Pub Date : 2025-01-01Epub Date: 2025-08-09DOI: 10.1159/000547422
Zhenzhen Lu, Chen Zheng, Peijun Ren, Junjie Gao, Changqing Zhang, Jan Vijg, Shixiang Sun
Introduction: DNA damage in chondrocytes has been found to be associated with osteoarthritis (OA) and could be a primary pathological mechanism of the disease. Here, we performed transcriptomic analysis of human chondrocytes using existing RNA-seq datasets to characterize DNA damage repair pathway alterations associated with OA status.
Methods: We collected 9 public RNA-seq datasets of cartilage samples in the Gene Expression Omnibus from 57 OA patients and 35 non-OA controls. We identified differentially expressed genes (DEGs), examined enriched pathways, and predicted regulatory networks of the DNA damage response (DDR) in OA by comparing RNA-seq data from OA and non-OA chondrocytes. Furthermore, we evaluated the potential associations between DDR-related gene signatures and OA status.
Results: We identified 490 upregulated and 350 downregulated DEGs in OA. The upregulated DEGs are significantly enriched in DDR pathways, including the Fanconi anemia, mismatch repair, and base excision repair pathways. A total of 10 significant DDR downstream pathways were enriched and upregulated in OA, including DNA replication, DNA repair, and cell cycle pathways in relation to the DDR. Finally, we identified 9 core genes for DNA damage repair in OA (DDR-OA genes) as potential targets for OA biomarkers. Three of these genes are known to be associated with both DDR processes and OA pathology.
Conclusion: Elevated expression of DDR-related genes and enhanced activity of DDR signaling pathways were observed in conjunction with OA onset and progression. Our computational analysis prioritizes identified DDR-OA genes as high-confidence candidates for further experimental investigation.
{"title":"Comprehensive Bioinformatics Analysis Reveals Associations between the DNA Damage Response and Osteoarthritis.","authors":"Zhenzhen Lu, Chen Zheng, Peijun Ren, Junjie Gao, Changqing Zhang, Jan Vijg, Shixiang Sun","doi":"10.1159/000547422","DOIUrl":"10.1159/000547422","url":null,"abstract":"<p><strong>Introduction: </strong>DNA damage in chondrocytes has been found to be associated with osteoarthritis (OA) and could be a primary pathological mechanism of the disease. Here, we performed transcriptomic analysis of human chondrocytes using existing RNA-seq datasets to characterize DNA damage repair pathway alterations associated with OA status.</p><p><strong>Methods: </strong>We collected 9 public RNA-seq datasets of cartilage samples in the Gene Expression Omnibus from 57 OA patients and 35 non-OA controls. We identified differentially expressed genes (DEGs), examined enriched pathways, and predicted regulatory networks of the DNA damage response (DDR) in OA by comparing RNA-seq data from OA and non-OA chondrocytes. Furthermore, we evaluated the potential associations between DDR-related gene signatures and OA status.</p><p><strong>Results: </strong>We identified 490 upregulated and 350 downregulated DEGs in OA. The upregulated DEGs are significantly enriched in DDR pathways, including the Fanconi anemia, mismatch repair, and base excision repair pathways. A total of 10 significant DDR downstream pathways were enriched and upregulated in OA, including DNA replication, DNA repair, and cell cycle pathways in relation to the DDR. Finally, we identified 9 core genes for DNA damage repair in OA (DDR-OA genes) as potential targets for OA biomarkers. Three of these genes are known to be associated with both DDR processes and OA pathology.</p><p><strong>Conclusion: </strong>Elevated expression of DDR-related genes and enhanced activity of DDR signaling pathways were observed in conjunction with OA onset and progression. Our computational analysis prioritizes identified DDR-OA genes as high-confidence candidates for further experimental investigation.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"885-898"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The problem of population aging is intensifying worldwide. Osteoporosis has become an important cause affecting the health status of older populations. However, the diagnosis of osteoporosis and people's understanding of it are seriously insufficient. We aim to develop a deep learning model to automatically measure bone mineral density (BMD) and improve the diagnostic rate of osteoporosis.
Methods: The images of 801 subjects with 2,080 vertebral bodies who underwent chest or abdominal paired computer tomography (CT) and quantitative computer tomography (QCT) scanning was retrieved from June 2020 to January 2022. The BMD of T11-L4 vertebral bodies was measured by QCT. Developing a multistage deep learning-based model to simulate the segmentation of the vertebral body and predict BMD. The subjects were randomly divided into training dataset, validation dataset and test dataset. Analyze the fitting effect between the BMD measured by the model and the standard BMD by QCT. Accuracy, precision, recall and f1-score were used to analyze the diagnostic performance according to categorization criterion measured by QCT.
Results: 410 males (51.2%) and 391 females (48.8%) were included in this study. Among them, there were 154 (19.2%) males and 118 (14.7%) females aged 23-44; 182 (22.7%) males and 205 (25.6%) females aged 45-64; 74 (9.2%) males and 68 (8.5%) females aged 65-84. The number of vertebral bodies in the training dataset, the validation dataset, and the test dataset was 1433, 243, 404, respectively. In each dataset, the BMD of males and females decreases with age. There was a significant correlation between the BMD measured by the model and QCT, with the coefficient of determination (R2) 0.95-0.97. The diagnostic accuracy based on the model in the three datasets was 0.88, 0.91, and 0.91, respectively.
Conclusion: The proposed multistage deep learning-based model can achieve automatic measurement of vertebral BMD and performed well in the prediction of osteoporosis.
{"title":"Prediction of Bone Mineral Density based on Computer Tomography Images Using Deep Learning Model.","authors":"Jujia Li, Ping Zhang, Jingxu Xu, Ranxu Zhang, Congcong Ren, Fan Yang, Qian Li, Yanhong Dong, Chencui Huang, Jian Zhao","doi":"10.1159/000542396","DOIUrl":"10.1159/000542396","url":null,"abstract":"<p><strong>Introduction: </strong>The problem of population aging is intensifying worldwide. Osteoporosis has become an important cause affecting the health status of older populations. However, the diagnosis of osteoporosis and people's understanding of it are seriously insufficient. We aim to develop a deep learning model to automatically measure bone mineral density (BMD) and improve the diagnostic rate of osteoporosis.</p><p><strong>Methods: </strong>The images of 801 subjects with 2,080 vertebral bodies who underwent chest or abdominal paired computer tomography (CT) and quantitative computer tomography (QCT) scanning was retrieved from June 2020 to January 2022. The BMD of T11-L4 vertebral bodies was measured by QCT. Developing a multistage deep learning-based model to simulate the segmentation of the vertebral body and predict BMD. The subjects were randomly divided into training dataset, validation dataset and test dataset. Analyze the fitting effect between the BMD measured by the model and the standard BMD by QCT. Accuracy, precision, recall and f1-score were used to analyze the diagnostic performance according to categorization criterion measured by QCT.</p><p><strong>Results: </strong>410 males (51.2%) and 391 females (48.8%) were included in this study. Among them, there were 154 (19.2%) males and 118 (14.7%) females aged 23-44; 182 (22.7%) males and 205 (25.6%) females aged 45-64; 74 (9.2%) males and 68 (8.5%) females aged 65-84. The number of vertebral bodies in the training dataset, the validation dataset, and the test dataset was 1433, 243, 404, respectively. In each dataset, the BMD of males and females decreases with age. There was a significant correlation between the BMD measured by the model and QCT, with the coefficient of determination (R2) 0.95-0.97. The diagnostic accuracy based on the model in the three datasets was 0.88, 0.91, and 0.91, respectively.</p><p><strong>Conclusion: </strong>The proposed multistage deep learning-based model can achieve automatic measurement of vertebral BMD and performed well in the prediction of osteoporosis.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"71-80"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-04-03DOI: 10.1159/000545679
Chun Wang, Desheng Song, Jingran Dong, Yicheng Zhao, Yin Liu, Jing Gao, Zhuang Cui, Changping Li
Introduction: Cardiovascular disease (CVD) is more likely to occur in old people with mildly reduced kidney function. We aimed to identify target features in this cohort to reduce cardiovascular death using deep learning models.
Methods: A total of 12,650 older people (age ≥60) with mildly reduced kidney function from Tianjin Community Health Promotion Prospective Study were recruited from 2014 to 2020. Cardiovascular death was verified by the death certificates from the provincial vital statistics offices. Mildly reduced kidney function was defined when estimated glomerular filtration rate (eGFR) between 45 mL/min/1.73 m2 ≤ and 90 mL/min/1.73 m2. Data were analyzed using Cox regression, random survival forest (RSF), DeepHit (DH), and Dynamic DH (DDH). Concordance Index (C-index) and Brier Score (B-S) were used to compare the models' performances.
Results: During the follow-up of 7 years, 838 people died of CVD (6.62%). Age, gender, hypertension, diabetes, and eGFR were closely related to cardiovascular death. Both accuracy and precision of models, predictive performance gets better as the number of follow-up visits increases. In predicting cardiovascular death, the C-index and B-S value of COX were only 0.711 and 0.001 at the first follow-up, and values were 0.767 and 0.073 at last time, respectively. This trend is similar in the other three models, with the DDH model standing, which showed the individual survival prediction with more accuracy at different time points (for the 6-year survival prediction, the C-index = 0.797 and B-S = 0.022 for the average of all time points) than the Cox, RSF, and DH.
Conclusion: A novel deep learning algorithm used in our study has shown its superior performance in the prediction of individual dynamics in longitudinal studies, which improves predictive power with increasing data input over time.
{"title":"Dynamic Prediction of Cardiovascular Death among Old People with Mildly Reduced Kidney Function Using Deep Learning Models Based on a Prospective Cohort Study.","authors":"Chun Wang, Desheng Song, Jingran Dong, Yicheng Zhao, Yin Liu, Jing Gao, Zhuang Cui, Changping Li","doi":"10.1159/000545679","DOIUrl":"10.1159/000545679","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is more likely to occur in old people with mildly reduced kidney function. We aimed to identify target features in this cohort to reduce cardiovascular death using deep learning models.</p><p><strong>Methods: </strong>A total of 12,650 older people (age ≥60) with mildly reduced kidney function from Tianjin Community Health Promotion Prospective Study were recruited from 2014 to 2020. Cardiovascular death was verified by the death certificates from the provincial vital statistics offices. Mildly reduced kidney function was defined when estimated glomerular filtration rate (eGFR) between 45 mL/min/1.73 m2 ≤ and 90 mL/min/1.73 m2. Data were analyzed using Cox regression, random survival forest (RSF), DeepHit (DH), and Dynamic DH (DDH). Concordance Index (C-index) and Brier Score (B-S) were used to compare the models' performances.</p><p><strong>Results: </strong>During the follow-up of 7 years, 838 people died of CVD (6.62%). Age, gender, hypertension, diabetes, and eGFR were closely related to cardiovascular death. Both accuracy and precision of models, predictive performance gets better as the number of follow-up visits increases. In predicting cardiovascular death, the C-index and B-S value of COX were only 0.711 and 0.001 at the first follow-up, and values were 0.767 and 0.073 at last time, respectively. This trend is similar in the other three models, with the DDH model standing, which showed the individual survival prediction with more accuracy at different time points (for the 6-year survival prediction, the C-index = 0.797 and B-S = 0.022 for the average of all time points) than the Cox, RSF, and DH.</p><p><strong>Conclusion: </strong>A novel deep learning algorithm used in our study has shown its superior performance in the prediction of individual dynamics in longitudinal studies, which improves predictive power with increasing data input over time.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"474-487"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-13DOI: 10.1159/000545244
Ava Naffah, Valeria A Pfeifer, Matthias R Mehl
Introduction: Studying what older adults say can provide important insights into cognitive, affective, and social aspects of aging. Available language analysis tools generally require audio-recorded speech to be transcribed into verbatim text, a task that has historically been performed by humans. However, recent advances in AI-based language processing open up the possibility of replacing this time- and resource-intensive task with fully automatic speech to text.
Methods: This study evaluates the accuracy of two common automatic speech-to-text tools - OpenAI's Whisper and otter.ai - relative to human-corrected transcripts. Based on two speech tasks completed by 238 older adults, we used the Linguistic Inquiry and Word Count (LIWC) to compare language features of text generated by each transcription method. The study further assessed the degree to which manual tagging of filler words (e.g., "like," "well") common in spoken language impacts the validity of the analysis.
Results: The AI-based LIWC features evidenced very high convergence with the LIWC features derived from the human-corrected transcripts (average r = 0.98). Further, the manual tagging of filler words did not impact the validity for all LIWC features except the categories filler words and netspeak.
Conclusion: These findings support that Whisper and otter.ai are valuable tools for language analysis in aging research and provide further evidence that automatic speech to text with state-of-the art AI tools is ready for psychological language research.
{"title":"Spoken Language Analysis in Aging Research: The Validity of AI-Generated Speech to Text Using OpenAI's Whisper.","authors":"Ava Naffah, Valeria A Pfeifer, Matthias R Mehl","doi":"10.1159/000545244","DOIUrl":"10.1159/000545244","url":null,"abstract":"<p><strong>Introduction: </strong>Studying what older adults say can provide important insights into cognitive, affective, and social aspects of aging. Available language analysis tools generally require audio-recorded speech to be transcribed into verbatim text, a task that has historically been performed by humans. However, recent advances in AI-based language processing open up the possibility of replacing this time- and resource-intensive task with fully automatic speech to text.</p><p><strong>Methods: </strong>This study evaluates the accuracy of two common automatic speech-to-text tools - OpenAI's Whisper and otter.ai - relative to human-corrected transcripts. Based on two speech tasks completed by 238 older adults, we used the Linguistic Inquiry and Word Count (LIWC) to compare language features of text generated by each transcription method. The study further assessed the degree to which manual tagging of filler words (e.g., \"like,\" \"well\") common in spoken language impacts the validity of the analysis.</p><p><strong>Results: </strong>The AI-based LIWC features evidenced very high convergence with the LIWC features derived from the human-corrected transcripts (average r = 0.98). Further, the manual tagging of filler words did not impact the validity for all LIWC features except the categories filler words and netspeak.</p><p><strong>Conclusion: </strong>These findings support that Whisper and otter.ai are valuable tools for language analysis in aging research and provide further evidence that automatic speech to text with state-of-the art AI tools is ready for psychological language research.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 5","pages":"417-424"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-07-11DOI: 10.1159/000547314
Dominic N Farsi, Gareth J McKay, Gerry J Linden, Michael McAlinden, Jessica Teeling, Peter Passmore, Clive Holmes, Christopher C Patterson, Bernadette McGuinness, Claire T McEvoy
Introduction: The relationship between cognitive impairment and a phenotype comprising low muscle strength coupled with excess adiposity, representative of sarcopenic obesity, is not well defined. The present study aimed to elucidate the relationship between low hand grip strength (HGS), representative of "probable sarcopenia," coupled with obesity, thus representing "probable sarcopenic obesity" and cognitive impairment.
Methods: Logistic regression models were implemented between probable sarcopenia and cognitive impairment in older men residing in Northern Ireland within the Prospective Epidemiological Study of Myocardial Infarction (PRIME)-COG cohort, a nested study in the PRIME cohort. In addition, associations across BMI strata were evaluated, including probable sarcopenic obesity (low HGS and BMI ≥30 kg/m2). Models were adjusted for demographics, cardiometabolic disease and risk factors, APOE-ε4, and lifestyle behaviours.
Results: Among 792 men (79.1, SD 3.2 years), low HGS was associated with a significantly increased odds ratio (OR) of cognitive impairment (OR 2.14; 95% confidence intervals [CIs] 1.51-3.03, p < 0.001). The risk was broadly consistent across BMI strata, including men with probable sarcopenic obesity (OR 2.36 [95% CI: 0.85-6.35], p = 0.05). The consistent risk across BMI strata was supported by a non-significant interaction between BMI and probable sarcopenia (likelihood ratio test, p = 0.772).
Conclusions: Probable sarcopenia, indicated by low HGS, was associated with an increased risk of cognitive impairment in older men, with risk consistent across BMI strata, including men living with probable sarcopenic obesity. Our findings have clinical relevance, suggesting that phenotypes comprising low muscle strength, in the presence of excess adiposity, must not be overlooked and appropriate interventions explored to attenuate physical perturbations which could carry significance towards ameliorating cognitive function in ageing.
.
背景:认知障碍与低肌力伴过度肥胖的表型之间的关系尚不明确,而低肌力伴过度肥胖是肌少性肥胖的代表。本研究旨在阐明低握力(HGS)与肥胖之间的关系,HGS代表“可能的肌肉减少症”,因此代表“可能的肌肉减少性肥胖”,以及认知障碍。方法:在PRIME- cog队列(PRIME(前瞻性心肌梗死流行病学研究)队列的嵌套研究)中,对居住在北爱尔兰的老年男性进行可能的肌肉减少症和认知障碍之间的Logistic回归模型。此外,还评估了身体质量指数(BMI)各阶层之间的关联,包括可能的肌肉减少型肥胖(低HGS和BMI≥30 kg/m2)。根据人口统计学、心脏代谢疾病和危险因素、APOE-ε4和生活方式行为对模型进行了调整。结果:在792名男性(79.1 SD 3.2年)中,低HGS与认知功能障碍的优势比(OR)显著增加相关(OR 2.14(95%可信区间(CI) 1.51 - 3.03), p < 0.001)。该风险在BMI各阶层中大致一致,包括可能患有肌肉减少性肥胖的男性(OR 2.36 (95% CI 0.85 - 6.35), p = 0.05)。BMI和可能的肌肉减少症之间不存在显著的相互作用(似然比检验,p = 0.772),支持了BMI各阶层之间一致的风险。结论:低HGS表明的可能的肌肉减少症与老年男性认知功能障碍的风险增加有关,其风险在BMI各阶层中是一致的,包括可能患有肌肉减少性肥胖的男性。我们的研究结果具有临床相关性,表明在存在过度肥胖的情况下,不应忽视包括低肌肉力量的表型,并探索适当的干预措施来减轻身体扰动,这可能对改善衰老过程中的认知功能具有重要意义。
{"title":"Low Hand Grip Strength Is Associated with Increased Risk of Cognitive Impairment in Older Men, Including Men with Probable Sarcopenic Obesity: Results from the Northern Ireland PRIME-COG Cohort.","authors":"Dominic N Farsi, Gareth J McKay, Gerry J Linden, Michael McAlinden, Jessica Teeling, Peter Passmore, Clive Holmes, Christopher C Patterson, Bernadette McGuinness, Claire T McEvoy","doi":"10.1159/000547314","DOIUrl":"10.1159/000547314","url":null,"abstract":"<p><p><p>Introduction: The relationship between cognitive impairment and a phenotype comprising low muscle strength coupled with excess adiposity, representative of sarcopenic obesity, is not well defined. The present study aimed to elucidate the relationship between low hand grip strength (HGS), representative of \"probable sarcopenia,\" coupled with obesity, thus representing \"probable sarcopenic obesity\" and cognitive impairment.</p><p><strong>Methods: </strong>Logistic regression models were implemented between probable sarcopenia and cognitive impairment in older men residing in Northern Ireland within the Prospective Epidemiological Study of Myocardial Infarction (PRIME)-COG cohort, a nested study in the PRIME cohort. In addition, associations across BMI strata were evaluated, including probable sarcopenic obesity (low HGS and BMI ≥30 kg/m2). Models were adjusted for demographics, cardiometabolic disease and risk factors, APOE-ε4, and lifestyle behaviours.</p><p><strong>Results: </strong>Among 792 men (79.1, SD 3.2 years), low HGS was associated with a significantly increased odds ratio (OR) of cognitive impairment (OR 2.14; 95% confidence intervals [CIs] 1.51-3.03, p < 0.001). The risk was broadly consistent across BMI strata, including men with probable sarcopenic obesity (OR 2.36 [95% CI: 0.85-6.35], p = 0.05). The consistent risk across BMI strata was supported by a non-significant interaction between BMI and probable sarcopenia (likelihood ratio test, p = 0.772).</p><p><strong>Conclusions: </strong>Probable sarcopenia, indicated by low HGS, was associated with an increased risk of cognitive impairment in older men, with risk consistent across BMI strata, including men living with probable sarcopenic obesity. Our findings have clinical relevance, suggesting that phenotypes comprising low muscle strength, in the presence of excess adiposity, must not be overlooked and appropriate interventions explored to attenuate physical perturbations which could carry significance towards ameliorating cognitive function in ageing. </p>.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"811-822"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-06-30DOI: 10.1159/000546772
Alina Zhawatibai, Huanbing Liu, An Xie, He Zhou, Jingwei Jiang, Na Yuan, Jun Wang, Chuancai Dan, Sujun Li, Shu Wang
Introduction: The global aging population poses significant challenges to healthcare, with frailty, balance impairment, and fall risks being prominent issues. However, the conventional clinical assessments often fail to detect early signs of these conditions. This study aimed to explore the potential of metabolomics in early identification of biomarkers related to frailty, poor balance, and fall risks in older adults.
Methods: We analyzed plasma samples from 110 participants aged 25-98 years using untargeted metabolomic analysis. Clinical assessments, including Instrumental Activities of Daily Living (IADL), Morse Fall Risk Scale, Timed Up and Go (TUG), and Fried Frailty Criteria, were performed. We examined the correlation between metabolomic results, aging-related blood tests, and clinical assessments. Statistical analysis and pathway analysis were used to identify key metabolic alterations.
Results: The metabolomics analysis identified 914 metabolites matching in the human metabolome database, with 293 metabolites significantly correlated with age. Metabolomic profiles showed distinct alterations in older adults, with significant metabolic changes observed in the old-old group, particularly in pathways related to lipid metabolism, sphingolipid signaling, and fatty acid metabolism. A new age classification based on metabolic profiles revealed significant differences in frailty risks across groups, with metabolic signatures linked to poor balance and fall risks.
Conclusion: Metabolomics offers a promising approach to identify early biomarkers of frailty, balance impairment, and fall risks in older adults. The integration of metabolic profiles with clinical assessments could lead to more precise and personalized healthcare interventions, improving fall prevention strategies and frailty management. Future studies with larger cohorts are needed to validate these findings and explore the clinical utility of Metabolomics in aging-related healthcare.
引言:全球人口老龄化对医疗保健提出了重大挑战,虚弱、平衡障碍和跌倒风险是突出的问题。然而,传统的临床评估往往不能发现这些疾病的早期迹象。本研究旨在探索代谢组学在早期识别与老年人虚弱、平衡不良和跌倒风险相关的生物标志物方面的潜力。方法:我们使用非靶向代谢组学分析分析了110名年龄在25岁至98岁之间的参与者的血浆样本。临床评估包括日常生活工具活动(IADL)、Morse跌倒风险量表、Timed Up and Go (TUG)、Fried衰弱标准等。我们检查了代谢组学结果、与衰老相关的血液检查和临床评估之间的相关性。统计分析和途径分析用于确定关键的代谢改变。结果:代谢组学分析鉴定出914种代谢物与人类代谢组数据库匹配,其中293种代谢物与年龄显著相关。代谢组学特征在老年人中显示出明显的变化,在Old-Old组中观察到显著的代谢变化,特别是在脂质代谢、鞘脂信号和脂肪酸代谢相关的途径中。一项基于代谢特征的新年龄分类揭示了各组之间脆弱风险的显着差异,代谢特征与平衡能力差和跌倒风险有关。结论:代谢组学为识别老年人虚弱、平衡障碍和跌倒风险的早期生物标志物提供了一种有希望的方法。代谢特征与临床评估的整合可以导致更精确和个性化的医疗干预,改善跌倒预防策略和虚弱管理。未来需要更大规模的研究来验证这些发现,并探索代谢组学在衰老相关医疗保健中的临床应用。
{"title":"Metabolomic Profiling Identifies Early Biomarkers of Frailty, Balance Impairment, and Fall Risks in Older Adults.","authors":"Alina Zhawatibai, Huanbing Liu, An Xie, He Zhou, Jingwei Jiang, Na Yuan, Jun Wang, Chuancai Dan, Sujun Li, Shu Wang","doi":"10.1159/000546772","DOIUrl":"10.1159/000546772","url":null,"abstract":"<p><strong>Introduction: </strong>The global aging population poses significant challenges to healthcare, with frailty, balance impairment, and fall risks being prominent issues. However, the conventional clinical assessments often fail to detect early signs of these conditions. This study aimed to explore the potential of metabolomics in early identification of biomarkers related to frailty, poor balance, and fall risks in older adults.</p><p><strong>Methods: </strong>We analyzed plasma samples from 110 participants aged 25-98 years using untargeted metabolomic analysis. Clinical assessments, including Instrumental Activities of Daily Living (IADL), Morse Fall Risk Scale, Timed Up and Go (TUG), and Fried Frailty Criteria, were performed. We examined the correlation between metabolomic results, aging-related blood tests, and clinical assessments. Statistical analysis and pathway analysis were used to identify key metabolic alterations.</p><p><strong>Results: </strong>The metabolomics analysis identified 914 metabolites matching in the human metabolome database, with 293 metabolites significantly correlated with age. Metabolomic profiles showed distinct alterations in older adults, with significant metabolic changes observed in the old-old group, particularly in pathways related to lipid metabolism, sphingolipid signaling, and fatty acid metabolism. A new age classification based on metabolic profiles revealed significant differences in frailty risks across groups, with metabolic signatures linked to poor balance and fall risks.</p><p><strong>Conclusion: </strong>Metabolomics offers a promising approach to identify early biomarkers of frailty, balance impairment, and fall risks in older adults. The integration of metabolic profiles with clinical assessments could lead to more precise and personalized healthcare interventions, improving fall prevention strategies and frailty management. Future studies with larger cohorts are needed to validate these findings and explore the clinical utility of Metabolomics in aging-related healthcare.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"705-722"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-11-14DOI: 10.1159/000542624
Natalia Sanchez Garrido, Julio Manuel Fernandez-Villa, Miguel Germán Borda, Carmen Garcia-Peña, Mario Ulises Perez Zepeda
Introduction: The aging process of the incarcerated population is a growing concern, yet there are few data on older adults in this demographic group. Hence, this study sought to examine the health status of older adults who are incarcerated in Mexican prisons and its association with the duration of their imprisonment.
Methods: This is a secondary analysis of the 2021 Mexico National Prisons Survey. We analyzed 50-year-old and older prisoners and performed a descriptive analysis of the sample's age, sex, sociodemographic variables, and chronic conditions. Multivariate analysis stratified by age was performed to assess the effect of the time spent in prison on older prisoners' health.
Results: The mean age was 56.95 (±6.4 SD), and the mean duration of imprisonment was 8.93 years (±6.94 SD). Regarding health conditions, 17.80% had diabetes, 29.62% had hypertension, 10.33% had suicidal ideation, and 40.87% were visually impaired, 17.01% had hearing impairment, and 17.64% had mobility impairment. Multivariate analysis revealed that among categories of imprisonment duration, longer time imprisoned was associated with an increased risk of diabetes and hypertension for all groups but was not associated with mobility impairment or suicidal ideation except in the younger group.
Conclusion: Longer periods of incarceration appear to be associated with a greater occurrence of diabetes and hypertension in older prisoners. Sensory impairments and suicidal ideation are mainly identified in younger prisoners, while mobility impairments do not appear to be influenced by the time spent in prison. Further research needs to be done in prisons, where the addition of physical performance tests and cognitive tests could help further study geriatric conditions in older prisoners.
{"title":"Behind Bars: Exploring Health and Geriatric Conditions among Incarcerated Older People in Mexican Prisons.","authors":"Natalia Sanchez Garrido, Julio Manuel Fernandez-Villa, Miguel Germán Borda, Carmen Garcia-Peña, Mario Ulises Perez Zepeda","doi":"10.1159/000542624","DOIUrl":"10.1159/000542624","url":null,"abstract":"<p><strong>Introduction: </strong>The aging process of the incarcerated population is a growing concern, yet there are few data on older adults in this demographic group. Hence, this study sought to examine the health status of older adults who are incarcerated in Mexican prisons and its association with the duration of their imprisonment.</p><p><strong>Methods: </strong>This is a secondary analysis of the 2021 Mexico National Prisons Survey. We analyzed 50-year-old and older prisoners and performed a descriptive analysis of the sample's age, sex, sociodemographic variables, and chronic conditions. Multivariate analysis stratified by age was performed to assess the effect of the time spent in prison on older prisoners' health.</p><p><strong>Results: </strong>The mean age was 56.95 (±6.4 SD), and the mean duration of imprisonment was 8.93 years (±6.94 SD). Regarding health conditions, 17.80% had diabetes, 29.62% had hypertension, 10.33% had suicidal ideation, and 40.87% were visually impaired, 17.01% had hearing impairment, and 17.64% had mobility impairment. Multivariate analysis revealed that among categories of imprisonment duration, longer time imprisoned was associated with an increased risk of diabetes and hypertension for all groups but was not associated with mobility impairment or suicidal ideation except in the younger group.</p><p><strong>Conclusion: </strong>Longer periods of incarceration appear to be associated with a greater occurrence of diabetes and hypertension in older prisoners. Sensory impairments and suicidal ideation are mainly identified in younger prisoners, while mobility impairments do not appear to be influenced by the time spent in prison. Further research needs to be done in prisons, where the addition of physical performance tests and cognitive tests could help further study geriatric conditions in older prisoners.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"39-46"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Age-related alterations in muscle tissue morphology and function, as well as chronic pro-inflammatory conditions, contribute to the development of sarcopenia. To elucidate the multidimensional pathogenesis of sarcopenia, we performed a comprehensive genetic analysis, including common variants, rare variants, and human leukemia antigen (HLA).
Methods: A total of 129 older adults were analyzed using whole-genome sequencing (WGS), including 67 sarcopenia patients and 62 normal controls. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. WGS data and associated clinical data were obtained from the National Center for Geriatrics and Gerontology Biobank in Japan. We performed logistic regression adjusted for age, sex, and body mass index for common variant (minor allele frequency [MAF] ≧0.01), rare variant (MAF <0.01), and HLA analyses. For the functional analysis, we performed RNA interference using human myoblasts and estimated gene expressions (MYOG, MYMK, MYMG) by quantitative PCR.
Results: Rare variant analysis identified five rare coding variants of genes - SLC41A3, SYNRG, CLUAP1, CCHCR1, and ALDH2 - expressed in skeletal muscle. Of these, a deleterious frameshift deletion in SLC41A3 was associated with the pathogenesis of sarcopenia (p = 0.0012, odds ratio [OR] = 11.52, 95% confidence interval [CI] = 2.62-50.69). This deletion significantly reduced expression of myogenin (MYOG), a factor involved in myoblast differentiation (p = 0.0094), but did not affect the fusion of myogenic cells. We also discovered a new protective allele, HLA-DPB1*02:01 associated with sarcopenia (OR = 0.17, 95% CI = 0.060-0.51, p = 0.0015), which has a high occurrence rate in the Northeast Asian population.
Conclusion: Rare variant analysis identified a deleterious frameshift deletion in SLC41A3 as a risk factor for sarcopenia. Our findings suggest that the suppression of MYOG could play a role in myogenesis or muscle maintenance, although this mutation did not impact the terminal differentiation of human myoblasts. Additionally, HLA analysis revealed that HLA-DPB1*02:01 has a protective effect, especially in Northeast Asian populations. Our study enhances the understanding of the etiology of sarcopenia and provides new insights into the mechanisms of its pathogenesis.
{"title":"Identification of a Risk Allele at SLC41A3 and a Protective Allele HLA-DPB1*02:01 Associated with Sarcopenia in Japanese.","authors":"Motoki Furutani, Tetsuaki Kimura, Koya Fukunaga, Mutsumi Suganuma, Marie Takemura, Yasumoto Matsui, Shosuke Satake, Yukiko Nakano, Taisei Mushiroda, Shumpei Niida, Kouichi Ozaki, Tohru Hosoyama, Daichi Shigemizu","doi":"10.1159/000545298","DOIUrl":"10.1159/000545298","url":null,"abstract":"<p><strong>Introduction: </strong>Age-related alterations in muscle tissue morphology and function, as well as chronic pro-inflammatory conditions, contribute to the development of sarcopenia. To elucidate the multidimensional pathogenesis of sarcopenia, we performed a comprehensive genetic analysis, including common variants, rare variants, and human leukemia antigen (HLA).</p><p><strong>Methods: </strong>A total of 129 older adults were analyzed using whole-genome sequencing (WGS), including 67 sarcopenia patients and 62 normal controls. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. WGS data and associated clinical data were obtained from the National Center for Geriatrics and Gerontology Biobank in Japan. We performed logistic regression adjusted for age, sex, and body mass index for common variant (minor allele frequency [MAF] ≧0.01), rare variant (MAF <0.01), and HLA analyses. For the functional analysis, we performed RNA interference using human myoblasts and estimated gene expressions (MYOG, MYMK, MYMG) by quantitative PCR.</p><p><strong>Results: </strong>Rare variant analysis identified five rare coding variants of genes - SLC41A3, SYNRG, CLUAP1, CCHCR1, and ALDH2 - expressed in skeletal muscle. Of these, a deleterious frameshift deletion in SLC41A3 was associated with the pathogenesis of sarcopenia (p = 0.0012, odds ratio [OR] = 11.52, 95% confidence interval [CI] = 2.62-50.69). This deletion significantly reduced expression of myogenin (MYOG), a factor involved in myoblast differentiation (p = 0.0094), but did not affect the fusion of myogenic cells. We also discovered a new protective allele, HLA-DPB1*02:01 associated with sarcopenia (OR = 0.17, 95% CI = 0.060-0.51, p = 0.0015), which has a high occurrence rate in the Northeast Asian population.</p><p><strong>Conclusion: </strong>Rare variant analysis identified a deleterious frameshift deletion in SLC41A3 as a risk factor for sarcopenia. Our findings suggest that the suppression of MYOG could play a role in myogenesis or muscle maintenance, although this mutation did not impact the terminal differentiation of human myoblasts. Additionally, HLA analysis revealed that HLA-DPB1*02:01 has a protective effect, especially in Northeast Asian populations. Our study enhances the understanding of the etiology of sarcopenia and provides new insights into the mechanisms of its pathogenesis.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 5","pages":"376-387"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-02-20DOI: 10.1159/000544779
Suyeong Bae, Mi Jung Lee, Daewoo Pak, Eun-Young Yoo, Jongbae Kim, Ickpyo Hong
Introduction: The aim of this study was to identify fall-risk groups among community-dwelling older adults in South Korea and build a classification model to investigate risk-associated factors.
Methods: This cross-sectional study analyzed data of 9,231 older adults from the 2020 Korea Elderly Survey. We used latent class analysis to identify fall-risk groups based on fall indicators. Thereafter, classification models were developed with these identified groups as outcome variables.
Results: Latent class analysis results indicated that a three-class model was more interpretable and fit the data better than other models. Among the models, the XGBoost algorithm displayed superior performance (accuracy = 0.70, precision = 0.69, recall = 0.70, F1-score = 0.68). Key variables associated with fall-risk groups included self-rated health, cognitive function, recent healthcare use, and assistance needed in instrumental activities of daily living.
Conclusion: The study adopted a preventive approach by differentiating among low-, moderate-, and high-fall-risk groups, thus providing valuable insights for healthcare professionals. Identifying these risk factors can support the development of customized fall prevention programs for older adults.
{"title":"Development of Fall Risk Classification Models for Community-Dwelling Older Adults using Latent Class Analysis and Machine Learning.","authors":"Suyeong Bae, Mi Jung Lee, Daewoo Pak, Eun-Young Yoo, Jongbae Kim, Ickpyo Hong","doi":"10.1159/000544779","DOIUrl":"10.1159/000544779","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to identify fall-risk groups among community-dwelling older adults in South Korea and build a classification model to investigate risk-associated factors.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data of 9,231 older adults from the 2020 Korea Elderly Survey. We used latent class analysis to identify fall-risk groups based on fall indicators. Thereafter, classification models were developed with these identified groups as outcome variables.</p><p><strong>Results: </strong>Latent class analysis results indicated that a three-class model was more interpretable and fit the data better than other models. Among the models, the XGBoost algorithm displayed superior performance (accuracy = 0.70, precision = 0.69, recall = 0.70, F1-score = 0.68). Key variables associated with fall-risk groups included self-rated health, cognitive function, recent healthcare use, and assistance needed in instrumental activities of daily living.</p><p><strong>Conclusion: </strong>The study adopted a preventive approach by differentiating among low-, moderate-, and high-fall-risk groups, thus providing valuable insights for healthcare professionals. Identifying these risk factors can support the development of customized fall prevention programs for older adults.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"71 5","pages":"337-350"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-11-06DOI: 10.1159/000542395
Nienke Legdeur, Maryam Badissi, Vikram Venkatraghavan, Davis C Woodworth, Fanny Orlhac, Jean-Sébastien Vidal, Frederik Barkhof, Claudia H Kawas, Pieter Jelle Visser, María M Corrada, Majon Muller, Hanneke F M Rhodius-Meester
<p><strong>Introduction: </strong>Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.</p><p><strong>Methods: </strong>We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).</p><p><strong>Results: </strong>Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline.</p><p><strong>Conclusion: </strong>In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.</p><p><strong>Introduction: </strong>Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.</p><p><strong>Methods: </strong>We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).</p><p><strong>Results: </strong>Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer a
{"title":"The Temporal Relation of Physical Function with Cognition and the Influence of Brain Health in the Oldest-Old.","authors":"Nienke Legdeur, Maryam Badissi, Vikram Venkatraghavan, Davis C Woodworth, Fanny Orlhac, Jean-Sébastien Vidal, Frederik Barkhof, Claudia H Kawas, Pieter Jelle Visser, María M Corrada, Majon Muller, Hanneke F M Rhodius-Meester","doi":"10.1159/000542395","DOIUrl":"10.1159/000542395","url":null,"abstract":"<p><strong>Introduction: </strong>Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.</p><p><strong>Methods: </strong>We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).</p><p><strong>Results: </strong>Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline.</p><p><strong>Conclusion: </strong>In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.</p><p><strong>Introduction: </strong>Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.</p><p><strong>Methods: </strong>We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).</p><p><strong>Results: </strong>Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer a","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"13-27"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}