British journal of hospital medicine最新文献

{"title":"Improving Understanding, Recognition and Treatment for Men With Anorexia Nervosa.","authors":"James Downs, Clive Kelly","doi":"10.12968/hmed.2024.0643","DOIUrl":"https://doi.org/10.12968/hmed.2024.0643","url":null,"abstract":"<p><p><b>Aims/Background</b> Anorexia Nervosa (AN) in males is often overlooked due to the traditional perception of eating disorders as female concerns. Despite this, there has been an increased focus on male presentations. Research evidence, including concerns from people with lived experience, highlights specific risks and unmet clinical needs as a result of delayed help-seeking, inaccessible services, and treatment that does not account for men's needs. <b>Methods</b> Published research and personal narrative from an author with lived experience are combined to assess (1) existing evidence and gaps in knowledge and treatment for males with AN, and (2) solutions which may address challenges across research, policy, and clinical practice. <b>Results</b> There is an increased prevalence of AN amongst males, with most recent data from National Health Service (NHS) England showing a faster increase in hospitalisations amongst males compared with females. However, the quantity and quality of prevalence data and research into the drivers of this trend are severely lacking. The exclusion of males from clinical research has hindered efforts to assess the efficacy of current AN treatments, despite emerging evidence for males-specific symptoms and health impacts across biopsychosocial domains. These include more frequent use of excessive exercise, feelings of emasculation, neurodivergence, and specific physiological risks occurring at higher weights than females. These factors combine with under-resourced treatment provision which often feels exclusionary to males to create an increased risk of death and significant barriers to recovery. <b>Conclusion</b> Evidenced solutions for providing more timely recognition and effective treatment for males with AN are limited, emphasising the importance of further research. Present-day clinical practice needs to ensure the safe medical management of males with AN, taking an integrated approach to treatment that accounts for co-occurring conditions and minority status identities. Being more responsive to the needs of males with AN and removing the barriers to effective care can be aided by projects that collaborate with men with lived experience.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483190","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":"Investigation of Knowledge, Attitudes, and Practices Related to Pulmonary Rehabilitation Among AECOPD Patients During the Transitional Period After Discharge and Analysis of Influencing Factors.","authors":"Tingting Zhu, Xiuyun Chen, Fang Li, Xinyu Zhu, Qing Wang, Junjun Yang, Jixiang Bo","doi":"10.12968/hmed.2025.0146","DOIUrl":"https://doi.org/10.12968/hmed.2025.0146","url":null,"abstract":"<p><p><b>Aims/Background</b> Pulmonary rehabilitation is widely recognized as one of the most effective treatment strategies to improve dyspnea, health status, and exercise endurance in patients with chronic obstructive pulmonary disease (COPD). However, participation in pulmonary rehabilitation among patients experiencing acute exacerbation of COPD remains suboptimal. Current research primarily focuses on the knowledge, attitude, and practice (KAP) of pulmonary rehabilitation among COPD patients during hospitalization or at home, with limited studies investigating the transitional period following discharge. This study aimed to investigate the KAP of pulmonary rehabilitation during the discharge transition period and identify the associated influencing factors, providing significant reference and guidance for improving the rehabilitation outcomes in COPD patients. <b>Methods</b> This cross-sectional study employed a convenience sampling method to recruit patients with acute exacerbation of COPD (AECOPD) treated at Jiangsu Subei People's Hospital between June 2023 and May 2024. Data collection instruments included a general data questionnaire, a COPD-specific pulmonary rehabilitation KAP questionnaire, and the Mini Nutrition Assessment-Short Form (MNA-SF). Univariate and multivariate linear regression analyses were conducted to identify factors influencing KAP of pulmonary rehabilitation in AECOPD patients during the discharge transition period. <b>Results</b> A total of 130 questionnaires were distributed, with 128 valid responses collected, yielding an effective response rate of 98.46%. The overall KAP score of AECOPD patients during the discharge transition period was 57.52 ± 8.92. Among the three dimensions, mean scores from the highest to the lowest were attitude (2.54 ± 0.29), practice (2.39 ± 0.36), and knowledge (2.15 ± 0.36). Univariate analysis revealed significant differences in KAP scores based on age, education level, monthly household income per capita, smoking history, degree of dyspnea, and nutritional status of AECOPD patients during the transitional discharge period (<i>p</i> < 0.05). Multivariate linear regression identified these same factors as significant influencers of KAP levels (<i>p</i> < 0.05). <b>Conclusion</b> The KAP of pulmonary rehabilitation among AECOPD patients during the discharge transition period is at a moderate level and is significantly influenced by age, educational level, monthly household income per capita, smoking history, degree of dyspnea, and nutritional status. Healthcare professionals should design targeted interventions based on these factors to help patients recognize the importance and necessity of pulmonary rehabilitation, establish correct attitudes about it, and improve compliance with it, thereby improving long-term outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483192","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 Predictive Value of Serum miR-141-3p, Fibrinogen, and Prostate-Specific Antigen Levels for Bone Metastasis in Prostate Cancer.","authors":"Jianwen Li, Weining Wang","doi":"10.12968/hmed.2024.0881","DOIUrl":"https://doi.org/10.12968/hmed.2024.0881","url":null,"abstract":"<p><p><b>Aims/Background</b> Prostate cancer is a prevalent malignancy among men that frequently progresses to bone metastasis, significantly affecting prognosis and quality of life. Serum biomarkers such as miR-141-3p, fibrinogen (FIB), and prostate-specific antigen (PSA) are emerging as promising tools for early detection and personalised interventions for bone metastasis. This study investigated their predictive value for bone metastasis in prostate cancer. <b>Methods</b> Conducted from March 2018 to March 2023, this study included 100 prostate cancer patients monitored over time. All participants underwent radionuclide bone imaging combined with positron emission tomography-computed tomography (PET-CT). Patients who developed bone metastasis (32 cases) were classified as the metastasis group, while those without (68 cases) were categorised as the non-metastasis group. Additionally, a control group of 50 healthy volunteers was established for comparison. A retrospective analysis assessed serum miR-141-3p, FIB, and PSA levels across the three groups. Clinical data were analysed to identify factors influencing bone metastasis using univariate and multivariate analyses, after which a prediction model was created to evaluate its prognostic value. <b>Results</b> Serum levels of miR-141-3p, FIB, and PSA were significantly different among the three groups, with the highest levels in the metastasis group, followed by the non-metastasis group, and the lowest in the control group (<i>p</i> < 0.05). Both univariate and multivariate analyses confirmed that these serum biomarkers significantly influenced the occurrence of bone metastasis. The combined predictive model demonstrated high clinical value for assessing the risk of bone metastasis in prostate cancer, with an area under the curve (AUC) of 0.923 (95% confidence interval [CI]: 0.868-0.979, <i>p</i> < 0.05). <b>Conclusion</b> Serum levels of miR-141-3p, FIB, and PSA are elevated in prostate cancer patients, particularly those with bone metastasis. The predictive model utilising these biomarkers effectively forecasts the likelihood of bone metastasis.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483209","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":"Combined Effects of Donepezil and Memantine on Behavioral and Psychological Symptoms, Cognitive Function, and Daily Living Abilities in Patients With Alzheimer's Disease.","authors":"Hongyan Tu, Si Zhou, Jixin Lin","doi":"10.12968/hmed.2024.1037","DOIUrl":"https://doi.org/10.12968/hmed.2024.1037","url":null,"abstract":"<p><p><b>Aims/Background</b> Combined with memantine, donepezil has a beneficial impact on the treatment of moderate to severe Alzheimer's disease (AD), but it can potentially increase the risk of adverse events. The aim of this study is to compare the effects of low-dose and high-dose donepezil combined with memantine on the behavioral and psychological symptoms, cognitive function, and daily living abilities of patients with moderate to severe AD, and to explore their safety. <b>Methods</b> This retrospective study includes 106 AD patients who received treatment in the Third People's Hospital of Fuyang from January 2022 to January 2024. The patients were grouped according to treatment regimen: patients receiving low-dose donepezil (5 mg/day) combined with memantine were included in the low-dose group (<i>n</i> = 45), and those receiving high-dose donepezil (10 mg/day) combined with memantine were included in the high-dose group (<i>n</i> = 61). The assessment results of behavioral and psychological symptoms, cognitive function, daily living ability, quality of life, sleep quality, as well as the occurrence of adverse reactions during treatment were obtained from electronic medical records for the two groups of patients before and after 24 weeks of treatment, and were compared using appropriate statistical tests. <b>Results</b> After 24 weeks of treatment, the scores of neuropsychiatric inventory (NPI) and behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) were similar between the two groups (<i>p</i> > 0.05). The scores of Mini-Mental State Examination (MMSE) and Alzheimer's disease assessment scale-cognitive section (ADAS-Cog) were similar between the two groups (<i>p</i> > 0.05). The scores of activities of daily living (ADL) were comparable between the two groups (<i>p</i> > 0.05), and the low-dose group had significantly higher quality of life-Alzheimer's disease (QOL-AD) scores compared to the high-dose group (<i>p</i> < 0.05). The Pittsburgh sleep quality index (PSQI) scores of patients in the high-dose group were significantly higher than those before treatment and those in the low-dose group (<i>p</i> < 0.05). There was no statistically significant difference in PSQI scores between the low-dose group before and after treatment (<i>p</i> > 0.05). During the treatment period, the total incidence of adverse reactions in the low-dose group was significantly lower than that in the high-dose group (11.11% vs. 27.87%, <i>p</i> < 0.05). <b>Conclusion</b> Both 5 mg/day or 10 mg/day donepezil in combination with memantine holds the potential to improve behavioral and psychological symptoms, cognitive function and daily living abilities in patients with moderate-to-severe AD. In addition, high doses of donepezil may lead to decreased sleep quality in patients, increased risk of adverse reactions, and less improvement in quality of life than low doses.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483183","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":"Anaesthetic Management of Patients With Do-Not-Attempt Resuscitation Orders: A Case for and Against Suspension During Anaesthesia and Surgery.","authors":"Jieling Jacqueline Wu","doi":"10.12968/hmed.2024.0966","DOIUrl":"10.12968/hmed.2024.0966","url":null,"abstract":"<p><p>Managing patients with Do-Not-Attempt Resuscitation (DNAR) orders during anaesthesia and surgery presents an ethical dilemma: should DNAR orders be temporarily suspended or continued to allow for essential, reversible interventions? This paper examines arguments for and against suspension, emphasising the need for preoperative discussions to balance patient autonomy with perioperative safety and delivery of adequate care.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483088","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 Novel Small Molecule Drugs in the Management of Inflammatory Bowel Disease.","authors":"Nadia Eden, Elizabeth Gaunt, Elaine Ming San Ong, Kassem Sharif, Christian Selinger","doi":"10.12968/hmed.2024.0798","DOIUrl":"https://doi.org/10.12968/hmed.2024.0798","url":null,"abstract":"<p><p>Treatment algorithms have traditionally been based on biological therapy when conventional therapy was not successful in controlling inflammatory bowel disease (IBD). Novel small molecule drugs (SMDs) for IBD include the Janus Kinase (JAK) inhibitors Tofacitinib, Filgotinib and Upadactinib and the sphingosine-1 phosphate (S1P) inhibitors Ozanimod and Etrasimod. SMDs have advantages over biologics, such as oral administration, lack of immunogenicity, and rapid onset of action. All agents are effective in treating ulcerative colitis, while Upadactinib is the only SMD for Crohn's disease. There is growing interest in the use of JAK inhibitors for acute severe colitis. However, safety profiles are distinct from biologics. Clinicians need to be aware of the need for additional lipid monitoring for JAK inhibitors. S1P inhibitors require pre-treatment electrocardiograms to reduce the risk of bradycardia and retinal exams at least in high-risk patients to avoid macular oedema. In this review we highlight the key evidence on efficacy and safety for general hospital physicians.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483210","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":"Exploration of the GM-IC-DLBCL Axis: A Mendelian Randomization Analysis of the Gut Microbiota, Immune Cells, and Diffuse Large B-Cell Lymphoma.","authors":"Haoqing Chen, Yan Gao, Huiqiang Huang","doi":"10.12968/hmed.2025.0068","DOIUrl":"https://doi.org/10.12968/hmed.2025.0068","url":null,"abstract":"<p><p><b>Aims/Background</b> This study aims to investigate the causal relationship among gut microbiome (GM), immune cells (IC), and diffuse large B-cell lymphoma (DLBCL) using the Mendelian randomization (MR) approach. <b>Methods</b> This analysis included GM data (471 taxa; n = 5959), genome-wide association study (GWAS) data on 731 IC phenotypes, and DLBCL data (1373 cases and 345,118 controls) from the FinnGen Consortium. A two-sample bidirectional MR analysis established causal links between GM, IC phenotypes, and DLBCL, followed by a two-step mediation analysis to assess immune cell mediation. <b>Results</b> Potential causal links were observed among 15 GM taxa, 38 IC phenotypes, and DLBCL. Mediation analysis revealed 14 possible gut microbiota-immune cell-diffuse large B-cell lymphoma (GM-IC-DLBCL) axes, with quantifiable effects in five. The maximum and minimum mediating effects included <i>g__Roseibacillus</i> (odds ratio [OR] = 3.30, 95% confidence interval [CI]: 1.22-8.91, <i>p</i> < 0.05; 10.4% via \"CD45RA on naive CD8br cells\") and <i>s__Lachnospira rogosae</i> (OR = 1.14, 95% CI: 1.01-1.28, <i>p</i> < 0.05; 5.8% via \"CD127 on CD28- CD8br cells\"), respectively. <b>Conclusion</b> This study suggests that GM may contribute to DLBCL pathogenesis through IC mechanisms, supporting the potential existence of a GM-IC-DLBCL axis.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-17"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483188","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 Current State of Artificial Intelligence on Detecting Pulmonary Embolism via Computerised Tomography Pulmonary Angiogram: A Systematic Review.","authors":"Moustafa Said Taman Ahmed Hassan, Mahmoud Abdrabo Mahmoud Elhotiby, Viraj Shah, Henry Rocha, Arian Arjomandi Rad, George Miller, Johann Malawana","doi":"10.12968/hmed.2024.0757","DOIUrl":"https://doi.org/10.12968/hmed.2024.0757","url":null,"abstract":"<p><p><b>Aims/Background</b> Pulmonary embolism (PE) is a life-threatening condition with significant diagnostic challenges due to high rates of missed or delayed detection. Computed tomography pulmonary angiography (CTPA) is the current standard for diagnosing PE, however, demand for imaging places strain on healthcare systems and increases error rates. This systematic review aims to assess the diagnostic accuracy and clinical applicability of artificial intelligence (AI)-based models for PE detection on CTPA, exploring their potential to enhance diagnostic reliability and efficiency across clinical settings. <b>Methods</b> A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Excerpta Medica Database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane, PubMed, and Google Scholar were searched for original articles from inception to September 2024. Articles were included if they reported successful AI integration, whether partial or full, alongside CTPA scans for PE detection in patients. <b>Results</b> The literature search identified 919 articles, with 745 remaining after duplicate removal. Following rigorous screening and appraisal aligned with inclusion and exclusion criteria, 12 studies were included in the final analysis. A total of three primary AI modalities emerged: convolutional neural networks (CNNs), segmentation models, and natural language processing (NLP), collectively used in the analysis of 341,112 radiographic images. CNNs were the most frequently applied modality in this review. Models such as AdaBoost and EmbNet have demonstrated high sensitivity, with EmbNet achieving 88-90.9% per scan and reducing false positives to 0.45 per scan. <b>Conclusion</b> AI shows significant promise as a diagnostic tool for identifying PE on CTPA scans, particularly when combined with other forms of clinical data. However, challenges remain, including ensuring generalisability, addressing potential bias, and conducting rigorous external validation. Variability in study methodologies and the lack of standardised reporting of key metrics complicate comparisons. Future research must focus on refining models, improving peripheral emboli detection, and validating performance across diverse settings to realise AI's potential fully.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-21"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483197","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":"Prostate Specific Antigen (PSA) Testing and Cancer Detection: Guidance Notes for the Non-Urologist.","authors":"Patrick Juliebø-Jones, Christian Beisland","doi":"10.12968/hmed.2024.1035","DOIUrl":"10.12968/hmed.2024.1035","url":null,"abstract":"<p><p>Prostate cancer is the most frequently diagnosed cancer in men and is a leading cause of cancer-related deaths. Prostate specific antigen (PSA) is one of the key tests that can aid in making such a diagnosis. It is, however, a test with both advantages and disadvantages. Despite having been a part of clinical practice for over 40 years, its use still represents many challenges. Clinicians across all specialties can benefit from gaining deeper insight into how it can be effectively integrated into their practice.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483195","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":"A Novel Glucokinase Mutation Causing Maturity-onset Diabetes of the Young: A Case Report.","authors":"Dongying Nie, Xueyong Lou","doi":"10.12968/hmed.2024.1056","DOIUrl":"10.12968/hmed.2024.1056","url":null,"abstract":"<p><p>Maturity-onset diabetes of the young (MODY) is a group of monogenic disorders characterized by early-onset, non-insulin-dependent diabetes mellitus, typically inherited in an autosomal dominant manner. MODY type 2 (MODY2), also known as glucokinase-MODY (GCK-MODY), results from mutations in the <i>GCK</i> gene. Unlike type 1 and 2 diabetes, MODY is generally mild and has a different pathophysiology. This case report describes a 3-year-old boy diagnosed with MODY2 who presented with elevated fasting blood glucose levels in the absence of ketosis. His family history revealed diabetes spanning three consecutive generations, with his mother having a history of gestational diabetes mellitus (GDM). Whole-exome sequencing identified a heterozygous mutation in the <i>GCK</i> gene (c.1007C > A (p.Ser336*)) in the patient and his mother. The diagnosis of MODY2 allowed for tailored management, with blood glucose levels successfully controlled through dietary regulation and appropriate exercise without pharmacological intervention. This report underscores the importance of genetic testing in pediatric hyperglycemia cases to avoid unnecessary treatment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483087","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}