Critical reviews in clinical laboratory sciences最新文献

{"title":"Rethinking hyperhomocysteinemia: from causal risk factor to biomarker of glutathione deficiency in chronic diseases.","authors":"Alexey Polonikov","doi":"10.1080/10408363.2026.2743757","DOIUrl":"https://doi.org/10.1080/10408363.2026.2743757","url":null,"abstract":"<p><p>Hyperhomocysteinemia (HHcy) is a common metabolic disorder characterized by systemic elevation of the thiol amino acid homocysteine. Although HHcy is recognized as an independent risk factor for cardiovascular and many other chronic diseases, the causes and underlying mechanisms remain unclear despite decades of extensive research. The objective of this review is to critically examine the available literature in order to explore the hypothesis that endogenous glutathione deficiency may represent a primary pathological condition underlying hyperhomocysteinemia. Glutathione (GSH) is a tripeptide composed of the amino acids glycine, cysteine, and glutamate. GSH primarily serves as a master antioxidant, protecting cells from free radicals and playing a crucial role in maintaining redox homeostasis. Beyond its antioxidant properties, GSH plays a crucial role in numerous cellular processes, making it essential for health and for addressing age-related chronic diseases. The review examines into the redox regulation of homocysteine production and the connection between homocysteine and glutathione metabolism, while also addressing methodological aspects of homocysteine and glutathione measurement and the pre‑analytical and analytical challenges associated with their reliable quantification in clinical settings. It also includes a critical analysis of current experimental HHcy models and their relevance for extrapolation to humans. It is concluded that experimental HHcy is confounded by oxidative stress, a pathological condition that results from, contribute to, or be exacerbated by decreased endogenous glutathione levels. A strong negative correlation between homocysteine and glutathione has been demonstrated, and restoration of endogenous glutathione through nutritional interventions is associated with normalization of blood homocysteine. The literature indicates that the same environmental factors that induce oxidative stress and GSH depletion also activate redox‑sensitive enzymes in the methionine cycle and transsulfuration pathway, thereby driving the metabolic shift toward hyperhomocysteinemia. Consequently, these enzymes facilitate the production of homocysteine and its conversion into cysteine, supplying the rate-limiting substrate essential for glutathione biosynthesis. In this context, hyperhomocysteinemia can be considered an indicator of metabolic reprogramming aimed at restoring disrupted redox homeostasis by supporting glutathione biosynthesis, thereby alleviating oxidative stress and its associated pathological changes. The review concludes by outlining the evidence supporting the view that glutathione deficiency, rather than hyperhomocysteinemia, may constitute the primary underlying abnormality in chronic human diseases. The concept of glutathione depletion as a Trojan horse\" challenges the prevailing paradigm that attributes disease pathogenesis primarily to hyperhomocysteinemia. Instead, this condition may be better understood as ","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-29"},"PeriodicalIF":6.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between viral infections and aplastic anemia: a comprehensive scoping review.","authors":"Hojjat Ghahvechi, Sajjad Sadeghi Zarghari, Amir Hossein Esfandiari, Mohammad Reza Keramati","doi":"10.1080/10408363.2026.2735636","DOIUrl":"https://doi.org/10.1080/10408363.2026.2735636","url":null,"abstract":"<p><p>Aplastic anemia (AA) is a rare hematological disorder characterized by bone marrow failure and pancytopenia, with viral infections implicated as a significant acquired cause. This scoping review evaluates the pathophysiological mechanisms linking viral infections to AA and assesses current therapeutic strategies for managing virus-associated cases. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a scoping review was conducted from April to May 2024 using PubMed, Google Scholar, Web of Science, and ScienceDirect. Eligible studies included those reporting viral infections associated with AA, diagnostic approaches, or therapeutic interventions. Data were extracted on study design, type of virus, diagnostic methods, and treatment strategies. A total of 48 studies were included, identifying parvovirus B19, Epstein-Barr virus, cytomegalovirus, human immunodeficiency virus, hepatitis viruses, human T-cell lymphotropic virus type 1, and SARS-CoV-2 as key pathogens. Rare cases of post-vaccination complications were also reported. Identified mechanisms include direct bone marrow suppression, immune-mediated destruction, and viral reactivation during immunosuppression. Antiviral therapies and hematopoietic stem cell transplantation constitute the primary treatments, and virological monitoring is essential to prevent reactivation. Viral infections play a significant role in AA etiology and progression. Tailored antiviral regimens and proactive virological monitoring are essential for optimizing outcomes. Future research should focus on longitudinal studies to clarify causal relationships and refine therapeutic approaches.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-16"},"PeriodicalIF":6.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteasuria: extending an existing term into a framework for concentration-based and catalytic protease diagnostics in urine, with emphasis on activity-based methods.","authors":"Adam Lesner, Natalia Gruba, Magdalena Wysocka","doi":"10.1080/10408363.2026.2742201","DOIUrl":"https://doi.org/10.1080/10408363.2026.2742201","url":null,"abstract":"<p><p>Proteases are central to cancer pathobiology and attractive targets for noninvasive diagnosis. Diagnostic use of urinary proteases has developed along two methodologically distinct streams: measurement of protein abundance by immunoassay and increasingly by mass spectrometry, and direct measurement of enzymatic activity using peptide substrates. However, no common terminology unifies these approaches. This narrative review synthesizes evidence published between 2016 and 2026, concentrating on urine and, for the transferability of the methodology, on fecal water and serum. Saliva and seminal fluid are surveyed only to show that protease biomarkers there are measured by abundance alone. It adopts, from its existing use in nephrology, the term proteasuria as a unifying construct for the urinary protease diagnostic field, proposing a wider scope than the pathophysiological sense in which it was introduced. Two operational subtypes are defined: concentration-based and catalytic proteasuria. The distinction rests on the parameter measured rather than on the detection chemistry. Within the catalytic subtype single-enzyme detection using a selective substrate is distinguished from disease profiling using a multi-substrate panel. Evidence was identified by a PubMed search supplemented by citation and semantic search and screened by a single reviewer without protocol registration or formal risk-of-bias assessment. Concentration-based proteasuria is the clinically established stream, yet no urinary analyte has displaced cystoscopy, and approved assays remain insufficient as stand-alone rule-out or triage tests. The catalytic stream rests mainly on small single-center case-control studies reporting activity qualitatively; only one reports formal diagnostic performance, with a single elastase-specific substrate in 12 cases and 24 controls, and no head-to-head comparison with concentration-based assays has been published. Analytical validity is partial: substrate selectivity is established by combinatorial screening and confirmed with inhibitor and orthogonal controls, but precision, limits of quantification in urine and inter-laboratory reproducibility are not systematically reported, and no reference material or external quality-assessment scheme exists for this assay class. A largely independent exogenous stream of synthetic urinary biomarkers and activity-based nanosensors reports high accuracy, but all published diagnostic-accuracy data derive from animal models. On a translational-readiness scale the urinary catalytic stream is proof-of-concept, research-grade work, and any realistic target is therefore not cystoscopy but the margin at which established assays fail, principally low-grade noninvasive disease. The same reasoning identifies the detection of advanced adenoma, for which the fecal immunochemical test performs poorly, as the concrete benchmark for extending the framework to fecal protease profiling in colorectal cancer.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-22"},"PeriodicalIF":6.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-coding RNAs as potential clinical biomarkers of heart failure: analytical validation, laboratory methodology, and clinical implementation pathways.","authors":"Lizhou Song, Jingjing Zhang, Bakiah Shaharuddin, Zengwu Wang","doi":"10.1080/10408363.2026.2742200","DOIUrl":"https://doi.org/10.1080/10408363.2026.2742200","url":null,"abstract":"<p><p>Heart failure (HF) is a heterogeneous clinical syndrome that has pathophysiologic manifestations of hemodynamic abnormalities, downstream neurohumoral activation and inflammation, myocardial fibrosis, metabolic dysfunction, and cardiomyocyte injury. Relevant to the issue of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) as clinically established biomarkers, their interpretation may be influenced by confounding factors such as obesity, renal dysfunction, atrial fibrillation, and HF phenotype. Recent data highlight a broad spectrum of non-coding RNA (ncRNA) types, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), which can be detected in circulating samples and participate in regulatory networks associated with myocardial remodeling, supporting their investigation as potential complementary biomarkers. A structured literature search of PubMed/MEDLINE, Web of Science Core Collection, and Scopus from database inception to August 6, 2026, was conducted according to predefined eligibility, study-selection, and evidence-appraisal criteria. Here, HF-associated ncRNAs are assessed from perspectives including biological relevance, pre-analytical variables, detection platforms, quality control (QC), analytical and clinical validation, clinical-use scenarios, and implementation pathways. The available evidence so far rather supports a role in which ncRNAs serve as adjunctive rather than stand-alone biomarkers. The field is highlighted by the fact that presently no ncRNA-based assay is ready for routine clinical use in HF. Harmonized pre-analytical and analytical workflows, independent multicenter validation, predefined clinical-use scenarios, as well as demonstration of incremental clinical value and cost-effectiveness beyond established biomarkers, imaging, and clinical variables will be needed for future progress.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-31"},"PeriodicalIF":6.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric urinalysis revisited: developmental physiology, preanalytical challenges, clinical decision limits, and age- and sex-specific reference intervals.","authors":"Karolina Samsel, Olga Martyna Koper-Lenkiewicz, Joanna Matowicka-Karna, Joanna Kamińska","doi":"10.1080/10408363.2026.2730967","DOIUrl":"https://doi.org/10.1080/10408363.2026.2730967","url":null,"abstract":"<p><p>Urinalysis comprises test strip examination of physicochemical parameters together with microscopic or automated analysis of formed urine elements. The test strip covers pH, relative density (specific gravity, SG), protein, glucose, ketone bodies, urobilinogen, bilirubin, blood, and leukocyte esterase. In selected settings, it is supplemented by quantitative indices such as the urine protein-to-creatinine and albumin-to-creatinine ratios. This review evaluates age- and sex-specific reference intervals and clinical decision limits for urinalysis parameters in children, integrating developmental renal physiology with preanalytical and analytical determinants of test performance. A search of PubMed identified 148 publications published between 1982 and 2026. Pediatric urine composition is shaped by immature glomerular and tubular function, changing muscle mass, hormonal changes during puberty, and anatomical differences between sexes. Preanalytical variables, particularly the collection technique, materially affect reliability contamination rates range from approximately 1% for suprapubic aspiration to 26-80% for adhesive bag specimens. Automated systems improve reproducibility and require smaller specimen volumes, but pediatric validation data remain limited, and reference limits are not transferable between analyzer generations. Critically, values reported in the literature comprise both reference limits derived from healthy populations and clinical decision limits selected for diagnostic use; these are not interchangeable, and several widely cited pediatric values originate from screen-positive or hospitalized cohorts. Laboratories serving pediatric populations should report reference intervals together with the method, analyzer generation, and source population; define diagnostic decision limits locally rather than adopting adult-derived defaults; and confirm any positive bag-collected specimen by a less contamination-prone method. No reference intervals for formed elements have been published for preterm neonates, which remains the most urgent gap.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-23"},"PeriodicalIF":6.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous glucose monitoring devices in hospitalized pediatric patients.","authors":"Isaiah K Mensah, Christopher W Farnsworth","doi":"10.1080/10408363.2026.2722682","DOIUrl":"https://doi.org/10.1080/10408363.2026.2722682","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) has revolutionized the landscape of diabetes management both in adults and pediatrics. CGM devices are now standard-of-care for pediatric diabetes management and are increasingly used in hospitalized patients. In the outpatient setting, studies show increasing analytical and clinical performance of CGM devices with improved diabetes outcomes. However, there are several inpatient factors that impact the accuracy of CGM devices relevant to hospitalized patients. The pediatric population is also the most vulnerable, and changes in management based on a false CGM reading can cause adverse events. Therefore, it is imperative to critically assess the accuracy and clinical performance of CGM devices in hospitalized pediatric patients. In this review, we assess the literature and summarize recent studies on the accuracy of CGM devices in pediatric inpatients, discuss regulatory requirements for their use, safety considerations, and procedures for confirmatory testing using standard-of-care glucose tests.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"1-11"},"PeriodicalIF":6.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the evidence: a scoping review of the impact of COVID-19 on non-communicable disease care in Sub-Saharan Africa.","authors":"Elsie C Kruger, Aaqilah Fataar, Andre P Kengne, Rajiv T Erasmus, Annalise E Zemlin","doi":"10.1080/10408363.2026.2651301","DOIUrl":"10.1080/10408363.2026.2651301","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Non-communicable diseases (NCDs) are the leading cause of mortality globally and account for a growing proportion of the disease burden in sub-Saharan Africa (SSA), where health systems face significant resource constraints. The COVID-19 pandemic disrupted healthcare delivery globally, raising concerns that interruptions to routine NCD care could lead to higher morbidity and mortality among populations requiring ongoing care. Although evidence of the pandemic's impact on NCD care has been documented in high-income settings, the experience of SSA health systems, which entered the pandemic with preexisting infrastructure and workforce limitations, remains incompletely understood. This scoping review aimed to systematically map the evidence on COVID-19's impact on NCD care in SSA and to identify service adaptations implemented to maintain care continuity during the pandemic. Studies examining the COVID-19 pandemic and disruptions in NCD screening, diagnosis, or monitoring among adults in SSA were identified from four electronic databases: PubMed/Medline, Scopus, EBSCOhost, and Web of Science. The search strategy combined Medical Subject Headings (MeSH) terms and keywords related to geographic location (SSA), exposure (COVID-19 pandemic and related public health measures), and outcomes (screening, diagnosis, and monitoring of NCDs). Inclusion was limited to original research published between March 2020 and December 2023, written in English, French, or German, and reporting observational data on pandemic-related disruptions to NCD care. Two reviewers independently screened titles, abstracts, and full texts, with data extraction conducted using a standardized form capturing study characteristics, NCD types examined, nature of documented disruptions, and reported innovations. Twenty-eight studies were eligible for inclusion across seven countries in SSA, with the majority of evidence originating from South Africa and Ethiopia. Included studies were mainly retrospective and cross-sectional, with some using mixed-methods and time-series designs, and examined various NCDs, including diabetes mellitus, hypertension, and cancers. Sample sizes ranged from fewer than 100 participants to datasets exceeding 9 million records. Due to the heterogeneity of study designs, populations, and outcomes, findings were synthesized narratively. Six major themes emerged: disrupted access to routine care, interruptions to diagnostics and monitoring, medicine supply chain challenges, adoption of remote care models, health equity impacts, and clinical outcome implications. The pandemic was associated with widespread barriers to healthcare access, diagnostic delays, and medication shortages, with the implementation of innovations such as telemedicine and community-based delivery often hindered by technological and resource limitations. COVID-19 significantly disrupted NCD care across SSA, though health systems demonstrated notable capacity for adaptation, emphasizing the ","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"508-520"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-regional pro-atrial natriuretic peptide in managing cardiovascular and cerebrovascular diseases.","authors":"Xu-Lei Hao, Gjin Ndrepepa, Wen-Qi Zheng, Zhi-De Hu","doi":"10.1080/10408363.2026.2631481","DOIUrl":"10.1080/10408363.2026.2631481","url":null,"abstract":"<p><p>Mid-regional pro-atrial natriuretic peptide (MR-proANP), along with B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), is a type of natriuretic peptide hormone that is released by atrial muscle cells upon stress. Previous studies have shown that MR-proANP has high diagnostic accuracy for heart failure (HF) in several clinical settings, and it also helps in the risk stratification of patients with HF. In the general population, elevated MR-proANP levels indicate a high risk of cerebrovascular and cardiovascular diseases, including stroke and atrial fibrillation. In patients with established cardiovascular and cerebrovascular diseases, elevated MR-proANP levels are associated with a poor prognosis. This review summarizes the value and the use of MR-proANP in assessing the risk, diagnosis, and prognosis of patients with cardiovascular and cerebrovascular disease(s).</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"542-554"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dual roles of microorganisms in inflammatory diseases: initiators and regulators.","authors":"Yan Liao, Ruoyu Jiang, Haoling Zhang, Wangzheqi Zhang","doi":"10.1080/10408363.2026.2637106","DOIUrl":"10.1080/10408363.2026.2637106","url":null,"abstract":"<p><p>Research on the microbiome is reshaping the conceptual foundations of inflammatory diseases. As a dynamic component of the host ecosystem, microbial communities collectively influence inflammatory responses and homeostatic balance through their metabolites, structural signals, and interactions with immune pathways. Dysbiosis can amplify immune activation and metabolic disturbances, leading to persistent inflammation, whereas specific commensal taxa and their metabolites possess the capacity to suppress excessive immune responses and restore homeostasis. This bidirectional regulatory capacity positions the microbiome as a central node that both drives and modulates inflammatory networks. Multi-omics investigations have delineated the systemic architecture of microbe-host interactions, revealing cross-system axes such as the gut-brain, gut-liver, and skin-gut pathways that constitute a signaling framework integrating inflammation and immunity, thereby reshaping our understanding of disease pathogenesis. Within this framework, inflammation is redefined as an adaptive strategy for maintaining systemic stability rather than merely a singular pathological reaction. Therapeutic approaches including fecal microbiota transplantation (FMT), engineered microbial strains, and interventions targeting metabolic signaling are propelling microecological medicine into an era of precision modulation. As systems biology converges with spatial omics, research on the microbiome is shifting from descriptive pathology toward mechanistic control, establishing it as a critical nexus linking immunity, metabolism, and disease evolution. This transformation heralds a paradigm shift in medicine from merely \"suppressing inflammation\" to actively \"reconstructing ecological order.\"</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"555-587"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/10408363.2026.2655071","DOIUrl":"10.1080/10408363.2026.2655071","url":null,"abstract":"","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":" ","pages":"I-IV"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}