Journal of Bone and Mineral Research最新文献

{"title":"Fracture probability is predictive of fall-associated hospitalization: the Manitoba BMD Registry.","authors":"Fatima Zarzour, Eugene V McCloskey, Helena Johansson, Nicholas C Harvey, John A Kanis, William D Leslie","doi":"10.1093/jbmr/zjag020","DOIUrl":"10.1093/jbmr/zjag020","url":null,"abstract":"<p><p>The current version of FRAX does not consider prior falls as a primary input variable. Limited data suggest that greater FRAX-derived fracture probability is associated with incident falls at least in elderly men. Our aim was to examine the association of FRAX-derived fracture probability with the risk for subsequent fall-associated hospitalizations. We identified individuals aged 40 yr or older at the time of baseline DXA with FRAX-derived major osteoporotic fracture (MOF) probability assessed through the Manitoba BMD Program. We used linkage with population-based data to identify subsequent hospitalization that included a fall diagnosis code. Sensitivity analyses examined fall-associated hospitalizations unrelated to a concurrent fracture (diagnosed within 30 d). Cox regression was used to estimate HR for time to fall-associated hospitalization according to MOF probability without and with BMD (per SD increase and also for individual variables in the FRAX tool). The study comprised 88 684 individuals, mean age 64.6 yr, 89.5% female. During mean 8.6 yr observation (total 759 963 person-years), 9715 (11.0%) individuals experienced a fall-associated hospitalization; of these, 3363 (3.8%) were unrelated to concurrent fracture. Every SD increase in MOF fracture probability was strongly associated with fall-associated hospitalization (without BMD HR, 2.47; 95% CI, 2.41-2.52; with BMD HR, 2.48; 95% CI, 2.43-2.53). No significant interaction was seen between fracture probability and follow-up time (p = .516). Findings were similar when restricted to individuals with falls unrelated to concurrent fracture, when adjusted for previous fall-associated hospitalization (last 3 yr) or self-reported fall (last 12 mo), when restricted to individuals without previous falls, and for FRAX-derived hip fracture probability. All FRAX variables except for parental hip fracture showed a positive relationship with fall-associated hospitalization. In conclusion, FRAX-derived fracture probability is strongly associated with risk for future fall-associated hospitalization, including falls unrelated to concurrent fracture.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1080-1086"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of current and previous smoking on fracture risk in older women: the role of physical function, bone density, and bone microarchitecture.","authors":"Michail Zoulakis, Margarita Ambjörn, Raju Jaiswal, Kristian F Axelsson, Henrik Litsne, Lisa Johansson, Mattias Lorentzon","doi":"10.1093/jbmr/zjag028","DOIUrl":"10.1093/jbmr/zjag028","url":null,"abstract":"<p><p>While smoking is a known risk factor for fractures, its precise mechanisms among older women, particularly involving physical function, bone density, and bone microarchitecture, remain incompletely understood. This prospective cohort study included 3024 community-dwelling Swedish women aged 75-80 yr, followed for a median of 7.3 yr. Participants were categorized as current smokers (n = 157), former smokers (n = 1343), and never smokers (n = 1524). Radiographically verified fractures and all-cause mortality were assessed. Cox proportional hazards models, mediation analyses, and competing risk models evaluated associations between smoking status, fracture risk, and potential mediators, including walking speed and total volumetric BMD (vBMD). Current smokers had significantly increased risks of any fracture (HR 1.35; 95% CI 1.04-1.75) and hip fracture (HR 2.23, 95% CI 1.43-3.49) compared to never smokers. Former smokers exhibited intermediate risks. Women who had ceased smoking for 5-10 yr had substantially lower fracture risk than current smokers. Each year since cessation conferred an ~1% relative reduction in fracture and mortality risk. Mediation analyses revealed significant indirect effects via slower walking speed (18%-28%) and lower total vBMD, suggesting these factors are key contributors to fracture risk. Importantly, competing risk models confirmed elevated fracture risk in smokers even after accounting for increased mortality. These findings demonstrate that smoking is associated with increased fracture risk in older women, partly through impairments in physical function and vBMD. Smoking cessation appears to confer meaningful skeletal benefits, indicating a need for integrated strategies targeting both behavior change and physical function to reduce fracture burden in aging populations.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1096-1108"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palopegteriparatide for adults with chronic hypoparathyroidism: skeletal dynamics through 3 years of the phase 2 PaTH forward trial.","authors":"Mishaela R Rubin, Bart L Clarke, Lorenz C Hofbauer, Aliya Khan, Peter Schwarz, Tamara Vokes, Intekhab Ahmed, Andrea Palermo, Filomena Cetani, Uberto Pagotto, Carol Zhao, Michael S Ominsky, Bryant Lai, Jenny Ukena, Aimee D Shu, Lars Rejnmark","doi":"10.1093/jbmr/zjag013","DOIUrl":"10.1093/jbmr/zjag013","url":null,"abstract":"<p><p>Hypoparathyroidism is an endocrine disease caused by insufficient levels of PTH, which acts directly on bone and kidney and indirectly on the intestine to regulate calcium and phosphate balance. In clinical trials, palopegteriparatide (TransCon PTH) treatment enabled independence from conventional therapy (no active vitamin D, ≤600 mg/d calcium) and maintained serum biochemistries within normal ranges. The current analyses describe patterns of change in BMD, serum bone turnover markers, and serum and urine calcium in adults with chronic hypoparathyroidism treated with palopegteriparatide through 3 years of the PaTH Forward trial. Baseline BMD Z-scores for the LS, TH, FN, and 1/3 distal radius were above zero, indicating bone mass exceeding age-adjusted normative values. BMD decreased from these elevated baseline levels with palopegteriparatide treatment, with larger reductions during the first 26 weeks and modest declines thereafter. Mean BMD Z-scores at week 162 remained above zero for all 4 sites. Participants with lower baseline BMD (Z-scores below -1 and T-scores below -2.5) generally exhibited lesser declines in BMD versus those with higher baseline BMD. Palopegteriparatide treatment was associated with early increases in bone resorption (serum C-terminal telopeptide of type I collagen, CTx) and bone formation (serum procollagen type 1 N-terminal propeptide, P1NP) that peaked at weeks 12 and 26, respectively, followed by declines to levels moderately higher than baseline at week 162. Mean CTx and P1NP in the overall population and the subgroup of postmenopausal women were below their upper limits of normal from weeks 58-162. At week 162, mean serum and median urine calcium remained within normal ranges and 91% of participants were independent from conventional therapy. These results suggest that long-term palopegteriparatide therapy in adults with chronic hypoparathyroidism gradually returns the skeleton toward its natural state thereby enhancing the skeleton's contribution to calcium homeostasis.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1069-1079"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palopegteriparatide therapy for hypoparathyroidism: targeting the PTH receptor rouses the sleeping skeleton.","authors":"Michael A Levine","doi":"10.1093/jbmr/zjag078","DOIUrl":"10.1093/jbmr/zjag078","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1041-1044"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's musculoskeletal health: insights from the 2024 National Academies of Sciences, Engineering, and Medicine report on chronic conditions.","authors":"Melia Matthews, Rachel Cooper, Sarah L Dallas, Sundeep Khosla, Kristi Lengyel, Neena Nizar, Sanique M South, Marjolein C H van der Meulen, Tamara Alliston, Mary L Bouxsein, John J Wysolmerski","doi":"10.1093/jbmr/zjag092","DOIUrl":"10.1093/jbmr/zjag092","url":null,"abstract":"<p><p>In 2024, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a report entitled Advancing Research on Chronic Conditions in Women. A major purpose of this report was to summarize the current state of research into a series of 21 chronic conditions that affect women differently or that are more common in women. The American Society for Bone and Mineral Research (ASBMR) established a working group to evaluate the NASEM report's implications for women's musculoskeletal (MSK) health. This perspective summarizes key research gaps identified in the NASEM report, including the lack of sex-specific data, underrepresentation of women in clinical studies, and minimal integration of MSK health with other chronic conditions. The NASEM report underscores the need for more comprehensive study designs that consider hormonal, genetic, and social determinants of health across the lifespan. In addition to osteoporosis, in this perspective, the ASBMR working group highlights emerging but poorly understood evidence of detrimental effects on musculoskeletal biology in non-MSK, chronic diseases that were identified in the NASEM report to disproportionately affect women. To advance the field, we advocate for better diagnostics, increased investment, and stronger representation of women in research studies. Addressing these gaps is critical for improving prevention, care, and outcomes for chronic conditions that uniquely or disproportionately affect women.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1045-1055"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vivo mechanical assessment of cortical bone rigidity enhances fracture discrimination beyond DXA in postmenopausal women.","authors":"Brian C Clark, Todd M Manini, Janet E Simon, Leatha A Clark, Charalampos Lyssikatos, Stuart J Warden","doi":"10.1093/jbmr/zjag032","DOIUrl":"10.1093/jbmr/zjag032","url":null,"abstract":"<p><p>DXA-derived areal BMD remains the clinical standard for assessing osteoporosis risk, yet it fails to identify over 75% of individuals who sustain fragility fractures. Direct in vivo mechanical assessment of cortical bone strength may address this diagnostic gap by capturing structural and material properties that govern whole-bone strength but are not reflected by BMD. We conducted a multicenter case-control study with cross-sectional exposure assessment to compare ulna flexural rigidity (EI), a biomechanical property correlated with whole-bone strength (R2 ≈ 0.99), estimated using cortical bone mechanics technology (CBMT), with DXA-derived BMD for discriminating prior fragility fractures in postmenopausal women. A total of 372 women aged 50-80 yr (109 with low-trauma fractures and 263 matched controls) were enrolled across 4 U.S. sites. Ulna EI was assessed by dynamic vibrational analysis; BMD was measured at the spine, hip, and 1/3 radius. Women with prior fractures had significantly lower EI than controls (absolute: 20.0 vs 24.8 N·m2; 21% lower; weight-normalized: 0.29 vs 0.36 N·m2/kg; 22% lower; both p < .001). Cortical bone mechanics technology demonstrated good discriminatory accuracy (AUC = 0.80 normalized; 0.76 absolute), with significantly better AUCs than DXA, which showed only fair to poor performance (AUC ≤ 0.63). In multivariable models including CBMT and DXA-derived BMD, CBMT remained independently associated with fracture status, whereas BMD did not. Subgroup analyses showed CBMT retained good performance in treatment-naïve women (AUC = 0.85) and in those with non-osteoporotic BMD (AUC = 0.80). Exploratory fracture-site analyses demonstrated that ulna EI discriminated upper and lower extremity fractures, including hip, whereas DXA-derived BMD generally showed fair to poor discrimination. Biomechanical assessment of bone rigidity provides clinically relevant information beyond areal BMD, including women not classified high risk. Direct in vivo assessment of cortical bone rigidity may enhance fracture risk stratification and enhance osteoporosis screening.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1109-1122"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal pathologies caused by PLS3 inactivation are predominantly associated with impaired cortical bone integrity.","authors":"Oskar Windels, Alexander Simon, Lara Schiewek, Julian Delsmann, Uwe Kornak, Michael Amling, Thorsten Schinke, Timur Yorgan, Ralf Oheim","doi":"10.1093/jbmr/zjag141","DOIUrl":"https://doi.org/10.1093/jbmr/zjag141","url":null,"abstract":"<p><p>The identification of pathogenic PLS3 variants in individuals with X-linked osteoporosis (XLO) has demonstrated the importance of the actin-bundling protein plastin-3 for skeletal integrity. We and others have previously reported that Pls3-deficient mice display a skeletal phenotype that unexpectedly affects only the cortical bone compartment. To better characterize the impact of PLS3 inactivation on bone (micro-)architectural parameters in humans, we retrospectively analyzed skeletal parameters obtained from male XLO patients and compared them to corresponding data from male individuals with genetically diagnosed osteogenesis imperfecta type I (OI-I). We observed no major differences between XLO and OI-I patients in baseline characteristics, laboratory parameters, or bone mineral density measurements by dual-energy X-ray absorptiometry (DXA). However, there was a significant difference between the two groups observed by high resolution peripheral quantitative computed tomography (HRpQCT). More specifically, XLO patients displayed significantly reduced cortical bone parameters, compared to both normal reference ranges and OI-I, especially at the distal radius. We also analyzed female heterozygous carriers of (likely) pathogenic PLS3 alleles, who were less affected compared to male XLO patients. However, two of them displayed osteoporotic fractures at a postmenopausal age, thus treatment with romosozumab, a monoclonal antibody targeting sclerostin, was initiated and appeared to be effective. Since another sclerostin-neutralizing antibody is currently studied for the treatment of OI patients, we crossed Pls3-deficient mice with mice carrying a high bone mass allele of Lrp5 (Lrp5A213V), which serves as a molecular mimic of anti-sclerostin therapy. We found that the presence of the Lrp5A213V allele led to significantly increased cortical and trabecular bone mass not only in wildtype but also in Pls3-deficient mice. Taken together, our data raise the hypothesis that PLS3 inactivation predominantly affects cortical bone parameters in mice and humans and that anti-sclerostin therapy could be effective for the treatment of XLO.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jump power testing as a screening tool to assess fracture risk: a giant leap or a hop in the right direction?","authors":"Cassandra Smith, Namki Hong","doi":"10.1093/jbmr/zjag064","DOIUrl":"10.1093/jbmr/zjag064","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1039-1040"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147661953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of U.S.-FRAX by race and ethnicity for short-term hip and major osteoporotic fracture prediction in U.S. women with rheumatoid arthritis.","authors":"Rachel E Elam, Jing Li, Angel Paul, Emma Kersey, Gabriela Schmajuk, William D Leslie, Laura D Carbone","doi":"10.1093/jbmr/zjag033","DOIUrl":"10.1093/jbmr/zjag033","url":null,"abstract":"<p><p>Women with RA face elevated fracture risk, yet performance of the U.S.-FRAX across racial and ethnic groups in RA remains understudied. In this retrospective cohort study, we examined 14 533 women aged ≥65 yr with RA from the U.S. national Rheumatology Informatics System for Effectiveness registry, linked to Medicare claims (2016-2018), to assess the performance of race- and ethnicity-adapted U.S.-FRAX calculators without BMD for predicting short-term (2-yr) hip and major osteoporotic fracture (MOF) risk across racial and ethnic groups. Most participants were White (86.5%), with smaller proportions of Black or African American (7.8%), Hispanic or Latina (4.7%), and Asian (1.1%) women. Overall fracture incidence was high (15.3 per 1000 person-years (PY) for hip fracture; 55.8 for MOF), with variability by race and ethnicity. Hip fracture incidence (per 1000 PY) was lowest among Asian (6.5) and Black or African American (7.0) women and highest among Hispanic or Latina (16.3) and White (16.2) women. MOF incidence (per 1000 PY) was lowest in Black or African American (26.0) and highest in White (58.7) women. Discrimination of U.S.-FRAX for short-term fractures was modest, with overall cross-validated area under the curves (AUCs) of 0.71 (95% CI, 0.69-0.73) for hip fracture and 0.66 (95% CI, 0.65-0.68) for MOF. No significant differences in AUCs were found between Black or African American, Hispanic or Latina, and White women with RA. Short observation period for fractures precluded formal calibration testing, but our data suggests U.S.-FRAX without BMD may underestimate MOF risk, particularly among Black or African and Hispanic or Latina women with RA. Performance in Asian women was not reported due to low fracture rates. The modest discrimination and insufficient calibration data in all racial and ethnic RA groups studied underscore the need for larger studies in diverse RA populations. Ultimately, RA-specific fracture risk assessment tools may be needed.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1123-1135"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leg power and velocity predict the risk of major osteoporotic fractures (MOF): the Osteoporotic Fractures in Men (MrOS) study.","authors":"Tong Yu, Elsa S Strotmeyer, Nina Z Heilmann, Deborah M Kado, Kristine Ensrud, Mary Winger Knueven, Paolo Caserotti, Peggy Cawthon, Jane A Cauley","doi":"10.1093/jbmr/zjag014","DOIUrl":"10.1093/jbmr/zjag014","url":null,"abstract":"<p><p>Lower extremity muscle function has been associated with risk of falls and fractures; however, most studies have examined strength (force), but not power (force*velocity). A jump test on a force plate measures weight-bearing power and allows the dissection of peak power into its components, force and velocity. We investigated the association between jump test power measures and major osteoporotic fractures (MOF) risk in 1841 older men (median age 84 yr). Peak jump power (W/kg body weight), force (N/kg body weight) at peak power, and velocity (m/s) at peak power were measured by jump tests on a force plate. Fractures were identified by triannual questionnaires, with all self-reported fractures confirmed by medical record. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) by continuous (per one SD increment) and across quartiles of jump test measures. Participants that were excluded from the jump tests were classified into the \"lowest\" group (referent; N = 599). A total of 136 incident MOF occurred over 5 yr of follow-up. In the multiply adjusted models, one SD increment of peak power/kg body weight was associated with a lower risk of MOF (HR 0.71, 95% CI: 0.54-0.92), with a similar risk reduction observed with velocity at peak power (HR 0.76, 95% CI: 0.59-0.98). Further adjustment for femoral neck (FN) bone mineral density (BMD) did not attenuate the association. There was significant trend of decreasing MOF with increasing power and velocity. For force, only the highest quartile was significantly associated with lower risk of MOF, but this was not significant after adjusting for FN BMD. In older men, peak leg power and velocity, but not force, predicted MOF risk independent of FN BMD. Power, which incorporates velocity, may play a more important role than force in reducing the risk of a fracture.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1060-1068"},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}