Endocrine Connections最新文献

{"title":"Sex-specific differences in the association of magnesium intake with femoral neck bone mineral density among older adults.","authors":"Bo Wang, Xin Tan, Xiaocong Yao, Zhongxin Zhu","doi":"10.1530/EC-25-0020","DOIUrl":"10.1530/EC-25-0020","url":null,"abstract":"<p><strong>Background: </strong>Magnesium plays a crucial role in bone metabolism, but its relationship with bone mineral density (BMD) remains complex and potentially sex-specific. This study aimed to investigate the association between magnesium intake and femoral neck BMD in older adults.</p><p><strong>Methods: </strong>We analyzed data from 1,343 adults aged ≥65 years in the 2017-2020 National Health and Nutrition Examination Survey, conducted by the National Center for Health Statistics in the United States. Magnesium intake was assessed using 24 h dietary recalls, and femoral neck BMD was measured by dual-energy X-ray absorptiometry. We employed weighted multivariate linear regression, subgroup analyses, and non-linear modeling techniques.</p><p><strong>Results: </strong>The fully adjusted model (controlling for demographic, clinical, lifestyle, nutritional, and biochemical factors) revealed a significant positive association between magnesium intake and femoral neck BMD (β = 0.0020 g/cm2 per 50 mg/d increase in magnesium intake, 95% CI: 0.0001, 0.0039, P = 0.042). This association was stronger in women and participants with BMI >30 kg/m2. In men, we identified a non-linear relationship with an inflection point at 480 mg/d magnesium intake, above which the positive association diminished.</p><p><strong>Conclusions: </strong>Our findings reveal complex, sex-specific relationships between magnesium intake and femoral neck BMD in older adults, highlighting the need for tailored dietary recommendations. The observed non-linear associations and threshold effects underscore the importance of optimal magnesium intake levels for bone health.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689599","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":"SLPI as a dedifferentiation biomarker in BRAFV600E-mutant papillary thyroid cancer.","authors":"Wei Luo, Xin Ji, Xiang-Yu Tan, Yu-Ting Li, Zhi-Qiang Zhang, Chui-Mian Zeng","doi":"10.1530/EC-25-0349","DOIUrl":"10.1530/EC-25-0349","url":null,"abstract":"<p><p>The BRAFV600E mutation drives papillary thyroid carcinoma (PTC) progression and therapy resistance, yet its downstream effectors remain incompletely characterized. Here, we identify secretory leukocyte protease inhibitor (SLPI) as a novel dedifferentiation biomarker in BRAFV600E-mutant PTC through integrated multi-omics analyses and functional validation. SLPI expression was significantly elevated in BRAFV600E-mutant tumors and correlated with advanced TNM stage, lymph node metastasis, and poor survival. Its overexpression was caused, mechanistically, by AP-1 transactivation and SLPI promoter hypomethylation. SLPI knockdown in PTC cells suppressed proliferation, increased anoikis sensitivity, and reduced FAK/AKT phosphorylation. Enrichment analysis linked high SLPI expression to PI3K/AKT pathway activation. Drug sensitivity prediction revealed that SLPI-high tumors were vulnerable to MAPK/AKT inhibitors. Notably, SLPI positively correlated with immune checkpoint genes, suggesting a potential immunosuppressive role. Our findings establish SLPI as a BRAFV600E-AP-1-FAK/AKT axis effector and propose its targeting as a strategy for PTC therapy.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752706","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":"Endoplasmic reticulum stress contributes to insulin resistance in Hashimoto's Thyroiditis.","authors":"Qing Zhou, Li Yong Zhang, Xue Lin Gao, Chao Chun Zou, Hui Liu","doi":"10.1530/EC-25-0158","DOIUrl":"10.1530/EC-25-0158","url":null,"abstract":"<p><p>Hashimoto thyroiditis (HT) is one of the most common autoimmune disorders. Patients with HT are more likely to be affected by insulin resistance, even euthyroid individuals. Endoplasmic reticulum (ER) stress is related to the pathogenesis of several immunological diseases, such as HT. Thus, the aim of the present study was to explore the potential mechanism and effect of HT on insulin resistance in HT model mice in vivo and to assess the role of ER stress in this process. In this study, euthyroid HT model mice were established by simultaneously giving high amounts of iodine in drinking water and subcutaneously injecting thyroglobulin emulsified with Freund's adjuvant twice. HT mice were treated with or without 4-phenylbutyric acid (4-PBA), an inhibitor of ER stress. We detected increased protein expression of binding immunoglobulin protein (Bip), activating transcription factor 6 (ATF6), and upregulated phosphor-inositol-requiring enzyme 1 (IRE1), phosphor- c-Jun N-terminal kinase (JNK) in the thyroid tissue and adipose tissue of HT mice. In addition, HT mice exhibited impaired insulin sensitivity, decreased insulin receptor substrate 1 (IRS-1) tyrosine phosphorylation and protein kinase B (AKT) phosphorylation in adipose tissue, but these effects were alleviated by 4-PBA. Moreover, HT mice had higher serum tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) levels than control mice did. Similarly, the ER stress inhibitor 4-PBA significantly decreased TNF-α and IL-6 levels compared with those in HT mice. These findings suggest that HT is related to the development of insulin resistance and that the mechanism may involve ER stress.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752705","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":"BRAF V600E and TERT promoter mutations and their impact on recurrent papillary thyroid carcinoma progression.","authors":"Nguyen Thi Nhung, Van Dong Hoang, Zhanna Mussazhanova, Hirokazu Kurohama, Le Ngoc Ha, Katsuya Matsuda, Van Phu Thang Nguyen, Ngo Thi Minh Hanh, Thi Ngoc Anh Nguyen, Masahiro Nakashima","doi":"10.1530/EC-25-0116","DOIUrl":"10.1530/EC-25-0116","url":null,"abstract":"<p><p>Papillary thyroid carcinoma (PTC) is the most prevalent histological subtype of thyroid cancer. However, it remains unclear whether BRAF V600E, TERT promoter (TERT-p), and certain pathological markers, such as loss of polarity/loss of cell cohesiveness (LOP/LCC), tall cells, mitotic count, and Ki-67 labeling index (LI) in recurrent tumors, are associated with clinical outcomes in patients with PTC after reoperation for recurrent PTC. This study investigates the impact of BRAF V600E and TERT-p mutations on progression-free survival (PFS) after reoperation for recurrent PTC. Cox regression analysis was employed to identify parameters associated with PFS. During a mean follow-up period of 27 months after reoperation, 39 patients (21.3%) experienced disease progression. Coexistence of BRAF V600E and TERT-p mutations (double mutation: Dmut) was observed in 21.3% of patients. TERT-p, Dmut, LOP/LCC (≥10%), mitotic count (≥3 per 2 mm2), and Ki-67 LI were found to be significantly associated with disease progression in unadjusted analyses. In a multivariable analysis, these associations remained significant, with hazard ratios and 95% confidence intervals for TERT-p, Dmut, LOP/LCC, mitotic count, and Ki-67 LI being 5.98 (2.31-15.5), 5.44 (2.21-13.3), 6.81 (2.00-23.2), 5.05 (2.07-12.3), and 5.85 (2.48-13.7), respectively. Extranodal extension was associated with disease progression in both unadjusted and multivariable analyses. TERT-p, Dmut, Ki-67 LI, LOP/LCC, mitotic count, and extranodal extension were identified as independent risk factors for poor PFS after reoperation. Close surveillance following reoperation is recommended for patients exhibiting these factors.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658739","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":"Teprotumumab and sensorineural hearing loss: a propensity score-matched retrospective cohort study.","authors":"Maxim John Levy Barnett, Justin Lam, Mikaela Nikkola Jara-Tantoco, Carlo Casipit, Sarah Eidbo, Catherine Anastasopoulou","doi":"10.1530/EC-25-0293","DOIUrl":"10.1530/EC-25-0293","url":null,"abstract":"<p><p>Teprotumumab, a monoclonal antibody that antagonizes the insulin-like growth factor 1 receptor, is the first medication within the United States to receive Food and Drug Administration (FDA) approval for thyroid eye disease (TED). The FDA recently issued a warning regarding otologic complications, such as hearing loss. We aimed to study the association between teprotumumab and sensorineural hearing loss in thyrotoxic patients with TED. A real-world retrospective cohort study was performed through the TriNetX Collaborative Network (globally de-identified database) over a 5-year period. Inclusion criteria were patients at least 18 years of age with a diagnosis of Graves' disease and TED, and were stratified into two cohorts: those treated with teprotumumab and those who were not. Propensity score-matching was performed for an even balance among cohorts (adjusting for age, sex, race, ethnicity, comorbidities, medications, smoking, and laboratory values), providing 532 patients per cohort. We identified a significantly higher risk difference of sensorineural hearing loss in patients treated with teprotumumab compared to those without exposure (risk difference 8.415%, 95% CI 4.954-11.876; 12.222 versus 3.808%), with a near three-fold increased relative risk for acquiring sensorineural hearing loss (risk ratio 3.21, 95% CI 1.936-5.323, P < 0.0001) over a 5-year period. Although the mechanism of teprotumumab-induced hearing loss remains unknown, and there is a lack of data to identify patients at risk (or those more likely to recover), our study confirms a higher risk for sensorineural hearing loss, which patients and providers alike must be aware of. Further studies providing prospective data are required to confirm such findings.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667417","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":"Associations among serum FGF21 levels, inflammation, and metabolic dysfunction-associated steatotic liver disease: Mediation analyses in a Chinese community-based population.","authors":"Hongyu Tan, Tingting Hu, Yunhui Pan, Yiting Xu, Yufei Wang, Xiaojing Ma, Yuqian Bao","doi":"10.1530/EC-25-0351","DOIUrl":"10.1530/EC-25-0351","url":null,"abstract":"<p><strong>Objective: </strong>This study was aimed to explore the relationship between serum fibroblast growth factor 21 (FGF21) levels and metabolic dysfunction-associated steatotic liver disease (MASLD), and further explore the mediation effect of inflammation in their association.</p><p><strong>Methods: </strong>This study included 1,710 community residents, including 697 men and 1,013 women, with a median age of 59 (55-63) years old. Abdominal ultrasound was used to detect the liver and calculate liver fat content (LFC). MASLD was diagnosed according to 2023 Delphi consensus. Serum FGF21 levels were measured using enzyme-linked immunosorbent assay. Inflammation levels were assessed through C-reactive protein (CRP), white blood cells (WBC), and tumor necrosis factor-α (TNF-α).</p><p><strong>Results: </strong>Regardless of overweight/obese status, serum FGF21 levels were higher in individuals with MASLD than those in individuals without MASLD (all P < 0.05). In the multivariate Logistic regression model, for every 1 unit increase in serum FGF21 levels, the risk of MASLD was 1.46 (95% confidence interval [CI] 1.11-1.92) and 1.51 (95% CI 1.19-1.93) in lean and overweight/obesity subjects, respectively. Moreover, serum FGF21 levels were positively correlated with LFC (P < 0.05), and the relationship between serum FGF21 and LFC could be partially mediated by CRP, WBC, and TNF-α.</p><p><strong>Conclusions: </strong>Regardless of overweight/obese status, serum FGF21 levels were significantly associated with an elevated risk of MASLD. Furthermore, serum FGF21 levels were independently associated with LFC, which could be partially mediated by inflammation.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706736","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":"Impact of COVID-19 on Growth Hormone Therapy Efficacy in Pediatric Patients with Short Stature.","authors":"Yoo-Mi Kim, Ah-Reum Oh, Heon-Seok Han, Jeesuk Yu, Jaehong Yu, Tae Kwan Lee, Gyung Min Lee, Jaewon Choe, Jun Suk Oh, Han Hyuk Lim","doi":"10.1530/EC-25-0218","DOIUrl":"10.1530/EC-25-0218","url":null,"abstract":"<p><p>The coronavirus disease (COVID-19) pandemic has affected global healthcare and raised concerns about growth hormone (GH) therapy outcomes in pediatric patients with short stature. This study compared GH therapy efficacy and outcomes before and during the pandemic. We retrospectively analyzed 2,827 pediatric patients with idiopathic GH deficiency, short stature in children born small for gestational age (SGA), Turner syndrome (TS), or idiopathic short stature (ISS) from the LG Growth Study, categorized into pre-pandemic (February 2017-January 2020, N=1,612) and pandemic (February 2020-January 2023, N=1,215) groups. The key outcomes included height-standard deviation score (SDS), body mass index (BMI)-SDS, insulin growth factor-1 levels, and adverse events. Significant differences were observed between groups. During the pandemic, the proportion of SGA and TS decreased, whereas that of ISS increased. IGF-Ⅰ and total cholesterol levels were higher in the early treatment phase of the pandemic but tended to normalize over time. Reported adverse events were markedly lower during the pandemic, particularly infectious and systemic complications. GH therapy remained effective during the pandemic despite healthcare disruptions. Pandemic-related shifts in BMI, IGF-Ⅰ, and adverse event reports suggest environmental influences on treatment patterns. These findings underscore the importance of monitoring chronic pediatric care under changing public health conditions.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706737","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":"IRISIN ATTENUATES SARS-CoV-2 ENTRY INTO CELLS AND CELL DAMAGE IN 2D AND 3D CULTURES OF HUMAN SUBCUTANEOUS ADIPOCYTES.","authors":"Maria Teresa De Sibio, Ester Mariane Vieira, Paula Barreto Da Rocha, Miriane De Oliveira, Regiane Marques Castro Olimpio, Vinícius Vigliazzi Peghinelli, Lucas Solla Mathias, Helena Paim Tilli, Bianca Mariani Gonçalves Meneghim, Igor Deprá, Maria Beatriz Bravin, Mariana Menezes Lourenço, Giovanna Bonatto Luca, Matheus de Souza Marino, Pedro Henrique Soares Kossooski, Camila Renata Corrêa, Marna Eliana Sakalem, Cormarie Fernández Pulido, Célia Regina Nogueira","doi":"10.1530/EC-25-0046","DOIUrl":"10.1530/EC-25-0046","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 is associated with an inflammatory pathophysiology and, when associated with chronic diseases, can trigger severe infection and increase death risk. Irisin, a hormone produced by skeletal muscle during physical activity, has demonstrated therapeutic effects against metabolic disorders and exhibits anti-inflammatory and antioxidant effects. There is great interest in investigating irisin's influence on the interaction between SARS-CoV-2 and host cells. The aim of the present study is to investigate the role of irisin in viral infection in monolayers (2D) or three-dimensional (3D) cell cultures of human subcutaneous adipocytes infected with a SARS-CoV-2 pseudovirus(PV).</p><p><strong>Materials and methods: </strong>Preadipocytes were cultured to maturity in 2D or 3D conditions and divided into four groups: Group 1: adipocytes with no treatment; Group 2: adipocytes optimized for angiotensin-converting enzyme 2(ACE2) expression; Group 3: adipocytes optimized for ACE2 expression and then exposed to SARS-CoV-2 pseudovirus(ACE2+PV); and Group 4: adipocytes treated with irisin 20nM for 24h, optimized for ACE2 expression and exposed to PV(ACE2+I+PV). Fluorescence levels of SARS-CoV-2PV and ACE2 were measured to investigate cell infection; lactate dehydrogenase(LDH) activity to investigate cytotoxicity; and malondialdehyde(MDA) and protein carbonylation to access oxidative stress levels.</p><p><strong>Results and discussion: </strong>Irisin significantly reduced viral particles (PV) capture in 2D and 3D conditions. In addition, irisin decreased LDH release, MDA and protein carbonylation levels, both in 2D and 3D conditions.</p><p><strong>Conclusion: </strong>The results indicate irisin as a promising therapeutic target against COVID-19 pathophysiology by reducing viral entry into adipose cells as well as reducing cytotoxicity and oxidative stress indicators.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706738","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":"Thyroid Disease in Ageing Populations.","authors":"Xin Hou, Xiaomeng Sun, Shuhang Xu, Yushu Li","doi":"10.1530/EC-25-0393","DOIUrl":"10.1530/EC-25-0393","url":null,"abstract":"","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706739","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":"Oxidative stress, antioxidant capacity, and cardiovascular risk in patients with non-functioning adrenal incidentalomas.","authors":"Hanife Bolat Erdogan, Kamile Gül, Tuncay Sahutoglu, Volkan Erdogan","doi":"10.1530/EC-25-0259","DOIUrl":"10.1530/EC-25-0259","url":null,"abstract":"<p><strong>Introduction: </strong>Adrenal incidentalomas are unexpectedly discovered adrenal masses with an estimated prevalence of 8%, often found during imaging for unrelated medical conditions. While primarily benign and hormonally inactive, these lesions have been associated with subtle cortisol autonomy, oxidative stress, and increased cardiovascular risk. The present study investigates the subclinical metabolic and cardiovascular impacts of non-functioning adrenal incidentalomas through oxidative stress and antioxidant marker analysis.</p><p><strong>Methods: </strong>This prospective study included 30 patients with non-functioning adrenal incidentalomas, compared to two control groups: 26 individuals with diabetes mellitus and/or hypertension (HT) and 24 healthy controls matched for age, sex, and body mass index. Hormonal evaluations, oxidative stress markers (malondialdehyde (MDA), nitric oxide (NO), and 3-nitrotyrosine (3-NTx)), antioxidant parameters (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), and melatonin), and high-sensitivity C-reactive protein (hsCRP) were assessed.</p><p><strong>Results: </strong>Oxidative stress markers were significantly elevated in patients with adrenal incidentalomas compared to controls (P < 0.001). Antioxidant markers, including SOD, CAT, GPx, GSH, and melatonin, were significantly lower in the case group (P < 0.001). Cortisol levels post-dexamethasone suppression, although within normal limits, were higher in the incidentaloma group, correlating positively with oxidative stress markers (MDA, NO, and 3-NTx) and inversely with antioxidant parameters. Elevated hsCRP levels in the case group indicated a pro-inflammatory state.</p><p><strong>Conclusions: </strong>Non-functioning adrenal incidentalomas are associated with heightened oxidative stress, diminished antioxidant capacity, and systemic inflammation, potentially contributing to cardiovascular and metabolic risks. These findings challenge the assumption that non-functioning incidentalomas are clinically insignificant, emphasizing the need for long-term monitoring and comprehensive evaluation of their systemic effects.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559525","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}