Diabetology International最新文献

{"title":"Decoding thyroid: liver cross talk in type 2 diabetes mellitus-an MASLD perspective.","authors":"Sowmiya Subramani, S Gayathri, Karpagavel Lakshmanan","doi":"10.1007/s13340-026-00916-3","DOIUrl":"10.1007/s13340-026-00916-3","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) has emerging major global health problem and is closely linked to metabolic abnormalities. Given, central role of thyroid hormones in lipid metabolism and overall energy balance, and by focusing on thyroid hormone sensitivity rather than hormone levels alone, this study seeks to provide new insights into the role of thyroid hormone resistance in the development of MASLD.</p><p><strong>Aim: </strong>To evaluate the relationship between thyroid hormone sensitivity indices and the presence of MASLD in euthyroid adults with Type 2 Diabetes Mellitus.</p><p><strong>Methods: </strong>A total of 534 euthyroid participants with T2DM were enrolled at Chettinad Hospital and Research Institute. Participants were divided into two groups based on the presence or absence of MASLD and further categorized into quartiles according to each Indices. Thyroid hormone sensitivity was assessed using multiple indices, including the FT3/ FT4 ratio, TT3RI, TT4RI, TSHI, and TFQI_FT3 and TFQI_FT4. The associations between indices and MASLD were evaluated using regression analyses.</p><p><strong>Results: </strong>MASLD prevalence increased with higher levels of FT3/ FT4 ratio, TT3RI, and TFQI_FT3. After adjusting for potential confounders, elevated FT3/FT4 and TFQI_FT3 remained independent risk factors for MASLD. The association between FT3/FT4, TFQI_FT3 and MASLD was particularly more pronounced in participants aged ≤ 40 years. Mediation analysis suggested that the TyG index partially mediated the relationships between FT3/FT4, TFQI_FT3, and MASLD.</p><p><strong>Conclusion: </strong>Higher FT3/FT4 and TFQI_FT3 levels were strongly associated with the prevalence of MASLD in euthyroid individuals. This relationship was partially mediated by the TyG index, suggesting a role for insulin resistance in linking thyroid hormone sensitivity to MASLD.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"63"},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of distinct metabolic subtypes among Japanese men with prediabetes: a data-driven cluster analysis from the J-DOIT1 study.","authors":"Naoki Sakane, Kaoru Takahashi, Masayuki Domichi, Akiko Suganuma, Hideshi Kuzuya","doi":"10.1007/s13340-026-00917-2","DOIUrl":"10.1007/s13340-026-00917-2","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>To identify distinct metabolic subtypes among Japanese men with prediabetes and evaluate their association with the future risk of type 2 diabetes.</p><p><strong>Methods: </strong>A data-driven cluster k-means cluster analysis was conducted in 2,172 men with prediabetes, defined as a fasting plasma glucose (FPG) concentration of 100-125 mg/dL (5.6-6.9 mmol/L) from the JDOIT-1 cohort. Four biochemical indicators-body mass index (BMI), fasting plasma glucose (FPG), alanine aminotransferase (ALT), and non-HDL cholesterol-were standardized and used for clustering. The optimal number of clusters (k = 3) was determined using the elbow method. The association between cluster membership and 5-year diabetes-free survival was examined.</p><p><strong>Results: </strong>Three metabolic phenotypes were identified: Cluster 1 (MRP, <i>n</i> = 1,149), metabolically resilient; Cluster 2 (OFIP, <i>n</i> = 581), obesity- and insulin-resistant; and Cluster 3 (NOHP, <i>n</i> = 442), non-obese hyperglycemic. Annual diabetes incidence rates were 0.70%, 2.73%, and 6.73% in the MRP, OFIP, and NOHP groups, respectively (<i>p</i> < 0.001). Compared with MRP, adjusted hazard ratios were 3.95 (95% CI 2.64-5.92) for OFIP and 9.81 (95% CI 6.75-14.26) for NOHP. Lifestyle interventions significantly reduced diabetes risk only in the OFIP group (HR 0.59, 95% CI 0.36-0.97, <i>p</i> = 0.037).</p><p><strong>Conclusions/interpretation: </strong>Unsupervised clustering identified distinct metabolic subtypes predictive of diabetes onset. Diabetes risk increased progressively from metabolically resilient to insulin-resistant and hyperglycemic phenotypes. Targeted lifestyle interventions may be particularly effective in individuals with obesity- and dyslipidemia-related insulin resistance.</p><p><strong>Trial registration: </strong>University hospital Medical Information Network (UMIN) Center UMIN000000662)、Approval date 11 December 2006.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-026-00917-2.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"62"},"PeriodicalIF":1.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and validation of tolerogenic dendritic cells-related biomarkers in diabetic retinopathy.","authors":"Chun-Yi Wei, Song-Man Li, Ling-Juan Liu, Jun-Peng Huang, Xiao-Hui Lai, Li-Juan Yang, Wen-Wang Liang","doi":"10.1007/s13340-026-00914-5","DOIUrl":"10.1007/s13340-026-00914-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a primary microvascular complication of diabetes. Its pathogenesis is associated with chronic inflammation and immune responses. While tolerogenic dendritic cells (tolDCs) are critical for suppressing excessive inflammation and maintaining immune homeostasis, their function in DR is not well characterized.</p><p><strong>Objective: </strong>To identify biomarkers associated with tolDCs in DR and to explore their mechanisms.</p><p><strong>Methods: </strong>Biomarkers were identified from public databases using differential analysis, machine learning (LASSO regression analysis and Random Forest analysis), and expression validation. Their mechanisms were then explored through enrichment analysis and immune infiltration, and ultimately validated by reverse transcription-quantitative PCR (RT-qPCR) on clinical blood samples.</p><p><strong>Results: </strong>A total of 2096 differentially expressed genes (DEGs)1 were identified between DR and control groups. By intersecting with 6267 tolDCs-related genes, 51 key candidates were selected. Machine learning and expression validation further pinpointed two biomarkers: transcription factor EC (TFEC) and chromatin modifying protein 2 A (CHMP2A). Gene Set Enrichment Analysis (GSEA) showed significant enrichment of TFEC in 994 pathways and CHMP2A in 748, with co-enriched pathways including apoptosis, VEGFA-VEGFR2 signaling, and VEGF signaling. Analysis identified eight altered immune cell types; TFEC correlated strongest with activated NK cells (cor = - 0.49, <i>p</i> < 0.001), while CHMP2A correlated with resting mast cells (cor = 0.49, <i>p</i> < 0.001). RT-qPCR confirmed TFEC upregulation and CHMP2A downregulation in DR, validating the bioinformatic results.</p><p><strong>Conclusion: </strong>TFEC and CHMP2A are potential biomarkers involved in DR pathogenesis via tolDCs.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"61"},"PeriodicalIF":1.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase angle, extracellular to intracellular water ratio, and advanced glycation end products according to four sarcopenia categories and in relation to muscle strength/mass in elderly out-patients with diabetes.","authors":"Toshihiro Amagawa, Hiroki Yokoyama, Yumiko Teramoto, Youko Fujimaki, Atsushi Ohno, Hiroshi Takamura","doi":"10.1007/s13340-026-00894-6","DOIUrl":"10.1007/s13340-026-00894-6","url":null,"abstract":"<p><strong>Objective: </strong>Sarcopenia is classified into normal, presarcopenia, dynapenia, and sarcopenia according to muscle strength/mass. As assessment methods for muscle strength and mass, phase angle (PhA), extracellular water/intracellular water ratio (ECW/ICW), and advanced glycation end products (AGEs) have been developed. We investigated the proportions in elderly outpatients with diabetes and elucidate clinical characteristics, including PhA, ECW/ICW, and AGEs among the four groups.</p><p><strong>Methods: </strong>A cross-sectional study was performed in 695 patients with diabetes aged 65 years or older, who were classified according to the classification proposed by the Asian Working Group for Sarcopenia. Clinical characteristics of the four groups were compared by ANOVA. Associations of grip strength and skeletal muscle index (SMI) with PhA, ECW/ICW, and AGEs and interrelations among grip strength, SMI, PhA, ECW/ICW, and AGEs were analyzed by multiple linear regression analyses.</p><p><strong>Results: </strong>Proportions of those (male/female, %) classified as normal, presarcopenia, dynapenia, and sarcopenia were 42.3/42.9, 30.3/26.6, 19.9/21.0, and 7.4/9.4, respectively. In order from normal, presarcopenia, dynapenia, and sarcopenia, age, ECW/ICW, and AGEs increased, while grip strength, gait speed, and PhA decreased (<i>p</i> < 0.001). Grip strength had significant associations with PhA, ECW/ICW, and AGEs independent of the effect of age, sex, and SMI. SMI had significant associations with PhA and ECW/ICW, but not AGEs. ECW/ICW was independently associated with both grip strength and SMI, together with PhA and AGEs.</p><p><strong>Conclusions: </strong>PhA, ECW/ICW, and AGEs were significantly different according to the four sarcopenia groups, and ECW/ICW was independently associated with both grip strength and SMI.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"58"},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term efficacy and safety of sensor-augmented pump for type 1 diabetes.","authors":"Satoshi Takagi, Junnosuke Miura, Mikako Takita, Shota Mochizuki, Kanako Shimura, Sari Hoshina, Hiroko Takaike, Tetsuya Babazono","doi":"10.1007/s13340-026-00908-3","DOIUrl":"10.1007/s13340-026-00908-3","url":null,"abstract":"<p><strong>Aims/introduction: </strong>To evaluate the real-world efficacy of sensor-augmented pump (SAP) for long-term glycemic control and glycemic variability indices.</p><p><strong>Materials and methods: </strong>This was a single-center, retrospective, observational study that included individuals with type 1 diabetes who switched from multiple daily injections to SAP or continuous subcutaneous insulin infusion (CSII). Changes in HbA1c and body weight up to 3 years were compared between the two groups. Changes in the proportion of participants in each group were also analyzed. In the SAP group, changes in continuous glucose monitoring (CGM) metrics were also examined.</p><p><strong>Results: </strong>There were 32 individuals in the SAP group and 39 in the CSII group. HbA1c decreased significantly in both groups at 1 year compared with the pre-introduction levels and was maintained for 3 years (- 0.83 ± 0.26%, <i>p</i> = 0.009, and - 0.86 ± 0.18%, <i>p</i> < 0.001, respectively); however, no significant differences were observed between the two groups after 3 years. Body weight increased significantly in the CSII group after 3 years (2.7 ± 0.9 kg in the SAP group, 2.7 ± 3.3 kg in the CSII group. No significant changes were observed in the CGM metrics.</p><p><strong>Conclusions: </strong>In individuals who started SAP or CSII, HbA1c decreased after 1 year and was maintained for 3 years.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-026-00908-3.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"55"},"PeriodicalIF":1.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in insulin resistance and basal insulin secretion among elderly men and women without a history of diabetes: a comparative study between obese and non-obese groups.","authors":"Hironari Sano, Yusaku Hayashi, Rimei Nishimura","doi":"10.1007/s13340-026-00904-7","DOIUrl":"10.1007/s13340-026-00904-7","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine sex differences in insulin resistance and basal insulin secretion among elderly individuals without a history of diabetes, comparing obese and non-obese groups in early elderly (aged 65-74 years) and late elderly (aged 75-89 years).</p><p><strong>Patients and methods: </strong>A total of 478 individuals (258 men and 220 women) who underwent comprehensive medical checkups at Tsunan Municipal Hospital between 2008 and 2014 were included. We investigated whether there were interactive effects between age and Body Mass Index (BMI) on homeostasis model assessment of insulin resistance (HOMA-IR) values and homeostasis model assessment of beta cell function (HOMA-β) values, and examined their associations with each factor using analysis of variance (ANOVA) and multivariate analysis.</p><p><strong>Results: </strong>In elderly men, elevated BMI was significantly associated with higher HOMA-IR values, and HOMA-β values were also significantly higher in the obese group than in the non-obese group. In contrast, among elderly women, HOMA-β values in the obese group were comparable to those in the non-obese group regardless of early and late elderly.</p><p><strong>Conclusions: </strong>In elderly men, insulin resistance associated with obesity was firmly present regardless of age, whereas, in elderly women, there is no difference in basal insulin secretion between the obese and non-obese groups irrespective of age.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"56"},"PeriodicalIF":1.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Discontinuation of oral semaglutide due to adverse effects: a database study on Japanese individuals with type 2 diabetes.","authors":"Mizuki Ishiguro, Rimei Nishimura","doi":"10.1007/s13340-026-00893-7","DOIUrl":"10.1007/s13340-026-00893-7","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s13340-025-00868-0.].</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"54"},"PeriodicalIF":1.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: A case-control study on the prevalence of depression and its biomarkers in Type 2 diabetes mellitus patients.","authors":"Haya Majid, Sajad Ul Islam, Sunil Kohli, Nidhi","doi":"10.1007/s13340-026-00891-9","DOIUrl":"10.1007/s13340-026-00891-9","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s13340-025-00858-2.].</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"53"},"PeriodicalIF":1.1,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in accuracy management of continuous glucose monitoring systems.","authors":"Keiichi Torimoto, Yosuke Okada","doi":"10.1007/s13340-026-00901-w","DOIUrl":"10.1007/s13340-026-00901-w","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) has markedly advanced diabetes care by enabling real-time visualization of glycaemic variability, prevention of hypoglycaemia, and direct integration into therapeutic decision-making. As CGM use expands in routine practice and automated insulin delivery systems, however, accuracy has become a critical determinant of treatment safety. This mini-review summarizes recent advances in CGM accuracy management across three major driving forces: (1) accelerating technological innovation, including multi-analyte sensors, non-invasive devices, and artificial intelligence (AI)-based signal processing; (2) systematization and international harmonization of regulatory accuracy frameworks, exemplified by U.S. Food and Drug Administration (FDA) integrated CGM (iCGM) and the proposed CGM in Europe (eCGM) concept; and (3) growing societal demands for transparency, including public disclosure of performance data and strengthened lot-to-lot evaluation. We outline the four key dimensions of CGM accuracy-analytical accuracy, clinical accuracy, trend accuracy, and precision. We then review the evolution of regional accuracy standards, focusing on highly influential frameworks in the United States and Europe. Key considerations in accuracy-study design are discussed, along with clinical risks associated with reduced accuracy optimization, and progress toward global standardization. Finally, we examine future directions in the era of next-generation technologies, such as multi-analyte and non-invasive sensors, AI-driven accuracy optimization, and progress toward international standardization. This review provides an overview of the current landscape and future directions of CGM accuracy management in an era where fluctuations in accuracy directly affect treatment safety. We aim to clarify the perspectives required in both clinical practice and research to ensure safe and effective use of CGM.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"46"},"PeriodicalIF":1.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a remote nutrition education on low-carbohydrate diet based in type 2 diabetes management: findings from a Brazilian primary care randomized controlled trial.","authors":"Gisely Sanagiotto Balbinot, Romulo Scariot Costódio, Geraldo Emílio Vicentini","doi":"10.1007/s13340-026-00898-2","DOIUrl":"10.1007/s13340-026-00898-2","url":null,"abstract":"<p><strong>Introduction: </strong>The difficulty of nutritional management of type 2 diabetes mellitus (T2DM) in primary health care in Brazil highlight the need for innovative strategies based on nutritional education.</p><p><strong>Methods: </strong>This study evaluated the effectiveness of an online educational intervention based on a low-carbohydrate diet for adults with T2DM and compared with conventional primary care management. A 16-week parallel randomized clinical trial enrolled 58 non-insulin users (mean age: 61 years), randomized to an Intervention (<i>n</i> = 29) or Control group (CG) (<i>n</i> = 29).</p><p><strong>Results: </strong>After 16 weeks, the Intervention Group (IG) showed significant reductions in HbA1c (- 0.91 ± 0.16%), fasting glucose (- 1.46 ± 0.06 mmol/L) and BMI (- 1.63 ± 0.8 kg/m²). In contrast, the CG exhibited significant increases in fasting glucose (+ 1.03 ± 0.17 mmol/L) and Body Mass index (+ 0.96 ± 0.5 kg/m²), with no significant HbA1c change (+ 0.25 ± 0.04%). Between-group comparisons favored the IG (<i>p</i> < 0.001), with net differences of 1.17% in HbA1c and 27.5% in fasting glucose. Additionally, 31% of IG participants achieved HbA1c ≤ 6.5%, whereas none of the CG participants achieved the HbA1c target. Use of oral antidiabetic medication decreased significantly in the <i>IG</i>; notably, this reduction was not observed in the <i>CG</i> (44.8% vs. 0%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In conclusion, the online education intervention improved glycemic control, reduced BMI, and lowered medication requirements, representing a promising strategy for T2DM management with potential to reduce complications and healthcare system costs.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 3","pages":"42"},"PeriodicalIF":1.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}