Archives of Medical Research最新文献

{"title":"Probiotics for the Management of Liver Cirrhosis and Its Complications","authors":"Junxiu Chen ,&nbsp;Haonan Zhao ,&nbsp;Nahum Méndez-Sánchez ,&nbsp;Xingshun Qi","doi":"10.1016/j.arcmed.2025.103304","DOIUrl":"10.1016/j.arcmed.2025.103304","url":null,"abstract":"<div><div>Cirrhosis is the terminal stage of various chronic liver diseases, and its decompensated stage is mainly characterized by serious complications, such as hepatic encephalopathy, ascites, spontaneous bacterial peritonitis, and gastrointestinal bleeding. Gut microbial dysbiosis is prevalent in patients with cirrhosis. Considering the bidirectional regulation of the gut-liver axis, dysbiosis is closely related to the development and progression of liver cirrhosis. Probiotics, which modulate the gut microbiome, have received significant attention for managing cirrhosis and its complications. Through a review of relevant literature, we have provided a comprehensive summary of the potential efficacy of probiotics in treating cirrhosis and its complications, providing new insights into targeting the gut microbiome.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 8","pages":"Article 103304"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996325","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":"Implications of the Liver-Gut Axis in Liver Disease: From Mechanisms to Therapeutic Targets","authors":"Mariana M. Ramírez-Mejía ,&nbsp;Guadalupe Ponciano-Rodríguez ,&nbsp;Nahum Méndez-Sánchez","doi":"10.1016/j.arcmed.2025.103335","DOIUrl":"10.1016/j.arcmed.2025.103335","url":null,"abstract":"<div><div>The liver-gut axis is a bidirectional communication system that integrates metabolic, immune, microbial, and nutritional signals which are critical to hepatic homeostasis. Disruption of this axis, through dysbiosis, altered intestinal barrier integrity, microbial translocation, and maladaptive immune activation, has become a central mechanism in the onset and progression of chronic liver diseases. Common pathways include changes in microbial composition and altered production of metabolites such as short-chain fatty acids, bile acids, ethanol, and trimethylamine N-oxide and activation of proinflammatory cascades via Toll-like receptors, NOD receptors, and inflammasomes. These alterations lead to steatosis, oxidative stress, fibrogenesis, and carcinogenesis. Notably, each liver disease presents distinct alterations. Beyond pathogenesis, modulation of the liver-gut axis has been shown to have therapeutic potential. Microbiota-targeted interventions, bile acid signaling modulators, and dietary and lifestyle strategies can restore microbial balance, strengthen the intestinal barrier, and attenuate liver injury. However, long-term safety, disease-specific efficacy, and integration with standard treatments remain key challenges. This review aims to provide an overview of the liver-gut axis. First, it describes its general regulatory mechanisms, then analyzes the specific alterations in the main chronic liver diseases and finally, it discusses the therapeutic implications of acting on this axis.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 8","pages":"Article 103335"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440163","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":"Phase Angle/C-reactive Protein-Index as a Novel Combined Tool for Predicting Liver-Related Hospitalizations in MASLD-Decompensated Cirrhosis","authors":"Marcello Dallio ,&nbsp;Mario Romeo ,&nbsp;Annachiara Coppola,&nbsp;Giuseppina Martinelli,&nbsp;Claudio Basile,&nbsp;Fiammetta Di Nardo,&nbsp;Carmine Napolitano,&nbsp;Paolo Vaia,&nbsp;Alessia De Gregorio,&nbsp;Alessia Silvestrin,&nbsp;Giusy Senese,&nbsp;Alessandro Federico","doi":"10.1016/j.arcmed.2025.103306","DOIUrl":"10.1016/j.arcmed.2025.103306","url":null,"abstract":"<div><h3>Background</h3><div>Phase angle (<em>PA</em>), a bioelectrical impedance analysis (BIA)-assessable marker of sarcopenia, can accurately predict hospitalizations in advanced chronic liver disease (ACLD). <em>PA</em> has never been specifically investigated in metabolic dysfunction-associated steatotic liver disease (MASLD). Sarcopenia is commonly observed in patients with MASLD, whereas individuals with compensated ACLD (cACLD)-MASLD progress more rapidly to decompensated ACLD (dACLD).</div></div><div><h3>Aims</h3><div>To evaluate the <em>PA</em> values across the different stages of liver disease progression in MASLD, and to estimate the accuracy of the novel <em>PA</em>/C-reactive-protein (CRP) index (PAC-I) in predicting 3 month further liver-related events (LREs) and hospitalizations in MASLD-dACLD.</div></div><div><h3>Methods</h3><div>Patients with MASLD were consecutively enrolled and stratified according to liver stiffness measurement (LSM) and eventual previous LREs in ≤F3 fibrosis (AF), cACLD, and dACLD. At baseline, anthropobiochemical, nutritional, and clinical data were collected. Patients with MASLD-dACLD were followed up, and further LRE-determining hospitalizations within the subsequent three months were recorded.</div></div><div><h3>Results</h3><div>In patients with MASLD, <em>PA</em> values were inversely correlated with LSM, and progressively decreased according to the worsening of liver disease (cACLD vs. dACLD, <em>p</em> &lt;0.0001). In patients with dACLD, <em>PA</em> inversely correlated with CRP levels. PAC-I showed greater accuracy and superiority compared to <em>PA</em> alone in predicting the occurrence of further LREs within three months (PAC-I &lt;2.35: optimal cut-off). Consistently, patients with dACLD with PAC-I &lt;2.35 presented a higher risk of further LREs.</div></div><div><h3>Conclusions</h3><div>In MASLD, PA correlates with disease progression status. PAC-I represents a useful noninvasive tool in predicting short-term liver-related hospitalizations in dACLD.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 8","pages":"Article 103306"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093035","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":"The future of pancreatic cancer therapy: getting better, but not good enough yet","authors":"Johannes Klose,&nbsp;Jessica Doebereiner,&nbsp;Yoshiaki Sunami,&nbsp;Artur Rebelo,&nbsp;Ulrich Ronellenfitsch,&nbsp;Jorg Kleeff","doi":"10.1016/j.arcmed.2025.103336","DOIUrl":"10.1016/j.arcmed.2025.103336","url":null,"abstract":"<div><div>Diagnosis of pancreatic cancer is generally regarded as dismal with poor prognosis due to advanced stage at presentation and limited treatment options. In the last years, treatment options for patients with pancreatic cancer, even in advanced stages of disease, improved. Beside tailored-approaches including chemotherapies in neo or adjuvant intention, new targets as well as vaccination has been implemented into therapeutic strategies. Additionally, embedded into individual treatment strategies, surgical approached were refined providing the potential chance for cure even in metastatic disease.</div><div>The aim of this review article is to describe current and further treatment options for patients with pancreatic cancer showing promising results. However, more efforts are needed to further improve patients’ prognosis.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 8","pages":"Article 103336"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Risk Stratification Score for Predicting First Episode of Upper Gastrointestinal Bleeding in Patients With Cirrhosis","authors":"Nasser Mousa ,&nbsp;Sherif Elbaz ,&nbsp;Alaa Elmetwalli ,&nbsp;Marwa Mansour ,&nbsp;Mostafa Abdelsalam ,&nbsp;Mohammed Abdelaziz ,&nbsp;Manal Hashem ,&nbsp;Ola El-Emam ,&nbsp;Niveen El-wakeel ,&nbsp;Ayman Elgamal ,&nbsp;Mohamed Wahba ,&nbsp;Mohamed Selim ,&nbsp;Muhammad Diasty ,&nbsp;Wesam Elderiny ,&nbsp;Adel El-Assmy ,&nbsp;Eman Abdelkader","doi":"10.1016/j.arcmed.2025.103253","DOIUrl":"10.1016/j.arcmed.2025.103253","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Although endoscopy is the standard method for diagnosing esophageal varices (EV), it is only available in developed countries. This study aims to identify predictors of the initial variceal bleeding (VB) occurrence and to develop a scoring system to predict the VB in patients with cirrhosis.</div></div><div><h3>Methods</h3><div>This study analyzed 236 patients with cirrhosis who experienced their first upper gastrointestinal bleeding (UGIB) episode. A logistic regression model was used to identify independent risk factors for VB and create a scoring system. We assessed the predictive ability of the scoring system using the area under the receiver operating characteristic curve (AUC-ROC).</div></div><div><h3>Results</h3><div>Of the included patients, 154 had EV as the bleeding source. The following were identified as independent risk factors for the first VB episode: age over 60 years, diabetes mellitus (DM), absence of ischemic heart disease, platelets below 130,000/uL, albumin &gt;2.9 g/dL, bilirubin level &gt;1.4 mg/dL, and Child-Pugh score B. A score was developed by assigning points to each risk factor and summing the total score (maximum 7 points). This score was categorized into three risk groups: low risk &lt;3 points; intermediate risk 3–4 points; and high risk ≥5 points. The performance score was assessed using AUC-ROC analysis. Both the low- and high-risk categories had high sensitivity but low specificity, while the intermediate-risk group had balanced sensitivity and specificity.</div></div><div><h3>Conclusion</h3><div>Our score is a valuable noninvasive tool for predicting the first VB episode. It helps determine the urgency of endoscopy and the need for aggressive management strategies.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103253"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653397","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":"Semaphorin 7A Induces Liver Inflammation and Promotes Parenteral Nutrition-Associated Cholestasis via ITGβ1/NF-κB Pathway","authors":"Leilei Shen,&nbsp;Xiaodong Sun,&nbsp;Ruixue Zheng,&nbsp;Min Tao,&nbsp;Sheng Chen","doi":"10.1016/j.arcmed.2025.103244","DOIUrl":"10.1016/j.arcmed.2025.103244","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the mechanistic role of semaphorin 7A (Sema7A) in neonatal parenteral nutrition-associated cholestasis (PNAC).</div></div><div><h3>Methods</h3><div>First, we measured the expression levels of Sema7A and inflammatory factors in both neonates with PNAC and rat models. Then, to investigate the mechanism underlying the regulatory role of Sema7A in hepatic inflammatory injury, we assessed NF-κB pathway activation and monitored inflammatory factor variations following Sema7A/integrin β1 (ITGβ1) inhibition and overexpression in rat models and isolated primary Kupffer cells. Furthermore, liver pathology and cholestatic changes were systematically examined by Sema7A manipulation (inhibition and overexpression) in animal models.</div></div><div><h3>Results</h3><div>Neonates and rats with PNAC showed increased levels of TNF-α and IL-1β, and decreased levels of IL-4 and IL-10. Accordingly, Sema7A, ITGβ1, and P65/p-P65 mRNA and protein expression were elevated. In vitro, Sema7A overexpression activated the NF-κB pathway, which was reversible by ITGβ1 inhibition; conversely, Sema7A knockdown attenuated NF-κB activation, which was partially reversible by ITGβ1 overexpression. In vivo, Sema7A overexpression worsened liver injury and cholestasis through activation of the NF-κB pathway, while its inhibition ameliorated these effects.</div></div><div><h3>Conclusions</h3><div>Sema7A activates the NF-κB signaling pathway in an ITGβ1-dependent manner and exacerbates PN-induced liver injury and cholestasis. Targeting Sema7A may provide a therapeutic strategy to alleviate neonatal PNAC.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103244"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230295","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":"Knowledge, Attitudes and Practices Regarding COVID-19 and Its Vaccination in a High School Population","authors":"Mauricio Rodríguez-Álvarez ,&nbsp;Luis Pablo Cruz-Hervert ,&nbsp;María Eugenia Jiménez-Corona ,&nbsp;Norma Mongua-Rodríguez ,&nbsp;María Dolores Valle Martínez ,&nbsp;Benjamín Barajas Sánchez ,&nbsp;Javier Romero y Fuentes ,&nbsp;Lourdes García-García ,&nbsp;Samuel Ponce-de-León-Rosales","doi":"10.1016/j.arcmed.2025.103241","DOIUrl":"10.1016/j.arcmed.2025.103241","url":null,"abstract":"<div><h3>Background</h3><div>The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on education in Mexico, with extended school closures and the shift to distance learning. The absence of an initial vaccine and the general need for evidence on prevention measures within university communities prompted this study.</div></div><div><h3>Objective</h3><div>To assess the knowledge, attitudes, and practices regarding COVID-19 and its vaccination in the high school community (HSC) of the National Autonomous University of Mexico (UNAM) by the third year of the pandemic.</div></div><div><h3>Methods</h3><div>A cross-sectional, 26-question online survey was conducted among UNAM HSC in September 2022. The data were analyzed using multivariate logistic and linear regression models to identify factors associated with vaccination.</div></div><div><h3>Results</h3><div>A total of 22,000 surveys were collected, 16,789 of which were eligible for analysis. Among these, 16,361 (97.4 %) respondents were vaccinated. The primary reason for nonvaccination was the inability to access a vaccine (37.2 %). Younger respondents (&lt;18 years) were more likely to be unvaccinated, 10–14 years, (OR: 5.36; 95 % CI: 2.12–13.55; <em>p</em> &lt; 0.001); and 15–18 years, (OR: 2.77; 95 % CI: 1.12–6.82, <em>p</em> = 0.028). Individuals with overweight/obesity (OR: 1.39; 95 % CI 1.05–1.85; <em>p</em> = 0.023); immunosuppression (OR: 2.6; 95 % CI: 1.56–4.33; <em>p</em> &lt; 0.001), and those who considered these conditions as risk factors for COVID-19 were significantly more likely to be unvaccinated. Conversely, those who viewed hypertension as a risk factor OR 0.7 (95 % CI 0.53–0.93)) or who were accustomed to face mask use OR 0.28 (95 % CI 0.22–0.35), <em>p</em> &lt; 0.001) were more likely to be vaccinated.</div></div><div><h3>Conclusions</h3><div>We found a high acceptance of COVID-19 vaccination at UNAM HSC, which may have contributed to the safer resumption of in-person activities and helped mitigate the impact of subsequent epidemic waves; the reasons for non-vaccination appear addressable through targeted logistical measures and tailored information.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103241"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154389","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":"Response to: Loneliness and Cognitive Function in Older Adults Living in Latin America: A Systematic Review","authors":"DAVID CAMACHO ,&nbsp;PAMELA TELLA-VEGA ,&nbsp;FERNANDO A. WAGNER ,&nbsp;CAROLINA SANTAMARÍA-ULLOA ,&nbsp;AMANDA LEHNING ,&nbsp;JOSEPH J. GALLO ,&nbsp;CARMEN GARCIA-PEÑA","doi":"10.1016/j.arcmed.2025.103278","DOIUrl":"10.1016/j.arcmed.2025.103278","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103278"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653398","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":"Catheter Ablation of Triggers and Arrhythmogenic Epicardial Substrates in Patients With QT Prolongation","authors":"Yoga Yuniadi,&nbsp;Dicky A. Hanafy,&nbsp;Sunu B. Raharjo,&nbsp;Dony Y. Hermanto","doi":"10.1016/j.arcmed.2025.103257","DOIUrl":"10.1016/j.arcmed.2025.103257","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Long QT syndrome (LQTS) ablation is currently limited to high-risk or refractory cases, targeting the elimination of triggers such as ventricular premature contraction (VPC). However, the characteristics of the underlying substrate and the role of radiofrequency ablation have not been extensively discussed.</div></div><div><h3>Methods and Results</h3><div>Eight symptomatic patients with LQTS (all women; aged 36 ± 10.2 years) underwent 3-D endocardial and epicardial mapping of triggers and/or substrates of ventricular arrhythmias. Genetic testing revealed P1093A mutations in the <em>KCNH2</em> gene, H558R mutations in the <em>SCN5A</em> gene, and K28E mutations in the <em>KCNH2</em> gene in three patients, respectively. A total of 13 VPC morphologies were identified, including five right ventricular outflow tract (RVOT) VPCs, one basal lateral RV, two from inferoapical RV, one from the lateral to annulus tricuspid, three from basal lateral LV and one from epicardial site of the lateral mitral annulus. Epicardial voltage mapping revealed moderate to extensive areas of scar and low voltage in all patients. The localized abnormal ventricular activities (LAVAs) were recorded in all patients and were successfully ablated. The corrected QT interval (QTc) shortened after the epicardial LAVA elimination (594.9 ± 85.98 ms vs. 490 ± 67.49 ms, <em>p</em> = 0.001). During a mean follow-up period of 288 ± 147.4 d (range 170–492 d), two patients experienced ventricular tachycardia (VT) /ventricular fibrillation (VF) recurrence.</div></div><div><h3>Conclusion</h3><div>Regional and limited epicardial LAVAs could be identified in patients with LQTS. Radiofrequency ablation of VPC triggers and epicardial LAVAs had a modest effect on preventing future VT/VF recurrences.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103257"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517925","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":"Health in the Time of Nature Crisis","authors":"Luis Zambrano ,&nbsp;Constantino González-Salazar","doi":"10.1016/j.arcmed.2025.103256","DOIUrl":"10.1016/j.arcmed.2025.103256","url":null,"abstract":"<div><div>Human health faces significant challenges due to global changes driven by human activities, such as climate change and biodiversity loss. These phenomena can impact the quality of life both independently and together. The United Nations Environmental Program has labeled these changes as a “nature crisis” because they affect various aspects of human life. In this context, health issues can be categorized as direct or indirect effects of the nature crisis. Direct effects: i. Temperature change: Heat waves are rapidly increasing mortality rates. ii. Hydrometeorological hazards: Floods can compromise water quality, creating health risks. iii. Air pollution: Climate change can increase the mobility of pollutants, worsening air quality. Indirect effects: i. Vector-borne diseases: For example, changes in weather patterns can alter the distribution of vectors, such as mosquitoes, affecting disease transmission. ii. Water-borne diseases: Increased incidence of diarrheal diseases can occur as water quality deteriorates. iii. Food-borne diseases: For instance, climate change can increase pathogens in agricultural products, posing health risks. Health impacts vary by regions, and vulnerable populations often have lower adaptive capacities. Health policies must be tailored globally and locally to address these issues, emphasizing protection for the most at-risk groups. Collaboration between the health and environmental sectors is essential to solve these growing problems. However, current adaptation policies are constantly challenged by the nature crisis. Therefore, humanity must intensify its efforts to mitigate climate change and reduce land use changes to preserve biodiversity.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103256"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279081","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}