Drugs & Aging最新文献

{"title":"Polypill Strategies for Cardiovascular Prevention in Older Adults: Evidence, Opportunities, and Implementation Challenges.","authors":"Ryan Cheikhali, Victoria Maksymiuk, Sara Elattar, Amro Aglan, Wilbert Aronow","doi":"10.1007/s40266-025-01243-z","DOIUrl":"10.1007/s40266-025-01243-z","url":null,"abstract":"<p><p>Cardiovascular disease remains the leading cause of morbidity and mortality among older adults, who often face unique challenges in preventive care due to multimorbidity, frailty, and polypharmacy. The polypill, a fixed-dose combination of multiple cardiovascular medications, has emerged as a promising strategy to improve adherence, simplify treatment, and reduce the burden of major cardiovascular events. This review aims to synthesize current evidence supporting polypill use in both primary and secondary prevention, with a particular focus on older populations. Landmark clinical trials such as TIPS, HOPE-3, PolyIran, and SECURE have demonstrated favorable outcomes related to blood pressure and lipid reduction, medication adherence, and cardiovascular event prevention. In addition, real-world data suggest improved cost-effectiveness and feasibility across diverse healthcare settings. Despite these benefits, implementation remains limited by barriers including inflexible dosing, provider hesitancy, variable guideline endorsements, and regulatory challenges. Special considerations in geriatric populations such as heightened sensitivity to adverse drug reactions and the need for individualized care further underscores the importance of thoughtful integration into practice. As the global population ages, strategic adoption of polypill-based prevention can help address health disparities, streamline cardiovascular care, and improve outcomes in older adults worldwide.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"933-943"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991739","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 Antipsychotic Dose with Surrogate Efficacy and Safety Outcomes in Hospitalized Older Adults: A Retrospective Cohort Study.","authors":"Nicole M Sarisky, Collin M Clark, Stephanie Seyse, Nicole E Cieri-Hutcherson, Ashley E Woodruff","doi":"10.1007/s40266-025-01250-0","DOIUrl":"https://doi.org/10.1007/s40266-025-01250-0","url":null,"abstract":"<p><strong>Introduction: </strong>Antipsychotics are frequently used in hospitalized older adults to manage agitation and delirium, despite limited supporting evidence and known risks. While guidelines recommend low doses and short durations, high doses remain common. This study evaluated the efficacy and safety of low-versus high-dose antipsychotics in hospitalized adults aged ≥ 65 years.</p><p><strong>Methods: </strong>This retrospective cohort study included patients from two hospitals within a single health system between August 2021 and August 2023. Patients were included if they received inpatient administration of haloperidol, olanzapine, quetiapine, risperidone, or ziprasidone and excluded for prior antipsychotic use, benzodiazepine use, psychiatric comorbidities, or prolonged intensive care unit (ICU) admission. Patients were stratified into low- and high-dose groups. Low doses were haloperidol 0.5-1 mg, olanzapine 2.5-5 mg, quetiapine 12.5-25 mg, risperidone 0.25-1 mg, or ziprasidone 10-20 mg, and doses were considered high if they were above the criteria for a low dose. The primary outcome was a surrogate marker of efficacy: antipsychotic redosing within 6 h. Secondary outcomes included length of stay (LOS), antipsychotic continuation at discharge, and possible antipsychotic-associated adverse events through 90 days post discharge as assessed through index and readmission records. Multivariable logistic regression was used to assess factors associated with antipsychotic redosing within 6 h.</p><p><strong>Results: </strong>A total of 305 patients were included (low dose: n = 176; high dose: n = 129). Redosing within 6 h occurred at similar rates in low versus high groups (n = 25 [14.2%] versus n = 18 [14.0%], p = 0.950). Multivariable regression showed haloperidol use (compared with quetiapine) was associated with higher odds of redosing. Adverse event rates were numerically higher in the high-dose group, including a greater incidence of inpatient pneumonia and mortality, though most deaths occurred in patients receiving palliative care.</p><p><strong>Conclusions: </strong>Low- and high-dose antipsychotics demonstrated similar short-term efficacy, but higher doses may carry increased risk of adverse events in hospitalized older adults. Clinicians should prioritize low-dose regimens and evaluate the necessity of antipsychotic use in this vulnerable population.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148357","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":"Anesthesia Considerations in Older Adults Undergoing Emergency Mechanical Thrombectomy for Acute Ischaemic Stroke.","authors":"Byrappa Vinay, Nitin Manohara, Amit Jain","doi":"10.1007/s40266-025-01246-w","DOIUrl":"https://doi.org/10.1007/s40266-025-01246-w","url":null,"abstract":"<p><p>Acute ischemic stroke (AIS) is a significant cause of morbidity and mortality among older adults, with its incidence, severity, and complication rates increasing with age. Endovascular thrombectomy (EVT) is the standard treatment for AIS due to a large vessel occlusion (LVO), but many landmark trials have excluded patients aged 80 years and older, resulting in a gap in the available evidence. Nonetheless, meaningful recovery is possible when successful recanalization is achieved, especially in patients with good pre-stroke functionality. When making EVT decisions for older adults, it is crucial to consider the unique challenges presented by this population. These challenges include age-related vascular changes, comorbidities, declining organ function, polypharmacy, altered drug responses, frailty, and baseline cognitive impairment. Anesthesiologists play a crucial role in optimizing outcomes through rapid assessment, careful physiological management, and effective multidisciplinary coordination. Both general anesthesia (GA) and conscious sedation (CS) are valid options for EVT, with the choice depending on patient factors, the complexity of the procedure, and the expertise of the institution. While GA may enhance recanalization rates and improve outcomes, it also carries increased risks such as delayed time from door to groin, hypotension, and a higher incidence of postoperative delirium and pneumonia. In contrast, CS may offer a safer alternative in selected cases, although it can limit the effectiveness of the procedure, potentially impacting reperfusion success. The impact of specific anesthetic agents on outcomes for older patients is still unclear. In addition, age-related changes in cardiovascular, respiratory, renal, and neurological functions, along with polypharmacy, contribute to an increased risk of hemodynamic instability and drug interactions. Older patients also face a higher risk of perioperative complications, such as delirium and cognitive dysfunction, which complicate the management of anesthesia. However, anesthesiologists can positively influence outcomes by managing modifiable factors such as, maintaining blood pressure within guideline-based targets, keeping blood glucose levels between 140 and 200 mg/dL, ensuring normoxia and normocapnia, avoiding hyperthermia, and anticipating technical challenges posed by tortuous, atherosclerotic vessels and resistant clots. This review aims to thoroughly examine anesthesia management for EVT in older adults.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130272","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":"Characteristics of Late-Onset Systemic Lupus Erythematosus: Clinical Manifestations and Diagnostic and Treatment Challenges.","authors":"Natsuki Sakurai, Ryusuke Yoshimi, Hideaki Nakajima","doi":"10.1007/s40266-025-01245-x","DOIUrl":"https://doi.org/10.1007/s40266-025-01245-x","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is widely recognized as a systemic autoimmune disease predominantly affecting young women. However, since the initial report in 1959, cases of late-onset SLE have been increasingly documented. Late-onset SLE, commonly defined as disease onset at or after 50 years of age, sometimes exhibits different clinical characteristics compared with the typical SLE phenotype. There is a higher proportion of male patients and a lower frequency of skin rash, renal involvement, neuropsychiatric manifestations, hypocomplementemia, and anti-DNA antibody seropositivity, whereas serositis is observed more frequently. Furthermore, although disease activity in late-onset SLE is generally lower, it is associated with more severe irreversible organ damage and a poorer prognosis. Data shows that the use of immunosuppressive drugs in late-onset SLE is lower, which may be due to delay in diagnosis, different manifestations, and the presence of comorbidities. However, the clinical situation would have merited their use. Given the aging of the global population, the prevalence of late-onset SLE is expected to increase. A thorough understanding of the characteristics of late-onset SLE may facilitate early diagnosis and appropriate treatment, ultimately improving patient outcomes. This review summarizes the reported characteristics of late-onset SLE and discusses the key considerations for its accurate diagnosis and effective management.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063863","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":"Reduced-Dose Edoxaban in Patients Aged ≥ 80 Years: A Single-Center Real-World Analysis.","authors":"Ruiqi Zhang, Jiali Du, Meilin Liu","doi":"10.1007/s40266-025-01247-9","DOIUrl":"10.1007/s40266-025-01247-9","url":null,"abstract":"<p><strong>Background: </strong>Optimal anticoagulation strategies in octogenarians remain controversial owing to age-related risks of thromboembolism and bleeding. This study evaluates real-world outcomes of reduced-dose edoxaban (15-30 mg daily) in very old populations.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 217 patients (aged ≥ 80 years) receiving edoxaban at Peking University First Hospital (2022-2023). Patients were stratified by dosage (30 mg once daily [QD] [n = 95] versus 15 mg QD [n = 122]). Outcomes included pharmacodynamics (anti-Xa levels), clinical endpoints (bleeding, thrombosis, and mortality), and survival analysis.</p><p><strong>Results: </strong>The 15-mg-QD group was older (90.0 versus 85.8 years, P = 0.001) and had reduced activities of daily living (ADL) scores (65.5% versus 82.6, P = 0.003) and reduced estimated glomerular filtration rate (eGFR) (58.6 versus 62.6 mL/min/1.73 m², P = 0.005). Anti-Xa peak levels were 0.56 ± 0.25 IU/mL (30 mg) versus 0.35 ± 0.15 IU/mL (15 mg). Over 15.8 ± 9.8 months follow-up, mortality was reduced in the 30-mg group (0.7% versus 3.5%, P = 0.044), with comparable bleeding (3.5% overall) and thrombosis (0.7%) rates.</p><p><strong>Conclusions: </strong>Reduced-dose edoxaban demonstrates a favorable safety-efficacy profile in advanced-age patients, necessitating comprehensive bleeding-ischemic risk assessment to optimize individualized anticoagulation regimens.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052475","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":"Medication Non-adherence in Older Adults: Underlying Factors, Potential Interventions and Outcomes.","authors":"Elstin Anbu Raj Stanly, Rajesh Vilakkathala, Johnson George","doi":"10.1007/s40266-025-01249-7","DOIUrl":"https://doi.org/10.1007/s40266-025-01249-7","url":null,"abstract":"<p><p>Polypharmacy is very common among older adults and is associated with poor health outcomes. This scoping review aimed to understand the underlying factors for poor medication taking by older patients and potential solutions to mitigate these risks. The ability to take medications and adherence are affected by various factors related to patients, treatments, health conditions and socio-demographics, healthcare providers and the healthcare systems. Educational and behavioural interventions are used alone or in combination for the optimisation medication use. Medication review and deprescribing, including regimen simplification, by trained practitioners has the potential to enhance patient safety and reduce healthcare costs. Engaging the patient and family may bring about additional benefits. Various technology-based interventions to promote self-efficacy are evolving and are used to support consumer self-management.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033040","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":"Medication Use and Quality of Life in Older Adults with Personality Disorders.","authors":"Julie E M Schulkens, Sebastiaan P J van Alphen, Lara Stas, Mark A Louter, Frans R J Verhey, Sjacko Sobczak","doi":"10.1007/s40266-025-01244-y","DOIUrl":"https://doi.org/10.1007/s40266-025-01244-y","url":null,"abstract":"<p><strong>Background: </strong>Medication use is increasing in psychiatric populations, particularly those with personality disorders (PDs). Older adults with PDs are at higher risk for adverse drug reactions (ADRs), which may interfere with daily functioning.</p><p><strong>Objectives: </strong>This study aimed to describe medication use and health-related quality of life (HR-QOL) in older adults with PDs compared with control groups and to evaluate predictors of medication use and HR-QOL.</p><p><strong>Methods: </strong>The PhArmacotherapy aND pOlypharmacy in oldeR Adults (PANDORA) study is a Dutch multicenter cross-sectional study including 77 older adults with PDs (OA-PD), 54 younger to middle-aged adults with PDs (A-PD), and 88 healthy older adults (OA-H). Medication use was assessed via participant questionnaires and verified against electronic health records for patients. HR-QOL was measured using the EQ-5D-3L (visual analog scale [VAS] and utility score). Statistical analyses were performed with general linear models.</p><p><strong>Results: </strong>Polypharmacy (≥ 5 medications daily) was present in 55.8% of the OA-PD group. OA-PD used more psychotropic and somatic medications than OA-H (b = - 1.555, p < 0.001 and b = - 1.341, p < 0.001, respectively) and A-PD (b = - 0.753, p < 0.001 and b = - 2.128, p < 0.001, respectively). Medication use was predicted by the number of psychiatric and somatic diagnoses. OA-PD reported lower EQ-VAS (b = 20.659, p < 0.001) and lower EQ-utility scores (b = 0.351, p < 0.001) compared with OA-H. ADRs, rather than the number of medications, significantly predicted HR-QOL (p < 0.001).</p><p><strong>Conclusions: </strong>Both somatic and psychotropic medication use is highly prevalent in OA-PD. OA-PD report lower HR-QOL compared with OA-H, in which ADRs may be a mediating factor. These findings underline the importance of regular medication reviews in older adults with PDs. Future research should investigate longitudinally the effect of deprescribing on HR-QOL in this population.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946872","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":"Pain in Osteoporosis: Current and Future Strategies.","authors":"Giada Barresi, Cecilia Oliveri, Nunziata Morabito, Herbert Ryan Marini, Anastasia Xourafa, Agostino Gaudio, Gabriella Martino, Letteria Minutoli, Antonino Catalano","doi":"10.1007/s40266-025-01225-1","DOIUrl":"10.1007/s40266-025-01225-1","url":null,"abstract":"<p><p>Osteoporosis is the most common metabolic bone disease and the main cause of fractures in older adults. Although it is commonly described as a silent disease, the bone pain caused by fragility fractures is its main symptom. Besides acute pain, fragility fractures may trigger a sequence of events that perpetuate and progress into chronic pain. The pathogenesis of musculoskeletal pain in patients with osteoporosis is complex and largely depends on skeletal and muscular changes, unbalanced bone turn-over, alterations in bone innervation, and central sensitization. Pain, in the context of bone fragility, represents an outstanding contributor to functional limitation, disability, and impaired quality of life. Pain prevention is closely related to identification of osteoporosis risk factors and early diagnosis and treatment of bone fragility. The management of pain in patients with severe osteoporosis also benefits from a multidimensional approach combining nonpharmacological with pharmacological therapies (e.g., physical exercise, nutrition, analgesics, and anti-osteoporotic drugs, as appropriate). This review aims to examine the mechanisms of pain in osteoporosis and provide an evidence-based overview of current and emerging treatment strategies.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"821-836"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599714","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":"Comparison of Clinical Characteristics in Older-Onset and Common-Age-of-Onset Gout: A Prospective Gout Cohort Study.","authors":"Hyunsue Do, Chang-Nam Son, Hyo Jin Choi, In Ah Choi, Kichul Shin, Min Jung Kim, Sang-Hyon Kim, You-Jung Ha, Joong Kyong Ahn, Hyun-Ok Kim, Sung Won Lee, Chang Hoon Lee, Se Hee Kim, Kyeong Min Son, Ki Won Moon","doi":"10.1007/s40266-025-01240-2","DOIUrl":"10.1007/s40266-025-01240-2","url":null,"abstract":"<p><strong>Objectives: </strong>Gout is an inflammatory arthritis caused by monosodium urate crystal deposition in the joints. Its clinical presentation varies by age of onset. This study compared the clinical features and treatment patterns of older-onset gout and common-age-of-onset gout.</p><p><strong>Methods: </strong>We analyzed data from the Urate Lowering TheRApy in Gout registry. Eligible participants were aged ≥ 18 years and met the 2015 American College of Rheumatology/European League Against Rheumatism classification criteria for gout. Older-onset gout was defined as gout diagnosed at or after age 65 years, and common-age-of-onset gout as gout diagnosed before age 65 years. Demographics, clinical features, treatment patterns, quality of life, and laboratory findings were collected at baseline and 6 months.</p><p><strong>Results: </strong>Among 477 patients, 105 (22.0%) had older-onset gout and 372 (78.0%) had common-age-of-onset gout. The older-onset group included more women (25.7 versus 2.4%, P < 0.001) and showed higher frequencies of radiographic gout-related joint damage (erosion) (30.5 versus 19.6%, P = 0.018), comorbidities (e.g., hypertension, cardiovascular disease, chronic kidney disease, and malignancy), and glucocorticoid use for flare prophylaxis. In contrast, the common-age-of-onset group had higher body mass index (BMI), more frequent flares, unhealthier lifestyle habits (e.g., smoking, alcohol), and higher rates of nonsteroidal anti-inflammatory drug (NSAID) and benzbromarone use. Febuxostat was more frequently prescribed in the older-onset group (71.4 versus 58.9%, P = 0.019), while benzbromarone use was more common in the common-age-of-onset group (7.3 versus 0%, P = 0.004). The febuxostat dose was lower in the older-onset group. After 6 months, both groups showed similar follow-up adherence, flare frequency, and healthcare utilization.</p><p><strong>Conclusions: </strong>Older-onset gout and common-age-of-onset gout have distinct clinical characteristics, particularly in comorbidities, lifestyle factors, and treatment patterns. Gout management should be tailored on the basis of age at onset.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"853-862"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820923","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":"Charcot foot disease: A new approach.","authors":"Michal Dubský, Robert Bém, Dominika Sojáková, Vladimira Fejfarová, Michael Hughes, Edward B Jude","doi":"10.1007/s40266-025-01234-0","DOIUrl":"10.1007/s40266-025-01234-0","url":null,"abstract":"<p><p>Charcot neuropathic osteoarthropathy (CNO) is a condition that develops in the presence of neuropathy, most commonly diabetes-related neuropathy. Owing to the neuropathy, microtrauma to the bones occur without the individual feeling them. With continued walking, bone inflammation, resorption, microfractures and structural changes occur in the bones, which result in irreversible deformities. Diagnosing this condition is often difficult and requires advanced imaging techniques, such as scintigraphy or magnetic resonance imaging, as X-ray changes may not be specific. Treatment of CNO includes immobilization, offloading, recalcification (supplementation of vitamin D and calcium) and in the most advanced cases, surgical treatment. This narrative review aims to synthesize the recent research and clinical implications relating to Charcot foot to help healthcare professionals to stay up-to-date in this relevant topic.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"837-851"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820922","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}