Indian heart journal最新文献

{"title":"Agreement between transthoracic echocardiography and CT coronary angiography for left ventricular outflow tract diameter in stable Indian adults: A prospective observational study.","authors":"Manu M K Varma, Shreedhara Nagol Shekharappa, Kingshuk Saha, G Vikneswaran, Vimal Raj, Raghavi Goel, Satish C Govind","doi":"10.1016/j.ihj.2026.04.016","DOIUrl":"10.1016/j.ihj.2026.04.016","url":null,"abstract":"<p><strong>Objective: </strong>To assess the agreement between transthoracic echocardiography (TTE) and computed tomography coronary angiography (CT-CAG) for measurement of the left ventricular outflow tract diameter (LVOTd) in the parasternal long-axis orientation, and to explore anthropometric predictors of LVOTd in stable Indian adults.</p><p><strong>Methods: </strong>In this prospective, single-centre study, hemodynamically stable adults in sinus rhythm undergoing outpatient CT-CAG were enrolled (October-December 2024). LVOTd was measured by TTE (parasternal long-axis view, mid-systole) and by CT in a matched long-axis orientation (anteroposterior diameter at the same anatomical level) by separate blinded readers. Agreement was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis.</p><p><strong>Results: </strong>Of 100 screened subjects, 91 were analysed (mean age 53.9 ± 8.7 years; 72.5% male; 84.6% health screening). Mean LVOTd was 1.94 ± 0.24 cm (CT-CAG) versus 1.88 ± 0.18 cm (TTE). The two modalities demonstrated good agreement for LVOTd (ICC 0.85; 95% CI 0.77-0.89). Bland-Altman analysis revealed a bias of 0.05 cm (limits of agreement 0.25 to 0.34 cm), with CT-CAG yielding larger values. Agreement diminished for derived parameters, being moderate for LVOT area (ICC 0.74) and modest for cardiac output (CO) (ICC 0.57; bias 0.5 L/min), indicating non-interchangeability for hemodynamic calculations. Body weight was the sole significant predictor of LVOTd (β = 0.004 cm/kg; R² = 0.29; p = 0.04).</p><p><strong>Conclusions: </strong>In stable Indian adults, TTE and CT-CAG show good agreement for LVOTd measured in a comparable anatomical plane. Agreement diminishes for derived area and CO estimates. The weight-based model requires validation in larger, more diverse cohorts.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770421","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":"Comment on \"Exploring the role of left atrial fibrosis and left atrial volume index through cardiac magnetic resonance imaging in embolic stroke of undetermined source: A network meta-analysis\".","authors":"Bhumesh Tyagi, Prashant Ramdas Kokiwar, Archana Dhyani","doi":"10.1016/j.ihj.2026.04.011","DOIUrl":"10.1016/j.ihj.2026.04.011","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770429","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 single center experience with the use of Occlunix septal occluder for closure of atrial septal defects.","authors":"N Sharath, Anjana S Jayan, Kavassery Mahadevan Krishnamoorthy, Deepa Sasikumar, Arun Gopalakrishnan","doi":"10.1016/j.ihj.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.014","url":null,"abstract":"<p><p>The Occlunix® septal occluder (OSO) is a new generation double disk occluder device for catheter closure of the secundum atrial septal defect (ASD). Fifty-six consecutive patients who underwent ASD device closure with the OSO between February 2022 and April 2024 were evaluated in this single-center observational study. All procedures were done under transesophageal echocardiography guidance. The OSO was successfully deployed in all patients (technical success 100%). Fifty-five patients had complete closure of the intervened ASD after device closure (procedural success 98.2%). The sole patient with trivial intradevice shunt had complete seal of the defect at 1-month follow-up. There were no device related complications - cardiac, vascular or systemic. During the follow-up period of 32.2 ± 9.1 months, the device position was satisfactory in all, with no complications. The OSO was associated with lower procedural cost than one of the most used conventional ASD occluders used in the country.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770389","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":"Frailty and advanced age in atrial fibrillation: Implications for treatment strategies and clinical outcomes - A systematic review.","authors":"Akash Batta, Razieh Parizad, Juniali Hatwal, Ankur Mittal, Manjeet Kumar Goyal, Bishav Mohan","doi":"10.1016/j.ihj.2026.04.006","DOIUrl":"10.1016/j.ihj.2026.04.006","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is common among frail older adults and poses complex management challenges due to reduced physiological reserve and heightened vulnerability to adverse outcomes.</p><p><strong>Aims: </strong>This systematic review (2015-2025) examined influence of frailty and advanced age on AF management and outcomes, focusing on anticoagulation, interventional therapies and quality of life.</p><p><strong>Methods: </strong>Eligible cohort studies, trials, meta-analyses assessed outcomes including mortality, stroke, major bleeding, functional decline, recurrence, healthcare costs and quality of life with frailty measured using validated tools like Clinical Frailty Scale.</p><p><strong>Results: </strong>Frail patients had a two-to threefold higher mortality risk and 40-50% greater incidence of stroke and major bleeding than non-frail peers. Low-dose NOACs reduced stroke in frail octogenarians but bleeding risk persisted. Rate control therapy improved symptoms yet increased hypotension risk. Catheter ablation showed lower success and more complications.</p><p><strong>Conclusions: </strong>Severe frailty and age ≥85 were associated with poorer outcomes, higher resourcutilization and reduced quality of life.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721957","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":"Beyond the STEMI paradigm: Prevalence, predictors, and angiographic signatures of Wellens, de Winter, and Aslanger patterns in acute coronary syndromes.","authors":"Qayoom Yousuf, Aamir Rashid, Sameer Purra, Imran Hafeez, Hilal Ahmad Rather, Bilal Syed","doi":"10.1016/j.ihj.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.008","url":null,"abstract":"<p><strong>Objective: </strong>Several high-risk electrocardiographic (ECG) phenotypes in acute coronary syndrome (ACS)-Wellens, de Winter, and Aslanger-signal critical ischemia or occlusion despite absent diagnostic ST-segment elevation myocardial infarction (STEMI) and would benefit from expedited reperfusion. Data on their joint estimates are scarce. The objectives were: (1) to quantify their prevalence; and (2) to compare their baseline characteristics and angiographic vessel-burden.</p><p><strong>Methods: </strong>In this prospective single centre observational study, 1223 consecutive ACS patients undergoing invasive coronary angiography were included with their ECGs reviewed against prespecified criteria for Wellens (Types A/B), de Winter, and Aslanger pattern. Their prevalence, baseline and angiographic features were analysed.</p><p><strong>Results: </strong>High-risk ECG phenotypes occurred in 71/1223 (5.8%): Wellens 48 (3.9%), Aslanger 15 (1.2%), and de Winter 8 (0.7%). Wellens presented as non-STEMI (NSTEMI) 36/48 (75%) or unstable angina (UA) 12/48 (25%), representing 10.4% (48/463) of combined NSTEMI plus UA presentations. de Winter constituted 2.3% of anterior STEMI (8/351). Aslanger accounted for 3.6% of NSTEMI (15/415). Compared to other ACS, Aslanger patients were older (69.3 ± 9.3 years) with marked metabolic clustering (diabetes 73.3%, dyslipidaemia 73.3%). Wellens (54.5 ± 11.4 years) and de Winter (54.2 ± 7.9 years) were younger and smoking-predominant (60.4% and 62.5%, respectively). Angiographically, Wellens was single-vessel disease (SVD) predominant (56.2%); de Winter localized to the left anterior descending artery (100%) and Aslanger exhibited a multivessel signature.</p><p><strong>Conclusions: </strong>About 1 in 17 (∼6%) ACS presentations exhibits a high-risk ECG phenotype not captured by STEMI criteria and each with a distinct clinico-angiographic profile. Recognizing these patterns supports an occlusion myocardial infarction (OMI) focused approach and expedited invasive management.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716621","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":"Correlation of right ventricular volumes and ejection fraction by 3D echo and cardiac MRI in postoperative tetralogy of Fallot patients with free pulmonary valve regurgitation.","authors":"Touseef Ul Ayoub, Athar Un Nisa Quraishi, Anuradha Agarwal, Ashutosh Marwah, Neeraj Awasthy","doi":"10.1016/j.ihj.2026.04.007","DOIUrl":"10.1016/j.ihj.2026.04.007","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to compare and correlate the right ventricular volumes and ejection fraction by 3D echo and cardiac MRI in postoperative tetralogy of Fallot patients with free pulmonary valve regurgitation.</p><p><strong>Methods: </strong>Twenty-six patients with severe PR secondary to either pulmonary valvotomy or tetralogy of Fallot repair were evaluated using 3D echo and MRI.</p><p><strong>Results: </strong>The mean end-diastolic volumes (ml/m²) were 161.61 ± 29.31 and 170.16 ± 30.79 (p = 0.03) and the mean end-systolic volumes(ml/m²) 83.74 ± 24.16 and 94.18 ± 24.13 (p = 0.12) on 3D echo and MRI, respectively. The mean RV ejection fractions were 47.90 ± 7.81% on 3D echo and 44.83 ± 8.29% on MRI (r = 0.89, P < .001). Similarly, there were strong correlations of both end-diastolic volume and end-systolic volume on 3D echo and MRI (r = 0.94 and r = 0.74, respectively).</p><p><strong>Conclusions: </strong>Three-dimensional echo was comparable with MRI in determining RV volume and ejection fraction in post operative TOF patients with free pulmonary regurgitation. It will be important to study 3D echo in a larger population of patients with TOF, which will be possible only through multi-centre collaboration.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689813","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":"Impact of a multicomponent digital health and telemonitoring intervention on hypertension and diabetes control in cardiac patients: A randomized controlled trial.","authors":"Arvind Kumar, Tania Bansal, Salil Jaura","doi":"10.1016/j.ihj.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.005","url":null,"abstract":"<p><strong>Background: </strong>Digital health technologies are promising tools to improve cardiovascular risk factors. We evaluated the impact of a multicomponent digital health program-including a mobile app, home blood pressure (BP) monitor, wearable activity tracker, and telecoaching-on hypertension and diabetes control in cardiac outpatients.</p><p><strong>Methods: </strong>In this pragmatic randomized controlled trial, 240 adults with cardiovascular disease and hypertension and/or type 2 diabetes were assigned to receive either the digital health program plus usual care or usual care alone for 6 months. Co-primary outcomes were change in systolic BP and hemoglobin A1c (HbA1c). Secondary outcomes included risk factor target achievement, medication adherence, and quality of life.</p><p><strong>Results: </strong>A total of 228 patients (mean age 57 ± 12 years; 38% women) completed follow-up. At 6 months, the intervention group showed a greater reduction in systolic BP compared with controls (-11.2 ± 12.6 vs -5.1 ± 11.8 mmHg; adjusted mean difference -6.1 mmHg, 95% CI -9.3 to -2.9; p < 0.001). Among participants with diabetes (n = 142), HbA1c decreased by -0.7 ± 1.1% versus -0.3 ± 1.0% (adjusted mean difference -0.4%, 95% CI -0.7 to -0.1; p = 0.008). More intervention patients achieved BP < 130/80 mmHg (52% vs 34%, p = 0.01) and HbA1c <7% (48% vs 32%, p = 0.04). Physical activity improved significantly, with increased step counts. More benefit observed in patients with poorly controlled baseline risk factors. Medication adherence and quality-of-life scores improved significantly.</p><p><strong>Conclusions: </strong>A multicomponent digital health intervention significantly improved BP and glycemic control in cardiac outpatients, supporting integration of digital strategies into secondary cardiovascular prevention.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654020","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":"Outcomes of off-pump coronary artery bypass surgery in the elderly: A propensity-matched analysis.","authors":"Keshav Bansal, Varshini Subash, Neethu Krishna, Sheejamol V Sukumaran, Rohik Micka, Rajesh Jose, Praveen Kerala Varma, Kirun Gopal","doi":"10.1016/j.ihj.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.004","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery bypass surgery (CABG) in the elderly is associated with increased mortality. Comorbidities are also more common in the elderly. The objective of this study was to ascertain the impact of comorbidities on mortality in elderly patients undergoing CABG.</p><p><strong>Methods: </strong>All patients undergoing isolated off-pump CABG at a single-center from October 2014 to December 2021 were included. Patients were divided into two groups - <75 years and ≥75 years. Cox-regression analysis was done to assess for factors associated with mortality. Kaplan-Meier survival curves were used to assess survival. Due to unequal distribution of comorbidities between the two groups, 1:1 propensity score matching was done to assess the impact of age on outcomes.</p><p><strong>Results: </strong>A total of 2200 patients who underwent off-pump CABG were included of which 139 were ≥75 years. Both operative mortality and intermediate-term mortality (mean 4.7 years) was higher in patients ≥75 years (6.5% vs 1.5% and 20.1% vs 8.9% p value < 0.001). Multivariate Cox-regression analysis showed re-exploration, high EuroSCORE II and the presence of chronic obstructive pulmonary disease to be associated with intermediate-term mortality. Overall survival was worse for patients ≥75 years (6-year survival 68.9% vs 89.6% p value < 0.001). However, on propensity matching these differences between the two groups disappeared.</p><p><strong>Conclusion: </strong>Factors other than age also contribute to mortality in elderly patients who undergo CABG. Comorbidity assessment should be an important focus of attention when evaluating risks for surgery in elderly patients.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645133","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":"Electrocardiographic Prediction of Multivessel Disease in ST-Elevation Myocardial Infarction: A Validation of Standard Criteria and Identification of Novel Patterns.","authors":"Saurabh V Limaye, Siddhant Yadav, Milind S Phadke, Pratap J Nathani, Yash Y Lokhandwala","doi":"10.1016/j.ihj.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.003","url":null,"abstract":"<p><strong>Objective: </strong>To assess the value of the admission electrocardiogram (ECG) in predicting multivessel coronary artery disease (MVD) in patients with ST-elevation myocardial infarction (STEMI) and to identify novel predictive patterns.</p><p><strong>Methods: </strong>This was a single-center, retrospective observational study of 169 STEMI patients who underwent coronary angiography. Two cardiologists, blinded to angiographic findings, reviewed admission ECGs to identify the culprit artery and predict MVD using pre-specified criteria. Diagnostic accuracy metrics were calculated, and associations between ECG findings and MVD were assessed.</p><p><strong>Results: </strong>MVD was present in 81 (48%) patients. While the ECG identified the culprit artery with 97% accuracy, its sensitivity for predicting MVD using standard criteria was low (21.0%), though specificity was high (94.3%). However, in inferior STEMI, ST depression in aVR was significantly associated with MVD (p=0.010; OR 4.2). In anterior STEMI, the absence of limb lead changes was a highly specific predictor of MVD (p=0.009; OR 13.3; Spec 98.4%).</p><p><strong>Conclusions: </strong>While the admission ECG is highly accurate for culprit artery localization, its sensitivity for MVD is low. ST depression in aVR in inferior STEMI and the absence of limb lead changes in anterior STEMI are novel, highly specific predictors of MVD that can enhance early risk stratification.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622847","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":"Upfront Aspirin-Free Antiplatelet Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Safety and Efficacy.","authors":"Kunal Mahajan, Deep Dutta, A B M Kamrul-Hasan, Akshyaya Pradhan, Shekhar Vohra, Nitin Mahajan","doi":"10.1016/j.ihj.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.002","url":null,"abstract":"<p><strong>Background: </strong>Evidence comparing non-aspirin single antiplatelet therapy (SAPT) with aspirin-containing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is limited. We performed a systematic review and meta-analysis to evaluate the safety and efficacy of non-aspirin SAPT with a P2Y12​ inhibitor started at or within one week of PCI.</p><p><strong>Methods: </strong>Electronic databases were searched for studies evaluating non-aspirin SAPT after PCI. Primary outcomes were bleeding defined by Bleeding Academic Research Consortium (BARC) criteria [BARC 1-5 (any bleeding) and BARC 3-5 (major bleeding)], all-cause mortality (ACM), and cardiovascular mortality. Secondary outcomes were stroke, myocardial infarction (MI), need for revascularization, and stent thrombosis (STS).</p><p><strong>Results: </strong>Seven studies (2 randomized controlled trials and 5 observational studies) including 5468 patients on non-aspirin SAPT were analysed. In the single-arm meta-analysis of non-aspirin SAPT, pooled prevalence was 5% (95% CI 3-11;I²=92%) for any BARC 1-5 bleeding, 3% (95% CI 1-7;I²=92.5%) for major BARC 3-5 bleeding, 2% (95% CI 1-3;I²=65.4%) for ACM, 2% (95% CI 2-3;I²=31%) for cardiovascular mortality, 1% (95% CI 1-1;I²=0%) for STS, 1% (95% CI 0-1;I²=40.1%) for stroke, 2% (95% CI 1-3;I²=66.6%) for MI, and 2% (95% CI 1-4;I²=75.9%) for revascularization. In pairwise analyses of the two trials, non-aspirin SAPT versus aspirin-based DAPT showed similar risks of all-cause mortality, cardiovascular mortality, bleeding, and stroke but higher risks of MI (odds ratio [OR]1.41;95% CI 1.01-1.97; P=0.05; I²=0%) and revascularization (OR1.73; 95% CI 1.18-2.52;P=0.005;I²=0%).</p><p><strong>Conclusion: </strong>Upfront aspirin-free SAPT after PCI was associated with increased risks of MI and revascularization without a reduction in bleeding compared with aspirin-based DAPT.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622854","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}