Surgical neurology international最新文献

{"title":"Novel untethered micro-robotic platform developed for minimally invasive ultra-selective microsurgical procedures and targeted drug delivery: Preliminary characterization of tissue response to intraparenchymal navigation in ovine brain.","authors":"William Loudon, Michael Kardosh, Florent Cros, Be'eri Katznelson, Aviv Shtein, Katerina Fedotenko, Didi Castel, Olin J Palmer, Alexander Kiselyov","doi":"10.25259/SNI_841_2024","DOIUrl":"10.25259/SNI_841_2024","url":null,"abstract":"<p><strong>Background: </strong>To expand surgical options for safe, minimally invasive microsurgical procedures or targeted delivery of diverse therapeutics, a novel untethered micro-robotic platform is presented. This technology enables precision travel to predetermined central nervous system (CNS) parenchymal and complex cerebrospinal fluid pathway targets.</p><p><strong>Methods: </strong>Utilizing an <i>in vivo</i> ovine model, gross pathological and microscopic histopathological brain tissue reactions to the navigation of this micro-robot were compared to inserting standard neurosurgical catheters, routed from an occipital burr hole to the frontal lobe and then returning. Descriptions of the evolving tissue responses were documented at 24 h, 2, 12, and 26 weeks following the procedures.</p><p><strong>Results: </strong>No deaths or surgical complications occurred in either group. No neurological or behavioral differences were identified between the groups. No significant differences in gross or microscopic tissue pathology were identified when comparing the channels created by the micro-robot to the catheter control group.</p><p><strong>Conclusion: </strong>These findings support the equivalence of tissue responses to this micro-robot navigation compared to catheter insertion as a preliminary surrogate for addressing the safety and accuracy of this novel platform. This platform may set a new standard for safe, anatomically precise, and minimally invasive therapeutic procedures. The described approach offers untethered navigation, capable of traversing CNS tissues in controlled, complex, curvilinear trajectories. Preliminary results utilizing this micro-robotic capacity to deliver diverse therapeutic payloads are discussed. Novel applications designed to address CNS pathologies, including neurodegenerative diseases, epilepsy, neuro-oncology, and functional and microsurgical procedures, are proposed.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"157"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228121","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 giant infrasellar craniopharyngioma with extensive invasion of the pterygopalatine fossa: A case report and literature review.","authors":"Vittor Sérgio Santos de Quintela, Sofia Morais Silva Almeida, Arthur Campos do Nascimento, Nelson Almeida D'Ávila Melo, Arthur Maynart Pereira Oliveira","doi":"10.25259/SNI_134_2025","DOIUrl":"10.25259/SNI_134_2025","url":null,"abstract":"<p><strong>Background: </strong>Craniopharyngiomas are benign epithelial tumors that arise along the craniopharyngeal duct, commonly located in the sellar or suprasellar region. Infrasellar extension is a rare variant and may involve the nasopharynx, sphenoid sinus, clivus, and pterygopalatine fossa.</p><p><strong>Case description: </strong>A 66-year-old male patient is presented to the otorhinolaryngology service due to a complaint of left ear obstruction for the past 4 months. After no response to clinical treatment, investigation with computed tomography and magnetic resonance imaging showed a heterogeneous lesion with areas of calcification and bone destruction located in the sphenoid sinus region, which projected inferiorly and laterally invading the clivus in its entirety, the petrous apex, middle fossa, pterygopalatine, and infratemporal fossae with no involvement of the sellar/suprasellar region. The patient was referred to a multidisciplinary skull base surgery group that performed an extended transpterygoid endoscopic endonasal approach with gross total resection. The anatomopathological study was consistent with adamantinomatous craniopharyngioma.</p><p><strong>Conclusion: </strong>We present a rare case of a giant infrasellar craniopharyngioma with extensive invasion of the skull base without involvement of the sella or the pituitary gland.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"161"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228154","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":"Paroxysmal sympathetic hyperactivity: Current update on diagnosis, treatments, and outcomes.","authors":"Jeremia Aris Pandapotan Panjaitan, Lenny Florentina Ginting, Mirachel Rajagukguk, Deak Bastian Sibagariang, Andre Marolop Pangihutan Siahaan","doi":"10.25259/SNI_1130_2024","DOIUrl":"10.25259/SNI_1130_2024","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal sympathetic hyperactivity (PSH) is a severe dysregulation of the sympathetic nervous system, often resulting from traumatic brain injury (TBI). With a prevalence of 10-30% in TBI patients, PSH poses diagnostic and therapeutic challenges. This study reviews advancements in diagnosis, management, and outcomes associated with PSH.</p><p><strong>Methods: </strong>A comprehensive literature review of studies published in the past decade was conducted using PubMed, Scopus, Web of Science, and the Cochrane Library. Keywords included PSH, diagnostic criteria, treatment strategies, and clinical outcomes.</p><p><strong>Results: </strong>The PSH Assessment Measure (PSH-AM), combining the clinical feature scale and diagnosis likelihood tool, enhances early detection and differentiates PSH from similar conditions. Acute management using opioids and benzodiazepines proved effective, while beta-blockers and alpha-2 agonists reduced episodic recurrence. Despite improved diagnostic accuracy, challenges persist, such as overlapping symptoms and difficulty quantifying autonomic dysfunction. PSH is associated with prolonged hospital stays and poorer neurological outcomes, emphasizing the importance of timely intervention.</p><p><strong>Conclusion: </strong>Accurate diagnosis using tools like PSH-AM is essential for mitigating PSH-related complications. Future research should explore biomarkers and personalized therapies to refine diagnosis and optimize long-term outcomes through multicenter trials.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"163"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228122","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 parietal transcortical approach to the lateral ventricle: Opening Pandora's box.","authors":"Allan J Drapkin","doi":"10.25259/SNI_213_2025","DOIUrl":"10.25259/SNI_213_2025","url":null,"abstract":"<p><strong>Background: </strong>Intraventricular tumors present a difficult decision regarding the selection of the optimal surgical approach for their resection. Among various possibilities, the parietal transcortical approach (PTA) is currently used in this endeavor.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted on the surgical approaches used for the resection of intraventricular tumors, focusing on the PTA.</p><p><strong>Results: </strong>This approach presents multiple potential sequelae, some of them clinically recognized, sequelae that have varying clinical significance.</p><p><strong>Conclusion: </strong>The PTA should be replaced by other safer ones.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"169"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228163","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":"Quadrangular space schwannoma affecting the axillary nerve.","authors":"Narottam Das, Pranathi Chandana, Manmeet Singh Chhabra, Praveen L Basanagoudar","doi":"10.25259/SNI_115_2025","DOIUrl":"10.25259/SNI_115_2025","url":null,"abstract":"<p><strong>Background: </strong>Schwannomas are benign neural tumors originating primarily from Schwann cells associated with cranial and spinal nerves, which are a well-known medical entity. However, their occurrence in the extremities, particularly those involving the axillary nerve, is a rare phenomenon with limited literature documentation.</p><p><strong>Case description: </strong>We present a case of a 29-year-old male who complained of painful swelling in the posterior shoulder region. Further diagnostic investigations, including ultrasound and magnetic resonance imaging, unveiled the presence of a subdeltoid tumor situated in the quadrangular space, originating from the axillary nerve.</p><p><strong>Conclusion: </strong>This case report documents our experience in successfully surgically excising this rare benign axillary nerve tumor using an extracapsular approach. Intraoperative neural monitoring was employed to safeguard neural integrity. Our case highlights the importance of a high degree of suspicion, early diagnosis, and meticulous surgical techniques in managing such uncommon nerve sheath tumors while preserving neurological function.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"164"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228143","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":"Predictors of temporalis muscle atrophy and head asymmetry following frontotemporal craniotomy: A retrospective analysis of clinical factors and volumetric comparison.","authors":"Marcus Jackson, Sasidhar Karuparti, Ravi Nunna, Thomas David Willson, Arnaldo Rivera, Steven B Carr","doi":"10.25259/SNI_996_2024","DOIUrl":"10.25259/SNI_996_2024","url":null,"abstract":"<p><strong>Background: </strong>Temporalis muscle (TM) atrophy is a commonly encountered cosmesis issue following craniotomies. This retrospective study aims to investigate the correlation of clinical and surgical factors with postoperative TM volume and head symmetry in patients undergoing frontotemporal craniotomy.</p><p><strong>Methods: </strong>Medical records were retrospectively reviewed for patients undergoing pterional or middle fossa craniotomy. Pre- and post-operative clinical factors, intraoperative factors, and magnetic resonance imaging magnetic resonance imaging scans were obtained. TM volumes (cm³) were measured using volumetric analysis. 3-D reconstructed images of the head were independently reviewed to grade head symmetry on a binary scale. Pairwise correlation matrix, multiple linear regression (MLR), and logistic regression (LR) were used to assess the relationship of clinical and operative factors with TM volume and head symmetry.</p><p><strong>Results: </strong>A total of 46 patients were included for analysis, including pterional (<i>n</i> = 27) and middle fossa (<i>n</i> = 19) groups. The average TM volume loss was 36.8% (standard deviation [Std]: 17.18%) and 29.5% (Std: 16.72%) for patients receiving pterional and middle fossa craniotomies, respectively, indicating the pterional approach may carry a greater risk of disrupting the TM neurovascular supply ensuing subsequent cosmetic disfigurement. MLR identified age and scalp thickness as predictors of TM volume (<i>P</i> < 0.05). Age and scalp thickness were also the only factors found to be predictors of head asymmetry (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Pterional and middle fossa craniotomy procedures are both associated with significant TM volume loss and subsequent head asymmetry. Age and preoperative scalp thickness are independent risk factors for the development of TM volume loss and head asymmetry. These findings could contribute to the development of preoperative risk stratification algorithms, enabling neurosurgeons to predict the likelihood of cosmetic disfigurement. This would enhance preoperative counseling for patients undergoing craniotomy procedures, especially for elderly individuals and those with thin scalps. Overall, this study provides valuable insights into prognostic factors that may impact the development of poor cosmesis following frontotemporal craniotomy.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"159"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228138","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":"Contrast-induced posterior reversible encephalopathy syndrome following diagnostic angiography of vertebral artery.","authors":"Shinya Tokunaga, Daisuke Arai, Tomoyuki Yamashita, Tsukasa Sato","doi":"10.25259/SNI_216_2025","DOIUrl":"10.25259/SNI_216_2025","url":null,"abstract":"<p><strong>Background: </strong>Posterior reversible encephalopathy syndrome (PRES) is characterized by transient vasogenic edema, predominantly affecting the white matter in the posterior cerebral hemispheres. It presents with acute neurological symptoms such as headaches, visual disturbances, and seizures. The pathophysiology of PRES, including its overlap with contrast-induced encephalopathy and transient cortical blindness, remains unclear.</p><p><strong>Case description: </strong>A 76-year-old woman with a basilar artery aneurysm underwent diagnostic angiography. During the procedure, she experienced a hypertensive spike following the injection of contrast medium. Four hours post-angiography, she developed disorientation and bilateral light perception, which progressed to complete blindness. Magnetic resonance imaging revealed bilateral occipital hemisphere edema, confirming a diagnosis of PRES. All neurological symptoms resolved within 48 h. Subsequently, she successfully underwent coil embolization of the aneurysm. With careful blood pressure management and a switch to a different type of contrast medium, PRES did not recur despite the use of a larger volume of contrast medium.</p><p><strong>Conclusion: </strong>This case of contrast-induced PRES underscores the potential overlap in pathogenesis between PRES and contrast-induced encephalopathy. It emphasizes the need for careful blood pressure management and consideration of contrast medium type in patients undergoing angiography, especially those with a history of PRES. The successful management of this case provides valuable insights into the prevention and treatment of PRES in similar clinical scenarios.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"160"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228184","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":"Early cerebral hypoperfusion with small artery vasospasm and delayed development of cortical T2* hypointense lesions in contrast-induced encephalopathy.","authors":"Toshiharu Nomura, Kouichirou Okamoto, Hiroshi Abe, Hideaki Abe, Hitoshi Hasegawa","doi":"10.25259/SNI_211_2025","DOIUrl":"10.25259/SNI_211_2025","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced encephalopathy (CIE) is a rare complication arising from neurotoxicity caused by iodinated contrast agents. Its clinical presentation closely resembles that of acute stroke, which can occur following endovascular procedures. Distinguishing these two conditions is essential for proper patient management but is challenging based on clinical symptoms alone. While characteristic computed tomography findings for CIE and magnetic resonance imaging (MRI) findings for acute stroke are well established, early MRI findings of CIE - particularly in magnetic resonance angiography (MRA) and perfusion imaging (MRP) - remain underrecognized. In addition, delayed cortical hypointensities on T2*-weighted imaging (T2*WI) in chronic-stage cases have not been previously reported.</p><p><strong>Case description: </strong>A 78-year-old woman developed CIE immediately following endovascular coil embolization for an unruptured cerebral aneurysm. Small artery vasospasms and hypoperfusion were identified on MRA and MRP, respectively, in the affected hemisphere 6 h postprocedure and resolved a day before symptom improvement. Ten months later, asymptomatic, punctate, and short linear cortical hypointensities appeared on T2*WI, suggesting microhemorrhages.</p><p><strong>Conclusion: </strong>Early transient small artery vasospasms and hypoperfusion on neuroimaging are indicative of CIE and likely contribute to the neurological symptoms of this condition. Persistent blood-brain barrier dysfunction may underlie the delayed development of cortical hypointensities on T2*WI, seen in chronic-stage CIE cases.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228095","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":"Encephalitis-causing free-living amoebic infections in children: A rare and fatal disease.","authors":"John Vargas-Urbina, Raúl Martinez-Silva, Giuseppe Rojas-Panta, Gabriel Ponce-Manrique, Jerson Flores-Castillo, Dalila Y Martínez, Alfonso Martin Cabello-Vilchez, John A Cabrera-Enriquez","doi":"10.25259/SNI_65_2025","DOIUrl":"10.25259/SNI_65_2025","url":null,"abstract":"<p><strong>Background: </strong>Brain infection by free-living amoebae can present as granulomatous amoebic encephalitis if caused by <i>Acanthamoeba</i> spp. or <i>Balamuthia mandrillaris</i>, or as primary amoebic meningoencephalitis if caused by <i>Naegleria fowleri</i>, the latter with high morbidity and mortality. Diagnosis is made by studying cerebrospinal fluid or tissue samples by direct microscopy, culture, polymerase chain reaction, or immunofluorescence. There is no specific treatment, and there are only reports of success with prolonged use of combined drugs.</p><p><strong>Cases description: </strong>We present five cases with a diagnosis of brain infection by free-living amoebae treated at the Hospital Almenara. The patients received surgical treatment, and four of them also received antiparasitic treatment; in one case, the diagnosis was post-mortem. Antiparasitic treatment consisted of a combination of miltefosine, voriconazole, and albendazole mainly, with an average time of 4.8 months. All cases were diagnosed after the initial surgery, and two patients died. Diagnosis in all cases was by direct microscopy, but typing of the free-living amoeba involved was not possible.</p><p><strong>Conclusion: </strong>Brain infection by free-living amoebae is a disease with high morbimortality, which requires early diagnosis for a better prognosis if long-term combined treatment is established.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"166"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228096","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":"Cerebrospinal fluid diversion procedure utilization and physician reimbursement in adult hydrocephalus patients.","authors":"Melanie Alfonzo Horowitz, Linda Tang, Nolan J Brown, Saarang Patel, Mohammad Faizan Khan, Sachiv Chakravarti, Mohammad Mirahmadi Eraghi, Zach Pennington, Julian Lassiter Gendreau, Benjamin D Elder","doi":"10.25259/SNI_209_2025","DOIUrl":"10.25259/SNI_209_2025","url":null,"abstract":"<p><strong>Background: </strong>As the population continues to age, the number of adults receiving care for hydrocephalus is expected to increase. Here, we assess trends in the utilization and physician reimbursement for ventriculoperitoneal shunts (VPS), lumboperitoneal shunting (LPS), and endoscopic third ventriculostomy (ETV) for adult hydrocephalus.</p><p><strong>Methods: </strong>The Medicare Part B National Summary Data files from 2000 to 2021 were collected, and information was extracted on procedures performed per year, total charges billed, and actual payments. Linear mixed-model regression analyses were conducted to assess the significance of changes in procedural volume and physician reimbursement over time while adjusting for inflation.</p><p><strong>Results: </strong>Over the period studied, there was a 26% increase in VPS placement (<i>P</i> = 0.11), 11.34% increase in ETV utilization (<i>P</i> < 0.01), and 43.1% decrease in LPS utilization (<i>P</i> < 0.01). This corresponded to annualized changes of + 4.29% for ETV procedures, -8.78% for LPS, and + 45.8% for VPS. There was a statistically significant difference in the change of rate of number of procedures annually between LPS and VPS (<i>P</i> = 0.04). In both inflation-unadjusted and inflation-adjusted analyses, all procedures experienced an annual decline in reimbursement with inflation-adjusted changes of -11.54%/year for ETV, -4.13% for LPS, and -13.12% for VPS. There was a statistically significant difference in the change of rate of reimbursement between LPS procedures and both ETV (<i>P</i> < 0.01) and VPS (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Medicare reimbursement data shows that a commensurate decline in physician reimbursement has accompanied the ongoing rise in adult hydrocephalus procedures.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"162"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228173","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}