British Journal of Sports Medicine最新文献

{"title":"Genetic liability to sedentary behaviour and cardiovascular disease incidence in the FinnGen and HUNT cohorts","authors":"Laura Joensuu, Kaisa Koivunen, Niko Paavo Tynkkynen, Teemu Palviainen, Jaakko Kaprio, FinnGen Consortium, Marie Klevjer, Karsten Øvretveit, Ulrik Wisløff, Anja Bye, Ulf Ekelund, Elina Sillanpää","doi":"10.1136/bjsports-2024-109491","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109491","url":null,"abstract":"Objective Energy-saving sedentary behaviour may be an evolutionarily selected trait that is no longer advantageous. We investigated the associations between genetic liability to sedentary behaviour and the incidence of the most common cardiovascular disease (CVD). Methods We constructed and validated a genome-wide polygenic score for leisure screen time (PGS LST) as a measure of genetic liability to sedentary behaviour. We performed survival analyses between higher PGS LST and register-based CVDs using the FinnGen cohort (N=293 250–333 012). Replication and exploratory analyses were conducted in an independent Norwegian Trøndelag Health Study (HUNT) cohort (N=35 289). Results In FinnGen, each SD increase in PGS LST was associated with a higher risk of incident CVD (HR: 1.05 (95% CI 1.05 to 1.06)) (168 770 cases over 17 101 133 person-years). The magnitudes of association for the three most common CVDs were 1.09 ((95% CI 1.08 to 1.09), 1.06 ((95% CI 1.05 to 1.07) and 1.05 ((95% CI 1.04 to 1.06) for hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively. Those in the top decile of PGS LST had 21%, 35%, 26% and 19% higher risk of any CVD, hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively, than those in the bottom decile. Associations were replicated in HUNT and remained independent of covariates (socioeconomic status, body mass index and smoking) except for cerebrovascular disease. Besides direct effects, reduced physical activity served as a potential mediating pathway for the observed associations. Conclusions We found that genetic liability to sedentary behaviour is associated with incident CVD, although effect sizes with current PGS remained small. These findings suggest that genetic liability to sedentary behaviour is an under-recognised driver of common CVDs. Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. The used FTC subsample data are in the Biobank of the National Institute for Health and Welfare. Data are available for qualified researchers through a standardised application procedure (see the website <https://thl.fi/en/web/thl-biobank/for-researchers> for details). Access to individual-level genotypes and register data from FinnGen participants can be applied via the Fingenious portal (<https://site.fingenious.fi/en/>) hosted by the Finnish Biobank Cooperative FinBB (<https://finbb.fi/en/>). The register data also needs permission from FinData ([www.findata.fi][1]). Researchers affiliated with a Norwegian research institution can apply for HUNT data access from the HUNT Research Centre ([www.ntnu.edu/hunt][2]) if they have obtained project approval from the Regional Committee for Medical and Health Research Ethics (REC). Researchers not affiliated with a Norwegian research institution should collaborate with and apply through a Norwegian principal investigator. Information on the application and conditi","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"72 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations and regulations for sport events in the heat: ReFORM summary of the International Olympic Committee's consensus statement.","authors":"Anne-Charlotte Dupont, Camille Tooth, Franck Brocherie, Sebastien Racinais, Janne Bouten","doi":"10.1136/bjsports-2024-109607","DOIUrl":"10.1136/bjsports-2024-109607","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"447-449"},"PeriodicalIF":11.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air quality, respiratory health and performance in athletes: a summary of the IOC consensus subgroup narrative review on 'Acute Respiratory Illness in Athletes'.","authors":"Valerie Bougault, Christopher Carlsten, Paolo Emilio Adami, Nicola Sewry, Wolfgang Schobersberger, Torbjørn Soligard, Lars Engebretsen, Richard Budgett, Martin Schwellnus, Ken Fitch","doi":"10.1136/bjsports-2024-109145","DOIUrl":"10.1136/bjsports-2024-109145","url":null,"abstract":"<p><p>With the WHO stating that nearly 99% of the global population is exposed to air pollution levels that increase the risk of chronic diseases, the question of exercising in polluted environments is relevant to the health of athletes. Major sporting events held under conditions of poor air quality (AQ) have highlighted the lack of answers to concerns raised by organisers and athletes about the associated health risks. This evidence-based narrative review compiles current knowledge and identifies gaps regarding the relationship between AQ and sport. It is a summary of a more comprehensive report prepared for the International Olympic Committee (IOC) Medical and Scientific Commission. This article discusses the various sources of air pollutants encountered during exercise, summarises current AQ guidelines and provides insights into AQ conditions during the Paris 2024 Olympic and Paralympic Games (OPG) as well as in Los Angeles over the past four summers, in preparation for the 2028 OPG. It also summarises the effects of air pollution on the respiratory health and performance of athletes, while proposing mitigation strategies, with a particular emphasis on AQ education.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"480-490"},"PeriodicalIF":11.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Canadian guideline for physical activity, sedentary behaviour and sleep throughout the first year post partum","authors":"Margie H Davenport, Stephanie-May Ruchat, Alejandra Jaramillo Garcia, Muhammad Usman Ali, Milena Forte, Nicole Beamish, Karen Fleming, Kristi B Adamo, Émilie Brunet-Pagé, Radha Chari, Kirstin N Lane, Michelle F Mottola, Sarah E Neil-Sztramko","doi":"10.1136/bjsports-2025-109785","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109785","url":null,"abstract":"This consensus aims to provide guidance for postpartum women and people, healthcare providers and exercise professionals on physical activity, sedentary behaviour and sleep throughout the first year postpartum. The development of this guideline followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology and the Appraisal of Guidelines for Research and Evaluation II instrument. The Guideline Consensus Panel consisted of representatives from key professional groups, researchers and methodological experts. Literature was retrieved through searches of 12 online databases, and articles on maternal physical activity, sedentary behaviour or sleep in the first year after childbirth were eligible for inclusion if they reported on any of 21 maternal or infant health outcomes, which were prioritised considering the preferences and values of postpartum individuals. There was no restriction on language, and all study designs were eligible except for case studies. The certainty of evidence was rated using GRADE. This evidence review produced seven systematic reviews, which informed this consensus statement. A Delphi process was conducted to identify relative contraindications to postpartum moderate-intensity to vigorous-intensity physical activity, which informed the development of the Get Active Questionnaire for Postpartum. Evidence to decision tables were developed, and feedback on the recommendations was solicited from end users (healthcare providers, exercise professionals, researchers, policy organisations and postpartum women and people). Adhering to these consensus recommendations for postpartum women and people is likely to result in large improvements in psychological well-being, as well as pelvic, musculoskeletal and cardiometabolic health, and reduced fatigue, while not experiencing adverse events (moderate certainty evidence). Most end users indicated that following these recommendations would be feasible, acceptable and equitable, and likely to require minimal resources from individual and health systems perspectives. PROSPERO registration number CRD42022359282.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"47 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative approaches to injury prevention and performance enhancement in running: insights from PhD research on hamstring strengthening, running biomechanics and energetics, and wearable technology (PhD Academy Award).","authors":"Bas Van Hooren","doi":"10.1136/bjsports-2024-109159","DOIUrl":"10.1136/bjsports-2024-109159","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"511-512"},"PeriodicalIF":11.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sprint running mechanics are associated with hamstring strain injury: a 6-month prospective cohort study of 126 elite male footballers","authors":"Christopher Bramah, Samantha Rhodes, Alexandra Clarke-Cornwell, Thomas Dos’Santos","doi":"10.1136/bjsports-2024-108600","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108600","url":null,"abstract":"Objective To investigate the association between sprint running biomechanics and sprint-related hamstring strain injury (HSI) in elite male football players. Methods This prospective cohort study recruited 126 professional male football players from eight clubs in the English football league, who were followed across a 6-month period. Maximal velocity sprint running videos (240 fps) were collected from five teams during preseason (June to August) and three teams during the in-season period (October to March) and subsequently assessed using the Sprint Mechanics Assessment Score (S-MAS) by a single, blinded assessor. Sprint-related HSI within the previous 12 months and any new MRI-confirmed sprint-related HSI were reported by club medical staff. Incidence rate ratios were calculated using a Poisson regression model to determine the association between S-MAS and new sprint-related HSIs. Results There were 23 players with a previous sprint-related HSI and 17 new HSIs during the follow-up period, with 14 sprint-related injuries. S-MAS values were significantly greater among players with a previous HSI (median difference (MD): 1, p=0.007, 95% CI: 0 to 3) and those sustaining a new sprint-related HSI (MD: 2, p=0.006, 95% CI: 1 to 3) compared with uninjured players. Adjusting for age and previous injury found a significant association between the S-MAS and prospective sprint-related HSIs, with an adjusted incidence rate ratio of 1.33 (95% CI: 1.01 to 1.76) for each one-point increase in S-MAS. Conclusions This is the first study to identify an association between sprint running kinematics and prospective sprint-related HSI in elite male football players. Sprint running mechanics assessed using the S-MAS were associated with both past and future HSIs, with a 33% increase in the risk of a new HSI with every one-point increase in S-MAS. Given the association to injury, evaluating sprint mechanics within rehabilitation and injury prevention may be warranted. Data sharing not applicable as no datasets generated and/or analysed for this study.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis","authors":"Matthew J Gervais, Stephanie-May Ruchat, Muhammad Usman Ali, Talia Sjwed, Brittany A Matenchuk, Sarah Meyer, Michelle F Mottola, Kristi B Adamo, Allison Sivak, Margie H Davenport","doi":"10.1136/bjsports-2024-108449","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108449","url":null,"abstract":"Objective This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics. Design Systematic review with random-effects meta-analysis and meta-regression. Study eligibility criteria Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other interventions (eg, dietary; ‘exercise+cointervention’)); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist–hip ratio). Results 64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI −2.06 to –0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI −1.21 to –0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI −3.01 to –0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose–response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference −0.13; 95% CI −0.48, 0.21, I2 0%) compared with no exercise. Conclusions These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR. PROSPERO registration number CRD42022359282. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus recommendations to inform an update of the NCAA Mental Health Best Practices","authors":"Emily Kroshus-Havril, Carey Wheelhouse, James Houle, Jessica Bartley, Darcy Gruttadaro, Casey Pick, Ashwin L Rao, Alicia Fine, Jean Merrill, Deena Casiero, Brian Hainline","doi":"10.1136/bjsports-2024-109183","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109183","url":null,"abstract":"We sought to generate consensus-based recommendations to inform updates to the National Collegiate Athletic Association (NCAA) Mental Health Best Practices. A two-phase modified Delphi consensus process was used to identify foundational premises and actionable recommendations for NCAA member schools. Participants were members of the NCAA’s Mental Health Advisory Group (n=31), including student-athletes, representatives from leading national organisations involved in college student or athlete mental health and higher education, and licensed mental health providers who work with student-athletes. The consensus process produced 11 foundational premises and 36 recommendation statements that were considered useful and feasible for NCAA member schools. Foundational premises addressed multiple levels of risk factors that may adversely impact student-athlete mental health. Recommendations for member schools were broadly grouped into (1) creating healthy environments that support mental health and promote well-being; (2) developing procedures for identifying student-athletes with mental health symptoms and disorders, including the use of validated mental health screening tools; (3) establishing mental health action plans that outline referral pathways of student-athletes to licensed mental health providers; and (4) ensuring licensure of providers who oversee and manage student-athlete mental healthcare. These premises and recommendations provide guidance for understanding and supporting student-athlete mental health needs.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"15 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory fitness and health in children and adolescents: an overview of systematic reviews with meta-analyses representing over 125 000 observations covering 33 health-related outcomes","authors":"Iryna Demchenko, Stephanie A Prince, Katherine Merucci, Cristina Cadenas-Sanchez, Jean-Philippe Chaput, Brooklyn J Fraser, Taru Manyanga, Ryan McGrath, Francisco B Ortega, Ben Singh, Grant R Tomkinson, Justin J Lang","doi":"10.1136/bjsports-2024-109184","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109184","url":null,"abstract":"Objective To synthesise data on the associations between cardiorespiratory fitness (CRF) and health in children and adolescents, evaluate the certainty of evidence and identify knowledge gaps. Design An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE. Data sources Medline, Embase, Scopus, CINAHL and SPORTDiscus were searched from January 2002 to March 2024. Eligibility criteria for selected studies Systematic reviews with meta-analyses exploring CRF and health in children and adolescents aged <18 years. Results From the 9062 records identified, 14 reviews were included. Meta-analysed data from 125 164 observations covering 33 health outcomes were compiled, showing favourable (n=26) or null (n=7) associations with CRF. Among general populations, the associations were weak-to-moderate, with favourable links between CRF and indicators of anthropometry and adiposity, cardiometabolic and vascular health, and mental health and well-being. Among clinical populations, CRF was lower in participants with a condition compared with healthy controls, with the largest difference for newly diagnosed cancer (mean difference=−19.6 mL/kg/min; 95%CI: −21.4,–17.8). Patients with cystic fibrosis had a greater risk for all-cause mortality when comparing low CRF vs. high (relative risk=4.9; 95%CI: 1.1, 22.1). The certainty of evidence ranged from very low to moderate. Conclusion CRF shows promising links to numerous health outcomes in paediatric populations, though the low certainty of evidence calls for further research. High-quality longitudinal evidence is warranted to confirm the findings and investigate a predictive role of childhood CRF for future health. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"20 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of knee osteoarthritis with a single injection of autologous micro-fragmented adipose tissue is not superior to a placebo saline injection: a blinded randomised controlled trial with 2-year follow-up","authors":"Kristoffer W Barfod, Lars Blønd, Rasmus Kramer Mikkelsen, Jasmin Bagge, Lisbet Rosenkrantz Hölmich, Thomas Kallemose, Anders Troelsen, Per Hölmich","doi":"10.1136/bjsports-2024-108732","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108732","url":null,"abstract":"Objective To investigate if treatment with a single injection of autologous micro-fragmented adipose tissue improved patient-reported health compared with a placebo saline injection in patients suffering from pain and functional impairment due to knee osteoarthritis. Methods We conducted a randomised controlled trial with patients blinded to the treatment and allocated in a 1:1 ratio to one of two parallel groups. Patients aged 18–70 years with Kellgren-Lawrence grades 2–3 in the tibiofemoral joint and suffering from pain and functional impairment of the knee were eligible for inclusion. Abdominal adipose tissue was harvested by liposuction in all patients. The active treatment group was treated with an intra-articular injection of autologous micro-fragmented adipose tissue, and the placebo group with isotonic saline. The primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS4) evaluated at 6 months. Results 238 patients were assessed for eligibility and 120 (mean age 52.2, 58% female) included from January 2019 to February 2022. There were no statistically significant differences between the active treatment and the placebo group at any time point. Both groups showed statistically significant and clinically relevant improvements from baseline to 6, 12 and 24 months. Mean KOOS4 at 6 months was 55.5 (95% CI 51.4 to 59.6) for the active treatment group and 51.5 (95% CI 47.4 to 55.6) for the placebo group. Conclusion This study did not show superiority of micro-fragmented adipose tissue compared with a placebo saline injection for the treatment of knee osteoarthritis. Trial registration number [NCT03771989][1]. Data are available upon reasonable request. Individual deidentified participant data that underlie the results reported in this paper (text, tables, figures and appendices) and the study protocol will be shared if requested and approved by the Danish Data Regulation Authority. Data will be available beginning 1 month and ending 5 years after publication of this paper. Data will be available for researchers who provide a methodologically sound scientific proposal, which has been approved by an ethical committee. Proof of the latter should be provided. Analyses should achieve the aims reported in the approved proposal. Proposals for data should be directed to the corresponding author (Kristoffer.barfod@regionh.dk). [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03771989&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F18%2Fbjsports-2024-108732.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"214 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}