Journal of Allergy and Clinical Immunology-In Practice最新文献

{"title":"Impact of Food Allergy on the Atopic March Progression from Atopic Dermatitis in Early Childhood to Other Atopic Disorders at School Age.","authors":"Robert S Zeiger, Michael Schatz, Botao Zhou, Julie A Stern, Qiaowu Li, Sanah Basrai, Richard H Stanford, Marissa Shams, Hernan Avella, Arun Subramaniam, Wansu Chen","doi":"10.1016/j.jaip.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.05.001","url":null,"abstract":"<p><strong>Background: </strong>The relationship between food allergy (FA) in children with atopic dermatitis (AD) aged birth to 36 months and the prevalence of other atopic disorders at ages 5-11 years needs further study.</p><p><strong>Objective: </strong>To analyze the progression of AD with and without FA from infancy/toddlers to other atopic disorders from ages 5-11 years.</p><p><strong>Methods: </strong>Using electronic health records, 10,688 children with AD onset (2 separate ICD-9/10 coded AD visits and 2 separate AD dispensed medications) from birth to 36 months were identified. Atopic disorders were determined based on ICD-9/10 coded visits. Moderate-severe asthma was defined as GINA-step care level of ≥3 for ≥4 years from ages 5-11 years. Unadjusted and adjusted risk ratios for moderate-severe asthma, allergic rhinitis (AR) plus aeroallergen sensitization, and anaphylaxis in children at aged 5-11 years with FA (FA+) and without FA (FA-) by age 36 months were determined by using Robust Poisson Regression.</p><p><strong>Results: </strong>Compared to FA- (N=8,415), FA+ (N=2,273) children were significantly more likely (P<.001) to be male, of Asian/Pacific Islander ethnicity, have an earlier onset of AD, have more physician visits and dispensed medications for AD, and have higher incidence of asthma visits by age 36 months. Multivariate analysis revealed increased adjusted risk ratios (aRR, 99% CI) (P<.001) for the prevalences of moderate-severe asthma (aRR:1.42, 1.14-1.76), AR (aRR:1.34, 1.19-1.51), and anaphylaxis (aRR: 1.69, 1.33-2.15).</p><p><strong>Conclusions: </strong>Early-onset FA in infants/toddlers with AD enhances the atopic march by increasing the risk from ages 5-11 years for future moderate-severe asthma, AR, and anaphylaxis.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor asthma control increases the risk of COVID-19 hospitalization in children.","authors":"Madhura Baxi, Jennifer Barrows, Louis Ehwerhemuepha, Stanley Paul Galant","doi":"10.1016/j.jaip.2025.04.045","DOIUrl":"10.1016/j.jaip.2025.04.045","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-generated answers to patients' questions on asthma: the AIR-Asthma study.","authors":"Mattia Nigro, Andrea Aliverti, Alessandra Angelucci, Fulvio Braido, Giorgio W Canonica, Apostolos Bossios, Hilary Pinnock, Jeanette Boyd, Pippa Powell, Stefano Aliberti","doi":"10.1016/j.jaip.2025.04.051","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.04.051","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a prevalent chronic respiratory disease requiring ongoing patient education and individualized management. The increasing reliance on digital tools, particularly generative artificial intelligence (AI), to answer health-related questions has raised concerns about the accuracy, reliability, and comprehensibility of AI-generated information for people living with asthma.</p><p><strong>Objective: </strong>To systematically evaluate reliability, accuracy, comprehensiveness, and understandability of responses generated by three widely used AI-based chatbots (ChatGPT, Bard, Copilot) to common questions formulated by people with asthma.</p><p><strong>Methods: </strong>In this cross-sectional study, 15 questions regarding asthma management were formulated by patients and categorized by difficulty. Responses from ChatGPT, Bard, and Copilot were evaluated by international experts for accuracy and comprehensiveness, and by patient representatives for understandability. Reliability was assessed through consistency testing across devices. A blinded evaluation was conducted.</p><p><strong>Results: </strong>A total of 21 experts and 16 patient representatives participated in the evaluation. ChatGPT demonstrated the highest reliability (15/15 responses), accuracy (median score 9.0 [IQR 7.0-9.0]), and comprehensiveness (8.0 [8.0-9.0]) compared to Bard and Copilot (P < 0.0001). Bard achieved superior scores in understandability (median score 9.0 [8.0-10.0]) (P < 0.0001). Performance differences were consistent across question difficulty levels.</p><p><strong>Conclusion: </strong>AI-driven chatbots can provide generally accurate and understandable responses to asthma-related questions. Variability in reliability and accuracy underscores the need for caution in clinical contexts. AI tools may complement but cannot replace professional medical advice in asthma management.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal asthma and adverse perinatal outcomes: An analysis of 434,068 pregnancies in Canada.","authors":"Subhabrata Moitra, Anamaria Savu, Isabella Annesi-Maesano, Judith Garcia-Aymerich, Paige Lacy, Amy Metcalfe, Padma Kaul","doi":"10.1016/j.jaip.2025.04.046","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.04.046","url":null,"abstract":"<p><strong>Background: </strong>Maternal asthma is a known risk factor for asthma and allergic diseases in children. However, there is a lack of data on the role of asthma phenotypes in the association with perinatal outcomes.</p><p><strong>Objective: </strong>To investigate the role of maternal asthma in adverse perinatal outcomes, such as preterm birth (PTB), low-birthweight (LBW), and cesarean (C-section) deliveries.</p><p><strong>Methods: </strong>This cohort study included all singleton live-birth pregnancies in Alberta between October 2009 and December 2018. Maternal asthma was defined by the International Classification of Diseases codes (ICD-9/10: 493/J45) and was categorized by (i) status - ever (>1 year before pregnancy), current (within 1 year or during pregnancy), and active (during delivery hospitalization) asthma, and (ii) phenotypes - high (H) or low (L) blood (B) eosinophil (E) and neutrophil (N) counts. PTB (gestational age at delivery <37 weeks), LBW (≤2500 g), and C-section were the main perinatal outcomes of interest.</p><p><strong>Results: </strong>Of 434,068 pregnancies, 37,394 (8.6%) women had asthma, of which 52%, 40%, and 7% had ever, current, and active asthma, respectively. In adjusted analysis, maternal asthma was associated with increased risks of PTB (aRR: 1.15; 95%CI: 1.11-1.20), LBW (aRR: 1.11; 95%CI: 1.07-1.16), and C-section (aRR: 1.10; 95%CI: 1.08-1.12), and the risks were highest in active asthma, followed by current and ever asthma. The risk of PTB, LBW, and C-section were higher in the HBE/HBN phenotype, followed by HBN/LBE, HBE/LBN, and LBE/LBN phenotypes.</p><p><strong>Conclusion: </strong>Women with any history of asthma, but particularly those with current and active asthma, are at higher risk of PTB, LBW, and C-sections.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient reported outcomes on food immunotherapy differ between countries and foods: results from COFAITH.","authors":"Pablo Rodríguez Del Río, Carmen Riggioni, Antoine Deschildre, Matthew Greenhawt, Sabine Schnadt, Stefania Arasi, Anna Nowak-Wegrzyn, Richard L Wasserman, Philippe Begin, Susan Waserman, Nandinee Patel, Gabriel Lins de Holanda Coelho, Pedro Cuesta Alvaro, Francesca Mori, Lucia Caminiti, Douglas P Mack, Michael Wexler, Marta Bernaola, Francisco Javier Ruano Perez, Antonio Ramirez Jimenez, Kamal El Abd, Stephanie Wanin, Mohamed Yassin, Lydie Guenard-Bilbaut, Carine Metz-Favre, Laura Badina, Rachel Schreiber, Silvia Molo Amorós, Adam T Fox, Sonia Vazquez-Cortés, Teresa Garriga-Baraut, Pierrick Cros, Raphaëlle Bazire, David Fitzhugh, Antonella Muraro, Alberto Alvarez Perea, Paul J Turner, Montse Alvaro-Lozano, Montserrat Fernandez-Rivas, Audrey Dunn Galvin","doi":"10.1016/j.jaip.2025.04.049","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.04.049","url":null,"abstract":"<p><strong>Background: </strong>Food allergen immunotherapy (FAIT) is a consolidated treatment included in clinical guidelines that has shown efficacy in terms of researcher-defined variables, but little work has been done yet to evaluate patient´s perspectives.</p><p><strong>Objective: </strong>We aimed to understand and explore the relevance of different patient-reported outcomes (PROs) METHODS: An EAACI Taskforce designed a questionnaire to prospectively collect information from parents or caregivers of patients below 18 years on FAIT. Participants from North America and several European countries were invited to provide data regarding socioeconomic aspects, allergic background, FAIT modality, burden, safety and food allergy quality of life (FAQoL). As primary outcome, 19 proposed PROs were ranked according to their relevance (5-point Likert scale). A descriptive and cluster analysis of the data was performed.</p><p><strong>Results: </strong>84 FAIT prescribers recruited 857 patients suitable for analysis, 41.5%, 39.7% and 18.8% were on milk, peanut, and egg AIT, respectively. Patients were grouped into regions, South Europe (46.2%), North America (24.3%), Western Europe (20.7%) and United Kingdom (8.9%). Total FAQoL questionnaire score was 4.1 (±SD1.4), significantly higher among South Europeans [4.7 (±SD1.3), p<0.0001]. Worse FAQoL scores were found for milk and egg FAIT vs peanut. Cluster analysis identified 5 different phenotypes of patients considering similar replies to the proposed PROs, labeled: \"High expectations\", \"Beyond protection\", \"Social Functioning\", \"Aiming at normalization\" and \"Low motivations\".</p><p><strong>Conclusions: </strong>The data-driven analysis provided novel information on the level of complexity and personalization that patient´s desires display and opens the field to future research lines to improve FAIT patient-perceived value.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappraisal of biologic efficacy from phase 3 trials in refractory chronic rhinosinusitis and nasal polyps.","authors":"Brian J Lipworth, Robert Greig, Rory Chan, Chris RuiWen Kuo","doi":"10.1016/j.jaip.2025.04.043","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.04.043","url":null,"abstract":"<p><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is commonly associated with type 2 inflammation and may be punctuated by exacerbations requiring systemic corticosteroids and eventually a need for surgery . The use of biologics to target type 2 inflammation has greatly ameliorated the management of refractory CRSwNP . Currently available biologics act upstream by blocking the epithelial cytokine thymic stromal lymphopoiten (TSLP) or downstream blocking type 2 cytokines including interleukins (IL) 4,5 and 13 , or immunoglobulin E (IgE) . Synthesising the data from phase 3 randomised control trials using Forest plots to compare crude 95% confidence intervals permits an indirect comparison of different biologics in terms of their relative efficacy . Anti-TSLP (tezepelumab) or anti-IL4Rα (dupilumab) provide the best improvements in co-primary end points of nasal polyp and congestion score compared to other biologics including anti-IL5/5Rα (mepolizumab ,depemokimab, benralizumab) and anti-IgE (omalizumab) .Greater improvements were also seen with tezepelumab and dupilumab in regards to olfaction as loss of smell score and University of Pennsylvania Smell Identification Test, computerized tomography sinus imaging as Lund Mackay score ,and also the need for surgery or rescue use of systemic corticosteroid . Prospective pragmatic studies are required to directly compare different biologics in type 2 high and low CRSwNP , including effects on the unified airway in patients with severe asthma and CRSwNP, in particular to look at quality of life as well as clinical remission for upper and lower airway outcomes .</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of skin-gut-lung microbiome in allergic diseases.","authors":"Lan Yang, Zhen Lin, Ting Gao, Piao Wang, Gaofeng Wang","doi":"10.1016/j.jaip.2025.04.041","DOIUrl":"https://doi.org/10.1016/j.jaip.2025.04.041","url":null,"abstract":"<p><p>The incidence of allergic diseases has continued to rise in recent years, affecting ∼20% of the worldwide population especially children. Allergic diseases are chronic immune diseases that greatly reduce the quality of life of patients, leading to great economic and medical burden. The epidemiological studies indicated that children who had atopic dermatitis (AD) in infancy are more likely to develop food allergy (FA) later, and then allergic asthma (AA) and allergic rhinitis (AR) in childhood, which was defined as the \"atopic march\" (AM). Anatomically, AM follows a spatial sequence from the skin to the gastrointestinal tract then to the respiratory tract. Although the mechanisms underlying AM remain to be elucidated, microbiome alteration was considered as a critical cause. Skin and gut are the two main habitats of microbiota, and research in recent decades also indicated the presence of bacteria in lung. We here not only summarized the roles of skin, gut, lung microbiota in AD, FA, and AA, respectively, but investigated the crosstalk effects of microbiota in each anatomic site on remote organs, including microbiota-gut-skin axis, microbiota-gut-lung axis, and microbiota-skin-lung axis. In addition, we proposed the limitations of current research and the direction of future research in this field.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sticking With It: The Continued Benefits of 2 Years of Peanut Epicutaneous Immunotherapy in Young Children","authors":"Michelle F. Huffaker MD","doi":"10.1016/j.jaip.2025.02.037","DOIUrl":"10.1016/j.jaip.2025.02.037","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1188-1189"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guide to Pediatric Antibiotic Allergy Testing: A Report From the US Drug Allergy Registry","authors":"John J.O. Accarino MD ,&nbsp;Timothy G. Chow MD ,&nbsp;Allison Ramsey MD ,&nbsp;Christine R.F. Rukasin MD ,&nbsp;Alexei Gonzalez-Estrada MD ,&nbsp;Anne Y. Liu MD ,&nbsp;David A. Khan MD ,&nbsp;Kimberly G. Blumenthal MD, MSc ,&nbsp;US Drug Allergy Registry Study Team","doi":"10.1016/j.jaip.2024.12.036","DOIUrl":"10.1016/j.jaip.2024.12.036","url":null,"abstract":"<div><div>Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The US Drug Allergy Registry Pediatrics (USDAR-Peds) is a multisite prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions. Interpretation of multisite data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multisite research collaboration efforts such as USDAR-Peds.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1018-1026.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Biologic Therapy in Allergic Bronchopulmonary Aspergillosis","authors":"Charlotte Carter MBChB ,&nbsp;Irene Berrar Torre MSc ,&nbsp;Sophia Blackburn MSc ,&nbsp;Lisa Nwankwo MSc, BPharm Hons ,&nbsp;Tom Semple MDRes ,&nbsp;Bhavin Rawal MDRes ,&nbsp;Darius Armstrong-James PhD ,&nbsp;Pujan H. Patel MD ,&nbsp;Anand Shah PhD","doi":"10.1016/j.jaip.2025.03.006","DOIUrl":"10.1016/j.jaip.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Allergic bronchopulmonary aspergillosis (ABPA) is characterized by a severe hypersensitivity reaction to <em>Aspergillus</em> species. Current treatment relies on oral corticosteroids (OCS) and triazole antifungal therapy, but there is increasing evidence of the benefits of biologic therapies targeting type 2 inflammatory pathways.</div></div><div><h3>Objective</h3><div>To assess the real-world effectiveness of biologic therapies in patients with ABPA.</div></div><div><h3>Methods</h3><div>We performed a large retrospective single-center analysis of patients with ABPA as defined by the modified International Society for Human and Animal Mycology (ISHAM) criteria between 2014 and 2022. Baseline characteristics were recorded. Clinical outcomes were assessed at 12 months after commencement of a biologic including symptom scores, exacerbation frequency, corticosteroid use, and multidisciplinary team consensus of effectiveness.</div></div><div><h3>Results</h3><div>A total of 74 patients received a biologic, of whom 32% (n = 24) received anti-IgE therapy, 65% (n = 48) anti-IL5/5Rα therapy, and 3% (n = 2) anti-IL4-Rα therapy. Of the total, 65% (n = 48) patients were deemed to have a successful response at 12 months with a ≥50% reduction in OCS use and 35% (n = 26) stopped or changed biologic during the follow-up period because of failed clinical response (n = 21), side effects (n = 4), or medical comorbidities (n = 1). There was a significant reduction in the 6-item Asthma Control Questionnaire score (<em>P</em> &lt; .0001), exacerbation rate over 12 months (<em>P</em> &lt; .0001), and maintenance OCS use (<em>P</em> = .0173). Univariate analysis revealed that mucus plugging was associated with nonresponse to biologic therapy (<em>P</em> = .0189).</div></div><div><h3>Conclusion</h3><div>Biologic therapies are effective in a number of patients with ABPA. However, further prospective clinical trials are required to determine the effectiveness and which phenotypes likely to respond. These data nevertheless increase the evidence base for biologics in ABPA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 5","pages":"Pages 1094-1102.e1"},"PeriodicalIF":8.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}