Journal of Nutrition最新文献

{"title":"Development of the Nordic Nutrition Recommendations 2023 Food-Based Diet Score and Its Association with All-Cause Mortality in Two Swedish Cohorts.","authors":"Anne B Mørch, Daniel B Ibsen, Alicja Wolk, Christina C Dahm","doi":"10.1016/j.tjnut.2025.06.030","DOIUrl":"10.1016/j.tjnut.2025.06.030","url":null,"abstract":"<p><strong>Background: </strong>The 2023 Nordic Nutrition Recommendations (NNR23) presented a dual focus on disease prevention and planetary health.</p><p><strong>Objectives: </strong>We aimed to develop a food-based diet score measuring adherence to NNR23 and assess its association with all-cause mortality in a Swedish population.</p><p><strong>Methods: </strong>We developed a novel diet score with 15 food components representing NNR23. Each component was scored between 0 and 1 point on a continuous scale, 1 being full adherence, based on participants' intakes. The study population included women (48-83 y old) from the Swedish Mammography Cohort (n = 39,984) and men (45-79 y old) from the Cohort of Swedish Men (n = 48,850), who completed food frequency questionnaires in 1997, 2009, and 2019 and were followed up although linkage to the National Death Register. Multivariable adjusted Cox proportional hazards regression models with age as the underlying timescale were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between adherence to NNR23 and all-cause mortality, as well as cardiovascular- and cancer-specific deaths.</p><p><strong>Results: </strong>The median NNR23 score was 9.5 (p10, p90; 8.3, 11) for women and 8.9 (p10, p90; 7.4, 10) for men; no participant achieved full adherence. During a median 18.8 y of follow-up, 30,142 participants died. Participants with the highest adherence (>10 points) at baseline had a 23% lower all-cause mortality (HR 0.77; 95% CI: 0.74, 0.80) compared with the lowest adherence group (<8 points). Results were similar for cardiovascular- and cancer-specific mortality. For long-term average food intake, we found an even lower mortality risk when comparing the highest adherence with the lowest adherence (HR 0.38; 95% CI: 0.37, 0.40).</p><p><strong>Conclusions: </strong>With a new food-based diet score representing NNR23, we found that higher compared with lower adherence to NNR23 was associated with lower mortality in a Swedish population.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567507","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":"Maternal Hemoglobin Concentrations in Early and Late Pregnancy and Adverse Birth Outcomes: A Nationwide Cohort Study in Sri Lanka.","authors":"Malshani L Pathirathna, Megumi Haruna, Satoshi Sasaki, Kaori Yonezawa, Yuriko Usui, Yasuhiro Hagiwara","doi":"10.1016/j.tjnut.2025.06.029","DOIUrl":"10.1016/j.tjnut.2025.06.029","url":null,"abstract":"<p><strong>Background: </strong>Maternal hemoglobin (Hb) plays a critical role in pregnancy and may influence birth outcomes.</p><p><strong>Objectives: </strong>The study aimed to examine associations between maternal Hb in early and late pregnancy and adverse birth outcomes in a cohort of singleton pregnancies in Sri Lanka.</p><p><strong>Methods: </strong>This prospective study analyzed 1315 mother-newborn pairs. Anemia was defined as Hb < 11.0 g/dL, based on World Health Organization cutoffs for the first and third trimesters, corresponding to the early and late pregnancy time points studied. Outcomes included preterm birth, low birth weight (LBW), and small-for-gestational age (SGA). Multivariate logistic regression and restricted cubic spline analyses were used to assess associations, adjusting for maternal age, prepregnancy body mass index, parity, and history of pregnancy loss. LBW models were evaluated with and without adjustment for gestational age.</p><p><strong>Results: </strong>Median Hb was 12.0 g/dL (interquartile range [IQR]: 11.4-12.7) in early pregnancy and 11.4 g/dL (IQR: 10.8-12.0) in late pregnancy. Anemia prevalence increased from 16% to 32%, with a notable shift of women from the 11.0 to 12.9 g/dL category into the anemic range. Early-pregnancy Hb 9.0-10.9 g/dL was associated with higher odds of preterm birth [adjusted odds ratio (aOR): 2.18; 95% confidence interval (CI): 1.42, 3.34], whereas Hb ≥ 13.0 g/dL showed a nonsignificant increase (aOR: 1.49; 95% CI: 0.97, 2.30). In late pregnancy, Hb ≥ 13.0 g/dL was associated with increased odds of LBW (aOR: 2.18; 95% CI: 1.04, 4.54) in models without gestational age adjustment. No significant associations were observed for SGA. Restricted cubic spline analysis showed a significant U-shaped association between early-pregnancy Hb and preterm birth, with the lowest odds at 11.0-12.9 g/dL.</p><p><strong>Conclusions: </strong>Low and high maternal Hb concentrations were associated with increased odds of adverse birth outcomes. These findings support careful monitoring of maternal Hb during pregnancy and further research to define an upper limit for Hb in pregnancy.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567509","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":"Reconsidering Plant-Based Diets in Erectile Dysfunction: Nuances from Andrological Practice.","authors":"Shengyi Chen, Yuekun Fang, Bin Cheng","doi":"10.1016/j.tjnut.2025.06.032","DOIUrl":"10.1016/j.tjnut.2025.06.032","url":null,"abstract":"","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564907","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":"Cognitive Impairment Is Associated with Alterations in Diet Quality and Inflammatory Biomarkers in Older Adults: A Cross-Sectional Analysis of Data Collected from the Microbiome in Aging Gut and Brain (MiaGB) Consortium Cohort.","authors":"Andrea Y Arikawa, Anna Waterman, Sidharth P Mishra, Corinne Labyak, Cynthia Williams, Diptaraj S Chaudhari, Rohit Shukla, Vivek Kumar, Michal Masternak, Peter Holland, Adam Golden, Mariana Dangiolo, Judyta Kociolek, Amoy Fraser, Marc Agronin, Mariolga Aymat, Hariom Yadav, Shalini Jain","doi":"10.1016/j.tjnut.2025.06.026","DOIUrl":"10.1016/j.tjnut.2025.06.026","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that gut inflammation and alterations in intestinal barrier function may be important mechanisms linking diet, systemic inflammation, and cognitive outcomes.</p><p><strong>Objectives: </strong>The objective of this study was to explore the relationship between diet, cognitive health, and inflammatory markers in older adults. It was hypothesized that cognitive impairment would be associated with lower diet quality and higher levels of inflammatory markers.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from the microbiome in aging gut and brain consortium cohort. Participants aged 60 y and older were assessed for cognitive status using the Montreal Cognitive Assessment (MoCA), diet quality using the Healthy Eating Index-2020 (HEI-2020), and dietary inflammatory potential using the dietary inflammatory index (DII). Inflammatory biomarkers were measured in plasma and stool samples, including interleukin (IL)-6, IL-1β, lipopolysaccharide-binding protein (LBP), toll-like receptor 4 (TLR4), and zonula occludens-1 (ZO-1).</p><p><strong>Results: </strong>Among 217 participants, 33.6% presented with cognitive impairment based on MoCA scores. There were no differences in DII and HEI-2020 scores between participants with and without cognitive impairment. The only significant finding related to the components of the HEI was a higher adequacy of dairy intake in those without cognitive impairment (54.8%) compared with those with cognitive impairment (44.4%, P = 0.035). Key inflammatory markers, including IL-6, IL-1β, LBP, and TLR4, were elevated in those with cognitive impairment, whereas plasma ZO-1 levels were reduced. Stool calprotectin levels were notably higher in those with cognitive impairment, suggesting increased intestinal inflammation. There was a weak but significant correlation between stool calprotectin and DII score (r_s = 0.283, P = 0.046).</p><p><strong>Conclusions: </strong>The findings suggest that elevated inflammatory markers and disrupted intestinal barrier integrity may contribute to cognitive decline. These results highlight the need to develop dietary interventions to mitigate cognitive impairment through modulation of inflammation.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567506","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":"Calcium Supplementation, Genetic Susceptibility, and Idiopathic Pulmonary Fibrosis Risk: A Prospective Study.","authors":"Bingxin Shang, Yuxin Yao, Yujia Xie, Haoyu Yin, Shiyu Yang, Xiaojie You, Haoxiang Liu, Fei Luo, Jixuan Ma","doi":"10.1016/j.tjnut.2025.06.024","DOIUrl":"10.1016/j.tjnut.2025.06.024","url":null,"abstract":"<p><strong>Background: </strong>The association between calcium supplementation and the risk of incident idiopathic pulmonary fibrosis (IPF) is largely unknown.</p><p><strong>Objectives: </strong>This study aimed to investigate the association of calcium supplementation with IPF incidence and further explore the modifying effect of genetic susceptibility.</p><p><strong>Methods: </strong>This study analyzed 472,468 participants from the UK Biobank. The information on the calcium supplement use was obtained from the baseline touchscreen questionnaire, and the IPF case was identified using the International Classification of Diseases with the 10th edition codes J48.1, and further excluded secondary pulmonary fibrosis-related diseases. We used the Cox proportional hazard model to assess the association between calcium supplementation and the risk of IPF incidence. Besides, we calculated the IPF-specific polygenic risk score for each individual and assessed the modifying effect of genetic susceptibility.</p><p><strong>Results: </strong>During a median follow-up of 12.82 y, a total of 1859 new-onset IPF cases were identified. After adjusting for traditional risk factors, we found that calcium supplement use was significantly associated with a 30% increased risk of IPF (hazard ratio: 1.30; 95% confidence interval: 1.08, 1.57). Stratified analyses showed that sex modified the observed associations, and the adverse effect of calcium supplement use was stronger among males (P-interaction: 0.037). Moreover, there was a cumulative effect of genetic factors and calcium supplementation on the risk of incident IPF. Compared with calcium supplementation nonusers with low genetic risk, those with calcium supplementation and high genetic risk had the highest risk of IPF incidence (hazard ratio: 3.47; 95% CI: 2.59, 4.66).</p><p><strong>Conclusions: </strong>This study provides observational evidence that calcium supplementation may be a novel risk factor for IPF. Our findings highlight the importance of caution regarding the use of calcium supplements. Further experimental studies are still required to validate our results and elucidate the exact mechanisms.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560435","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":"Maternal Undernutrition Exacerbates Effects of Ambient Heat During Pregnancy in Mice.","authors":"Ian J Griffin","doi":"10.1016/j.tjnut.2025.06.034","DOIUrl":"10.1016/j.tjnut.2025.06.034","url":null,"abstract":"","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564904","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":"Golden Rice: A Quarter-Century of Innovation, Challenges, and the Promise of Better Nutrition.","authors":"Amanda C Palmer","doi":"10.1016/j.tjnut.2025.06.025","DOIUrl":"10.1016/j.tjnut.2025.06.025","url":null,"abstract":"<p><p>Golden Rice was first introduced to the scientific community and the wider public 25 y ago and arguably remains the most widely recognized biofortified crop. Unlike most staples, the provitamin A carotenoid biosynthetic pathway is absent in the grain of all known rice cultivars. Scientists therefore relied on modern biotechnology to introduce 2 transgenes that enabled carotenoid production and accumulation, with 80%-90% as β-carotene. The second generation of Golden Rice, incorporating genes from maize and a common soil bacterium, can produce 20-30 μg of β-carotene per gram of edible rice. Although carotenoid levels decline in storage, they remain high enough to contribute meaningfully to vitamin A intake. After its initial development, Golden Rice technology was transferred to public sector breeding programs in low- and middle-income countries, prioritizing Bangladesh and the Philippines due to prevalent vitamin A deficiency, high per capita rice consumption, strong agricultural research institutes, and prior experience with transgenic crops. Both countries have developed locally adapted Golden Rice varieties matching conventional rice in agronomic performance, cultivation practices, and cost. However, regulatory hurdles have stalled their release-approval remains pending in Bangladesh, whereas legal challenges in the Philippines have at least temporarily halted further research and deployment. Although recent data indicate a decline in the prevalence of vitamin A deficiency in the Philippines, rural populations remain vulnerable, and Golden Rice has the potential to serve as a safety net to achieve adequate vitamin A intake.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560437","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":"Protective Role of Dietary Short-Chain Fatty Acid Propionate against Autoimmune Responses and Pathology of Systemic Lupus Erythematosus in MRL-lpr Mice.","authors":"Hui Wang, Yuejin Liang, Paul J Boor, Kamil Khanipov, Yuanyi Zhang, Xiaoying Yu, Chandra Shekar R Ambati, Nagireddy Putluri, M Firoze Khan","doi":"10.1016/j.tjnut.2025.06.031","DOIUrl":"10.1016/j.tjnut.2025.06.031","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs, including the skin and kidneys. The etiology of SLE remains unclear but involves hormonal, environmental, and genetic factors. Environmental factors, such as diet and microbiota-derived metabolites, among which short-chain fatty acids (SCFAs) are major players, can influence autoimmune disease pathogenesis.</p><p><strong>Objectives: </strong>This study investigates the involvement of SCFAs in the pathogenesis of SLE and further investigates the effect of propionate (PA) supplementation on SLE disease outcome in MRL-lpr mice.</p><p><strong>Methods: </strong>Cecal SCFAs from mouse models with varying degrees of SLE disease activities (C57BL/6, MRL+/+, and MRL-lpr) were determined by liquid chromatography/MS analysis. Five-week-old MRL-lpr mice were supplemented with PA (200 mM, via drinking water) for 6 wk, and assessed for autoimmunity and disease markers.</p><p><strong>Results: </strong>Liquid chromatography/mass analysis of cecal SCFAs showed a significant decrease of PA in MRL-lpr mice (P < 0.001). PA treatment ameliorated the autoimmune response, evident from reduced serum autoantibodies (P < 0.05 for both antinuclear antibodies and anti-double-stranded deoxyribonucleic acid) and a significant alleviation of glomerulonephritis (P < 0.05). Furthermore, it restored the imbalances in gut microbiome composition and SCFAs, especially PA (P < 0.01). Additionally, PA treatment resulted in decreased splenic activated CD4 T cells (P < 0.05) and alterations in renal inflammatory signaling pathways.</p><p><strong>Conclusions: </strong>Our findings support the beneficial effects of PA in alleviating SLE and the therapeutic potential of PA or PA-producing bacteria for SLE.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564906","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":"Effects of L-Arabinose on Glycemic Responses After the Consumption of Sucrose-Rich Foods in Individuals with Impaired Fasting Glucose: A Randomized Controlled Cross-Over Trial.","authors":"Leoné Pretorius, Korrie Pol, Corine Perenboom, Katherine M Appleton, Janet James, Monica Mars","doi":"10.1016/j.tjnut.2025.06.028","DOIUrl":"10.1016/j.tjnut.2025.06.028","url":null,"abstract":"<p><strong>Background: </strong>Impaired fasting glucose (IFG) is considered a preclinical stage of type 2 diabetes. L-arabinose is a sucrase inhibitor that interferes with sucrose breakdown and has been shown to lower glycemic and insulinemic responses in healthy individuals. However, its effects in individuals with IFG are unknown.</p><p><strong>Objectives: </strong>This study aims to assess effects of L-arabinose on glycemic responses after the consumption of sucrose-rich foods in individuals with IFG.</p><p><strong>Methods: </strong>Eighteen adults [4 females, 14 males; age 73 ± 4 y; body mass index 27.5 ± 2.4 kg/m²] with IFG participated in a double-blind, randomized, cross-over trial. Participants received 10% w/w L-arabinose (treatment) in a 550 mL sucrose drink or a sucrose-only drink (control). Blood glucose and insulin were measured before and ≤180 min post consumption. After this, participants consumed a 2-d controlled diet with sucrose-rich (9-10 en%) meals and snacks, preceded by a 15% w/w L-arabinose supplement or no L-arabinose (control). Continuous glucose monitoring (CGM) assessed glycemic variability throughout the trial.</p><p><strong>Results: </strong>A single treatment of 10% w/w L-arabinose significantly reduced glucose peaks (-14%) and insulin peaks (-30%), with delays of 10 and 32 min, respectively. CGM also revealed significant reductions in variability compared with control value: standard deviation (-25%), coefficient of variation (-24%), and mean amplitude of glycemic excursions (-26%). However, no effects on glycemic variability were observed during the controlled diet.</p><p><strong>Conclusions: </strong>A single treatment of L-arabinose to a sucrose-rich drink reduced insulin and glucose responses in individuals with IFG, but this effect did not extend to a sucrose-rich diet containing complex meals and snacks.</p><p><strong>Trial registration number: </strong>https://onderzoekmetmensen.nl/nl/trial/27001.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564905","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":"Monitoring Nutrition Security: Perspectives from a Workshop on Nutrition Security Measurement.","authors":"Ximena Perez-Velazco, Edward A Frongillo, Joanne F Guthrie, Alisha Coleman-Jensen, Mariah D Ehmke, Christian Gregory, Hilary K Seligman","doi":"10.1016/j.tjnut.2025.06.022","DOIUrl":"10.1016/j.tjnut.2025.06.022","url":null,"abstract":"<p><p>Nutrition security, an emerging concept distinct from and complementary to food security, has gained increasing interest as a focus of efforts to reduce hunger, improve nutrition, and prevent diet-related health conditions. Yet, unlike food security, which has well-established measures, nutrition security lacks standardized measures for assessment. This gap hinders the ability to evaluate progress in improving nutrition security both in the United States and globally. In September 2024, a workshop to explore how to measure nutrition security was hosted by the United States Department of Agriculture Economic Research Service, in collaboration with the Southern University Agricultural Science Center of Excellence for Nutrition and Diet Nutrition Hub. A recent conceptual framework proposes that nutrition security includes the 2 constructs of healthy diets and nutritional status, but consensus on that framework and on measurement is lacking. Various measures of nutrition security have been proposed, each with different methods, feasibility, cost, and data requirements. With consensus yet to emerge on the conceptualization and measurement of nutrition security, further research is needed to validate proposed conceptual frameworks, refine measurement methods and measures, assess their validity, and determine their utility for monitoring nutrition security at the population level. This research will advance efforts to improve nutrition security and inform nutrition policy and program interventions.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560439","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}