Obesity (Silver Spring, Md.)最新文献

{"title":"Lipid-associated macrophages are more abundant in subcutaneous than visceral adipose tissue in patients with obesity.","authors":"Marjorie Reyes-Farias, Pablo Fernández-García, Patricia Corrales, Lorena González, David Navarro-Sanagustín, Andrea Soria-Gondek, Silvia Pellitero, Jordi Tarascó, Pau Moreno, José M Balibrea, Laia Gatell, Lauro Sumoy, María Galán, Ester Martínez, Francesc Villarroya, Rubén Cereijo, Laura Herrero, David Sánchez-Infantes","doi":"10.1002/oby.24323","DOIUrl":"https://doi.org/10.1002/oby.24323","url":null,"abstract":"<p><strong>Objective: </strong>Because white adipose tissue is infiltrated by several immune cells and their signature in individuals with obesity has not been fully characterized, we wanted to study the most abundant population, which is macrophages, a subtype of myeloid cell.</p><p><strong>Methods: </strong>To address this objective, we performed transcriptomic analysis of subcutaneous adipose tissue (SAT)- and visceral adipose tissue (VAT)-infiltrated CD11b⁺ myeloid cells from individuals with severe obesity.</p><p><strong>Results: </strong>Our results showed that gene expression in human white adipose tissue-infiltrated CD11b⁺ myeloid cells was depot-dependent. The expression of lipid-associated macrophage biomarkers was higher in SAT- than VAT-infiltrated CD11b⁺ cells (TREM2, CD9, GPNMB, CD68). In contrast, VAT-infiltrated CD11b⁺ cells overexpressed genes associated with a perivascular M2-like adipose tissue macrophage signature (LYVE1, TIMD4, MRC1). In addition, no classical gene expression polarization (M1 and M2) was shown when VAT and SAT CD11b⁺ cells were compared. Finally, high levels of CD248, a sensor of lipids associated with insulin resistance, were found to be overexpressed in SAT- compared with VAT-infiltrated CD11b⁺ myeloid cells.</p><p><strong>Conclusions: </strong>This study characterizes for the first time the macrophage biomarker signature in human VAT- and SAT-infiltrated CD11b⁺ myeloid cells from individuals with severe obesity. Further studies are required to elucidate their potential role and specific function in the immunometabolism of individuals with obesity.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Weight-loss drugs like Wegovy could lead to an increased risk of fragility fractures in population at risk\".","authors":"Robert F Kushner, Donna H Ryan, Nina M Harder-Lauridsen, Ole Kleist Jeppesen, Klaus Kallenbach, A Michael Lincoff, Ildiko Lingvay","doi":"10.1002/oby.24345","DOIUrl":"https://doi.org/10.1002/oby.24345","url":null,"abstract":"","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tirzepatide for reduction of morbidity and mortality in adults with obesity: rationale and design of the SURMOUNT-MMO trial.","authors":"Carolyn S P Lam, Angel Rodriguez, Ali Aminian, Ele Ferrannini, Hiddo J L Heerspink, Ania M Jastreboff, Luke J Laffin, Ambarish Pandey, Kausik K Ray, Paul M Ridker, Arun J Sanyal, Hannele Yki-Jarvinen, Denise Mason, Michelle Strzelecki, Amy K Bartee, Can Cui, Karla Hurt, Bruno Linetzky, Mathijs C Bunck, Steven E Nissen","doi":"10.1002/oby.24332","DOIUrl":"https://doi.org/10.1002/oby.24332","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is a major cause of morbidity and mortality worldwide. Tirzepatide is a glucose-dependent insulinotropic polypeptide receptor and glucagon-like peptide-1 receptor agonist providing substantial weight reduction and metabolic benefits both in type 2 diabetes and obesity. We hypothesized that tirzepatide can improve morbidity and mortality in adults with obesity or overweight but without diabetes.</p><p><strong>Methods: </strong>SURMOUNT-MMO is a randomized, double-blind, event-driven trial to investigate the impact on morbidity and mortality with once-weekly tirzepatide compared with placebo in adults living with obesity, without diabetes, and with, or at risk of, cardiovascular disease. The primary endpoint is time to first occurrence of a five-component composite outcome of nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, heart failure events, or death from any cause.</p><p><strong>Results: </strong>The trial will enroll ~15,000 participants aged ≥40 from 664 sites across 27 countries with BMI ≥27.0 kg/m² and either established cardiovascular disease or multiple cardiovascular risk factors.</p><p><strong>Conclusions: </strong>SURMOUNT-MMO will provide evidence of the clinical benefits of tirzepatide on multiple outcomes among individuals with overweight or obesity but without diabetes. This is the first outcome trial of an incretin medication that assesses both primary and secondary cardiovascular disease prevention.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat taste sensitivity in women with obesity: transcriptomic analysis of fungiform papillae before and after bariatric surgery.","authors":"Arnaud Bernard, Corentin Richard, Loredana Radoi, Romain Boidot, Séverine Ledoux, Philippe Besnard","doi":"10.1002/oby.24325","DOIUrl":"https://doi.org/10.1002/oby.24325","url":null,"abstract":"<p><strong>Objective: </strong>Fat taste sensitivity has been implicated in long-term weight loss after bariatric surgery. Unexpectedly, improvement of orosensory fat acuity was not systematic in operated patients.</p><p><strong>Methods: </strong>Obesity-induced alterations of gene expression in gustatory papillae having been recently reported, we have explored the fungiform transcriptomic activity in the bariatric surgery context. Fat taste detection thresholds (three-alternative ascending forced-choice tests) alongside transcriptomic profiling of freshly isolated fungiform papillae were assessed in women with severe obesity before and 6 months after sleeve gastrectomy.</p><p><strong>Results: </strong>According to evolution of post surgery detection thresholds, lipid-improved and -unimproved subgroups were identified, despite similar initial anthropometric parameters. Lower weight loss and higher plasma fasting insulin, C-reactive protein, and fibrinogen levels distinguished lipid-unimproved patients. This subgroup also overexpressed genes involved in inflammation and apoptosis, with certain ones being positively correlated with high lipid detection thresholds (low sensitivity), whereas the key gene of taste bud cell signaling, TRPM5, was down-expressed. In lipid-improved patients, genes implicated in cell renewal, neuronal function, and receptor recycling were upregulated and associated with better lipid detection efficiency. Pathway enrichment identified immune and anti-inflammatory activities in lipid-unimproved and -improved groups, respectively.</p><p><strong>Conclusions: </strong>These findings collectively suggest that changes in gene expression within gustatory papillae contribute to fat taste sensitivity after sleeve gastrectomy.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight loss drugs like Wegovy could lead to an increased risk of fragility fractures in population at risk.","authors":"Léa Karam, Julien Paccou","doi":"10.1002/oby.24341","DOIUrl":"10.1002/oby.24341","url":null,"abstract":"","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in weight loss and glycemic outcomes after sleeve gastrectomy by race and ethnicity.","authors":"Sally M Vanegas, Silvia Curado, Boyan Zhou, Nicholas Illenberger, Ericka N Merriwether, Evelyn Armijos, Ann Marie Schmidt, Christine Ren-Fielding, Manish Parikh, Brian Elbel, José O Alemán, Melanie Jay","doi":"10.1002/oby.24320","DOIUrl":"https://doi.org/10.1002/oby.24320","url":null,"abstract":"<p><strong>Objective: </strong>This study examined racial and ethnic differences in percent total weight loss (%TWL) and glycemic improvement following sleeve gastrectomy (SG) and explored the role of socioeconomic and psychosocial factors in postsurgical outcomes.</p><p><strong>Methods: </strong>This longitudinal study included patients who underwent SG between 2017 and 2020, with follow-up visits over 24 months.</p><p><strong>Results: </strong>Non-Hispanic Black (NHB) participants had lower %TWL at 3, 12, and 24 months compared with Hispanic (H) and non-Hispanic White (NHW) participants. Fat mass index was initially lower in NHB, with smaller reductions over time and significant group differences persisting at 24 months. NHB participants had higher baseline fat-free mass index values; by 24 months, fat-free mass index values were lower in H participants. Hemoglobin A1c decreased across all groups but remained consistently higher in NHB and H compared with NHW at 24 months. NHB participants reported higher perceived discrimination, sleep disturbance, and perceived stress than H and NHW participants at all time points. Employment status predicted %TWL at 12 months. There was a significant interaction between race and ethnicity and employment status observed at 12 and 24 months, suggesting that employment-related disparities could impact surgical outcomes.</p><p><strong>Conclusions: </strong>NHB participants experienced less favorable outcomes following SG, emphasizing the need for tailored interventions addressing socioeconomic and psychosocial disparities.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of obesity-associated plasma markers on adipose stem cell function and epigenetic regulation.","authors":"Andressa França Sousa Bispo, Jussara de Jesus Simao, Miguel Ambrizzi Moraes, Ana Beatriz Marques Abel, Victor Tadeu Gonçalves Plata, Monica Marques Telles, André Valente Santana, Paula Volpe, Lucia Maria Armelin-Correa, Maria Isabel Cardoso Alonso-Vale","doi":"10.1002/oby.24321","DOIUrl":"https://doi.org/10.1002/oby.24321","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the correlations between obesity-related plasma markers and epigenetic/inflammatory changes in white adipose tissue (WAT), focusing on adipose-derived stem cells (ASCs). We hypothesize that obesity modulates histone H3K27 marks, modified by demethylases (lysine-specific demethylase 6A and 6B [KDM6A/KDM6B]) and acetylases (CREB-binding protein [CREBBP]/histone acetyltransferase EP300), affecting ASC function.</p><p><strong>Methods: </strong>Serum and visceral WAT (omental region) was collected from male patients (n = 16, 30-50 years old) undergoing elective gastric or bariatric surgery. BMI and obesity markers were correlated with changes in ASCs (transcript expression, proliferation, and secretion) using reverse transcriptase-polymerase chain reaction.</p><p><strong>Results: </strong>ASCs from individuals with higher BMI exhibited slower proliferation, increased inflammatory profile, and reduced adipogenic potential, with lower expression of key adipogenic genes. H3K27 acetylase transcripts were also negatively correlated with adipogenesis regulators. Moreover, C-C motif chemokine 2 (CCL2) and KDM6A expression was higher in the group with obesity, as were CREBBP and EP300. Finally, leptin levels positively correlated with serum, WAT, and ASC CCL2 expression. In vitro, leptin exposure enhanced CCL2 expression/secretion and increased KDM6A/KDM6B and EP300 transcription.</p><p><strong>Conclusions: </strong>In vitro leptin exposure enhanced CCL2 expression/secretion and increased KDM6A/KDM6B and EP300 transcription, highlighting how obesity-driven epigenetic mechanisms, including leptin-mediated pathways, disrupt ASC plasticity and perpetuate adipose tissue dysfunction, offering novel therapeutic targets for metabolic disease intervention.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in weight and glycemic control following obesity treatment with semaglutide or tirzepatide by discontinuation status.","authors":"Hamlet Gasoyan, W Scott Butsch, Rebecca Schulte, Nicholas J Casacchia, Phuc Le, Christopher B Boyer, Marcio L Griebeler, Bartolome Burguera, Michael B Rothberg","doi":"10.1002/oby.24331","DOIUrl":"https://doi.org/10.1002/oby.24331","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to characterize changes in body weight and glycated hemoglobin (in those with prediabetes at baseline) through 12 months by obesity pharmacotherapy discontinuation status.</p><p><strong>Methods: </strong>This retrospective cohort study used electronic health record data from a large health system in Ohio and Florida to identify adults with overweight or obesity without type 2 diabetes who initiated injectable semaglutide or tirzepatide between 2021 and 2023. Treatment discontinuation was defined by a >90-day gap between exhaustion of previous supply and next dispense or end of study follow-up (December 2024) and was classified into early discontinuation (i.e., within 3 months of index date) and late discontinuation (i.e., within 3-12 months).</p><p><strong>Results: </strong>We identified 7881 patients; 6109 received semaglutide, and 1772 received tirzepatide. A total of 80.8% had low maintenance dosages. Mean (SD) percentage weight reduction at 1 year was 8.7% (9.6%); and it was 3.6% (8.1%) with early discontinuation, 6.8% (9.1%) with late discontinuation, and 11.9% (9.2%) with non-discontinuation (p < 0.001). The mean (SD) absolute reduction in percent glycated hemoglobin at 1 year was 0.1 (0.4) with early discontinuation, 0.2 (0.4) with late discontinuation, and 0.4 (0.4) with non-discontinuation (p < 0.001).</p><p><strong>Conclusions: </strong>The average weight reduction in this cohort was lower than that observed in the main phase 3 trials, likely because of higher rates of discontinuation and lower maintenance dosages.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society.","authors":"Dariush Mozaffarian, Monica Agarwal, Monica Aggarwal, Lydia Alexander, Caroline M Apovian, Shagun Bindlish, Jonathan Bonnet, W Scott Butsch, Sandra Christensen, Eugenia Gianos, Mahima Gulati, Alka Gupta, Debbie Horn, Ryan M Kane, Jasdeep Saluja, Deepa Sannidhi, Fatima Cody Stanford, Emily A Callahan","doi":"10.1002/oby.24336","DOIUrl":"https://doi.org/10.1002/oby.24336","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glucagon-like peptide 1 receptor agonists and combination medications (hereafter collectively referred to as GLP-1s) are shifting the treatment landscape for obesity. However, real-world challenges and limited clinician and public knowledge on nutritional and lifestyle interventions can limit GLP-1 efficacy, equitable results, and cost-effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment of obesity for the practicing clinician.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An expert group comprising multiple clinical and research disciplines appraised the scientific literature, informed by expert knowledge and clinical experience, to identify and summarize relevant topics, priorities, and emerging directions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;GLP-1s reduce body weight by 5% to 18% in trials, with modestly lower effects in real-world analyses, and multiple demonstrated clinical benefits. Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness. Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread. Priorities to address this include: (a) patient-centered initiation of GLP-1s, including goals for weight reduction and health; (b) baseline screening, including usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions; (c) comprehensive exam including muscle strength, function, and body composition assessment; (d) social determinants of health screening; (e) and lifestyle assessment including aerobic activity, strength training, sleep, mental stress, substance use, and social connections. During GLP-1 use, nutritional and medical management of gastrointestinal side effects is critical, as is navigating altered dietary preferences and intakes, preventing nutrient deficiencies, preserving muscle and bone mass through resistance training and appropriate diet, and complementary lifestyle interventions. Supportive strategies include group-based visits, registered dietitian nutritionist counseling, telehealth and digital platforms, and Food is Medicine interventions. Drug access, food and nutrition insecurity, and nutrition and culinary knowledge influence equitable obesity management with GLP-1s. Emerging areas for more study include dietary modulation of endogenous GLP-1, strategies to improve compliance, nutritional priorities for weight maintenance post-cessation, combination or staged intensive lifestyle management, and diagnostic criteria for clinical obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Evidence-based nutritional and lifestyle strategies play a pivotal role to address","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and environmental contributions to the associations between midlife personality and late-life metabolic health.","authors":"Colin D Freilich, Jacob J Kunkel, Keely A Dugan, Elise J Vomacka, Adolfo G Cuevas, Kristian Markon, Matt McGue, Glenn I Roisman, Robert F Krueger","doi":"10.1002/oby.24268","DOIUrl":"https://doi.org/10.1002/oby.24268","url":null,"abstract":"<p><strong>Objective: </strong>Personality traits such as conscientiousness and emotional stability are consistently linked with better metabolic health, but there is limited evidence on the etiology of these associations and their robustness across the life-span.</p><p><strong>Methods: </strong>Therefore, we estimated phenotypic, genetic, and unique environmental associations of traits indexed by the Multidimensional Personality Questionnaire in early-to-middle adulthood (mean age = 38.3 years) with BMI, waist circumference, high-density lipoprotein cholesterol, C-reactive protein, triglycerides, and glycated hemoglobin in older adulthood (mean age = 70.4 years) using the Minnesota Twin Registry sample (n = 950).</p><p><strong>Results: </strong>Traits that indexed emotional instability in midlife, such as alienation and stress reactivity, were significant predictors of several metabolic outcomes late in life (bivariate |r| ≤ 0.22), whereas negative associations with traits related to conscientiousness (e.g., control, constraint, achievement) tended to be more modest. For most traits that were phenotypically associated, we observed significant genetic correlations. Additionally, alienation and stress reactivity had weak-to-moderate unique environmental correlations with BMI, waist circumference, and C-reactive protein (r_e = 0.10-0.29).</p><p><strong>Conclusions: </strong>These results are consistent with an etiology of declining metabolic health into old age involving the propensity toward negative affective experiences decades prior, further validating the health relevance of individual differences in personality.</p>","PeriodicalId":94163,"journal":{"name":"Obesity (Silver Spring, Md.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}