Clinical Medicine Insights. Cardiology最新文献

{"title":"Neurogenic Orthostatic Hypotension: State of the Art and Therapeutic Strategies.","authors":"Dinesh K Kalra, Anvi Raina, Sumit Sohal","doi":"10.1177/1179546820953415","DOIUrl":"10.1177/1179546820953415","url":null,"abstract":"<p><p>Neurogenic orthostatic hypotension (nOH) is a subtype of orthostatic hypotension in which patients have impaired regulation of standing blood pressure due to autonomic dysfunction. Several primary and secondary causes of this disease exist. Patients may present with an array of symptoms making diagnosis difficult. This review article addresses the epidemiology, pathophysiology, causes, clinical features, and management of nOH. We highlight various pharmacological and non-pharmacological approaches to treatment, and review the recent guidelines and our approach to nOH.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820953415"},"PeriodicalIF":2.3,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/c5/10.1177_1179546820953415.PMC7466888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38489487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia.","authors":"Swathi Subramany,&nbsp;Ajoe John Kattoor,&nbsp;Swathi Kovelamudi,&nbsp;Subodh Devabhaktuni,&nbsp;Jawahar L Mehta,&nbsp;Srikanth Vallurupalli,&nbsp;Hakan Paydak,&nbsp;Naga Venkata K Pothineni","doi":"10.1177/1179546820953416","DOIUrl":"https://doi.org/10.1177/1179546820953416","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiogram (ECG) differentiation of wide complex tachycardia (WCT) into ventricular tachycardia (VT) and supraventricular tachycardia with aberration (SVT-A) is often challenging.</p><p><strong>Objective: </strong>To determine if the presence of Q-waveforms (QS, Qr, QRs) in the inferior leads (II, III, aVF) can differentiate VT from SVT-A in a WCT compared to Brugada algorithm. We studied 2 inferior lead criteria namely QWC-A where all the inferior leads had a similar Q wave pattern and QWC-B where only lead aVF had a Q-waveform.</p><p><strong>Methods: </strong>A total of 181 consecutive cases of WCT were identified, digitally separated into precordial leads and inferior leads and independently reviewed by 2 electrophysiologists. An electrocardiographic diagnosis of VT or SVT-A was assigned based on Brugada and inferior lead algorithms. Results were compared to the final clinical diagnosis.</p><p><strong>Results: </strong>VT was the final clinical diagnosis in 24.9% of ECG cohort (45/181); 75.1% (136/181) were SVT-A. QWC-A and QWC-B had a high specificity (93.3% and 82.8%) and accuracy (78.2% and 71.0%), but low sensitivity (33.3% and 35.6%) in differentiating VT from SVT-A. The Brugada algorithm yielded a sensitivity of 82.2% and specificity of 68.4%. Area under the curve in ROC analysis was highest with Brugada algorithm (0.75, 95% CI 0.69-0.81) followed by QWC-A (0.63, 95% CI 0.56-0.70) and QWC-B (0.59, 95% CI 0.52-0.67).</p><p><strong>Conclusion: </strong>QWC-A and QWC-B criteria had poor sensitivity but high specificity in diagnosing VT in patients presenting with WCT. Further research combining this simple criterion with other newer diagnostic algorithms can potentially improve the accuracy of the overall diagnostic algorithm.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820953416"},"PeriodicalIF":3.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820953416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38391479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting Coronary and Carotid Artery Disease - Which Technique and in Which Order? Case Report and Review of Literature.","authors":"Sina Manthey,&nbsp;Jenna Spears,&nbsp;Sheldon Goldberg","doi":"10.1177/1179546820951797","DOIUrl":"https://doi.org/10.1177/1179546820951797","url":null,"abstract":"<p><p>Coexisting carotid artery stenosis and coronary artery disease is common and there is currently no consensus in treatment guidelines on the timing, sequence and methods of revascularization. We report a case of a patient with symptomatic triple vessel coronary artery disease as well as asymptomatic severe right internal carotid artery stenosis. Our patient underwent myocardial revascularization first, because she presented with unstable angina and was asymptomatic neurologically. This article summarizes current literature about the approach to carotid and coronary artery revascularization and addresses the decision-making process regarding the timing and sequence of revascularization.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820951797"},"PeriodicalIF":3.0,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820951797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38376030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid Plaque Morphology is Similar in Patients with Reduced and Normal Renal Function.","authors":"Caroline Heijl, Fredrik Kahn, Andreas Edsfeldt, Christoffer Tengryd, Jan Nilsson, Isabel Goncalves","doi":"10.1177/1179546820951793","DOIUrl":"10.1177/1179546820951793","url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD) is associated with an increased risk for cardiovascular events such as stroke. However, it is still unclear if decreased kidney function is associated with a vulnerable atherosclerotic plaque phenotype. To explore if renal function was associated with carotid plaque vulnerability we analyzed carotid plaques obtained at surgery from the Carotid Plaque Imaging Project (CPIP).</p><p><strong>Methods: </strong>Patients were enrolled through the CPIP cohort. The indication for surgery was plaques with stenosis >70%, associated with ipsilateral symptoms or plaques with stenosis >80% not associated with symptoms. Transversal sections from the most stenotic plaque region were analyzed for connective tissue, calcium, lipids, macrophages, intraplaque hemorrhage, and smooth muscle cells. Homogenates were analyzed for collagen and elastin.</p><p><strong>Results: </strong>Carotid endarterectomy specimens from 379 patients were obtained. The median GFR was 73 ml/min/1.73 m². Plaque characteristics showed no significant association with eGFR, neither when eGFR was divided in CKD groups nor when eGFR was handled as a continuous variable and adjusting for other known risk factors (ie, age, diabetes, hypertension, and smoking).</p><p><strong>Conclusions: </strong>The higher risk of cardiovascular disease such as stroke in CKD is not associated with increased plaque vulnerability and other factors have to be sought.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820951793"},"PeriodicalIF":3.0,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38376028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Study Assessing Immediate Complete Versus Delayed Complete Revascularisation in Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention.","authors":"Krishnaraj Sinhji Rathod, Marco Spagnolo, Mark K Elliott, Anne-Marie Beirne, Elliot J Smith, Rajiv Amersey, Charles Knight, Roshan Weerackody, Andreas Baumbach, Anthony Mathur, Daniel A Jones","doi":"10.1177/1179546820951792","DOIUrl":"10.1177/1179546820951792","url":null,"abstract":"<p><strong>Background: </strong>More than half of the patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) have multi-vessel coronary artery disease. This is associated with worse outcomes compared with single vessel disease. Whilst evidence now exists to support complete revascularisation for bystander disease the optimal timing is still debated. This study aimed to compare clinical outcomes in patients with STEMI and multi-vessel disease who underwent complete revascularisation as inpatients in comparison to patients who had staged PCI as early outpatients.</p><p><strong>Methods and results: </strong>We conducted an observational cohort study consisting of 1522 patients who underwent primary PCI with multi-vessel disease from 2012 to 2019. Exclusions included patients with cardiogenic shock and previous CABG. Patients were split into 2 groups depending on whether they had complete revascularisation performed as inpatients or as staged PCI at later outpatient dates. The primary outcome of this study was major adverse cardiac events (consisting of myocardial infarction, target vessel revascularisation and all-cause mortality).834 (54.8%) patients underwent complete inpatient revascularisation and 688 patients (45.2%) had outpatient PCI (median 43 days post discharge). Of the inpatient group, 652 patients (78.2%) underwent complete revascularisation during the index procedure whilst 182 (21.8%) patients underwent inpatient bystander PCI in a second procedure. Overall, there were no significant differences between the groups with regards to their baseline or procedural characteristics. Over the follow-up period there was no significant difference in MACE between the cohorts (<i>P</i> = .62), which persisted after multivariate adjustment (HR 1.21 [95% CI 0.72-1.96]). Furthermore, in propensity-matched analysis there was no significant difference in outcome between the groups (HR: 0.86 95% CI: 0.75-1.25).</p><p><strong>Conclusions: </strong>Our study demonstrated that the timing of bystander PCI after STEMI did not appear to have an effect on cardiovascular outcomes. We suggest that patients with multi-vessel disease can potentially be discharged promptly and undergo early outpatient bystander PCI. This could significantly reduce length of stay in hospital.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820951792"},"PeriodicalIF":2.3,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/fd/10.1177_1179546820951792.PMC7444144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38368137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staged Percutaneous Coronary Intervention with Rotational Atherectomy or Bypass Surgery in Chronic Hemodialysis and Severely Calcified Left Main True Bifurcation Lesion: A Case Report and Literature Review.","authors":"Kazuhiro Dan, Akira Shinoda, Hector M Garcia-Garcia","doi":"10.1177/1179546820951798","DOIUrl":"10.1177/1179546820951798","url":null,"abstract":"<p><p>Previous observational studies and meta-analyses reported that the optimal strategy of coronary revascularization (percutaneous coronary intervention [PCI] and bypass surgery) for anatomically complex coronary artery lesions in the chronic hemodialysis setting is still controversial because the long-term outcomes were superior with coronary artery bypass grafting, especially with regard to repeat revascularization; however, short-term mortality with PCI was significantly lower because it is less invasive. Moreover, no guidelines show a strategy for this setting. We report the case of a patient with chronic dialysis and calcified left main true bifurcation lesion who underwent staged PCI with rotational atherectomy and minimally invasive direct coronary artery bypass for in-stent restenosis who died of non-occlusive mesenteric ischemia.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820951798"},"PeriodicalIF":2.3,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/39/10.1177_1179546820951798.PMC7444146.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38366019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Noncardiac Chest Pain Truly Noncardiac?","authors":"Hiroki Teragawa,&nbsp;Chikage Oshita,&nbsp;Yuichi Orita","doi":"10.1177/1179546820918903","DOIUrl":"https://doi.org/10.1177/1179546820918903","url":null,"abstract":"<p><p>Many causes of noncardiac chest pain (NCCP) have been studied and gastroesophageal reflux disease is considered to be the major cause. However, studies have reported that treatment with a proton pump inhibitor does not effectively provide relief for NCCP-related symptoms, and these symptoms frequently recur. These findings suggest that patients with cardiac disease may be excluded completely from the NCCP group. Several examinations can be conducted to verify the presence of cardiac disease. Such examinations include the assessment of biochemical markers, rest and exercise electrocardiogram, echocardiography, cardiac computed tomography, stress myocardial perfusion imaging, cardiac magnetic resonance imaging, and coronary angiography (CAG). However, the presence of functional coronary artery diseases (CADs), such as vasospastic angina and/or microvascular angina, cannot be detected using these modalities. These functional CADs can be diagnosed by CAG with spasm-provocation testing and/or physiological coronary measurement. Thus, when a patient who is suspected of having NCCP takes a proton pump inhibitor and does not respond well, further examination-including assessment for possible functional CADs-may be needed.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820918903"},"PeriodicalIF":3.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820918903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography.","authors":"Manal F Elshamaa,&nbsp;Fatma A Mostafa,&nbsp;Inas Aes Sad,&nbsp;Ahmed M Badr,&nbsp;Yomna Aem Abd Elrahim","doi":"10.1177/1179546820930015","DOIUrl":"https://doi.org/10.1177/1179546820930015","url":null,"abstract":"<p><strong>Background: </strong>Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE).</p><p><strong>Methods: </strong>Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE.</p><p><strong>Results: </strong>The LS was significantly reduced in pre-HD and post-HD patients compared with controls (<i>P</i> = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls (<i>P</i> < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments (<i>P</i> = .035 and <i>P</i> = .013, respectively).</p><p><strong>Conclusion: </strong>Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820930015"},"PeriodicalIF":3.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820930015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38060133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease.","authors":"Alexandra C Murphy, Georgina Meehan, Anoop N Koshy, Phelia Kunniardy, Omar Farouque, Matias B Yudi","doi":"10.1177/1179546820927402","DOIUrl":"10.1177/1179546820927402","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation programs provide a comprehensive framework for the institution of secondary preventive measures. Smartphone technology can provide a platform for the delivery of such programs and is a promising alternative to hospital-based services. However, there is limited evidence to date supporting this approach. Accordingly, we performed a systematic review and meta-analysis examining smartphone-based secondary prevention programs to traditional cardiac rehabilitation in patients with established coronary artery disease to ascertain the feasibility and effectiveness of these interventions.</p><p><strong>Methods: </strong>A systematic search of PubMed, MEDLINE, EMBASE, and the Cochrane Library was conducted. A meta-analysis was performed using a random-effects model with the outcomes of interest being 6-minute walk test (6MWT) distance, systolic blood pressure, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI).</p><p><strong>Results: </strong>A total of 8 studies with 1120 patients across 5 countries were included in the quantitative analysis. Follow-up ranged from 6 weeks to 12 months. Five studies examined all patients post acute coronary syndrome, 2 studies examined only patients undergoing percutaneous coronary intervention, and 1 study examined all patients with a diagnosis of coronary artery disease, independent of intervention. Exercise capacity, as measured by the 6MWT, was significantly greater in the smartphone group (20.10 meters, 95% confidence interval [CI] 7.44-33.97; <i>P</i> < .001; <i>I</i> ² = 45.58). There was no significant difference in BMI reduction, systolic blood pressure, or LDL cholesterol levels between groups (<i>P</i> value for all > .05).</p><p><strong>Conclusion: </strong>Publicly available smartphone-based cardiac rehabilitation programs are a convenient and easily disseminated intervention which show merit in exercise promotion in patients with established coronary artery disease. Further research is required to establish the clinical significance of recent findings favoring their use.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820927402"},"PeriodicalIF":3.0,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/44/10.1177_1179546820927402.PMC7278307.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38060132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Management Strategies, and In-Hospital Outcomes of Acute Coronary Syndrome in a Low Socioeconomic Status Cohort: An Observational Study From Urban India.","authors":"Navdeep Singh Sidhu,&nbsp;Sunil Kumar Kondethimmannahally Rangaiah,&nbsp;Dwarikaprasad Ramesh,&nbsp;Kumaraswamy Veerappa,&nbsp;Cholenahally Nanjappa Manjunath","doi":"10.1177/1179546820918897","DOIUrl":"https://doi.org/10.1177/1179546820918897","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease is the leading cause of mortality in India. There is scarcity of data on demographic profile and outcomes of acute coronary syndrome (ACS) in low socioeconomic status (SES) population of India.</p><p><strong>Objectives: </strong>This study was undertaken to determine the clinical presentation, management strategies, and in-hospital outcomes of ACS in low SES population.</p><p><strong>Methods: </strong>We conducted 1-year prospective observational cohort study of ACS patients admitted at Employees State Insurance Corporation unit of our tertiary care cardiac center. Clinical parameters, management strategies, and in-hospital outcomes of 621 patients enrolled during the study period from February 2015 to January 2016 were studied.</p><p><strong>Results: </strong>Mean age of patients was 56.06 ± 11.29 years. Majority (62%) of the patients had ST elevation myocardial infarction (STEMI), whereas Non-ST elevation acute coronary syndrome (NSTE-ACS) was seen in 38% of the patients. Median time from symptom onset to hospital admission was 285 min with wide range from 105 to 1765 min. Coronary angiography was performed in 81% of patient population. Single-vessel disease (SVD) was the most common pattern (seen in 43.3%) of coronary artery involvement with left anterior descending coronary artery (LAD) being the most frequently involved vessel (62.8%). Pharmaco-invasive approach was the preferred strategy. Overall percutaneous coronary intervention (PCI) rates were 59.1% (62.1% in STEMI and 54.2% in NSTE-ACS). Overall in-hospital mortality was 3.2%, being significantly higher in STEMI (4.2%) as compared with NSTE-ACS (1.7%).</p><p><strong>Conclusions: </strong>With implementation of evidence-based pharmacotherapy and interventions, outcomes comparable with developed countries can be achieved even in low SES populations of developing world.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 ","pages":"1179546820918897"},"PeriodicalIF":3.0,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546820918897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37949482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}