Journal of diabetes and its complications最新文献

{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00149-7","DOIUrl":"10.1016/S1056-8727(25)00149-7","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109096"},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194746","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":"Relationship between body fat and cognitive function in individuals with diabetes mellitus","authors":"Micaela Rabelo Quadra ,&nbsp;Antônio Augusto Schäfer ,&nbsp;Fernanda Oliveira Meller ,&nbsp;Carla Damasio Martins ,&nbsp;Emilio Luiz Streck","doi":"10.1016/j.jdiacomp.2025.109105","DOIUrl":"10.1016/j.jdiacomp.2025.109105","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the relationship between body fat and cognitive function in individuals with Diabetes mellitus (DM).</div></div><div><h3>Methods</h3><div>Cross-sectional study conducted at a clinical school between March and August 2023. Individuals aged ≥18 years, with medical diagnosis of DM type 1 or 2, treated at the clinical school were included. The outcome was cognitive function, assessed using the Montreal Cognitive Assessment. The exposure was body fat, measured by skinfolds. Crude and adjusted analyses were conducted using Poisson regression, with results reported as prevalence ratios (PR) and their corresponding 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>A total of 365 individuals were studied. 67.9 % exhibited cognitive decline and 91.8 % had excess body fat. Although no association between excess body fat and cognitive decline was found in the crude analysis, an association emerged in the adjusted analyses. Individuals with DM and excess body fat had a 26 % lower prevalence of cognitive decline than those without excess body fat (PR = 0.74, 95%CI 0.62–0.88).</div></div><div><h3>Conclusion</h3><div>Excess body fat appears to be associated with a lower prevalence of cognitive decline, underscoring the complexity of this relationship and suggesting caution in interpreting these findings.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109105"},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230725","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":"Incremental value of CT-based perirenal fat characteristics in the categorization and progression prediction of diabetic kidney disease","authors":"Jinlei Fan ,&nbsp;Liping Zuo ,&nbsp;Xiaoyun Liu ,&nbsp;Yuqing Tang ,&nbsp;Min He ,&nbsp;Qichao Cheng ,&nbsp;Chuanbin Yang ,&nbsp;Dexin Yu","doi":"10.1016/j.jdiacomp.2025.109104","DOIUrl":"10.1016/j.jdiacomp.2025.109104","url":null,"abstract":"<div><h3>Aims</h3><div>To explore the association between computed tomography (CT)-derived perirenal adipose tissue (PAT) characteristics and diabetic kidney disease (DKD) risk categories according to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline, and to determine the incremental predictive value of PAT characteristics for DKD rapid progression in patients with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>404 patients with T2DM who underwent plain abdominal CT were categorized into four KDIGO risk groups (low, moderate, high, and very-high). The area and CT attenuation values of different abdominal fat deposits were measured. Logistic and Cox regression analyses were performed to identify risk factors for high and very-high KDIGO risk categories and predictors of DKD rapid progression.</div></div><div><h3>Results</h3><div>In multivariate logistic regression analysis, the PAT index (PATI) (<em>P</em> &lt; 0.001), PAT attenuation value (<em>P</em> = 0.023) were independent risk factors for high- and very-high-risk KDIGO categories. In 125 patients with kidney function follow-up data, multivariate Cox regression analysis revealed that PAT attenuation value (<em>P</em> = 0.021) and haemoglobin (<em>P</em> = 0.031) were independent predictors of DKD rapid progression.</div></div><div><h3>Conclusions</h3><div>Patients with T2DM with higher PAT attenuation values and PATI exhibited an increased risk for higher DKD KDIGO risk categories. Baseline PAT attenuation values may have incremental value in DKD prognosis assessment.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109104"},"PeriodicalIF":2.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213122","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":"The role of biomarkers of innate and adaptive immunity in the early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus","authors":"Ayşen Türedi Yıldırım ,&nbsp;Nilay Tuğçe Işık Bayar ,&nbsp;Yeşim Yiğit ,&nbsp;Betül Ersoy","doi":"10.1016/j.jdiacomp.2025.109090","DOIUrl":"10.1016/j.jdiacomp.2025.109090","url":null,"abstract":"<div><h3>Aims</h3><div>Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are biomarkers linked to microvascular complications in adult diabetics. This study aimed to assess whether NLR and PLR, which increase in chronic inflammation, could aid in early detection of diabetic nephropathy (DN) in children and adolescents with Type 1 diabetes mellitus (T1DM).</div></div><div><h3>Methods</h3><div>The study included 90 children and adolescents with T1DM and 30 healthy controls. Microalbuminuria, defined as urine albumin &gt;20 μg/min, was used to indicate early DN. Participants were grouped by diabetes duration: 0–60 months, 61–120 months, and &gt;120 months.</div></div><div><h3>Results</h3><div>NLR was significantly higher in patients with microalbuminuria compared to controls and those without microalbuminuria (p10 years. Positive correlations were observed between urinary albumin and NLR (<em>r</em> = 0.274, <em>p</em> = 0.003) and between PLR and diabetes duration (<em>r</em> = 0.286, <em>p</em> = 0.006). For early DN diagnosis, an NLR threshold of 1.675 showed 60 % specificity and 84.2 % sensitivity.</div></div><div><h3>Conclusions</h3><div>NLR outperformed PLR in early DN detection and may prompt timely urine albumin testing in children with T1DM. Further studies are needed to confirm these results.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109090"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204285","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":"Impaired cerebral hemodynamics and oxygenation in type 2 diabetes: insights into insulin resistance and hyperglycemia effects","authors":"Islem Jlali ,&nbsp;Imen Touil ,&nbsp;Hassen Haj Amor ,&nbsp;Sémah Tagougui","doi":"10.1016/j.jdiacomp.2025.109102","DOIUrl":"10.1016/j.jdiacomp.2025.109102","url":null,"abstract":"<div><h3>Aims</h3><div>Emerging evidence suggests Type 2 diabetes (T2D) may adversely affect cerebral hemodynamics and oxygenation. This study aimed to explore the impact of uncomplicated T2D on cerebral hemodynamics and oxygenation during maximal exercise.</div></div><div><h3>Methods</h3><div>In a comparative clinical trial, 30 matched pairs of subjects with obesity, stratified by T2D status, were enrolled. Hemodynamic and oxygenation parameters were assessed during incremental maximal exercise. Additionally, physical activity levels, lipid profiles, and insulin resistance markers were evaluated.</div></div><div><h3>Results</h3><div>Participants with T2D exhibited significantly impaired cerebral blood volume (total hemoglobin) and oxygenation (oxygenated hemoglobin) compared to controls, especially at exercise intensities above 80 % of VO_2peak. This impairment was independent of differences in arterial carbon dioxide partial pressure (PaCO₂) levels between the groups at peak exercise (<em>P</em> &gt; 0.05, PaCO₂ 34.4 ± 3.2 vs 34.5 ± 1.3 mmHg). Moreover, individuals with T2D had a lower estimated glucose disposal rate (eGDR) compared to the control group (<em>P</em> = 0.02; 7.4 ± 2.4 vs 9.27 ± 0.97 mg/kg/min).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that insulin resistance and hyperglycemia in T2D contribute to impaired cerebral hemodynamics and oxygenation, even before clinical signs of microangiopathy appear. These alterations could have significant implications for cognitive function and overall brain health in individuals with T2D.</div></div><div><h3>Trial registration</h3><div>PACTR202301667050563.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109102"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204286","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 national quality survey of in-patient diabetic foot care calls for centralizing care and improving patient communication","authors":"Yaffa Ein-Gal ,&nbsp;Genya Aharon-Hananel ,&nbsp;Tal Sigawi ,&nbsp;Omer Hamtzany ,&nbsp;Itamar Raz ,&nbsp;Avivit Cahn","doi":"10.1016/j.jdiacomp.2025.109088","DOIUrl":"10.1016/j.jdiacomp.2025.109088","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the quality of inpatient care for patients with diabetic foot ulcers (DFU) and examine the relationship between managerial awareness of quality indicators and the actual care provided, as documented in the electronic medical records (EMRs).</div></div><div><h3>Methods</h3><div>A peer-reviewed audit of inpatient DFU care based on interviews with hospital and department management, yielding a comprehensive management score for each hospital; review of electronic medical records (EMR); and patient interviews. Data regarding facilities and personnel were collected as well.</div></div><div><h3>Results</h3><div>Data was collected from 26 hospitals, 199 EMR and 86 patient interviews. Larger hospital size was correlated with higher comprehensive management scores (<em>p</em> = 0.008). Moreover, large hospitals were more likely to have dedicated DFU cohorts thus simplifying provision of multidisciplinary state-of-the-art care (<em>p</em> = 0.034). Committed managers were more likely to dedicate surgical sessions to DFU patients, mean (±SD) comprehensive management score of 95.9 ± 3.4 in hospitals with dedicated session vs. 79.7 ± 9.6 in those without (<em>p</em> &lt; 0.001). Hospitals with committed management had better documentation and more prevalent use of correct diagnostic codes (<em>r</em> = 0.542), while higher dedication of head nurses of the DFU departments was significantly correlated with higher scores in inpatient care and patient education (<em>r</em> = 0.509, 0.826 respectively). Overall, patient communication and shared decision-making scored relatively low with only 78.8 % of the patients interviewed noting satisfaction.</div></div><div><h3>Conclusions</h3><div>Large hospitals were more likely to deliver high-quality multidisciplinary care, pivotal to the care of DFU patients. Dedicated management teams strongly impact better delivery of care. Better communication and shared decision-making should be reinforced.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109088"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213121","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":"High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis","authors":"Dhruva Patel ,&nbsp;Amy S. Shah ,&nbsp;Bliss Magella ,&nbsp;Mozhdeh Bahrainian ,&nbsp;Elizabeth A. Brown ,&nbsp;T.Y. Alvin Liu ,&nbsp;Veeral Shah ,&nbsp;Roomasa Channa ,&nbsp;Risa M. Wolf","doi":"10.1016/j.jdiacomp.2025.109091","DOIUrl":"10.1016/j.jdiacomp.2025.109091","url":null,"abstract":"<div><h3>Introduction</h3><div>The TODAY2 study reported that 80 % of young adults with youth-onset T2D (YoT2D) had at least one diabetes comorbidity or complication at a mean duration of 13 years. Prevalence rates of comorbidities and microvascular complications in YoT2D with shorter duration and younger age is unclear, particularly in the age of new pharmacotherapies.</div></div><div><h3>Methods</h3><div>In a multicenter retrospective analysis, presence of comorbidities (hypertension (systolic BP &gt; 130 or diastolic BP &gt; 80), dyslipidemia (LDL &gt; 130 mg/dL or triglycerides&gt;150 mg/dL), elevated liver enzymes (AST &gt; 25 U/L, or ALT U/L &gt; 22 for females or &gt;26 U/L for males)) and microvascular complications (microalbuminuria (microalbumin/creatinine ratio &gt; 30), diabetic retinopathy) in patients with YoT2D at three academic pediatric diabetes centers were assessed. Ordinal logistic regression models assessed the associations between demographic and clinical variables and increased odds of either comorbidities or complications.</div></div><div><h3>Results</h3><div>The study included 298 youth (median age 16.6 years, 60 % female, 57 % Black, 14 % Hispanic). The median duration of T2D was 1.8 years, median HbA1c was 6.9 % (42 % had an HbA1c &lt; 6.5 %). Over 80 % of patients had at least 1 comorbidity, 29 % with hypertension, 49 % with dyslipidemia, and 56 % with elevated liver enzymes. In the cohort, 21 % had at least 1 microvascular complication, 17 % with microalbuminuria, and 4.6 % with diabetic retinopathy. Proportion using GLP-1 receptor agonists and SGLT-2 inhibitors were 36 % and 7 %, respectively. Higher HbA1c and BMI increased the odds of having an additional comorbidity or complication, and longer diabetes duration increased the odds of having microvascular complications.</div></div><div><h3>Conclusions</h3><div>This study found comorbidities and microvascular complications in YoT2D at younger ages and short duration of diabetes despite use of new medications. Efforts are needed to improve glycemic control and other risk factors to reduce diabetes-related complications in YoT2D.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109091"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470751","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":"Real-world initiation of continuous glucose monitoring (CGM) in adults with type 1 diabetes leads to increased body mass index - A brief report from IMI-SOPHIA study","authors":"Jimena Soto-Hernaez ,&nbsp;Rory J. McCrimmon ,&nbsp;Ewan R. Pearson ,&nbsp;Enrique Soto-Pedre","doi":"10.1016/j.jdiacomp.2025.109089","DOIUrl":"10.1016/j.jdiacomp.2025.109089","url":null,"abstract":"<div><div>Continuous glucose monitoring (CGM) has beneficial effects on glycaemic control in adults with type 1 diabetes (T1D), but the potential effects on body mass index (BMI) remain unclear. This study underscores a trend of increasing BMI within two years after CGM initiation.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109089"},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147610","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 remnant cholesterol and triglycerides on diabetes foot and disease in type 1 diabetes: A propensity score-matched case-control study","authors":"Fernando Sebastian-Valles ,&nbsp;Alberto Santiago-Redondo ,&nbsp;Elena García-Artacho ,&nbsp;Miguel Antonio Sampedro-Nuñez ,&nbsp;Victor Navas-Moreno ,&nbsp;Jose Alfonso Arranz Martín ,&nbsp;Mónica Marazuela","doi":"10.1016/j.jdiacomp.2025.109082","DOIUrl":"10.1016/j.jdiacomp.2025.109082","url":null,"abstract":"<div><h3>Objective</h3><div>Remnant cholesterol is an emerging cardiovascular risk factor; however, its impact on diabetes foot disease (DFD) remains poorly studied. This study evaluates the association between dyslipidaemia and DFD in a cohort of individuals with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>A nested case–control study was conducted within a cohort of 419 individuals with T1D. DFD was defined as a history of peripheral arterial disease—such as prior lower limb revascularization or vascular-origin amputations—or as the presence of diabetic foot according to the Wagner classification. Clinical and sociodemographic data were collected, and a 1:2 propensity score matching was performed based on age, sex, diabetes duration, smoking status, HbA1c, diabetic retinopathy, and nephropathy. Conditional logistic regression models were used to evaluate the association between dyslipidemia and DFD, adjusting for confounding variables.</div></div><div><h3>Results</h3><div>Of the 419 subjects, 56 (13.4 %) had DFD. After matching, 17 subjects were excluded, leaving 39 cases and 78 controls (<em>n</em> = 117). The mean age was 61.6 ± 14.3 years, 40.2 % were women, and the mean diabetes duration was 30.0 ± 14.4 years. Remnant cholesterol was significantly higher in cases (22 ± 10 mg/dL vs. 17 ± 11 mg/dL, <em>p</em> = 0.038), as were triglycerides (111 ± 49 mg/dL vs. 90 ± 65 mg/dL, <em>p</em> = 0.005). In multivariable analysis, remnant cholesterol (OR = 1.15, 95 % CI [1.03–1.27]) and triglycerides (OR = 1.03, 95 % CI [1.01–1.05]) were independently associated with DFD.</div></div><div><h3>Conclusion</h3><div>Remnant cholesterol and triglycerides are associated with DFD in individuals with long-standing T1D and high cardiovascular risk. Prospective studies are needed to confirm these findings.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109082"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124026","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":"Progressive improvements in patient-reported outcomes with the high-concentration capsaicin patch: A retrospective cohort study in patients with painful diabetic peripheral neuropathy (CASPAR study)","authors":"Michael A. Überall ,&nbsp;Zoltan Kender ,&nbsp;Tamara Quandel ,&nbsp;Sylvia Engelen ,&nbsp;Lucia Garcia Guerra ,&nbsp;Tawfik Fajri ,&nbsp;Samuel M. Allen ,&nbsp;Rita L. Freitas ,&nbsp;Mariëlle H. Eerdekens","doi":"10.1016/j.jdiacomp.2025.109085","DOIUrl":"10.1016/j.jdiacomp.2025.109085","url":null,"abstract":"<div><h3>Objective</h3><div>To assess long-term outcomes and tolerability associated with repeated topical high-concentration capsaicin patch (HCCP) treatments in painful diabetic peripheral neuropathy (pDPN).</div></div><div><h3>Methods</h3><div>CASPAR, a retrospective, non-interventional cohort study of HCCP for neuropathic pain, utilizes real-world data from the German Pain e-Registry. This analysis included 826 patients with pDPN of the hands, feet, or legs receiving ≥1 HCCP with ≥12 months of follow-up.</div></div><div><h3>Results</h3><div>Significant reductions in 24-ho average pain intensity (API) were seen at baseline to Month 3 (mean 57.5 vs 42.4). Successive treatments generated further improvements; these were lost upon HCCP discontinuation. Patients receiving four HCCPs had a mean API decrease from 59.0 (baseline) to 16.0 (Month 12). A ≥30 % API decrease was achieved at Month 12 in 98.9 %, 90.8 %, 67.7 %, and 22.0 % of patients receiving four, three, two, or one HCCP, respectively. Improvements were observed across sleep, QoL, mood, daily activities, and concomitant pain medication use, with the greatest benefits for patients receiving four HCCPs. Results were consistent across treatment locations. Safety and tolerability aligned with the well-established profile for HCCP, consisting of local application-site reactions.</div></div><div><h3>Conclusion</h3><div>HCCP is a non-systemic treatment for pDPN associated with increasing improvements in neuropathic pain, sleep, mood, and QoL with successive treatments.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109085"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239431","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}