Acta Diabetologica最新文献

{"title":"Nutrient intake order on metabolic outcomes in type 2 diabetes: a systematic review and meta-analysis.","authors":"Luisa M Saldarriaga-Callejas, Piyush Ratan, Eric Pasqualotto, Ticiane Bovi, Talita Trevisan","doi":"10.1007/s00592-025-02586-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02586-0","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Macronutrient sequence has been proposed as a practical strategy to improve postprandial glycemia in individuals with type 2 diabetes (T2D). However, current evidence remains inconclusive. This meta-analysis aims to provide an updated evaluation of the impact of a carbohydrate-last (CL) strategy, compared to carbohydrate-first or unordered (CF) intake, on metabolic parameters in adults with T2D.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) evaluating nutrient intake order in T2D. Outcomes were analyzed using mean difference (MD) with 95% confidence intervals (CI) under a random-effects model. Heterogeneity was assessed using Cochrane's Q test and I² statistics. Analyses were conducted using R, version 4.4.2.</p><p><strong>Results: </strong>Seventeen studies involving 389 participants were included, with 114 (29%) in a parallel design and 192 (49%) in a crossover design receiving CL. In the pooled analysis, the CL group had significantly lower postprandial glucose at 60 min (MD: -42.73 mg/dL; 95% CI: -55.51, -29.96; p < 0.01) and 120 min (MD: -13.00 mg/dL; 95% CI: -21.07, -4.94; p < 0.01), higher postprandial glucagon-like peptide-1 (GLP-1) levels (MD: 8.21 pmol/L; 95% CI: 2.34, 14.09; p < 0.01), delayed gastric emptying half-time (MD: 28.14 min; 95% CI: 16.06, 40.23; p < 0.01), and reduced glycated hemoglobin (HbA1c) at follow-up (MD: -0.16%; 95% CI: -0.31, -0.01; p = 0.04).</p><p><strong>Conclusion: </strong>Carbohydrate-last eating pattern has been shown to improve postprandial glycemia, enhance GLP-1 secretion, and delay gastric emptying, with a minimal effect on HbA1c in individuals with mild T2D. Further research is needed to confirm its applicability in advanced disease stages and to establish long-term metabolic benefits.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278658","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":"Therapeutic potential of copper II oxide in treating diabetic wounds: an emerging approach for enhanced healing.","authors":"Subhasri Bogadi, Md Ekhtiar Uddin, Veera Venkata Satyanarayana Reddy Karri, Rahima Begum, Mohammed Abdul Kader, Shahabe S Abullais, Md Shahin Reza, Athanasios Alexiou, Marios Papadakis","doi":"10.1007/s00592-025-02582-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02582-4","url":null,"abstract":"<p><p>Diabetes is the most serious consequence of Type 2 Diabetes Mellitus, which affects almost all vital organs in the human body. According to the World Health Organization, 537 million adults worldwide are affected by diabetes and its complications. By 2030, this figure is expected to reach 643 million, and by 2045, it will reach 783 million. Up to 25% of diabetic patients experience the equivalent foot Ulcer (Diabetic wound). Infections result in hospitalization in more than 50% of wounds, and 20% of infections necessitate amputations. In India, people with DWs account for 80% of all non-traumatic amputations performed yearly. The rise in blood sugar levels, reflected by a chronic hyperglycemic state, is a significant contributor to the failure of the healing process. This is because the extremities do not get enough blood, which reduces oxygen. In diabetic wounds, oxidative stress plays a critical role in stabilizing Hypoxia hypoxia-inducible factor (HIF-1 α). Numerous researchers have looked into the theory that oxidative stress in a specific area causes delayed chronic diabetic wounds. Some of the existing remedies, such as hyperbaric oxygen inhalation therapy (HBO) and other topical gaseous oxygen (TGO) administration, have certain drawbacks, such as the inability to stop oxidative stress in particular regions of the wound that cannot synthesize oxygen in the target site. Therefore, it is crucial to reduce oxidative stress in chronic diabetic wounds. In this review, we focus on metal oxide-related nanoparticles such as copper II oxide, which act as an anti-oxidant activity property by lowering the oxidative stress and stabilizing Hypoxia Inducible Factor (HIF), which in turn encourages proangiogenic factors and vascular endothelial growth factors to aid in wound healing.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237628","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":"In women with pre-existing diabetes, the contribution to pregnancy outcomes of gestational weight gain as defined by IOM guidelines, differs when adjustment for gestational age is used.","authors":"Xinglei Xie, Jiaming Liu, Alicia López, Apolonia García-Patterson, J M Adelantado, Esther López, Rosa Corcoy","doi":"10.1007/s00592-025-02587-z","DOIUrl":"https://doi.org/10.1007/s00592-025-02587-z","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the association between gestational weight gain (GWG) as per Institute of Medicine 2009 (IOM) and pregnancy outcomes in women with gestational (GDM) or preexisting diabetes mellitus (PDM), when applying or not a correction for gestational age (IOM-CGWG and IOM-GWG respectively).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of pregnant women with either GDM or PDM attended in our center. Exposure variables: IOM-GWG and IOM-CGWG.</p><p><strong>Outcome variables: </strong>Maternal and fetal/neonatal clinical outcomes.</p><p><strong>Statistics: </strong>Logistic regression with adjustment for other potential independent variables.</p><p><strong>Results: </strong>In women with GDM, correction for gestational age did not affect the distribution of weight gain or the association with clinical outcomes (pregnancy-induced hypertension, preeclampsia, cesarean delivery, large-for-gestational age newborns (LGA), macrosomia and small-for-gestational age newborns (SGA)). In women with PDM, correction for gestational age, caused a shift in the distribution to a higher rate of excessive weight gain. In the adjusted analysis, IOM-GWG was significantly associated with cesarean delivery, preterm birth, LGA, macrosomia, SGA and neonatal respiratory distress. With IOM-CGWG, the association with preterm birth disappeared while an association with PIH emerged. Population-attributable and preventive fraction were substantial for both women with GDM and PDM.</p><p><strong>Conclusions: </strong>We conclude that the associations of IOM-GWG and IOM-CGWG are substantial in both women with GDM and PDM, indicating an area for potential intervention. In women with PDM, the modification of associations when gestational age is accounted for is relevant, highlighting the importance of considering this variable.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237689","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":"Blunted cortisol and altered antioxidant defense as biomarkers of systemic stress in hyperglycemic Zebrafish.","authors":"Roseleena Minz, Praveen Kumar Sharma","doi":"10.1007/s00592-025-02585-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02585-1","url":null,"abstract":"<p><strong>Background/aim: </strong>Emerging evidence links hyperglycemia, a \"hallmark of diabetes mellitus\" not only to peripheral metabolic dysfunction but also to its detrimental impact on brain health, often contributing to stress-related pathologies such as depression and cognitive decline. Zebrafish, with their well-characterized vascular system and behavioral assays, offer a unique model to study the impacts of sucrose-induced hyperglycemia. This study aims to investigates the effects of sucrose-induced hyperglycemia on stress mechanisms in type 2 diabetes using the zebrafish.</p><p><strong>Methods: </strong>Male zebrafish were divided into two groups: control, and 55.5mM sucrose immersed. Over two weeks, these were subjected to behavioural assays- the novel tank test (NTT) and the light/dark test (LDT). The NTT assessed anxiety-related behaviour by measuring the time spent in different vertical zones of a novel tank, while the light/dark test evaluated anxiety responses based on the time spent in illuminated versus dark compartments. Trajectory body coordinates and tail kinematics were quantified using ZebraZoom software to asses locomotor metrics status. Cortisol levels were measured to assess HPA axis function. Antioxidant enzymes, including superoxide dismutase (SOD) and catalase (CAT), were quantified to evaluate oxidative stress.</p><p><strong>Results: </strong>The results revealed that zebrafish exposed to sucrose exhibited significant hyperglycemia (**p < 0.01) and behavioural changes compared to those on control. Specifically, in the NTT, the hyperglycemic group demonstrated heightened anxiety-like behaviour, spending more time at the bottom zone of the tank. In the light/dark test, male zebrafish showed increased anxiety by spending more time in the dark compartment. Hyperglycemic zebrafish showed a significant blunting of the cortisol response, indicating impaired stress regulation. Additionally, SOD activity was increased, while CAT activity was decreased, suggesting an imbalance in antioxidative defense mechanisms.</p><p><strong>Conclusion: </strong>The zebrafish system effectively models the negative impacts of sucrose-induced hyperglycemia, providing valuable insights into the stress mechanisms associated with type 2 diabetes. These findings demonstrate that hyperglycemia alters both endocrine stress response and antioxidant systems, potentially serving as biomarkers of systemic stress.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237721","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":"Non-invasive biomarkers for diabetic complications: insights from corneal and retinal imaging.","authors":"Meichun Xiao, Yunhan Chen, Xiaoxin Yan, Li Wang, Huiqin Cheng, Wenqu Chen","doi":"10.1007/s00592-025-02588-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02588-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes-related complications, such as diabetic peripheral neuropathy (DPN) and chronic kidney disease (CKD), severely affect quality of life. Early detection is crucial. This study investigates ocular imaging parameters as potential biomarkers for these conditions using corneal confocal microscopy (CCM) and optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>This cross-sectional study included 76 type 2 diabetes patients (139 eyes) from Fujian Medical University Union Hospital. Participants underwent CCM to assess corneal nerve fiber density (CNFD), branching density (CNBD), and nerve fiber length (CNFL). OCTA and OCT were used to evaluate macular and peripapillary retinal vascular densities (VD) and retinal nerve fiber layer (RNFL) thickness. Laboratory tests measured sural nerve conduction velocity (SSNCV), urine albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). DPN and CKD were categorized using Toronto consensus criteria and UACR thresholds, respectively. Statistical analyses included Spearman correlation and ROC curve evaluations.</p><p><strong>Results: </strong>Significant reductions in CNFD, CNBD, and CNFL were observed in the DPN + group compared to DPN- (P < 0.001, P = 0.005, P < 0.001). Corneal nerve parameters correlated positively with SSNCV (r = 0.419-0.430, P < 0.001). ROC analysis demonstrated CNFD as the most sensitive marker for detecting DPN (AUC = 0.7179, 95% CI: 0.6328-0.8031). Retinal superficial VD in the superior macular region showed the highest diagnostic performance for CKD (AUC = 0.7140, 95% CI: 0.6057-0.8223), with significant correlations between retinal VD parameters and UACR.</p><p><strong>Conclusions: </strong>Corneal nerve parameters measured by CCM and retinal vascular parameters assessed by OCTA are promising non-invasive biomarkers for early detection and monitoring of diabetic neuropathic and microvascular disorders.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231225","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":"Italian guidelines for the treatment of type 1 diabetes.","authors":"Basilio Pintaudi, Daniela Bruttomesso, Angela Girelli, Liliana Indelicato, Edoardo Mannucci, Andrea Pizzini, Valentina Anelli, Elisabetta L Romeo, Riccardo Schiaffini, Federico Spandonaro, Antonio Migliore, Massimiliano Orso, Daniela D'Angela, Barbara Polistena, Katja Speese, Rita Stara, Giovanni Targher, Marilena Vitale, Riccardo Candido","doi":"10.1007/s00592-025-02569-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02569-1","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231235","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":"Metrics in pregnancy: is it the time for new glycaemic goals for pregnant women with type 1 diabetes? An experience with advanced hybrid closed loop.","authors":"O Bitterman, R Fresa, A Napoli","doi":"10.1007/s00592-025-02590-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02590-4","url":null,"abstract":"<p><strong>Introduction: </strong>Recommended pregnancy specific Time in Range (TIR) 63-140 mg/dl is a quite wide range and, even if the goal of > 70% is achieved, the specific targets for fasting and mean glycaemia, which are much lower than 140 mg/dl, could not be complied. This case series aimed to explore the performance of an Advanced Hybrid closed Loop (AHCL) in pregnancy on a stricter glycaemic range.</p><p><strong>Methods: </strong>We collected retrospective data about recommended glucose metrics and an hypothetic TITR 63-95 mg/dl, more suitable for fasting periods, from 11 type 1 diabetes patients, using Medtronic MiniMed™ 780G, with glucose target 100 mg/dl and Active Insulin Time 2 h, from preconceptional phase until delivery.</p><p><strong>Results: </strong>TIR 63-140 mg/dl quickly improved throughout pregnancy, with progressively improving HbA1c and no significant changes in Time Below Range (TBR). TITR 63-95 mg/dl was 26% in the 1st trimester, 20% in the 2nd and 30% in the 3rd, corresponding to 6, 5 and 7 h per day, less than the hypothetic 8/24 hours of fasting. TAR > 140 reduced more compared to TAR > 95, reflecting a greater improve in postprandial values than in fasting.</p><p><strong>Conclusions: </strong>Although the AHCL Medtronic MiniMed™ 780G helped improving glycaemic control during pregnancy, our patients spent very few hours in the range 63-95 mg/dl, probably because they did not reach fasting glucose goals. A stricter TIR may be hypothesized for pregnant women too, as an additional goal along with TIR 63-140 mg/dl, but studies are needed to explore the consequences on maternal and fetal outcomes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231286","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":"Preliminary real-world observational data on A8 TouchCare use in adults with type 1 diabetes.","authors":"Nicolò Diego Borella, Anna Corsi, Cristiana Scaranna, Roberto Trevisan, Giuseppe Lepore","doi":"10.1007/s00592-025-02589-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02589-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231282","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":"Development and validation of a risk predictive nomogram for carotid intima-media thickening in patients with type 2 diabetes.","authors":"Yongqi Zheng, Luni Tuo, Jie Xiao, Runzi Ling, Lei Yan","doi":"10.1007/s00592-025-02584-2","DOIUrl":"https://doi.org/10.1007/s00592-025-02584-2","url":null,"abstract":"<p><strong>Aim: </strong>Carotid intima-media thickness (CIMT) serves as a valuable cardiovascular risk marker in type 2 diabetes mellitus (T2DM). We aimed to develop and validate a nomogram incorporating novel indicators, including the triglyceride-glucose (TyG) index, to predict CIMT thickening in T2DM.</p><p><strong>Methods: </strong>In this retrospective study of 804 patients with T2DM, we employed least absolute shrinkage and selection operator regression followed by stepwise regression for predictor selection. Six machine learning models were evaluated, with model selection based on the area under the receiver operating characteristic curve (AUROC). The optimal model was used to develop the nomogram, assessed using AUROC, calibration curves, decision curve analysis (DCA), and SHapley Additive exPlanations (SHAP) for feature importance.</p><p><strong>Results: </strong>Independent predictors of CIMT thickening in T2DM included age, body mass index, current smoking status, regular exercise habits, glycated hemoglobin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and TyG index. Logistic regression demonstrated excellent predictive performance and was selected for nomogram development. The predictive model showed strong discriminative ability and good calibration in both the training and testing datasets. DCA confirmed its clinical utility across relevant risk thresholds, with SHAP analysis identifying age as the most influential predictor.</p><p><strong>Conclusions: </strong>This study developed and validated a nomogram integrating routine clinical parameters and novel indicators, including the TyG index, to assess the risk of CIMT thickening in T2DM patients. This nomogram provides an evidence-based tool to help clinicians identify high-risk patients and guide early therapeutic interventions.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079377","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":"Modified cut-off value of the urine albumin-to-creatinine ratio is helpful for identifying patients at high risk for chronic kidney disease in prediabetes.","authors":"Jing Liu, Liu Yang, Jinli Wu, Lili You, Li Yan, Meng Ren","doi":"10.1007/s00592-025-02518-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02518-y","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes is associated with higher risk of chronic kidney disease (CKD), however studies investigating the prognostic index for incident CKD in patients with prediabetes are lacking. Thus, the present study aims to find the risk factors for CKD in prediabetic population.</p><p><strong>Methods: </strong>We included 1220 prediabetic participants without CKD in the REACTION study and examined the associations of clinical indicators with CKD incidence with 3.6 years of follow-up using logistic regression analyses. To explore the nonlinear relationship between the Urine Albumin-To-Creatinine Ratio (UACR) and the hazard ratio (HR) of CKD, a Restricted Cubic Spline (RCS) analysis was conducted. Logistic regression analysis was employed to assess the association between UACR categories and the risk of CKD incidence.</p><p><strong>Results: </strong>There were 78 (6.4%) individuals developed CKD, and elevated UACR was observed in patients who developed CKD. UACR was an independent risk factor of CKD after adjusting for covariates and RCS presented an association between elevated UACR and higher risk of CKD incidence. UACR cutoff points of 7.54 mg/g overall was associated with the risk of CKD progression. In comparison to a UACR range of 0-7.54 mg/g (B1), those who falling within the ranges of 7.54-14.95 (B2), 14.95-22.36 (B3), and 22.36-30 (B4), exhibited a significantly increased risk of CKD development. eGFR below the threshold of 81.64 mL/min/1.73m² was significantly associated with an increased risk of CKD characterized by impaired glomerular filtration.</p><p><strong>Conclusion: </strong>In conclusion, the novel UACR cutoff of 7.54 mg/g serves as an effective tool to identify individuals at high risk of developing CKD-ACR during the prediabetes stage.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074044","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}