Pharmacogenomics Journal最新文献

{"title":"FTO rs7195994 Is associated with TNF inhibitor response in lean rheumatoid arthritis patients: A BMI-stratified pharmacogenetic analysis.","authors":"Yi-Ting Li, I-Chieh Chen, Hui-Wen Yang, Chung-Mao Kao, Yen-Ju Chen, Wen-Nan Huang, Yi-Ming Chen","doi":"10.1038/s41397-026-00409-1","DOIUrl":"https://doi.org/10.1038/s41397-026-00409-1","url":null,"abstract":"<p><p>Tumor necrosis factor inhibitors (TNFi) have transformed the management of rheumatoid arthritis (RA); however, up to 40% of patients fail to achieve an adequate clinical response. Current clinical predictors remain insufficient, highlighting the need for pharmacogenetic biomarkers to guide biologic therapy selection. In this study, we investigated genetic variants associated with TNFi treatment response, with a particular focus on body mass index (BMI)-dependent effects, using a large real-world cohort. A total of 519 patients with RA were identified from the Taiwan Precision Medicine Initiative (TPMI), an electronic health record-linked biobank. Eligible patients had received TNFi therapy for at least 6 months and had available genotyping data. Ninety-seven candidate single nucleotide polymorphisms (SNPs) previously reported to be associated with TNFi response were identified through a systematic literature search. Five variants located in immune-metabolic genes (FTO, ZNF618, RANK, CD84, and LOC105375523) were further analyzed using univariable and multivariable logistic regression models. Subgroup analyses stratified by BMI were performed to explore potential effect modification. Three variants-FTO rs7195994, ZNF618 rs16911006, and LOC105375523 rs834811-were significantly associated with TNFi response in initial analyses. In multivariable models, only FTO rs7195994 remained an independent predictor of non-response (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22-0.87; p = 0.019). Among patients with BMI < 27 kg/m², carriers of the rs7195994 risk allele had a 49% lower likelihood of achieving treatment response (OR 0.51, 95% CI 0.28-0.92; p = 0.0249), whereas no significant association was observed in patients with higher BMI. These findings identify FTO rs7195994 as a novel, BMI-modulated pharmacogenetic marker of TNFi non-response in RA. Incorporating BMI-stratified genetic profiling into clinical decision-making may facilitate early identification of patients unlikely to benefit from TNFi therapy, thereby supporting precision treatment strategies. Further validation in multiethnic populations and functional studies is warranted.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CYPRI: a clinical decision-making tool to select psychiatric patients for pharmacogenetic testing.","authors":"Ivana Tašková, Nicole Šafářová, Martina Hahn","doi":"10.1038/s41397-026-00414-4","DOIUrl":"10.1038/s41397-026-00414-4","url":null,"abstract":"<p><p>Pharmacogenetic (PGx) testing of cytochrome P450 (CYP) enzymes CYP2D6 and CYP2C19 is increasingly utilised to personalise psychopharmacological treatment, but clear criteria for patient selection are lacking. We developed and conducted a pilot evaluation of a clinical decision-making tool, the CYPRI (CYP Pharmacogenetic Risk Index), which uses routinely available clinical and pharmacological data to estimate the likelihood of a clinically relevant and actionable PGx testing result. A pilot observational study involving 34 patients was conducted at Psychiatric Hospital Bohnice in Prague, Czech Republic. A significant correlation was observed between the CYPRI score and the IMPACT score (ordinal logistic regression: t = 3.279, p = 0.0011; Kendall's τ = 0.46, p = 0.0011). Discriminative ability was high, with an area under the curve (AUC) of 0.83 (95% CI: 0.69-0.97), based on ROC analysis performed using two outcome categories (0-2 vs. ≥ 2 points of IMPACT score). The optimal cut-off was 4. The CYPRI score offers a straightforward method to prioritise patients for PGx testing, potentially enhancing cost-effectiveness and clinical outcomes in psychiatric care.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cytochrome P450 polymorphisms in the pharmacokinetics of oral esketamine.","authors":"Daniël T Coerts, Sanne Y Smith-Apeldoorn, Jérôme C Oude Nijhuis, Ron H N van Schaik, Wim J Tamminga, Daan J Touw, Jolien K E Veraart, Robert A Schoevers, Jens H van Dalfsen","doi":"10.1038/s41397-026-00405-5","DOIUrl":"https://doi.org/10.1038/s41397-026-00405-5","url":null,"abstract":"<p><p>Oral esketamine displays therapeutic potential for treatment-resistant depression. However, treatment is complicated by a low and variable bioavailability. Genetic polymorphisms in the cytochrome P450 (CYP) enzymes responsible for esketamine's metabolism may influence bioavailability. In a subsample of patients included in a placebo-controlled trial investigating repeated, low dose oral esketamine (N = 18), blood samples were collected four hours after dosing. CYP2B6 516 G > T, CYP3A4*22, and CYP3A5*3 genotyping was performed, and the plasma levels of esketamine and its metabolites were measured. CYP2B6 516 G > T carriers (Mdn = 5.1 µg/L) demonstrated higher esketamine plasma levels compared to non-carriers (Mdn = 2.1 µg/L) (U = 45.00, p = 0.032). No significant associations were observed for CYP3A4*22 carriership (n = 2) or CYP3A5*3 heterozygosity (n = 2), nor for esketamine's metabolites. In summary, CYP2B6 516 G > T is associated with higher esketamine plasma concentrations. Further research with more participants is warranted to draw conclusions about CYP3A4*22 and CYP3A5*3. Clinical trial registration: NTR6161 (Dutch Trial Register).</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized trial to evaluate attitudes regarding pharmacogenomics among pregnant and pediatric populations: design and baseline characteristics.","authors":"Alexandra C Sundermann, Salisha E Marryshow Batson, Elizabeth A Jasper, Sarah H Jones, Darlene F Fountain, Michelle Liu, Sudeep D Sunthankar, Digna R Velez Edwards","doi":"10.1038/s41397-026-00413-5","DOIUrl":"https://doi.org/10.1038/s41397-026-00413-5","url":null,"abstract":"<p><p>Pharmacogenomics (PGx) is a key component of precision medicine, yet most PGx studies exclude pregnant people and children. The VICE (Vanderbilt Integrated Center of Excellence)-MPRINT (Maternal and Pediatric Precision in Therapeutics): Maternal and Pediatric Pharmacogenetics Trial is a single-center, randomized control trial to assess how PGx testing and return of results influence patients' understanding and perceived utility of PGx testing in a pregnancy and pediatric cohort. Pregnant individuals and families or guardians of children with a chronic health condition aged 0-16 were recruited. We assessed participants' knowledge and attitudes regarding PGx testing at baseline and after receiving results with patient-friendly interpretations. Cases received an educational video about PGx testing with return of results. Controls received PGx test results alone. We aimed to determine perspectives regarding PGx in these understudied populations with the goal of promoting research and clinical implementation of PGx for pregnant women and children.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular prescriber attitudes to pharmacogenomics: a survey by the ESC working group on cardiovascular pharmacotherapy.","authors":"Emma F Magavern, G-Andrei Dan, Gianluigi Savarese, Claudio Borghi, Dobramir Dobrev, Juan Tamargo, Peter Ferdinandy, John H McDermott, William G Newman, Munir Pirmohamed, Mark J Caulfield, Juan Carlos Kaski","doi":"10.1038/s41397-026-00412-6","DOIUrl":"https://doi.org/10.1038/s41397-026-00412-6","url":null,"abstract":"<p><p>The aim of this study was to elucidate cardiovascular prescriber access, uptake, and attitudes toward CYP2C19 and CYP2D6 genetic testing to guide prescribing of commonly used medications such as clopidogrel, antiarrhythmics, proton pump inhibitors, and antidepressants. A survey, designed in collaboration with the European Society of Cardiology (ESC) WG on Cardiovascular Pharmacotherapy and external experts was disseminated to ESC members using SurveyMonkey. 265 prescribers from 68 countries participated. Most respondents thought testing would be beneficial, though CYP2C19 testing was perceived as more beneficial (73%) and desirable than CYP2D6 (61%). Access to CYP2C19 testing was more common (30%) than CYP2D6 testing (19%), but mostly outside of public funded health systems. Uptake in those who had access was higher for CYP2C19 (67%), than for CYP2D6 (33%). Confidence in interpreting results to prescribe was also higher with CYP2C19 (69%) than with CYP2D6 (53%), but most respondents wanted information prior to prescribing. One third of respondents highlighted the need for a turnaround time that matched their clinical practice. Unsolicited Pharmacogenomic (PGx) information from a patient was uncommon, but most prescribers acted on the information. A minority of respondents had undertaken PGx testing themselves, but most wanted testing for relevant medications. Respondents' experiences as patients made them more likely to believe that PGx testing was warranted. A minority ( ~ 15%) were aware of either local prescriber guidance or patient information materials regarding PGx testing. Prescribers want access to pharmacogenomics data regarding CYP2C19 and CYP2D6 for prescribing cardiovascular medicines. However, there are barriers which hamper implementation. Prescribers lived experience with medication use as patients impacted their views of PGx. 265 prescribers responded to the ESC survey from 68 countries. Most prescribers wanted access to pharmacogenomic testing for CYP2C19 and CYP2D6 for their patients and for themselves. Though most prescribers thought these pharmacogenomic tests would be useful and could improve the risk/benefit profile of relevant medications, prescribers responded more positively to CYP2C19 compared with CYP2D6 testing. Guidance and information for both prescribers and patients were lacking.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of genotype-guided acenocoumarol therapy in atrial fibrillation: a pharmacogenomic simulation study in the chilean population.","authors":"Maximiliano Mena, Matías Carrasco, Leslie C Cerpa, Juan P Cayún, Valentina Torres, Luis A Quiñones","doi":"10.1038/s41397-026-00411-7","DOIUrl":"10.1038/s41397-026-00411-7","url":null,"abstract":"<p><p>Cardiovascular diseases are the leading cause of death in Chile and worldwide, representing a major public health challenge that demands urgent preventive and therapeutic strategies. In atrial fibrillation, anticoagulation is essential, and in Chile acenocoumarol rather than warfarin, used in most countries, is the standard agent. Its dosing shows substantial interindividual variability due to CYP2C9 and VKORC1 polymorphisms. We developed a cohort-based Markov model to compare standard care, genotype-guided dosing, and genotype-guided dosing adjusted for population-level adherence in 123 Chilean patients with atrial fibrillation and 123 matched simulated individuals. Outcomes were measured as quality-adjusted life years (QALYs) and direct medical costs, with cost-effectiveness assessed at a willingness-to-pay (WTP) threshold of US$17,093, estimated using the international approach of approximating the country's GDP per capita rather than a Chilean policy-based value. Genotype-guided dosing achieved the highest effectiveness (2938.34 QALYs) with an incremental cost-effectiveness ratio of US$436.86/QALY versus standard care, remaining cost-effective in sensitivity analyses up to test prices far exceeding the current US$190. The adherence-adjusted strategy was weakly dominated. These results strongly support implementing pharmacogenetic testing for acenocoumarol dosing to optimize anticoagulation safety, efficacy, and cost-effectiveness in Chile.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of pharmacogenomic testing as a tool to enhance depression care in Veterans","authors":"Kevin P. Kennedy,&nbsp;Kevin G. Lynch,&nbsp;Ryan Bremseth-Vining,&nbsp;Charlotte E. Williams,&nbsp;Deepak Voora,&nbsp;David W. Oslin","doi":"10.1038/s41397-026-00406-4","DOIUrl":"10.1038/s41397-026-00406-4","url":null,"abstract":"Modest outcomes from pharmacogenomic (PGx) testing in depression may be influenced by low rates of actionable gene-drug interactions. This 12-week pilot pragmatic randomized clinical trial evaluated the effectiveness of selectively targeting PGx testing to depressed Veterans receiving psychiatric polypharmacy with an antidepressant on the Sanford Pharmacogenomics Panel. 60&nbsp;Veterans were randomized to having their PGx test results available immediately or delayed until the end of the 12-week trial. Patient Health Questionnaire-9 (PHQ-9) scores were assessed monthly by blinded raters, with medication changes assessed via the electronic medical record. 30% of subjects had an actionable gene-drug interaction, compared to 20% in prior PGx research in Veterans. There were no significant differences in PHQ-9 scores, proportion of patients with medication changes, or time to first medication change. This study showed that targeted PGx testing can increase rates of actionable genotypes in patients with depression.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 2","pages":"14-"},"PeriodicalIF":2.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41397-026-00406-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of combined CYP2C19 and CYP2D6 phenotypes on adverse drug reactions in patients with major depressive disorder: a clinical cohort study","authors":"Carolin Görnert,&nbsp;Maike Scherf-Clavel,&nbsp;Heike Weber,&nbsp;Sibylle C. Roll,&nbsp;Andreas Eckert,&nbsp;Andreas Reif,&nbsp;Martina Hahn","doi":"10.1038/s41397-026-00407-3","DOIUrl":"10.1038/s41397-026-00407-3","url":null,"abstract":"Variants in cytochrome P450 enzymes are known risk factors for developing adverse drug reactions (ADR). Most antidepressants (AD) are simultaneously metabolized by major or minor pathway of CYP2C19 and CYP2D6, resulting in a complex interplay of metabolites. This study is one of the first to investigate and demonstrate the combined CYP 2C19/2D6 functional metabolic status as a possible risk factor for ADR in AD treatment of major depressive disorder. Most prescribed AD venlafaxine underwent subgroup analysis. More ADR in non-normal metabolizers (nNM) for one or both CYP enzymes compared with normal metabolizers (p = 0.039) were observed. Both slow (PM and IM) and rapid metabolizers (RM and UM) were affected. There were non-significant trends for CYP2C19 RM and UM with ADR in venlafaxine, which may be avoided in CYP2C19 nNM. More research is required to identify risk variants for personalized and safe AD treatment.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 2","pages":"13-"},"PeriodicalIF":2.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic effectiveness of pharmacogenomics-guided prescribing for psychiatric disorders: a systematic review and meta-analysis","authors":"Ellen R. Mason,&nbsp;Mohamed Y. Ali,&nbsp;David S. Gibson,&nbsp;Elaine K. Murray,&nbsp;Richéal M. Burns,&nbsp;Catriona Kelly","doi":"10.1038/s41397-026-00408-2","DOIUrl":"10.1038/s41397-026-00408-2","url":null,"abstract":"Pharmacogenomics (PGx)-guided prescribing is a promising approach to reduce variability in drug response, although its cost-effectiveness remains uncertain. We performed a systematic review and meta-analysis evaluating the cost-effectiveness of PGx-guided prescribing compared to standard care in psychiatry. In January 2026, we searched MEDLINE, Embase and PsycINFO for studies published between 2014 and 2025. We included any peer-reviewed study that included adults with a diagnosed psychiatric disorder, comparing PGx-guided prescribing to standard care, and reported both quality-of-life and economic outcomes. Given the lack of consensus on synthesising economic evidence, both a narrative synthesis and meta-analysis were conducted. Pooled incremental net benefit (INB) was used as the effect measure for the meta-analysis and heterogeneity measures including the I2 test were used to assess heterogeneity and determine which model to use for the meta-analysis. From an initial 1 271 records, 17 studies were included. The narrative synthesis found that 88% of studies favoured PGx-guided prescribing. Meta-analyses produced positive, though non-significant, pooled Incremental Net Benefits (INBs) for the total study groups (£1 623.14, 95% CI: -£116.50 to £3 362.79, p = 0.07, I2 = 100%), and for a statistically homogeneous subgroup (£41.54, 95% CI: -£18.27 to £101.35, p = 0.17, I2 = 0%). Our review indicates that PGx-guided prescribing can be cost-effective in psychiatry but highlights the need for increased consensus in economic modelling methods.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 2","pages":"12-"},"PeriodicalIF":2.9,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of folylpolyglutamate synthase polymorphisms with methotrexate response and toxicity in rheumatoid arthritis: a meta-analysis","authors":"Young Ho Lee,&nbsp;Gwan Gyu Song","doi":"10.1038/s41397-026-00404-6","DOIUrl":"10.1038/s41397-026-00404-6","url":null,"abstract":"This meta-analysis evaluated the association between FPGS gene polymorphisms (rs10106 (1994A &gt; G) and rs1544105 (2572 C &gt; T)) and methotrexate (MTX) efficacy and toxicity in rheumatoid arthritis (RA). Studies published up to October 2025 were identified through PubMed, Embase, Web of Science, Scopus, and manual searches. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under various genetic models. Subgroup and sensitivity analyses were conducted, and publication bias was assessed using Egger’s test. Ten studies involving 2345 RA patients receiving MTX were included in this meta-analysis. The FPGS rs10106 G allele was significantly associated with enhanced MTX efficacy in the dominant model (OR = 1.22, 95% CI: 1.05–1.41, p = 0.009) and homozygous model, although the allelic model showed only borderline significance (p = 0.052). In contrast, rs10106 was consistently associated with increased toxicity across all genetic models (all p ≤ 0.001). For rs1544105, the T allele showed robust and highly significant associations with both improved efficacy (dominant model OR = 1.66, 95% CI: 1.45–1.89, p &lt; 0.001) and higher toxicity risk across all analyzed models (all p &lt; 0.001). Significant effects were observed mainly in Asian and European populations, with no associations in US/Other groups. Results were robust with no evidence of publication bias. FPGS rs10106 and rs1544105 polymorphisms significantly influence MTX response and toxicity in RA, with ethnic variability, supporting their potential use in individualized MTX therapy.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"26 2","pages":"11-"},"PeriodicalIF":2.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}