Surgical neurology international最新文献

{"title":"Rethinking central nervous system sparganosis: Beyond surgical cure toward integrated immune-parasitic surveillance.","authors":"Nathkapach Kaewpitoon Rattanapitoon, Nav La, Patpicha Arunsan, Schawanya Kaewpitoon Rattanapitoon","doi":"10.25259/SNI_784_2025","DOIUrl":"10.25259/SNI_784_2025","url":null,"abstract":"","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"372"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208329","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":"Trochlear nerve palsy associated with intracranial aneurysms: Scoping review.","authors":"Ahmed Muthana, Zahraa A Alsubaihawi, Bandar M Alhadeethi, Zahraa I Al-Anssari, Mohammedbaqer Ali Al-Ghuraibawi, Abdullah O Al-Jumaili, Aktham O Al-Khafaji, Zinah A Alaraji, Haneen A Salih, Mayur Sharma, Samer S Hoz","doi":"10.25259/SNI_570_2025","DOIUrl":"10.25259/SNI_570_2025","url":null,"abstract":"<p><strong>Background: </strong>Trochlear nerve palsy (TNP) in patients with ruptured or unruptured intracranial aneurysms (IA) can result from the disease process or its treatment. We systematically reviewed the literature on TNP in patients with IA.</p><p><strong>Methods: </strong>PubMed, ScienceDirect, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction and quality assessment were performed according to pre-established guidelines.</p><p><strong>Results: </strong>Our review yielded 29 studies out of 273 retrieved articles. A total of 134 patients with TNP and IA were included in our study. The mean age was 55.35 years and females accounted for 78%. Among the TNP cases, 91% harbored aneurysms located in the internal carotid artery and posterior communicating artery, and 93% of these aneurysms were large to giant-sized aneurysms. Out of the total cases, the vast majority (96.2%) exhibited TNP at the time of their initial presentation. Only a small proportion (<i>n</i> = 5, 3.73%) developed TNP after the treatment of their aneurysms. For the multiplicity of cranial nerve involvement, 81 (60.4%) had cranial nerve palsies other than trochlear palsy, and the remaining 53 (39.5%) had isolated TNP. Finally, in terms of TNP outcome, the recovery rate from TNP was identified in 110 cases (85.2%), with a duration of resolution of <6 months (<i>n</i> = 58, 89.2%).</p><p><strong>Conclusion: </strong>TNPs are correlated with IAs, and this correlation depends on the location and size of the aneurysms.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"366"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208743","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":"Orbito-cranial penetrating head injury by tear gas canister: A case report.","authors":"Bandar M Alhadeethi, Ahmed E Sarhan, Ozair Nissar Sheikh, Mohammedbaqer Ali Al-Ghuraibawi, Ahmed Muthana, Samer S Hoz","doi":"10.25259/SNI_79_2025","DOIUrl":"10.25259/SNI_79_2025","url":null,"abstract":"<p><strong>Background: </strong>Orbito-cranial penetrating injuries caused by tear gas canisters (TGCs) are rare but devastating incidents. These injuries combine severe kinetic trauma with chemical irritation, resulting in complex neurosurgical emergencies that demand prompt multidisciplinary intervention.</p><p><strong>Case description: </strong>This report describes a 27-year-old male who sustained a penetrating orbital injury from a TGC during a protest. The patient presented with a Glasgow Coma Scale (GCS) score of 9, a fractured skull, herniated brain tissue, and multiple intracranial hemorrhages. Emergency craniotomy was performed, including hematoma evacuation, removal of the canister and bone fragments, and reconstruction of the skull base. Despite initial stabilization, the patient's condition deteriorated postoperatively, leading to sudden cardiac arrest on day three. Tear gas canisters, commonly used for riot control, can cause severe orbito-cranial injuries when deployed at high velocity. These injuries pose significant diagnostic and therapeutic challenges due to their combined mechanical and chemical effects. The case underscores the critical need for resources like intracranial pressure monitoring and advanced neurosurgical care in managing such injuries, especially in conflict zones. The orbito-cranial involvement highlights the vulnerability of the orbital region and its potential to result in fatal outcomes.</p><p><strong>Conclusion: </strong>Orbito-cranial injuries caused by TGCs represent a unique and severe subset of trauma requiring immediate and specialized intervention. This case emphasizes the need for improved safety protocols, systematic injury documentation, and enhanced neurosurgical infrastructure to effectively manage and improve outcome.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"367"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208815","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":"Evaluating the role of surgical timing on clinical outcomes in traumatic spinal cord injury: A systematic review and meta-analysis.","authors":"Tommy Alfandy Nazwar, Farhad Bal'afif, Donny Wisnu Wardhana, Fachriy Bal'afif, Christin Panjaitan","doi":"10.25259/SNI_678_2025","DOIUrl":"10.25259/SNI_678_2025","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the impact of surgical timing on neurological and functional outcomes in patients with traumatic spinal cord injury (TSCI).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PUBMED and ScienceDirect databases for studies published between 2015 and 2025, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing surgical timing (≤12 h, ≤24 h, and >24 h) were included.</p><p><strong>Results: </strong>A total of 22 comparative studies comprising 2,395 patients were included. Among them, 346 underwent ultra-early decompression (≤12 h), 1,140 underwent early surgery (≤24 h), and 908 underwent delayed surgery (>24 h). Ultra-early surgery (≤12 h) significantly improved neurological outcomes compared to surgery after 12 h (odds ratio [OR] 2.30; 95% confidence interval [CI]: 1.69-3.14; <i>P</i> < 0.00001). Surgery within 24 h also outperformed surgery after 24 h (OR 1.49; 95% CI: 1.19-1.87; <i>P</i> < 0.0005). While the American Spinal Injury Association motor scores at 6 months were not significantly different (mean difference [MD] -3.30; 95% CI: -8.24-1.65; <i>P</i> = 0.19), scores at 1 year significantly favored the ≤24-h group (MD 4.90; 95% CI: 2.84-6.95; <i>P</i> < 0.00001). Early surgery reduced hospital stay duration (MD -4.94; 95% CI: -9.69--0.20; <i>P</i> = 0.04), with no significant differences in mortality or major complications.</p><p><strong>Conclusion: </strong>Surgical decompression within 24 h, especially within 12 h, is associated with significantly better neurological recovery, improved long-term motor outcomes, and shorter hospitalization, without increased mortality or major complications. These findings underscore the critical role of timely surgical intervention in acute TSCI management.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"368"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208733","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 presentation of diffuse idiopathic skeletal hyperostosis with progressive dysphagia and choking.","authors":"Raissa Piassali Carvalho, Luiz Felipe Pereira Picazio, Isabela de Cássia Marins Quinsan, Paulo Henrique Pires de Aguiar","doi":"10.25259/SNI_515_2025","DOIUrl":"10.25259/SNI_515_2025","url":null,"abstract":"<p><strong>Background: </strong>Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatological disorder characterized by the formation of spinal osteophytes due to the ossification of paravertebral ligaments and muscles, particularly involving the anterior longitudinal ligament. The disease typically manifests after the fifth decade of life and is most commonly seen in the thoracic spine. Here, we present the case of an 85-year-old female with cervical DISH who experienced dysphagia, choking, and even airway obstruction. Following anterior resection of the osteophytes, her symptoms largely resolved.</p><p><strong>Case description: </strong>An 85-year-old female patient presented with progressive dysphagia and choking for 2 years. With the diagnosis of DISH, she underwent anterior resection of C4-C6 with subsequent marked significant improvement in symptoms.</p><p><strong>Conclusion: </strong>Cervical DISH may cause progressive dysphagia and choking due to anterior cervical osteophyte formation. In this case, the patient showed significant clinical improvement following direct anterior resection of C4-C6 osteophytes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"371"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208681","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 radiological finding suggesting Blake's pouch cyst: A rare pediatric anomaly associated with hydrocephalus - A case report.","authors":"Feda Anisah Makkiyah, Enrico Yusuf, Rendy Badri","doi":"10.25259/SNI_205_2025","DOIUrl":"10.25259/SNI_205_2025","url":null,"abstract":"<p><strong>Background: </strong>Blake's pouch cyst (BPC) is a rare congenital anomaly resulting from the failure of the embryonic Blake's pouch to perforate during early fetal development. This condition leads to hydrocephalus, which may lead to increased intracranial pressure and a range of symptoms. According to authors, Indonesia faces infrastructure shortages in performing endoscopic third ventriculostomy or cyst fenestration; not many neurosurgeons are equipped to perform this procedure. The patient was treated with a ventriculoperitoneal (VP) shunt, resulting in good outcomes.</p><p><strong>Case description: </strong>A 6-month-old female infant was brought to the emergency department, presenting with signs of elevated intracranial pressure, including vomiting and irritability. Computed tomography (CT) scans confirmed the presence of hydrocephalus. Due to limited hospital resources and the high cost associated with endoscopic third ventriculostomy, which requires specialized equipment and expertise not readily available in our setting, a VP shunt procedure was chosen as a more economically feasible treatment option. The procedure significantly improved the patient's condition, resulting in substantial neurological recovery without complications.</p><p><strong>Conclusion: </strong>A CT scan diagnosis and placement of a VP shunt effectively improved the patient's outcome, highlighting the differences in treatment in developed countries.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"365"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208625","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":"Endovascular management of spinal arteriovenous malformations: Report of four cases and literature review.","authors":"Pablo Andrés Vega Medina, Gabriela Jezzabel Sarzosa Quimí, Laura Alexandra González Chang, Orlando Villarreal-Barrera","doi":"10.25259/SNI_383_2025","DOIUrl":"10.25259/SNI_383_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal arteriovenous malformations (AVMs) are rare vascular lesions of the central nervous system that may lead to progressive myelopathy or acute neurological decline. Early diagnosis remains challenging due to the nonspecific nature of symptoms and limitations in imaging.</p><p><strong>Case description: </strong>We present a series of four cases of AVMs treated with endovascular embolization. Patients ranged in age from 19 to 65 years and presented with various symptoms, including tetraparesis, progressive spastic paraparesis, and acute paraplegia. Malformations included type II (glomus), type III (juvenile), and a complex medullary-bulbar AVM associated with cerebellar hemangioblastomas. Embolization was performed using ethylene-vinyl alcohol copolymer with or without functional balloon occlusion testing. In one case, hemorrhage prompted surgical decompression following embolization - another required staged endovascular treatment for a prenidal aneurysm. Outcomes included partial improvement in motor and sensory symptoms, with persistent deficits in severe cases.</p><p><strong>Conclusion: </strong>Endovascular therapy, a proven and often preferred option for managing AVMs, especially in cases where surgical access is limited or high-risk, has demonstrated significant effectiveness. While complete obliteration is not always achievable, reducing flow and nidus volume can significantly improve symptoms and decrease the risk of hemorrhage. Multidisciplinary planning and individualized treatment are essential for optimal outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"369"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208751","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":"Hepatitis C ventriculitis obscured by concurrent methicillin-resistant <i>Staphylococcus aureus</i> infection after ventriculoperitoneal shunt placement: An illustrative case.","authors":"Chiemeka David Uwakwe, Racheed Mani, Sujith Swarna, Andrew Blaszczyk, Colleen Calandra, Michael Egnor","doi":"10.25259/SNI_708_2025","DOIUrl":"10.25259/SNI_708_2025","url":null,"abstract":"<p><strong>Background: </strong></p><p><p>Hepatitis C virus (HCV) is the most common blood-borne virus, affecting tens of millions of people worldwide. Neurologic manifestations of chronic HCV are rare and may be overlooked during workup of central nervous system (CNS) infections. We report on a patient who was diagnosed with hepatitis C meningoencephalitis after a protracted treatment course for presumed methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) ventriculitis.</p><p><strong>Case description: </strong>This was a 34-year-old male with a history of intravenous drug use and ventriculoperitoneal shunt placement for hydrocephalus secondary to post-traumatic intracranial hemorrhage, who presented 1 week following shunt surgery with worsening dizziness, with initial assessment demonstrating shunt infection with positive MRSA on cerebrospinal fluid (CSF) cultures. Over his hospital course, the patient demonstrated worsening ventriculomegaly on imaging, with pleocytosis and hyperproteinosis on CSF analyses despite aggressive antibiotic treatment, ventricular irrigation, and negative bacterial and fungal cultures. His symptoms resolved within 1 week of antiviral therapy for HCV with sofosbuvir-velpatasvir.</p><p><strong>Conclusion: </strong>In patients with chronic HCV, viral reactivation may manifest as protracted ventriculitis in the setting of low-to-normal pressure ventriculomegaly. Providers should be cognizant of serologically covert viral etiologies for post-operative infections and consider preemptive antiviral treatment in patients with aseptic CSF profiles when refractory to empiric antibiotic regimens for more common CNS pathogens.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"370"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208789","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":"Profile of pituitary adenoma in patients from rural areas: A study at Dr. Saiful Anwar hospital, Indonesia, 2024.","authors":"Donny Wisnu Wardhana, Farhad Balafif, Tommy Alfandy Nazwar, Fachriy Balafif, Wino Vrieda Vierlia, Iriana Maharani, Rulli Rosandi, Laksmi Sasiarini, Dessika Rahmawati, Yuyun Yueniwati, Harjoedi Adji Tjahjono, Anisa Nur Kholipah","doi":"10.25259/SNI_516_2025","DOIUrl":"10.25259/SNI_516_2025","url":null,"abstract":"<p><strong>Background: </strong>Pituitary adenoma is a benign tumor that can greatly affect prognosis, with delayed diagnosis posing a significant challenge. In Indonesia, epidemiological data on this tumor remain scarce. This study aims to explore the clinical profile of pituitary adenoma patients treated at Dr. Saiful Anwar General Hospital in 2024.</p><p><strong>Methods: </strong>A retrospective, single-center, consecutive case series study was conducted by a multidisciplinary research team. Diagnoses were pathologically confirmed through clinical and radiological assessments. Inclusion criteria were patients diagnosed and operated on in 2024. Patients with incomplete data were included in the descriptive analysis but excluded from specific analyses.</p><p><strong>Results: </strong>In 2024, 17 pituitary adenoma patients were treated at Dr. Saiful Anwar General Hospital. The majority were female (70.58%) and aged ≥18 years (100%). Visual disturbance was the predominant presenting symptom (88.23%). The most common tumor type was functional adenoma (prolactinoma, 52.94%), with Knosp grades 3A and 4 each found in 29.42% and 23.53% of cases. All patients underwent endonasal transsphenoidal surgery, with the majority achieving near-total resection (47.05%). Postoperatively, patients demonstrated favorable outcomes: All were discharged alive (100%), had normal urinary function at discharge (100%), and experienced improvements in hormonal status (77.77%), visual acuity (93.33%), and olfaction (100%).</p><p><strong>Conclusion: </strong>The endonasal transsphenoidal approach is a safe and effective technique for pituitary adenoma management. Multidisciplinary collaboration and integrated care improve outcomes and postoperative monitoring. Strengthening rural referral systems and implementing telemedicine may enhance access and long-term follow-up.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"374"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208901","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":"Indocyanine green-assisted endoscopic endonasal resection of an olfactory groove meningioma with vascular involvement.","authors":"Guilherme Gago, Martin Côté, Sylvie Nadeau, Pierre-Olivier Champagne","doi":"10.25259/SNI_392_2025","DOIUrl":"10.25259/SNI_392_2025","url":null,"abstract":"<p><strong>Background: </strong>Olfactory groove meningiomas are complex anterior skull base tumors representing approximately 10% of intracranial meningiomas. These tumors may involve critical structures, including the frontal lobes, optic nerves, and anterior cerebral arteries. The endoscopic endonasal approach offers direct access to the tumor, enabling early devascularization and optic canal decompression while minimizing brain retraction. However, lateral extension into the optic canals and vascular involvement remain major challenges requiring careful intraoperative management. Intraoperative indocyanine green (ICG) angiography is a valuable adjunct to safely navigate tumors involving vascular structures.</p><p><strong>Case description: </strong>We present the case of a 52-year-old female with a large olfactory groove meningioma causing anosmia, blurred vision in the right eye, memory loss, apathy, and personality changes. The lesion was associated with extensive bifrontal vasogenic edema and involved cortical branches of the A2 segment of the anterior cerebral arteries. The endonasal endoscopic approach was selected to allow early optic canal decompression, early tumor devascularization, and potential complete resection. In the immediate postoperative period, the patient experienced transient worsening of the right eye vision without other complications. A lumbar drain was maintained for 3 days, and the patient was discharged on postoperative day 5. At 3-month follow-up, visual function improved, and cognitive and memory functions recovered significantly. Postoperative magnetic resonance imaging demonstrated gross-total resection except for a small remnant of infiltrated dura near the right optic canal. Pathology confirmed a World Health Organization grade I meningioma.</p><p><strong>Conclusion: </strong>The integration of microsurgical techniques with ICG angiography proved beneficial, improving vascular visualization and guiding surgical decision-making.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"373"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208842","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}