Clinical and Translational Gastroenterology最新文献

{"title":"Novel Artificial Intelligence Systems in Detecting Adenomas in Colonoscopy: A Systemic Review and Network Meta-Analysis.","authors":"Sunny Kumar, Mahveer Maheshwari, Shahnoor Aleem, Zoha Batool, Nawal Alsubaie, Saifullah Syed, Nida Fatima Daterdiwala, Hina Fatima Memon, Jaweria Azeem, Sajida Moiz Hussain Qamari, Mohammad Jawwad","doi":"10.14309/ctg.0000000000000904","DOIUrl":"10.14309/ctg.0000000000000904","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) has the potential to improve adenoma detection rates (ADRs) during colonoscopy, but the efficacy of various AI-assisted systems remains unclear. To evaluate and compare the effectiveness of different AI-assisted systems for detecting colorectal neoplasia during colonoscopy.</p><p><strong>Methods: </strong>A systematic literature search of PubMed, Scopus, and Google Scholar databases was conducted up to March 4, 2025, to identify randomized controlled trials comparing AI-assisted colonoscopy with conventional colonoscopy. The analysis included AI systems such as GI Genius (Medtronic, Dublin, Ireland), CAD EYE (Fujifilm, Tokyo, Japan), ENDOANGEL, EndoScreener, and EndoAID. The primary outcome was ADR, analyzed using random-effects models to calculate pooled odds ratios (OR) and 95% confidence intervals (CI). Surface under the cumulative ranking curve (SUCRA) rankings and subgroup analyses were also performed.</p><p><strong>Results: </strong>Seventeen randomized controlled trials with 10,547 participants were included. ENDOANGEL showed the highest efficacy (OR 1.84, 95% CI 1.50-2.30; SUCRA 0.9), followed by EndoAID (OR 1.64, 95% CI 1.20-2.26; SUCRA 0.7). CAD EYE and GI Genius were similarly ranked (OR 1.46 and 1.45, respectively). EndoScreener was ranked just above the control group (OR 1.37, 95% CI 1.20-1.56; SUCRA 0.4).</p><p><strong>Discussion: </strong>AI-assisted colonoscopy systems showed improved ADR detection rates compared with traditional colonoscopy. These results suggest that artificial intelligence may help enhance detection during colonoscopy procedures; however, additional large-scale studies are needed to confirm these findings.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Yang et al.","authors":"Tianhui Zhou, Meng Shu, Yanan Du, Wei Cai","doi":"10.14309/ctg.0000000000000866","DOIUrl":"10.14309/ctg.0000000000000866","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00866"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperammonemic Encephalopathy after Bariatric Surgery: A Two-Hit Vulnerability in Liver Disease.","authors":"Mohammed Abdulrasak, Mostafa Mohrag, Ali M Someili","doi":"10.14309/ctg.0000000000000892","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000892","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Markers in Gastric Fluids Differentiate Patients With Eosinophilic Gastritis: Search for a Disease Screener.","authors":"Ashley L Pyne, Sophia S Schuman, Ben J Brintz, Wallace Dodds, Bryan Silon, Maria A Pletneva, Kathryn A Peterson","doi":"10.14309/ctg.0000000000000898","DOIUrl":"10.14309/ctg.0000000000000898","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic gastritis (EoG) is commonly missed because of limited biopsy collection and failure to request tissue eosinophil counts on gastric biopsies. Continued efforts to identify less invasive biomarkers to improve diagnosis and disease monitoring have resulted in little success. We studied gastric fluids and serum in EoG and control patients to determine whether less invasive inflammatory markers can predict active EoG disease.</p><p><strong>Methods: </strong>By Luminex MAGPIX, we measured cytokines, chemokines, and matrix metalloproteinases biomarkers from gastric fluids collected during routine upper endoscopy and serum from patients with active EoG (n = 20), active eosinophilic esophagitis (EoE) (n = 21), and non-eosinophilic gastrointestinal disease controls (n = 19). Comparison of biomarker concentrations among patients and predictive modeling for EoG status were performed.</p><p><strong>Results: </strong>Twenty-six biomarker in gastric fluids and 6 biomarkers in serum were significantly elevated in active EoG compared with active EoE and non-eosinophilic gastrointestinal disease controls. Tree-based model, eXtreme Gradient Boosting, identified important biomarkers in both gastric fluids and serum predictive of EoG.</p><p><strong>Discussion: </strong>We successfully measured inflammatory markers in gastric secretions. Th2-mediated cytokines were elevated in gastric secretions in EoG, differentiating them from EoE and expanding our understanding of inflammation in EoG. Notably, our results are the first to implicate matrix metalloproteinases in the EoG inflammatory process. Importantly, we found that gastric secretions can discern patients with active gastric eosinophilia involvement. Modeling identified 9 markers that predicted EoG with an area under the curve of 0.86. With further validation, gastric fluids could be used as an easy test to screen EoG by identify patients who would benefit from histopathologic enumeration of eosinophils on biopsies.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Validity of the TIGER Score for Daily-Life Disease Burden, Complications, and Medication Use in Inflammatory Bowel Disease After 12 Months.","authors":"Eran Zittan, Matthew Levy, Shiraz Vered, A Hillary Steinhart, Raquel Milgrom, Mark S Silverberg, Shira Zelber-Sagi","doi":"10.14309/ctg.0000000000000901","DOIUrl":"10.14309/ctg.0000000000000901","url":null,"abstract":"<p><strong>Introduction: </strong>The Toronto Inflammatory Bowel Disease (IBD) Global Endoscopic Reporting (TIGER) score was developed to provide 1 endoscopic scoring index for patients with both Crohn's disease (CD) and ulcerative colitis (UC). The goal of this study was to assess the predictive validity the TIGER score for daily-life disease burden (IBD Disk) and disease complications.</p><p><strong>Methods: </strong>A prospective 12-month study was conducted in 1 tertiary IBD center. Baseline colonoscopy was performed. Moderate-to-severe mucosal involvement was defined as a TIGER score ≥100, Simple Endoscopic Score for CD >6, Mayo Endoscopic Score >1, and was used as a predictor for clinical outcomes. At each visit, IBD Disk questionnaires, disease complications, hospitalizations, surgeries, and medications were documented.</p><p><strong>Results: </strong>A total of 107 adults, 52 with CD and 55 with UC, were included. Patients with a baseline TIGER score ≥100 had a significantly higher prevalence of an IBD Disk score ≥40 after the 12-month follow-up period despite receiving advanced therapy (33.9% vs 7.8%, P < 0.001). There were significantly more patients with a baseline TIGER score ≥100 who experienced at least 1 hospitalization (39.3% vs 2.0%, P < 0.001), underwent surgery (14.3% vs 0.0%, P < 0.005), had IBD-related complications (41.1% vs 9.8%, P < 0.001), and required steroids (67.9% vs 5.9%, P < 0.001) or advanced therapy (85.7% vs 7.8%, P < 0.001). Similar significant results were obtained with Simple Endoscopic Score for CD and Mayo Endoscopic Score as predictors of outcomes over the 12 months.</p><p><strong>Discussion: </strong>The TIGER score is a simple endoscopic score for patients with CD and UC with an adequate predictive validity for worse clinical outcomes while having noninferiority to the current best-referenced endoscopic scores.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for Relapse in Autoimmune Pancreatitis.","authors":"Wenfeng Xi, Qingwei Jiang, Xiaoyin Bai, Tao Guo, Aiming Yang","doi":"10.14309/ctg.0000000000000903","DOIUrl":"10.14309/ctg.0000000000000903","url":null,"abstract":"<p><p>Autoimmune pancreatitis (AIP) is a distinct inflammatory pancreatic disorder characterized by its responsiveness to glucocorticoid therapy and association with autoimmune features. AIP primarily consists of type 1 and type 2, with relapse being a significant problem mainly associated with type 1 AIP, which has a high relapse rate of approximately 40%, whereas type 2 AIP has significantly lower relapse rates. This narrative review comprehensively examines the multifaceted factors influencing AIP relapse, particularly focusing on type 1 AIP. Dynamic changes in serum IgG4 levels-particularly insufficient decline, relative increase, or persistently elevated levels after steroid therapy-consistently correlate with relapse risk. Other serological markers including immunoglobulin E and autotaxin may serve as potential relapse predictors. Imaging features associated with relapse include diffuse pancreatic swelling, persistent post-treatment pancreatic enlargement, and elevated fluorodeoxyglucose positron emission tomography metabolic parameters. Extrapancreatic involvement, especially proximal biliary and renal manifestations, significantly increases relapse risk. Therapeutic considerations reveal that prolonged maintenance of glucocorticoid therapy reduces relapse rates, whereas immunosuppressants and rituximab show promise in managing refractory cases. This review synthesizes current evidence to guide clinicians in developing effective management strategies for this challenging pancreatic disorder.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostaglandin E2 as a Mechanistic Biomarker of Chronic Pancreatitis.","authors":"Jami L Saloman, Bahiyyah Jefferson, Samuel Han, William E Fisher, Evan L Fogel, Phil A Hart, Liang Li, Walter G Park, Santhi Swaroop Vege, Dhiraj Yadav, Mark D Topazian, Darwin L Conwell","doi":"10.14309/ctg.0000000000000897","DOIUrl":"10.14309/ctg.0000000000000897","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pancreatitis (CP) is a disease associated with chronic inflammation, fibrosis, and pain. There is a lack of tools available that facilitate early diagnosis, when intervention could prevent irreversible damage. Pilot data suggested prostaglandin E2 (PGE2) as a candidate biomarker for early CP. PGE2 activates signaling pathways that promote inflammation, pain, and fibrosis.</p><p><strong>Methods: </strong>We assessed PGE2, metabolites, and downstream targets in pancreatic fluid collected endoscopically 0-10 (n = 110) and 10-20 (n = 111) minutes after intravenous secretin administration. PGE2 and metabolites were measured in plasma (n = 75) and urine (n = 71) from the same subjects. Subjects were enrolled in the PROCEED study and classified symptomatic controls, acute/recurrent acute pancreatitis (AP/RAP), or CP.</p><p><strong>Results: </strong>A significant main effect was detected in 10-20 minutes pancreas fluid ( P = 0.027) and plasma ( P = 0.046); post hoc testing showed PGE2 was lower in the AP/RAP group compared with symptomatic controls. There was also trend toward lower PGE2 in urine ( P = 0.062). To elucidate the active downstream pathways, calcitonin gene-related peptide, substance P, and matrix metalloproteinases (MMPs) 1, 2, 3, 7, 9, and 13 were measured in pancreas fluid. A significant difference between the 3 groups was detected for both MMP7 and MMP9. MMP7 was elevated in individuals with CP vs AP/RAP ( P = 0.012) for samples collected early but both time points for MMP9 ( P = 0.027, P = 0.002).</p><p><strong>Discussion: </strong>While PGE2 is detectable in pancreas fluid, these data suggest that it may not be sensitive enough to distinguish between AP/RAP and CP. However, MMPs may distinguish between stages of pancreatitis and require further testing as potential diagnostic biomarkers.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Predictors of Pancreatic Health and Islet Yield in Pediatric Total Pancreatectomy with Islet Autotransplantation.","authors":"Michelle Saad, Nadeen Abu Ata, Syed Ahmad, Christopher Anton, Appakalai N Balamurugan, John Brunner, Lin Fei, Qin Sun, Maisam Abu-El-Haija, Andrew T Trout","doi":"10.14309/ctg.0000000000000891","DOIUrl":"10.14309/ctg.0000000000000891","url":null,"abstract":"<p><strong>Introduction: </strong>Total pancreatectomy and islet autotransplantation (TPIAT) can alleviate symptoms in chronic pancreatitis. We aimed to identify pre-TPIAT imaging markers predicting explanted pancreas health and islet yield.</p><p><strong>Methods: </strong>We retrospectively analyzed 104 pediatric TPIAT patients, excluding those with presurgical diabetes or pancreatic surgeries. Pancreas parenchymal volume was manually segmented, and T1 signal intensity ratio pancreas to spleen (T1 SIRp/s) was calculated. An islet biologist assessed fat infiltration, fibrosis, and islet yield. Logarithmic transformation and regression analyses were used for variance stabilization and predictive modeling.</p><p><strong>Results: </strong>Ninety-four patients (60% female, median age 12.5 years) were included. Univariate analyses revealed that an increase in pancreas volume was associated with less fibrosis (odds ratio [OR] = 0.88 per 5 mL, 95% CI: 0.77-0.99, P < 0.05), higher pellet volume, total islet equivalent and total islet count. For advanced fibrosis, an increase in T1 SIRp/s was linked to decreased odds (OR = 0.74 per 0.1 unit, 95% CI: 0.59-0.92, P < 0.05), whereas a higher Cambridge score was associated with increased odds (OR = 1.34 per 1 unit of Cambridge, 95% CI: 1.01-1.77, P < 0.05). A model incorporating segmented pancreas volume and T1 SIRp/s predicted advanced fibrosis with an area under receiver operating curve (AUC) of 0.75 (95% CI: 0.64-0.87). In addition, models that included larger pancreas volume and the absence of acute pancreatitis predicted total islet count and total islet equivalent.</p><p><strong>Discussion: </strong>In children with chronic pancreatitis, noninvasive cross-sectional imaging focused on the parenchyma can guide the management, as a smaller parenchymal bulk and lower T1 SIRp/s predict advanced fibrosis, whereas larger pancreas volume and T1 SIRp/s predict larger pellet volumes.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Burden of Chronic Hepatitis B-Related Cirrhosis From 1990 to 2021 and Projections to 2050: A Finding From the Global Burden of Disease Study 2021.","authors":"Jinyan Sun, Jin Guo","doi":"10.14309/ctg.0000000000000890","DOIUrl":"10.14309/ctg.0000000000000890","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hepatitis B (CHB) is a widespread liver infection caused by hepatitis B virus, affecting 296 million people globally. The disease often progresses to severe conditions such as cirrhosis, hepatocellular carcinoma, and liver failure. The aim of this study was to evaluate the global, regional, and national burden of CHB-related cirrhosis from 1990 to 2021 and projected the disease development from 2022 to 2050.</p><p><strong>Methods: </strong>In this study, data from the Global Burden of Disease 2021 database were used to analyze the global burden of CHB-related cirrhosis. Metrics such as incidence, prevalence, deaths, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost were examined. Descriptive analysis explored the burden distribution by sex, age, Sociodemographic Index levels, and country in 1990 and 2021. Trend analysis used estimated annual percentage change to assess changes in age-standardized rates over time. The Autoregressive Integrated Moving Average model and the exponential smoothing model were applied to predict future trends.</p><p><strong>Results: </strong>In 2021, CHB-related cirrhosis caused 4.8 million incident cases, 432,000 deaths, and 13.9 million DALYs globally, with decreasing trends in age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs rate since 1990. Men exhibited higher burdens than women. Age-specific analysis revealed the highest age-standardized incidence rate in those aged younger than 5 years and the highest age-standardized mortality rate in the 85-89 years age group. Regionally, the greatest burden was observed in low Sociodemographic Index areas, with Sierra Leone and Egypt showing the highest rates. Projections indicate stable mortality but declining incidence and slightly increasing DALYs globally by 2050, with minor sex-specific variations.</p><p><strong>Discussion: </strong>The 2021 Global Burden of Disease Study highlights progress in reducing CHB-related cirrhosis. Targeted efforts and lessons from successful interventions are essential to further alleviate this burden and improve outcomes worldwide.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Obesity on Colon/Liver Resection With Colorectal Liver Metastasis: Analysis of US Nationwide Inpatient Sample 2005-2020.","authors":"Tun-Sung Huang, Jiunn-Chang Lin, Hung-Fei Lai, Po-Chun Wang, Wen-Ching Ko, Kung-Chen Ho","doi":"10.14309/ctg.0000000000000885","DOIUrl":"10.14309/ctg.0000000000000885","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity and overweight are linked to increased postoperative issues in patients with colorectal cancer (CRC). However, the impact of obesity on outcomes of simultaneous colon and liver resections for colorectal liver metastasis (CRLM) is not well studied. This study was to assess the impact of obesity and overweight on outcomes of simultaneous colon/rectum and liver resection in patients with CRLM.</p><p><strong>Methods: </strong>This retrospective study analyzed data from the US Nationwide Inpatient Sample between 2005 and 2020. Regression analysis evaluated associations between obesity/overweight and in-hospital outcomes.</p><p><strong>Results: </strong>Of the 3,269 patients included, 413 were overweight or obese. Overweight and obese patients were younger and had higher rates of comorbidities such as heart failure, diabetes, hypertension, nonalcoholic fatty liver disease, and chronic pulmonary disease compared with nonobese patients. Overweight and obesity were associated with an increased risk of unfavorable discharge (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 1.00-2.07) and a greater likelihood of developing any complication (aOR 1.27, 95% CI 1.05-1.5). In addition, overweight and obese patients had significantly higher odds of experiencing acute kidney injury (aOR 1.61, 95% CI 1.15-2.25), with the effect being more pronounced in patients younger than 60 years (aOR 1.80, 95% CI 1.13-2.87).</p><p><strong>Discussion: </strong>Overweight and obesity are associated with increased risks of complications, particularly acute kidney injury, and unfavorable discharge in patients undergoing simultaneous colon and liver resection for CRLM.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}