Clinics and research in hepatology and gastroenterology最新文献

{"title":"Metabolic factors drive early increase in hepatic steatosis despite improvement in non-invasive fibrosis markers after hepatitis C eradication with direct-acting antivirals","authors":"Mohamed Shengir ,&nbsp;Wesal Elgretli ,&nbsp;Felice Cinque ,&nbsp;Agnihotram V. Ramanakumar ,&nbsp;Rosa Lombardi ,&nbsp;Annalisa Cespiati ,&nbsp;Anna Ludovica Fracanzani ,&nbsp;Luz Ballesteros ,&nbsp;Marc Deschenes ,&nbsp;Philip Wong ,&nbsp;Tianyan Chen ,&nbsp;Giada Sebastiani","doi":"10.1016/j.clinre.2025.102639","DOIUrl":"10.1016/j.clinre.2025.102639","url":null,"abstract":"<div><h3>Background</h3><div>While direct-acting antivirals (DAAs) achieve high sustained virologic response (SVR) rates in people with hepatitis C virus (HCV), their impact on hepatic steatosis (HS) remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 108 HCV patients from McGill University and the University of Milan who achieved SVR following DAAs. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were used to assess HS and liver fibrosis at baseline and 24 weeks post-SVR. HS was defined as CAP ≥248 dB/m, significant liver fibrosis as LSM ≥8 kPa, and metabolic dysfunction-associated steatotic liver disease (MASLD) as HS plus ≥1 cardiometabolic risk factors. Changes were evaluated using Wilcoxon signed-rank test and standardized mean difference (SMD). Multivariable logistic regression identified predictors of post-SVR HS.</div></div><div><h3>Results</h3><div>HS prevalence increased from 47 % to 61 % post-SVR (<em>p</em> = 0.0007, SMD = 0.30). Among patients with baseline HS, 88 % had persistent steatosis. New-onset steatosis developed in 37 % of patients without baseline HS, with a significant CAP increase (<em>p</em> &lt; 0.0004, SMD=0.48). In patients without baseline HS, total cholesterol and triglycerides increased (<em>p</em> = 0.0084, SDM = 0.43 and <em>p</em> &lt; 0.0001, SDM = 0.71, respectively), whereas in those with baseline HS, only total cholesterol rose (<em>p</em> = 0.0296, SDM = 0.50). MASLD remained the leading etiology at both time points (94 % at baseline, 92 % post-SVR). Significant fibrosis declined markedly from 49 % to 17 % (<em>p</em> &lt; 0.0001, SMD = –0.80). Higher BMI at 24 weeks was independently associated with HS (adjusted odds ratio 1.92, 95 %CI 1.22–3.03).</div></div><div><h3>Conclusions</h3><div>Despite improvement in liver fibrosis markers, HS often persists or emerges following DAAs therapy, particularly alongside metabolic dysfunctions marked by elevated cholesterol and triglycerides.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102639"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrevealing emphysematous gastritis: Insight from a comprehensive systematic review","authors":"Mohamed Elnaggar ,&nbsp;Omar F Abbas ,&nbsp;Roaa Haddad ,&nbsp;Mohamed Mohsen Helal ,&nbsp;Hala AbouShawareb ,&nbsp;Alaa Abdrabou Abouelmagd ,&nbsp;Abdullah Almarfadi ,&nbsp;Ahmed Galal Amer ,&nbsp;Yousif Ahmad Hanafi Hussein ,&nbsp;Motasem Ayoub ,&nbsp;Mohamed Ayman Ebrahim ,&nbsp;Mohamed A. Aldemerdash ,&nbsp;Ismail Elkhattib ,&nbsp;Mohamed Ghallab ,&nbsp;Hatem Eltaly ,&nbsp;Mohamed Abd El Aziz ,&nbsp;Neil Parikh","doi":"10.1016/j.clinre.2025.102638","DOIUrl":"10.1016/j.clinre.2025.102638","url":null,"abstract":"<div><h3>Background</h3><div>Emphysematous Gastritis is a rare condition, characterized by the presence of gas within the gastric wall. It is associated with a high mortality rate, but early diagnosis and treatment can significantly reduce mortality and improve patient outcomes.</div></div><div><h3>Methodology</h3><div>For this systematic review, we searched PubMed, Scopus, Web of Science, and Embase from inception until October 2024 to find relevant case reports or case series on emphysematous gastritis.</div></div><div><h3>Results</h3><div>A 116 case report and case series revealed that patient ages ranged from 4 months to 96 years (mean age: 55), male (55 %). Most cases were reported in Asia and the USA. The majority of symptoms were 90 % abdominal pain, and 80 % vomiting and nausea. Infection of the gastric wall by gas-forming organisms was commonly Sarcina ventriculi. Abdominal CT scans identified emphysematous changes in 95 % of cases. Endoscopic examinations revealed Gastric Mucosal Erythema in 80 % of patients, with elevated leukocytosis in 80 % of cases. The majority of the recovery rate was 70 %, and the mortality rate was 15 %; (75 % received medical treatment,25 % surgical treatment), and 79 % were given medical treatment including antibiotics and supportive care while in severe cases 21 % were surgical.</div></div><div><h3>Conclusion</h3><div>Emphysematous Gastritis requires a multidisciplinary approach for optimal outcomes. CT imaging remains pivotal for diagnosis, and management should be individualized based on disease severity and patient factors. While mortality remains significant, early recognition and advancements in medical care have improved survival in many cases.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102638"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the benefit of optimal MASH treatment depend on a reduction in myosteatosis?","authors":"Nicolas Lanthier","doi":"10.1016/j.clinre.2025.102640","DOIUrl":"10.1016/j.clinre.2025.102640","url":null,"abstract":"<div><div>The muscle-liver axis, well known in cirrhosis, is also important in the multisystem disease known as metabolic dysfunction-associated steatohepatitis (MASH). The convincing results obtained with a triple peroxisome proliferator-activated receptor (PPAR) agonist in this setting confirm this hypothesis, demonstrating a beneficial effect not only on the severity of MASH in terms of steatosis, inflammation and fibrosis, but also in terms of hepatic and muscle insulin sensitivity. The pathophysiology of MASH and mechanism of action of triple PPAR agonist suggest that this may be related to improved lipid management in skeletal muscles and highlights the importance of studying the muscle-adipose tissue-liver axis in the management of MASH.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102640"},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoids accelerate the reduction of disease severity and biochemical parameters in drug-induced liver injury: Assess the causal relationship using the updated RUCAM scale","authors":"Punan Wang ,&nbsp;Guanya Guo ,&nbsp;Shuangshuang Jiang ,&nbsp;Dawei Ding,&nbsp;Jiaqi Yang,&nbsp;Yi Lu,&nbsp;Ying Han,&nbsp;Xinmin Zhou","doi":"10.1016/j.clinre.2025.102635","DOIUrl":"10.1016/j.clinre.2025.102635","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The efficacy and clinical application of glucocorticoids (GCs) in patients with drug-induced liver injury (DILI) remain controversial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;To determine the efficacy and suitable population of GCs in patients with DILI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a single-center, retrospective study. Patients with moderate-to-severe DILI who met the diagnostic criteria from January 1, 2009 to December 31, 2024 were enrolled. Patients in the GC group and the non-GC group were matched 1:1 by propensity score-matched (PSM), and the reduction of disease severity and biochemical parameters were compared between the two groups. According to the level of TB, the patients with DILI were divided into three groups, and the efficacy of GCs in each subgroup was compared.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Patients with DILI in our study were evaluated by the updated RUCAM causality assessment scale. All patients had RUCAM scores≥6 and causal relationship graded as \" probable\" or \" highly probable\". The use of GC treatment differs according to the severity of patients, especially the baseline level of TB ( % in patients with TB &lt;5 ULN, % in patients with 5ULN≤TB≤10ULN, and % in TB≥10ULN). After PSM analysis, 163 patients were included in each group. After PSM, the time of severity reduction was faster in the GC group than the non-GC group (&lt;em&gt;P&lt;/em&gt; = 0.022). The adjusted cumulative rate of severity reduction was 62 % in the GC group and 43.6 % in the non-GC group. The cumulative rates of reaching 50 % reduction in AST, ALP, TB level was higher in the GC group than in the non-GC group (&lt;em&gt;P&lt;/em&gt; &lt; 0.001, &lt;em&gt;P&lt;/em&gt; = 0.0086 and &lt;em&gt;P&lt;/em&gt; = 0.003). Patients were divided into three subgroups according to baseline TB level. We found the cumulative rates of who achieved severity reduction and 50 % reduction in liver biochemical parameters at discharge was higher in the GC group than in the non-GC group in patients with 5ULN≤ TB level ≤10ULN but not in patients with TB &lt;5ULN and TB&gt;10ULN. Multivariate analysis showed that sex, age, treatment group and severity were significantly associated with disease severity reduction of patients with DILI. After PSM, there were 56 patients with drug-induced autoimmune hepatitis (DI-AIH) and 270 patients with DILI with no autoimmune features cases in our cohort. The cumulative rate of severity reduction at discharge in the GC group was higher than that in the non-GC group in patients with DI-AIH (&lt;em&gt;P&lt;/em&gt; = 0.049). Although the incidence of side effects in the GC group was higher than that in the non-GC group, the adverse reactions were basically relieved with the withdrawal of GCs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;GCs accelerated the reduction of disease severity and liver biochemical parameters, especially in patients with 5ULN≤baseline TB level≤10ULN. Sex, age, treatment group and severity were significantly associated with disease severit","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102635"},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA in peripheral blood may predict the efficacy of immune-targeted therapy in patients with hepatocellular carcinoma","authors":"Su-Su Zheng ,&nbsp;Dai Zhang ,&nbsp;Jing-Fang Wu ,&nbsp;Hong Chen ,&nbsp;Zhen-Zhen Zhang ,&nbsp;Guo-Bin Chen ,&nbsp;Xiao-Ying Xie ,&nbsp;Bo-Heng Zhang","doi":"10.1016/j.clinre.2025.102632","DOIUrl":"10.1016/j.clinre.2025.102632","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Hepatocellular carcinoma (HCC) is a highly prevalent and fatal malignancy globally. Accurate prognosis prediction is crucial for developing personalized therapeutic strategies.</div></div><div><h3>Methods</h3><div>This study involved 28 HCC patients who received immune-targeted therapy at the Xiamen Branch of Zhongshan Hospital of Fudan University from April 2020 to June 2022. Next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) was conducted at baseline and after two treatment cycles. The primary objective was to investigate the relationship between changes in variation allele frequency (VAF) during therapy and clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 134 single nucleotide variants, 1 insertion-deletion mutation, and 5 copy number variations were detected across the cohort. A decrease in mean VAF (VAF_mean) after two cycles of immune-targeted therapy was associated with longer progression-free survival. The sensitivity and specificity of VAF_mean reduction in predicting partial response(PR) and complete response(CR) were 1.0 and 0.8125, respectively, which were higher than those of serum alpha-fetoprotein (AFP) levels (0.9167 and 0.4667). No significant correlation was observed between baseline mutation status and the efficacy of immune-targeted therapy.</div></div><div><h3>Conclusions</h3><div>This study highlights that advanced ctDNA analysis can detect somatic mutations in a substantial proportion of patients with advanced HCC. Monitoring ctDNA dynamics during immune-targeted therapy enables real-time assessment of disease status and provides a basis for optimizing treatment strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102632"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in food protein-induced allergic proctocolitis (FPIAP): Mechanisms and treatment targeting gut microbiome","authors":"Yan Liu ,&nbsp;Zhenmei Li ,&nbsp;Lina Shen ,&nbsp;Kejun Shuai ,&nbsp;Chao Zhang ,&nbsp;Zhifeng Ning","doi":"10.1016/j.clinre.2025.102634","DOIUrl":"10.1016/j.clinre.2025.102634","url":null,"abstract":"<div><h3>Background</h3><div>Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated food allergy characterized by subacute or chronic inflammatory processes in the gut. Unlike IgE-mediated food allergies that may cause multi-organ syndromes, non-IgE-mediated food allergies mainly affect the gastrointestinal tract. The incidence of FPIAP is rising globally, becoming a significant health concern.</div></div><div><h3>Objectives</h3><div>This article aims to systematically review the epidemiological characteristics, pathogenesis, cell death programs involved in FPIAP, and its relationship with the gut microbiota. It also explores therapeutic developments targeting the intestinal microbiota.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search across multiple databases, including PubMed, Web of Science, and Scopus, up to December 2024. Studies were selected based on predefined inclusion and exclusion criteria. Data extraction and quality assessment were performed by two independent reviewers.</div></div><div><h3>Results</h3><div>The review identified key epidemiological trends, highlighting the increasing incidence of FPIAP. The pathogenesis section elucidates the mechanisms underlying non-IgE-mediated allergies, emphasizing the role of the gut microbiome in mediating dietary factors and immune responses. Specific cell death programs, such as apoptosis and pyroptosis, were found to be involved in the progression of FPIAP. Therapeutic strategies targeting the gut microbiota show promise in managing FPIAP, with probiotics and prebiotics emerging as potential interventions.</div></div><div><h3>Conclusions</h3><div>This review provides valuable insights into the mechanisms of FPIAP and highlights the potential of microbiota-targeted therapies. Future research should focus on large-scale clinical trials to validate the efficacy of these interventions and further explore the complex interplay between diet, gut microbiota, and immune responses in FPIAP.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102634"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The triple association of sickle cell disease, primary sclerosing cholangitis and inflammatory bowel disease (SCD-PSC-IBD): iceberg in sight","authors":"Philippe Marteau,&nbsp;Yvon Calmus","doi":"10.1016/j.clinre.2025.102633","DOIUrl":"10.1016/j.clinre.2025.102633","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102633"},"PeriodicalIF":2.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: A prospective study”: Authors’ reply","authors":"Erkin Saeed Saifi","doi":"10.1016/j.clinre.2025.102629","DOIUrl":"10.1016/j.clinre.2025.102629","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102629"},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on “Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: a prospective study”","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.clinre.2025.102628","DOIUrl":"10.1016/j.clinre.2025.102628","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102628"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the fibrosis-3 index for predicting liver fibrosis 5 years after achieving sustained virological response in patients with chronic hepatitis C","authors":"Kazuya Kariyama ,&nbsp;Hidenori Toyoda ,&nbsp;Takashi Kumada ,&nbsp;Satoshi Yasuda ,&nbsp;Yoshihiko Tachi ,&nbsp;Takanori Hirai ,&nbsp;Shohei Shiota ,&nbsp;Akiko Wakuta ,&nbsp;Kazuhiro Nouso","doi":"10.1016/j.clinre.2025.102625","DOIUrl":"10.1016/j.clinre.2025.102625","url":null,"abstract":"<div><h3>Aim</h3><div>Non-invasive tests for liver fibrosis frequently use serum aminotransferases; however, their accuracy may be influenced by hepatitis virus eradication. This study evaluated the effectiveness of the age-independent FIB-3 index in patients with chronic hepatitis C who achieved sustained virological response (SVR).</div></div><div><h3>Methods</h3><div>A total of 115 patients who achieved SVR following interferon therapy were analyzed. Liver fibrosis was assessed by biopsy before treatment and 5 years after achieving SVR. The diagnostic accuracies of the FIB-3 and FIB-4 indices were compared using Receiver Operating Characteristic (ROC) curve analysis and representative cutoff values (FIB-3:3.5, FIB-4:2.67), with a specific focus on age-stratified performance.</div></div><div><h3>Results</h3><div>Age-stratified analysis revealed distinct patterns in fibrosis index performance before and after SVR. Among patients aged ≥ 65 years, both indices demonstrated poor accuracy pre-SVR (FIB-3:0.35, FIB-4:0.29) but markedly improved post-SVR, with FIB-3 demonstrating significantly superior performance (accuracy: 0.82 vs 0.64). This improvement was primarily due to better specificity (FIB-3:0.85 vs FIB-4,0.60) while maintaining high sensitivity (0.62 vs 0.87). In patients aged &lt; 65 years, both indices exhibited modest improvement post-SVR, with no significant differences observed.</div></div><div><h3>Conclusions</h3><div>At established cutoff values, the FIB-3 index demonstrated significantly higher diagnostic performance than the FIB-4 index, particularly in patients aged ≥ 65 years who achieved SVR. These findings suggest that the FIB-3 index is a reliable tool for long-term monitoring of liver fibrosis after hepatitis C eradication.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102625"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}