Acta orthopaedica et traumatologica turcica最新文献

{"title":"Role of Piezo2/P2X7/MG pathway in synaptic plasticity and analgesic effects of massage therapy in cervical spondylotic radiculopathy: A preclinical study in animal models.","authors":"Xueyu Jiang, Song Yang, Xiaxia Duan, Keying Liao, Siqi Li, Zhifang Qiu, Jiaxuan Tan, Lingyao Xie, Yaoyao Xiao, Jiani Yang, Kuiming Zhou","doi":"10.5152/j.aott.2024.24097","DOIUrl":"10.5152/j.aott.2024.24097","url":null,"abstract":"<p><p>Objective: This study aimed to investigate the synaptic plasticity of the spinal dorsal horn regulated by the Piezo2/P2X7/MG signaling pathway and elucidate its role in the analgesic effects of massage in Cervical Spondylotic Radiculopathy (CSR), with the goal of identifying potential therapeutic targets for effective treatment. Methods: This experimental animal study included 40 Sprague-Dawley rats (180 ± 20 g), randomly divided into four groups (control, model, sham-operated, and massage; n=10 per group) after a one-week acclimation period. The CSR model was established by spinal canal insertion. Blood and spinal cord tissues were collected post-intervention. Mechanical pain threshold (MPT), 50% paw withdrawal threshold (50% PWT), immunofluorescence, Western blot, and qRT-PCR assays were employed to evaluate synaptic plasticity and pathway expression. Results: The massage group demonstrated significantly higher MPT and 50% PWT values compared to the model group post-intervention (P < 0.05). Downregulation of the Piezo2/P2X7/MG signaling pathway was observed in the massage group, correlating with a reduction in CSR progression, while upregulation in the model group promoted CSR (P < 0.05). Conclusion: The Piezo2/P2X7/MG signaling pathway regulates the synaptic plasticity of the spinal dorsal horn in CSR. These findings suggest that massage therapy can effectively alleviate CSR-associated pain by modulating this pathway, offering a potential noninvasive therapeutic approach.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 2","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031818","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":"Dose-independent adverse effects of corticosteroid injections on rotator cuff healing in a rat model.","authors":"Hikmet Şahin, Yavuz Akalın, Nazan Çevik, Özgür Avci, Harun Sağlıcak, Alpaslan Öztürk","doi":"10.5152/j.aott.2025.24075","DOIUrl":"10.5152/j.aott.2025.24075","url":null,"abstract":"<p><p>Objective: The aim of this experimental study in a rat model was to investigate the biomechanical and histological effects of subacromial corticosteroid injections on the healing of the tendon-bone junction after repair in the rotator cuff tear model. Methods: A total of 48 rats were divided into 3 groups: the control group, the single-dose steroid group, and the 4-dose steroid group. The supraspinatus tendon was completely dissected from the footprint attachment site and repaired. Saline was injected into the subacromial area in the control group, while 0.6 mL-4.8 mg/kg of single-dose methylprednisolone was applied to the single-dose group, and the same dose was applied 4 times at 1-week intervals to the 4-dose steroid group. All animals were allowed unrestricted movement during this period, and all animals were sacrificed by cervical dislocation 4 weeks after the last dose in the 4-dose steroid group. Cell shape and the number of apoptotic cells were assessed histopathologically, and the fracture load, maximum stress, and energy absorption were assessed biomechanically. Results: There were no significant differences in terms of cell shape between the groups. There was a significant difference in the mean number of apoptotic cells in the control group and in the single-dose and 4-dose steroid groups (P=.028). There was a 36% reduction in the mean number of apoptotic cells in the steroid groups compared to the control group. In the biomechanical evaluation, no differences were found between the groups in terms of maximum tension or breaking load (n.s.). A significant difference was found when the 3 groups were compared in terms of energy absorption (P=.001). There was a significant difference in energy absorption between the control group and the steroid-treated groups, but there was also a significant difference between the single-dose group and the 4-dose group (P=.038). Conclusion: The administration of corticosteroids was found to have a negative effect on healing at the tendon-bone junction, but this effect did not vary with the number of steroid injections. From a biomechanical perspective, it was observed that the energy absorption at the surgical repair site was lower with corticosteroid administration, and this negative effect increased with the increasing number of injections.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 2","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060347","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":"Biomechanical comparison of rotator cuff repair techniques in osteoporotic conditions: testing a novel technique.","authors":"Hakan Eskara, Ahmet Keskin, Yasar Tatar, Nejla Gercek, Yunus Imren, Suleyman Semih Dedeoglu","doi":"10.5152/j.aott.2025.24077","DOIUrl":"10.5152/j.aott.2025.24077","url":null,"abstract":"<p><p>Objective: This study aimed to compare the biomechanical characteristics of conventional transosseous equivalent (TOE) techniques with those of the novel free independent double-row medial fixation method, using rigid polyurethane (PU) foam blocks to simulate osteoporotic humerus bone. Methods: In this biomechanical study, 4 groups were tested using rigid PU foam blocks with osteoporotic properties and bovine infraspinatus tendons to simulate the rotator cuff. Groups 1 and 2 employed conventional TOE techniques: medial row knotted repair and knotless repair, respectively. Groups 3 and 4 utilized the \"free independent double-row medial fixation method,\" differing in the order of suture tying. Several biomechanical characteristic and pressure parameters were measured. Results: Groups 3 (0.16 ± 0.04 MPa) and 4 (0.17 ± 0.05 MPa) achieved significantly higher initial contact pressure compared to standard TOE techniques (P=.039). While contact area (Group 3: 102.4 ± 55.0 mm², Group 4: 110.4 ± 37.2 mm²) and ultimate failure force (Group 3: 212.0 ± 26.5 N, Group 4: 214.7 ± 30.2 N) were relatively higher, the differences were not statistically significant (P=.135 and P=.3, respectively). The overall failure types included medial anchor pullout (40%) and suture/tendon stripping (32.5%), with no significant differences among groups (P=.260). Conclusion: With superior contact pressure and comparable ultimate failure and contact area measurements, the novel independent double-row medial fixation technique may be a viable alternative to conventional TOE techniques for enhancing medial row stability in osteoporotic conditions. Level of Evidence: N/A.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014817","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":"The dose-dependent effect of tranexamic acid on epidural fibrosis after laminectomy: an experimental study on rats.","authors":"Alican Baris, Esra Circi, Emre Ozmen, Hazal Izol Ozmen, Serdar Yuksel, Ozan Beytemur","doi":"10.5152/j.aott.2025.24108","DOIUrl":"10.5152/j.aott.2025.24108","url":null,"abstract":"<p><p>Objective: This study aimed to evaluate the dose-dependent efficacy of tranexamic acid (TXA) in preventing epidural fibrosis in a rat laminectomy model and explore its potential as a therapeutic intervention for postoperative fibrosis in spinal surgery. Methods: In this experimental animal study, 32 female Wistar-Albino rats were randomized into four groups (control, 10 mg/kg TXA, 30 mg/kg TXA, and 100 mg/kg TXA; n=8 per group). Following a standardized laminectomy procedure, TXA was administered intravenously as a loading dose through the tail vein prior to surgery. The rats were sacrificed at the 4th-week post-surgery, the lumbar vertebrae were excised en bloc, and epidural fibrosis, inflammatory cell density, and fibroblast density were assessed histologically. Results: High-dose TXA (100 mg/kg) significantly reduced epidural fibrosis compared to the control (p=0.004), 10 mg/kg (p=0.002), and 30 mg/kg TXA groups (p=0.03). While the 30 mg/kg group showed lower epidural fibrosis grades compared to the control, the difference was not statistically significant. No significant differences were observed in inflammatory or fibroblast densities across groups. Conclusion: High-dose TXA (100 mg/kg) effectively reduced epidural fibrosis in a dose-dependent manner, demonstrating potential as a systemic therapeutic option to improve postoperative outcomes in spinal surgery.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 2","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046277","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":"Exploring the role of artificial intelligence in Turkish orthopedic progression exams.","authors":"Gokhan Ayik, Ulas Can Kolac, Taha Aksoy, Abdurrahman Yilmaz, Mazlum Veysel Sili, Mazhar Tokgozoglu, Gazi Huri","doi":"10.5152/j.aott.2025.24090","DOIUrl":"https://doi.org/10.5152/j.aott.2025.24090","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate and compare the performance of the artificial intelligence (AI) models ChatGPT-3.5, ChatGPT-4, and Gemini on the Turkish Specialization Training and Development Examination (UEGS) to determine their utility in medical education and their potential to improve patient care.</p><p><strong>Methods: </strong>This retrospective study analyzed responses of ChatGPT-3.5, ChatGPT-4, and Gemini to 1000 true or false questions from UEGS administered over 5 years (2018-2023). Questions, encompassing 9 orthopedic subspecialties, were categorized by 2 independent residents, with discrepancies resolved by a senior author. Artificial intelligence models were restarted for each query to prevent data retention. Performance was evaluated by calculating net scores and comparing them to orthopedic resident scores obtained from the Turkish Orthopedics and Traumatology Education Council (TOTEK) database. Statistical analyses included chi-squared tests, Bonferroni-adjusted Z tests, Cochran's Q test, and receiver operating characteristic (ROC) analysis to determine the optimal question length for AI accuracy. All AI responses were generated independently without retaining prior information.</p><p><strong>Results: </strong>Significant di!erences in AI tool accuracy were observed across di!erent years and subspecialties (P < .001). ChatGPT-4 consistently outperformed other models, achieving the highest overall accuracy (95% in specific subspecialties). Notably, ChatGPT-4 demonstrated superior performance in Basic and General Orthopedics and Foot and Ankle Surgery, while Gemini and ChatGPT-3.5 showed variability in accuracy across topics and years. Receiver operating characteristic analysis revealed a significant relationship between shorter letter counts and higher accuracy for ChatGPT-4 (P=.002). ChatGPT-4 showed significant negative correlations between letter count and accuracy across all years (r=\"0.099, P=.002), outperformed residents in basic and general orthopedics (P=.015) and trauma (P=.012), unlike other AI models.</p><p><strong>Conclusion: </strong>The findings underscore the advancing role of AI in the medical field, with ChatGPT-4 demonstrating significant potential as a tool for medical education and clinical decision-making. Continuous evaluation and refinement of AI technologies are essential to enhance their educational and clinical impact.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"18-26"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025932","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":"Letter to the Editor: Clinical Effect of Posterior-Only Approach Debridement, Intervertebral Fusion, and Internal Fixation for Upper Thoracic Tuberculosis.","authors":"Safak Ekinci, Ayhan Akcali","doi":"10.5152/j.aott.2025.24135","DOIUrl":"10.5152/j.aott.2025.24135","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"6"},"PeriodicalIF":1.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061515","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 rare case of an isolated scaphoid dislocation neglected for 45 years: A case report and literature review.","authors":"Erdi İmre","doi":"10.5152/j.aott.2025.23167","DOIUrl":"https://doi.org/10.5152/j.aott.2025.23167","url":null,"abstract":"<p><p>Isolated dislocation of the scaphoid bone is an extremely rare injury. If left untreated, results may be catastrophic. This paper presents a late complication of a neglected open scaphoid dislocation injury. A 63-year-old woman was admitted to the orthopedic outpatient department with symptoms of pain and restricted movement in her left wrist. Her medical history revealed a previous open injury to her left wrist approximately 45 years ago due to being trapped between a cart and a tree. X-ray and computed tomography showed volar dislocation of the scaphoid bone, collapse of the lunate bone, advanced arthritic changes, and cystic alterations in the lunocapitate joint. The decision on surgical treatment was made. Scaphoid excision and radiometacarpal fusion surgery were performed on her left wrist. Isolated scaphoid dislocations are rare injuries. Early recognition and treatment in the acute phase prevent severe complications and yield successful results. Advanced wrist arthritis can be observed in delayed cases. Radiometacarpal fusion is a successful treatment option for advanced cases with complete loss of motion.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026215","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":"Outcomes of scaphocapitate fusion versus proximal row carpectomy in advanced-stage Kienböck's disease.","authors":"Mehmet Can Gezer, Uğur Bezirgan, Yener Yoğun, Seyit Şerif Ünsal, Mehmet Armangil","doi":"10.5152/j.aott.2025.24046","DOIUrl":"https://doi.org/10.5152/j.aott.2025.24046","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical results and determine functional superiority in patients treated with scaphocapitate fusion (SCF) versus proximal row carpectomy (PRC) for advanced-grade Kienböck disease.</p><p><strong>Methods: </strong>The patients were assessed in terms of demographic data, follow-up duration, disease stage, preoperative and final follow-up values of the disability of arm, shoulder, and hand (DASH) score, patient-rated wrist evaluation (PRWE) score, and visual analog scale (VAS) pain score, together with the key-pinch grip and palmar grip values. The preoperative and postoperative flexion and extension angles and radial and ulnar deviation angles were also recorded and compared. As there were no records of preoperative grip strength values, comparisons were made with the healthy contralateral hand.</p><p><strong>Results: </strong>A total of 26 patients were evaluated, including 10 who underwent PRC surgery and 16 who underwent SCF. Preoperatively, the flexion range was 65.8% in the PRC group and 58.8% in the SCF group, the extension range was 65.8% and 56.7%, radial deviation was 35% and 40.6%, and ulnar deviation was 65% and 61.1%, respectively. Postoperatively, the mean values of these parameters were comparable between the 2 groups. When grip strength was compared with the non-operated hand, it was determined to be 58.8% of the healthy hand in the PRC group and 60.9% in the SCF group. Similarly, pinch strength was 45.5% of the healthy hand in the PRC group and 55.6% in the SCF group. In all patients, a statistically significant reduction was observed in postoperative DASH, PRWE, and VAS scores compared to preoperative values. Specifically, in the PRC group, the postoperative scores were DASH: 22.6, PRWE: 43.6, and VAS: 3.2, while in the SCF group, the corresponding values were DASH: 26.5, PRWE: 38.2, and VAS: 2.9.</p><p><strong>Conclusion: </strong>In advanced-grade Kienböck disease, PRC appears to be a more favorable option when preserving joint range of motion is a priority, whereas SCF may provide better outcomes in terms of grip strength. Both techniques seem to o!er comparable pain relief and functional results, suggesting that the choice of procedure should be tailored to the patient's individual needs and priorities.</p><p><strong>Level of evidence: </strong>Level IV, Therapeutic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055141","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":"Efficacy of bone cement volume in unilateral kyphoplasty of thoracolumbar compression fractures: A clinical comparative study.","authors":"Hüseyin Berk Benek, Tahsin Ulgen, Alper Tabanlı, Cafer Ak, Emrah Akcay, Hakan Yilmaz","doi":"10.5152/j.aott.2025.24064","DOIUrl":"https://doi.org/10.5152/j.aott.2025.24064","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical and radiological e!cacy of bone cement volumes injected during unilateral percutaneous balloon kyphoplasty for thoracolumbar vertebral compression fractures.</p><p><strong>Methods: </strong>In this retrospective study, we reviewed data from 96 patients who underwent single-level unilateral kyphoplasty. The patients were categorized into 2 groups based on the cement volume injected: group 1 (cement volume \"4 mL, minimum 3 mL; n=48) and group 2 (cement volume >4 mL, maximum 6 mL; n=48). The clinical outcomes, as assessed using the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores, were evaluated preoperatively and then at the final follow-up 1 month postoperatively. The vertebral corpus height at the fracture level was measured at the anterior, middle, and posterior regions through sagittal computed tomography scanning.</p><p><strong>Results: </strong>The mean age of the patients was 64.2 years in group 1 and 63.8 years in group 2. In group 1, the mean anterior vertebral height increased from 19.0 ± 3.3 mm preoperatively to 19.9 ± 3.2 mm postoperatively, whereas in group 2, it increased from 17.9 ± 3.8 mm to 19.6 ± 3.7 mm, respectively. The middle vertebral heights were 15.4 ± 2.5 mm preoperatively and 16.9 ± 2.8 mm postoperatively in group 1 and 16.0 ± 3.6 mm and 17.5 ± 3.2 mm, respectively, in group 2. Both groups exhibited significant improvements in ODI and VAS scores, with no significant di#erence between the groups. A statistically significant increase was recorded within each group for the anterior, middle, and posterior vertebral heights. However, a significantly greater increase was noted in the anterior height in group 2 compared to that in group 1 (P < .05).</p><p><strong>Conclusion: </strong>Unilateral kyphoplasty is an e#ective procedure for managing painful vertebral compression fractures. The greatest loss of vertebral height occurred in the middle column, which also exhibited the greatest potential for restoration. Thus, a higher cement volume facilitated greater restoration of the anterior column height.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054829","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":"Colonel Dr. Zeynep Karaosmanğlu: A trailblazer in Turkish orthopedics and traumatology.","authors":"Emel Gönen, Tülin Türközü","doi":"10.5152/j.aott.2025.24142","DOIUrl":"https://doi.org/10.5152/j.aott.2025.24142","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"2-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002185","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}