Diabetes research and clinical practice最新文献

{"title":"Managing obesity in adults with type 1 diabetes.","authors":"Alejandro Campos, Rene Rivera Gutierrez, Rodolfo J Galindo, Rozalina G McCoy, Maria D Hurtado Andrade","doi":"10.1016/j.diabres.2024.111983","DOIUrl":"10.1016/j.diabres.2024.111983","url":null,"abstract":"<p><p>As the prevalence of obesity has reached epidemic proportions, its prevalence has also increased among adults living with type 1 diabetes mellitus. Unlike the pathophysiologic relationship between obesity and type 2 diabetes mellitus, the relationship between obesity and type 1 diabetes mellitus, and management of obesity in the setting of type 1 diabetes mellitus, have not been well reviewed. In this article, we discuss the comprehensive management of obesity in adults with type 1 diabetes mellitus, focusing on medical nutrition therapy and adjunct therapies such as weight loss-promoting medications and metabolic/bariatric surgery.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111983"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921258","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":"Empowerment in Type 2 diabetes: A patient-centred approach for lifestyle change.","authors":"Charlotte Björk Ingul, Siri Marte Hollekim-Strand, Mari Mørkeset Sandbakk, Torunn Ingfrid Grønseth, Tone Iren K Rånes, Lars Tung Dyrendahl, Katarina Eilertsen, Stephan Kristensen, Turid Follestad, Bjarte Bye Løfaldli","doi":"10.1016/j.diabres.2025.111998","DOIUrl":"10.1016/j.diabres.2025.111998","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the effectiveness of personalized lifestyle intervention service for persons with Type 2 diabetes (T2D), implemented in a real-world setting at two Healthy Life Centers (HLC) in Norway.</p><p><strong>Methods: </strong>Persons with T2D were randomized into either an HLC intervention group or a usual care group for 12 weeks. All participants were screened using a questionnaire tool and had one initial patient-centred health conversation at the HLC. In the intervention group, participants chose interventions with support from HLC staff. The usual care group continued independently. Outcome variables were assessed at baseline, 12 weeks, and 24 weeks (if completing two interventions).</p><p><strong>Results: </strong>110 participants were included (mean age 59.9, 59 % T2D duration < 10 years, 36 % females). There was no significant difference in HbA1c change between intervention and usual care groups (mean difference -1.2 mmol/l, 95 % CI: -3.7 to 1.3, p = 0.33). HbA1c was significantly reduced in both groups (mean reduction 3.8 mmol/l (95 % CI: 2.1 to 5.5, p < 0.001) vs. 2.6 mmol/l (95 % CI: 0.7 to 4.4, p = 0.006), respectively).</p><p><strong>Conclusions: </strong>Both the HLC personalized follow-up and usual care groups reduced HbA1c with no significant differences between groups. This suggests that low-threshold municipal healthcare can effectively support lifestyle changes in individuals with T2D.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111998"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001874","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":"Effects of silymarin on insulin resistance and sensitivity: A systematic review and meta-analysis of randomized controlled trials.","authors":"Shao Yin, Fengya Zhu, Ying Liu, Qiu Chen","doi":"10.1016/j.diabres.2025.112008","DOIUrl":"10.1016/j.diabres.2025.112008","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the effect of silymarin on insulin resistance and insulin sensitivity through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and Cochrane Library up to September 2024 for relevant RCTs. The intervention required silymarin supplementation for at least 4 weeks. Primary outcomes were homeostatic model assessment of insulin resistance (HOMA-IR) and fasting insulin (FI), while secondary outcomes included quantitative insulin sensitivity check index (QUICKI). Bias risk was assessed using Cochrane RoB 2. Subgroup analyses were based on disease type, duration, and dosage. Sensitivity and publication bias analyses were conducted using Egger's and Begg's tests. Statistical analysis and meta-analysis were performed using Stata 15.1.</p><p><strong>Results: </strong>Six studies with 673 participants from Iran, Egypt, and Italy were included. All studies had low risk of bias. Meta-analysis showed that Silybum marianum significantly improved HOMA-IR (WMD = -2.29, 95 % CI: -4.55 to -0.03, p = 0.047) but had no effect on FI (WMD = -2.56, 95 % CI: -7.60 to 2.48, p = 0.862). Subgroup analyses revealed improvements in HOMA-IR for T2DM and diabetics with alcoholic cirrhosis, but no effect in non-alcoholic fatty liver disease (NAFLD) patients. QUICKI did not show significant changes in any group. Only one study reported changes in QUICKI. The results indicated that, compared to the placebo, silymarin improved insulin sensitivity in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Conclusion: </strong>In conclusion, the results of this study indicate that there is limited evidence supporting the effectiveness of silymarin in improving HOMA-IR and FI levels in metabolic diseases, and it generally does not appear to significantly improve these parameters. Future studies should aim to increase the number of high-quality RCTs to further validate the efficacy and safety of silymarin, as well as to explore its underlying mechanisms.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"220 ","pages":"112008"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037542","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":"Type 1 diabetes incidence curves differ by age for girls and boys between 1996 and 2022: Results from the North Rhine-Westphalia Diabetes Registry, Germany.","authors":"Anna Stahl-Pehe, Christina Baechle, Stefanie Lanzinger, Michael S Urschitz, Reinhard W Holl, Joachim Rosenbauer","doi":"10.1016/j.diabres.2025.111996","DOIUrl":"10.1016/j.diabres.2025.111996","url":null,"abstract":"<p><p>The type 1 diabetes incidence was analyzed in 0- to 14-year-old children in North Rhine-Westphalia, Germany, from 1996 to 2022. The data revealed an overall increasing trend, with variations by age and sex. The incidence increased in boys across age groups but peaked in girls in the 5-9-year age group.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111996"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977927","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":"Association of gestational and childhood circulating C-peptide concentrations in the hyperglycemia and adverse pregnancy outcomes follow-up study.","authors":"Ananthi Rajamoorthi, Hao Zheng, Alicja A Skowronski, Noelia Zork, Uma M Reddy, Pei Wen Tung, Allison Kupsco, Dympna Gallagher, Rany M Salem, Rudolph L Leibel, Charles A LeDuc, Vidhu V Thaker","doi":"10.1016/j.diabres.2024.111967","DOIUrl":"10.1016/j.diabres.2024.111967","url":null,"abstract":"<p><strong>Aims: </strong>This study examined the association of gravida C-peptide with progeny islet function and insulin sensitivity in the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS).</p><p><strong>Methods: </strong>Pregnancy 3rd trimester oral glucose tolerance test (OGTT), cord blood, and offspring OGTT glucose, C-peptide and insulin at age 10-14 years were analyzed for 4,121 mother-child dyads. Gravida fasting and 1-hour C-peptide concentration correlations with cord blood and childhood C-peptide, insulin, insulinogenic index and insulin sensitivity, and insulin resistance [HOMA-IR]), were assessed by multiple linear regression. Maternal covariates included age, gestational age, BMI and glucose at OGTT; child covariates included age, sex, pubertal stage, BMI z score and glucose.</p><p><strong>Results: </strong>Gravida fasting and 1-hour OGTT C-peptide was positively correlated with cord blood C-peptide, offspring OGTT C-peptide and insulin concentrations at fasting, 30 min, 1-hour and 2-hour at 10-14 years of age. Maternal fasting and 1-hour C-peptide concentrations were positively correlated with the insulinogenic index and HOMA-IR but inversely correlated with insulin sensitivity. Maternal C-peptide explained more variance than maternal glucose concentrations (3.0-17.9 % vs 0.2-3.5 %).</p><p><strong>Conclusions/interpretation: </strong>The correlation between gravida and offspring C-peptide suggests that without crossing the placenta, insulin may influence the offspring pancreatic beta-cell development and insulin sensitivity.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111967"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881540","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":"Diabetic foot: A systematic review and meta-analysis on its prevalence and associated factors among patients with diabetes mellitus in a sub-Saharan Africa.","authors":"Kirubel Eshetu Haile, Yordanos Sisay Asgedom, Gedion Asnake Azeze, Atitegeb Alebachew Amsalu, Amanuel Yosef Gebrekidan, Gizachew Ambaw Kassie","doi":"10.1016/j.diabres.2024.111975","DOIUrl":"10.1016/j.diabres.2024.111975","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is one of the non-communicable diseases that represents the greatest public health challenge in sub-Saharan Africa, where diabetes related needs are currently largely unmet, and the debilitating aspects of the foot are worsened by issues related to healthcare costs, self-care practices, and inadequate knowledge. To estimate the pooled prevalence and associated factors of diabetic foot ulcers among patients with Diabetes mellitus, we conducted a systematic review and meta-analysis. Although studies on, diabetic foot ulcer among patients with diabetes mellitus have been available, the results have been inconsistent.</p><p><strong>Objectives: </strong>To determine the pooled prevalence and associated factors of diabetic foot ulcers among patients with diabetes mellitus in sub-Saharan Africa.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. To identify papers published in English up to May 29, 2024, the electronic databases of Medline, Science Direct, Excerpta Medica Database, Cochrane Library, African Journals Online, and Google Scholar were searched. The DerSimonian and Laird method for random-effects models was used to estimate the pooled prevalence of diabetic foot ulcers. To test for heterogeneity between studies and publication bias, forest plots and funnel plots were, respectively used.</p><p><strong>Results: </strong>A total of 28 studies with 10,635 participants were included in this systematic review and meta-analysis. The pooled prevalence of diabetic foot ulcer among patients with diabetes mellitus was 13.35 % (95 % CI 10.86, 15.67). Rural residence (OR = 3.25, 95 % CI = 2.15-4.99), peripheral neuropathy (OR = 5.89, 95 % CI = 2.5-13.5), poor self-care practice (OR = 2.39, 95 % CI = 1.12-5.13), illness duration greater than 10 years (OR = 2.94, 95 % CI = 1.14, 7.63), and history of ulcer (OR = 6.07, 95 % CI = 1.68-21.9) were significantly associated with diabetic foot ulcers.</p><p><strong>Conclusion: </strong>Sub-Saharan Africa has a high prevalence of diabetic foot ulcers. Thus, emphasis should be given to Prevention, periodic foot examination, and early identification of risk factors.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"220 ","pages":"111975"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946355","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":"Discovery and exploration of adaptive immune response-related drug targets in diabetic retinopathy by Mendelian randomization.","authors":"Ning Gao, Jingming Li, Ting Wei, Qiaochu Cheng, Shan Gao, Yaguang Hu","doi":"10.1016/j.diabres.2025.111987","DOIUrl":"10.1016/j.diabres.2025.111987","url":null,"abstract":"<p><strong>Background: </strong>Persistent diabetes raises diabetic retinopathy (DR) risk, and management is challenging. Integrating transcriptomics and MR, this study provides a current reference for the clinical treatment of DR by identifying potential drug targets in adaptive immune response-associated genes (AIR-RGs).</p><p><strong>Methods: </strong>The GSE102485 dataset about AIR-RGs and DR was downloaded from a public database. Initially, the MR and Steiger test identified AIR-related candidate genes with causal associations to DR. Bayesian co-localization analysis pinpointed DR drug targets, followed by phenotype scanning for side effects. Functional enrichment and immune infiltration analyses elucidated target mechanisms in DR.</p><p><strong>Results: </strong>Identified 27 AIR-RGs associated with DR, with TRAV23DV6 (OR = 1.367, 95 % CI = 1.005-1.859, p = 0.0046) as a risk factor. Co-localization analysis confirmed TRAV23DV6's potential as a DR drug target. Phenotype scanning linked TRAV23DV6 to hepatocellular carcinoma, thromboembolism, and pyelonephritis, indicating potential side effects. TRAV23DV6 engages in adaptive immunity, autophagy, and antigen binding. DR involves infiltration of 22 immune cell types and activation of 16 immune functions related to TCR, BCR pathways, and TNF family. Correlation analysis shows high TRAV23DV6 expression, immune cell infiltration, and function activation may exacerbate DR.</p><p><strong>Conclusion: </strong>TRAV23DV6 has been identified as a potential drug target for DR, offering a new perspective for the treatment of this condition.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111987"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977972","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":"Applying 1-hour postload plasma glucose diagnostic criteria reveals high Progressive Risks of potential MASLD.","authors":"Long Teng, Ling Luo, Yanhong Sun, Wei Wang, Zhi Dong, Xiaopei Cao, Junzhao Ye, Bihui Zhong","doi":"10.1016/j.diabres.2024.111973","DOIUrl":"10.1016/j.diabres.2024.111973","url":null,"abstract":"<p><strong>Background: </strong>Recently, a 1-h PG value of ≥ 8.6 mmol/L, a more sensitive predictor of diabetes mellitus-related long-term cardiovascular complications than routine glucose markers, has been recommended as an additional diagnostic criterion for diabetes in the International Diabetes Federation Position Statement. However, its value in MASLD remains uncertain.</p><p><strong>Methods: </strong>Consecutive participants with imaging assessments of fatty liver and a 75-g oral glucose tolerance test, including 1154 participants with MASLD, 161 fulfilling the nonalcoholic fatty liver disease but not the MASLD diagnostic criteria (NAFLD-non-MASLD) and 1026 subjects with non-fatty liver, were retrospectively enrolled from June 2009 to May 2024.</p><p><strong>Results: </strong>Patients with MASLD or NAFLD-non-MASLD had higher 1-h PG levels than those with non-fatty liver (p < 0.001). In patients with MASLD or NAFLD-non-MASLD, 1-h PG ≥ 8.6 mmol/L was associated with the risk of moderate-to-severe steatosis (p < 0.001), ALT elevation (p < 0.001), advanced fibrosis (p = 0.03), and cardiovascular diseases (p < 0.001). Furthermore, NAFLD-non-MASLD patients with 1-h PG ≥ 8.6 mmol/L showed a higher prevalence of advanced fibrosis than MASLD patients with or without 1-h PG ≥ 8.6 mmol/L (p < 0.05).</p><p><strong>Conclusions: </strong>NAFLD-non-MASLD patients with 1-h PG ≥ 8.6 mmol/L are still at high risk of poor clinical outcomes. These findings support including 1-h PG ≥ 8.6 mmol/L as a component of the metabolic dysfunction definition.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111973"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885258","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":"Duration of physical activity required to Ameliorate hyperglycemia without causing hypoglycemia in type 1 diabetes: A T1DEXI adults and pediatric cohort analyses.","authors":"John Pemberton, Zoey Li, Robin L Gal, Lauren V Turner, Simon Bergford, Peter Calhoun, Michael C Riddell","doi":"10.1016/j.diabres.2024.111981","DOIUrl":"10.1016/j.diabres.2024.111981","url":null,"abstract":"<p><strong>Aims: </strong>To estimate physical activity (activity) duration required to lower glucose from above target range (>180 mg/dL) to within target range (TIR: 70-180 mg/dL) in individuals with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>Continuous glucose monitoring and activity data were collected from 404 adults (28-day observation) and 149 adolescents (10-day observation) with T1D. Activities (N = 1902) with a starting glucose between 181-300 mg/dL, duration 10-60 min, and no reported meals during activity were included in the analysis. Kaplan-Meier curves were used to estimate activity duration required to drop starting glucose levels from above to within TIR.</p><p><strong>Results: </strong>An overall starting glucose value of 181-199, 200-224, 225-249, and 250-300 mg/dL required an estimated activity duration of 15, 31, 59, and ≥ 60 min, respectively, to have a 50 % chance of reducing glucose to be within target range, with a 0-11 % incidence of hypoglycemia in the hour after activity. Activity duration requirements increased irrespective of starting glucose levels when glucose was trending upwards before activity and with zero bolus insulin on board at the start of activity. Adult and adolescent results were similar.</p><p><strong>Conclusions: </strong>Time-limited activity is an effective means of restoring TIR when hyperglycemia exists in adolescents and adults with T1D.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111981"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902719","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":"Association between sex, age, temporal trends, and glycemic control of 221,769 adults with type 2 diabetes in a multi-ethnic middle-income Asian country.","authors":"Swee Hung Ang, Lee-Ling Lim, Feisul Idzwan Mustapha, Eliana Ahmad, Sanjay Rampal","doi":"10.1016/j.diabres.2024.111976","DOIUrl":"10.1016/j.diabres.2024.111976","url":null,"abstract":"<p><strong>Aims: </strong>We examined the association between sex, age, temporal trends, and glycemic control among people with type 2 diabetes (T2D) in a multi-ethnic middle-income Asian country.</p><p><strong>Methods: </strong>Using the National Diabetes Registry (2011-2020), we analyzed data for 221,769 adult Malaysians with T2D.We used quantile regressions to estimate the association of sex, age, and their interaction on HbA_1clevels at the 5th, 50th, and 95thpercentile and logistic regression to estimate the odds of good control (HbA_1c < 7 %).</p><p><strong>Results: </strong>The participants were Malays (61.8 %), females (59.3 %), and aged 50-69 years (63.5 %). The median (interquartile range [IQR]) HbA_1c was 7.2 % (6.4 %, 8.9 %) for males and 7.3 % (6.4 %, 9.0 %) for females. The prevalence of good control was 42.8 % for males and 41.8 % for females. Glycemic control improved from 2011 to 2020 for both females and males above 40. Control significantly improved with age among both sexes. However, females had increasingly better control than men with increasing age (P_{Heterogeneity} < 0.001). The adjusted odds (95 % CI) of good control comparing females to males at 30, 50, and 70 years was 0.90 (0.81, 0.99), 0.93 (0.90, 0.97), and 1.12 (1.08, 1.16) respectively.</p><p><strong>Conclusions: </strong>A more aggressive approach to type 2 diabetes management is needed for both sexes, targeting especially the younger age groups, to improve glycemic control and reduce diabetes burden.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"111976"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914005","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}