Arthroplasty Today最新文献

{"title":"Clarifying Potential Candidates for Extended Oral Antibiotic Prophylaxis: A Retrospective Analysis of Risk Factors for Infection Following Revision Hip and Knee Arthroplasty","authors":"Mia J. Fowler BS ,&nbsp;Allina A. Nocon PhD, MPH ,&nbsp;Yu-fen Chiu MS ,&nbsp;Kathleen Tam MPH ,&nbsp;Alberto V. Carli MD, MSc","doi":"10.1016/j.artd.2025.101866","DOIUrl":"10.1016/j.artd.2025.101866","url":null,"abstract":"<div><h3>Background</h3><div>Extended oral antibiotic prophylaxis (EOAP) has gained popularity after a study showed an 81% reduction in periprosthetic joint infection (PJI) among “high-risk” patients undergoing total joint arthroplasty (TJA). However, subsequent studies report inconsistent efficacy, particularly in revision TJA (rTJA) where PJI risk is higher. EOAP also conflicts with antibiotic stewardship principles. To optimize EOAP use, consensus on “high-risk” patients is needed. This study determined which preoperative comorbidities from the Inabathula comorbidities (IC) actually increase PJI risk in aseptic rTJA patients.</div></div><div><h3>Methods</h3><div>1995 consecutive aseptic rTJAs (1014 hips, 981 knees) met criteria for retrospective analysis. International Classification of Diseases-10 codes identified IC comorbidities, including autoimmune diseases, smoking, among others. Reoperations for PJI at 90 days and 1 year were recorded. Chi-squared/Fisher’s exact tests analyzed associations between IC and PJI. Multivariable logistic regressions evaluated specific comorbidities’ contributions to PJI risk.</div></div><div><h3>Results</h3><div>502 (50%) revision hips and 580 (60%) revision knees had at least 1 IC. Having at least 1 IC did not significantly increase the risk of developing PJI for revision hips. Only body mass index &gt;35 kg/m² (90-day RR = 3.5; <em>P</em> = .011; 1-year RR = 3.0; <em>P</em> = .014) and chronic kidney disease (90-day RR = 4.1; <em>P</em> = .016; 1-year RR = 4.0; <em>P</em> = .006) were the comorbidities significantly associated with developing PJI for revision hip cases. Meanwhile for knees, having at least 1 IC produced a 3.6x-fold increased relative risk for developing PJI at 1 year (<em>P</em> = .010). However, on multivariate analysis, diabetes mellitus was the only comorbidity significantly associated (90-day odds ratio = 3.5; 95% confidence interval [1.3-9.4]; 1-year odds ratio = 3.3; 95% confidence interval [1.4-7.7]) with developing PJI for revision knee cases. In hips and knees, having &gt;3 IC comorbidities conferred the highest odds of PJI.</div></div><div><h3>Conclusions</h3><div>Although over half of rTJA patients meet IC and could be eligible for EOAP, very few comorbidities significantly confer increased PJI risk. Prospective EOAP studies should consider using indications that are stricter than the IC to avoid unnecessary antibiotic use.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101866"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replace the Joint, Preserve the Surgeon: The Importance of Maintaining Physical and Emotional Health as an Arthroplasty Surgeon","authors":"Elizabeth Lieberman MD","doi":"10.1016/j.artd.2025.101931","DOIUrl":"10.1016/j.artd.2025.101931","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101931"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensive Femoral Bone Loss Following Two-Stage Periprosthetic Joint Infection Treatment: Persistent Challenges in Proximal Femoral Replacement","authors":"Nelo J.Z. Chihal Lima MD,&nbsp;Vasfi Karatosun MD","doi":"10.1016/j.artd.2025.101906","DOIUrl":"10.1016/j.artd.2025.101906","url":null,"abstract":"<div><h3>Background</h3><div>Proximal femoral replacement (PFR) has gained popularity in nononcological reconstruction surgeries over recent decades. However, there is sparse literature on its application in extensive bone defects following 2-stage revision treatment for periprosthetic joint infection (PJI). This study retrospectively evaluates the clinical and functional outcomes, complication rates, and prosthesis survivorship in patients undergoing PFR surgery for severe bone defects due to 2-stage PJI treatment.</div></div><div><h3>Method</h3><div>This single-center retrospective study analyzed patients who underwent PFR as part of a 2-stage treatment for hip arthroplasty-related PJI between 2010 and 2020. All patients had extensive proximal femoral bone loss (Paprosky type 3B and 4) before the PFR surgery. Inclusion required a minimum follow-up period of 24 months. Functional outcomes were evaluated using the Musculoskeletal Tumor Society Score (MSTS), while PFR prosthesis failure was classified according to Henderson's Classification. Combined PFR and acetabular prosthesis survival was determined using Kaplan–Meier survival curves.</div></div><div><h3>Results</h3><div>Thirty-four patients (21 women and 13 men, average age 72.9) were included in the study. The mean follow-up was 75 months (range: 24-132). Pre-PFR surgeries averaged 3.88 per patient (range: 2-13). Mechanical complications were present in 7 patients (20.6%), nonmechanical complications in 8 (23.5%), and 2 patients (5.9%) had both. The mean MSTS score was 66.74%. The all-cause complication-free survival rate was 80% in the second year and decreased to 52% by the fifth year. The all-cause revision-free rate was 73 % in the second year and decreased to 47% by the fifth year.</div></div><div><h3>Conclusions</h3><div>PFR is effective for limb salvage in complex cases but comes with high mechanical and non-mechanical complications and moderate to poor survival rates. While larger femoral heads and constrained liners help reduce dislocation, infection remains a significant issue. The gap between high MSTS scores and difficulties in daily activities signals a need for improved functional assessment tools. These findings highlight the persistent challenges in managing PJIs.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101906"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Dexamethasone Administered Perioperatively vs 8 Hours Prior to Incision to Control Pain after Total Knee Arthroplasty. A Prospective Randomized Clinical Trial","authors":"Burin Sutthapakti MD ,&nbsp;Kritsanat Lertussavavivat MD ,&nbsp;Kritsada Sukha MD ,&nbsp;Wiboon Wanitcharoenporn MD ,&nbsp;Artit Laoruengthana MD","doi":"10.1016/j.artd.2025.101912","DOIUrl":"10.1016/j.artd.2025.101912","url":null,"abstract":"<div><h3>Background</h3><div>Theoretically, intravenous dexamethasone administered 6-8 hours prior to surgical trauma may inhibit the transcription of genes via the genomic pathway and optimize their anti-inflammatory effects. Thus, the purpose of the study was to compare the efficacy of intravenous dexamethasone administered preoperatively and more common use, perioperative injection for controlling pain after total knee arthroplasty (TKA).</div></div><div><h3>Method</h3><div>One-hundred fifty TKAs were randomized to receive 10 mg of intravenous dexamethasone 8 hours prior to incision (preoperative group) or to receive before incision (perioperative group). The outcomes included a visual analog scale (VAS) for pain, morphine consumption, frequency of postoperative nausea and vomiting, knee circumference, C-reactive protein levels, and blood glucose levels.</div></div><div><h3>Results</h3><div>No differences in VAS at rest and during movement were observed between groups at any time point, except the perioperative group had 0.45 lower VAS during movement at 4 hours postoperatively (<em>P</em> = .038). The preoperative group had 0.75 mg lower morphine consumption at 12 hours postoperatively (<em>P</em> = .020). However, both differences did not reach the minimal clinically important difference. There were no significant differences between groups regarding postoperative nausea and vomiting, knee circumference, and C-reactive protein. Over 50% of patients in both groups experienced high blood glucose level (&gt;137 mg/dl) during the first 48 hours postoperatively, however, no infection was observed during 3 months of follow-up.</div></div><div><h3>Conclusions</h3><div>Perioperative dexamethasone injection provides comparable clinical outcomes and inflammation level after TKA to those administered 8 hours prior to incision. Thus, both intravenous dexamethasone approach can be an option for current clinical pathways of TKA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101912"},"PeriodicalIF":2.1,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients With Lymphedema are at Increased Risk of Complication After Total Knee Arthroplasty: A Population Level Study","authors":"Bryce T. Hrudka MD,&nbsp;Evan Bailey MD,&nbsp;Alyssa Woltemath MD,&nbsp;Grayson Nour BS,&nbsp;Ajay Premkumar MD, MPH,&nbsp;Jacob M. Wilson MD","doi":"10.1016/j.artd.2025.101900","DOIUrl":"10.1016/j.artd.2025.101900","url":null,"abstract":"<div><h3>Background</h3><div>Lymphedema, a chronic disorder characterized by abnormal lymphatic fluid buildup, most commonly affects the lower extremities. Limited literature exists regarding the impact of lymphedema on outcomes following primary total knee arthroplasty (TKA). This study examined the effect of lymphedema’s impact on complications and early revision-free survivorship following primary TKA using population-level data. We hypothesized that patients with preoperative lymphedema would have higher complication and revision rates.</div></div><div><h3>Methods</h3><div>Patients undergoing TKA for osteoarthritis between 2009 and 2020 were identified from a national claims database. Those with preoperative lymphedema were matched 1:1 to contemporaries without lymphedema using propensity score matching. Comparisons between matched and unmatched cohorts were performed using Chi-square and independent t-tests, while Cox proportional hazards models assessed revision risk.</div></div><div><h3>Results</h3><div>Of the 530,938 TKA patients, 1.05% (n = 5602) had preoperative lymphedema. Matched analysis showed lymphedema had higher 90-day rates of periprosthetic joint infection (2.9% vs 1.4%, <em>P</em> &lt; .001), superficial surgical site infection (2.3% vs 1.6%, <em>P</em> = .007), wound complications (2.4% vs 1.7%, <em>P</em> = .013), and pulmonary embolism (6.6% vs 4.6%, <em>P</em> &lt; .001). At 2 years, lymphedema was associated with increased risk of all-cause (hazard ratio (HR) = 1.42, <em>P</em> &lt; .001) and septic revisions (HR = 1.88, <em>P</em> &lt; .001) but not aseptic revisions (HR = 0.99, <em>P</em> = .929).</div></div><div><h3>Conclusions</h3><div>Preoperative lymphedema is associated with increased 90-day rates of periprosthetic joint infection and superficial surgical site infection, wound complications, and pulmonary embolism after primary TKA. Although aseptic revision risk was not increased, the association with higher all-cause and septic revisions warrants attention. These findings emphasize the need for aggressive counseling and preoperative optimization before TKA in lymphedema patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101900"},"PeriodicalIF":2.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the Editor Regarding “Utility of Frailty Index in Predicting Discharge Disposition and Prolonged Length of Stay Following Enhanced Recovery After Surgery Protocol Total Hip and Knee Arthroplasty”","authors":"Christoper Reynolds MD,&nbsp;Tariq Z. Issa MD,&nbsp;Jennings Dooley MD,&nbsp;Isaac Sontag-Milobsky BS,&nbsp;W. Christian Thomas MD,&nbsp;Kevin D. Hardt MD,&nbsp;David W. Manning MD","doi":"10.1016/j.artd.2025.101894","DOIUrl":"10.1016/j.artd.2025.101894","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101894"},"PeriodicalIF":2.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythrocyte Exchange Transfusion Enabling Simultaneous Bilateral Total Hip Arthroplasty by a direct anterior approach in a Young Patient with Sickle Cell Disease","authors":"Enrique Alberto Vargas Meouchi MD ,&nbsp;Ricard Llovera González-Adrio MD ,&nbsp;David Beneitez Pastor MD ,&nbsp;Veronica Pons MD ,&nbsp;Marta Garcia Bernal MD ,&nbsp;Victor Manuel Barro Ojeda MD","doi":"10.1016/j.artd.2025.101909","DOIUrl":"10.1016/j.artd.2025.101909","url":null,"abstract":"<div><div>Sickle cell disease (SCD) is a known risk factor for femoral head osteonecrosis, often leading to early joint degeneration. We report a 17-year-old male with homozygous SCD and bilateral femoral head collapse who underwent simultaneous bilateral total hip arthroplasty through a direct anterior approach. Preoperative optimization included erythrocyte exchange transfusion effectively reducing hemoglobin S from 76% to 26%. The procedure was completed without complications, and the patient recovered uneventfully, with no sickling crises or acute chest syndrome. Cemented implants were used due to poor bone quality. The patient regained full, pain-free ambulation by three months. This case supports the safety and feasibility of simultaneous bilateral total hip arthroplasty in selected SCD patients when preceded by targeted erythrocyte exchange transfusion and managed by a multidisciplinary team.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101909"},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and Clinical Determinants of Unicondylar Vs Total Knee Arthroplasty Selection","authors":"Nikita Golovachev MD,&nbsp;Kassem Ghayyad MD,&nbsp;Ramakanth Yakkanti MD,&nbsp;Obinna Adigweme MD","doi":"10.1016/j.artd.2025.101904","DOIUrl":"10.1016/j.artd.2025.101904","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis is the most common degenerative joint disease in the elderly. Depending on affected compartments, treatment options include unicondylar knee arthroplasty (UKA) or total knee arthroplasty (TKA). Studies show higher osteoarthritis incidence and disparities in arthroplasty use and outcomes among minority groups. This study aimed to compare demographic and clinical differences in UKA and TKA procedures.</div></div><div><h3>Methods</h3><div>Patients who underwent primary UKA or TKA at 2 different institutions between 2014 and 2024 were identified. Variables compared between UKA and TKA groups included patient sex, age, body mass index (BMI), ethnicity, smoking status, comorbidities, assistance in activities of daily living (ADL), number of falls, and the American Society of Anesthesiologists (ASA) class.</div></div><div><h3>Results</h3><div>Of the 58,794 patients identified, 2421 received a UKA, and 56,373 received a TKA. The UKA group had a higher proportion of men and a lower average BMI. UKA patients had a higher percentage of White patients and a lower percentage of African American patients. Fewer UKA patients required assistance in ADL, and fewer had experienced falls in the past year. TKA patients had higher percentages of diabetes, heart disease, and hypertension. A higher percentage of UKA patients were ASA class II, and a lower percentage were ASA class III.</div></div><div><h3>Conclusions</h3><div>Patients who underwent primary UKA vs TKA showed significant differences in sex, BMI, race, ADL, comorbidities, falls in the past year, and ASA class. The results suggest that UKA patients are generally younger, have lower BMI, fewer comorbidities, and better functional status compared to TKA patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101904"},"PeriodicalIF":2.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reducible Neglected Recurrent Posterior Hip Dislocation Treated With Cemented Total Hip Arthroplasty","authors":"Subhan Shahid MBBS, FCPS ,&nbsp;Waqas Ahmad MBBS ,&nbsp;Abdul Rafeh Awan MBBS ,&nbsp;Meher Ayyazuddin MBBS, MD ,&nbsp;Faisal Masood MBBS, FCPS, CMT","doi":"10.1016/j.artd.2025.101908","DOIUrl":"10.1016/j.artd.2025.101908","url":null,"abstract":"<div><div>Hip dislocations in adults are uncommon and usually follow high-energy trauma, with neglected cases being rarer but still encountered in low-resource settings. This report describes a 67-year-old man with 6 months of recurrent posterior hip dislocations after an initial injury. He first sought traditional treatment and eventually learned self-reduction techniques. Examination showed limb shortening, muscle wasting, and a neglected posterior acetabular wall fracture with major bone loss. He underwent cemented total hip arthroplasty via a posterior approach, with reconstruction of the posterior wall using an autologous femoral head-neck graft secured by cannulated screws. The case underscores the need for early recognition and proper surgical planning to prevent avascular necrosis, joint degeneration, and long-term disability, especially in developing regions.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101908"},"PeriodicalIF":2.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Primary Total Knee Arthroplasty is Associated With Decreased 90-Day Opioid Prescribing Patterns Compared to Manual Instrumentation","authors":"Nathaniel T. Ondeck MD, MHS,&nbsp;Colin C. Neitzke MD,&nbsp;Yu-Fen Chiu MS,&nbsp;Sonia K. Chandi MD,&nbsp;Pravjit Bhatti MD,&nbsp;Alejandro Gonzalez Della Valle MD,&nbsp;Geoffrey H. Westrich MD,&nbsp;Brian P. Chalmers MD","doi":"10.1016/j.artd.2025.101886","DOIUrl":"10.1016/j.artd.2025.101886","url":null,"abstract":"<div><h3>Background</h3><div>Robotic assistance minimizes bony resection and surrounding soft tissue damage during total knee arthroplasty (TKA), potentially decreasing postoperative pain. The objective of this study was to evaluate in-hospital opioid consumption, 90-day opioid prescribing patterns, length of stay (LOS), and patient-reported outcome measures (PROMs) following robotic-assisted vs manual primary TKA.</div></div><div><h3>Methods</h3><div>Utilizing an institutional database, all patients undergoing primary unilateral TKA between 2019 and 2022 with 90-day minimum follow-up were retrospectively queried. Patients were excluded if they had another surgery within 90 days of the index TKA, were discharged to a rehabilitation center, or were prescribed opioid or benzodiazepine medications preoperatively. One-to-one propensity score matching identified 1476 patients undergoing robotic-assisted (n = 738) or manual (n = 738) TKA. Multivariable regression analysis assessed in-hospital morphine milligram equivalents (MMEs) consumption, LOS, 90-day opioid prescribing patterns (not necessarily consumption), and PROMs (preoperative, 6 weeks, and 3 months).</div></div><div><h3>Results</h3><div>The robotic-assisted cohort consumed on average 12 fewer in-hospital MMEs (<em>P</em> = .026) and had an average LOS that was 8 hours shorter than the manual cohort (<em>P</em> &lt; .001). There was no difference in MMEs prescribed at discharge (<em>P</em> = .12), but the robotic-assisted cohort had on average 113 fewer 90-day postdischarge MMEs prescribed (<em>P</em> = .001) and 145 fewer total 90-day MMEs (consumed in-hospital plus prescribed) (<em>P</em> &lt; .001). There was no difference in PROMs at 6 weeks or 3 months.</div></div><div><h3>Conclusions</h3><div>Robotic-assisted TKA may confer shorter LOS with decreased 90-day opioid use patterns. This information is important given the increased scrutiny on opioid usage and recent focus on rapid recovery and ambulatory TKA pathways.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101886"},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}