Hormone Research in Paediatrics最新文献

{"title":"The Role of Endocrine Disruptors in Childhood Obesity: Unraveling the Obesogens.","authors":"Aikaterini Kapama, Charikleia Stefanaki, George Mastorakos, Maria Papagianni","doi":"10.1159/000545043","DOIUrl":"10.1159/000545043","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a disease, acknowledged by WHO, characterized as an epidemic in a worldwide range, particularly in Western countries. Childhood obesity, lately, has raised major concerns. Among the complex factors contributing to obesity, environmental factors, such as endocrine disruptors, are gaining attention as emerging contributors to obesity.</p><p><strong>Summary: </strong>Toxicants, such as bisphenol A, phthalates, perfluoroalkyl and polyfluoroalkyl substances, heavy metals, and pesticides, have been associated with increases in the incidence of obesity in human populations, animals, and cellular models. These EDCs, called obesogens, disrupt the endocrine system across multiple pathways. They influence appetite, promote inflammation, disrupt the ecology and function of the gut microbiome, and induce transgenerational epigenetic changes. At the cellular level, they act as agonists of peroxisome proliferator-activated receptor γ, steroid, and aryl hydrocarbon receptors.</p><p><strong>Key messages: </strong>Children are exposed to obesogens through multiple metabolic pathways, which contribute directly and indirectly to the development of obesity. Despite the increasing evidence, more studies are needed to identify additional obesogens and elucidate their mechanisms of action to minimize exposure to pediatric and adolescent populations.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"194-207"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728495","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":"Strategies for Equitable Recruitment to Engage Underrepresented Youth and Their Families into Clinical Research: Findings from the BEAD-T1D Pilot Study.","authors":"Ricardo Medina Peñaranda, Lauren E Figg, Sarah J Hanes, Gary M Shaw, Lisa J Chamberlain, Jennifer Raymond, Diana Naranjo, David M Maahs, Korey K Hood, Ananta Addala","doi":"10.1159/000541774","DOIUrl":"10.1159/000541774","url":null,"abstract":"<p><strong>Introduction: </strong>To address disparities in clinical research, we present strategies to optimize recruitment of underrepresented families into the Building the Evidence to Address Disparities in Type 1 Diabetes (BEAD-T1D) study.</p><p><strong>Methods: </strong>A bilingual/bicultural Latino research assistant (RA) was hired to facilitate culturally congruent recruitment for pediatric type 1 diabetes families. The RA screened, approached, and consented families using their preferred language, time of contact, and answered personal concerns around research. Families were given the option to consent during outpatient clinic visits (in-person, or virtually via video/phone call) at a pace set by the parent/guardian to ensure understanding.</p><p><strong>Results: </strong>Sixty-four families (Hispanic-65%, Non-Hispanic White [NHW]-17%, Non-Hispanic Black-1%, and Other-4%) were eligible. Of 49 approached, 32 consented (39 ± 7.9 years; female-81%; Hispanic-72%, NHW-28%, <50K income-69%, Spanish-speaking-50%). Clinic approaches were important to successful consent: 87% of the clinic approaches resulted in consent. Barriers to clinic approaches for RA included late/no response from clinicians, care team ending visit, and bandwidth/connectivity issues. Facilitators to clinic approaches included collaborative clinic care teams, flexible RA hours, and patient screening days in advance. We exceeded our recruitment goals for surveys (31/30), focus groups/interviews (26/20), and advisory board (22/10).</p><p><strong>Conclusions: </strong>We identified that culturally and linguistically congruent staff, flexible recruitment practices, and prioritizing participant availability were solutions to recruit a diverse study cohort resulting exceeding recruitment goals. Cultural interpersonal relationships formed with families addressed barriers to research participation within and outside of the medical system. These strategies suggest equitable clinical trial recruitment is feasible in diabetes research.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"122-130"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380706","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":"Thyrotoxic Hypokalemic Periodic Paralysis Induced by High-Dose Insulin in an Adolescent Male with Type 1 Diabetes Mellitus.","authors":"Ozge Bayrak Demirel, Cansu Koc, Ummahan Tercan, Saygin Abali, Asli Derya Kardelen, Melek Yildiz, Sukran Poyrazoglu, Firdevs Bas, Feyza Darendeliler","doi":"10.1159/000543329","DOIUrl":"10.1159/000543329","url":null,"abstract":"<p><p><p>Introduction: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but severe complication of hyperthyroidism characterized by acute muscle weakness. This study reports the first case of THPP in an adolescent with type 1 diabetes mellitus (T1DM) and Graves' disease, triggered by high-dose insulin, high carbohydrate intake, and strenuous exercise. It highlights the clinical presentation, management, and implications of THPP in this context. Case Presentation: A 17-year-old male patient with T1DM and Graves' disease presented to the emergency department with weakness in the extremities. The patient had engaged in strenuous exercise and high-dose rapid-acting insulin, and consumed a large amount of rice shortly before the onset of the symptoms. He exhibited hypertension and tachycardia, with diminished muscle strength and deep tendon reflexes with severe hypokalemia (1.6 mmol/L). Treatment with potassium and magnesium replacements was initiated. The patient's symptoms resolved within 5 h, and his neurological examination was normalized. Hypokalemia did not recur during follow-up. All symptoms improved rapidly with potassium replacement, β-blocker therapy, and antithyroid treatment. Conclusion: This case represents the first documented instance of THPP in an adolescent with T1DM and Graves' disease. This entity should be included in the differential diagnosis of acute paralysis in patients with known thyrotoxicosis or those exhibiting symptoms such as tachycardia and hypertension. Insulin treatment in a hyperthyroid diabetic patient may increase the risk of THPP. </p>.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"57-61"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885766","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":"Epigenetics of Childhood Obesity.","authors":"Maria Keller, Mandy Vogel, Antje Garten, Stina Ingrid Alice Svensson, Elena Rossi, Peter Kovacs, Yvonne Böttcher, Wieland Kiess","doi":"10.1159/000543467","DOIUrl":"10.1159/000543467","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity has become a global pandemic and is one of the strongest risk factors for cardiovascular disease later in life. The correlation of epigenetic marks with obesity and related traits is being elucidated. This review summarizes the latest research and its challenges in the study of epigenetics of (childhood) obesity.</p><p><strong>Summary: </strong>Epigenome-wide association studies helped identify novel targets and methylation sites that are important in the pathophysiology of obesity. In the future, such sites will become essential for developing methylation risk scores (MRS) for metabolic and cardiovascular diseases. Although MRS are very promising for predicting the individual risk of obesity, the implementation of MRS is challenging and has not been introduced into clinical practice so far.</p><p><strong>Key messages: </strong>Future research will undoubtedly discover numerous methylation sites that may be involved in the development of obesity and its comorbidities, especially at a young age. This will contribute to a better understanding of the complex etiology of human obesity. From a clinical perspective, the overarching aim was to generate MRS that is robust for reliable and accurate prediction of obesity and its comorbidities.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"208-220"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983211","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":"Recognition of Hyperinsulinaemic Hypoglycaemia in Infants with Congenital Central Hypoventilation Syndrome.","authors":"Neha Malhotra, Thia Hanania, Daphne Yau, Clare Gilbert, Kate Morgan, Emma Wakeling, Wendy D Jones, Martin Samuels, Indraneel Banerjee, Antonia Dastamani","doi":"10.1159/000542234","DOIUrl":"10.1159/000542234","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital central hypoventilation syndrome (CCHS) is a rare autosomal dominant condition due to mutations in the transcription factor PHOX2B. It is characterized by alveolar hypoventilation with symptoms of autonomic nervous system dysfunction. Hyperinsulinaemic hypoglycaemia (HH) due to glucose dysregulation caused by anomalous insulin secretion has been reported as a feature of CCHS. However, HH and glycaemic outcomes in the context of CCHS have not been characterized in longitudinal follow-up. We describe the variable phenotype of glucose dysregulation and glycaemic outcomes in children with CCHS.</p><p><strong>Case presentation: </strong>We report 6 children with PHOX2B mutation-positive CCHS diagnosed with HH in a national cohort from two UK congenital hyperinsulinism specialist centres. We describe the initial presentation, the challenges in management, and glycaemic outcomes in longitudinal follow-up. All patients were term infants diagnosed with CCHS in the neonatal period due to PHOX2B mutations and required long-term ventilation by tracheostomy. HH was diagnosed at a median age of 222 days (median, range 36-594) with postprandial hypoglycaemia (4/6 patients) or fasting hypoglycaemia (2/6 patients). Two patients were treated with diazoxide monotherapy; one with diazoxide and overnight continuous gastrostomy feeds; one with acarbose; and two with dietary manifestations and use of continuous glucose monitoring sensor. Three patients who presented earlier in the observation period demonstrated a reduction in the severity of HH over time, leading to hypoglycaemia resolution at a median age of 4.8 years (range 4.45-5.5 years).</p><p><strong>Conclusion: </strong>Patients with CCHS, due to PHOX2B mutations, may experience both fasting and postprandial hypoglycaemia, necessitating treatment for HH. Clinicians should screen children with CCHS for hypoglycaemia symptoms to quickly identify those affected by HH, initiate prompt treatment, and prevent potential brain injury from severe hypoglycaemia. The severity of hypoglycaemia due to HH tends to decrease over time, with glycaemic resolution potentially being achieved over several years.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"356-364"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499392","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":"Utility of First-Morning-Voided Urinary Total Luteinizing Hormone in Detecting the Onset of Central Puberty.","authors":"And Demir, Matti Hero, Katharina M Main, Anders Juul","doi":"10.1159/000541586","DOIUrl":"10.1159/000541586","url":null,"abstract":"<p><strong>Introduction: </strong>Early morning basal serum luteinizing hormone (S-LH) ≥0.3 IU/L is a specific marker for the onset of central puberty. In this study, we aimed to investigate the sensitivity and specificity of the first-morning-voided (FMV) total urinary LH (U-LH) to replace this marker.</p><p><strong>Methods: </strong>We re-analyzed our previously published data set of 297 children (145 boys and 152 girls, aged 5-15 years, across Tanner stages 1 through 5) using receiver operating characteristic (ROC) analysis and determined cutoff values for FMV total U-LH in predicting early morning S-LH concentration at or above 0.3 IU/L. We also determined S-LH and serum follicle-stimulating hormone (S-FSH) concentrations in girls at different stages of sexual maturation.</p><p><strong>Results: </strong>ROC analysis showed that FMV total U-LH levels of 0.60 and 0.63 IU/L in girls and boys, respectively, predicted early morning S-LH levels of 0.3 IU/L or higher with 97.4% sensitivity and 90.6% specificity. Higher cutoff levels for U-LH (0.78 IU/L for boys and 0.79 IU/L for girls) yielded 94.7% specificity at the expense of a relatively lower level of sensitivity (94.1%). The areas under the curve were 0.98 in boys and 0.99 in girls, respectively. Additionally, the increase in FMV total U-LH (or S-LH) levels identified the activation of central pubertal development at the mean age of 10.3 (10.3) in boys and 10.5 (10.6) in girls. The S-FSH concentrations of the six biochemically prepubertal girls with thelarche, ranging between 2.3 and 2.7 IU/L, were significantly higher than those measured in biochemically and clinically prepubertal girls of the same 10-12-year-old age group and significantly lower than those measured in both biochemically and clinically pubertal girls (p = 0.039 and p = 0.018, respectively).</p><p><strong>Conclusions: </strong>A FMV total U-LH concentration of 0.6 IU/L or above reliably reflects pubertal morning S-LH levels and is effective in detecting the onset of central puberty, which occurs at similar ages in both sexes. Concurrent S-FSH or noninvasive FMV U-FSH determinations may be useful in the differential diagnosis of isolated thelarche.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"3-11"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582549","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":"Growth Hormone Therapy and Quality of Life: Evidence versus Assumptions.","authors":"Stefano Cianfarani","doi":"10.1159/000549736","DOIUrl":"10.1159/000549736","url":null,"abstract":"","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"314-318"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573522","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":"Feasibility of Using Continuous Glucose Monitoring to Detect Glycemic Abnormalities in Children with Cystic Fibrosis.","authors":"Amanda Leonard, Isabel R Judware, Lori L Vanscoy, Shruti M Paranjape, Donna Peeler, Malinda Wu, Scott M Blackman, Peter J Mogayzel","doi":"10.1159/000542786","DOIUrl":"10.1159/000542786","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic fibrosis-related diabetes (CFRD) is linked to worsening pulmonary function and increased mortality in people with cystic fibrosis (CF). Because of this correlation, early recognition of CFRD is important. Current recommendations for detecting glucose abnormalities using an oral glucose tolerance test (OGTT) can be difficult to achieve in a busy clinical setting.</p><p><strong>Methods: </strong>We trialed a 10-day continuous glucose monitoring (CGM) (Dexcom G6Pro) session in patients seen in our pediatric CF clinic that could not do an OGTT (reasons include emesis with OGTT or fear of needles) or that had an abnormal OGTT (to gather additional data to make treatment decisions).</p><p><strong>Results: </strong>Of the 36 sensors placed, 34 (94%) were returned. Devices were worn for a median of 10 days (range 4-10 days). Of the 34 CGMs returned, 20 (59%) met the criterion for referral to a pediatric endocrinologist.</p><p><strong>Conclusion: </strong>CGM placement is feasible in a busy CF clinic to detect glucose abnormalities in children.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"385-390"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739484","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":"Obesity Is Associated with Increased 11-Oxyandrogen Serum Concentrations during Puberty.","authors":"Friederike Wagner, Robert Zeidler, Uta Ceglarek, Wieland Kiess, Jürgen Kratzsch, Alexander Gaudl, Ronald Biemann, Mandy Vogel","doi":"10.1159/000540433","DOIUrl":"10.1159/000540433","url":null,"abstract":"<p><strong>Introduction: </strong>While the influence of various factors on classical androgen synthesis in children and adolescents and its impact on puberty has been widely investigated, there appear to be gaps and contradictory findings regarding the association of overweight and obesity with the synthesis of adrenal-derived 11-oxygenated androgen (11-OA) serum levels. With this study, we aimed to examine how overweight and obesity affect 11-OA serum levels during puberty in a large cohort of children and adolescents.</p><p><strong>Methods: </strong>Our cohort comprised 1,054 healthy children aged 6-19 years providing serum samples at a total of 1,734 visits. Liquid chromatography-tandem mass spectrometry was used to quantify 11-ketotestosterone (11-KT), 11-ketoandrostendione (11-KA4), 11-β-hydroxytestosterone (11-OHT), 11-β-hydroxyandrostendione (11-OHA4), testosterone, androstenedione, and DHEAS. In addition, we assessed BMI-SDSs, skinfold thicknesses, and Tanner stages. The significance level α was set to α = 0.05.</p><p><strong>Results: </strong>Increases in 11-KT, 11-KA4, 11-OHT, and 11-OHA4 levels were observed in boys and girls during puberty. 11-KT (β = 0.2, p < 0.001), 11-KA4 (β = 0.16, p < 0.001), and 11-OHA4 (β = 0.12, p = 0.003) were positively correlated with BMI in boys aged 13 years and under. 11-KT (β = 0.1, p = 0.047) was positively correlated with BMI in girls aged 11 years and under. 11-OHT was positively correlated with BMI independent of age (boys 13 years and under: β = 0.17, p < 0.001; over 13 years: β = 0.14, p = 0.001; girls 11 years and under: β = 0.17, p < 0.001; over 11 years: β = 0.18, p < 0.001).</p><p><strong>Conclusion: </strong>We found increasing 11-OA serum levels throughout all Tanner stages. 11-OAs were observed to be associated with BMI and skinfold thickness, suggesting that overweight and obesity may be associated with pubertal alterations in 11-OA serum levels.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"91-100"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748032","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":"Obesity in Childhood and Adolescence: Epidemiology and Financial Implications.","authors":"Konstantinos Zisis, Kostas Athanasakis","doi":"10.1159/000546506","DOIUrl":"10.1159/000546506","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a growing global health concern with significant epidemiological and economic consequences. This study aimed to provide an overview of the prevalence, socioeconomic determinants, and financial burden of childhood obesity, emphasizing its impact on healthcare systems and society.</p><p><strong>Summary: </strong>A non-systematic targeted literature review was conducted using PubMed and institutional sources such as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Organization for Economic Co-Operation and Development (OECD). Two independent reviewers screened and extracted relevant data, which were categorized into three domains: epidemiology (prevalence and trends), socioeconomic determinants (income, education, ethnicity, and family factors), and economic impact (direct, indirect, and intangible costs). Findings show that childhood obesity prevalence has been rising globally, with higher rates observed in high-income countries. Socioeconomic disparities play a crucial role, with lower-income families and certain ethnic groups experiencing higher obesity rates. Direct costs include increased medical expenses due to obesity-related comorbidities, while indirect costs result from productivity losses and long-term healthcare needs. Intangible costs, such as psychological distress and reduced quality of life, further highlight the burden of childhood obesity. Economic evaluations indicate that childhood obesity leads to substantial healthcare expenditures and productivity losses over a lifetime, emphasizing the need for early intervention.</p><p><strong>Key messages: </strong>Childhood obesity imposes a significant public health and economic burden, necessitating urgent policy interventions. A multi-sectoral approach, including public health strategies, socioeconomic support, and cost-effective interventions, is essential to mitigate its impact.</p>","PeriodicalId":13025,"journal":{"name":"Hormone Research in Paediatrics","volume":" ","pages":"169-174"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110461","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}