Surgical neurology international最新文献

{"title":"Retrospective analysis of recurrence patterns and clinical outcomes in grade I-III meningiomas after surgery.","authors":"Yuli Felistia, Nadira Fildza Amanda, Fandi Hendrawan, Nugroho Harry Susanto, Asra Al Fauzi, Muhammad Miftahussurur","doi":"10.25259/SNI_32_2025","DOIUrl":"https://doi.org/10.25259/SNI_32_2025","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to evaluate the outcomes of meningioma patients with the World Health Organization (WHO) grades I-III who underwent surgical resection and identify factors influencing recurrence and survival.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent surgery for meningioma at the National Brain Center Hospital between January 2020 and December 2022. Clinical characteristics of patients with recurrence, such as gender, age, preoperative Karnofsky Performance Scale (KPS), grading, and history of radiotherapy, were recorded. The recurrence time was assessed within 2 years post-surgery. Magnetic resonance imaging or computed tomography imaging results were used to determine meningioma location, while the WHO grading was based on pathological findings. Survival analysis of recurrence across different grades was performed using Kaplan-Meier curves.</p><p><strong>Results: </strong>Of the 184 patients who had surgical resection for meningioma, 53 (28.8%) experienced recurrence. The recurrence group consisted primarily of women (81%), with a preoperative KPS > 70% (83%), Simpson grading II-III (60.3%), WHO grade II (39.6%), and meningiomas located in the convexity (24.5%). Most patients (81.1%) had no history of radiotherapy, and 64.15% had two or more resections. The average recurrence-free period after surgery was 17.95 ± 20.39 months. Mortality due to recurrence was most common in the WHO grade II patients (11.1%). Kaplan-Meier curves showed differences in recurrence between grading subgroups, with the WHO grade III meningiomas exhibiting the highest recurrence rate and the worst prognosis.</p><p><strong>Conclusion: </strong>Higher-grade meningiomas are more likely to recur and result in poorer outcomes. Further research is needed to investigate tumor recurrence at the molecular level. A multidisciplinary approach to treatment improves outcomes and reduces complications associated with recurrence.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"149"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060784","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":"Fulminant simultaneous multiple dissections of the cervical and vertebral arteries leading to hemorrhagic and ischemic stroke: A case report.","authors":"Kazuki Fukumoto, Yukihiro Imaoka, Hiroki Sato, Masataka Yoshimura, Shinya Kohyama","doi":"10.25259/SNI_167_2025","DOIUrl":"https://doi.org/10.25259/SNI_167_2025","url":null,"abstract":"<p><strong>Background: </strong>Intra-and extracranial artery dissections are uncommon but significant causes of ischemic stroke and subarachnoid hemorrhage (SAH). While individual dissections are well-documented, simultaneous dissections of multiple vessels leading to both hemorrhagic and ischemic strokes are extremely rare.</p><p><strong>Case description: </strong>A 41-year-old man presented with acute onset of headache, vomiting, and loss of consciousness. Imaging revealed multiple arterial dissections involving the bilateral internal carotid arteries and vertebral arteries (VAs). The patient was diagnosed with SAH caused by a ruptured fusiform aneurysm in the left VA. Emergency endovascular trapping was performed to treat the ruptured VA aneurysm. The following day, ischemic infarctions were observed in both hemispheres, prompting the initiation of dual antiplatelet therapy for the cervical carotid artery dissection. Despite the complexity of his condition, the patient achieved functional recovery, with a modified Rankin Scale score of 3 at discharge.</p><p><strong>Conclusion: </strong>Simultaneous hemorrhagic and ischemic strokes due to multiple arterial dissections pose significant diagnostic and therapeutic challenges. This case highlights the importance of individualized treatment strategies and calls for further research to establish evidence-based guidelines for managing such complex conditions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"154"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056172","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":"Recurrence of partially thrombosed superficial temporal artery aneurysm after endovascular trapping: A case report and literature reviews.","authors":"Shohei Kinoshita, Hidefumi Tabata, Hana Tobishima, Akira Munakata, Tomomi Kusumi, Tomohiro Kaji, Kiyohide Kakuta, Kosuke Katayama, Takahiro Morita, Atsushi Saito","doi":"10.25259/SNI_206_2025","DOIUrl":"https://doi.org/10.25259/SNI_206_2025","url":null,"abstract":"<p><strong>Background: </strong>Superficial temporal artery (STA) aneurysms are relatively rare diseases, and the treatment approach is based on factors such as the location of the aneurysm, curability, complications, and patient request. However, the detailed outcome of STA aneurysms treated with endovascular surgery remains unknown.</p><p><strong>Case description: </strong>A 75-year-old woman found a pulsatile mass lesion at a preauricular region with gradual enlargement. Angiography showed a thrombosed aneurysm originating from STA. Endovascular trapping was selected because she rejected open surgery for cosmetic reasons. Intra-aneurysmal blood flow disappeared on postoperative angiography. However, the aneurysm had enlarged for 8 months after the initial embolization. A recurrent aneurysm was resected, and pathological examination revealed neovascularization within the thrombotic lesion, suggesting neovascularization and re-canalization.</p><p><strong>Conclusion: </strong>Endovascular trapping for thrombosed STA aneurysm might include recurrent risk, and direct resection should be considered as the first-line treatment.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"155"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002178","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":"Paradoxical evolution of spheno-orbital meningioma after cessation of progestin treatment.","authors":"Maximilien Steinmetz, Julie Lebeau, Olivier Bouchain, Martin Moïse, Elettra Bianchi, Cécile Andris, Anne-Catherine Chapelle, Axelle Pintiaux, Gilles Reuter","doi":"10.25259/SNI_947_2024","DOIUrl":"https://doi.org/10.25259/SNI_947_2024","url":null,"abstract":"<p><strong>Background: </strong>Meningioma is the most frequent primary benign intracranial tumor, with a higher incidence in women. Treatment with progesterone acetates, including cyproterone, nomegestrol, chlormadinone, promegestone, medrogestone, and medroxyprogesterone acetate, has been identified as a risk factor of meningioma, particularly in the anterior and middle cranial fossae. Discontinuation of these treatments often leads to volume stabilization or regression of the tumor.</p><p><strong>Case description: </strong>A 42-year-old woman undergoing treatment with nomegestrol acetate (NA) presented with headaches and visual loss in her right eye. She was diagnosed with a large spheno-orbital meningioma invading the sphenoid and ethmoid sinuses, associated with hyperostosis of the sphenoid wing. An initial resection was performed using an extended endonasal approach. Immunohistochemistry confirmed a chondroid meningioma, Grade II, with progestin receptor in 100% of the tumor cell nuclei and a Ki-67 proliferation index of 3-5%. NA was immediately stopped on diagnosis. Despite the cessation of the NA, the intraosseous sphenoidal part of the tumor continued to grow, leading to optic nerve compression. A second surgery was performed using a right fronto-temporo-orbito-zygomatic approach. Examination of the dura of the middle fossa showed subtle tumoral infiltration, while the Ki-67% index was estimated at 1%. Examination of the sphenoid bone demonstrated reactive hyperostosis with minimal to no tumor infiltration.</p><p><strong>Conclusion: </strong>This case illustrates that the proliferative activity of the progestin-associated meningioma does not account for intraosseous progression within the sphenoid bone following cessation of progestin therapy. Our observations suggest an upregulation of osteogenesis in infiltrated bone, even as the dural part of the meningioma regresses.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"151"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059394","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":"Glossopharyngeal neuralgia and hypoglossal nerve palsy: A singular clinical case of two rare concomitant neurovascular conflicts.","authors":"Luigi Valentino Berra, Francesca Di Cristanziano, Antonio Santoro","doi":"10.25259/SNI_55_2025","DOIUrl":"https://doi.org/10.25259/SNI_55_2025","url":null,"abstract":"<p><strong>Background: </strong>Neurovascular conflict (NVC) is described as a pathological contact between cranial nerves and vessels. Glossopharyngeal neuralgia (GPN) and hypoglossal nerve palsy (HNP) due to NVC represent rare clinical entities. To our knowledge, we present the first reported case of concomitant GPN and HNP caused by vertebral artery (VA)-posterior inferior cerebellar artery (PICA) complex compression.</p><p><strong>Case description: </strong>We report an extremely rare case of a 52-year-old man with combined unilateral left-sided GPN and HNP because of NVC involving both the VA and the PICA, successfully treated with a retrosigmoid approach for microvascular decompression (MVD). Postoperatively, the patient immediately recovered without new-onset dysfunction of lower cranial nerves, and a complete remission of symptoms was achieved.</p><p><strong>Conclusion: </strong>As far as we know, in this article, we present the first singular case in the literature of concomitant classical GPN and HNP due to NVC involving both the VA and the PICA. Despite the low incidence of GPN and HNP, clinical picture and intraoperative findings represent clear and reliable elements for their diagnosis. MVD is a successful therapeutic strategy that offers a long-term cure for GPN and HNP.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"153"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029318","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 topical hemostatic agents in neurosurgery: An experimental study in a rat model.","authors":"Florencia Casto, Miguel Villaescusa, Ezequiel Jungberg, Tomas Saavedra Azcona, Delfina Lanusse, Pedro Plou, Matteo Baccanelli, Pablo Ajler","doi":"10.25259/SNI_791_2024","DOIUrl":"https://doi.org/10.25259/SNI_791_2024","url":null,"abstract":"<p><strong>Background: </strong>Few studies have compared different topical hemostatic agents in live models or brain tissue, and their doses are not standardized. Little is known about the combined use of these different elements in terms of efficacy and safety, especially in neurosurgery. The objective of this study was to evaluate the efficacy of different topic hemostatic agents used in daily neurosurgical practice in an experimental animal model study.</p><p><strong>Methods: </strong>A group of 42 Wistar rats was used. A stereotaxic frame was fixed, and coordinates were determined to locate the bregma. A 3 mm hole was drilled with a bone-profile burr on each side of the midline. A stylet was inserted into the brain to create the defect and induce bleeding. The rats were randomly divided into seven groups, with each group assigned a hemostatic agent. Hemostasis time and control time on the opposite side were measured.</p><p><strong>Results: </strong>Hemostasis was achieved after an average of 1 82 s in the group treated with Beriplast, making it the hemostatic agent that stopped the bleeding the fastest. The control time was an average of 40, 14 s. Compared with the negative control, all the agents resulted in significantly better hemostasis (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>A reduction in postoperative bleeding positively impacts annual morbidity and mortality rates, hospitalization time, and hospital bed turnover. Understanding the efficacy and safety of different hemostatic agents will enable surgeons to optimize intraoperative hemostasis, thereby achieving better postoperative outcomes and increased patient safety.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"148"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994824","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":"Percutaneous endoscopic lumbar discectomy for extreme lateral lumbar disc herniation.","authors":"Thomas Luebbers, Albatol Ali, Rainer Baalmann, Aydemir Kale","doi":"10.25259/SNI_144_2025","DOIUrl":"https://doi.org/10.25259/SNI_144_2025","url":null,"abstract":"<p><strong>Background: </strong>Far lateral disc herniation (FLDH) constitutes a minor portion of the total discectomy workload for spine surgeons. So far, there is still a debate about the term \"extreme lateral,\" and in general, it describes the intra - and extraforaminal position of the disc herniation. We present a surgical treated case series in which the disc herniation on the lumbar spine was still ventral of the exiting nerve root far outside of the foramen.</p><p><strong>Methods: </strong>Study Design and Patient Characteristics: retrospective analysis of 14 surgical treated patients. Surgical Technique: In all patients, the so-called foraminal retreat maneuver (percutaneous endoscopic lumbar discectomy) was performed. A foraminoscope with a 15° optic orientation and a nonbeveled working sleeve were used in all cases. The aforementioned technique represents a modification of the \"inside-out\" endoscopic surgery on the lumbar spine.</p><p><strong>Results: </strong>We treated 11 male and 3 female patients with an average age of 67 years and 66 years, respectively. Except for one, 13 patients presented with clear monoradicular symptoms accompanied by mild-to-moderate neurological deficits. In 11 cases, the disc herniation exhibited cranial migration; two were at the disc level, and in another case, caudal migration was observed. Immediate pain relief and significant improvement of neurological symptoms occurred in all patients. Two patients developed neuropathic pain, which improved after conservative treatment within 6 weeks following the procedure. No recurrence was observed in this case series.</p><p><strong>Conclusion: </strong>Patients suffering from extreme lateral lumbar disc herniation were found to be significantly older. Furthermore, there is a higher tendency toward male patients and cranial migration of the herniation. The described and modified inside-out technique, along with a 15° optic, allows for clear identification of the exiting nerve root and safe removal of the displaced disc herniation far outside of the spinal canal and foramen. No complications occurred in this small series, and the development of neuropathic pain appears to be relatively common.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"150"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032252","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":"Lingual artery: Angiographic anatomy and variations review for neurosurgeons.","authors":"John Na, Aaron Kakazu, Ahmed Muthana, Mustafa Shukur, Samer S Hoz, Charles J Prestigiacomo","doi":"10.25259/SNI_282_2025","DOIUrl":"https://doi.org/10.25259/SNI_282_2025","url":null,"abstract":"<p><strong>Background: </strong>The lingual artery (LA) is an important branch of the external carotid artery with a distinct course and vascular supply. However, the knowledge of the LA's angiographic anatomy and variation may represent an obscure area for practicing neurosurgeons. Inconsistencies in the origin, shape, three-dimensional orientation, exact course, and branches are key features of the LA, necessitating a better understanding of its detailed angio-anatomical characteristics.</p><p><strong>Methods: </strong>Summarized key concepts were included based on a review of the literature, including PubMed medical database, focusing on LA anatomy, angiography, and variations.</p><p><strong>Results: </strong>A focused, high-yield review was provided in this paper, depicting multiple anatomical and angiographic characteristics of the LA based on 20 final identified articles.</p><p><strong>Conclusion: </strong>Appreciating the LA's anatomy is essential for angiographic interpretation and enhances the precision of related neurovascular procedures.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046654","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 meta-analysis of modern neuro-stimulation modalities-Advances in neuro-stimulation techniques.","authors":"Abdulsalam Mohammed Aleid, Saud Nayef Aldanyowi, Ayat Aleid, Khaled Albazli, Ghadeer Mohammad Fatani, Sami Almalki","doi":"10.25259/SNI_656_2024","DOIUrl":"https://doi.org/10.25259/SNI_656_2024","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a debilitating condition that affects about 3% of the population globally. Conventionally, pharmacologic approaches, psychotherapy, and surgery have been used in the management of chronic refractory pain. However, over the past decades, advances in neurotechnology have enabled modern novel techniques of neurostimulation, such as spinal cord stimulation (SCS) and dorsal root ganglion (DRG), to be used in the management of chronic neuropathic pain that does not respond to conventional management. This review, therefore, aims to establish the efficacy of these two novel technologies in the management of chronic neuropathic pain compared to conventional medical management (CMM) techniques.</p><p><strong>Methods: </strong>A systematic search was conducted on three electronic databases, PubMed, Science Direct, and CENTRAL, for all relevant articles to the study topic. After a detailed review by two independent reviewers, only the articles that met the inclusion criteria were included. The Review Manager 5.4 software was utilized to conduct a meta-analysis of the outcomes of pain reduction.</p><p><strong>Results: </strong>Our online search yielded 345 articles; however, only eight studies were included in the analysis according to our inclusion criteria. The results from our pooled analysis indicated that SCS and dorsal root stimulation both resulted in a significant reduction in the rating of chronic pain mean difference (MD) (-4.73; 95% confidence interval [CI] [-4.76, -4.71] <i>P</i> < 0.00001) and MD (-1.09; 95% CI [-1.29, -0.90] <i>P</i> < 0.00001), respectively. Similarly, for the studies that reported percentage change in pain rating, the pooled analysis showed that SCS resulted in a higher percentage reduction in pain rating compared to CMM MD (69.47; 95% CI [64.31, 74.64] <i>P</i> < 0.00001).</p><p><strong>Conclusion: </strong>Based on the results of our analysis, we conclude that advances in neurostimulation techniques, such as SCS and DRG stimulation, have resulted in better management of chronic neuropathic pain compared to conventional pain management techniques.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033371","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":"Cavernous malformation in the lumbar nerve rootlet.","authors":"Phi Nguyen, Phu An Huynh, Tra My Ton Nu, Minh Huynh Quang Bui, Nhu Phuc Tran, Van Tri Truong","doi":"10.25259/SNI_227_2025","DOIUrl":"https://doi.org/10.25259/SNI_227_2025","url":null,"abstract":"<p><strong>Background: </strong>Intradural extramedullary (IDEM) cavernomas are rare vascular lesions that sometimes needs surgery. However, there has been little information about the surgical strategy for these lesions.</p><p><strong>Case description: </strong>A 39-year-old male presented with 1 month of left lumbosciatalgia. The magnetic resonance imaging was consistent with either an L4 IDEM neurofibroma or a meningioma. At surgery, we encountered a red-oval encapsulated lesion firmly adhered to the L4 nerve root, which was totally excised along with the root itself. Notably, postoperatively, the patient exhibited no new neurological deficit.</p><p><strong>Conclusion: </strong>IDEM cavernoma is rare but should always be a differential diagnosis for other common IDEM lesions. A total excision of an IDEM cavernoma and sacrification of the involved nerve root seem to be a reasonable option.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"152"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056313","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}