Obesity PillarsPub Date : 2025-01-19DOI: 10.1016/j.obpill.2025.100161
Jyotsna Ghosh , Kimberly A. Gudzune , Jessica L. Schwartz
{"title":"Electronic health records tools for treating obesity among adult patients in primary care: A scoping review","authors":"Jyotsna Ghosh , Kimberly A. Gudzune , Jessica L. Schwartz","doi":"10.1016/j.obpill.2025.100161","DOIUrl":"10.1016/j.obpill.2025.100161","url":null,"abstract":"<div><h3>Background</h3><div>Electronic health record (EHR)-based tools, such as clinical decision support systems (CDSS), support practitioners to promote evidence-based care, which may include obesity treatment. Our objective was to identify obesity-focused CDSS for adult patients in primary care settings to describe their designs, associated primary care practitioner (PCP) training, and outcomes among PCPs and patients.</div></div><div><h3>Methods</h3><div>We conducted a scoping review to identify and map available evidence using a search strategy for citations in MEDLINE from February 2009 to June 2024. We extracted information from included studies that described EHR-based CDSS tools designed to support obesity care (e.g., clinical decision support, counseling) for adult patients in primary care settings. We mapped common tool features to support weight management and synthesized key lessons learned during implementation of these tools.</div></div><div><h3>Results</h3><div>Of the 445 citations identified in our search, we included 13 citations reporting on 8 studies. The most common features across EHR-based CDSS tools were 1) identifying overweight or obesity using BMI (88 %) and 2) suggesting treatment strategies (88 %), particularly lifestyle modifications. Most studies provided limited information on the training PCPs received. Few PCPs used the CDSS with eligible patients (<20 %), describing these tools as cumbersome and lacking clinical workflow integration. Novel approaches included using CDSS during weight management-dedicated visits or for referral to obesity medicine physicians, which both showed promising early results of patients achieving weight reduction.</div></div><div><h3>Conclusion</h3><div>There is a growing body of evidence for obesity-focused CDSS among adult patients in the primary care setting. Our review identified three key lessons that may inform future health system implementation: 1) EHR-based CDSS tools need to be easy to use and integrate with clinical workflows; 2) PCPs need training on these tools for obesity treatment; and 3) Primary care workflow or work-scope may need to be modified to address obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152678","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":"Clinical considerations in the management of obesity in children and adolescents","authors":"Whitney Herring , Carina Kugelmas , Evan P. Nadler , Marsha Novick , Melissa Santos , Rachana Shah , Gitanjali Srivastava , Stephanie Walsh","doi":"10.1016/j.obpill.2025.100160","DOIUrl":"10.1016/j.obpill.2025.100160","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a complex, chronic disease affecting more than one-fifth of adolescent children aged 12–19 years in the United States. Recent guidelines have recommended optimization of diagnosis and treatment approaches to help improve the immediate and long-term health of people with obesity.</div></div><div><h3>Methods</h3><div>Here, we describe the insights and recommendations of 9 nationally recognized experts in pediatric obesity, summarized from a virtual advisory board discussion.</div></div><div><h3>Results</h3><div>Advisors described their background, experiences, and patient populations, conveyed the journey experienced by many pediatric patients with obesity, discussed the recent landscape for pharmacotherapy in adolescents, and provided their perspectives on updated American Academy of Pediatrics Clinical Practice Guidelines.</div></div><div><h3>Conclusion</h3><div>Overall, the advisors agreed that the key to addressing the growing prevalence of obesity in children and adolescents depends on increased education in the medical field and community-wide initiatives to promote early intervention. Collaboration among all parties (e.g., physicians, policymakers, insurance companies, academic institutions, and researchers) to address barriers to treatment and reduce the social stigma surrounding obesity is also essential.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152472","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}
Obesity PillarsPub Date : 2025-01-11DOI: 10.1016/j.obpill.2025.100159
Helena Piccinini-Vallis , Mathew Grandy , Lynn Bussey , Jillian Coolen , Sarah Sabri
{"title":"The relationship between timing of screening for gestational diabetes mellitus and maternal and fetal outcomes: A retrospective cohort study linking primary care electronic and hospital administrative data","authors":"Helena Piccinini-Vallis , Mathew Grandy , Lynn Bussey , Jillian Coolen , Sarah Sabri","doi":"10.1016/j.obpill.2025.100159","DOIUrl":"10.1016/j.obpill.2025.100159","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes (GDM) is associated with adverse outcomes including a large-for-gestational age (LGA) baby, which in turn is associated with downstream childhood obesity. Appropriate timing of GDM screening is important for prompt initiation and optimization of medical management, potentially mitigating the risk of those outcomes. The present study explored the association between the timing of GDM screening and macrosomia, LGA, shoulder dystocia and caesarean section.</div></div><div><h3>Methods</h3><div>This retrospective cohort study linked primary care prenatal data and intrapartum data from a provincial hospital administrative database. Women with singleton pregnancies who received prenatal care between July 1, 2019 and December 31, 2022 and who also delivered within that timeframe were included in the study.</div></div><div><h3>Results</h3><div>198 participants were linked between the databases. Among participants for whom GDM risk could be calculated (n = 180), 30.6 % had late GDM screening. Unadjusted logistic regression models showed that late screening for GDM was associated with higher likelihood of LGA (OR = 2.89; 95 % CI = 1.19–7.04; p = 00.019). Adjusted models showed that the best predictor of macrosomia, LGA, and shoulder dystocia was excess gestational weight gain (GWG) (OR = 3.26, CI = 1.17–9.10, p = 0.024; OR 3.00, 95 % CI 0.91–9.93, p = 00.072; and OR = 3.52, CI = 0.83–14.84, p = 00.087 respectively); the best predictor of caesarean section was pre-pregnancy BMI (OR = 2.86; CI = 1.12 = 7.27; p = 0.028).</div></div><div><h3>Conclusions</h3><div>Almost one-third of participants had screening later than recommended, and late screening for GDM was associated with a higher likelihood of LGA. Linking longitudinal prenatal primary care data to hospital administrative data creates opportunities for future studies pertaining to prenatal care, potentially resulting in improvements in the care provided to vulnerable populations experiencing disproportionate rates of pre-pregnancy obesity and excess GWG.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081877","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":"Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample","authors":"Rupak Desai , Avilash Mondal , Boney Lapsiwala , Venkata Balaji Chenna , Pratik Rajpopat , Vaidehi Mendpara , Athri Kodali , Amritha R. Nair , Ayodya Perera , Subramanian Gnanaguruparan","doi":"10.1016/j.obpill.2025.100158","DOIUrl":"10.1016/j.obpill.2025.100158","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18–44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group.</div></div><div><h3>Results</h3><div>Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, >84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70–1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4–3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39–30.53), drug users (aOR 2.87, 95%Cl 1.05–7.86), cancer patients (aOR 9.70, 95%Cl 2.14–44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07–116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86–11.08), elective admission (aOR 3.71, 95%Cl 0.74–18.58), and tobacco use (aOR 0.81, 95%Cl 0.26–2.60) were not statistically significant predictors.</div></div><div><h3>Conclusion</h3><div>Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153363","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}
Obesity PillarsPub Date : 2025-01-07DOI: 10.1016/j.obpill.2025.100157
Selvi Rajagopal , Edmond P. Wickham III , Tirissa J. Reid , Dana R. Brittan , Judith Korner , Kimberly A. Gudzune
{"title":"Comparing clinical practice habits among obesity medicine physicians by patient, physician and clinic factors","authors":"Selvi Rajagopal , Edmond P. Wickham III , Tirissa J. Reid , Dana R. Brittan , Judith Korner , Kimberly A. Gudzune","doi":"10.1016/j.obpill.2025.100157","DOIUrl":"10.1016/j.obpill.2025.100157","url":null,"abstract":"<div><h3>Background</h3><div>While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist in obesity medicine. Our objective was to compare practice habits by such factors among obesity medicine physicians certified by the American Board of Obesity Medicine (ABOM).</div></div><div><h3>Methods</h3><div>We conducted secondary analyses of cross-sectional data from the 2023 ABOM Practice Analysis Validation Survey. We included three obesity medicine practice habits – prescribing anti-obesity medications (AOMs), off-label prescribing of medications for weight reduction, and obesity medicine clinical practice hours (4–20 h/week versus >20 h/week). We included patient (patient population), physician (primary medical specialty, years of obesity medicine experience) and clinic factors (practice setting, geographic catchment, accepts insurance for obesity care). We conducted bivariate analyses using Χ<sup>2</sup> tests.</div></div><div><h3>Results</h3><div>Among 565 ABOM-certified physicians, 71.5 % had primary medical specialties within primary care and 9.2 % predominantly treated children/adolescents with obesity. Overall, 97.5 % prescribed AOMs and 85.1 % prescribed off-label medications for weight reduction. Fewer physicians who predominantly treated children/adolescents prescribed AOMs compared to physicians with no or limited treatment of children (88.5 % versus 98.4 % and 98.5 %, respectively; p < 0.001). Overall, 41.4 % reported practicing obesity medicine >20 h/week, which was more likely to occur as years of obesity medicine experience increased (i.e., 21.9 % among physicians with 1–2 years of experience versus 58.5 % with 10+ years; p < 0.001). No significant differences in practice habits occurred by primary medical specialty, practice setting, geographic catchment, or accepting insurance.</div></div><div><h3>Conclusion</h3><div>Our findings may suggest that ABOM-certified physicians have consistent obesity medication prescribing practices regardless of physician or clinic factors, which may be particularly important to patients seeking pharmacologic treatment. Most ABOM-certified physicians who predominantly treat children/adolescents prescribe obesity medications. These current rates are relatively higher than prior findings among pediatric ABOM-certified physicians, which might help support pharmacologic access for pediatric patients.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152679","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}
Obesity PillarsPub Date : 2024-12-11DOI: 10.1016/j.obpill.2024.100156
Musarrat Riaz , Sidrah Lodhi
{"title":"Beyond BMI: Exploring obesity trends in the south Asian region","authors":"Musarrat Riaz , Sidrah Lodhi","doi":"10.1016/j.obpill.2024.100156","DOIUrl":"10.1016/j.obpill.2024.100156","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a global health challenge affecting individuals across all demographics. In South Asia, the traditional method of assessing obesity using Body Mass Index (BMI), may not account for factors such as fat distribution, muscle mass, or ethnic variations.</div></div><div><h3>Objective</h3><div>This narrative review explores the multifaceted nature of obesity in South Asia, focusing on the region's demographic profiles and the socio-cultural and economic determinants shaping obesity trends. Additionally, the review critiques the limitations of BMI as an accurate measure of obesity in this diverse population.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted to identify studies that address obesity trends in South Asia, with a focus on regional variations, influencing factors, and the limitations of BMI.</div></div><div><h3>Results</h3><div>The review identifies significant variations in obesity prevalence across South Asian countries, influenced by cultural norms, economic disparities, and urbanization. The limitations of BMI as a tool for assessing obesity are highlighted, particularly in its inability to capture fat distribution and muscle mass variations specific to South Asian populations.</div></div><div><h3>Conclusions</h3><div>Obesity in South Asia is shaped by complex demographic, cultural, and economic factors. While BMI is commonly used, it is insufficient for accurately assessing obesity in this population. More refined, context-specific measures are needed to better understand and address the growing obesity epidemic in South Asia.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985960","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}
Obesity PillarsPub Date : 2024-12-05DOI: 10.1016/j.obpill.2024.100154
Sue Benson-Davies, Kirsten Frederiksen, Rutuja Patel
{"title":"Bariatric nutrition and evaluation of the metabolic surgical patient: Update to the 2022 Obesity Medicine Association (OMA) bariatric surgery, gastrointestinal hormones, and the microbiome clinical practice statement (CPS)","authors":"Sue Benson-Davies, Kirsten Frederiksen, Rutuja Patel","doi":"10.1016/j.obpill.2024.100154","DOIUrl":"10.1016/j.obpill.2024.100154","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, the Obesity Medicine Association (OMA) published a Clinical Practice Statement (CPS) which provided an overview of bariatric surgery and related procedures, a discussion on gastrointestinal hormones and a review of the microbiome as it relates to patients with obesity. This update to the 2022 OMA CPS provides a focus on nutrition as it relates to the adult bariatric surgery patient, incorporating a detailed discussion on how to conduct a bariatric nutrition assessment and manage patients seeking metabolic and bariatric surgery (MBS) and postoperative nutrition care. In particular, the section on macronutrients, micronutrients, and bariatric surgery has been updated, highlighting practical approaches to nutrient deficiencies typically encountered in the bariatric surgery patient. Also included is a section on how to envision and develop an interdisciplinary team of medical providers with evidence-based nutrition knowledge and consistent information that improves the quality of nutrition care provided to MBS patients. This CPS adds to the series of OMA CPSs meant to provide guidance to clinicians in their care of patients with obesity.</div></div><div><h3>Methods</h3><div>The foundation of this paper is supported by scientific evidence in the medical literature and expert opinion derived from several bariatric nutrition resources, as well as from the 2022 OMA CPS focused on bariatric surgery.</div></div><div><h3>Results</h3><div>This OMA Clinical Practice Statement provides an overview of the current bariatric nutrition clinical guidelines and nutrition tools adapted for clinicians who may not have access to an MBS team or a registered dietitian knowledgeable about bariatric nutrition.</div></div><div><h3>Conclusions</h3><div>This evidence-based review of the literature includes an overview of current bariatric nutrition recommendations. It is intended to provide clinicians with more advanced knowledge and skills in nutrition assessment and management of the preoperative and post-surgical MBS patients. This CPS also addresses macronutrient and micronutrient deficiencies common in MBS patients, and treatment recommendations designed to help the clinician with clinical decision making.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934302","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}
Obesity PillarsPub Date : 2024-12-05DOI: 10.1016/j.obpill.2024.100155
Jesse Richards , Madisen Fae Dorand , Maria Paszkowiak , Sana Ahmed , Courtney McCorkle , Pranay Kathuria
{"title":"Significantly higher rates of KIDINS220 polymorphisms in patients with obesity and end-stage renal disease","authors":"Jesse Richards , Madisen Fae Dorand , Maria Paszkowiak , Sana Ahmed , Courtney McCorkle , Pranay Kathuria","doi":"10.1016/j.obpill.2024.100155","DOIUrl":"10.1016/j.obpill.2024.100155","url":null,"abstract":"<div><h3>Background</h3><div>Kinase D-interacting substrate of 220 kDa (“KIDINS220”) is an integral plasma membrane protein essential to signaling throughout the body; abnormalities are linked to a variety of disorders, including obesity, but have never been directly linked to chronic- or end-stage renal disease.</div></div><div><h3>Methods</h3><div>Retrospective chart review identified patients with severe obesity who presented for pre-kidney transplant weight management. 20 individuals met criteria for testing for genetic causes of obesity. A χ<sup>2</sup> test of independence was utilized to compare genetic mutation rates in this cohort to all individuals tested nationally.</div></div><div><h3>Results</h3><div>This case series presents a cohort of patients with severe obesity and end-stage renal disease who were subsequently found to have a significantly higher rate of KIDINS220 mutations (20 %, χ<sup>2</sup> = 27.8, <em>p</em> < 0.0001) compared to the national positivity rate of all individuals tested for genetic causes of obesity.</div></div><div><h3>Conclusions</h3><div>Mutations within KIDINS220 may play a modulatory role in the progression of chronic kidney disease in patients with obesity, as evidenced by this small retrospective study. The relationship between KIDINS200, kidney disease, and obesity is complex and requires further study, but may represent a potential therapeutic target in the future.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974036","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}
Obesity PillarsPub Date : 2024-12-01DOI: 10.1016/j.obpill.2024.100144
Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen
{"title":"Corrigendum to “Retrospective review of seven patients with obesity simultaneously treated with a combination of a glucagon-like peptide-1 receptor agonist and a meal replacement product” [Obesity Pillars 12C (2024) 100138]","authors":"Catherine Bacus , Terri-Lynne South , Sonia Raudszus , Odd Erik Johansen","doi":"10.1016/j.obpill.2024.100144","DOIUrl":"10.1016/j.obpill.2024.100144","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904699","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}