Giornale italiano di cardiologia最新文献

{"title":"[Management of cardiac amyloidosis in Italy: a national survey of the Italian Cardiac Amyloidosis Network (RIAC)].","authors":"Cristina Chimenti, Aldostefano Porcari, Marco Cittar, Alberto Aimo, Francesco Musca, Alberto Cipriani, Marco Zuin, Simone Longhi, Andrea Di Lenarda, Marco Merlo, Massimo Iacoviello, Marco Canepa, Giuseppe Limongelli, Michele Emdin, Furio Colivicchi, Pasquale Perrone Filardi, Fabrizio Oliva, Gianfranco Sinagra","doi":"10.1714/4488.44888","DOIUrl":"10.1714/4488.44888","url":null,"abstract":"<p><strong>Background: </strong>The national survey of the SIC-ANMCO Amyloidosis Centers was designed to create a geographical mapping of the centers that identify and follow patients with cardiac amyloidosis in Italy and to describe their diagnostic capabilities and multidisciplinary organization.</p><p><strong>Methods: </strong>The survey was administered to 212 centers in Italy. Among them, 153 centers responded (72%), 31/35 (89%) of which were academic medical centers and 122/177 (69%) hospitals.</p><p><strong>Results: </strong>The results revealed a prevalence of centers in the North and Center of Italy compared to the South and the Islands, highlighting a greater number of patients in heart failure/cardiomyopathy clinics in hospitals (53%) and in clinics dedicated to amyloidosis in academic medical centers (71%). Most centers have an internal multidisciplinary collaboration network with the neurologist (82% in total, 97% in academic medical centers and 78% in hospitals) and the hematologist (69% in total, in 94% and 63%, respectively) and have the possibility of performing on-site cardiac magnetic resonance imaging (74%, in 94% and 68%, respectively) and scintigraphy with bone tracers (52%, in 91% and 44%, respectively), or alternatively to refer patients to other centers thanks to well-structured or occasional collaborations. Conversely, only a minority of centers perform endomyocardial biopsy (31%, in 71% of academic medical centers and in 20% of hospitals) and a smaller number of academic medical centers perform sophisticated amyloid tissue typing techniques such as immunogold labeling (11%) and mass spectrometry (4%).</p><p><strong>Conclusions: </strong>The survey provided important information on the current Italian situation, underlining the importance of collaboration between the various levels of the network, to guarantee the best possible pathways and treatments for all patients with amyloidosis.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 5","pages":"347-355"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cerebral amyloid angiopathy and left atrial appendage occlusion: evidence and possible management for a collaborative approach between Cardiology and Neurology].","authors":"Andrea Lalario, Enrico Fabris, Serena Rakar, Laura Massa, Alberto Benussi, Gianfranco Sinagra","doi":"10.1714/4464.44614","DOIUrl":"10.1714/4464.44614","url":null,"abstract":"<p><p>This review highlights the epidemiological and clinical challenge associated with managing patients who have cerebral amyloid angiopathy (CAA) and atrial fibrillation. As the population ages, clinicians are increasingly required to devise appropriate management strategies for this specific patient subgroup. These patients face not only the risk of intracerebral hemorrhage associated with oral anticoagulant therapy but also complications due to CAA. CAA is an age-related small vessel disease characterized by the deposition of β-amyloid in the walls of cortical and leptomeningeal arteries, arterioles, and capillaries. This condition progressively weakens the vascular integrity, thereby increasing the risk of major bleeding events. The lack of randomized clinical trials necessitates a multiparametric and multidisciplinary approach to assess the extent of vasculopathy and balance thromboembolic and hemorrhagic risks, aiming to tailor the most effective management strategy for each patient. In managing such cases, it is crucial to address concomitant risk factors and consider both pharmacological and non-pharmacological interventions, such as left atrial appendage occlusion, to mitigate the risk of stroke.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 4","pages":"251-260"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ANMCO Position paper: Management of heart failure with preserved ejection fraction].","authors":"Attilio Iacovoni, Alessandro Navazio, Leonardo De Luca, Mauro Gori, Marco Corda, Massimo Milli, Massimo Iacoviello, Andrea Di Lenarda, Giuseppe Di Tano, Marco Marini, Annamaria Iorio, Andrea Mortara, Gian Francesco Mureddu, Filippo Zilio, Cristina Chimenti, Manlio Gianni Cipriani, Michele Senni, Claudio Bilato, Massimo Di Marco, Giovanna Geraci, Vittorio Pascale, Carmine Riccio, Pietro Scicchitano, Emanuele Tizzani, Michele Massimo Gulizia, Federico Nardi, Domenico Gabrielli, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva","doi":"10.1714/4464.44616","DOIUrl":"10.1714/4464.44616","url":null,"abstract":"<p><p>Heart failure is the leading cardiovascular cause of hospitalization with an increasing prevalence, especially in older patients. About 50% of patients with heart failure have preserved ventricular function, a form of heart failure that, until a few years ago, was orphaned by pharmacological treatments effective in reducing hospitalization and mortality. New trials, which have tested the use of gliflozins in patients with heart failure with preserved ejection fraction (HFpEF), have for the first time demonstrated their effectiveness in changing the natural history of this insidious and frequent form of heart failure. Therefore, diagnosing those patients early is crucial to provide the best treatment. Moreover, the diagnosis is influenced by the patient's comorbidities, and some HFpEF patients have symptoms common to other rare diseases that, if unrecognized, develop an unfavourable prognosis. This position paper aims to provide the clinician with a useful tool for diagnosing and treating patients with HFpEF, guiding the clinician towards the most appropriate diagnostic and therapeutic pathway.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 4","pages":"270-299"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Role of inflammation in heart failure with preserved ejection fraction: from nephro-metabolic interactions to future therapeutic implications].","authors":"Emilia D'Elia, Manuela Benvenuto, Ilaria Battistoni, Marco Cittar, Gianluigi Tagliamonte, Daniele Masarone, Geza Halasz, Raul Limonta, Luisa De Gennaro, Renata De Maria, Samuela Carigi, Matteo Bianco, Concetta Di Nora, Paolo Manca, Maria Vittoria Matassini, Vittoria Rizzello, Vittorio Palmieri, Claudio Bilato, Giovanna Geraci, Mauro Gori, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva, Massimo Iacoviello","doi":"10.1714/4464.44612","DOIUrl":"10.1714/4464.44612","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a complex clinical entity frequently associated with chronic kidney disease (CKD). Recent studies indicate that 50-60% of HFpEF patients also have CKD, and the prevalence of HFpEF among CKD patients is similarly high. Chronic low-grade systemic inflammation is common to both conditions and is linked to risk factors such as obesity, insulin resistance, and diabetes. The hyperactivation of the mineralocorticoid receptor plays a central role in this process, contributing to interstitial fibrosis and inflammation. Additional factors, including metabolic acidosis, gut dysbiosis, and reduced expression of the α-Klotho protein, amplify the inflammatory response. This systemic inflammation reduces nitric oxide production, impairing cardiac diastolic function and, together with metabolic syndrome and aging, further exacerbates the already complex cardiac pathology. Therapeutic strategies aimed at reducing inflammation, such as renin-angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter 2 inhibitors, show promising potential. Additionally, the use of anti-inflammatory drugs and novel interventions to restore gut microbiota balance may offer new opportunities to improve prognosis in patients with HFpEF and CKD. Further studies are needed to clarify the clinical efficacy of these approaches and their role in optimizing the management of this complex patient population.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 4","pages":"223-236"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Follow-up of patients with acute and chronic heart failure: risk stratification to diversify the pathway].","authors":"Samuela Carigi, Vittoria Rizzello, Renata De Maria, Raul Limonta, Francesco Orso, Matteo Bianco, Luisa De Gennaro, Maria Vittoria Matassini, Paolo Manca, Concetta Di Nora, Maria Denitza Tinti, Vittorio Palmieri, Alessandro Navazio, Giovanna Geraci, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva, Mauro Gori","doi":"10.1714/4464.44613","DOIUrl":"10.1714/4464.44613","url":null,"abstract":"<p><p>Heart failure is a syndrome with a high clinical and healthcare impact. Currently, the incidence in Europe is approximately 5/1000 people/year in the adult population, with a prevalence of 1-2%. The prognosis is burdened by a still high mortality and hospitalization rate. The phase immediately following the hospitalization is defined as the \"vulnerable period\" because it is characterized by the greatest number of clinical events: 30% risk of rehospitalization and 10% risk of death. Taking care of the patients in this phase is crucial and must be accompanied by a risk stratification process, essential for planning a follow-up that is as personalized as possible, also necessary for resource optimization. In the chronic phase of the disease, risk stratification appears similarly important, as it could represent a support tool in the patient's transition from hospital to the community. The aims of this paper are to review the recommendations for the follow-up of the European and American guidelines, describe the tools available to the clinician to stratify the prognosis and diversify the pathway, and finally hypothesize a follow-up scheme both in the post-acute and chronic phases.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 4","pages":"237-250"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A decade of changes in cardiac surgery: an Italian geographical and gender analysis].","authors":"Giuseppe Santarpino, Anna Maria Moretti, Maria Avolio, Lanberto Giuliano, Khalil Fattouch, Luigi Specchia, Carlo Zebele, Roberto Coppola, Luigi Martinelli, Carlo Savini, Vinicio Fiorani, Mauro Lamanna, Mauro Del Giglio, Chiara Comoglio, Domenico Paparella, Carmine Carbone, Giuseppe Nasso, Giuseppe Speziale","doi":"10.1714/4464.44615","DOIUrl":"10.1714/4464.44615","url":null,"abstract":"<p><strong>Background: </strong>Numerous speculations have been made in recent years about the future of cardiac surgery, seen by some as an \"obsolete\" discipline and reserved for complex/emerging cases.</p><p><strong>Methods: </strong>From the central database of the private-affiliated group GVM Care & Research with the National Health System, data from 2014 to 2023 relating to elective cardiac surgery (57 736 patients) were extracted from 12 cardiac surgery centers located throughout the country, with specific reference to isolated coronary and valvular surgery.</p><p><strong>Results: </strong>The number of elective interventions performed from 2014 to 2023 has progressively increased with a slowdown in 2020 caused by the COVID-19 pandemic. The increase in the number of interventions is mainly linked to an increase in interventions in central-southern Italy which, starting from 2016, has led to equalizing the data in the two geographical areas. Women, throughout the country, have a higher average age at surgery than men and a higher surgical risk than men, especially if operated in northern Italy. Coronary artery bypass grafting has increased especially in southern Italy, and remains more frequent in males throughout the country. As for isolated valve interventions, there has been an increase in the total number, more significant in central and southern Italy, and a significant increase in the use of biological prostheses. Thirty-day mortality has not undergone significant changes in the last 10 years.</p><p><strong>Conclusions: </strong>Our results demonstrate that cardiac surgery is a specialty that has not reduced its activity over the years in the elective field despite a significant transformation of the branch with a shift towards transcatheter approaches. The observation of a possible diagnostic delay (and consequently of intervention) in the female sex remains, with an increase in the predicted risk in women.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 4","pages":"261-269"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical-instrumental management and anticoagulant therapy in the follow-up of patients with pulmonary embolism: the results of the \"FOLLOW-EP\" survey promoted by the ANMCO Working Group on Pulmonary Vascular Diseases].","authors":"Iolanda Enea, Maria Cristina Vedovati, Laura Scelsi, Andrea Garascia, Sergio Caravita, Claudio Picariello","doi":"10.1714/4454.44488","DOIUrl":"10.1714/4454.44488","url":null,"abstract":"<p><strong>Background: </strong>Follow-up management of patients with pulmonary embolism (PE) is crucial to reduce the risk of recurrence and the early identification of those who develop pulmonary hypertension. However, this pathway is poorly defined.</p><p><strong>Methods: </strong>The ANMCO Working Group on Pulmonary Vascular Diseases together with the ANMCO Study Center addressed a web-based set of 16 questions to ANMCO members to investigate their experience in PE follow-up settings and adherence to guidelines.</p><p><strong>Results: </strong>Out of 4488 submissions, 294 (6.5%) answered, of which 69% were cardiologists. An outpatient clinic for PE follow-up is not present in 43% of the centers, in 28% it is present in a structured form and in 27% only as an outpatient clinic for anticoagulant therapy (AC). The referring doctor is a cardiologist in 68% of cases. The first visit after PE is usually at 3 months (60%). The bleeding and recurrence risk profiles are assessed in 63% and 36% of cases, respectively. Thrombophilia screening guides AC discontinuation after idiopathic PE (47%), especially in women and young people (55%). Risk factors associated with the index event are decisive for AC extended duration in estrogen-progestin-induced PE (69%) as well as in incidental PE (80%). In the extended phase, direct oral anticoagulants (DOACs) at low dose are used in 45% in accordance with current literature, in 40% due to the risk of bleeding. In patients with active cancer, 47% continue DOACs at full dose indefinitely, 36% at reduced dose. In 93% of cases, exertional dyspnea in the follow-up leads to the request for additional tests: a ventilation-perfusion scan in 44%, a pulmonary computed tomography angiography in 34%.</p><p><strong>Conclusions: </strong>The data collected show wide heterogeneity in the follow-up management of PE. Dedicated clinics and local pathways are needed in caring for the patient after an episode of PE.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 3","pages":"195-204"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The evolving landscape of hypertrophic cardiomyopathy management: a review of the updated AHA/ACC/multisociety guidelines].","authors":"Edoardo Bertero, Marco Canepa, Maurizio Pieroni, Iacopo Olivotto","doi":"10.1714/4454.44487","DOIUrl":"10.1714/4454.44487","url":null,"abstract":"<p><p>Therapeutic options for the treatment of hypertrophic obstructive cardiomyopathy have recently expanded with the introduction of myosin inhibitors, mavacamten and aficamten, which demonstrated a remarkable effect on functional capacity and symptoms of patients with left ventricular outflow tract obstruction. In recent years, there has also been a change in the approach to physical exercise in patients with hypertrophic cardiomyopathy, which now also includes the possibility of participating in high-intensity and competitive sports for selected patients with a low-risk profile. In this review, we explore the main innovations of the American College of Cardiology/American Heart Association guidelines on hypertrophic cardiomyopathy, we highlight the differences with the guidelines on the management of cardiomyopathies of the European Society of Cardiology, and we highlight some important unresolved issues in the management of the disease.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 3","pages":"185-194"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ten questions about hormone replacement therapy and cardiovascular risk].","authors":"Vered Gil Ad, Stefania Angela Di Fusco, Maria Teresa Manes, Beatrice Scardovi, Daniela Pavan, Ivana Pariggiano, Massimo Iacoviello, Ilaria Battistoni, Manuela Benvenuto, Daniele Masarone, Alessandro Maloberti, Pier Luigi Temporelli, Roberta Rossini, Simona Giubilato, Italo Porto, Michela Pittaluga, Massimo Grimaldi, Giovanna Geraci, Furio Colivicchi, Fabrizio Oliva","doi":"10.1714/4454.44482","DOIUrl":"10.1714/4454.44482","url":null,"abstract":"<p><p>The impact of hormone replacement therapy (HRT) on the cardiovascular (CV) system in menopausal women has been the subject of significant debate for many years. After a phase marked by restrictive use following the outcomes of the first randomized trials in the 2000s, the last decade has witnessed a significant reassessment of the risks and benefits of therapy, especially CV risk. Thanks to new studies conducted in more selected populations and sub-analyses of earlier trials, there is now ample evidence regarding the high safety profile of HRT, and even protection on the CV system, for young women with a low CV risk profile in the early menopausal phase. This evidence has been incorporated into all national and international menopausal guidelines and, recently, also in a consensus document by the European Society of Cardiology. Therefore, the cardiologist assumes a central role in the risk assessment and treatment of modifiable CV risk factors during the menopausal transition, a critical period for women as it is associated with significant changes in the glycometabolic balance. This article summarises current knowledge on the subject and provides practical guidance for the cardiological management of such patients.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 3","pages":"147-158"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Minimally invasive thoracic aortic surgery: our experience].","authors":"Olimpia Bifulco, Paolo Berretta, Simone D'Alessio, Martina Giusti, Filippo Capestro, Alessandro D'Alfonso, Pietro Giorgio Malvindi, Marco Di Eusanio","doi":"10.1714/4454.44489","DOIUrl":"10.1714/4454.44489","url":null,"abstract":"<p><strong>Background: </strong>The growing experience in minimally invasive techniques, supported by outstanding outcomes and excellent surgical exposure of the entire proximal thoracic aorta via ministernotomy, has motivated surgeons to apply this approach to more challenging procedures such as aortic root and arch treatment.</p><p><strong>Methods: </strong>From September 2016 to April 2024, 243 consecutive patients underwent proximal aortic surgical treatment through the ministernotomy approach at the Cardiac Surgery Unit of the Lancisi Cardiovascular Center of Ancona - Polytechnic University of Marche, Italy. In all cases, a preoperative computed tomography scan was performed.</p><p><strong>Results: </strong>The mean age of the population was 65 ± 12 years, and 176 patients (72%) were male. Aortic valve disease occurred in 66.9% of cases (n=85) with significant aortic valve regurgitation or stenosis in 127 (52%) and 44 (18%) patients, respectively. Bicuspid aortic valve was found in 29% of patients (n=70). Surgical procedures included aortic root operations (n=88) using Bentall (n=64) or David (n=24) technique, isolated replacement of the ascending aorta (n=73), and combined treatment: replacement of the ascending aorta and the aortic valve (n=82). The 30-day mortality and stroke rate was 0.4%. In 132 patients (54%), extubation occurred within the first 6 h after surgical treatment. The median hospital stay was 7 days with 48% (n=107) of patients discharged home without need for any cardiac rehabilitation.</p><p><strong>Conclusions: </strong>Minimally invasive thoracic aortic surgery can be performed successfully at specialized cardiac surgery centers. Preoperative careful and accurate analysis of patient's computed tomography scan is essential to promote patient-tailored planning and promote optimal surgical exposure.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 3","pages":"205-210"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}