Annals of Coloproctology最新文献

{"title":"Extraperitoneal tunneling reduces intraperitoneal drain displacement in rectal cancer surgery: a single-center before-and-after comparative study.","authors":"Mi Jeong Choi, Min Hyeong Jo, Kyong Min Kang, Hong-Min Ahn, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang","doi":"10.3393/ac.2025.01536.0219","DOIUrl":"10.3393/ac.2025.01536.0219","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leakage (AL) is a serious complication of rectal cancer surgery, and a properly positioned pelvic drain may aid early detection and conservative management; however, intraperitoneal drains frequently migrate. We evaluated whether extraperitoneal tunneling (EPT) of the pelvic drain reduces drain displacement compared with conventional intraperitoneal placement.</p><p><strong>Methods: </strong>This single-center before-and-after comparative study enrolled adults with rectal cancer located within 15 cm of the anal verge who underwent elective radical resection between August 2021 and July 2024. Patients operated between August 2021 and December 2022 received conventional intraperitoneal drains (non-EPT group) and those operated between January 2023 and July 2024 received EPT drains (EPT group). The primary outcome was drain displacement (>3 cm from the anastomotic staple line) on postoperative day 2 plain radiograph. Secondary outcomes were AL, EPT-related complications, and the need for additional intervention. Multivariate logistic regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) were performed.</p><p><strong>Results: </strong>Of 228 patients, 111 received EPT and 117 received conventional drains. Drain displacement occurred in 5 of 111 EPT patients (4.5%) versus 55 of 117 non-EPT patients (47.0%; P<0.001). After multivariate adjustment, EPT was an independent protective factor (adjusted odds ratio [OR], 0.05; 95% confidence interval [CI], 0.02-0.13; P<0.001). The protective association was robust across PSM (matched OR, 0.07; 95% CI, 0.02-0.18) and IPTW (OR, 0.05-0.06; both P<0.001). AL occurred in 6 patients (2.6%) without a significant between-group difference (EPT, 1.8% vs. non-EPT, 3.4%; Fisher exact, P=0.681). Operative time, overall complications, and EPT-related complications did not differ between groups.</p><p><strong>Conclusion: </strong>In this single-center before-and-after series, EPT was associated with a substantially lower rate of postoperative day 2 drain displacement after rectal cancer surgery.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"446-453"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879104","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":"Feasibility and preliminary outcomes of spinal magnetic stimulation for functional constipation: a pilot randomized placebo-controlled trial.","authors":"Terence Si Quan Lee, Kai Xun Yew, Yew Long Lo, Peggy Pei Chee Teng, Yam Eng Tan, Emile John Kwong Wei Tan","doi":"10.3393/ac.2025.01599.0228","DOIUrl":"10.3393/ac.2025.01599.0228","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with chronic functional constipation suffer from debilitating symptoms which are unresponsive to conventional treatment options. Spinal magnetic stimulation (SMS) and its extracorporeal stimulation of peripheral nerves offer a potential noninvasive therapeutic option.</p><p><strong>Methods: </strong>A pilot blinded randomized sham-controlled study was performed. Patients randomized to the treatment SMS-arm underwent daily 60-minute SMS sessions at T9 and L3 spinal processes for 2 weeks. Symptom relief was measured at regular intervals up to 14 weeks after treatment with the use of constipation and quality-of-life questionnaires (Patient Assessment of Constipation Symptoms [PAC-SYM], EuroQOL 5-dimension instrument [EQ-5D], and Hospital Anxiety and Depression Scale [HADS]).</p><p><strong>Results: </strong>From December 2015 to July 2023, 14 patients completed the study (6 in the SMS arm and 8 in the sham arm). Mean age was 55 years (range, 41-70 years), and 12 (85.7%) were male. Median average bowel movements per week and spontaneous bowel movements per week at baseline for the SMS arm was 1.5 and 0.3, respectively, while the sham arm was 4 and 1, respectively. At 14 weeks from start of treatment, SMS arm patients showed a trend in improvement of symptoms in 11 out of 16 questions of PAC-SYM. Average bowel movements per week and EQ-5D health state scores increased from 1.5 to 3 and 50 to 60, respectively. However, these changes did not reach statistical significance. No statistical difference in the symptoms was noted in PAC-SYM (13 questions at weeks 1, 2, 4, 6, 8, 10, 12, and 14), EQ-5D (5 questions at weeks 0, 2, 14), and HADS (14 questions at weeks 0, 2, and 14) questionnaires within both arms.</p><p><strong>Conclusion: </strong>The pilot study showed the use of SMS is safe and feasible. While it improved constipation symptoms, the results did not achieve statistical significance possibly related to insufficient participants.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"415-424"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879165","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":"A simple, novel, noninvasive method to fix the drainage tube to the skin in anal fistula and gastrointestinal surgery: a technical note.","authors":"Pankaj Garg","doi":"10.3393/ac.2025.01158.0165","DOIUrl":"10.3393/ac.2025.01158.0165","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"478-480"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879108","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":"Article processing charges in colorectal surgery journals: a cross-sectional bibliometric analysis of cost, citation impact, and geographic disparity.","authors":"Sang-Ji Choi, Gibong Chae","doi":"10.3393/ac.2026.00542.0077","DOIUrl":"10.3393/ac.2026.00542.0077","url":null,"abstract":"<p><strong>Purpose: </strong>Article processing charges (APCs) are central to author-paid open access (OA) publishing. Disparities appear in oncology, pathology, and global surgery, but not colorectal surgery, spanning coloproctology, general surgery, gastroenterology, and oncology journals. We examined APC levels, citation-impact linkage, and authorship geography.</p><p><strong>Methods: </strong>This study was a cross-sectional bibliometric analysis of 32 journals (MEDLINE/PubMed search). APCs (publisher-direct 2026) and 2024 citation metrics (Journal Impact Factor [JIF], SCImago Journal Rank [SJR], SCImago H-index) were extracted. First- and last-author countries for all 2024-2025 articles (n=31,164) were mapped to World Bank income groups. Multivariable ordinary least squares regression modeled log10(APC) on publisher group, region, OA model, and log10(JIF 2024).</p><p><strong>Results: </strong>Median APC was US $3,980 (interquartile range, $3,580-$4,390), varying by region: $1,467 in Asia, $3,840 in the United Kingdom, $4,140 in Western Europe, and $4,175 in the United States. APC correlated with the SCImago H-index (ρ=0.51, P=0.003) but not with JIF (P=0.25) or SJR (P=0.13). Of 30,320 articles, first authors were from high-income countries in 62.5%, upper-middle-income countries in 34.7%, and lower-middle- or low-income countries in 2.8%; China (30.9%), the United States (23.1%), and Japan (8.0%) were the leading countries. First authors were more often from non-high-income countries than last authors (median difference, +0.68 percentage points; P<0.001). In multivariable regression (R2=0.90), society-direct publishing was associated with lower APCs (β=-0.44, P<0.001), whereas US-based publishing (β=+0.18, P=0.019), UK-based publishing (β=+0.16, P=0.037), and a hybrid OA model (β=+0.15, P=0.014) were associated with higher APCs. JIF was not independently associated with APC (P=0.93).</p><p><strong>Conclusion: </strong>Colorectal surgery APCs are high and decoupled from citation impact after adjustment, with underrepresentation of lower-resource-setting authors, especially at senior-author level. Society-owned and Asia-based journals offer lower-cost alternatives but remain a minority.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"454-467"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879131","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":"Moving forward as a global journal: a farewell reflection from the Editor-in-Chief.","authors":"In Ja Park","doi":"10.3393/ac.2026.00850.0121","DOIUrl":"10.3393/ac.2026.00850.0121","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 3","pages":"261-263"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374286","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":"Short-term outcomes following emergency Hartmann procedure: a comparison between colorectal and noncolorectal surgeons.","authors":"Jae Won Jo, Sung Chul Lee, Jung Wook Suh, Hwan Namgung, Dong-Guk Park","doi":"10.3393/ac.2025.01389.0198","DOIUrl":"10.3393/ac.2025.01389.0198","url":null,"abstract":"<p><strong>Purpose: </strong>Given the increasing staffing shortages that often necessitate noncolorectal surgeons performing emergency colorectal procedures, this study aims to evaluate the effect of surgeon subspecialty on short-term postoperative outcomes in patients undergoing emergency Hartmann procedure and whether strengthening residency training in Hartmann procedure could improve surgical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 141 patients who underwent emergency Hartmann procedure at a single tertiary center between January 2010 and December 2021. Patients were categorized into colorectal and noncolorectal groups. The clinical characteristics, operative details, and outcomes were compared. Complications were classified using the Clavien-Dindo classification. Logistic regression analysis was used to identify complications and mortality.</p><p><strong>Results: </strong>The noncolorectal group showed higher age (75 years vs. 69 years, P=0.038), hypertension prevalence (58.4% vs. 40.4%, P=0.039), and physiological instability (C-reactive protein >6.0 mg/dL: 55.1% vs. 36.5%, P=0.034; lactate: 1.90 mmol/L vs. 0.80 mmol/L, P<0.001). Complications were lower in the colorectal group (68.5% vs. 36.5%, P<0.001), with fewer major complications (Clavien-Dindo grade ≥III, 51.7% vs. 15.4%). The colorectal group had a lower mortality rate (25.8% vs. 3.8%, P=0.001). In the multivariate analysis, surgery performed by noncolorectal surgeons remained a significant independent risk factor for complications (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.27-6.89; P=0.012) and mortality (OR, 15.53; 95% CI, 2.11-114.18; P=0.006) even after adjusting for age, diagnosis, American Society of Anesthesiologists physical status, C-reactive protein levels, and time to surgery.</p><p><strong>Conclusion: </strong>Emergency Hartmann procedure for acute conditions yielded better short-term outcomes when performed by colorectal surgeons. These findings suggest that surgeon subspecialty is a critical determinant of survival, independent of patient severity or surgical timing. Improving surgical residency training in Hartmann procedure may enhance outcomes when noncolorectal surgeons must perform it due to staffing constraints.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 3","pages":"315-323"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374294","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":"Lymphopenia and C-reactive protein elevation on postoperative day 2 are independent risk factors for occurrence of major and minor complications in elective colorectal cancer surgery.","authors":"Minsuh Park, Kyung Jong Kim, Young-Hun Kim","doi":"10.3393/ac.2025.01011.0144","DOIUrl":"10.3393/ac.2025.01011.0144","url":null,"abstract":"<p><strong>Purpose: </strong>Early detection is the most critical factor in effectively managing complications following routine colorectal surgery. This study aimed to identify the most effective and useful factors related to body composition and inflammation in the selection of high-risk groups for postoperative complications.</p><p><strong>Methods: </strong>A retrospective review of 109 patients who underwent elective surgery between January 2021 and May 2023 was conducted. Patients were categorized according to the Clavien-Dindo classification into those discharged without complications (grade 0), those with minor complications (grades 1 and 2), and those with major complications (grade 3+). The characteristics of patients without complications and those with minor or major complications were compared.</p><p><strong>Results: </strong>Twenty patients developed only minor complications. Bowel obstruction at diagnosis and elevated C-reactive protein (CRP) levels at 2 days postoperatively were statistically significant factors. Eleven patients experienced major complications, and a low lymphocyte count at 2 days postoperatively was a significant predictor of complications. Receiver operating characteristic analysis revealed that CRP levels >125.6 mg/L on postoperative day 2 and lymphocyte count <905 cells/µL were associated with a higher likelihood of minor and major complications.</p><p><strong>Conclusion: </strong>These findings suggest that monitoring inflammatory markers on postoperative day 2 may help identify patients at risk of complications, enabling early intervention. Further prospective studies are warranted to validate these predictive markers and improve surgical outcomes.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 3","pages":"333-344"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374338","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":"From regression to machine learning: improving prediction of rectal cancer recurrence.","authors":"Thanat Tantinam, Ekkarin Supatrakul, Pawit Sutharat, Suwan Sanmee, Kullawat Bhatanaprabhabhan, Boonchai Ngamsirimas, Nataphon Santrakul, Rangsima Thiengthiantham, Punnawat Chandrachamnong, Suradet Buakhrun, Sarawut Ramjan","doi":"10.3393/ac.2025.01067.0152","DOIUrl":"10.3393/ac.2025.01067.0152","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrence after curative-intent treatment of rectal cancer remains a major clinical challenge. Conventional regression models may not adequately capture complex clinical interactions, whereas machine learning algorithms may improve predictive accuracy. This study compared regression-based and machine learning models for predicting recurrence using routinely collected clinical data.</p><p><strong>Methods: </strong>A retrospective cohort of 581 patients with rectal adenocarcinoma treated between 2013 and 2022 at 2 university hospitals in Thailand was analyzed. Seventeen demographic, pathological, and treatment-related features were used to develop logistic regression (LR), random forest (RF), support vector machine, extreme gradient boosting (XGBoost), and light gradient boosting machine (LightGBM) models. Data were split using stratified train-test sampling (80:20). Fivefold cross-validation, calibration, and decision curve analyses were performed. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), average precision (AP), F1 score, sensitivity, specificity, and feature importance.</p><p><strong>Results: </strong>All models demonstrated moderate discriminative performance. AUC values ranged from 0.626 (LightGBM) to 0.662 (XGBoost), while AP scores ranged from 0.483 (LightGBM) to 0.584 (RF). LR achieved perfect sensitivity (1.000) at the F1-optimized threshold, RF provided the strongest balance between precision and recall, and XGBoost achieved the highest AUC. Key predictors included carcinoembryonic antigen level, nodal status, surgical margin status, tumor grade, lymphovascular invasion, and the number of lymph nodes retrieved.</p><p><strong>Conclusion: </strong>Machine learning models modestly outperformed regression-based approaches, although their clinical value lies primarily in tailoring model strengths to specific priorities. Selecting LR, RF, or XGBoost according to objectives such as maximizing sensitivity, achieving balanced precision-recall, or enabling risk stratification may enhance recurrence surveillance in rectal cancer.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 3","pages":"293-302"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374267","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":"Bowel obstruction in mismatch repair-deficient colorectal cancer with excellent response to immunotherapy: a case series.","authors":"Sarah Johnston, Yu Jo Chua, Alisha Azmir","doi":"10.3393/ac.2026.00066.0009","DOIUrl":"10.3393/ac.2026.00066.0009","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 3","pages":"376-380"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374190","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":"Decreased fluorescence latency and plateau intensity ratio as predictive markers of intraoperative hypoperfusion: quantitative indocyanine green perfusion analysis in colorectal cancer surgery.","authors":"Paulina Daniluk-Marsy, Johannes Castelein, Karol Połom, Luigi Marano, Ronald J H Borra","doi":"10.3393/ac.2025.01298.0185","DOIUrl":"10.3393/ac.2025.01298.0185","url":null,"abstract":"<p><strong>Purpose: </strong>Intraoperative hypoperfusion is a major risk factor for postoperative anastomotic complications in colorectal surgery. Although most perfusion assessments emphasize arterial inflow, the roles of latency, sustained fluorescence, and venous outflow remain underexplored. This study aimed to identify quantitative indocyanine green (ICG) fluorescence parameters predictive of intraoperative hypoperfusion.</p><p><strong>Methods: </strong>Eighty patients who underwent colorectal cancer resection between 2018 and 2022 were analyzed. Intraoperative perfusion was evaluated qualitatively using near-infrared ICG angiography and quantitatively through post hoc analysis of fluorescence time-intensity curves. Associations with hypoperfusion were assessed using group comparisons and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Qualitative evaluation indicated hypoperfusion requiring intraoperative relocation of the anastomotic site in 12 patients (15%), with postoperative leakage in 1 patient (1.2%) despite revision of the anastomosis. Quantitative analysis showed that latency was significantly shorter in hypoperfused cases (5.5 seconds [interquartile range (IQR), 1.0-13.0 seconds] vs. 20.0 seconds [IQR, 6.8-27.0 seconds]; P=0.003), and the plateau intensity ratio (PIR; Fplateau/Fmax) was markedly decreased (0.6 [IQR, 0.6-0.7] vs. 0.8 [IQR, 0.6-0.9]; P=0.045). The ROC analysis demonstrated good diagnostic performance for latency (area under the curve [AUC], 0.76; sensitivity, 33.3% [95% confidence interval (CI), 13.8-60.9]; specificity, 92.8% [95% CI, 84.1-96.9]; positive likelihood ratio, 4.6) and moderate accuracy for PIR (AUC, 0.68; sensitivity, 66.7% [95% CI, 39.1-86.2]; specificity, 68.1% [95% CI, 56.4-77.9]; positive likelihood ratio, 2.1).</p><p><strong>Conclusion: </strong>Quantitative fluorescence analysis identified latency and PIR as complementary markers of perfusion dynamics. Whereas latency reflects early arterial inflow kinetics, PIR captures outflow characteristics related to microvascular and venous integrity. Combining these metrics may improve intraoperative detection of hypoperfusion and support data-driven decisions regarding anastomotic site selection.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"324-332"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025995","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}