Annals of Plastic Surgery最新文献

{"title":"Outcomes of Metacarpal Fracture Fixation With Intramedullary Nails: A Systematic Review.","authors":"Syeda Hoorulain Ahmed, Ramin Shekouhi, Ramiz Kardan, Cameron Gerhold, Harvey Chim","doi":"10.1097/SAP.0000000000004271","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004271","url":null,"abstract":"<p><strong>Background: </strong>Metacarpal fractures are the third most common upper extremity fracture and the second most common hand fracture, resulting in significant disability. This systematic review evaluates the clinical outcomes associated with using intramedullary nails to treat metacarpal fractures.</p><p><strong>Methods: </strong>A qualitative analysis was conducted to analyze summative data and calculate proportions for dichotomous variables and mean and standard deviation for continuous variables.</p><p><strong>Results: </strong>Seventeen studies involving 761 patients and 815 metacarpal fractures were included. Postoperative recovery of grip strength averaged 89.3% ± 7.7% compared to the unaffected hand. Significant improvement in angulation was noted, decreasing from a preoperative mean of 40.0° ± 9.1° to 11.5° ± 4.3° postoperatively. The mean metacarpal shortening was 2.0 ± 0.8 mm following surgery. The average time to fracture union was 7.3 ± 2.4 weeks, with a mean return-to-work time of 8.1 ± 1.4 weeks. Postoperative functional outcomes were favorable, with mean Disabilities of the Arm, Shoulder and Hand and QuickDASH scores of 4.0 ± 3.6 and 3.9 ± 3.2, respectively. The average postsurgical visual analog scale pain score was 1.1 ± 0.4. The mean postoperative total active arc of motion was 248.6° ± 11.9°.</p><p><strong>Conclusion: </strong>Intramedullary nailing provides favorable outcomes in the fixation of metacarpal fractures, with significant improvements in grip strength, angulation, and functional recovery.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S486-S492"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Peripheral Nerve Stimulation to Treat Neuropathies of the Upper Extremity: A Systematic Review.","authors":"Janice Choi, Gabrielle Li, Ian Kim, Brent R DeGeorge","doi":"10.1097/SAP.0000000000004400","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004400","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral neuropathy of the upper extremity often arises from nerve entrapment or nerve injury and can result in chronic, debilitating pain. Peripheral nerve stimulation (PNS) has been shown to restore nerve function and provide pain relief in various neuropathies, particularly in cases refractory to conventional pain management strategies. Our aim was to evaluate the effectiveness of PNS for alleviating peripheral neuropathy-related neuropathic pain resulting from upper extremity nerve entrapment or injury.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Cochrane, Ovid Medline, and Web of Science to identify studies using PNS in upper extremity nerve entrapment or injury patients with reported outcomes measuring neuropathy (pain, sensory and motor function). Data regarding PNS type, neuropathy type, pain scores, motor unit number estimation, treatment duration, and study quality were extracted.</p><p><strong>Results: </strong>Twenty-six studies (973 total participants) were included. Twenty-two studies reported pain relief, with significant decreases in the 11-point Numeric Pain Rating Scale from baseline (effect size: 2.92-6.43). Four studies reported improved nerve function. All studies evaluating secondary outcomes such as concomitant pain medication use and quality of life found improvement in at least one measure. Both permanent and temporary PNS yielded significant improvements, with minimal complications and promising long-term outcomes.</p><p><strong>Conclusion: </strong>Overall, PNS may be a safe and effective nonpharmacologic method to treat pain related to neuropathy as well as improve function and quality of life in patients with nerve entrapment or injury of the upper extremity. More controlled studies are needed to assess the effectiveness of PNS compared to usual care.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S539-S548"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Activity Measure for Postacute Care Scoring in Predicting Symptomatic Deep Venous Thromboembolism in Free Tissue Transfer.","authors":"Nikitha Potturi, Kelsey Gray, Stephanie H Carpentier, Stephanie Hamlin, James T Thompson","doi":"10.1097/SAP.0000000000004393","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004393","url":null,"abstract":"<p><strong>Background: </strong>Free tissue transfer (FTT) can be associated with limited postoperative mobility, increasing the risk for venous thromboembolism (VTE). Currently, no standardized protocol for anticoagulation in FTT exists. VTE risk has been calculated using the Caprini score, which is based on preoperative assessments and lacks real-time data on postoperative mobility. The Activity Measure for Postacute Care (AM-PAC) score assesses patients' activity limitations and rehabilitation needs postoperatively. We hypothesize that AM-PAC score will correlate with postoperative VTE in FTT patients and may be a useful adjunct to the Caprini score in anticoagulation decision-making.</p><p><strong>Methods: </strong>A review was completed of patients undergoing FTT for breast or lower extremity reconstruction at a single institution from 2012 to 2023. Data were collected on patient demographics, donor and recipient site, AM-PAC score, Caprini score, postoperative VTE, and medical comorbidities. A composite score was calculated using equally weighted AM-PAC and Caprini scores. Data were analyzed using Wilcox rank-sum tests with a significance level of 0.05.</p><p><strong>Results: </strong>There were 78 patients who underwent breast or lower extremity FTT with an inpatient AM-PAC score evaluation. Six patients developed VTE postoperatively. There was no significant association between VTE and Caprini or AM-PAC scores, but patients with VTE had significantly higher composite scores (P = 0.033), with a higher odds ratio than Caprini or AM-PAC scores.</p><p><strong>Conclusions: </strong>Patients with VTE had significantly higher composite scores than patients without VTE. This may support utilizing AM-PAC score as an adjunct to Caprini score to guide postoperative anticoagulation.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S531-S533"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic Society Meeting Supplement Issues Expand Journal Page Counts and Author Access to Publication.","authors":"William C Lineaweaver, Christopher L Kalmar, Dawn Angel, Jane Wood","doi":"10.1097/SAP.0000000000004381","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004381","url":null,"abstract":"<p><strong>Abstract: </strong>Academic journals can expand scientific content by development of supplement issues based on academic society meetings. From 2014 to 2023, Annals of Plastic Surgery published between 42 and 143 supplemental articles per year, representing between 212 and 719 supplemental pages per year in collaboration of academic society meetings. This feature can serve as a model for other journals exploring strategies of expansion.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S559-S561"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Epicondylectomy With Adipofascial Flap Versus Anterior Subcutaneous Transposition in Surgical Treatment of Cubital Tunnel Syndrome.","authors":"Tarik Mujadzic, Julia Bian, Carlos Martinez, Mirza M Mujadzic, Hata Botonjic, H I Friedman, Mirsad Mujadzic","doi":"10.1097/SAP.0000000000004382","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004382","url":null,"abstract":"<p><strong>Background: </strong>Cubital tunnel syndrome, the second most common compression neuropathy of the upper extremity, has several surgical treatment options including simple (in situ) decompression, decompression with medial epicondylectomy (ME), or anterior transposition to a subcutaneous, submuscular, or subfascial position. The existing literature does not clearly establish the superiority of one procedure over the other. This study aims to compare two techniques, ME combined with an adipofascial flap versus anterior subcutaneous transposition, in terms of outcomes including resolution of neurological deficits, surgical site discomfort, recurrence, and reoperation.</p><p><strong>Methods: </strong>This was an IRB-approved retrospective chart analysis on patients who had primary ulnar nerve decompression via either ME or subcutaneous anterior transposition. Outcomes recorded were tenderness at operative site, resolution of neurological deficits, recurrence rate, and need for secondary surgery.</p><p><strong>Results: </strong>Patients undergoing ME (n = 48) were classified into mild (n = 1, 2%), moderate (n = 11, 23%), and severe (n = 36, 75%) categories. For this group, complete resolution of neurological symptoms was recorded as <6 weeks (n = 10, 21%), 6 weeks to 3 months (n = 8, 16.6%), and >3 months (n = 13, 27%). Incomplete resolution was documented as improved (n = 15, 31.2%), unchanged (n = 2, 4.1%), or worse (0%). Surgical site discomfort was documented as lasting <3 weeks (n = 30, 62.5%), 3 to 6 weeks (n = 15, 37.5%), and 6 weeks to 3 months (n = 3, 6.3%), and there were no patients who had unresolved pain. The recurrence rate was 2/48 (4.1%). The secondary surgery rate was 1/48 (2%).Patients undergoing subcutaneous anterior transposition (n = 54) were classified into mild (n = 6, 11%), moderate (n = 26, 48%), and severe (n = 22, 41%) categories. For this group, complete resolution of symptoms was recorded as <6 weeks in (n = 13, 24%), 6 weeks to 3 months (n = 10, 18.5%), and >3 months (n = 12, 22.2%). Incomplete resolution was documented as improved (n = 13, 24.1%), unchanged (n = 4, 7.4%), or worse (n = 2, 3.7%). Surgical site discomfort was documented as lasting <3 weeks (n = 41, 76%), 3 to 6 weeks (n = 2, 4%), and 6 weeks to 3 months (n = 1, 2%), and 10 patients (18%) had unresolved pain. The recurrence rate (n = 13, 24%) and need for a second surgery (n = 19, 18.5%) were also recorded.</p><p><strong>Conclusions: </strong>Medial epicondylectomy with adipofascial flap is effective in treating cubital tunnel syndrome and has a lower potential for persistent surgical site pain and recurrence than subcutaneous transposition.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S526-S530"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Transfers: Core Principles and Workhorse Techniques.","authors":"Barite Gutama, Nikolas K Popa, Victor Byers, Benjamin L Savitz, Yomna E Dean, Ronald M Cornely, Erin N Abbott, Ricardo A Torres-Guzman, Shady Elmaraghi, John B Hill","doi":"10.1097/SAP.0000000000004385","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004385","url":null,"abstract":"<p><strong>Abstract: </strong>Despite the long history of experience in peripheral nerve reconstruction, dating back to the 1870s, recent decades have seen an explosion of innovation. Advancements have been made in primary repair, secondary repair, nerve grafts, tendon transfers, and, most recently, nerve transfers. These innovations address the distance-to-target problem faced by surgeons and provide improved functional outcomes. Key principles for successful nerve transfers include proper patient selection, preoperative discussions, intraoperative decisions, and postoperative management. In this review, we discuss 3 common peripheral nerve transfers: the anterior interosseous nerve to ulnar nerve transfer, median to radial nerve transfers, and the tibial to peroneal nerve transfer. These techniques can restore functional mobility in patients with severe peripheral nerve injuries.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S555-S558"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant Size Versus Mastectomy Weight in Breast Reconstruction: Does Matching Matter?","authors":"Katherine H Carruthers, Katya Remy, Matthew A DePamphilis, Eva Roy, Anna Reaman, Krishna Vyas, Eleanor Tomczyk, William G Austen","doi":"10.1097/SAP.0000000000004309","DOIUrl":"10.1097/SAP.0000000000004309","url":null,"abstract":"<p><strong>Introduction: </strong>During nipple-sparing mastectomy with direct-to-implant based breast reconstruction, if the size of the chosen implant is smaller than the mastectomy specimen, a volumetric mismatch occurs creating dead space. This study evaluates the effect of volumetric mismatch between chosen implant size and mastectomy weight on postoperative complications after breast reconstruction.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted on patients undergoing nipple-sparing mastectomy with direct-to-implant based breast reconstruction. The effect of volumetric mismatch [mastectomy weight (g) - implant size (mL)] on postoperative complications were evaluated using receiver operating characteristic analysis and multivariable regression analyses.</p><p><strong>Results: </strong>A total of 1617 breast reconstructions were performed in 1031 patients. The mean mastectomy weight was 442.6 g (±219.1), the mean implant size was 403.2 mL (±152.0) and the mean volumetric mismatch was 37.1 (±108.2). The mean follow-up was 25.3 months (±15.2). Total complication rate was 8.3%. A volumetric mismatch of ≥78 was associated with increased complications when controlled for mastectomy weight and implant size, with higher rates of any complication (14.6% vs 6.4%, P < 0.0001), explantation due to infection (2.9% vs 1.1%, P = 0.05), infection (4.5% vs 1.6%, P = 0.01), and seroma (6.9% vs 1.9%, P < 0.0001). On multivariable regression for any complication, volumetric mismatch [odds ratio 1.9 (95% CI 1.0-3.4) P = 0.043], smoking and age were significant predictors.</p><p><strong>Conclusions: </strong>A greater mismatch between implant size and mastectomy weight was a significant predictor of postoperative complications, including explantation. Knowing this, surgeons may choose to match implant size more evenly to mastectomy weight, opt for skin sparing mastectomies or consider operative techniques to minimize dead space.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"634-638"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Condyloma Acuminatum: A Review of Reconstructive Options.","authors":"Brooke E Barrow, Kwadwo O Ansah, Hani I Naga, Nicklas Sarantos, Brant A Inman, Andrew C Peterson, Detlev Erdmann","doi":"10.1097/SAP.0000000000004349","DOIUrl":"10.1097/SAP.0000000000004349","url":null,"abstract":"<p><strong>Abstract: </strong>The management of giant condyloma acuminatum in the male population remains challenging given the anatomic complexity of this region. Preservation of micturition and sexual function are key considerations. After primary resection, reconstructive plastic surgery is often necessary for coverage of soft-tissue defects, necessitating a multidisciplinary approach by urologic, plastic, and colorectal surgery. Because of the rarity of this disease, a defined treatment protocol has not been established. This review aims to outline key considerations and reconstructive options for this challenging disease, which are highlighted by two cases of successful reconstruction.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6","pages":"695-700"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Effect of Enhanced Recovery After Surgery in Autologous Breast Reconstruction.","authors":"Robert G DeVito, Benjamin G Ke, Kristen Stephens, Scott T Hollenbeck, Chris A Campbell, John T Stranix","doi":"10.1097/SAP.0000000000004391","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004391","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) pathways have become increasingly common in surgery, but the ERAS financial impact on autologous breast reconstruction has not been defined.</p><p><strong>Methods: </strong>This study performed a retrospective review of consecutive autologous breast reconstructions (July 2017 to June 2022; 264 patients, 156 pre-ERAS implementation and 108 post-ERAS implementation). Clinical outcomes included length of stay (LOS), ICU length of stay (ICU LOS), average daily morphine milligram equivalent (MME) use, and average total MME use. Financial metrics evaluated the total charges, total cost, direct cost, indirect cost, estimated reimbursement, and direct margin.</p><p><strong>Results: </strong>Average LOS was lower in the ERAS cohort (2.13 vs. 3.21 days, P < 0.001). Average ICU LOS was lower in the ERAS cohort (0.0 vs 0.75 days, P < 0.001). Total charges were lower in the ERAS cohort ($98,876 vs. $119,568, P < 0.001). Total cost was lower in the ERAS cohort ($25,725 vs. $30,972, P < 0.001). Direct cost was lower in the ERAS cohort ($15,900 vs. $18,823, P < 0.001). Indirect cost was lower in the ERAS cohort ($9825 vs. $12,149, P < 0.001). Estimated reimbursement was equivalent ($27,464 vs. $24,697, P = 0.14). Direct margin was higher in the ERAS cohort ($11,564 vs. $5874, P = 0.0015).</p><p><strong>Conclusions: </strong>ERAS pathways in autologous breast reconstruction decrease length of stay, ICU utilization, and improve financial metrics. Further investigations into quality improvements in ERAS warrant investigation.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 6S Suppl 4","pages":"S549-S554"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Techniques for Cleft Lip Repair: Insights From Latin America and the Caribbean.","authors":"Atenas Bustamante, Jonathan Diaz, Emily Jones, Laura Herrera Gomez, Karel-Bart Celie, José Nuñez, Allyn Auslander, William P Magee, Wieslawa De Pawlikowski","doi":"10.1097/SAP.0000000000004379","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004379","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip (CL) repair techniques vary significantly, often depending on surgeons' experience, preference, and cleft characteristics. In Latin America and the Caribbean (LAC), where CL prevalence is high, research on surgical practices remains limited. This study aims to document and analyze preferences for unilateral (UCL) and bilateral cleft lip (BCL) repair among Operation Smile surgeons in LAC to support improved cleft care.</p><p><strong>Methods: </strong>A 22-question survey was distributed anonymously electronically to credentialed LAC surgeons performing UCL and BCL repairs. The survey explored demographics, preferred repair techniques, and surgical approaches such as nasal floor closure, gingivoperiosteoplasty, and setback techniques. Responses were analyzed using descriptive and inferential statistics.</p><p><strong>Results: </strong>A total of 101 surgeons from 13 countries participated, with Peru (20%) having the highest representation. Most respondents were male (71%), with 36% having less than 5 years of experience. The Fisher technique was the most preferred method for UCL (66%) and BCL (29%), particularly among less experienced surgeons. Technique preferences varied significantly by country (P < 0.001). For UCL, most surgeons (78%) closed the nasal floor by joining septal and lateral mucosa, and 50% performed gingivoperiosteoplasty. For BCL, 58% used labial adhesion for maxillary protrusion, and 24% performed premaxillary setbacks, both varying significantly by experience and technique (P < 0.001).</p><p><strong>Conclusions: </strong>This study reveals substantial variability in cleft repair techniques across LAC, with the Fisher technique emerging as a dominant preference. These findings provide a foundation for future research focusing on outcomes and complications to optimize cleft care in the region.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}