Acta Clinica Belgica最新文献

{"title":"Local control of RCC pancreatic metastases is obtained by angiogenesis inhibitors.","authors":"Britt Van Gessel, Lisa Kinget, Giulia Mammone, Martin Zarba, Maarten Albersen, Philip R Debruyne, Marcella Baldewijns, Pauline Biesemans, Heidi Van Den Bulck, Herlinde Dumez, Octavie Demeulenaere, Baki Topal, Halit Topal, Henri Vandermeulen, Abhishek D Garg, Annouschka Laenen, Edward Scott McTaggart, Stefan Naulaerts, Daniel Heng, Benoit Beuselinck","doi":"10.1080/17843286.2026.2717715","DOIUrl":"https://doi.org/10.1080/17843286.2026.2717715","url":null,"abstract":"<p><strong>Background: </strong>Metastatic clear-cell renal cell carcinoma (m-ccRCC) with pancreatic and/or thyroid metastases (PM/TM) is sensitive to vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs). Optimal first-line therapy for these patients (VEGFR-TKI-monotherapy, immune checkpoint inhibitor (ICPI) combinations (ipilimumab/nivolumab) or ICPI/VEGFR-TKI-combinations) remains unknown.</p><p><strong>Materials and methods: </strong>We studied (A) the specific impact of axitinib and/or pembrolizumab dose reductions and treatment interruptions on response in patients treated with axitinib/pembrolizumab, (B) tumor shrinkage in individual PM upon VEGFR-TKIs and ICPIs, (C) the optimal first-line therapy in m-ccRCC patients with PM/TM in terms of tumor shrinkage, response rate (RR), time-to-progression (TTP) and cancer-specific-survival (CSS) and (D) explored molecular features of PM.</p><p><strong>Results: </strong>We describe 5 cases of m-ccRCC patients with PM, treated with first-line axitinib/pembrolizumab, in whom tumor response was clearly linked to axitinib administration and dose rather than pembrolizumab. In 119 individual PM, tumor shrinkage was the highest with ICPI/VEGFR-TKI-combinations followed by VEGFR-TKIs-monotherapy and lowest with ICPIs without VEGFR-TKIs (<i>p</i> < 0.0001). In 40 patients with PM/TM, median maximal tumor shrinkage was -54%, -39% and 0%, respectively (<i>p</i> = 0.04). RR was 83% with ICPI/VEGFR-TKI-combinations, 69% with VEGFR-TKI-monotherapy and 22% with ipilimumab/nivolumab (<i>p</i> = 0.01). Median TTP was not reached, 19 and 27 months, respectively (<i>p</i> = 0.07). Median CSS was not similarly impacted by first-line therapy. PM displayed high <i>AXL</i>-expression and higher infiltration by M2-like anti-inflammatory macrophages compared to other metastatic sites.</p><p><strong>Conclusion: </strong>In m-ccRCC patients with PM/TM, first-line therapy with VEGFR-TKIs or ICPI/VEGFR-TKI-combinations leads to improved RR and tumor shrinkage, compared to ipilimumab/nivolumab, but not to CSS benefit in the current analysis. PM displayed high AXL-expression and higher infiltration by M2-like anti-inflammatory macrophages compared to other metastatic sites.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-14"},"PeriodicalIF":0.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset respiratory adverse event patterns of omalizumab in pediatric patients: an age-stratified FAERS pharmacovigilance study.","authors":"Hairui Zheng, Lu Liang, Ning Li, Yi Su","doi":"10.1080/17843286.2026.2719664","DOIUrl":"https://doi.org/10.1080/17843286.2026.2719664","url":null,"abstract":"<p><strong>Objectives: </strong>To compare age-specific respiratory adverse event (AE) reporting patterns associated with omalizumab in pediatric and adult patients using FAERS, interpreting findings as signal-detection rather than causal or incidence evidence.</p><p><strong>Methods: </strong>FAERS reports for omalizumab/Xolair from Q1 2004 to Q4 2025 were analyzed after FDA-recommended deduplication. Reports were stratified as pediatric (<18 years) or adult (≥18 years); reports with missing age were described but excluded from age-stratified comparisons. Signal detection used ROR, PRR, BCPNN/IC, and MGPS/EBGM. PTs with ≥3 reports were evaluated, with emphasis on signals concordant across algorithms. Early onset was predefined as valid time-to-onset (TTO) ≤100 days.</p><p><strong>Results: </strong>Among 62,925 omalizumab-associated AE reports, 2,792 were pediatric, 28,075 adult, and 32,058 (50.94%) lacked age information. Respiratory, thoracic and mediastinal disorders and immune system disorders were prominent in both age-known groups. Pediatric reports showed concentrated respiratory PTs, including asthma, dyspnoea, cough, wheezing, and asthmatic crisis. Asthmatic crisis showed strong pediatric disproportionality, although this may reflect underlying asthma severity, exacerbation, treatment failure, differential reporting, and potential drug-related events. Valid TTO records indicated earlier reported onset in pediatric patients than adults (median: 34.4 vs. 63.1 days), with clustering within the first 100 days.</p><p><strong>Conclusion: </strong>FAERS reports suggest age-related differences in omalizumab-associated respiratory AE reporting and TTO patterns. These hypothesis-generating signals do not establish causality, incidence, or risk magnitude but support closer early respiratory monitoring in pediatric patients, with careful consideration of indication-related confounding.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-13"},"PeriodicalIF":0.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond toxicity: redefining proteinuria in precision onconephrology.","authors":"Charlotte Delrue, Marijn M Speeckaert","doi":"10.1080/17843286.2026.2719659","DOIUrl":"https://doi.org/10.1080/17843286.2026.2719659","url":null,"abstract":"","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic and inflammatory biomarkers in NSTEMI: a comparative analysis of predictive value for obstructive coronary disease.","authors":"Veysi Can, Fuat Polat, Ahmet Ferhat Kaya, Ömer Kümet, Görkem Ayhan, Emrah Özbek","doi":"10.1080/17843286.2026.2719660","DOIUrl":"https://doi.org/10.1080/17843286.2026.2719660","url":null,"abstract":"<p><strong>Background: </strong>The atherogenic index of plasma (AIP) and inflammatory indices may reflect the burden of atherosclerosis. This study evaluated their predictive value for obstructive coronary artery disease (CAD) in patients with non-ST-elevation myocardial infarction (NSTEMI).</p><p><strong>Methods: </strong>This retrospective study included 624 NSTEMI patients undergoing coronary angiography. Patients were classified as having obstructive or non-obstructive CAD. Demographic, clinical, laboratory, and echocardiographic characteristics were compared. Independent predictors were identified using multivariable logistic regression, and discriminative performance was assessed by receiver operating characteristic analysis.</p><p><strong>Results: </strong>          The obstructive CAD group was significantly older (64.3 ± 12.3 vs. 57.4 ± 14.2 years; p < 0.001) with higher prevalence of males (63.3% vs. 50.8%; p = 0.003), hypertension (52.1% vs. 30.2%; p < 0.001), and diabetes mellitus (47.6% vs. 28.9%; p < 0.001). Inflammatory markers were markedly elevated: NLR [4.2 vs. 1.9; p < 0.001], PLR [140.9 vs. 119.1; p < 0.001], SII [1113.3 vs. 520.1; p < 0.001], and CRP [0.4 vs. 0.2 mg/dL; p < 0.001]. AIP was significantly higher [0.71 vs. 0.46; p < 0.001]. ROC analysis demonstrated that NLR (AUC = 0.764) and SII (AUC = 0.738) had the highest discriminative ability, while AIP showed limited performance (AUC = 0.563). In multivariable analysis, independent predictors included age (OR = 1.031), hypertension (OR = 1.645), diabetes (OR = 1.547), PLR (OR = 1.004), CRP (OR = 1.156), and AIP (OR = 2.413; all p < 0.05).</p><p><strong>Conclusion: </strong>AIP was independently associated with obstructive CAD beyond traditional risk factors and inflammatory indices, despite modest standalone discriminative ability. These findings are hypothesis-generating and require prospective validation with clinical outcomes before routine clinical implementation.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-15"},"PeriodicalIF":0.9,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance between symptomatic, echocardiographic and renal trajectories after SGLT2 inhibitor initiation in heart failure: a landmark analysis of the prospective CaRD registry.","authors":"Ivana Jurin, Antonio Hanžek, Petar Lišnjić, Tomislav Jakljević","doi":"10.1080/17843286.2026.2719667","DOIUrl":"https://doi.org/10.1080/17843286.2026.2719667","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify the concordance and stability of symptomatic, echocardiographic and renal trajectories after sodium-glucose cotransporter 2 inhibitor (SGLT2i) initiation and examine their association with subsequent events.</p><p><strong>Methods: </strong>This day-210 landmark analysis included 618 adults with heart failure, baseline left ventricular ejection fraction (LVEF) <50%, and paired New York Heart Association (NYHA) class, LVEF and estimated glomerular filtration rate (eGFR) measurements on days 150-210. Domains were cross-classified rather than treated as equivalent causal components. Repeat classification was assessed by day 365. Death or heart-failure hospitalisation on days 211-365 was analysed with multivariable Cox regression; fixed-horizon Firth logistic regression and continuous, threshold, weighting and co-intervention analyses tested robustness.</p><p><strong>Results: </strong>Discordant trajectories occurred in 368/618 patients (59.5%). Among 209 with repeat assessment, 181 (86.6%) retained the same classification (κ=0.74). Outcome status was complete in 576 patients, with 33 events. Non-concordance was associated with the time-to-event outcome (adjusted hazard ratio 4.27, 95% confidence interval 1.61-11.32; <i>p</i> = 0.004); the fixed-horizon Firth estimate was concordant (odds ratio 4.27, 95% confidence interval 1.64-11.13; <i>p</i> = 0.003). NYHA improvement contributed most of the prognostic signal. Adding non-concordance to a conventional baseline model increased the area under the curve from 0.752 to 0.790, but the bootstrap interval for the increment included zero.</p><p><strong>Conclusion: </strong>Trajectories were frequently discordant and usually stable to day 365. Their association with events was non-causal, driven predominantly by symptomatic change and of uncertain incremental predictive value.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-13"},"PeriodicalIF":0.9,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring treatment challenges in Whipple's disease: two case reports and review of the literature.","authors":"Celine Tack, Jodie Langbeen, Kristel Goubert, Ann Stuer, Caroline Verbist, Céline Melis, Dirk Vogelaers","doi":"10.1080/17843286.2026.2718523","DOIUrl":"https://doi.org/10.1080/17843286.2026.2718523","url":null,"abstract":"<p><strong>Objectives: </strong>To review the literature concerning the antimicrobial treatment of Whipple's disease and to highlight consequences of diagnostic delay (including inappropriate use of immunosuppressants). This in the context of two illustrative case reports in which the standard treatment regimen of intravenous (IV) ceftriaxone for two weeks followed by oral trimethoprim-sulfamethoxazole (TMP-SMX) was either ineffective or poorly tolerated.</p><p><strong>Methods: </strong>A narrative review of the literature on antimicrobial treatment and the interplay of Whipple's disease with immunosuppressants was conducted alongside the clinical case descriptions.</p><p><strong>Results: </strong>A review of the literature identified two principal treatment strategies in use: the standard IV ceftriaxone/TMP-SMX regimen and the doxycycline/hydroxychloroquine oral-only combination. Debate regarding optimal approach is ongoing, however several studies report on the failure or relapse of the standard IV regimen. Diagnostic delay and inappropriate use of immunosuppressants can lead to severe complications.</p><p><strong>Conclusion: </strong>In patients with Whipple's disease who fail or cannot tolerate the standard IV regimen, combination of doxycycline and hydroxychloroquine represents a viable and effective alternative in patients without cerebral involvement. Clinical awareness of this condition and its treatment options is essential for a timely diagnosis and appropriate management.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative outcomes in patients with chronic respiratory failure dependent on home ventilation - a retrospective cohort study.","authors":"Jan De Mey, Lauren Heyman, Luc De Baerdemaeker, Pieter Depuydt, Eric Derom","doi":"10.1080/17843286.2026.2711056","DOIUrl":"https://doi.org/10.1080/17843286.2026.2711056","url":null,"abstract":"<p><strong>Objectives: </strong>Due to increased life expectancy, patients with chronic respiratory failure treated with home ventilation have an increasing likelihood of requiring surgery in their lifetime. Evidence on the safety and feasibility of surgery in this population is scarce.</p><p><strong>Methods: </strong>Retrospective analysis of all surgical procedures under general anaesthesia in patients included in the chronic home ventilation registry at Ghent University Hospital.</p><p><strong>Results: </strong>Between 1 October 2006 and 1 March 2022, 128 surgical procedures were performed on 53 (female: 25) patients with a median age of 52 yr, BMI of 25 kg/m², Charlson Comorbidity Index of 2 and FVC of 1.12 L (34%). 21 patients were ventilated via tracheostomy. The most common cause of respiratory failure was neuromuscular disease and tetraplegia (28 patients). Most procedures were minor (e.g. tracheostomy revisions), but 30 non-elective or emergency procedures (including 7 laparotomies) were registered. Respiratory complications occurred in 25 procedures (19%) and were associated with length of stay (<i>p</i> < 0.001) and hospital mortality (<i>p</i> = 0.029). Four patients (8%) died, all after emergency surgery, with one death deemed not attributable to the underlying respiratory failure (intracerebral haemorrhage). The ARISCAT score (median: 19; range: 0-86) was significantly associated with respiratory complications, length of stay, and hospital mortality (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Surgery is feasible in chronically ventilated patients, though the risk of respiratory complications and death after surgery, particularly if non-elective, is not negligible. The ARISCAT score was associated with outcomes and appears to be a valuable tool for risk assessment in this population.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analyses of quadrivalent influenza vaccinations in the general European population - a systematic review.","authors":"Bram Van Sassenbroeck, Veerle Piessens, Maarten Roegies, Dominique Vandijck","doi":"10.1080/17843286.2026.2652263","DOIUrl":"10.1080/17843286.2026.2652263","url":null,"abstract":"<p><strong>Objectives: </strong>Influenza infections affect around 20% of the population annually, generally causing a mild viral syndrome, but occasionally leading to severe complications or death. Influenza vaccines, with quadrivalent influenza vaccines (QIV) as the newest generation, decrease the likelihood of infection and complications. Because both influenza infections and vaccinations impose costs on patients and on the broader society, the health gains of vaccination programs should be weighed against their financial impact. This review summarises the literature on cost-effectiveness analyses for quadrivalent influenza vaccinations compared with non-vaccination, in the general European population since 2012.</p><p><strong>Methods: </strong>We conducted a systematic review of the literature on cost-effectiveness analyses that compared quadrivalent influenza vaccination with non-vaccination.</p><p><strong>Results: </strong>The eight included studies found that QIVs were cost-effective in 18/19 analyses at a willingness-to-pay threshold of 35 000 euro/QALY and in 15/19 analyses at 20 000 euro/QALY. Herd immunity was a major factor, as a large part of the observed cost-effectiveness gains occurred not in the targeted population for vaccination (children) but in the generations of their (grand)parents .</p><p><strong>Conclusions: </strong>This review suggests that vaccination programs with quadrivalent influenza programs are cost-effective compared with no influenza vaccination, regardless of the modelling assumptions. Their implementation should always be based on multiple factors, such as cost-effectiveness, the latest recommendations on <i>optimal</i> effectiveness for each influenza season, and ethical considerations. These results may have been influenced by the clinical and epidemiological validity of the data used by the included studies and the limited number of included analyses, most of which were industry funded.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"316-329"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 olfactory and salivary gland pathways in periodontal disease-mediated Alzheimer's disease progression: mechanistic insights and early diagnostic implications.","authors":"Hao Liang, Wenlei Yu, Zeyang Han, Bo Xu, Zhijie Zhuang, Jun Liu","doi":"10.1080/17843286.2026.2652268","DOIUrl":"10.1080/17843286.2026.2652268","url":null,"abstract":"<p><strong>Objectives: </strong>Periodontal disease, characterized by subgingival biofilm dysbiosis and Porphyromonas gingivalis (<i>P. gingivalis</i>) colonization, has been increasingly implicated in Alzheimer's disease (AD) pathogenesis. This review systematically delineates the pathophysiological mechanisms underlying the periodontal-AD nexus, highlighting olfactory dysfunction (OD) and salivary gland hypofunction as putative prodromal biomarkers for periodontal disease-associated AD progression.</p><p><strong>Methods: </strong>PubMed/MEDLINE database was systematically searched for English-language articles published between January 1994 and March 2025. Search terms encompassed periodontal disease, Porphyromonas gingivalis, Alzheimer's disease, neuroinflammation, olfactory dysfunction, salivary gland hypofunction, blood-brain barrier, microglial activation, and cognitive decline.</p><p><strong>Results: </strong>Periodontal disease compromises blood-brain barrier integrity via bacterial translocation, systemic pro-inflammatory mediator dissemination, and peripheral immune cell activation, thereby potentiating microglial polarization and neuroinflammatory cascades integral to early AD neuropathology. Both OD and salivary gland hypofunction demonstrate robust associations with periodontal disease severity and constitute sensitive biomarkers for prodromal AD.</p><p><strong>Conclusions: </strong>Periodontal disease-mediated neuroinflammation constitutes a pivotal mechanistic pathway linking oral dysbiosis to AD onset. OD and salivary gland hypofunction emerge as promising early diagnostic indicators for periodontal disease-associated AD susceptibility, warranting prospective clinical validation.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"330-346"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 <i>Helicobacter pylori</i>- and <i>Porphyromonas gingivalis</i>-associated metabolic syndrome in local and systemic diseases pathophysiology.","authors":"Jannis Kountouras, Evangelos Kazakos, Stergios A Polyzos, Elisabeth Vardaka, Pavlos Papadopoulos, Maria C Mouratidou, Maria Tzitiridou-Chatzopoulou, Dimitrios Chatzopoulos, Michael Doulberis","doi":"10.1080/17843286.2026.2706158","DOIUrl":"https://doi.org/10.1080/17843286.2026.2706158","url":null,"abstract":"","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}