Toxicon最新文献

{"title":"Expanding the repertoire of conopeptides from the venom of the vermivorous snail Conus regius","authors":"Helena B. Fiorotti ,&nbsp;Suely G. Figueiredo ,&nbsp;Emídio Beraldo-Neto ,&nbsp;Fabiana V. Campos ,&nbsp;Daniel C. Pimenta","doi":"10.1016/j.toxicon.2025.108551","DOIUrl":"10.1016/j.toxicon.2025.108551","url":null,"abstract":"<div><div>This study presents a comprehensive proteomic characterization of <em>Conus regius</em> venom. Venom samples were fractionated using reversed-phase chromatography and analyzed by Q-TOF mass spectrometry. Spectral data were processed with Peaks Studio V7.0 and searched against a <em>Conus</em> protein database. A total of 520 peptide and protein sequences were identified, with most corresponding to conopeptides. Among these, eight presented similarities to disulfide-poor conopeptides of the Conantokin, ConoGay, and ConoCAP classes, as well as two sequences not classified in the literature. Additionally, 284 peptides showed similarity to conotoxins from 13 gene superfamilies (M, A, T, P, S, I1, Conodipine, O1, Insulin, G2, O2, Q, and H), while 102 sequences were linked to undetermined superfamilies. Of the identified sequences, 21 had been previously described in <em>C. regius</em> venom, while many others shared similarities with conotoxins from other <em>Conus</em> species. Most conotoxins identified were associated with the M and A superfamilies, suggesting their predominance in the venom. This study expands the known repertoire of <em>C. regius</em> venom components and provides valuable insights into its molecular diversity, supporting future research into its biotechnological potential.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108551"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In silico multiscale computational modelling of botulinum toxin a diffusion for glabellar wrinkle treatment: Optimizing injection volumes across formulations","authors":"Eqram Rahman ,&nbsp;Jean D.A. Carruthers ,&nbsp;Parinitha Rao ,&nbsp;Munim Ahmed ,&nbsp;Greg J. Goodman ,&nbsp;William Richard Webb","doi":"10.1016/j.toxicon.2025.108548","DOIUrl":"10.1016/j.toxicon.2025.108548","url":null,"abstract":"<div><div>While botulinum neurotoxin A (BoNT/A) is a cornerstone in glabellar wrinkle treatment, inconsistencies in clinical outcomes often stem from formulation-dependent diffusion behaviour. Currently volumes recommendation per site lacks mechanistic justification, especially in anatomically confined regions like the glabella, where millimetric diffusion differences can produce significant adverse effects. A high-fidelity, multiscale in silico platform was developed, integrating quantum mechanical (TD-DFT) modelling of SV2-binding (ΔG_bind range: −9.2 to −11.7 kcal/mol), molecular dynamics-derived hydrodynamic radius (R_H: 9.4–11.2 nm), anisotropic finite element modelling of poroelastic muscle tissue, and agent-based receptor and immune kinetics. Simulations encompassed five formulations— AbobotulinumtoxinA (ABO), DaxibotulinumtoxinA (DAXI), IncobotulinumtoxinA (INCO), OnabotulinumtoxinA (ONA), and PrabotulinumtoxinA (PRABO)—across injection volumes from 0.025 to 0.1 mL, at fixed toxin unit dosing, within anatomically realistic glabellar meshes (n = 10,000 synthetic patient variants). Diffusion profiles varied significantly by formulation. ABO showed the largest Reff (1.64 ± 0.14 cm) and E_off, while PRABO and ONA remained spatially constrained (Reff = 0.96 ± 0.07 cm and 1.13 ± 0.08 cm, respectively). Increasing injection volume from 0.025 to 0.1 mL caused a 2.2-fold rise in E_off and a 36–49 % increase in off-target V_IC50 across formulations. Optimal containment was formulation-specific: PRABO and ONA achieved ≥95 % V_IC90 coverage with &lt;10 % V_IC50 spillover at 0.025–0.035 mL; INCO and DAXI required 0.035–0.05 mL; ABO balanced broader coverage with acceptable diffusion at 0.04–0.045 mL. Agent-based models revealed 78 % receptor saturation at 0.025 mL versus 56 % at 0.1 mL, with immune clearance rates up to 42 % higher at high volumes due to increased perivascular redistribution. Volume emerged as the dominant spread driver (Sobol S₁ = 0.48), followed by hydrodynamic radius (S₁ = 0.35) and macrophage density (S₁ = 0.28); interaction terms were negligible (S_T − S₁ &lt; 0.05). This study provides the first in-silico quantitative, multiscale evidence that reducing BoNT/A reconstitution volume to ≤0.045 mL/site significantly enhances target localization while minimizing off-target effects. Contrary to prevailing clinical heuristics, dilution amplifies mechanical spread and immune clearance risk.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108548"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero mortality in 2024: Retrospective assessment of snakebite cases and their effective management at Demow rural community health centre, Sivasagar, Assam, India","authors":"Amit Talukdar ,&nbsp;Prasenjit Roy ,&nbsp;Jayaditya Purkayastha ,&nbsp;Simanta Jyoti Taye ,&nbsp;Deepak Agarwalla ,&nbsp;Ruma Shyam ,&nbsp;Hridoy Baruah ,&nbsp;Rentu Kumar Gam ,&nbsp;Gaurav Choudhary ,&nbsp;Rajib Jangid ,&nbsp;Anurag Borthakur ,&nbsp;Surajit Giri ,&nbsp;Robin Doley","doi":"10.1016/j.toxicon.2025.108549","DOIUrl":"10.1016/j.toxicon.2025.108549","url":null,"abstract":"<div><div>Assam, a state in North Eastern India, is a biodiversity hotspot and home to various venomous and non-venomous snakes. In 2024, approximately 11,000 snakebite cases and 36 mortalities have been reported from Assam. In this study, we report the success story of snakebite management resulting in “Zero Mortality” at Demow Rural Community Health Centre cum Model Hospital (DRCHCMH), Sivasagar, Assam for the fourth consecutive year (2021–2024). This report reflects the success of on-time reporting to the hospital and its management. The hospital registered 863 snakebite patients in 2024, of which 146 were venomous bites. The majority of snakebites occurred in the monsoon season (June to September) and most snakebite incidents were attributed to the Green pit vipers (<em>Trimeresurus</em> sp.), followed by cobras (<em>Naja</em> sp.), Banded kraits (<em>Bungarus fasciatus</em>), Black kraits (<em>B. niger/B. lividus</em>) and Red-necked keelback (<em>R. helleri</em>). Patients exhibiting early symptoms of envenomation were treated with polyvalent antivenom administration and medication following a standardized treatment protocol developed in-house. All the envenomated patients recovered post treatment resulting in no mortality. The snakebite management model of DRCHCMH may be followed in other affected areas for managing snakebite cases.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108549"},"PeriodicalIF":2.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the use of botulinum toxin injection for treating neurological disorders safe during pregnancy and lactation?","authors":"Kartika Gulati ,&nbsp;Aparna Wagle Shukla ,&nbsp;Sanjay Pandey","doi":"10.1016/j.toxicon.2025.108546","DOIUrl":"10.1016/j.toxicon.2025.108546","url":null,"abstract":"<div><div>Botulinum neurotoxin (BoNT) is a mainstay in treating several neurological disorders including in women of reproductive age. This review, based on 43 studies encompassing 658 human cases and supporting animal data, evaluates its safety during pregnancy and lactation. Available evidence is limited and predominantly observational, with most reports describing first-trimester exposure at doses below 200 units. As a result, data on later trimesters and higher doses remain scarce. Notably, the available literature does not show an increased prevalence of fetal losses and malformations, compared to the background population rates. Evidence for BoNT use during lactation is even more limited and confined to aesthetic indications, which typically involve lower doses than those used for neurological indications. Animal studies have shown fetal toxicity only at maternally toxic doses, without teratogenic effects. These findings offer interim practical guidance on BoNT use in pregnancy and lactation. Key evidence gaps should be addressed through neurology-specific prospective studies and pregnancy registries.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108546"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive profiling of Apis cerana indica Fabricius crude venom: A dual approach using LCMS and GCMS","authors":"Muthuraja Vikaash,&nbsp;Rasappan Kanagarajan,&nbsp;Eswaramoorthy Manikandan,&nbsp;Venkatraman Dharani","doi":"10.1016/j.toxicon.2025.108547","DOIUrl":"10.1016/j.toxicon.2025.108547","url":null,"abstract":"<div><div>Honeybee venom (HBV) possesses various kinds of proteins and metabolites, which are essential for their regular biological process. The presence of biologically active compounds in venom acts as a defensive substance for honeybees. The availability of peptides and enzymes might be used as potential therapeutics in healthcare sectors. The present investigation aimed to detect the low and high molecular weight compounds present in <em>Apis cerana indica</em> venom which was extracted by electrical stimulation method. To achieve maximum compound coverage, untargeted Liquid Chromatography Mass Spectrometry (LC-MS/MS) and Gas chromatography mass spectrometry (GC-MS/MS) based approaches were deployed. These combined techniques expedited the identification of 114 high molecular weight compounds, (69 protein families). The most dominant of which is the Major Royal Jelly Proteins (MRJP) family comprised of MRJPs 1, 2, 3, 4, 5, 6, 7. MRJP 1 was found to contribute significantly among the other venom proteins with high combined peptide match scores and peptide spectrum matches. A total of 159 low molecular weight compounds were detected, which includes 136 metabolite compounds dominated by fatty acid derivatives (42.05 %) and 23 volatile compounds dominated by the alcohol group (58.16 %). The present investigation revealed a substantial contribution to the expansion of the understanding of the HBV composition and ought to be quantified to achieve the complete possible venom profile.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108547"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A best-worst scaling statistical design of experiment study to model healthcare workers' prioritization of snake antivenoms available in sub-Saharan Africa for treating snakebite envenoming: Perspectives from Ghana","authors":"Eric Nyarko,&nbsp;Ebenezer Kwesi Ameho","doi":"10.1016/j.toxicon.2025.108544","DOIUrl":"10.1016/j.toxicon.2025.108544","url":null,"abstract":"<div><h3>Introduction</h3><div>In low- and middle-income countries (LMICs) with tropical or subtropical climates and a high poverty rate, the risk of snakebite envenoming (SBE) is high. Healthcare workers, together with patients, are the end-users of antivenom. This study aimed to assess healthcare workers' antivenom prioritization by providing quantitative evidence to guide policymakers to make better decisions to improve the procurement and supply of antivenoms, enhance the effectiveness of snakebite treatment, and improve patient care quality in Ghana.</div></div><div><h3>Method</h3><div>We gathered data through an interview-based survey, selecting a random sample of 203 healthcare workers from two districts in the Eastern Region of Ghana in August 2023. We employed the best-worst scaling method to evaluate how healthcare workers prioritize antivenoms.</div></div><div><h3>Result</h3><div>Participants highly prioritized Inoserp Pan-Africa polyvalent antivenom. Snake Venom Antiserum -PanAfrica is also commonly prioritized, followed by EchiTabPlus, ASNA antivenom D, ASNA antivenom C, Snake Venom Antiserum African, Anti Snake Venom Serum Pan Africa, and Fav-Afrique. However, some antivenoms are least commonly prioritized, such as SAIMR Echis, Combipack of Snake Venom Antiserum, Anti Snake Venom Serum Central Africa, Anti-Snake Venom Serum Central Africa, Snake Venom Antiserum Echiven Plus, Antivipmyn-Africa, Menaven, Snake Venom Antitoxin, Echiven, Anti Snake Venom Serum Monovalent Echis ocellatus, EchiTAbG, and VINS-Echis. In comparison to other antivenoms, Inoserp Pan-Africa is more frequently prioritized. At the same time, Snake Venom Antiserum - PanAfrica is less frequently prioritized but is still more likely than other options. EchiTabPlus is more likely to be prioritized than other antivenom options.</div></div><div><h3>Conclusion</h3><div>Our findings provide valuable insights to inform policy discussions on the use of available antivenoms in treating SBE. There is an urgent need to implement regulations on antivenom products, improve procurement and supply, and provide training to healthcare workers to combat SBE.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108544"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Comment on “Interaction of cholinesterase inhibitors with snake venom acetylcholinesterase from snake species of Southern Africa” (Petzer et al., 2025)","authors":"Parth Aphale,&nbsp;Shashank Dokania,&nbsp;Himanshu Shekhar","doi":"10.1016/j.toxicon.2025.108545","DOIUrl":"10.1016/j.toxicon.2025.108545","url":null,"abstract":"","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108545"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyaluronidase activity of Indian ornamental tarantula (Poecilotheria regalis) venom is significantly reduced by commercial Latrodectus mactans and American scorpion antivenoms","authors":"Michell García-García ,&nbsp;Juan Mosqueda ,&nbsp;Jesica Esther Escobar-Cabrera ,&nbsp;Juan Manuel Murillo-Maldonado ,&nbsp;García-Arredondo José Alejandro","doi":"10.1016/j.toxicon.2025.108543","DOIUrl":"10.1016/j.toxicon.2025.108543","url":null,"abstract":"<div><div>A recent clinical case involving a <em>Poecilotheria regalis</em> bite was treated with Mexican L. <em>mactans</em> antivenom (Aracmyn Plus, Silanes, Mexico), resulting in the improvement of some of the symptoms. This could be attributed to cross-reactivity caused by structural similarities between certain components of <em>L. mactans</em> and <em>P. regalis</em> venoms. The aim of the present study was to evaluate the cross-reactivity of <em>P. regalis</em> venom with commercial antivenoms that target the venom of the <em>Latrodectus mactans</em> spider and American scorpions. Hyaluronidase activity was evaluated via a turbidimetric method, while edema was evaluated in rat paw via a histopathological analysis. Cross-reactivity was determined using SDS-PAGE and western blotting. The results obtained showed that both antivenoms significantly reduced the hyaluronidase activity of <em>P. regalis</em> venom and that induced by other tarantula venoms. Aracmyn Plus did not reduce inflammation caused by <em>P. regalis</em> venom. Furthermore, it was previously observed that this antivenom failed to reduce the characteristic muscle cramps induced by this venom. Finally, western blotting revealed that both antivenoms showed cross-reactivity with <em>P. regalis</em> venom. The above findings suggest that hyaluronidases and other high-molecular-weight components exhibit structural similarities across the venoms from different arachnid species.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108543"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scorpion venoms from the Buthidae family: A dual study of proteomic composition and anticancer potentials","authors":"Isac G. Mabunda ,&nbsp;Benedict C. Offor ,&nbsp;Beric Muller ,&nbsp;Lesetja R. Motadi ,&nbsp;Lizelle A. Piater","doi":"10.1016/j.toxicon.2025.108542","DOIUrl":"10.1016/j.toxicon.2025.108542","url":null,"abstract":"<div><div>Scorpion venom comprises complex proteins/peptides (neurotoxins and enzymes), organic compounds, inorganic salts, mucopolysaccharides, and other organic compounds. Understanding the composition of scorpion venom and its mechanism of action will help treat victims and develop new therapeutic drugs. The present study objectives were to fractionate the crude venom of <em>Buthus occitanus</em>, <em>Androctonus crassicauda</em>, <em>Leiurus quinquestriatus</em>, and <em>Parabuthus granulatus</em> and identify significant protein/peptide compositions thereof, and to evaluate the cytotoxic effect of these scorpion crude venoms and fractions on different cancer cell lines. The LC-MS/MS results allowed the identification of several toxins, such as neurotoxins acting on ion channels, including sodium toxins (NaTxs), potassium toxins (KTxs), chloride toxins (ClTxs), and calcium toxins (CaTxs), as well as orphan peptides, chlorotoxin, kurtoxin, mauriporin, and ikitoxin. The venoms exerted cytotoxic effects on the A375 cell line in a dose-dependent manner, while on the other cancer cell lines, a mild effect for <em>A. crassicauda</em> (MCF-7), <em>L. quinquestriatus</em> (HeLa), and <em>P. granulatus</em> (HeLa) was observed. The current study has thus revealed and identified components of the four scorpion venoms that are likely involved in the envenomation and may also have helpful therapeutic activities. Furthermore, the scorpion venoms anticancer efficacy seems to be cancer-specific. The results obtained add to the increasing body of evidence supporting the anticancer potential of scorpion venoms.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108542"},"PeriodicalIF":2.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of Amanita vidua poisoning","authors":"Ertugrul Kaya ,&nbsp;Esra Sultan Karabulut Keklik ,&nbsp;Ilgaz Akata ,&nbsp;Ersan Horoz ,&nbsp;Ismail Yilmaz","doi":"10.1016/j.toxicon.2025.108541","DOIUrl":"10.1016/j.toxicon.2025.108541","url":null,"abstract":"<div><div>The similarities between poisonous and edible mushrooms, combined with the inexperience of foragers, increase the risk of mushroom poisoning. Amatoxin-containing mushrooms are responsible for most fatal mushroom poisonings. However, there is limited clinical data regarding the toxin content of certain <em>Amanita</em> species, such as <em>Amanita vidua</em>, and the severity of poisoning they may cause if consumed. This case report presents the first documented instance of poisoning from <em>A. vidua</em> in the literature. A 72-year-old woman mistakenly consumed a toxic <em>A. vidua</em> mushroom, believing it to be the non-toxic <em>Amanita vaginata</em>. Approximately 10 hours later, she arrived at the emergency room with symptoms including nausea, vomiting, and diarrhea. All laboratory parameters were normal on the first day. However, the patient subsequently developed refractory circulatory shock and multiple organ failure, which began on the second day and rapidly worsened over the following days. Liver function tests peaked at 73 hours post-ingestion, showing aspartate transaminase levels of 2534 IU/L, alanine transaminase levels exceeding 942 IU/L, and lactate dehydrogenase levels above 3325 U/L. We identified <em>A. vidua</em> by both macroscopic and microscopic examinations. Additionally, high-performance liquid chromatography (HPLC) analysis of the consumed <em>A. vidua</em> mushroom detected the presence of toxic alpha- and beta-amanitins, confirming amatoxin poisoning. This study details a case of <em>A. vidua</em> mushroom poisoning that occurred in Türkiye, ultimately resulting in death despite treatment. This is significant as it represents the first known case of poisoning worldwide from <em>A. vidu</em>a, highlighting its potential lethality when ingested by humans.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"266 ","pages":"Article 108541"},"PeriodicalIF":2.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}