuroendocrine neoplasms in the gallbladder, extrahepatic biliary tract, and ampulla of Vater: A single-center cross-sectional study.","authors":"Young Mok Park, Hyung Il Seo, Byeong Gwan Noh, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Dong Uk Kim, Sung Yong Han","doi":"10.14701/ahbps.23-045","DOIUrl":"10.14701/ahbps.23-045","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment.</p><p><strong>Methods: </strong>We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors.</p><p><strong>Results: </strong>G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm², and Ki-67 index > 20% were strongly correlated with patient survival (<i>p</i> = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm² were significantly correlated with disease recurrence (<i>p</i> = 0.033 and 0.010, respectively).</p><p><strong>Conclusions: </strong>AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"380-387"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241603","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":"Surgical outcome of extrahepatic portal venous obstruction: Audit from a tertiary referral centre in Eastern India.","authors":"Somak Das, Tuhin Subhra Manadal, Suman Das, Jayanta Biswas, Arunesh Gupta, Sreecheta Mukherjee, Sukanta Ray","doi":"10.14701/ahbps.23-025","DOIUrl":"10.14701/ahbps.23-025","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Extra hepatic portal venous obstruction (EHPVO) is the most common cause of portal hypertension in Indian children. While endoscopy is the primary modality of management, a subset of patients require surgery. This study aims to report the short- and long-term outcomes of EHPVO patients managed surgically.</p><p><strong>Methods: </strong>All the patients with EHPVO who underwent surgery between August 2007 and December 2021 were retrospectively reviewed. Postoperative complications were classified after Clavien-Dindo. Binary logistic regression in Wald methodology was used to determine the predictive factors responsible for unfavourable outcome.</p><p><strong>Results: </strong>Total of 202 patients with EHPVO were operated. Mean age of patients was 20.30 ± 9.96 years, and duration of illness, 90.05 ± 75.13 months. Most common indication for surgery was portal biliopathy (n = 59, 29.2%), followed by bleeding (n = 50, 24.8%). Total of 166 patients (82.2%) had shunt procedure. Splenectomy with esophagogastric devascularization was the second most common surgery (n = 20, 9.9%). Nine major postoperative complications (Clavien-Dindo > 3) were observed in 8 patients (4.0%), including 1 (0.5%) operative death. After a median follow-up of 56 months (15-156 months), 166 patients (82.2%) had favourable outcome. In multivariate analysis, associated splenic artery aneurysm (<i>p</i> = 0.007), isolated gastric varices (<i>p</i> = 0.004), preoperative endoscopic retrograde cholangiography and stenting (<i>p</i> = 0.015), and shunt occlusion (<i>p</i> < 0.001) were independent predictors of unfavourable long-term outcome.</p><p><strong>Conclusions: </strong>Surgery in EHPVO is safe, affords excellent short- and long-term outcome in patients with symptomatic EHPVO, and may be considered for secondary prophylaxis.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"350-365"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10019512","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":"Long-term complications after extrahepatic cyst excision for type IV-A choledochal cysts.","authors":"Utpal Anand, Aaron George John, Rajeev Nayan Priyadarshi, Ramesh Kumar, Basant Narayan Singh, Kunal Parasar, Bindey Kumar","doi":"10.14701/ahbps.23-021","DOIUrl":"10.14701/ahbps.23-021","url":null,"abstract":"<p><p>Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"433-436"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9451534","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":"Exocrine pancreatic cancer as a second primary malignancy: A population-based study.","authors":"Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sung Chun Cho, Sang-Jae Park, Sun-Whe Kim, Young-Joo Won","doi":"10.14701/ahbps.23-053","DOIUrl":"10.14701/ahbps.23-053","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC).</p><p><strong>Methods: </strong>Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods.</p><p><strong>Results: </strong>Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females.</p><p><strong>Conclusions: </strong>Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"415-422"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185612","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}