Canadian Journal of Diabetes最新文献

{"title":"Kidney Pathology in Diabetes: A Comparative Study of Youth and Young Adults","authors":"Jasmine Manji BHSc ,&nbsp;Bryce Barr MD ,&nbsp;Ian W. Gibson MD ,&nbsp;Oksana D. Harasemiw MSc ,&nbsp;Elizabeth A.C. Sellers MD ,&nbsp;Navdeep Tangri MD ,&nbsp;Olivier Tremblay-Savard PhD ,&nbsp;Melissa H. Del Vecchio MSc ,&nbsp;Brandy A. Wicklow MD ,&nbsp;Allison B. Dart MD","doi":"10.1016/j.jcjd.2026.01.001","DOIUrl":"10.1016/j.jcjd.2026.01.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Rates of progression to kidney failure have been shown to differ by age of diabetes diagnosis in many populations. We evaluated clinically performed kidney biopsies to better understand this observation. We hypothesized that youth with a diabetes diagnosis have more nondiabetic kidney pathology than young adults.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used a kidney biopsy registry linked to the Manitoba Centre for Health Policy (MCHP) to evaluate all kidney biopsies (2002 to 2021) from young adults (19 to 40 years of age) with a diagnosis of diabetes. Kidney biopsies of youth (≤18 years) and additional adult biopsies from the 2022–2023 period were manually reviewed. Clinical data were extracted from MCHP (young adults) and clinical charts (youth), including sex, age, diabetes duration, glycated hemoglobin (A1C), estimated glomerular filtration rate (eGFR), urine albumin:creatinine ratio (ACR), hypertension status, and medications.</div></div><div><h3>Results</h3><div>One hundred fifty-three young adult and 34 youth biopsies were included in the study. Diabetes duration at time of biopsy was a median of 5.0 (1.0 to 10.0) years for young adults and 2.8 (1.3 to 4.9) years for youth. Young adults had lower A1C (7.6% vs 10.3%, p&lt;0.0001), more albuminuria (median ACR 330.0 [172.3 to 591.5] vs 94.0 [34.9 to 204.8] mg/mmol, p&lt;0.0001), and lower eGFR (37 vs 143 mL/min per 1.73 m², p&lt;0.0001) at time of biopsy. Youth had more nondiabetic kidney pathology compared with diabetic pathology in young adults, including nonproliferative glomerulonephritis (29.4% vs 13.7%, p=0.05). Young adults had more severe tubulointerstitial scarring (52.2% vs 5.9%, p&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>Youth with diabetes are more likely to have nondiabetic kidney diseases, whereas adult biopsies demonstrated more severe diabetic nephropathy and chronic scarring. Further research is needed to explore associations between clinicopathologic changes and eGFR trajectories.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Pages 162-170"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986140","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":"Diabetes Self-care in Daily Life: A Qualitative Study on Goal Conflict Management in Emerging Adults With Type 1 Diabetes","authors":"Esther Sulkers PhD ,&nbsp;Joke Fleer PhD ,&nbsp;Henk-Jan Aanstoot PhD, MD ,&nbsp;Giesje Nefs PhD","doi":"10.1016/j.jcjd.2025.12.011","DOIUrl":"10.1016/j.jcjd.2025.12.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Our aim in this study was to gain further insight into the way emerging adults with type 1 diabetes experience and manage conflicts between their desire to take good care of their diabetes and reaching daily goals in other life domains.</div></div><div><h3>Methods</h3><div>Participants were recruited from 3 locations of a Dutch type 1 diabetes care and research centre until researchers considered data saturation to have been reached. Sixteen emerging adults were interviewed and completed a diary for 3 days. Interview transcripts were analyzed by 2 researchers, using directed content analysis.</div></div><div><h3>Results</h3><div>Participants had daily conflicts between self-management and attaining goals in various life domains (including food, alcohol, sports, school/work, and leisure activities); social goals figured prominently. Generally, participants first tried to combine their diabetes goal and other goals by means of flexible self-care supported by modern technology, thorough planning, and social support. When combining was not possible, most participants tended to prioritize nondiabetes goals, unless they perceived a high risk for adverse health outcomes. Prioritization of diabetes goals, as well as nondiabetes goals, often resulted in negative emotions such as sadness and guilt.</div></div><div><h3>Conclusions</h3><div>For emerging adults, good care of diabetes is a challenge to undertake while also addressing other goals of daily life. Combination and prioritization strategies both play a role in efforts to deal with these goal conflicts, although the latter often trigger negative emotions. The present findings can be used for the optimization of diabetes self-management support by taking the broader life context into account.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Pages 146-152.e5"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879763","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":"Impact of Prescription Data on Administrative Data Case Definitions of Pediatric Type 1 and 2 Diabetes: A Validation Study","authors":"Jeffrey N. Bone PhD ,&nbsp;Qian Zhang MPH ,&nbsp;Joseph Leung MD ,&nbsp;Shazhan Amed MD","doi":"10.1016/j.jcjd.2026.01.004","DOIUrl":"10.1016/j.jcjd.2026.01.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Population surveillance of diabetes relies on administrative data, which requires accurate case definitions to inform public health decision-making. The objective of this study was to compare the Canadian Chronic Disease Surveillance System (CCDSS) diabetes definition with an expanded definition in a pediatric population cohort from British Columbia (BC).</div></div><div><h3>Methods</h3><div>This was a retrospective population-level study using linked administrative databases in BC between April 1, 1996, and March 31, 2024. A subcohort was linked with a prospectively collected cohort of pediatric diabetes patients from the BC Pediatric Database Registry (BCPDR). Rates of type 1 and 2 pediatric diabetes were compared between the CCDSS definition, based on hospital and physician claims information, and an expanded BC definition encompassing prescription information. Both definitions were validated against “gold-standard” diagnosis data from the BCDPR.</div></div><div><h3>Results</h3><div>There were 6,716 cases of diabetes using the CCDSS definition. Under the expanded BC definition, the total number of cases increased by 1,074 (16.0%). Furthermore, 458 cases met the CCDSS definition but not the BC definition, with the majority (67.7%) never having received a diabetes-related medication. The differences between definitions were similar for both sexes but increased with increasing age. When compared with the gold-standard BCPDR, the sensitivity of the BC and CCDSS definitions was 94.0% and 72.7%, respectively.</div></div><div><h3>Conclusions</h3><div>The CCDSS definition of diabetes does not capture all patients with diabetes and results in false positive cases when compared with an expanded definition and with gold-standard diagnoses from a provincial registry.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Pages 171-176"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047398","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 IDEA Framework: A Consensus-based Model for Integrating Continuous Glucose Monitoring Into Pharmacy Practice for Diabetes Care","authors":"Aaron Sihota BSc, BScPharm ,&nbsp;Akshay B. Jain MD ,&nbsp;Alicia Chin BScPharm ,&nbsp;Walter Chow MD ,&nbsp;Susie Jin BScPharm ,&nbsp;Trisha Molberg BScPharm ,&nbsp;Smita Patil BScPharm ,&nbsp;Rick Siemens BScPharm ,&nbsp;Sivajanan Sivapalan MPharm ,&nbsp;Tim Smith BScPharm ,&nbsp;Ilana Halperin MSc, MD","doi":"10.1016/j.jcjd.2026.01.005","DOIUrl":"10.1016/j.jcjd.2026.01.005","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Pages 177-182.e4"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121332","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":"Uptake of Publicly Funded Flash Glucose Monitoring Systems: A Population-based Cohort Study in Ontario, Canada","authors":"Mary N. Elias MSc ,&nbsp;Sara Allin PhD ,&nbsp;Joanna Yang MSc ,&nbsp;Maria Chiu PhD ,&nbsp;Baiju R. Shah MD, PhD ,&nbsp;Fangyun Wu MSc ,&nbsp;Tara Gomes PhD","doi":"10.1016/j.jcjd.2025.12.001","DOIUrl":"10.1016/j.jcjd.2025.12.001","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study we investigated uptake of flash glucose monitoring (FGM) among Ontario residents ≥66 years of age who require insulin and are eligible for Ontario's universal drug coverage program (the Ontario Drug Benefit [ODB]). Specifically, we assessed differences based on immigration status.</div></div><div><h3>Methods</h3><div>Using administrative data, we conducted a population-based, repeated cross-sectional study among Ontarians ≥66 years of age with insulin-requiring diabetes between September 1, 2019, and March 31, 2023. The primary outcome was the monthly rate of unique individuals receiving publicly funded FGM through the ODB program. We compared characteristics of FGM users based on immigration status by considering demographic, neighbourhood, and health-care use factors.</div></div><div><h3>Results</h3><div>We found a total of 14,151 immigrants and 85,710 long-term residents who had FGM over the study period. In the first month of funding, the rate of new users was lower among immigrants (37.1 per 1,000) compared with long-term residents (48.8 per 1,000). Rates peaked at 98.0 and 96.0 per 1,000, for immigrants and long-term residents respectively, in October 2019, declining thereafter and stabilizing in April 2020. Immigrants receiving FGM were younger, more likely to reside in neighbourhoods with greater racialized and newcomer populations, and more likely to have received noninsulin diabetes medications in the prior year, when compared with long-term residents receiving FGM.</div></div><div><h3>Conclusions</h3><div>We observed significant FGM uptake in the first months after public funding among both immigrants and long-term residents. Although long-term residents showed slightly higher initial uptake, differences between groups were minimal after the first month of funding.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Pages 129-136"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727657","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":"Virtual vs In-person Care in Gestational Diabetes Management: A Retrospective Cohort Analysis","authors":"Rongrong Chen MD,&nbsp;Lin Sheng MD,&nbsp;Xiaohan Zhang MD","doi":"10.1016/j.jcjd.2025.05.001","DOIUrl":"10.1016/j.jcjd.2025.05.001","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 3","pages":"Page 191"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121656","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":"Barriers to Diabetic Ketoacidosis Prevention in Adults With Type 1 Diabetes: Implications for Education and Implementation of New Monitoring Technologies","authors":"Natasha J. Verhoeff HBHSc ,&nbsp;Wajeeha Cheema HBSc ,&nbsp;Sara Mojdehi BMSc ,&nbsp;Hoda Gad BSc, MSc, PhD ,&nbsp;Doug Mumford BASc(EE) ,&nbsp;Mary Rose Waniss BSc ,&nbsp;Andrej Orszag MD ,&nbsp;Akshay Jain MD ,&nbsp;Priya Bapat MD, PhD ,&nbsp;Dalton Budhram BSc, MD ,&nbsp;Abdulmohsen Bakhsh MBBS ,&nbsp;Mohammad I. Abuabat MD ,&nbsp;Leif Erik Lovblom MSc, PhD ,&nbsp;Noah Ivers MD, PhD ,&nbsp;Bruce A. Perkins MD, MPH","doi":"10.1016/j.jcjd.2025.11.002","DOIUrl":"10.1016/j.jcjd.2025.11.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Diabetic ketoacidosis (DKA) is a major acute complication whose prevention depends on patient knowledge and self-management skills. In this study we aimed to identify the patient-level barriers to effective DKA prevention behaviours.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study using a behavioural science lens and implementation science methods involving 3 independent, sequential focus groups. Informed by the Action, Actor, Context, Target, Time framework, 3 targeted behaviours were defined: testing ketone levels; acting upon ketone results; and seeking emergency medical care. Deductive coding was used to categorize barriers and enablers for each targeted behaviour using the Theoretical Domains Framework. This was followed by thematic analysis and then member checking of key findings.</div></div><div><h3>Results</h3><div>Twenty-two participants (9 with type 1 diabetes, 1 caregiver, 12 health-care providers) contributed to 1 of 3 focus groups. Key barriers to engaging in the target behaviours were 1) a lack of understanding of the clinical relevance of ketones; 2) inability to retain necessary steps for ketone testing and a lack of access to supplies; 3) mental health challenges, sense of identity, and resistance to change; and 4) negative experiences with and fear of stigma from the health-care system. Key enablers included 1) reminders from clinicians and technologies; and 2) community supports and accessible resources.</div></div><div><h3>Conclusions</h3><div>Acknowledgment of specific barriers is essential to designing future simplified DKA prevention educational tools and for implementation of continuous ketone monitoring. In a subsequent step we aim to co-create a simplified DKA prevention infographic that addresses these barriers for individuals living with diabetes.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 2","pages":"Pages 72-81.e2"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650377","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":"Evaluating Virtual Care for Adults with Type 2 Diabetes During the COVID-19 Pandemic: Results From a Pre–Post Retrospective Cohort Pilot Study in a Canadian Family Health Team","authors":"Karla Freeman MSc ,&nbsp;John Tamale MBChB, MMed, MCISc, CCFP(EM), FCFP ,&nbsp;Edward Tamale MD ,&nbsp;Jennifer Salerno MSc, PhD","doi":"10.1016/j.jcjd.2025.12.010","DOIUrl":"10.1016/j.jcjd.2025.12.010","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study we aimed to determine the feasibility of using electronic medical record (EMR) data to assess whether virtual care provided by a family health team (FHT) located in Ontario during the early COVID-19 pandemic impacted key diabetes indicators, and to identify whether content of diabetes-specific appointments was comparable to in-person care.</div></div><div><h3>Methods</h3><div>A retrospective pre–post cohort study was performed using patient-level EMR data from eligible FHT patients with type 2 diabetes. Feasibility outcomes were defined with prespecified success criteria. Scientific outcomes included 3 diabetes indicators: glycated hemoglobin (A1C), low-density lipoprotein (LDL), and blood pressure (BP). Indicator results from the prepandemic period (September 2019) and during-pandemic period (March 2020 to March 2021) were recorded and compared. Patient characteristics and content of diabetes-specific appointments were also collected.</div></div><div><h3>Results</h3><div>All feasibility outcomes met predefined criteria for success. No significant differences in A1C, LDL, or BP were identified between pre- and during-pandemic cohorts. Depression screening was performed significantly more frequently during the pandemic (73.85% vs 47.06%, p&lt;0.001) at diabetes-specific appointments compared with the pre-pandemic period. No significant differences in frequency of screening for other complications (i.e. hypoglycemia, foot, eye) were found.</div></div><div><h3>Conclusions</h3><div>Results signal that virtual care delivery in the during-pandemic period was not associated with significant changes in diabetes indicators or reduced screening for complications; however, many patients did not have BP measurements recorded during the pandemic. Findings support evidence that virtual care may help maintain continuity of care for diabetes management when in-person appointments are not possible.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 2","pages":"Pages 97-105.e4"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879779","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":"Corrigendum to “Managing Medications During ‘Sick Days’ in Patients With Diabetes, Kidney, and Cardiovascular Conditions: A Theory-informed Approach to Intervention Design and Implementation”","authors":"Kaitlyn E. Watson BPharm (Hons), PhD, GradCertAppPharmPrac, FHEA ,&nbsp;Kirnvir Dhaliwal RN, MN, PhD ,&nbsp;Eleanor Benterud RN, MN ,&nbsp;Sandra Robertshaw ,&nbsp;Nancy Verdin ,&nbsp;Ella McMurtry ,&nbsp;Nicole Lamont MBT BHSc ,&nbsp;Kelsea M. Drall MSc ,&nbsp;Sarah Gil ,&nbsp;David J.T. Campbell MD, MSc, PhD, FRCPC ,&nbsp;Kerry McBrien MD, MPH, CCFP ,&nbsp;Ross T. Tsuyuki BSc(Pharm), PharmD, MSc, FCSHP, FACC, FCAHS, ISHF ,&nbsp;Neesh Pannu MD, SM ,&nbsp;Matthew T. James MD, PhD, FRCPC ,&nbsp;Maoliosa Donald PhD, BScPT","doi":"10.1016/j.jcjd.2025.12.014","DOIUrl":"10.1016/j.jcjd.2025.12.014","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 2","pages":"Page 63"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055323","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 Experience of a Guided Self-determination Intervention on Diabetes Distress Among Adults With Type 2 Diabetes","authors":"Laura Krogh Nygaard MScN, RN ,&nbsp;Anne Sophie Mathiesen PhD, MPH, RN ,&nbsp;Vibeke Zoffmann PhD, MScN, RN ,&nbsp;Mette Juel Rothmann PhD, MSc (Health), RN","doi":"10.1016/j.jcjd.2025.12.013","DOIUrl":"10.1016/j.jcjd.2025.12.013","url":null,"abstract":"<div><h3>Objectives</h3><div>Type 2 diabetes (T2D) can cause psychosocial difficulties, burdensome self-care, and stigmatization, which can lead to diabetes distress, reduced quality of life, and suboptimal diabetes management. Guided self-determination (GSD) has been identified as valuable in alleviating diabetes distress. In this study we explored the experience of a GSD intervention among people with T2D and aimed to understand the potential impact on diabetes distress.</div></div><div><h3>Methods</h3><div>A qualitative study was undertaken using semistructured interviews (n=10) and reflexive thematic analysis by Braun and Clarke. The study adhered to the Consolidated Criteria for Reporting Qualitative Studies checklist.</div></div><div><h3>Results</h3><div>Four themes were revealed: “Person-centred reflection creates self-insight,” becoming aware of how one deals with diabetes and finding renewed optimism; “Unburdening myself,” characterized by room and support for psychosocial aspects; “Making sense of diabetes: Creating meaning through reflection and dialogue,” reflecting on current difficulties while simultaneously making sense of diabetes; and “Barriers to changes: Between acceptance, effort, and everyday realities,” where readiness, motivation, and energy impacted possible changes.</div></div><div><h3>Conclusions</h3><div>GSD may improve the ability to alleviate stressors related to diabetes. However, some individuals experienced no changes. Readiness, motivation, and energy appear to be critical for the potential to change.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 2","pages":"Pages 106-114"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890682","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}