Age and ageing最新文献

{"title":"Low gait speed is better than frailty and sarcopenia at identifying the risk of disability in older adults","authors":"Aline Fernanda de Souza, Dayane Capra de Oliveira, Paula Camila Ramírez, Roberta de Oliveira Máximo, Mariane Marques Luiz, Maicon Luís Bicigo Delinocente, Andrew Steptoe, Cesar de Oliveira, Tiago da Silva Alexandre","doi":"10.1093/ageing/afaf104","DOIUrl":"https://doi.org/10.1093/ageing/afaf104","url":null,"abstract":"Objective To compare frailty, sarcopenia and their respective components to determine which is more effective in identifying the risk of disability in basic and instrumental activities of daily living (BADL and IADL, respectively). Methods A longitudinal study involving 3,637 individuals without disabilities concerning BADL and 3,696 individuals without disabilities regarding IADL at baseline. Frailty was defined using the phenotype. Sarcopenia was determined according to the criteria proposed by the EWGSOP2: low strength (grip strength <27 kg for men and <16 kg for women), low skeletal muscle mass index (<9.36 kg/m2 for men and <6.73 kg/m2 for women) and low physical performance (gait speed ≤0.8 m/s). In addition to the complete constructs, each component was assessed. Poisson mixed models were utilised, with the outcome identified as incident cases of disability over 8 years, adjusted for covariates. Results: Pre-frailty was associated with a 17% and 18% annual increase in the risk of disability for BADL and IADL, respectively. These figures were 27% and 28% for individuals classified as frail. Sarcopenia was not associated with an increased risk of disability. Amongst the components of frailty and sarcopenia, low physical performance, assessed by gait speed ≤0.8 m/s, was the most effective for identifying the risk of disability (12% per year for BADL and 14% per year for IADL). Conclusion In clinical practice, low physical performance (gait speed ≤0.8 m/s) may be the preferred tool for screening the risk of functional decline in older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"37 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a core outcome set for clinical trials targeting interventions aiming to improve adherence to appropriate polypharmacy in older people—an international consensus study","authors":"Hanadi Al Shaker, Heather Barry, Carmel Hughes","doi":"10.1093/ageing/afaf102","DOIUrl":"https://doi.org/10.1093/ageing/afaf102","url":null,"abstract":"Background Medication non-adherence is prevalent in older people taking polypharmacy. Several interventions have been employed to improve adherence in this population. However, inconsistencies in outcomes have impeded comparisons of findings. Accordingly, this work aimed to develop a core outcome set (COS) for use in trials aiming to improve adherence to appropriate polypharmacy in older people. Methods A group of stakeholders, including academics, journal editors, healthcare professionals (HCPs) and public participants, evaluated 13 outcomes compiled from the literature in a Delphi study using a nine-point Likert scale ranging from 1 to 9, where higher scores (7–9) indicated critical importance and lower scores (1–3) unimportance. The resultant Delphi consensus list was discussed and voted on (yes: critical and no: unimportant) in two online nominal group technique (NGT) meetings. The NGT followed a five-stage approach: introduction, silent generation, round-robin, clarification and voting. An outcome was included if ≥80% of participants scored it critical and ≤ 15% scored it as unimportant. Results Of the 13 outcomes originally presented to participants, consensus was achieved to include six outcomes in the COS after the Delphi study (Round 1, n = 57; Round 2, n = 53; Round 3, n = 50, where ‘n’ represents participant numbers) and the NGT meetings (n = 10) comprising medication adherence across multiple medications, treatment burden, health-related quality of life (HRQoL), healthcare utilisation (HCU), adverse events and side effects (AEs and SEs) and cost-effectiveness. Conclusion This COS should be used in intervention studies focusing on improving adherence to appropriate polypharmacy in older people. Future work should identify outcome measurement instruments to be used alongside the COS.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"7 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study","authors":"Shuomin Wang, Qianyuan Li, Jianzhong Hu, Qirong Chen, Shanshan Wang, Qian-Li Xue, Chongmei Huang, Hongyu Sun, Minhui Liu","doi":"10.1093/ageing/afaf101","DOIUrl":"https://doi.org/10.1093/ageing/afaf101","url":null,"abstract":"Background Chronic conditions often co-occur in specific disease patterns. Certain chronic diseases contribute to incident frailty or cognitive impairment (CI), but the associations of multimorbidity patterns and the order of frailty and CI occurrence remain unclear. Objectives To determine multimorbidity patterns amongst older adults and their associations with the order of frailty and CI occurrence. Design Prospective cohort study. Methods Using data from National Health and Aging Trends Study, 7522 community-dwelling participants were included and followed up for four years. Latent class analysis was conducted to identify multimorbidity patterns with clinical meaningfulness. Fine and Grey competing risks models were used to examine the associations between multimorbidity patterns and different orders of frailty and CI occurrence (frailty-first, CI-first, frailty-CI co-occurrence). Results Four multimorbidity patterns were identified: cardiometabolic, osteoarticular, cancer-dominated and psychiatric/multisystem pattern. Compared to non-multimorbidity, all four multimorbidity patterns were associated with a higher risk of developing frailty-first, but not developing CI-first. Specifically, the psychiatric/multisystem pattern had the highest risk of developing frailty-first ( Sub-distribution hazard ratios [SHR] = 3.74, 95% confidence intervals = 2.96, 4.71), followed by osteoarticular pattern (SHR = 2.53, 95% CI = 1.98, 3.22) and cardiometabolic pattern (SHR =2.41, 95% confidence intervals = 1.96, 2.98). In addition, only participants from psychiatric/multisystem and cardiometabolic pattern showed a higher risk of frailty-CI co-occurrence. Conclusions Our findings highlight the etiological heterogeneity between physical frailty and CI. Clinician should be aware of multimorbidity clusters and thus provide more effective strategies for comorbid older adults to prevent the onset of these two geriatric syndromes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction models for severe treatment-related toxicities in older adults with cancer: a systematic review","authors":"Wing-Lok Chan, Sally Ka-Wing Lau, Astor Mak, Chun-Ming Yau, Chak-Fung Fung, Holly Li-Yu Hou, Dora Kwong, Victor Ho-Fun Lee, Horace Chuek-Wai Choi","doi":"10.1093/ageing/afaf095","DOIUrl":"https://doi.org/10.1093/ageing/afaf095","url":null,"abstract":"Background Ageing increases the risk of treatment-related toxicities (TRT) in patients with cancer. This systematic review provided an overview of existing prediction models for TRT in this population and evaluated their predictive performances. Methods A systematic search was conducted in MEDLINE (Ovid), Embase, PubMed, CINAHL and CENTRAL (Cochrane Central Register of Controlled Trials) databases for studies developing severe TRT prediction models in older cancer patients published between 1 January 2000 and 31 October 2023. The included models were summarised and assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Results Out of the 6192 studies identified through literature searching, 12 studies involving 90 819 participants met the inclusion criteria. About 15 prediction models (9 (60%) for diverse cancer types; 6 (40%) for specific cancer types) were analysed. The models included between 4 and 11 variables. The most common predictors were physical function (n = 12, 80%), performance status (n = 5, 33.3%) and the MAX2 index (n = 5, 33.3%). About 2 models (13.3%) had external validation, 9 (60.0%) had internal validation and 6 (40.0%) lacked any validation. All studies were assessed to have a high risk of bias according to the PROBAST criteria. Conclusion This systematic review demonstrated that existing prediction models for TRT exhibited moderate discrimination ability in older patients with cancer, with significant heterogeneity in clinical settings and predictive variables. Standardised procedures for developing and validating prediction models are essential to improve the prediction of severe TRT in this vulnerable population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of in-hospital orthogeriatric care on health-related quality of life: a systematic review and meta-analysis","authors":"Karin Vleeshouwers, Jole Beert, Annelies Boonen, Daisy J A Janssen, Marian Dejaeger, Mieke Deschodt, Maaike L De Roo, Bart Spaetgens","doi":"10.1093/ageing/afaf106","DOIUrl":"https://doi.org/10.1093/ageing/afaf106","url":null,"abstract":"Background Orthogeriatric care has been shown to effectively reduce mortality and morbidity and has a potential impact on health-related quality of life (HRQoL). This systematic review and meta-analysis summarises the effects of orthogeriatric care on HRQoL in hip fracture patients. Methods The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO): CRD42021206280. We searched Medline and EMBASE from inception to January 2024 without language restrictions. We included randomised and non-randomised controlled trials comparing HRQoL in older hip fracture patients receiving orthogeriatric care to other fracture care. Study quality was evaluated using the Revised Cochrane Risk-of-Bias (RoB) tool or the Newcastle–Ottawa Scale (NOS). Pooled standardised mean differences (SMDs) were calculated using random-effects models. We reported according to the Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines. Results Eight studies involving 2411 patients were included, all employing various orthogeriatric care models with moderate to good methodological quality, based on the RoB tool and NOS. However, substantial clinical heterogeneity was present due to variations in study design, number and execution of intervention components, outcome measures and patient populations. Despite this variability, meta-analysis showed that in-hospital orthogeriatric care, compared to usual care, led to a small but statistically significant improvement in overall HRQoL (SMD 0.18, 95% CI 0.06–0.30) with moderate heterogeneity (I2 = 47%). Conclusion In-hospital orthogeriatric care has a small but significant effect on HRQoL. This study highlights the need for clear descriptions of orthogeriatric care models, their implementation, fidelity and contextual factors. High-quality future research is essential to advance clinical practice, refine care models, address methodological limitations and prioritise patient-centred short- and long-term HRQoL outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to exercise intervention for community-dwelling older adults with sarcopenia: a systematic review and meta-analysis","authors":"Shuang Wu, Jiahui Nan, Jing Chang, Dian Jiang, Zeng Cao, Shuhan Zhou, Hui Feng, Lily Dongxia Xiao","doi":"10.1093/ageing/afaf094","DOIUrl":"https://doi.org/10.1093/ageing/afaf094","url":null,"abstract":"Background Exercise is a highly recommended nonpharmacological intervention for older adults with sarcopenia. Poor exercise adherence is a main factor affecting treatment efficacy. However, evidence for overall adherence to exercise and intervention characteristics affecting adherence in this population remains unknown. Objective To determine whether community-dwelling older adults with sarcopenia adhere to exercise programmes, what intervention components are used to improve adherence and how adherence relates to intervention characteristics and efficacy. Methods Seven electronic databases and relevant systematic reviews were searched to identify randomised controlled trials (RCTs). The capability, opportunity, motivation and behaviour model with behaviour change techniques (BCTs) were used to categorise adherence intervention components. Random-effects meta-analysis and meta-regression analyses were employed. Results Seventeen RCTs with 2975 participants were included in this review. The pooled estimate of adherence rates for exercise interventions amongst older adults with sarcopenia was 85% (95% CI: 0.79–0.89, range: 71%–100%). Nine BCTs were identified from the included studies. Exercise with programme durations (<24 weeks) (P = 0.01) might be associated with higher adherence rates compared with programme durations (≥24 weeks). However, exercise adherence was not associated with intervention efficacy. Conclusion Adherence to exercise interventions in community-dwelling older adults with sarcopenia is relatively high and may be affected by programme duration. Most studies incorporated only a small number of BCTs into their exercise interventions. Such an approach may be insufficient to enhance adherence in this population effectively. Future studies with theory-informed interventions to improve adherence in the field of exercise for older people with sarcopenia are needed.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"68 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hospital-based special care unit for dementia decreased hospital readmission rates for behaviour while reducing rates of falls and occupational violence across medical wards","authors":"Frederick A Graham, Lisa Kelly, Elizabeth A Burmeister, Amanda Henderson, Annette Broome, Ruth E Hubbard, Emily H Gordon","doi":"10.1093/ageing/afaf096","DOIUrl":"https://doi.org/10.1093/ageing/afaf096","url":null,"abstract":"Background Hospital-based Special Care Units (SCU) for dementia show promise as effective models of care. However, limited research describes hospital-wide benefits. Objective To describe patient-level outcomes and hospital service-level outcomes of a SCU. Design Pre-post analyses of SCU-patient data and hospital service-unit incident report data. Setting, participants 2-years of SCU-patient admissions and 4-years of hospital incident-reports from four medical wards (2-years pre-post SCU). Methods Admission and discharge severity of SCU-patients’ behaviour was prospectively measured by specialist SCU nurses. One-year hospitalisation rates, length-of-stay, diagnosis and patient demographics were retrospectively obtained from medical records. Hospital service-unit data included 4 years of monthly incident report rates for falls, pressure injury and occupational violence (OV) across four medical wards. Analysis of count data used Poisson and Negative Binomial Regression models. Results 121 SCU admissions involved 107 unique patients. Median SCU LoS was 23 days (interquartile range [IQR], 13–50), and stabilisation of behaviour severity took 11 days (IQR 6–12). Barriers to discharge related to substitute decision-making and care facility availability. After SCU discharge, yearly hospitalisation rates for ‘all-reasons’ decreased by 68% (Incident Rate Ratio [IRR], 0.32, 95% CI, 0.23–0.43), and 83% for behaviour-related admissions (IRR 0.17, 95% CI, 0.11–0.28). For hospital service-unit outcomes, falls-per-month decreased by 21% (IRR 0.79, 95% CI 0.64–0.99) after SCU implementation and OV by 26% (IRR, 0.74, 95% CI 0.59–0.94). Conclusions A hospital-based SCU reduced hospital health service demand through decreased SCU-patient readmissions and was associated with decreased falls and OV rates across hospital medical wards.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle, inflammageing, and poor physical performance in middle-aged and older adults: a prospective cohort study in Taiwan","authors":"Chu-Chih Chen, Jih-Shin Liu, Ray-Chin Wu, Hsing-Yi Chang, Shu-Chun Chuang, I-Chien Wu, Chi-Shin Wu, Chao A Hsiung, Chih-Cheng Hsu","doi":"10.1093/ageing/afaf107","DOIUrl":"https://doi.org/10.1093/ageing/afaf107","url":null,"abstract":"Background and Aims Poor physical performance (PPP) in terms of weakness and slow walking speed is closely associated with frailty during ageing. We aimed to analyse the associations between modifiable lifestyle factors, inflammation markers (hs-CRP, D-dimer, and fibrinogen), and the odds of PPP and state transitions between normal and PPP in older adults. Methods A total of 3756 participants ($ge$ 55 years) in wave 1 (2009–2013) and wave 2 (2014–2019) of the Healthy Aging Longitudinal Study in Taiwan (HALST) were analysed. A logistic regression model was used to assess the associations between lifestyle factors (physical activity [PA], diet, and psychosocial health), inflammation markers, comorbidities, and PPP (two or more of the criteria: grip strength, 6-minute walking distance, or gait speed among the lowest 20%). Results In total, 229 and 149 of the 773 PPP participants at wave 1 reversed and persistent in PPP state at wave 2, respectively. Higher PA (OR 0.917, 95% CI 0.894–0.941), psychosocial health (OR 0.964, 95% CI 0.955–0.972), LDL-C, and education level had significant protective effects, whereas greater waist circumference, D-dimer, fibrinogen, longer sleeping time, and comorbidities were positively associated with PPP. Higher PA, psychosocial health, and diet scores were protective against conversion to PPP, and increased PA and higher psychosocial health score were significant for reversion. Conclusions Older adults are encouraged to engage in various forms of PA and participate in societal events to increase their physical performance. To avoid further deterioration in physical frailty, screening for PPP may be adopted as a standard clinical practice for older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital biomarkers for real-life, home-based monitoring of frailty: a systematic review and meta-analysis","authors":"Jundan Huang, Shuhan Zhou, Qi Xie, Jia Yu, Yinan Zhao, Hui Feng","doi":"10.1093/ageing/afaf108","DOIUrl":"https://doi.org/10.1093/ageing/afaf108","url":null,"abstract":"Background Frailty, characterised by decreased physiological function and increased vulnerability to stressors, was associated with an increase in numerous adverse outcomes. Although the number of digital biomarkers for detecting frailty in older adults is increasing, there remains a lack of evidence regarding their effectiveness for early detection and follow-up in real-world, home-based settings. Methods Five databases were searched from inception until 1 August 2024. Standardised forms were utilised for data extraction. The Quality Assessment of Diagnostic Accuracy Studies was used to assess the risk of bias and applicability of included studies. A meta-analysis was conducted to assess the overall sensitivity and specificity for frailty detection. Results The systematic review included 16 studies, identifying digital biomarkers relevant for frailty detection, including gait, activity, sleep, heart rate, hand movements and room transition. Meta-analysis further revealed pooled sensitivity of 0.78 [95% confidence interval (CI): 0.70–0.86] and specificity of 0.79 (95% CI: 0.72–0.86) to classify robust and pre-frailty/frailty participants. The overall risk of bias indicated that all the included studies were characterised as having a high or unclear risk of bias. Conclusion This study offers a thorough characterisation of digital biomarkers for detecting frailty, underscoring their potential for early prediction in home settings. These findings are instrumental in bridging the gap between evidence and practice, enabling more proactive and personalised healthcare monitoring. Further longitudinal studies involving larger sample sizes are necessary to validate the effectiveness of these digital biomarkers as diagnostic tools or prognostic indicators.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"61 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From biology of ageing to geroscience: where will knowledge take us?","authors":"Aurélie Mailliez, Chantal Fradin, Éric Boulanger","doi":"10.1093/ageing/afaf098","DOIUrl":"https://doi.org/10.1093/ageing/afaf098","url":null,"abstract":"Healthy life expectancy is a major challenge in many countries and one of the World Health Organisation’s main concerns for the current decade. With different animal models, from invertebrates to mammals, research into the biology of ageing has identified various biological and physiological processes that alter the quality of ageing. Twelve characteristics of ageing have been defined, and the aim of a growing number of studies is to find how to slow down or halt their onset. Unfortunately, the direct transposition of animal models to humans is too often disappointing, and the race to bring anti-ageing products to market is a source of misleading promises. The development of geroscience will enable the identification and validation, with more relevant clinical evidence, of pro-ageing targets to develop anti-ageing therapies and aim for healthy ageing.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"5 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}