Annals of Nutrition and Metabolism最新文献

{"title":"Association of platelet count and mean platelet volume with fish intake frequency: Implication for the cardioprotective effect of fish intake.","authors":"Shigemasa Tani, Kazuhiro Imatake, Yasuyuki Suzuki, Tsukasa Yagi, Atsuhiko Takahashi","doi":"10.1159/000546481","DOIUrl":"https://doi.org/10.1159/000546481","url":null,"abstract":"<p><strong>Introduction: </strong>Mean platelet volume (MPV) measures platelet activity, and high values indicate increased atherosclerotic cardiovascular disease (ASCVD) risk. Intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) found in fish can lower platelet count (PLC) and platelet activity, potentially reducing the risk of ASCVD. We aimed to investigate the relationship of fish intake with PLC, MPV, and n-3 PUFA intake.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among 9870 participants (average age: 47.5 ± 12.9 years; 55.9% men). N-3PUFA intake was calculated based on fish intake frequency (days/week) and information from the Nutritional Health Survey of Japan.</p><p><strong>Results: </strong>The average fish intake frequency was 2.14 ± 1.26 days/week. As fish intake frequency increased, PLC decreased (p < 0.0001) and MPV increased (< 0.034). Multi-regression analysis showed that PLC was an independent determinant of MPV (β = -0.081, p < 0.0001). Naturally, though, n-3 PUFA intake significantly increased with increased fish intake frequency (p < 0.0001).</p><p><strong>Conclusion: </strong>Higher fish intake was associated with lower PLC and larger MPV. The anti-platelet effect of n-3PUFAs, which intensifies with higher fish intake, may suppress platelet activity with larger MPV. Further studies are required to clarify the causal relationship between these factors.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-16"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198119","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":"Impact of a High-Calorie Diet on Metabolic Health, Carotid Intima-Media Thickness, and Endothelial Function in Individuals with Constitutional Thinness.","authors":"Umit Cavdar, Bercem Aycicek, Halit Diri, Mesude Uzun, Esref Arac, Onder Hamdi Silahtar, Nurhan Demir","doi":"10.1159/000546273","DOIUrl":"10.1159/000546273","url":null,"abstract":"<p><strong>Introduction: </strong>Constitutional thinness (CT) is an uncommon condition, allegedly non-pathological, defined by a persistently low body mass index (BMI <18 kg/m2) enduring from childhood through to later stages of life, without underlying chronic illnesses or hormonal abnormalities. Although CT is not associated with poor health outcomes, its long-term cardiovascular and metabolic implications remain unclear. Given that patients with CT often aim to achieve weight gain, and considering the lack of studies examining the outcomes of high-calorie dietary interventions in this population, we aimed to evaluate vascular and metabolic risk factors associated with atherosclerosis in CT individuals.</p><p><strong>Methods: </strong>This prospective before-and-after study involved 60 nonsmoking, normotensive, normoglycemic participants with CT, all exhibiting normal lipid profiles (HDL: 55.8 ± 16 mg/dL; LDL: 66 ± 19.9 mg/dL). Changes in carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), fasting, and postprandial blood glucose levels before (T0) and after (T1) a 3-month high-calorie diet intervention was assessed using paired Student's t test. In addition, postprandial insulin levels were evaluated to capture potential metabolic adaptations.</p><p><strong>Results: </strong>No significant changes were observed in CIMT (p = 0.54), FMD% (p = 0.423), BMI (p = 0.978), fasting (p = 0.297) or postprandial (p = 0.511) glucose levels, or lipid profiles (total cholesterol p = 0.138, HDL p = 0.858, LDL p = 0.66) after the 3-month high-calorie diet intervention. Both CIMT and FMD% remained within normal ranges at baseline and follow-up, suggesting that in the short term, individuals with CT do not experience substantial alterations in vascular or metabolic parameters despite increased caloric intake. A post hoc power analysis based on postprandial insulin (p = 0.007) showed a large effect size (Cohen's d = 0.71), with a power of 82% using G*Power software.</p><p><strong>Conclusions: </strong>Short-term high-calorie dietary intervention does not lead to significant cardiovascular or metabolic changes in individuals with CT. However, these findings should be interpreted with caution due to the small sample size and short duration. Further studies with longer follow-up and larger sample sizes, or different dietary compositions, may be necessary to evaluate long-term effects.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075691","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":"Brain-Derived Neurotrophic Factor Is Related with Sarcopenia in Patients with Disease-Related Malnutrition.","authors":"Daniel de Luis, David Primo, Olatz Izaola, Juan José López Gómez","doi":"10.1159/000546418","DOIUrl":"10.1159/000546418","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is a condition characterized by muscle mass loss. Some investigations have demonstrated the role of brain-derived neurotrophic factor (BDNF) as a protector against the presence of sarcopenia in patients with chronic kidney disease. We aimed to explore the role of circulating BDNF in the development of sarcopenia among individuals with disease-related malnutrition (DRM).</p><p><strong>Materials and methods: </strong>A total of 160 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria were enrolled. Anthropometric data, muscle mass assessed via ultrasound at the rectus femoris quadriceps (RFQ) level, bioelectrical impedance analysis (skeletal muscle mass [SMM], appendicular skeletal muscle mass [aSMM], and appendicular skeletal muscle mass index [aSMMI]), handgrip strength, biochemical parameters, dietary intake, and circulating levels of BDNF were measured.</p><p><strong>Results: </strong>A total of 55 patients (34.4%) were classified as sarcopenic, while 105 patients (65.6%) were classified as non-sarcopenic. Phase angle (-0.6 ± 0.2°; p = 0.01), reactance (-5.8 ± 2.1 Ohms; p = 0.03), SMM (-3.3 ± 0.2 kg; p = 0.04), aSMM (-2.1 ± 0.3 kg; p = 0.03), aSMMI (-0.8 ± 0.2 kg; p = 0.03), dominant muscle area (-0.7 ± 0.2 cm2; p = 0.04), and dominant Y-axis thickness (-0.4 ± 0.1 cm; p = 0.03) were worse in patients with sarcopenia. Muscle strength was higher in non-sarcopenic patients (8.5 ± 1.2 kg; p = 0.01). Circulating BDNF levels were significantly higher in non-sarcopenic patients compared to sarcopenic patients (94.7 ± 3.9 ng/mL; p = 0.01). Logistic regression analysis indicated a reduced risk of sarcopenia (OR = 0.16, 95% CI = 0.11-0.43; p = 0.03) in patients with higher BDNF levels, after adjusting for body mass index, gender, energy intake, and age.</p><p><strong>Conclusion: </strong>Our study identified an association between low serum BDNF levels and sarcopenia in patients with DRM.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148963","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":"Co-developed logic model for surgical prehabilitation in an acute care setting: a qualitative study of stakeholders' perspectives.","authors":"Jade Corriveau, Michelle St-Jacques, Sophia Yeung, Francesco Carli, A Sender Liberman, Debbie Watson, Rona Fleming, Andre Guigui, Michel Picard, Julio F Fiore, Nancy Mayo, Stéphanie Chevalier, Chelsia Gillis","doi":"10.1159/000546272","DOIUrl":"https://doi.org/10.1159/000546272","url":null,"abstract":"<p><strong>Background: </strong>Prehabilitation programs treat modifiable risk factors to improve surgical outcomes. However, translation of research into practice remains slow. Logic models, visual representations of how a program works, have the potential to bridge research-to-practice gaps. We aimed to develop a logic model for prehabilitation programs in tertiary care centers by interviewing stakeholders about what should be the mission, inputs, outputs (activities and participants), and targeted outcomes for prehabilitation implementation and evaluation?</p><p><strong>Methods: </strong>A multi-site qualitative study was conducted. Interviews were analyzed using manifest summative content analysis to determine logic model items. Focus groups for member checking were performed with stakeholders throughout the analysis process.</p><p><strong>Results: </strong>Sixty-one interviews were conducted with stakeholders: prehabilitation staff (n=12), patients (n=10), perioperative care physicians (n=10), nurses (n=9), dietitians (n=9), physiotherapists (n=5), and hospital administrators (n=6). Our findings underscored unanimous support for prehabilitation yet revealed challenges that hindered efficient and equitable resource utilization, which have been addressed in the logic model. To evaluate the success of prehabilitation, both clinician- (n=44) and patient-oriented outcomes (n=32) were valued by stakeholders; however, priority outcomes varied by stakeholder group: intervention adherence (prehabilitation staff), experience and satisfaction (patients), and facilitation of discharge (clinicians and hospital administrators).</p><p><strong>Conclusion: </strong>This co-developed logic model is designed to improve the efficiency, accessibility, and sustainability of acute care prehabilitation programs by offering a detailed blueprint. Researchers and clinicians can draw on the insights from this co-production process to develop, implement, and evaluate their own prehabilitation programs.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-30"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961290","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":"Relationships between Eating Styles and Body Mass Index in Women: A Moderating Role of Positive Eating.","authors":"Kamila Czepczor-Bernat, Magdalena Razmus, Marcela Mikulska, Paweł Matusik","doi":"10.1159/000545710","DOIUrl":"10.1159/000545710","url":null,"abstract":"<p><strong>Introduction: </strong>First, we investigated the relationships between eating styles (cognitive restraint, uncontrolled eating, and emotional eating) and body mass index (BMI) in women. Second, we aimed to explore whether positive eating serves as a protective factor in the relationships between eating styles and BMI.</p><p><strong>Methods: </strong>The sample comprised 404 women recruited via online surveys who completed: the Positive Eating Scale, the Three-Factor Eating Questionnaire, the sociodemographic survey. Data collection was independent.</p><p><strong>Results: </strong>First, we found that in women cognitive restraint, uncontrolled eating, and emotional eating are all positively related to BMI. Second, as predicted, we demonstrated the effect of positive eating as a moderator in the relationship between emotional eating style and uncontrolled eating style and BMI. Specifically, in women with average and low levels of positive eating, positive relationships between emotional eating and BMI, as well as uncontrolled eating and BMI were more pronounced. The effect of positive eating on the relationship between cognitive restraint and BMI was opposite to the expected.</p><p><strong>Conclusion: </strong>Our preliminary conclusions may suggest that food positivity should not be placed on the same continuum with unhealthy eating behaviours as its opposite end of the continuum. As a distinct construct, it may serve as a protective factor and strengthening a positive attitude towards food may possibly reduce the negative impact of unhealthy eating styles on individuals' BMI and, in turn, on health and well-being. It would be beneficial to verify these assumptions in future research.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969381","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 Economic Dimension of Childhood Obesity: Costs and Potential of New Anti-Obesity Medications.","authors":"Julian Gomahr, Julia Lischka, Caroline Braet, Marie-Laure Frelut, Teodora Handjieva-Darlenska, Edyta Łuszczki, Dénes Molnár, David Thivel, Gabriel Torbahn, Susanne Ring-Dimitriou, Andrea Vania, Elpis Vlachopapadopoulou, Daniel Weghuber","doi":"10.1159/000546140","DOIUrl":"10.1159/000546140","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-3"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967313","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":"Prevention of Food Allergy: Harmonizing Perspectives from the East and West.","authors":"Agnes Sze-Yin Leung, Gary Wing-Kin Wong","doi":"10.1159/000543617","DOIUrl":"https://doi.org/10.1159/000543617","url":null,"abstract":"<p><strong>Background: </strong>The global epidemiology of food allergies and anaphylaxis exhibits complex, heterogeneous patterns. While food allergy prevalence has stabilized in Western countries, anaphylaxis incidence continues to rise. In developing regions, data are limited, but urban centers show increasing food allergy prevalence, contrasting with lower rates in rural areas. These disparities likely stem from differences in environmental factors and urbanization levels across the globe. Furthermore, the dominant food allergens vary significantly by regions. Peanuts and tree nuts are the primary triggers in the USA and Europe, whereas eggs, milk, and shellfish are more common in Asia and Latin America.</p><p><strong>Summary: </strong>In this upcoming review, we will delve into the recommendations for preventing food allergies across Eastern and Western regions. These regional differences in allergen profiles and dietary patterns underscore the need for tailored food allergy prevention strategies. Current prevention guidelines focus on the timing and route of allergen exposure in early life. In high-prevalence regions, early oral exposure is recommended to promote oral tolerance and reduce allergy risk. Conversely, in lower-prevalence areas, non-delayed introduction of allergenic solids is preferred. Moreover, early skin exposure may increase allergy risk, and the role of early, whole-body use of specialized emollients requires further study. Proactive treatment of atopic dermatitis may reduce the incidence of food allergies in infants. Adapting prevention approaches to local contexts and continuously updating guidelines based on emerging evidence is crucial to comprehensively addressing the global burden of food allergies.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960354","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":"Predictive Value of Body Composition Indicators in Early Pregnancy for Gestational Diabetes Mellitus.","authors":"Yun Hong, Mengfei Ren, Jiajia Li, Jingran Jiao, Jiaqiang Cheng, Qingli Bo","doi":"10.1159/000546025","DOIUrl":"10.1159/000546025","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It is characterized by normal or possibly impaired glucose metabolism before pregnancy and abnormal glucose metabolism during pregnancy. We evaluate the predictive value of body composition indicators in early pregnancy for GDM.</p><p><strong>Methods: </strong>Pregnant women who visited Huaibei Maternal and Child Health Hospital from November 2022 to April 2023 were selected as study participants. Body composition indicators were measured using bioelectrical impedance assessment at 11-14 weeks of gestation. Study subjects completed a 75-g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Relationships between body composition indicators and GDM were explored using multivariate logistic regression. Additionally, the predictive value of body composition indicators for GDM was assessed through the receiver operating characteristic (ROC) curve and restricted cubic spline (RCS).</p><p><strong>Results: </strong>Five hundred eighty-eight participants were enrolled, 100 of whom had a diagnosis of GDM (17.9%). We found that percent body fat (PBF) and visceral fat index (VFI) were associated with a higher risk of GDM, with adjusting ORs of 1.82 (95% CI = 1.50-2.21) and 6.10 (95% CI = 3.91-9.51) after adjusting for confounders, respectively. The ROC showed that PBF and VFI were highly predictive values for GDM. The RCS displayed that there was a J-shaped connection between 3-point OGTT plasma glucose and PBF. There was a nonlinear relationship between 1-h plasma glucose and VFI.</p><p><strong>Conclusions: </strong>The findings suggest that PBF and VFI have high predictive value for GDM.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967324","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":"Do Global Infant Feeding Policies Respect the United Nations Principles on the Rights of Children and Families?","authors":"Stewart Forsyth","doi":"10.1159/000546054","DOIUrl":"10.1159/000546054","url":null,"abstract":"<p><strong>Background: </strong>Under the terms of the United Nations Convention on the Rights of the Child (UNCRC), governments are now required to enable all children to fulfil their full potential with the key principles being non-discrimination, the right to life and development, the best interests of the child, and the right to be heard. A recent statement by UNICEF indicated that implementation of the principles of the UNCRC provide a pathway for WHO, WHA, and UNICEF global infant feeding policy documents to be introduced into domestic law. But these documents are not recent and have not been updated, and they represent high levels of non-compliance. Moreover, do they actually comply with the principles set out in the UNCRC?</p><p><strong>Summary: </strong>Global decisions on infant feeding are being made by organisations who are distant from family circumstances and primarily reflect the views of WHO/UNICEF and activist groups. Evidence of dismissal of public consultation is discriminatory, and an unwillingness to manage differences of opinion is a denial of the right to be heard.</p><p><strong>Key message: </strong>National governments can serve the best interests of the child through sovereign rights, national responsibility and accountability, and development of national infant feeding policies that reflect UNCRC principles.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-5"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964838","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":"Prehabilitation and Inflammation.","authors":"Tobias Kammerer, Inês Mahú, Robert Schier","doi":"10.1159/000545181","DOIUrl":"10.1159/000545181","url":null,"abstract":"<p><strong>Background: </strong>In the perioperative setting, surgical trauma triggers an inflammatory reaction that is accompanied by an elevated risk for the development of severe immune-related complications (e.g., sepsis). The underlying pathophysiological mechanisms are partially caused by the patients' debilitated health conditions prior to the surgical procedure. As such, multimodal prehabilitation regimens (in particular preoperative exercise training and nutritional therapy) aimed at improving immune function have gained much attention. We hereby describe and highlight molecular and cellular targets for assessing the biological effects of prehabilitation and potential biomarkers for the success of these interventions.</p><p><strong>Summary: </strong>Prehabilitation can remodel skeletal muscles at the molecular level and improve immune cell function through physical exercise and nutritional therapy. This review focuses on two emerging molecular pathways modulated by exercise-based therapies and potential biomarkers of whole-body health and of inflammation: the regulation of hypoxia inducible factors and of a class of bioactive lipids called ceramides. Additionally, we describe and highlight important cellular targets of prehabilitation which are of particular relevance for driving and sustaining the benefits of prehabilitation on the patients' immune function postoperatively.</p><p><strong>Key messages: </strong>Dissecting the molecular mechanisms that modulate inflammation and immune cell function upon prehabilitation with beneficial effects on the patients' clinical outcomes is essential to properly diagnose the success of these interventions. And while there seems to be a multitude of organs and cells affected by physical conditioning, the key biological pathways which should be evaluated during prehabilitation interventions are yet to be uncovered and more research is needed for it. Nonetheless, some candidates are emerging as powerful regulators of inflammation and general health and deserve further investigation.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957238","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}