Osteoporosis International最新文献

{"title":"Standardized 25(OH)D and fall risk: overcoming challenges and enhancing clinical applications.","authors":"Yumei Zhong, Shanshan Liu, Xiaofeng Lv","doi":"10.1007/s00198-025-07451-y","DOIUrl":"10.1007/s00198-025-07451-y","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"929-930"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated low-dose multi-detector computed tomography: spatial effects on surrogate parameters of bone strength at the proximal femur.","authors":"Nico Sollmann, Kai Mei, Maximilian T Löffler, Sebastian Rühling, Meinrad Beer, Claus Zimmer, Jan S Kirschke, Peter B Noël, Thomas Baum, Julio Carballido-Gamio","doi":"10.1007/s00198-025-07467-4","DOIUrl":"10.1007/s00198-025-07467-4","url":null,"abstract":"<p><p>This study investigated simulated tube current reduction and sparse sampling for low-dose computed tomography (CT) regarding volumetric bone mineral density (vBMD) and cortical bone thickness (Ct.Th) of the proximal femur. Sparse sampling with dose reductions of up to 90% may still allow extraction of bone strength parameters with clinically acceptable accuracy.</p><p><strong>Introduction: </strong>We aimed to investigate effects of CT with simulated lowered tube current and sparse sampling on trabecular and cortical vBMD as well as Ct.Th of the entire proximal femur, its subregions, and with detailed spatial assessments.</p><p><strong>Methods: </strong>Clinical routine multi-detector CT (MDCT) scans covering the hips from 40 patients were used for simulations of low-dose imaging with 50% and 10% of the original tube current (D50, D10) or projections (P50, P10) combined with statistical iterative reconstruction (SIR), which were then compared against original data with full dose (D100 P100) regarding trabecular vBMD, cortical vBMD, and Ct.Th. An automated framework for multi-parametric assessments was used. Relative errors by comparing measures from original data and simulated low-dose data, regression analyses, Bland-Altman analyses, and statistical parametric mapping (SPM, to assess the spatial distribution of accuracy) were computed.</p><p><strong>Results: </strong>Sparse sampling enabled drastic reductions of radiation exposure (down to 10% of original imaging) while still producing determinants of bone strength with clinically acceptable relative changes. Lower biases according to Bland-Altman analyses were observed for sparse sampling compared to imaging with virtually lowered tube currents (D10 P100 versus D100 P10) regarding trabecular vBMD, cortical vBMD, as well as Ct.Th. Better accuracy across the whole proximal femur for D100 P50 than for D50 P100 and for D100 P10 than for D10 P100 was observed.</p><p><strong>Conclusions: </strong>Sparse sampling with SIR may enable drastic reductions of radiation exposure (up to 90% of original doses) for opportunistically measuring image-based surrogate parameters of bone strength.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"917-928"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between vertebral fractures and brain volume: insights from a community cohort study.","authors":"Koji Nakajima, Chiaki Horii, Hiroyasu Kodama, Tomohiko Shirokoshi, Akitoshi Ogawa, Takahiro Osada, Seiki Konishi, Yasushi Oshima, Toshiko Iidaka, Shigeyuki Muraki, Hiroyuki Oka, Hiroshi Kawaguchi, Toru Akune, Hiroshi Hashizume, Hiroshi Yamada, Munehito Yoshida, Kozo Nakamura, Masaaki Shojima, Sakae Tanaka, Noriko Yoshimura","doi":"10.1007/s00198-025-07403-6","DOIUrl":"10.1007/s00198-025-07403-6","url":null,"abstract":"<p><p>Investigating vertebral fractures and brain structure, we found significant gray matter volume reductions in the right hippocampus, amygdala, and parahippocampal gyrus, especially in males. These findings emphasize the importance of integrating skeletal and neural health in osteoporosis management.</p><p><strong>Purpose: </strong>Vertebral fractures (VF) due to osteoporosis impact morbidity and quality of life in the elderly. The relationship between VF and changes in brain structure remains underexplored. This study aimed to investigate the association between VF and gray matter volume (GMV) reductions in specific brain regions and to explore potential sex differences.</p><p><strong>Methods: </strong>Data from 1,751 participants (571 males, 1,180 females; mean age 64.9, range 18-97) in the fourth survey of the population-based Research on Osteoarthritis/Osteoporosis Against Disability study (2015-2016) were used. Participants were classified into those with and without VF (VF + and VF - groups) based on Genant's semiquantitative method, assessed by spine radiographs. Voxel-based morphometry was applied to MRI images to measure GMV, and a general linear model analysis was performed to compare GMV between groups, adjusting for age, sex, total brain volume, and Mini-Mental State Examination scores as covariates. Additionally, a two-way analysis of variance was conducted on the significant GMV cluster, with sex and VF presence as independent variables, to explore interaction effects.</p><p><strong>Results: </strong>The VF+ group consisted of 113 participants, while the VF- group included 1,638 participants. The analysis identified a significant cluster with reduced GMV in the VF + group compared to the VF - group. This cluster included the right hippocampus, right amygdala, and right parahippocampal gyrus. Further analysis revealed that males in the VF + group exhibited more pronounced GMV reductions in the significant cluster compared to females.</p><p><strong>Conclusion: </strong>These findings suggest that VF is associated with significant reductions in brain regions critical for memory, emotional processing, and visuospatial memory, with more severe effects observed in males.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"627-636"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking sunlight: balancing the benefits of sun exposure and vitamin D supplementation.","authors":"Berkay Yalçınkaya, Hilmi Berkan Abacıoğlu, Ahmet Furkan Çolak, Alp Çetin","doi":"10.1007/s00198-025-07420-5","DOIUrl":"10.1007/s00198-025-07420-5","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"755-756"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated baseline CTX levels predict enhanced therapeutic efficacy of zoledronic acid in augmenting lumbar spine bone mineral density among Chinese osteoporosis patients.","authors":"Qing Zhang, Wenxue Gao, Xiaojuan Xu, Ran Cui, Bin Su","doi":"10.1007/s00198-025-07448-7","DOIUrl":"10.1007/s00198-025-07448-7","url":null,"abstract":"<p><p>This study examined the link between baseline CTX levels and zoledronic acid's effectiveness in boosting bone density in osteoporosis patients. Among 472 Chinese patients, higher initial CTX levels correlated with greater lumbar spine bone density improvement after treatment. However, no such correlation was found for hip or femoral neck bones. This suggests CTX levels may aid in treatment selection for lumbar spine, though further research is needed. The findings have clinical implications for optimizing osteoporosis treatment.</p><p><strong>Purpose: </strong>To elucidate the correlation between baseline CTX levels and the therapeutic efficacy of zoledronic acid in augmenting bone mineral density (BMD) among individuals with osteoporosis.</p><p><strong>Methods: </strong>This study studied patients diagnosed with primary osteoporosis who were hospitalized at least twice and received annual zoledronic acid therapy. Patients were stratified into three groups based on their initial CTX levels prior to zoledronic acid administration. ANOVA was employed to compare BMD alterations across the groups. Generalized estimating equations (GEE) were utilized to analyze the relationship between baseline CTX levels and subsequent BMD changes post-zoledronic acid treatment. Statistical analyses were conducted using SPSS version 26.0.</p><p><strong>Results: </strong>A total of 472 patients were evaluated and categorized into three cohorts according to their initial CTX levels, arranged in ascending order. Notably, group 3, characterized by the highest initial CTX levels, demonstrated a significantly more pronounced increase in lumbar spine BMD compared to the other two groups. Specifically, when group 1 served as the reference, group 3 exhibited a 0.4-unit elevation in lumbar spine T-score. Conversely, no discernible relationship was observed between baseline CTX levels and BMD changes in the hip or femoral neck following zoledronic acid treatment.</p><p><strong>Conclusions: </strong>Our findings among a Chinese population indicate that elevated CTX levels, particularly exceeding 0.480 ng/ml, are notably associated with enhanced therapeutic efficacy of zoledronic acid in boosting lumbar spine BMD. However, this correlation appears less robust with respect to improvements in hip and femoral neck BMD.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"707-714"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing trabecular bone score (TBS): clinical performance of TBS version 4.0 with direct correction for soft tissue thickness-the osteolaus study.","authors":"Guillaume Gatineau, Karen Hind, Enisa Shevroja, Elena Gonzalez-Rodriguez, Olivier Lamy, Didier Hans","doi":"10.1007/s00198-025-07421-4","DOIUrl":"10.1007/s00198-025-07421-4","url":null,"abstract":"<p><p>This study compared TBS v4.0, which uses DXA-derived tissue thickness corrections, with TBS v3, which adjusts using BMI. TBS v4.0 improved soft tissue adjustments and maintained fracture risk prediction equivalence with TBS v3, enhancing applicability across diverse body compositions/phenotypes. Direct tissue thickness adjustment increases TBS's utility in osteoporosis assessment and management.</p><p><strong>Purpose: </strong>This study aimed to compare trabecular bone score (TBS) version 4.0, which uses direct tissue thickness correction via DXA measurements, with TBS version 3, which adjusts for soft tissues using body mass index (BMI). The objective was to assess the performance of TBS v4.0 compared to v3, for bone health evaluation and fracture risk assessment across diverse body compositions.</p><p><strong>Methods: </strong>Data from the OsteoLaus cohort were analyzed. Associations between TBS, BMI, DXA-measured tissue thickness, visceral fat (VFAT), and android fat were examined using regression and correlation analyses. Machine learning, including Random Forest (RF) and SHapley Additive exPlanations (SHAP), explored TBS changes between versions. Five-year fracture risk was assessed using FRAX adjustment, and logistic regression.</p><p><strong>Results: </strong>TBS v3 correlated with BMI (r = 0.110, p < 0 .001), VFAT mass (r =  - 0.162, p < 0 .001), and soft tissue thickness (r =  - 0.165, p < 0.001). TBS v4.0 demonstrated weaker correlations with BMI (r =  - 0.057, p > 0.999), VFAT Mass (r =  - 0.067, p > 0.779), and soft tissue thickness (r =  - 0.114, p = 0.019). Differences between TBS versions were investigated with SHapley Additive exPlanations (SHAP) and explained by BMI, tissue thickness, VFAT, and gynoid fat. Logistic regression and Delong's test revealed no significant differences in vertebral fracture prediction between the two TBS versions (p = 0.564). FRAX adjustments were highly consistent between versions (r = 0.994, p < 0.001), with no evidence of calibration bias (p = 0.241).</p><p><strong>Conclusion: </strong>TBS v4.0 enhances the adjustment for regional soft tissue effects and results suggest comparable vertebral fracture risk prediction to TBS v3. Explainable AI provided insights into the contributions of BMI, tissue thickness, visceral fat, and gynoid fat to the observed changes between TBS versions. Incorporating direct tissue thickness adjustment improves TBS applicability across diverse body sizes and compositions.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"715-724"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: enhancing osteoporosis management through AI-driven predictive models.","authors":"Alishba Noor, Rayyan Nabi, Heeba Tariq Khan, Amna Noor","doi":"10.1007/s00198-025-07396-2","DOIUrl":"10.1007/s00198-025-07396-2","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"749-750"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal health status among patients with chronic hypoparathyroidism: results from the Canadian National Hypoparathyroidism Registry (CNHR).","authors":"Aliya A Khan, Hajar AbuAlrob, Dalal S Ali, Zayd Al Kassem, Abdulrahman Almoulia, Habiba Afifi, Manoela Braga, Alice Cheng, Jouma Malhem, Adam Millar, Emmett Morgante, Parwana Muhammad, Terri L Paul, Ally Prebtani, Zubin Punthakee, Tayyab Khan, Sarah Khan, Muhammad Shrayyef, Stan Van Uum, James Edward Massey Young, Maria Luisa Brandi, Michel Ovize, Blandine Weiss","doi":"10.1007/s00198-025-07410-7","DOIUrl":"10.1007/s00198-025-07410-7","url":null,"abstract":"<p><p>In the CNHR study, 35% of postmenopausal women had osteoporosis by BMD or fragility fracture, and 4% had both. Three men ≥ 50 had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This suggests that close follow-up of skeletal health is necessary in postmenopausal women, and men ≥ 50 with chronic HypoPT.</p><p><strong>Purpose: </strong>Chronic hypoparathyroidism (HypoPT) has been associated with decreased bone turnover and abnormalities in bone mineral density (BMD), microarchitecture, and strength. Current guidelines do not recommend systematic evaluation of skeletal health in patients with chronic HypoPT. Our study assessed skeletal health in pre- and postmenopausal women with chronic HypoPT and adult men.</p><p><strong>Methods: </strong>This prospective study enrolled adults with chronic HypoPT from the Canadian National Hypoparathyroidism Registry. Clinical characteristics, bone fractures, biochemistry, and serum bone biomarkers were assessed at baseline. Skeletal health evaluation included assessments of fragility fractures, BMD at lumbar spine (LS), femoral neck (FN), total hip (TH), 1/3 radial sites, trabecular bone score (TBS), and bone biomarkers.</p><p><strong>Results: </strong>We present the baseline data of the patients enrolled in the registry. We analyzed a total of 101 patients: 18 men, 35 premenopausal, and 48 postmenopausal women. The mean (SD) age at the onset of HypoPT was 40.7 (16.8) years, and the average disease duration was 11.2 (8.6) years. The most common etiology was postsurgical (74.3% vs. 25.7% non-surgical). Most patients received calcium supplements (89%) and active vitamin D (80%) at baseline. No fragility fractures or low BMD were reported in premenopausal women. However, BMD at LS, FN, TH, and TBS were significantly lower in postmenopausal compared to premenopausal women.</p><p><strong>Conclusions: </strong>Overall, 35% of postmenopausal women had osteoporosis by BMD or prior fragility fracture, and 4% had both. Three men ≥ 50 years had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This study suggests that close follow-up of skeletal health is necessary in postmenopausal women with chronic HypoPT and men ≥ 50 years.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"673-684"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of combined protein and exercise interventions on bone health in middle-aged and older adults - A systematic literature review and meta-analysis of randomized controlled trials.","authors":"Julia V E Wolf, Daniel Schoene, Matthias Kohl, Wolfgang Kemmler, Eva Kiesswetter","doi":"10.1007/s00198-025-07393-5","DOIUrl":"10.1007/s00198-025-07393-5","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoporosis has become a global public health concern making prevention and treatment essential to reduce severe consequences for individuals and health systems. This systematic review with meta-analysis aimed to determine the effects of combined protein and exercise interventions compared to (a) exercise alone and (b) protein alone on bone mineral content (BMC) or density (BMD) in middle-aged and older adults.</p><p><strong>Methods: </strong>We systematically searched Medline, CINAHL, CENTRAL, Web of Science, and SPORTDiscus until 24th January 2023. Pairwise random-effects meta-analyses were performed to calculate weighted mean differences (WMD) with 95% confidence intervals (95% CI). We evaluated risk of bias (Cochrane RoB2) and certainty of evidence (CoE; GRADE). If pooling was not possible, the results were summarized descriptively.</p><p><strong>Results: </strong>For the comparison of combined protein supplementation and exercise vs. exercise alone, no meta-analysis for BMD (2 RCTs) was possible. For BMC, little to no intervention effect was found (WMD 0.03 kg; 95% CI - 0.00 to 0.05; 4 RCTs; IG = 97/CG = 98; I² = 58.4%). In a sensitivity analysis, restricted to combined milk-protein supplementation and exercise, the result remained similar (0.01 kg; 95% CI - 0.01 to 0.03; 4 RCTs; IG = 71/CG = 71; I² = 0.0%; low CoE). For the comparison of combined protein and exercise interventions vs. protein alone, no RCT on BMC was identified; the results on total or regional BMD (2 RCTs) were inconclusive.</p><p><strong>Conclusion: </strong>Based on our findings, no robust conclusions can be drawn on whether combining protein and exercise interventions is more beneficial for bone health than one component alone. Sufficiently powered studies with longer duration are required to clarify these questions (CRD42022334026).</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"609-625"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoclast in CRPS: an alleged guilty fully acquitted.","authors":"Massimo Varenna, Francesca Zucchi, Raffaele Di Taranto, Francesco Orsini, Chiara Crotti","doi":"10.1007/s00198-025-07415-2","DOIUrl":"10.1007/s00198-025-07415-2","url":null,"abstract":"<p><p>Contrary to popular belief, a recent study did not show increased osteoclastic activity in acute complex regional pain syndrome. Conversely, osteoblastic activity seems to be enhanced. The real meaning of diagnostic tools needs to be reassessed. Therefore, bisphosphonates act through mechanisms of action different from their anti-osteoclastic effect.</p><p><strong>Introduction: </strong>Bone tissue involvement is a widely acknowledged event in the course of complex regional pain syndrome (CRPS), and it is invariably depicted as \"high turnover osteoporosis.\" This statement needs to be revised in light of a recent biochemical study on bone turnover markers and regulators in patients with early CRPS.</p><p><strong>Methods: </strong>The real meaning of the findings arising from biochemical, radiological, and histopathological studies and the possible mechanism of action of parenteral bisphosphonates have been reviewed according to the bone metabolism derangement specific to this disease.</p><p><strong>Results: </strong>Consistent with the results of the recent biochemical study, no reliable data emerge from diagnostic studies sustaining an increased osteoclastic activity. Conversely, osteoblastic activity seems to be enhanced for an increased Wnt signaling due to lower levels of Sclerostin and Dickkopf-1. These results may provide a different and alternative interpretation of previous diagnostic and therapeutic studies.</p><p><strong>Conclusions: </strong>For the emerging role of bone in CRPS pathogenesis, these remarks could be useful for improving knowledge of the pathophysiology of the disease.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"737-740"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}