European Journal of Clinical Pharmacology最新文献

{"title":"The effects of trazodone exposure during pregnancy on fetal outcomes: a systematic review.","authors":"Britney Glasgow-Osment, Farah Wahib, Shama Kassam, Madeleine Zanin, Facundo Garcia-Bournissen","doi":"10.1007/s00228-025-03880-0","DOIUrl":"10.1007/s00228-025-03880-0","url":null,"abstract":"<p><strong>Purpose: </strong>Trazodone, a medication primarily used for anxiety and insomnia, is increasingly prescribed during pregnancy despite limited safety data. This systematic review aims to assess the effects of trazodone exposure during pregnancy on fetal outcomes.</p><p><strong>Methods: </strong>A search was conducted using MEDLINE and Embase databases from the year 2000 to present. Studies were limited to those involving human subjects, published in English, and investigating trazodone exposure during pregnancy. Keywords included \"pregnan*,\" \"trazodone,\" \"malformation*,\" and \"birth outcomes.\" Four reviewers independently extracted data from the selected records. Risk of bias was assessed using the Newcastle-Ottawa Scale. Data synthesis involved a qualitative analysis to summarize and interpret the findings, identifying patterns across the studies.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria. The main outcome measures included fetal and pregnancy outcomes such as congenital malformations, developmental outcomes, poor neonatal adaptation syndrome (PNAS), persistent pulmonary hypertension of the newborn (PPHN), congenital heart defects, gestational age, birth weight, stillbirth, preterm birth, spontaneous and therapeutic abortion, and pre-eclampsia.</p><p><strong>Conclusion: </strong>The review found no consistent evidence linking trazodone use during pregnancy to increased risks of congenital malformations, stillbirths, or low birth weight. However, some studies suggested a possible association with an increased risk of spontaneous and therapeutic abortions. Given the limited and varied data, further research with larger, well-controlled studies are needed to establish the safety profile of trazodone during pregnancy. Overall, clarifying the specific risks and benefits of trazodone use in pregnancy will better guide clinical decision-making and improve maternal-fetal health outcomes.</p><p><strong>Trial registration: </strong>PROSPERO number: CRD42024503611.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1401-1408"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682171","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":"From adoption to impact: linking prescribing tools to clinical outcomes-authors' response.","authors":"Monia Donati, Carlotta Lunghi, Giulia Grillini, Marco Domenicali, Maria Lia Lunardelli, Veronica Pasini, Susy Milandri, Monica Mussoni, Fabio Pieraccini, Elisa Sangiorgi, Emanuel Raschi, Valentina Colonnello, Elisabetta Poluzzi","doi":"10.1007/s00228-025-03888-6","DOIUrl":"10.1007/s00228-025-03888-6","url":null,"abstract":"","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1537-1538"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706836","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":"Tool use isn't enough-outcomes matter.","authors":"Muhammad Zahir Shah, Azka Mustaan","doi":"10.1007/s00228-025-03887-7","DOIUrl":"10.1007/s00228-025-03887-7","url":null,"abstract":"","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1539-1540"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706837","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":"Barriers and solutions for the European prescribing exam: a qualitative world café study.","authors":"Erik M Donker, Joost D Piët, David J Brinkman, Milan C Richir, Paraskevi Papaioannidou, Robert Likic, Emilio J Sanz, Thierry Christiaens, João N Costa, Fabrizio De Ponti, Milo Gatti, Ylva Böttiger, Cornelis Kramers, Michiel A van Agtmael, Jelle Tichelaar","doi":"10.1007/s00228-025-03886-8","DOIUrl":"10.1007/s00228-025-03886-8","url":null,"abstract":"<p><strong>Purpose: </strong>To harmonize and modernize clinical pharmacology and therapeutics (CPT) education across Europe, we developed the European Prescribing Exam. Before its introduction into medical degree programs, it is crucial to understand the potential barriers to its implementation and ways to overcome them. Therefore, the aim of this study was to identify barriers and potential solutions to the implementation of the European Prescribing Exam.</p><p><strong>Methods: </strong>This qualitative World Café (WC) study involved CPT teachers who participated in a 2-day event focused on the European Prescribing Exam. There were five tables in the WC, each dedicated to a different topic of implementation: (1) organization, (2) technical aspects, (3) content, (4) rollout logistics, and (5) politics. Participants rotated randomly between the tables every 20 min. During each round, they were encouraged to identify barriers and solutions, which were then discussed. The rounds continued until data saturation was reached. Findings were summarized at the end of the WC. We used inductive thematic analysis using a semantic approach to analyze the data.</p><p><strong>Results: </strong>In total, 26 CPT teachers (female: n = 14) from 19 medical schools in 15 European countries participated. After four rounds, 86 potential barriers and 86 solutions were identified. Most barriers were related to the topics \"Content\" (n = 22), \"Organization\" (n = 20), and \"Technical aspects\" (n = 18). Thematic analysis identified 11 themes, three of which were overarching, meaning they applied to multiple topics. The most significant themes included barriers related to curricula, motivation, information technology, and relevance.</p><p><strong>Conclusion: </strong>This study shows that organizing and implementing the European Prescribing Exam will be challenging. However, participants proposed potential solutions for nearly all barriers, which suggest that the implementation of the European Prescribing Exam is feasible.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1451-1459"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717747","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":"Administration of polyethylene glycol in critically ill patients with acute myocardial infarction: a retrospective propensity score-matched cohort study.","authors":"Linfeng Xie","doi":"10.1007/s00228-025-03892-w","DOIUrl":"10.1007/s00228-025-03892-w","url":null,"abstract":"<p><strong>Purpose: </strong>Polyethylene glycol (PEG) is commonly administered in acute myocardial infarction (AMI) cases, though its clinical efficacy remains unclear. This study investigated whether PEG treatment enhances survival outcomes in AMI patients.</p><p><strong>Methods: </strong>This retrospective study analyzed data from the American Medical Information Mart for Intensive Care (MIMIC)-IV database, examining critically ill patients with AMI. The exposure was defined as PEG administration during hospitalization. The primary endpoints were 7-day and in-hospital all-cause mortality. External validation was performed using the eICU 2.0 database.</p><p><strong>Results: </strong>The study included 2422 participants before propensity score matching (PSM) and 1730 after matching. Multivariate Cox regression analysis prior to PSM revealed that PEG administration significantly lowered 7-day (HR = 0.247, 95% CI 0.179-0.341, p < 0.001) and in-hospital (HR = 0.422, 95% CI 0.347-0.512, p < 0.001) all-cause mortality. Post-PSM analysis produced consistent findings, with PEG administration linked to reduced 7-day (HR = 0.244, 95% CI 0.168-0.354, p < 0.001) and in-hospital (HR = 0.420, 95% CI 0.337-0.524, p < 0.001) mortality. Subgroup analyses indicated PEG's protective effect persisted across all clinical subgroups (all p-interaction > 0.005). External validation using Cox regression further confirmed that PEG administration significantly reduced both in-ICU (HR = 0.353, 95% CI 0.211-0.591, p < 0.001) and in-hospital (HR = 0.403, 95% CI 0.268-0.607, p < 0.001) mortality.</p><p><strong>Conclusion: </strong>PEG administration improved survival outcomes in critically ill AMI patients, reducing both 7-day and in-hospital all-cause mortality.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1481-1491"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759523","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":"Efficacy and safety of insulin sensitisers for treating type 2 diabetes: a network meta-analysis.","authors":"Gerile Huang, Yujie Li, YuQi Shang, Huiduo Wang, Wenjing Zhang, Hao Guo","doi":"10.1007/s00228-025-03882-y","DOIUrl":"10.1007/s00228-025-03882-y","url":null,"abstract":"<p><strong>Purpose: </strong>Thiazolidinediones (TZDs), including pioglitazone and rosiglitazone, and non-TZD insulin sensitisers (chiglitazar sodium) demonstrate potential; however, their comparative efficacy and safety remain unclear. We aimed to analyse the efficacy and safety of commonly used insulin sensitisers, including chiglitazar sodium, sitagliptin, pioglitazone, and rosiglitazone for treating type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A computer-based search was conducted in the China National Knowledge Infrastructure, Wanfang Data, the VIP database, PubMed, Embase, and Cochrane Library databases from the establishment date of each database to January 2025. Included study quality was evaluated using the Cochrane risk of bias tool. Surface under the cumulative ranking curve was calculated for each outcome indicator to compare the efficacy and safety of different interventions.</p><p><strong>Results: </strong>In reducing haemoglobin A1c, 8 mg of rosiglitazone was superior over 100 mg sitagliptin, 30 mg pioglitazone, and 15 mg pioglitazone (P < 0.05), with no significant differences among the remaining medications. To reduce fasting plasma glucose, 45 mg of pioglitazone was more effective than any dosage of chiglitazar sodium, sitagliptin, or rosiglitazone (P < 0.05). Regarding safety, the incidence rate of adverse reactions was higher with 45 mg of pioglitazone than with 8 mg of rosiglitazone (P < 0.05), with no significant differences in adverse events among other medications.</p><p><strong>Conclusion: </strong>Compared with placebo, all four drugs were safe and effective in the treatment of T2DM. High-dose TZDs may be more effective than mitiglinide and sitagliptin. However, 45 mg of pioglitazone was associated with a higher incidence of adverse events, warranting close monitoring of its safety profile.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1493-1506"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759524","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":"Dose-dependent efficacy and safety of Filgotinib in moderate to severe Crohn's disease: a grade-assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed S Elgendy, Ahmed Raza, Mohamed Rifai, Wajeeh Ur Rehman, Ahmed Emara, Muhammad Haris Khan, Ayiz Jan, Muhammad Younas, Anum Nawaz, Ubaid Khan","doi":"10.1007/s00228-025-03891-x","DOIUrl":"10.1007/s00228-025-03891-x","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease is a chronic inflammatory condition that can relapse and can impact any part of the digestive tract. Janus kinase (JAK) inhibitors, like Filgotinib, have surfaced as a promising treatment option. This meta-analysis evaluates its dose-dependent effects (100 mg or 200 mg) in moderate-to-severe cases.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, CENTRAL, Web of Science, Scopus, and EMBASE up to March 2025. Risk ratio (RR) was used for dichotomous outcomes, with 95% confidence intervals (CI).</p><p><strong>Prospero id: </strong>CRD420251032985.</p><p><strong>Results: </strong>Four RCTs with 1681 patients were included. Filgotinib 200 mg compared to placebo had a higher rate of mucosal remission at 24 to 58 weeks (wk) (14.9% vs 6%, RR = 2.51, 95% CI [1.06:5.95], P = 0.0370), two-item patient'sreported outcome (PRO2) clinical remission at 10 wk (35.7% vs 22.5%, RR = 1.48, 95% CI [1.21:1.81], P = 0.0002), and Crohn's Disease Activity Index (CDAI) clinical remission at 10 wk (33.4% vs 17.8%, RR = 1.77, 95% CI [1.42:2.21], P < 0.0001). However, there was no significant difference between Filgotinib 100 mg and placebo in rates of CDAI clinical remission at 10 wk (P = 0.7490) and mucosal remission at 24 to 58 wk (P = 0.5850). In both doses, there was no significant difference in total treatment adverse events (TEAEs) at 20 to 58 wk (P = 0.4576, P = 0.2354) and serious TEAEs at 20 to 58 wk (P = 0.992, P = 0.2354).</p><p><strong>Conclusions: </strong>Filgotinib 200 mg demonstrated superior short-term clinical benefits and medium-term mucosal remission compared to placebo in moderate-to-severe CD. However, Filgotinib 100 mg showed no significant efficacy. Both doses have acceptable safety profiles, necessitating further long-term multicenter RCTs.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1517-1531"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768524","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":"A drug-based model to predict hyponatremia in outpatients of a geriatric clinic.","authors":"Anne Claire B van Orten-Luiten, Elske M Brouwer-Brolsma, André Janse, Renger F Witkamp","doi":"10.1007/s00228-025-03890-y","DOIUrl":"10.1007/s00228-025-03890-y","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic hyponatremia in older people is associated with adverse outcomes including gait disturbances, falls, osteoporosis, fractures, cognitive impairment, and cardiovascular disease. Diagnosis in outpatient settings is challenging due to the non-specific nature of its symptoms. While hyponatremia is well-studied in hospitalized patients, little research has focused on outpatient settings. This study aimed to develop a drug-based model to non-invasively predict hyponatremia in older adults attending a geriatric outpatient clinic.</p><p><strong>Methods: </strong>Cross-sectional data from 2181 outpatients aged ≥ 55 were analysed using logistic regression. Polypharmacy, 27 specific drug groups, sex, age, and BMI were considered as potential risk factors. Predictors were selected using stepwise backward logistic regression for the complex model and LASSO regression for the simple model. Internal validation was performed through bootstrapping, and model performance was evaluated by constructing a receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The prevalence of hyponatremia was 10.5%, with higher occurrence in women. The complex model identified predictors including sex, age, BMI, polypharmacy, and 11 drug groups, achieving an area under the curve (AUC) of 0.75, [95% CI 0.72-0.79], indicating a reasonably good ability to distinguish between hypo- and normonatremia. The simple model, including only polypharmacy, had limited predictive performance (AUC = 0.64 [95% CI 0.60-0.68]).</p><p><strong>Conclusion: </strong>The complex, drug-based model predicts hyponatremia risk in outpatients of a geriatric clinic. Timely recognition may prevent inappropriate treatments for undiagnosed cases and associated harms. The model merits further development for clinical use.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1507-1515"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759522","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":"Long-term results of a multidisciplinary medication optimization program for older adults including primary care and hospital team.","authors":"Camille Guerin, Romain Leguillon, Albane Cherel, Lucie Valembois, Gwladys Brochard, Mélissa Pierre, Antoine Bourderont, Bérénice Gaillot, Claire Bernardeau, Céline Vaesken, Ines Tebourski, Pablo Descatoire, Guillaume Saint-Lorant, Cédric Villain, Alexandre Meurant","doi":"10.1007/s00228-025-03889-5","DOIUrl":"10.1007/s00228-025-03889-5","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic optimization and deprescribing in older adults face multiple barriers, whereas drug-related hospitalization increased from 3.6% to 8.5% between 2006 and 2018. The OPTIMEDOC program aims to optimize older adults' prescriptions through clinical medication review conducted by a multidisciplinary team including clinical pharmacist, geriatrician, and general practitioner (GP). This collaboration between primary care and hospital team aims to enable appropriate and sustainable prescriptions.</p><p><strong>Purpose: </strong>This study aimed to assess the implementation of therapeutic optimizations at least 6 months after the intervention. The secondary objective was to document the most frequently deprescribed and newly introduced medications and their long-term implementation rate.</p><p><strong>Methods: </strong>This observational study was conducted in a university hospital, including patients who benefited from the OPTIMEDOC program from April 2022 to April 2024. The primary outcome was the long-term implementation rate of recommendations. The secondary outcome was a description of the optimized drugs according to ATC2 classes.</p><p><strong>Results: </strong>Among 1580 validated therapeutic recommendations for 143 patients included with an average age of 86.4 years old, 1473 were followed up (93.2%). Of these, 1017 were successfully implemented over 1 year (69.0%). Specifically, 81.8% of deprescriptions, 58.3% of introductions, and 70.5% of modifications were implemented. Although vaccine introductions were the most frequently recommended (n = 222), only 41% were implemented. Regarding deprescribing, psycholeptics, psychoanaleptics, and drugs for acid-related disorders had a long-term implementation rate of over 75%.</p><p><strong>Conclusion: </strong>These results validate the OPTIMEDOC program as an effective strategy for sustainable therapeutic optimization, especially for deprescribing. Engaging community pharmacists could further enhance the implementation of therapeutic recommendations.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":"1461-1471"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728938","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":"Population pharmacokinetic characteristics of tacrolimus in Chinese lung transplant recipients and optimisation of dosing regimen during the early post-transplantation phase.","authors":"Shouning Zhou, Qiaoyan Lian, Huilong Luo, Hui Xie, Yanping Guan, Jianxing He, Li Wei, Chunrong Ju","doi":"10.1007/s00228-025-03920-9","DOIUrl":"https://doi.org/10.1007/s00228-025-03920-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to establish a population pharmacokinetic model and optimise tacrolimus dosing regimens in Chinese lung transplant recipients.</p><p><strong>Methods: </strong>A total of 988 tacrolimus trough concentrations and clinical data of 142 adult lung transplant recipients were collected. Population pharmacokinetic analysis was performed using a nonlinear mixed effects model. A Monte Carlo simulation was conducted to determine the optimal dosing regimen.</p><p><strong>Results: </strong>The pharmacokinetics of tacrolimus could be best described by a one-compartment model with first-order absorption and elimination. The typical population parameter estimates of apparent clearance and apparent volume of distribution were 7.58 L·h^-1 and 701.39 L, respectively. The clearance of tacrolimus in rapid and intermediate metabolisers of CYP3A5 was 2.72-fold and 1.87-fold higher, respectively, than in poor metabolisers of CYP3A5. The concurrent use of voriconazole, posaconazole, and itraconazole led to a reduction in tacrolimus clearance by 38.21%, 26.30%, and 57.98%, respectively. Recommended dose regimens were obtained by Monte Carlo simulation based on the established model.</p><p><strong>Conclusion: </strong>Recipients with the CYP3A5*3/*3 genotype, elevated haematocrit levels, short postoperative days, and concurrent administration of azole antifungal drugs needed a reduced maintenance dose to reach the therapeutic window, which provided a reference for the formulation of individualised tacrolimus regimen during the early post-transplantation phase.</p>","PeriodicalId":11857,"journal":{"name":"European Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124540","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}