Journal of Cachexia Sarcopenia and Muscle最新文献

{"title":"Mitochondrial Sensitivity to Submaximal [ADP] Following Bed Rest: A Novel Two-Phase Approach Associated With Fibre Types","authors":"Lucrezia Zuccarelli, Maria De Martino, Antonio Filippi, Alice E. Knapton, Benjamin D. Thackray, Giovanni Baldassarre, Boštjan Šimunič, Rado Pišot, Giuseppe Sirago, Elena Monti, Marco Narici, Miriam Isola, Andrew J. Murray, Giovanna Lippe, Bruno Grassi","doi":"10.1002/jcsm.13775","DOIUrl":"https://doi.org/10.1002/jcsm.13775","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We recently demonstrated that following a 10-day exposure to inactivity/simulated microgravity impairments of oxidative metabolism were located ‘upstream’ of mitochondrial function, as evaluated by maximal ADP-stimulated mitochondrial respiration (JO<sub>2max</sub>) determined ex vivo. The aim of this study was to evaluate mitochondrial sensitivity to submaximal [ADP] by an alternative approach aimed at identifying responses associated with fibre type composition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Isolated permeabilized <i>vastus lateralis</i> fibres were analysed by high-resolution respirometry in 9 young males before and after a 10-day horizontal bed rest. Eleven submaximal titrations of ADP (from 12.5 to 10 000 μM) were utilized to assess complex I + II-linked ADP sensitivity. We applied to JO<sub>2</sub> versus [ADP] data a traditional Michaelis–Menten kinetics equation, with the calculation of the apparent K<sub>m</sub> and maximal respiration (V<sub>max</sub>), and two ‘sequential’ hyperbolic equations, yielding two K<sub>m</sub> and V<sub>max</sub> values. The two-hyperbolic equations were solved and the [ADP] value corresponding to 50% of JO<sub>2max</sub> was calculated. Isoform expression of myosin heavy chains (MyHC) 1, 2A and 2X was also determined. Control experiments were also carried out on rat skeletal muscle samples with different percentages of MyHC isoforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The two hyperbolic equations provided an alternative fitting of data and identified two distinct phases of the JO<sub>2</sub> versus [ADP] response: a first phase characterized by low V<sub>max</sub> (V<sub>max1</sub>, 28 ± 10 pmol s<sup>−1</sup> mg<sup>−1</sup>) and apparent K<sub>m</sub> (K<sub>m1</sub>, 62 ± 54 μM) and a second phase characterized by higher V<sub>max</sub> (V<sub>max2</sub>, 61 ± 16 pmol s<sup>−1</sup> mg<sup>−1</sup>) and K<sub>m</sub> (K<sub>m2</sub>, 1784 ± 833 μM). Data were confirmed in control experiments carried out in rat muscle samples with different percentages of MyHC isoforms. Correlation and receiver operating characteristics analyses suggest that the two phases of the response were related to the % of MyHC isoforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A novel mathematical approach (two sequential hyperbolic functions) for the fitting of JO<sub>2</sub> versus [ADP] data obtained by high-resolution respirometry on permeabilized skeletal muscle fibres, obtained in humans and rats, provided an alternative fitting of the experimental dat","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 3","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875601","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":"The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis","authors":"Konstantinos Prokopidis,&nbsp;Frank Moriarty,&nbsp;Gülistan Bahat,&nbsp;Joseph McLean,&nbsp;David D. Church,&nbsp;Harnish P. Patel","doi":"10.1002/jcsm.13799","DOIUrl":"https://doi.org/10.1002/jcsm.13799","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sarcopenia is associated with the loss of skeletal muscle function and mass. Nicotinamide precursors, such as nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), have received attention for their potential to improve NAD⁺ levels and mitigate age-related sarcopenia in preliminary models, though evidence on their effects in older adults remains inconclusive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Cochrane Library, Web of Science, and Scopus to identify randomized controlled trials (RCTs), comparing NR or NMN vs. placebo. A random-effects meta-analysis was employed to determine their impact on measures of sarcopenia such as skeletal muscle index (SMI), handgrip strength (HGS) and gait speed. A narrative synthesis was used for 5-time chair stand test (5CST), short physical performance battery (SPPB), timed-up-and-go (TUG), 6-min walking distance (6MWD), leg and chest press 80% 1RM (repetition maximum) and thigh muscle mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Included participants had a mean age range from 60.9 to 83 years. NMN supplementation showed no significant effects on SMI (<i>n</i> = 3; mean difference (MD): −0.42, 95% confidence interval (CI): −0.99 – 0.14, <i>I</i>² = 63%, <i>p</i> = 0.14), HGS (One study estimating left grip; <i>n</i> = 5; MD: 0.61, 95%CI: −0.89 – 2.10, <i>I</i>² = 0%, <i>p</i> = 0.42; One study estimating right grip; <i>n</i> = 5; MD: 0.45, 95%CI: −1.06 – 1.96, <i>I</i>² = 0%, <i>p</i> = 0.56), gait speed (<i>n</i> = 4; MD: -0.01, 95%CI: −0.08 – 0.06, <i>I</i>² = 0%, <i>p</i> = 0.79), or 5CST (<i>n</i> = 2; MD: -0.21, 95%CI: −0.70 – 0.29, <i>I</i>² = 11%, <i>p</i> = 0.41). Additionally, our narrative synthesis showed that NMN did not improve knee extension strength, SPPB, or thigh muscle mass. NR supplementation was associated with a longer 6MWD among individuals with peripheral artery disease. However, lower scores in the SPPB and slower 5CST were observed in those with mild cognitive impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Current evidence does not support NMN and NR supplementation for preserving muscle mass and function in adults with mean age of over 60 years. Future research should explore supplementation dosage, NAD⁺ baseline deficiency, and combined interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 3","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13799","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871474","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":"Severe Dietary Energy Restriction for Compensated Cirrhosis Due to Metabolic Dysfunction-Associated Steatotic Liver Disease: A Randomised Controlled Trial","authors":"Dimitrios A. Koutoukidis,&nbsp;Susan A. Jebb,&nbsp;Jeremy W. Tomlinson,&nbsp;Ferenc E. Mozes,&nbsp;Michael Pavlides,&nbsp;Miriam Lacharie,&nbsp;Francesca Saffioti,&nbsp;Paul Aveyard,&nbsp;Jeremy F. Cobbold","doi":"10.1002/jcsm.13783","DOIUrl":"https://doi.org/10.1002/jcsm.13783","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Compensated cirrhosis due to metabolic dysfunction-associated steatotic liver disease (CC-MASLD) increases morbidity and mortality risk but has no aetiology-specific treatment. We investigated the safety and efficacy signals of severe energy restriction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this randomised controlled trial, adults with CC-MASLD and obesity in a tertiary hepatology centre were randomised 2:1 to receive one-to-one remote dietetic support with a low-energy (880 kcal/day, 80 g protein/day) total diet replacement programme for 12 weeks and stepped food reintroduction for another 12 weeks or standard of care (SoC). Given the exploratory nature of the study, three pre-defined co-primary outcomes were used to assess safety and efficacy signals: severe increases in liver biochemistry, changes in iron-corrected T1, and changes in liver stiffness on magnetic resonance elastography. Changes in liver steatosis on magnetic resonance imaging, physical performance based on the physical performance test and liver frailty index, and changes in fat-free mass were secondary outcomes. Magnetic resonance outcomes were assessed blind.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Between February 2022 and September 2023, 17 participants (36% female, median [IQR] age 58 [7.5] years) were randomised to SoC (&lt;i&gt;n&lt;/i&gt; = 6) or intervention (&lt;i&gt;n&lt;/i&gt; = 11). The trial stopped earlier than planned due to slow recruitment rate. 91% and 94% of participants completed the intervention and attended the 24-week follow-up, respectively. Compared with the SoC, the between-group weight change in the intervention was −11.9 kg (95% CI: −17.2, −6.6, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) at 24 weeks. Liver biochemistry markers (alanine transaminase, aspartate transaminase, and total bilirubin) were stable in everyone throughout the trial. Iron-corrected T1 and steatosis significantly reduced (−149.9 ms [95% CI −258.1, −41.7, &lt;i&gt;p&lt;/i&gt; = 0.01] and −6% [95% CI −11.3, −0.6, &lt;i&gt;p&lt;/i&gt; = 0.03], respectively). There were no between-group differences in changes in liver stiffness (0.2 kPa [95% CI −1.1, 1.6]), the physical performance test (1.5 points [95% CI −1.9 to 4.9], &lt;i&gt;p&lt;/i&gt; = 0.70) or the liver frailty index (0 [95% CI −0.6 to 0.6], &lt;i&gt;p&lt;/i&gt; = 0.97). Compared with SoC, absolute fat-free mass reduced (−3.2 kg [95% CI −6 to −0.3], &lt;i&gt;p&lt;/i&gt; = 0.04) but relative fat-free mass as percentage of total body weight increased (5.4% [95% CI 0.5 to 10.3], &lt;i&gt;p&lt;/i&gt; = 0.046). No participant met the pre-defined safety criteria for enhanced observation or intervention discontinuation. There was no between-group differences in changes in cardiovascular marker","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 3","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871599","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":"Myo-Guide: A Machine Learning-Based Web Application for Neuromuscular Disease Diagnosis With MRI","authors":"Jose Verdu-Diaz,&nbsp;Carla Bolano-Díaz,&nbsp;Alejandro Gonzalez-Chamorro,&nbsp;Sam Fitzsimmons,&nbsp;Jodi Warman-Chardon,&nbsp;Goknur Selen Kocak,&nbsp;Debora Mucida-Alvim,&nbsp;Ian C. Smith,&nbsp;John Vissing,&nbsp;Nanna Scharff Poulsen,&nbsp;Sushan Luo,&nbsp;Cristina Domínguez-González,&nbsp;Laura Bermejo-Guerrero,&nbsp;David Gomez-Andres,&nbsp;Javier Sotoca,&nbsp;Anna Pichiecchio,&nbsp;Silvia Nicolosi,&nbsp;Mauro Monforte,&nbsp;Claudia Brogna,&nbsp;Eugenio Mercuri,&nbsp;Jorge Alfredo Bevilacqua,&nbsp;Jorge Díaz-Jara,&nbsp;Benjamín Pizarro-Galleguillos,&nbsp;Peter Krkoska,&nbsp;Jorge Alonso-Pérez,&nbsp;Montse Olivé,&nbsp;Erik H. Niks,&nbsp;Hermien E. Kan,&nbsp;James Lilleker,&nbsp;Mark Roberts,&nbsp;Bianca Buchignani,&nbsp;Jinhong Shin,&nbsp;Florence Esselin,&nbsp;Emmanuelle Le Bars,&nbsp;Anne Marie Childs,&nbsp;Edoardo Malfatti,&nbsp;Anna Sarkozy,&nbsp;Luke Perry,&nbsp;Sniya Sudhakar,&nbsp;Edmar Zanoteli,&nbsp;Filipe Tupinamba Di Pace,&nbsp;Emma Matthews,&nbsp;Shahram Attarian,&nbsp;David Bendahan,&nbsp;Matteo Garibaldi,&nbsp;Laura Fionda,&nbsp;Alicia Alonso-Jiménez,&nbsp;Robert Carlier,&nbsp;Ali Asghar Okhovat,&nbsp;Shahriar Nafissi,&nbsp;Atchayaram Nalini,&nbsp;Seena Vengalil,&nbsp;Kieren Hollingsworth,&nbsp;Chiara Marini-Bettolo,&nbsp;Volker Straub,&nbsp;Giorgio Tasca,&nbsp;Jaume Bacardit,&nbsp;Jordi Díaz-Manera,&nbsp;the Myo-Guide Consortium","doi":"10.1002/jcsm.13815","DOIUrl":"https://doi.org/10.1002/jcsm.13815","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Neuromuscular diseases (NMDs) are rare disorders characterized by progressive muscle fibre loss, leading to replacement by fibrotic and fatty tissue, muscle weakness and disability. Early diagnosis is critical for therapeutic decisions, care planning and genetic counselling. Muscle magnetic resonance imaging (MRI) has emerged as a valuable diagnostic tool by identifying characteristic patterns of muscle involvement. However, the increasing complexity of these patterns complicates their interpretation, limiting their clinical utility. Additionally, multi-study data aggregation introduces heterogeneity challenges. This study presents a novel multi-study harmonization pipeline for muscle MRI and an AI-driven diagnostic tool to assist clinicians in identifying disease-specific muscle involvement patterns.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We developed a preprocessing pipeline to standardize MRI fat content across datasets, minimizing source bias. An ensemble of XGBoost models was trained to classify patients based on intramuscular fat replacement, age at MRI and sex. The SHapley Additive exPlanations (SHAP) framework was adapted to analyse model predictions and identify disease-specific muscle involvement patterns. To address class imbalance, training and evaluation were conducted using class-balanced metrics. The model's performance was compared against four expert clinicians using 14 previously unseen MRI scans.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Using our harmonization approach, we curated a dataset of 2961 MRI samples from genetically confirmed cases of 20 paediatric and adult NMDs. The model achieved a balanced accuracy of 64.8% ± 3.4%, with a weighted top-3 accuracy of 84.7% ± 1.8% and top-5 accuracy of 90.2% ± 2.4%. It also identified key features relevant for differential diagnosis, aiding clinical decision-making. Compared to four expert clinicians, the model obtained the highest top-3 accuracy (75.0% ± 4.8%). The diagnostic tool has been implemented as a free web platform, providing global access to the medical community.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The application of AI in muscle MRI for NMD diagnosis remains underexplored due to data scarcity. This study introduces a framework for dataset harmonization, enabling advanced computational techniques. Our findings demonstrate the potential of AI-based approaches to enhance differential diagnosis by identifying disease-specific muscle involvement patterns. The developed tool surpasses expert performance in diagno","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 3","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13815","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871518","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":"Walking Speed and Risk of Cancer in Two Prospective Cohort Studies","authors":"Jonathan K. L. Mak,&nbsp;Kathryn Choon Beng Tan,&nbsp;Juulia Jylhävä,&nbsp;Sara Hägg,&nbsp;Ching-Lung Cheung","doi":"10.1002/jcsm.13792","DOIUrl":"https://doi.org/10.1002/jcsm.13792","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Walking speed is a reliable marker of sarcopenia and a strong predictor of mortality, but its relationship with cancer incidence remains largely unexplored. We aimed to investigate the association between walking speed and the risk of any cancer and five common cancers, including lung, breast, colorectum, prostate, and stomach, and to explore potential mediation by biomarkers of inflammation, and lipid and glucose metabolism.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The primary analysis was conducted in 431 598 participants from the UK Biobank (mean age 56.3 [SD 8.1] years at baseline), and the generalizability of findings was further tested in 1311 participants from the Hong Kong Osteoporosis Study (HKOS; mean age 57.8 [SD 11.9] years). Walking speed was self-reported in the UK Biobank and measured using a timed 6-m walk test in the HKOS. Incident cancer cases were identified from electronic health records. We used Cox models, adjusted for age, sex, height, body mass index, socioeconomic, lifestyle factors, family history of cancer, and grip strength, to estimate the association between walking speed and cancer incidence. Single and multiple mediator models were performed in the UK Biobank to examine the mediating effects of C-reactive protein (CRP), white blood cell (WBC) count, total cholesterol, low-density lipoprotein (LDL) cholesterol, and glucose levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Over a median follow-up of 10.9 and 6.9 years, 11.7% and 5.0% of the UK Biobank and HKOS participants were diagnosed with cancer, respectively. In the UK Biobank, those reported a brisk vs. slow walking pace had a 13% lower risk of any cancer (95% CI 0.84–0.90). Similarly, HKOS participants with a faster walking speed (≥ 1.0 vs. &lt; 1.0 m/s) had a 45% reduced risk of any cancer (95% CI 0.31–0.98). In the UK Biobank, brisk walking pace was associated with a significantly decreased risk of lung cancer (hazard ratio [HR] 0.47, 95% CI 0.42–0.53) and a slightly increased risk of prostate cancer (HR 1.11, 95% CI 1.02–1.21). CRP, WBC count, total cholesterol, and LDL cholesterol significantly mediated the association between brisk walking pace and any cancer, with proportions of mediation being 6.4% (95% CI 4.4–8.7%), 11.4% (8.4–17.1%), 9.3% (7.1–12.9%), and 8.3% (6.1–11.9%), respectively. The combined mediated proportion of all five potential mediators was 25.9% (19.5–37.2%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Faster walking speed, whether self-reported or measured, is associated with a reduce","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 3","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871475","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":"Prepregnancy Obesity Reprograms Offspring Skeletal Muscle Fibre Transition Through H3K9me3","authors":"Yichi Wu,&nbsp;Sujuan Li,&nbsp;Jingyi Zhang,&nbsp;Anran Tian,&nbsp;Xiangyao Wang,&nbsp;Xi Yang,&nbsp;Fucheng Meng,&nbsp;Qing Li,&nbsp;Yuan Gao,&nbsp;Yingying Li,&nbsp;Furong Liang,&nbsp;Minglan Yao,&nbsp;Xiaoping Luo,&nbsp;Cai Zhang","doi":"10.1002/jcsm.13825","DOIUrl":"https://doi.org/10.1002/jcsm.13825","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Maternal prepregnancy obesity predisposes offspring to obesity and metabolic disorders, yet its impact on skeletal muscle fibre transition remains unclear. Given that skeletal muscle plays a crucial role in systemic metabolism, we investigated how maternal prepregnancy high-fat diet (HFD) influences muscle fibre composition and metabolic function in offspring.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We established mouse models with a prepregnancy chow diet (CD) and a prepregnancy high-fat diet (HFD) for 8 weeks to compare metabolic phenotypes in offspring. Skeletal muscles from offspring were analysed using RNA sequencing, quantitative reverse transcription polymerase chain reaction and western blot to understand the changes in metabolic and signalling pathways. siRNA knockdown and lentiviral-mediated overexpression experiments were conducted in vitro and in vivo to validate molecular mechanisms. Chromatin immunoprecipitation followed by qPCR (ChIP-qPCR) was used to assess histone modification levels at promoter regions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Male and female offspring of prepregnancy obese dams (mHFD) exhibited a significant reduction in slow-twitch oxidative fibres (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and an increase in fast-twitch glycolytic fibres compared with controls. This was accompanied by impaired glucose tolerance (AUC increased by 12.87%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01), insulin resistance and mitochondrial dysfunction (mtDNA copy number reduced by 31%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). RNA sequencing identified IDH2 as the most significantly downregulated gene (29.67% decrease, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with protein levels further reduced in male (30.15%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and female (46.02%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) offspring. IDH2 knockdown in C2C12 cells impaired mitochondrial biogenesis and led to higher oxidative stress (NADP+/NADPH ratio elevated by 32%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01), while IDH2 overexpression restored mitochondrial integrity, enhanced slow-twitch fibre proportion (26.43 ± 0.6936% in mHFD-LV-IDH2, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and improved glucose metabolism (fasting glucose reduced by 14.7%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). ChIP-qPCR revealed increased H3K9me3 enrichment at the IDH2 promoter (2.54-fold in males, 2.55-fold in females, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), suggesting transgenerational epigenetic regulation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Maternal prepregnancy obesity induces a metabolic shift in offspring skeletal muscle by promoting a slow-to-fast fibre transition and impairing mitochondrial biogenes","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13825","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852766","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":"Comment on “Intermittent Hypoxic–Hyperoxic Training During Inpatient Rehabilitation Improves Exercise Capacity and Functional Outcome in Patients With Long Covid: Results of a Controlled Clinical Pilot Trial” by Doehner et al.","authors":"","doi":"10.1002/jcsm.13802","DOIUrl":"https://doi.org/10.1002/jcsm.13802","url":null,"abstract":"&lt;p&gt;To the Editors of the Journal of Cachexia, Sarcopenia and Muscle&lt;/p&gt;&lt;p&gt;It is estimated that around 10% of people infected with COVID-19 continue to struggle with permanent or new symptoms even months after the acute illness [&lt;span&gt;1&lt;/span&gt;]. One of the most severe forms of this Long Covid syndrome is known as myalgic encephalitis/chronic fatigue syndrome (ME/CFS). This is a neuroimmunological disease with a prevalence in Germany of around 0.6% after COVID disease, which often leads to incapacity for work and disability [&lt;span&gt;2&lt;/span&gt;]. I was therefore very interested to read a therapy study in which Long Covid patients were treated with ‘Intermittent Hypoxic–Hyperoxic Training’ (IHHT), three treatments per week for approximately 5 weeks [&lt;span&gt;3&lt;/span&gt;], which resulted in a significant improvement in performance. The existence of such a method, which earlier publications suggest is even low in side effects, will raise hopes among the many thousands of chronically ill Long Covid patients or ME/CFS sufferers, as effective treatment options have not existed to date.&lt;/p&gt;&lt;p&gt;Unfortunately, doubts have arisen as to the quality of the study and also the accuracy of its conclusions. Allow us to briefly explain our doubts below, focussing on the primary endpoint of the study.&lt;/p&gt;&lt;p&gt;The authors formed two groups of 70 and 75 patients from the population of patients at a rehabilitation centre. Group allocation was not randomised. The 6-min walking test was chosen as the primary endpoint as a measure of functional capacity. The baseline parameter was 352 ± 75 m in the study group and 430 ± 81 m in the control group. This corresponds to a difference of 25%. Statistically, this difference is highly significant with &lt;i&gt;p&lt;/i&gt; &lt; 0.001, that is, the probability that both groups come from the same collective is less than 1:100 000. Other performance parameters also differed significantly. It is therefore clear that different collectives are being compared here.&lt;/p&gt;&lt;p&gt;After the therapy, the IHHT group achieved a 6-min walking test value of 443 ± 77 m, the control group 462 ± 89 m. You do not have to be a statistics expert to be able to say with great certainty that these two values do not differ significantly from each other. However, the training effect, that is, the difference between baseline value and the endpoint reached, is significantly greater in the IHHT group. The authors then conclude: ‘Respiratory treatment with IHHT in addition to a multidisciplinary rehabilitation programme improves functional capacity, symptomatic status and quality of life in patients with disabling Long Covid’.&lt;/p&gt;&lt;p&gt;In our opinion, this conclusion cannot be substantiated by the study. Due to the lack of a real randomised control group that was subjected to a sham treatment, for example, it cannot be ruled out that it was the standard rehabilitation measures alone that led to such a strong increase in performance in the study group that the two groups no longer differed at the","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13802","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852623","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":"Oestrogen Receptor Alpha in Myocyte Maintains Muscle Regeneration in Duchenne Muscular Dystrophy","authors":"Xiaofei Huang,&nbsp;Sijia Li,&nbsp;Huna Wang,&nbsp;Lei Zhao,&nbsp;Xihua Li,&nbsp;Shusheng Fan,&nbsp;Wanting Hu,&nbsp;Haowei Tong,&nbsp;Guangyao Guo,&nbsp;Dengqiu Xu,&nbsp;Luyong Zhang,&nbsp;Zhenzhou Jiang,&nbsp;Qinwei Yu","doi":"10.1002/jcsm.13807","DOIUrl":"https://doi.org/10.1002/jcsm.13807","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Oestrogen receptor alpha (ERα) plays an important role in maintaining mitochondrial function and regulating metabolism in skeletal muscle. However, its alterations and potential mechanisms in Duchenne muscular dystrophy (DMD) remain incompletely understood. In this study, we demonstrated the protective role of ERα in myocyte for skeletal muscle regeneration in &lt;i&gt;mdx&lt;/i&gt; mice and explored the therapeutic effects of oestrogen receptor modulators on DMD.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;DMD patients' biopsies were obtained for histological analysis to explore the expression of ERα. The phenotype of muscle was analysed by histology and molecular biology. The therapeutical effect of different oestrogen receptor modulators was examined in &lt;i&gt;mdx&lt;/i&gt; mice treated with fulvestrant (FVT, 20 mg/kg once a week) or oestradiol (E2, 1 mg/kg per day) for 4 weeks. The protective effect of ERα was performed on &lt;i&gt;mdx&lt;/i&gt; mice after conditional knockout of ERα in skeletal muscle (ERα&lt;sup&gt;mKO&lt;/sup&gt; &lt;i&gt;mdx&lt;/i&gt; mice). Evidence of activation of ERα/oestrogen-related receptor alpha (ERRα)/myogenic differentiation 1 (MyoD) signalling pathway was inspected in the primary myoblasts isolated from mice, and C2C12 cells received intervention with E2/FVT/&lt;i&gt;Esr1&lt;/i&gt;-siRNA/&lt;i&gt;Esrra&lt;/i&gt; overexpression plasmid.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The ERα expression was increased in DMD patients' triceps (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and &lt;i&gt;mdx&lt;/i&gt; mice muscles (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). FVT reduced ERα levels in the &lt;i&gt;mdx&lt;/i&gt; mice muscles (&lt;i&gt;p&lt;/i&gt; &lt; 0.01) but had no significant effect on skeletal muscle regeneration on &lt;i&gt;mdx&lt;/i&gt; mice. Compared with &lt;i&gt;mdx&lt;/i&gt; mice, E2 reduced the levels of creatine kinase (CK) and lactic dehydrogenase (LDH) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) in serum, enhanced skeletal muscle function, alleviated skeletal muscle atrophy and fibre loss and upregulated the expression of ERα in GAS (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and TA (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The myogenic factors such as myosin heavy chain (MyHC, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), myogenin (MyoG, &lt;i&gt;p&lt;/i&gt; &lt; 0.05), MyoD (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and ERRα (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) were increased in &lt;i&gt;mdx&lt;/i&gt; mice GAS with E2. But E2 had no effect on ERα&lt;sup&gt;mKO&lt;/sup&gt; &lt;i&gt;mdx&lt;/i&gt; mice. The primary myoblasts and C2C12 were treated with E2 displayed an increased-on myocyte fusion index (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), ERα MyoD and ERRα expressions (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The myocytes' fusion index (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and ERα, MyoD and ERRα expression (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) were decreased in si-&lt;i&gt;Esr1&lt;/i&gt;-transfected C2C12 cells and increased in OE-&lt;i&gt;Esrra&lt;/i&gt;-transfected C2C12 cells.&lt;/p&gt;\u0000 &lt;","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857107","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":"Effectiveness of Mind–Body Exercise in Older Adults With Sarcopenia and Frailty: A Systematic Review and Meta-Analysis","authors":"Ruihan Wan,&nbsp;Jie Huang,&nbsp;Kangle Wang,&nbsp;Danting Long,&nbsp;Aolong Tao,&nbsp;Jia Huang,&nbsp;Zhizhen Liu","doi":"10.1002/jcsm.13806","DOIUrl":"https://doi.org/10.1002/jcsm.13806","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mind–body exercise (MBE) has shown promise in mitigating the effects of sarcopenia and frailty in older adults. Nevertheless, its effectiveness in enhancing muscle function and physical performance in this population has not been well established. This study aimed to investigate the effects of MBE on older adults with sarcopenia and frailty, to offer evidence-based exercise recommendations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A comprehensive search for randomized controlled trials (RCTs) was conducted through multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang, and Chinese Scientific Journals Full-Text Database (VIP), supplemented by manual reference searches from inception until February 2024. The eligible RCTs compared MBE with passive or active exercise controls, focusing on muscle function and physical performance in older adults aged 60 years or above. Subgroup analyses were conducted to evaluate the types, duration, and frequency of MBE.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nine eligible RCTs with 1838 participants were included in this study. MBE demonstrated significant improvements compared with passive control, particularly in grip strength (WMD [weighted mean difference] = 0.99; 95% CI [95% confidence interval] = 0.06, 1.92; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 3%, &lt;i&gt;p&lt;/i&gt; = 0.04), Timed Up and Go Test (TUGT) (WMD = −4.04; 95% CI = −5.54, −2.53; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 12%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01), and Berg Balance Scale (BBS) scores (WMD = 3.63; 95% CI = 0.38, 6.87; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%, &lt;i&gt;p&lt;/i&gt; = 0.03). Even when compared to active exercise training, improvements were still observed in TUGT and BBS (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), with a trend toward improved grip strength (WMD = −2.20; 95% CI = −4.35, −0.04; &lt;i&gt;p&lt;/i&gt; = 0.05). No positive effect on muscle mass was observed. Subgroup analysis indicated that MBE performed more than 5 times a week for a short or medium duration (4–24 weeks) could improve grip strength (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Moderate-frequency intervention over a short period in this population yielded greater improvements in gait speed and Chair Rise Test completion time (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MBE can enhance muscle function and physical performance to some extent in older adults with sarcopenia and frailty, whether they are compared with passive or active exercise training. However, positive effects on muscle mass have not been observed.","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852913","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":"Longitudinal Follow-Up of Patients With Duchenne Muscular Dystrophy Using Quantitative 23Na and 1H MRI","authors":"Teresa Gerhalter,&nbsp;Benjamin Marty,&nbsp;Lena V. Gast,&nbsp;Frank Roemer,&nbsp;Pierre-Yves Baudin,&nbsp;Regina Trollmann,&nbsp;Michael Uder,&nbsp;Pierre G. Carlier,&nbsp;Armin M. Nagel","doi":"10.1002/jcsm.13812","DOIUrl":"https://doi.org/10.1002/jcsm.13812","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Quantitative muscle MRI commonly evaluates disease activity and muscle wasting in Duchenne muscular dystrophy (DMD). Disturbances in ion homeostasis contribute to DMD pathophysiology, but their relationships with disease progression is unclear. &lt;sup&gt;23&lt;/sup&gt;Na MRI may provide insights into the disease course and treatment response. This longitudinal study assessed whether sodium levels are elevated in DMD patients regardless of fat fraction (FF) and whether baseline sodium levels influence FF changes over time. Additionally, we quantified the effect of slice selection on measured sodium values.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirteen DMD boys (age 7.8 ± 2.4 years) underwent MRI of lower leg muscles at 3T at three visits, spaced 6 months apart. We assessed FF for disease progression and water T&lt;sub&gt;2&lt;/sub&gt;, pH, apparent tissue sodium concentration (aTSC), and intracellular-weighted &lt;sup&gt;23&lt;/sup&gt;Na signal (ICwS) for disease activity. Fourteen healthy boys (age 9.5 ± 1.7 years) underwent the same MRI protocol once. Linear regression and mixed-effect modelling were used to examine sodium level increases and their impact on FF changes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In DMD, muscles with FF &lt; 10% exhibited significantly elevated aTSC (24.8 ± 4.6 mM vs. 14.5 ± 2.1 mM in controls, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and higher ICwS (23.6 ± 2.5 a.u. vs. 14.1 ± 2.1 a.u., &lt;i&gt;p&lt;/i&gt; &lt; 0.001). At Visit 1, FF values showed a significant negative association with aTSC (&lt;i&gt;β&lt;/i&gt; = −17.30, &lt;i&gt;p&lt;/i&gt; = 0.016) and ICwS (&lt;i&gt;β&lt;/i&gt; = −21.02, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The first mixed-effect model, which assessed aTSC alone, showed no significant effect on FF progression but indicated a weak trend (&lt;i&gt;p&lt;/i&gt; = 0.098). The second, more comprehensive model—incorporating also ICwS and water T&lt;sub&gt;2&lt;/sub&gt;—revealed that FF changes were positively associated with aTSC (&lt;i&gt;p&lt;/i&gt; = 0.0023) and negatively associated with ICwS and wT&lt;sub&gt;2&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt; &lt; 0.001 and &lt;i&gt;p&lt;/i&gt; = 0.025, respectively), with ICwS showing a significant interaction with time (&lt;i&gt;p&lt;/i&gt; = 0.0033).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Varying slice positioning and slice number demonstrated minimal impact on aTSC and ICwS, with low CV (2%–4%) in the mid-belly region.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study demonstrates significant MRI-based changes related to dystrophic alterations in DMD. We identified early alterations in sodium homeostasis, independent of FF. Our findings suggest that the re","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 2","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852846","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}