Archives of Endocrinology Metabolism最新文献

{"title":"Machine learning for high-risk hospitalization prediction in outpatient individuals with diabetes at a tertiary hospital.","authors":"Carolina Deina, Flavio S Fogliatto, Mateus Augusto Dos Reis, Beatriz D Schaan","doi":"10.20945/2359-4292-2024-0317","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0317","url":null,"abstract":"<p><strong>Objective: </strong>To characterize, via a predictive model using real-world data, patients with diabetes with a heightened probability of hospitalization.</p><p><strong>Methods: </strong>At the Endocrinology Unit of a tertiary public hospital in Rio Grande do Sul, Brazil, a retrospective cohort study analyzed initial consultations from January 1, 2015, to December 31, 2017, focusing on 617 patients with diabetes. Within this group, 82.98% (512 patients) did not require hospitalization, while 17.02% (105 patients) were hospitalized at least once. Multiple machine learning algorithms were tested, and the combination of XGBoost and Instance Hardness Threshold models displayed the best predictive performance. The SHapley Additive exPlanations method was used for result interpretation.</p><p><strong>Results: </strong>The most optimal performance was observed by combining the XGBoost and Instance Hardness Threshold models, resulting in the highest sensitivity (0.93) in accurately classifying hospitalization events, with an acceptable area under the curve of 0.72. Key predictive features included the number of outpatient visits, amplitude of estimated glomerular filtration rate, and age (individuals below 24 years old and between 65 to 70 years old had higher hospitalization likelihood).</p><p><strong>Conclusion: </strong>The proposed model demonstrated high predictive capability and may help to identify patients with diabetes who should be more closely monitored to reduce their risk of hospitalization.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"69 2","pages":"e230348"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between triglyceride-glucose index and the risk of type 2 diabetes mellitus.","authors":"Hui Luo, Qin Yang, Haolan Xu, Shan Wu, Wenjing Wang, Ru Zhou, Yanlang Yang, Qi Yu","doi":"10.20945/2359-4292-2023-0493","DOIUrl":"https://doi.org/10.20945/2359-4292-2023-0493","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of the triglyceride-glucose (TyG) index in predicting type 2 diabetes mellitus (T2DM) in the general population.</p><p><strong>Subjects and methods: </strong>Baseline data were collected from a community population that underwent physical examination between 2015 and 2020. The TyG index was calculated via the following formula: TyG = Ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. Cox regression and stratified analyses were performed to evaluate the ability of the TyG score to predict the occurrence of diabetes.</p><p><strong>Results: </strong>In total, 8 576 subjects were ultimately included and divided into a T2DM group (n = 882) and a non-T2DM group (n = 7,694) according to the results of the 5-year follow-up. Adjustment for all covariates revealed that every 1-unit increase in the TyG index multiplied the risk of T2DM in all the participants (HR: 3.348; 95% CI: 3.004-3.731; P < 0.001). When TyG was divided into three quantiles, the risk of T2DM in the highest quantile was 6.412 times greater than that in the lowest quantile. Subgroup analysis revealed that the correlation was more pronounced in middle-aged and young adults, females, and eutrophic individuals (interaction P value < 0.001).</p><p><strong>Conclusion: </strong>The TyG index can be a strong predictor of T2DM and is more useful for estimating the risk of T2DM in young and middle-aged adults, females, and eutrophic people.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"69 2","pages":"e230493"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenic obesity: a review.","authors":"Victoria Zeghbi Cochenski Borba, Tatiana Munhoz da Rocha Lemos Costa","doi":"10.20945/2359-4292-2024-0084","DOIUrl":"10.20945/2359-4292-2024-0084","url":null,"abstract":"<p><p>The global increase in life expectancy has led to a concomitant rise in diagnoses of sarcopenia. At the same time, the epidemic levels of obesity have given rise to the emergence of a complex condition known as sarcopenic obesity. Characterized by the simultaneous presence of loss of muscle mass and strength along with obesity or excess body fat, sarcopenic obesity represents a concerning health condition. Contrary to prevailing assumptions, sarcopenic obesity is not exclusive to older adults, as it may also manifest in individuals with obesity and chronic diseases and in those who undergo rapid weight loss. This juxtaposition of fat accumulation and muscle depletion epitomizes a harmful combination, especially in healthy adults. A precise definition of sarcopenic obesity and an understanding of how different body composition components affect functional parameters, comorbidities, and mortality rates are crucial for grasping the full extent and significance of this condition. Despite its multifaceted nature, sarcopenic obesity is often undiagnosed and undertreated, posing a considerable challenge to healthcare systems worldwide. In this review, we explore the intricate interplay of factors contributing to the development and consequences of sarcopenic obesity and discuss newly proposed diagnostic guidelines aimed at improved screening. Enhancing awareness and understanding of sarcopenic obesity is imperative for addressing its growing prevalence and mitigating its adverse health effects.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240084"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The C allele of the rs741301 polymorphism in the ELMO1 gene is associated with increased risk of diabetic retinopathy in patients with type 2 diabetes mellitus.","authors":"Luciane Moretto, Letícia de Almeida Brondani, Eliandra Girardi, Anna Carolina Meireles Vieira, Natália Emerim Lemos, Marilu Fiegenbaum, Luís Henrique Canani, Daisy Crispim, Cristine Dieter","doi":"10.20945/2359-4292-2024-0283","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0283","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of the rs741301 polymorphism in the ELMO1 gene with diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>This study analyzed 350 patients withT2DM and DR (cases) and 234 patients withT2DM without this complication but with more than 10 years of diabetes mellitus (DM) (controls). DR was diagnosed by indirect fundoscopy. Genotyping was performed by allelic discrimination real-time PCR.</p><p><strong>Results: </strong>The frequency of the C/C genotype of the rs741301 polymorphism in the ELMO1 gene was 26.9% in cases and 17.9% in controls (P = 0.011). After adjustment for covariables, the C/C genotype was associated with an increased risk of DR [odds ratio (OR) = 1.805, 95%CI 1.101-2.961; P = 0.019]. This association remained significant in dominant and additive inheritance models after adjustment for the same variables [OR = 1.597, 95%CI 1.089-2.343; P = 0.017; and OR = 1.818, 95%CI 1.099-3.007; P = 0.020].</p><p><strong>Conclusion: </strong>This study demonstrated an association between the presence of the C allele of the ELMO1 rs741301 polymorphism and an increased risk of DR in patients with T2DM from Southern Brazil.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240283"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cocoa flavanol supplementation in optimizing post-exercise glycemic control in rats with normoglycemia or diabetes mellitus: findings from the ECODIA study.","authors":"Bruno Pereira Melo, Joyce Camilla Cruz de Oliveira, Aline Cruz Zacarias, Letícia Maria de Souza Cordeiro, João Gabriel da Silveira Rodrigues, Mara Lívia Dos Santos, Gleide Fernandes de Avelar, Romain Meeusen, Elsa Heyman, Camila Berbert Gomes, Pedro Henrique Madureira Ogando, Danusa Dias Soares","doi":"10.20945/2359-4292-2024-0169","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0169","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the acute effects of cocoa flavanol (CF) supplementation on glucose homeostasis, aerobic performance, and lactate concentration in rats with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and normoglycemia (NORM).</p><p><strong>Materials and methods: </strong>The study included 28 male Wistar rats (220-290 g). Induction of T1DM (n = 8) was achieved through intraperitoneal injection of streptozotocin, while T2DM (n = 10) was induced using an ad libitum high-fat diet combined with a fructose-rich beverage. The rats in the NORM group (n = 10) received a standard diet for 30 days. Two experiments were conducted: (1) T1DM rats performed two successive 30-minute treadmill runs below the anaerobic threshold and (2) T2DM and NORM rats underwent two incremental maximal treadmill running tests, both after CF or placebo supplementation. Blood glucose concentrations were measured from pre-exercise to 60 minutes post-exercise.</p><p><strong>Results: </strong>Glycemic reduction at 60 minutes post-exercise was significantly potentiated by CF compared with placebo supplementation in T1DM, T2DM, and normoglycemic rats (p < 0.05 for all). In T2DM rats, CF induced a glycemic response comparable to the NORM placebo-supplemented condition. These effects of CF persisted despite variations in aerobic performance or lactate concentration after incremental exercise.</p><p><strong>Conclusion: </strong>Supplementation with CF prior to physical exercise elicited a pronounced post-aerobic exercise glycemic reduction. This represents a promising strategy for mitigating the duration of hyperglycemia exposure after physical exercise.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240169"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gluten-free diets for metabolic control of type 1 diabetes mellitus in children and adolescents: a systematic review and meta-analysis.","authors":"Yan Zhang, Suhong Yang, Pingping Wang","doi":"10.20945/2359-4292-2024-0165","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0165","url":null,"abstract":"<p><p>The aim of this review is to comprehensively assess the association between a gluten-free diet (GFD) and metabolic control of type 1 diabetes mellitus (T1DM) in children and adolescents with T1DM and with T1DM plus coeliac disease (CD). PubMed, Embase, Cochrane Library, and Web of Science were searched until June 19, 2023. Primary outcomes were hemoglobin A1c (HbA1c), insulin dose, insulin dose adjusted A1c (IDAA1c), blood glucose (B-glu) at 90 min during Mixed Meal Tolerance Test (MMTT), C-peptide area under the curve (AUC), and C-peptide. Seven studies involving 355 T1DM patients were included. Three studies involving 141 patients compared a GFD to a standard diet in children and adolescents withT1DM without CD. Additionally, two studies with 164 patients examined the same diet comparison in those with T1DM and concurrent CD. A comparison between T1DM with CD and T1DM alone, using a GFD, was conducted in two studies encompassing 50 patients. Patients withT1DM alone had similar HbA1c [pooled weighted mean difference (WMD) = -0.5, 95% confidence interval (CI): -1.0 to 0.1, P = 0.079] and IDAA1c (pooled WMD = -0.4, 95%CI: -0.9 to 0.1, P = 0.095) levels after a GFD and a standard diet. In children and adolescents withT1DM and CD, a GFD was associated with a significantly lower HbA1c compared with a standard diet (pooled WMD = -0.64, 95%CI: -1.22 to -0.05, P = 0.034). Insulin dose was significantly lower in T1DM combined with CD patients having a GFD vs a standard diet (pooled WMD = -0.34, 95%CI: -0.66 to -0.03, P = 0.032). Our study suggests that a GFD may offer significant benefits for children and adolescents with both T1DM and CD over a standard diet. While the evidence indicates improved glycemic control with a GFD, the quality of this evidence is low, highlighting the need for rigorous, randomized trials to confirm these preliminary findings. In the interim, enhancing dietary awareness and providing tailored nutritional guidance could be pivotal for optimizing glucose management in this patient population.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240165"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of adult patients with X-linked hypophosphatemia at a specialized center in Buenos Aires, Argentina.","authors":"Evangelina Giacoia, Laura María Schiró, Tatiana Martínez, María Celeste Balonga, Luisa Plantalech","doi":"10 20945/2359-4292-2024-0023","DOIUrl":"https://doi.org/10 20945/2359-4292-2024-0023","url":null,"abstract":"<p><strong>Objective: </strong>The study objectives were to characterize adult patients with XLH treated at a referral center, assess their physical function and the impact of X-linked hypophosphatemia (XLH) on their quality of life, and estimate their adherence to conventional treatment.</p><p><strong>Subjects and methods: </strong>Observational, retrospective study of patients with XLH from a referral center in Argentina, based on demographic and clinical data, complementary methods, and validated questionnaires (WOMAC, PROMIS, and SF-36).</p><p><strong>Results: </strong>Sixteen patients (age: 40.3 ± 13.2 years; female: 87.2%) were included. All patients had clinical and/or radiological skeletal manifestations (lower limb malformations and/or pseudofractures). The prevalence of clinical fractures was 60%. Hearing loss was the most frequent extra skeletal finding (67%). The WOMAC score was 47.8 ± 26 (62.5% of patients had ≥ 40 points). The PROMIS score was 23-33 (43% of patients) and ≥ 34 in 14% of patients. Except for emotional function, the median scores of the SF-36 domains were below 50 points. Only 20% of patients had good adherence to conventional treatment.</p><p><strong>Conclusions: </strong>Adult patients with XLH have numerous unmet needs, with frequent bone and extraskeletal complications. Physical function and quality of life scores were poor. Adherence to conventional treatment was unsatisfactory. Long-term studies are required to characterize these patients and confirm the efficacy and safety of continuous treatment, such as anti-fibroblast growth factor-23 monoclonal antibodies.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240023"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arginine-vasopressin deficiency due to long COVID-associated infundibulo-neurohypophysitis.","authors":"Regina S Medeiros, Lígia Neves, Isabel Sousa, Bernardo Dias Pereira","doi":"10.20945/2359-4292-2024-0168","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0168","url":null,"abstract":"<p><p>Long COVID is defined by the occurrence of signs, symptoms, and conditions that develop after COVID-19 and may affect several organs and systems. Arginine-vasopressin deficiency (AVP-D; central diabetes insipidus) is a very rare complication of COVID-19 and SARS-CoV-2 immunization. Case reports, original studies, and reviews on AVP-D and long COVID published until February 2024 were retrieved from PubMed. A 47-year-old man presented with polydipsia, polyuria, memory loss, and mental fog 8 weeks after an episode of mild COVID-19. His past personal and family medical history were unremarkable. Biochemical evaluation was relevant for low urine osmolality and a 24-hour urine volume of 10,350 mL. Basal anterior pituitary evaluation was normal. A water deprivation test was started and interrupted after 2 hours due to the development of hypernatremia, high serum osmolality, and low urine osmolality. Urine osmolality significantly increased after intranasal desmopressin 20 μg. Contrast-enhanced pituitary MRI was suggestive of infundibulo-neurohypophysitis. Further biochemical, genetic, and imaging tests excluded secondary AVP-D causes.The patient was subsequently started on oral desmopressin, showing prompt response. After a follow-up of 20 months, he remained well-controlled with isolated AVP-D. Although molecular and histologic confirmation of SARS-CoV-2 infundibulo-neurohypophysitis could not be investigated, a strong temporal relationship and the absence of an alternative diagnosis rendered plausible the inclusion of AVP-D in the myriad of long COVID manifestations. Further studies with patients recovered from COVID-19 are necessary for a better understanding of the epidemiology, pathophysiology, and clinical course of this very rare endocrine condition.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240168"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptin 30 years - A chat with Jeffrey M. Friedman.","authors":"Alexandre Moura-Assis, Licio A Velloso","doi":"10.20945/2359-4292-2024-0413","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0413","url":null,"abstract":"","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240413"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for permanent hypoparathyroidism following total thyroidectomy: A retrospective cohort study of 5,671 cases.","authors":"Daniela Tamega Joaquim, Hugo Fontan Kohler, José Guilherme Vartanian, Luiz Paulo Kowalski, Genival Barbosa de Carvalho","doi":"10.20945/2359-4292-2024-0379","DOIUrl":"https://doi.org/10.20945/2359-4292-2024-0379","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the rates of permanent hypoparathyroidism based on demographic variables, patient comorbidities, clinical staging of the disease, surgery performed, and severity of transient hypoparathyroidism.</p><p><strong>Subjects and methods: </strong>This is a retrospective cohort study with patients who underwent total thyroidectomy with or without neck dissection between January 2014 and December 2021.</p><p><strong>Results: </strong>5,671 patients were analyzed, 966 (17)%) presented transient hypoparathyroidism and 106 (1.8%) developed permanent hypoparathyroidism. The logistic regression model analyzing the cohort of patients with transient hypoparathyroidism demonstrates that the number of dissected lymph nodes from the central compartment, immediate postoperative PTH levels, the necessity of postoperative intravenous (IV) calcium supplementation and the duration of IV calcium supplementation are significant predictors. When applied to the original dataset, this model presents a NPV of 1.0000 and a PPV of 0.9594 with an overall accuracy of 0.9624.</p><p><strong>Conclusion: </strong>The incidence of permanent hypoparathyroidism was closely associated with the extent of level VI dissection, particularly regarding the number of lymph nodes removed and whether the dissection was bilateral. Furthermore, the severity of post-operative hypocalcemia was demonstrated by the decrease in PTH levels, as well as the need for and duration of intravenous calcium supplementation.</p>","PeriodicalId":54303,"journal":{"name":"Archives of Endocrinology Metabolism","volume":"68 ","pages":"e240379"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}