Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Prevalence of iron deficiency in patients with mild to moderate bleeding disorders and bleeding disorder of unknown cause","authors":"Tim Dreier ,&nbsp;Dino Mehic ,&nbsp;Justin Oosterlee ,&nbsp;Jasmin Rast ,&nbsp;Alexandra Kaider ,&nbsp;Helmuth Haslacher ,&nbsp;Cihan Ay ,&nbsp;Ingrid Pabinger ,&nbsp;Johanna Gebhart","doi":"10.1016/j.rpth.2025.102999","DOIUrl":"10.1016/j.rpth.2025.102999","url":null,"abstract":"<div><h3>Background</h3><div>Iron deficiency (ID) and ID anemia (IDA) are often caused by chronic bleeding, especially heavy menstrual bleeding, and thus may occur at a high frequency in patients with mild to moderate bleeding disorders (MBDs).</div></div><div><h3>Objectives</h3><div>To study the prevalence of iron deficiency in mild to moderate bleeding disorders and bleeding disorder of unknown cause.</div></div><div><h3>Methods</h3><div>The iron status of patients with MBD from the Vienna Bleeding Biobank, a prospective cohort study, was analyzed and compared with age- and sex-matched healthy controls. ID was defined as ferritin ≤30 μg/L, transferrin saturation &lt;16%, or iron therapy at inclusion. IDA was defined as hemoglobin &lt;12 g/dL in women and &lt;13 g/dL in men diagnosed with ID.</div></div><div><h3>Results</h3><div>The rates of ID and IDA were comparable between 646 patients with MBD and 118 controls, as 250 patients with MBD (39%) had ID and 40 (6%) had IDA, compared with 37 controls with ID (31%) and 6 with IDA (5%). von Willebrand disease showed a significantly higher rate of ID than controls (49%) before correction for multiple testing, while there was no significant difference between other MBD diagnoses and controls (bleeding disorder of unknown cause: 39%; platelet function disorders: 33%; and coagulation factor deficiencies: 28%). In multivariable regression, we identified female sex, younger age, and higher body mass index, but not MBD diagnoses, bleeding score, or blood group O, associated with ID.</div></div><div><h3>Conclusion</h3><div>ID was common among MBDs, especially von Willebrand disease and female patients, but also in controls. Our data highlight the importance of assessing iron status in patients with MBDs, especially in young female individuals, regardless of the presence of bleeding symptoms.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 102999"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019484","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":"Optimization of a Western blot protocol for the detection of low levels of tissue factor in human cells","authors":"Megan V. Perkins ,&nbsp;Ana T.A. Sachetto ,&nbsp;Nigel Mackman","doi":"10.1016/j.rpth.2025.103016","DOIUrl":"10.1016/j.rpth.2025.103016","url":null,"abstract":"<div><h3>Background</h3><div>The tissue factor (TF)/activated factor VII complex is the major activator of the coagulation system. TF is expressed by a variety of cells, including activated monocytes and tumor cells. Increased TF expression can cause thrombosis in different diseases, including sepsis, viral infections, and cancer. We have previously described a method for analyzing human TF in high-expressing cells by Western blotting.</div></div><div><h3>Objectives</h3><div>The goal of this study was to establish a method for detecting human TF in low-expressing cells.</div></div><div><h3>Methods</h3><div>We examined the ability of 3 different antibodies to detect TF in low-expressing cell lines: rabbit polyclonal anti-human TF antibody NBP2-15139 (Novus Biologicals), goat polyclonal anti-human TF antibody AF2339 (R&amp;D Systems), and rabbit monoclonal anti-human TF antibody ab252918 (clone EPR22548-240; Abcam). We also used the Abcam antibody to measure TF expression in lipopolysaccharide-stimulated peripheral blood mononuclear cells.</div></div><div><h3>Results</h3><div>We found that sensitivity was affected by various factors, including the blocking conditions, the detection method, and the primary and secondary antibodies. Both the R&amp;D and Abcam antibodies were more specific in assessing TF expression than the Novus antibody; however, the Abcam antibody was the best of the 3 in evaluating TF in low-expressing cell lines. We detected TF in lipopolysaccharide-stimulated human peripheral blood mononuclear cells using the new method with the Abcam antibody.</div></div><div><h3>Conclusion</h3><div>Researchers should consider each step in Western blotting when establishing a method for detecting low-abundance antigens, such as TF.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103016"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026453","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":"Plasmin-mediated proteolysis of von Willebrand factor in patients with acute and chronic liver disease","authors":"Hinde El Otmani ,&nbsp;Marilena Stamouli ,&nbsp;Jelle Adelmeijer ,&nbsp;William Bernal ,&nbsp;Coen Maas ,&nbsp;Vishal C. Patel ,&nbsp;Ton Lisman","doi":"10.1016/j.rpth.2025.103166","DOIUrl":"10.1016/j.rpth.2025.103166","url":null,"abstract":"<div><h3>Background</h3><div>In patients with acute and chronic liver disease, von Willebrand factor (VWF) antigen levels are markedly elevated, whereas a disintegrin and metalloproteinase with thrombospondin type 1 motifs, member 13 (ADAMTS13) activity is often reduced. The role of VWF proteolysis by other proteases, such as plasmin, remains unclear.</div></div><div><h3>Objectives</h3><div>To investigate whether plasmin-mediated VWF cleavage occurs in patients with acute and chronic liver disease and to assess its association with VWF parameters, ADAMTS13 activity, and fibrinolytic markers.</div></div><div><h3>Methods</h3><div>Plasma samples from 191 patients with stable or decompensated cirrhosis, acute liver failure or acute liver injury, acute-on-chronic liver failure, or sepsis without underlying chronic liver disease and 41 healthy controls were analyzed. VWF antigen and collagen-binding activity, ADAMTS13 antigen and activity, ADAMTS13-cleaved VWF, plasmin-cleaved VWF (cVWF), plasmin-α2-antiplasmin complexes, and D-dimer were measured by ELISA.</div></div><div><h3>Results</h3><div>VWF antigen levels were higher in all patient groups and increased with disease severity. VWF activity was also elevated but was not proportional to VWF antigen level. ADAMTS13 activity and specific activity decreased with worsening disease. cVWF was undetectable in healthy controls and patients with stable cirrhosis but was increased in patients with decompensated cirrhosis, acute liver failure or injury, and acute-on-chronic liver failure. cVWF levels correlated with D-dimer but not with plasmin-α2-antiplasmin complexes or VWF activity.</div></div><div><h3>Conclusion</h3><div>cVWF is detectable in patients with decompensated cirrhosis, acute liver failure or injury, and acute-on-chronic liver failure but not in those with stable cirrhosis or healthy individuals. Its association with D-dimer supports a link with fibrinolytic activation. These findings suggest that cVWF may reflect disease severity or ongoing microvascular thrombosis in patients with advanced liver disease.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103166"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105475","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":"Exploring the ex vivo effects of Bitis arietans snake venom on the coagulation, ultrastructure, and viscoelastic properties of human blood","authors":"Courtney Hill ,&nbsp;Christie Megaw ,&nbsp;Johan Potgieter ,&nbsp;Morné A. Strydom ,&nbsp;Janette Bester","doi":"10.1016/j.rpth.2025.103173","DOIUrl":"10.1016/j.rpth.2025.103173","url":null,"abstract":"<div><h3>Background</h3><div>Snakebite envenoming represents a significant and frequently overlooked public health challenge affecting tropical and subtropical regions. <em>Bitis arietans</em> venom toxins have cytotoxic effects and result in coagulopathy. However, there is limited literature on coagulopathies associated with <em>B arietans</em> envenomation or comparing traditional diagnostic tests with point-of-care (POC) methods.</div></div><div><h3>Objectives</h3><div>This study investigated the effects of <em>B arietans</em> venom on the coagulation of human blood, with a focus on comparing the 20-minute whole blood clotting test (20-WBCT) to other POC coagulation tests.</div></div><div><h3>Methods</h3><div>This study exposed human blood to 2 ng/μL <em>B arietans</em> venom <em>ex vivo</em>. Clot formation was studied using the 20-WBCT. Prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen levels were measured to obtain hematological clotting profiles of each participant. Viscoelastic properties of whole blood clot kinetics were quantified using thromboelastography (TEG). Red blood cell morphology and clot architecture were analyzed using scanning electron microscopy.</div></div><div><h3>Results</h3><div><em>Bitis arietans</em> venom had significant effects on red blood cell morphology and clot structure. Both the 20-WBCT and clinical coagulation assays revealed notable differences in the results of venom-exposed samples; however, they were still in the normal range. TEG indicated hypocoagulation and decreased clot stability. Morphological studies of venom-exposed samples revealed echinocytes with varying degrees of morphological abnormalities and membrane blebbing. In addition, venom-exposed blood clots had sparse, disorganized fibrin networks and limited crosslinking.</div></div><div><h3>Conclusion</h3><div><em>Bitis arietans</em> venom contains various hemotoxins that disrupt normal clot formation and affect TEG parameters. These insights provide a necessary link between clinical and laboratory analysis of <em>B arietans</em> venom. The study demonstrates the value of TEG as a POC test in snakebite management as it could provide a better indication of coagulopathy associated with envenomation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103173"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220129","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":"Promise and pitfalls of viscoelastic testing for assessing blood hemostasis in ultraendurance sports","authors":"Apostolos Z. Skouras,&nbsp;Panagiotis Koulouvaris","doi":"10.1016/j.rpth.2025.103011","DOIUrl":"10.1016/j.rpth.2025.103011","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103011"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989348","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":"Plasminogen mutation–associated thrombotic microangiopathy and role of anticoagulation: a single institution case series","authors":"Shreya Agarwal ,&nbsp;Nicola Pozzi ,&nbsp;Senthil Sukumar ,&nbsp;Camila Masias ,&nbsp;Anuja Java ,&nbsp;Spero Cataland","doi":"10.1016/j.rpth.2025.103012","DOIUrl":"10.1016/j.rpth.2025.103012","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge gaps exist regarding the role of coagulation pathway mutations such as those in the plasminogen (<em>PLG</em>) gene in the pathogenesis of thrombotic microangiopathy (TMA) and treatment outcomes.</div></div><div><h3>Objectives</h3><div>This study aims to describe the unique phenotypic features of patients with <em>PLG</em> mutations and perform structural mapping of the variants to enhance variant interpretation.</div></div><div><h3>Methods</h3><div>This was a single-center retrospective study of patients with TMA in whom genetic testing was performed between 2011 and 2023. Data were collected regarding demographics, clinical features at their first presentation, renal outcomes, genetic mutations, and recurrence for those who were found to have a <em>PLG</em> mutation. Structural mapping of the <em>PLG</em> variants was performed using X-ray structural data.</div></div><div><h3>Results</h3><div>Over the 12-year study period, we identified 6 individuals in our TMA cohort with <em>PLG</em> mutations. Median age at the time of first TMA event was 45.5 years (range: 5-57 years). Nearly all were female (<em>n</em> = 5, 83%). Half of the cohort (<em>n</em> = 3, 50%) had recurrent TMA, with 1 having recurrent episodes while on long-term complement blockade therapy. Three patients are now on long-term anticoagulation with no further TMA recurrences observed. Structural mapping of the variants revealed that the mutations could be categorized into 3 groups. Among these, group 2 variants (residues K38 in the PAN-apple domain and residue R523 in kringle-5) had a more severe phenotype with severe thrombocytopenia at presentation and a recurrent TMA course.</div></div><div><h3>Conclusion</h3><div>Patients with <em>PLG</em> mutation–associated TMAs appear to have a poor response to complement blockade therapy, suggesting that pathways in addition to or independent of complement dysregulation may be involved in some patients. Future studies are warranted to explore the role of anticoagulation in preventing recurrence in patients with <em>PLG</em> mutations.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103012"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045743","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 statins in mitigating venous thromboembolism incidence and severity","authors":"Lauren E. Merz MD, MSc ,&nbsp;Geoffrey D. Barnes MD, MSc ,&nbsp;Jordan K. Schaefer MD, MSc","doi":"10.1016/j.rpth.2025.103004","DOIUrl":"10.1016/j.rpth.2025.103004","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103004"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045819","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":"Factor X and combined factor VIIa/factor X augment coagulation potential in a plasma model of antithrombin-reduced hemophilia","authors":"Shigeharu Oh ,&nbsp;Yuto Nakajima ,&nbsp;Eisuke Takami ,&nbsp;Hirotoshi Nakano ,&nbsp;Keiji Nogami","doi":"10.1016/j.rpth.2025.103172","DOIUrl":"10.1016/j.rpth.2025.103172","url":null,"abstract":"<div><h3>Background</h3><div>Plasma-derived (pd) factor (F)VIIa/FX products are available for the hemostatic management of people with hemophilia with inhibitors in Japan. We have previously reported that FX alone augments emicizumab-driven hemostasis. Fitusiran is an investigational small interfering RNA that reduces antithrombin (AT) to rebalance hemostasis in people with hemophilia. The effects of supplementation with pd-FVIIa/FX or FX alone on coagulation potential in AT-reduced hemophilia remain to be clarified.</div></div><div><h3>Objectives</h3><div>To assess the coagulation potential of pd-FVIIa/FX or FX using an <em>in vitro</em> model of AT-reduced (fitusiran-treated) people with hemophilia.</div></div><div><h3>Methods</h3><div>Pd-FVIIa/FX (0.75 and 1.5 μg/mL as FVIIa), recombinant FVIIa (1.1 and 2.2 μg/mL), activated prothrombin complex concentrate (0.65 and 1.3 IU/mL), or FX (260 and 520 nM) were added to FVIII- or FIX-depleted AT-deficient plasmas at AT levels of 10% and 30% (AT-reduced model). Additionally, FX (0-1040 nM) was incubated with FVIII- or FIX-depleted FX-deficient plasmas to assess FVIIa/tissue factor (TF)-mediated FX activation. Coagulation potential was assessed by measuring thrombin generation (TG) and FXa.</div></div><div><h3>Results</h3><div>The addition of pd-FVIIa/FX, activated prothrombin complex concentrate, or FX to the AT-reduced plasma model of people with hemophilia improved TG potential within the normal range. The addition of recombinant FVIIa, however, had little effect on TG in this model. The addition of FX to FVIII- or FIX-depleted FX-deficient plasma increased TG potential and FVIIa/TF-triggered FXa generation dose-dependently.</div></div><div><h3>Conclusion</h3><div>Supplementation with FX or pd-FVIIa/FX enhanced FVIIa/TF-induced activation of FX and increased coagulation potential in the AT-reduced plasma model of people with hemophilia.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103172"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118345","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":"Time to integrate measurement uncertainty in method comparison and interpretation of hemostasis laboratory assays","authors":"François Mullier ,&nbsp;Isabelle Gouin-Thibault ,&nbsp;Piet Meijer ,&nbsp;Michael Hardy ,&nbsp;Thomas Lecompte","doi":"10.1016/j.rpth.2025.102993","DOIUrl":"10.1016/j.rpth.2025.102993","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 102993"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889016","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":"Thromboembolism and bleeding in newly diagnosed multiple myeloma: rates, risk profile, and patterns of thromboprophylaxis","authors":"Lea Vospernik ,&nbsp;Hermine Agis ,&nbsp;Cihan Ay ,&nbsp;Lina Rüsing ,&nbsp;Heinz Gisslinger ,&nbsp;Christina Brunbauer ,&nbsp;Clara Sophie Michel ,&nbsp;Ingrid Simonitsch-Klupp ,&nbsp;Alexandra Kaider ,&nbsp;Maria-Theresa Krauth ,&nbsp;Julia Riedl","doi":"10.1016/j.rpth.2025.103162","DOIUrl":"10.1016/j.rpth.2025.103162","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines suggest pharmacological thromboprophylaxis for patients with multiple myeloma (MM) treated with immunomodulatory drugs due to a high risk of venous thromboembolisms (VTE).</div></div><div><h3>Objectives</h3><div>To analyze rates of VTE and bleeding, risk profiles, and patterns of thromboprophylaxis in MM patients.</div></div><div><h3>Methods</h3><div>For this cohort study, all consecutive patients with newly diagnosed MM between January 2012 and January 2022 who received induction treatment at our center were included. Characteristics at time of diagnosis, antimyeloma treatment, thromboprophylaxis, and thrombotic and bleeding events during 2-year follow-up were recorded.</div></div><div><h3>Results</h3><div>Of 293 patients screened, 208 were included. During follow-up, VTE occurred in 19 (9.1%) patients, any bleeding in 35 (16.8%), and major bleeding in 14 (6.7%). IMPEDE-VTE score predicted VTE, but SAVED score did not. Two-year cumulative incidences of VTE by type of thromboprophylaxis prescribed after diagnosis (1) and at landmark 3 months (2) for aspirin versus standard anticoagulation (low molecular weight heparin or vitamin K antagonist) versus direct oral anticoagulants versus no antithrombotic therapy were (1) 18.73% (95% CI: 7.43-33.97) versus 2.78% (95% CI: 0.21-12.6) versus 4.00% (95% CI: 0.27-17.36) versus 9.88% (95% CI: 5.03-16.67) and (2) 12.46% (95% CI: 4.48-24.74) versus 5.56% (95% CI: 0.34-23.06) versus 0.00% versus 10.51% (95% CI: 4.88-18.64), respectively. Major bleeding rates did not significantly differ between antithrombotic strategies.</div></div><div><h3>Conclusion</h3><div>We observed a high rate of VTE and bleeding in patients with newly diagnosed MM. Use of anticoagulant therapy including direct oral anticoagulants was associated with a trend toward reduced risk of VTE compared with aspirin or no antithrombotic therapy. Bleeding risk was high irrespective of antithrombotic strategy.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103162"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158760","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}