Ana Paula Bravo-Garcia , Bridget E Radford , Rebecca C Hall , Sophie C Broome , Nicolin Tee , Bronte Arthur , Kristel Janssens , Rich D Johnston , Shona L Halson , Brooke L Devlin , John A Hawley , Evelyn B Parr
{"title":"Combined effects of time-restricted eating and exercise on short-term blood glucose management in individuals with Type 2 Diabetes Mellitus: The TREx study, a randomised controlled trial","authors":"Ana Paula Bravo-Garcia , Bridget E Radford , Rebecca C Hall , Sophie C Broome , Nicolin Tee , Bronte Arthur , Kristel Janssens , Rich D Johnston , Shona L Halson , Brooke L Devlin , John A Hawley , Evelyn B Parr","doi":"10.1016/j.diabres.2025.112081","DOIUrl":"10.1016/j.diabres.2025.112081","url":null,"abstract":"<div><h3>Aims</h3><div>Time-restricted eating (TRE) is a chrono-nutrition strategy where the daily ‘eating window’ is reduced to 8–10 h. We investigated the acute (14-h) effects of TRE, with and without post-meal exercise, on blood glucose and insulin concentrations in people with type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>Fourteen participants (5 F, 9 M; HbA1c: 7.6 ± 1.0%) completed four conditions in this randomised crossover study: CON (eating window, 0800–2000 h), CON with exercise (CON + Ex; 0800–2000 h + 15 min walking at 60% VO<sub>2</sub>peak, 45 min post-meal), TRE (eating window 1000–1800 h), and TRE with exercise (TRE + Ex, 1000–1800 h + 15 min walking as per CON + Ex), with standardised meals. Venous blood samples were collected at 26-timepoints and analysed for glucose and insulin concentrations. Statistical analysis used linear mixed-effects models with P < 0.05.</div></div><div><h3>Results</h3><div>Reducing the eating window had little effect on plasma glucose 14-h area under the curve (AUC). Exercise reduced insulin 14-h AUC (P=0.01) with no additive effect of TRE.</div></div><div><h3>Conclusion</h3><div>Post-meal exercise lowered 14-h insulin AUC, neither 8-h TRE nor post-meal exercise altered 14-h blood glucose compared with 12-h eating window. Future work should focus on long-term effects of TRE combined with exercise for enhancing blood glucose in people with type 2 diabetes mellitus.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112081"},"PeriodicalIF":6.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596355","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}
Takuya Yamanaka , Mary Christine Castro , Sharon E. Cox , Yoko V. Laurence , Anna Vassall
{"title":"Cost-effectiveness of diabetes screening and diagnosis services for people with TB in the Philippines","authors":"Takuya Yamanaka , Mary Christine Castro , Sharon E. Cox , Yoko V. Laurence , Anna Vassall","doi":"10.1016/j.diabres.2025.112085","DOIUrl":"10.1016/j.diabres.2025.112085","url":null,"abstract":"<div><h3>Aim</h3><div>Tuberculosis (TB) remains a leading cause of death in low- and middle-income countries, and diabetes is a known risk factor for progression to active TB disease. While the Philippines national strategic plan for TB aims to screen 90 % of TB cases for diabetes, the cost-effectiveness of screening is not well known.</div></div><div><h3>Methods</h3><div>We constructed a decision tree model to assess the cost-effectiveness of providing diabetes testing for 90% of people with an unknown diabetes status at their TB diagnosis and subsequent routine diabetes care, compared to the scenario of providing TB treatment only. Cost-effectiveness of the intervention was assessed from the provider and societal perspectives.</div></div><div><h3>Results</h3><div>The intervention was cost saving. At a willingness to pay threshold per disability-adjusted-life-year of 50 % of gross domestic product per capita, the probability of the intervention being cost saving was 99 % from the provider and societal perspectives in people aged ≥18 years. The probability was highest in people with BMI >18.5 kg/m<sup>2</sup> and in those aged >45 years.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that providing diabetes care for people with TB will be cost saving, and the intervention is likely to be most cost saving in people with BMI >18.5 kg/m<sup>2</sup> or those aged >45 years.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112085"},"PeriodicalIF":6.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596418","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}
R. Asaad Baksh , Sarah E. Pape , Li F. Chan , Rory Sheehan , Adam White , Umesh Chauhan , Martin C. Gulliford , André Strydom
{"title":"Type 2 diabetes mellitus in people with intellectual disabilities: Examining incidence, risk factors, quality of care and related complications. A population-based matched cohort study","authors":"R. Asaad Baksh , Sarah E. Pape , Li F. Chan , Rory Sheehan , Adam White , Umesh Chauhan , Martin C. Gulliford , André Strydom","doi":"10.1016/j.diabres.2025.112090","DOIUrl":"10.1016/j.diabres.2025.112090","url":null,"abstract":"<div><h3>Aims</h3><div>People with intellectual disabilities are at higher risk of type 2 diabetes mellitus (T2DM) but there are currently gaps in our understanding related to risk of new onset, care of T2DM and complications.</div></div><div><h3>Methods</h3><div>We examined electronic health-record data from Jan 2010 to May 2022 in 189,172 people with intellectual disabilities and 306,697 age, sex and family practice matched controls. We estimated incidence rates per 1,000-person-years, incidence rate ratios (IRRs), risk factors for T2DM (odds ratio, OR), indicators of quality of care and complications (hazard ratio, HR).</div></div><div><h3>Results</h3><div>Incidence of T2DM in people with intellectual disabilities was 3.74 compared to 2.21 per 1,000 person-years in controls. After allowing for the younger age of T2DM onset in intellectual disabilities, the adjusted IRR was 6.91 (95 % CI 5.81–8.22). Impaired mobility was associated with T2DM incidence in people with intellectual disabilities (OR = 7.72, 5.87–10.15). People with intellectual disabilities received blood tests for HbA1c and cholesterol, and eye and foot examinations less often; and had a 12 % higher risk of developing macrovascular complications.</div></div><div><h3>Conclusions</h3><div>People with intellectual disabilities are at increased risk of T2DM at younger ages, have specific risk factors, experience inequities in care and are at risk for macrovascular complications.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112090"},"PeriodicalIF":6.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584888","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}
Jia-Ai Yeh , Yu-Chang Liu , Amy Huaishiuan Huang , Carol Chiung-Hui Peng , Ching-Hui Loh , Kashif M. Munir , Huei-Kai Huang
{"title":"SGLT2 inhibitors and nephrolithiasis risk in patients with type 2 diabetes: A cohort study and meta-analysis","authors":"Jia-Ai Yeh , Yu-Chang Liu , Amy Huaishiuan Huang , Carol Chiung-Hui Peng , Ching-Hui Loh , Kashif M. Munir , Huei-Kai Huang","doi":"10.1016/j.diabres.2025.112088","DOIUrl":"10.1016/j.diabres.2025.112088","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to evaluate the relationship between sodium-glucose cotransporter 2 inhibitor (SGLT2i) use and nephrolithiasis risk.</div></div><div><h3>Methods</h3><div>In this real-world cohort study, we analyzed electronic health records from the TriNetX Analytics Network, which includes patients from 64 U.S. healthcare organizations. Adult patients with type 2 diabetes (T2D) who initiated SGLT2is, dipeptidyl peptidase-4 inhibitors (DPP4is), or glucagon-like peptide-1 receptor agonists (GLP-1RAs) between January 2015 and December 2023 were included. Comparisons were made between SGLT2is and DPP4is and between SGLT2is and GLP-1RAs. Patients were followed-up for up to 5 years. A <em>meta</em>-analysis was further conducted to synthesize available evidence.</div></div><div><h3>Results</h3><div>The cohort study included 500,000 patients (250,000 pairs) for SGLT2is vs. DPP4is comparisons and 482,284 patients (241,142 pairs) for SGLT2is vs. GLP-1Ras comparisons. The risk of nephrolithiasis was significantly lower in SGLT2i users compared with DPP4i (HR: 0.86; 95% CI: 0.83–0.90) and GLP-1RA users (HR: 0.90; 95% CI: 0.86–0.94). A <em>meta</em>-analysis combining our study with four additional real-world studies further supported these findings.</div></div><div><h3>Conclusions</h3><div>This study suggests that SGLT2is may provide benefits beyond glycemic control by reducing nephrolithiasis risk, offering an advantage when selecting glucose-lowering therapies for patients with T2D.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112088"},"PeriodicalIF":6.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584631","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":"Letter to \"Relationship between life's essential 8, vitamin D, and cardiometabolic outcomes\".","authors":"Wencheng Xu, Zhibao Sun, Qingbo Li","doi":"10.1016/j.diabres.2025.112089","DOIUrl":"https://doi.org/10.1016/j.diabres.2025.112089","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112089"},"PeriodicalIF":6.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584703","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}
Teresa Vanessa Fiorentino , Francesca De Vito , Resilde Maria Natale , Silvia Sergi , Mariangela Rubino , Velia Cassano , Elena Succurro , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti
{"title":"Reduced glomerular filtration rate in individuals with intermediate hyperglycemia and type 2 diabetes as defined by 1-hour post-load glucose levels according to the newly released IDF criteria","authors":"Teresa Vanessa Fiorentino , Francesca De Vito , Resilde Maria Natale , Silvia Sergi , Mariangela Rubino , Velia Cassano , Elena Succurro , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti","doi":"10.1016/j.diabres.2025.112075","DOIUrl":"10.1016/j.diabres.2025.112075","url":null,"abstract":"<div><h3>Aims</h3><div>Recently, the International Diabetes Federation (IDF) has recommended determination of 1 h-post-load glucose (PG) to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2DM). Herein, we investigate the implication of IDF recommendation in identifying subjects with chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>Estimated glomerular filtration rate (eGFR) was assessed on 2161 subjects classified on the basis of their fasting, 1 h and 2 h-PG, according to the IDF criteria, as having normal glucose tolerance (NGT), isolated impaired fasting glucose (iIFG), IH and T2DM.</div></div><div><h3>Results</h3><div>Prevalence of CKD (eGFR < 60 ml/min/1.73 m<sup>2</sup>) and mildly reduced kidney function (eGFR 90–60 ml/min/1.73 m<sup>2</sup>) progressively increased at worsening of glucose tolerance. In a logistic regression analysis adjusted for several cardio-metabolic confounders, individuals with iIFG and IH exhibited a 3.48- (95 %CI = 1.01–11.00, P = 0.05) and 3.69- (95 %CI = 1.42–9.60, P = 0.007) fold increased risk of having CKD compared to the NGT group. The risk for CKD was further increased in subjects with T2DM (OR = 3.93, 95 %CI = 1.36–10.66, P = 0.007). Additionally, participants with IH and T2DM had a 1.89-fold (95 %CI = 1.38–2.60, P < 0.0001) and 2.78-fold (95 %CI = 1.97–3.98, P < 0.0001) higher risk of mildly reduced GFR compared to the NGT group.</div></div><div><h3>Conclusions</h3><div>The 1 h-PG thresholds proposed by IDF as diagnostic for IH and T2DM are capable of identifying individuals at risk of kidney dysfunction.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112075"},"PeriodicalIF":6.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584710","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}
Jheng-Yan Wu , Wan‑Ling Tu , Tsung Yu , Kuang-Ming Liao , Yu-Min Lin
{"title":"Tirzepatide and major adverse limb events: Insights from a multicenter real-world analysis in PAD and diabetes patients","authors":"Jheng-Yan Wu , Wan‑Ling Tu , Tsung Yu , Kuang-Ming Liao , Yu-Min Lin","doi":"10.1016/j.diabres.2025.112083","DOIUrl":"10.1016/j.diabres.2025.112083","url":null,"abstract":"<div><h3>Aims</h3><div>Peripheral artery disease (PAD) is a major diabetic complication and a leading cause of amputation. While GLP-1 receptor agonists (GLP-1 RAs) provide cardiovascular and limb protection, the impact of tirzepatide, a dual GLP-1/GIP receptor agonist, on major adverse limb events (MALEs) remains unclear. This study assessed tirzepatide’s association with MALE risk in patients with PAD and diabetes using real-world data.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 8,046 propensity score-matched PAD patients with diabetes (4,023 on tirzepatide, 4,023 controls) from the TriNetX database. The primary outcome was MALEs, with secondary outcomes including all-cause mortality, acute stroke, acute myocardial infarction (AMI), and major adverse cardiovascular events (MACEs). Cox models and Kaplan-Meier curves were used for analysis.</div></div><div><h3>Results</h3><div>Tirzepatide significantly reduced MALE risk (HR: 0.44, 95 % CI: 0.33–0.59, p < 0.001) and was associated with lower mortality, stroke, and MACEs. AMI risk was similar between groups (HR: 0.85, p = 0.29). Subgroup analyses confirmed consistent findings, except in those with prior stroke.</div></div><div><h3>Conclusions</h3><div>Tirzepatide significantly lowered MALE risk in PAD patients with diabetes, suggesting a potential therapeutic role. Further prospective studies are needed to validate these findings.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112083"},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548807","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":"Letter to “Daytime napping and risk of incident main adverse cardiovascular events and mortality among adults with type 2 diabetes”","authors":"Siyu Qiao , Yuelai Chen","doi":"10.1016/j.diabres.2025.112084","DOIUrl":"10.1016/j.diabres.2025.112084","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"223 ","pages":"Article 112084"},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572434","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}
Hashmat Sayed Zohori Bahrami , Peter Godsk Jørgensen , Jens Dahlgaard Hove , Ulrik Dixen , Line Jee Hartmann Rasmussen , Jesper Eugen-Olsen , Peter Rossing , Magnus T. Jensen
{"title":"Association between interleukin-6, suPAR, and hsCRP with subclinical left ventricular dysfunction in type 1 diabetes: The Thousand & 1 study","authors":"Hashmat Sayed Zohori Bahrami , Peter Godsk Jørgensen , Jens Dahlgaard Hove , Ulrik Dixen , Line Jee Hartmann Rasmussen , Jesper Eugen-Olsen , Peter Rossing , Magnus T. Jensen","doi":"10.1016/j.diabres.2025.112071","DOIUrl":"10.1016/j.diabres.2025.112071","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the association between chronic inflammation and subclinical left ventricular dysfunction in type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>In a cross-sectional study of individuals with T1D without known heart disease, interleukin-6 (IL-6), soluble-urokinase-plasminogen-activator-receptor (suPAR), and high-sensitivity C-reactive-protein (hsCRP) were examined for associations with echocardiographic E/e′ (primary outcome) and global longitudinal strain (GLS) (secondary outcome). We adjusted for several clinical variables in linear regression analysis, including N-terminal pro–B-type natriuretic peptide (NT-proBNP). The biomarkers were categorized as elevated/non-elevated based on their upper quartiles.</div></div><div><h3>Results</h3><div>Of 962 individuals (52 % male, mean age 49 ± 14 years), mean E/e′ was 7 ± 3 and GLS 18 ± 3. In fully adjusted models, all biomarkers were each associated with increased E/e′: beta coefficients for IL-6 0.2 (95 % confidence intervals: 0.1–0.3, P = 0.001), suPAR 0.5 (0.1–0.7, P = 0.011), and hsCRP 0.1 (0.0–0.2, P = 0.023). Combining biomarkers showed stronger associations: elevated IL-6 and suPAR 1.3 (0.7–2.0, P < 0.001), elevated all three 1.9 (1.1–2.7, P < 0.001). Results were similar for decreased GLS with IL-6–0.4 (−0.7 to 0.0, P = 0.039), IL-6 and hsCRP −1.0 (−1.7 to −0.4, P = 0.007), all three −1.1 (−2.0 to −0.3, P = 0.009).</div></div><div><h3>Conclusions</h3><div>Inflammatory biomarkers are independently associated with subclinical left ventricular dysfunction. Chronic inflammation may contribute to the development of myocardial dysfunction in T1D.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112071"},"PeriodicalIF":6.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566317","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":"Characterisation of transfusion-dependent prediabetes using continuous glucose monitoring: The Haemoglycare study","authors":"Angela Zanfardino , Gulsum Ozen , Giorgia Ippolito , Domenico Roberti , Silverio Perrotta , Dario Iafusco , Emanuele Miraglia del Giudice , Maddalena Casale","doi":"10.1016/j.diabres.2025.112076","DOIUrl":"10.1016/j.diabres.2025.112076","url":null,"abstract":"<div><h3>Aims</h3><div>Continuous Glucose Monitoring (CGM) may help detect early dysglycemia in Transfusion-Dependent Thalassemia (TDT) patients, though previous reports suggest it may overestimate prediabetes prevalence. This study analyzed glucose-related metrics in TDT patients with negative diabetes screening tests, compared with healthy controls. A secondary objective was to assess the association between TAR140 > 6 % and clinical/laboratory characteristics of patients.</div></div><div><h3>Methods</h3><div>Patients resulted negative to the screening tests for glucose disorders were compared to healthy controls using CGM system for 7 days.</div></div><div><h3>Results</h3><div>This study involved 39 participants (19 patients, 20 controls). HbA1c was falsely elevated in patients, despite normal mean glucose and GMI. Standard deviations and coefficients of variation were higher in patients than controls.</div><div>No healthy control but 7/19 (37 %) TDT patients presented the interval TAR140 > 6 %. Significant differences were observed between “really euglycaemic” TDT patients (TAR140 ≤ 6 %) and “hyperglycemic” ones (TAR140 > 6 %) in terms of GMI, mean glucose and TAR140%. Comparing the glucose metrics of TDT euglycaemic patients (TAR140 ≤ 6 %) and healthy controls, no significant difference was reported. No differences in iron overload indexes were found between the hyperglycemia and euglycemia groups.</div></div><div><h3>Conclusions</h3><div>CGM reliably detects prediabetes in 37 % of TDT patients. TAR140 > 6 % may serve as a diagnostic cutoff.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"222 ","pages":"Article 112076"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540526","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}