Journal of Arrhythmia最新文献

{"title":"Totally Thoracoscopic Atrial Fibrillation Ablation With the Gemini S Bipolar Clamp: A Single-Center Descriptive Cohort Study of 1-Year Rhythm, Safety, and Quality-of-Life Outcomes","authors":"Michal Gruszczynski,&nbsp;Hector Rodriguez Cetina Biefer,&nbsp;Laura Rings,&nbsp;Sacha P. Salzberg,&nbsp;Vasileios Ntinopoulos,&nbsp;Omer Dzemali","doi":"10.1002/joa3.70498","DOIUrl":"https://doi.org/10.1002/joa3.70498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Outcome data for the Gemini S bipolar radiofrequency clamp are almost absent; the only indexed report being a three-patient case series. We describe 1-year outcomes in a consecutive cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed all consecutive patients treated with the Gemini S clamp between January 2021 and August 2024. Epicardial box isolation was combined with left atrial appendage (LAA) exclusion; completeness was confirmed by entry and exit block on epicardial three-dimensional mapping. The primary outcome was freedom from AF recurrence at 12 months, on and off antiarrhythmic drugs (AADs) after a 90-day blanking period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three patients were included (mean age 64.4 ± 8.0 years; 82.6% male). AF was paroxysmal in 34.8%, persistent in 26.1%, and long-standing persistent in 39.1%; 60.9% had prior catheter ablation and 69.6% had failed or were intolerant to a Class I or III agent. A complete block-verified box lesion was achieved in 95.7% and LAA exclusion in 91.3%. Three patients (13.0%) required conversion to sternotomy for bleeding, exceeding larger series. There was no death, stroke, phrenic nerve palsy, or pacemaker implantation. At 1 year, 87.0% (95% CI 67.9–95.5) were in sinus rhythm, all off Class I/III AADs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sinus rhythm was achieved in 87.0% of patients at 1 year. As the largest reported experience with this device, the series provides device-level evidence where little existed, but it is descriptive, not powered for comparison, and the conversion rate needs confirmation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205574","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":"Small Discrete Pre-Potential-Like Electrogram Recorded by a Lattice-Tip Catheter at the Initiation of Atrial Fibrillation","authors":"Yasuharu Matsunaga-Lee,&nbsp;Yasuyuki Egami,&nbsp;Masamichi Yano,&nbsp;Masami Nishino","doi":"10.1002/joa3.70501","DOIUrl":"10.1002/joa3.70501","url":null,"abstract":"<p>At the origin of the non-PV trigger, a small discrete pre-potential-like electrogram was recorded using a lattice-tip catheter after 5-mm catheter repositioning, preceding the potential at the previous site by 56 ms.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193753","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":"Successful Bailout Retrieval of an Active-Fixation Atrial Leadless Pacemaker Following Suspected Tissue Entrapment During Repositioning","authors":"Toshiya Yoshida,&nbsp;Akira Kasagawa,&nbsp;Daisuke Togashi,&nbsp;Ikutaro Nakajima,&nbsp;Tomoo Harada","doi":"10.1002/joa3.70483","DOIUrl":"10.1002/joa3.70483","url":null,"abstract":"<p>An 81-year-old woman with a medical history of mechanical mitral valve replacement, Maze procedure, and multiple myeloma presented with symptomatic sinus arrest and underwent AVEIR DR implantation. Although the AVEIR VR was successfully implanted, optimal electrical parameters could not be achieved during AVEIR AR placement. During repositioning of the AVEIR AR, myocardial entrapment with helix stretching was encountered. Here, we report that advancing the protective sleeve to fully encapsulate the device potentially enabled safe and successful retrieval.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166434","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":"Intraoperative Application of the PRAETORIAN Score to Predict Optimal Subcutaneous Implantable Cardioverter-Defibrillator Placement","authors":"Ken Yamazaki,&nbsp;Shingo Sasaki,&nbsp;Hiroaki Yokoyama,&nbsp;Yuji Ishida,&nbsp;Shogo Hamaura,&nbsp;Yuichi Toyama,&nbsp;Masaomi Kimura,&nbsp;Hirofumi Tomita","doi":"10.1002/joa3.70496","DOIUrl":"10.1002/joa3.70496","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The PRAETORIAN score (PS) estimates the risk of defibrillation failure after subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation based on postoperative chest radiography in the standing position. However, the usefulness of assessing the PS in the supine position intraoperatively has not yet been established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated conventional (standing) and intraoperative supine PS in 124 consecutive Japanese patients undergoing S-ICD implantation. Changes between conventional and supine PS values were analyzed in two ways: (1) the presence of any difference in the absolute PS values regardless of the risk category, and (2) changes in clinically relevant risk categories for conversion failure (low, intermediate, or high risk). Predictors of discordance between the two assessments were also investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median conventional PS was 30; 116 and 8 patients were classified as having low and intermediate risk of conversion failure, respectively. Numerical differences between the conventional and supine PS values were observed in 13 patients. However, clinically meaningful risk reclassification occurred in only two patients, suggesting that intraoperative supine PS assessment may underestimate PRAETORIAN score–based risk classification in a small subset of patients. Among patients with numerical PS changes, supine PS was significantly lower than conventional PS. An elevated BMI was strongly associated with PS discordance. Exploratory receiver operating characteristic curve analysis identified a BMI cutoff of 25.6 kg/m² for discriminating patients with numerical PS discordance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intraoperative supine PS assessment shows excellent concordance with conventional standing PS and may provide a practical tool for confirming appropriate system positioning in most Japanese patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166500","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":"Sleep-Disordered Breathing and Sleep Fragmentation in Relation to Atrial Fibrillation Risk: A Systematic Review and Meta-Analysis","authors":"Ermias Sori,&nbsp;Hassaan Abid,&nbsp; Zartasha,&nbsp;Walquiria Pedra,&nbsp;Anuoluwapo Odewabi,&nbsp;Ibrahim Layi Salau,&nbsp;Vaghani Jillkumar,&nbsp;Ali Hyder,&nbsp;Mohammed Mutar,&nbsp;Yasar Sattar","doi":"10.1002/joa3.70499","DOIUrl":"https://doi.org/10.1002/joa3.70499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias worldwide. This study aimed to evaluate the association between sleep-disordered breathing (SDB), primarily assessed using the apnea–hypopnea index (AHI), and AF risk, with additional analysis of sleep fragmentation parameters such as wake after sleep onset (WASO) and arousal index (AI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review and meta-analysis followed Cochrane Handbook recommendations and PRISMA guidelines, with protocol registration in PROSPERO (No. 127490). Randomized controlled trials (RCTs) and observational cohort studies assessing sleep disturbances and AF were included. MEDLINE, Cochrane Library, and Scopus were searched from inception to February 2026. Extracted data included study characteristics, demographics, cardiovascular risk factors, and sleep metrics. Outcomes were incident and recurrent AF. A random-effects model was applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one cohort studies (611,898 participants) were included. SDB was associated with increased incident AF risk (RR 1.67, 95% CI 1.41–1.97; <i>I</i>² = 66.5%), with consistent Bayesian estimates. A dose–response relationship showed a 2% increase in AF risk per unit rise in AHI. For AF recurrence, 11 studies (<i>n</i> = 1810) demonstrated a significant association (RR 1.55, 95% CI 1.40–1.72; <i>I</i>² = 0%), supported by Bayesian analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sleep disturbances are significantly associated with both incident and recurrent AF and may represent modifiable risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146190","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":"Conduction Gap of Left Atrial Anterior Wall Linear Ablation Undetected by Left Atrial Appendage Pacing but Revealed by Left Lateral Ridge Pacing","authors":"Yuma Tanaka,&nbsp;Takayuki Sekihara,&nbsp;Kentaro Ozu,&nbsp;Takafumi Oka,&nbsp;Yasushi Sakata","doi":"10.1002/joa3.70494","DOIUrl":"10.1002/joa3.70494","url":null,"abstract":"<p>Confirmation of counterclockwise conduction block across the left atrial anterior wall linear lesion is usually performed during left atrial appendage pacing. However, even when endocardial conduction block across the left atrial anterior wall linear lesion is suggested during left atrial appendage pacing, an epicardial connection between the left lateral ridge and the left atrial anterior wall can be a cause of residual conduction gap. In such a situation, assessment during pacing with the left lateral ridge capture should be considered.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136578","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":"Right Atrium–Dominant Single-Loop Biatrial Tachycardia Mimicking Reverse Typical Atrial Flutter After Mitral Valve Repair via a Superior Transseptal Approach","authors":"Kota Nakatsuji,&nbsp;Shogo Sakamoto,&nbsp;Moritoshi Irishio,&nbsp;Toru Kataoka,&nbsp;Daiju Fukuda","doi":"10.1002/joa3.70465","DOIUrl":"10.1002/joa3.70465","url":null,"abstract":"<p>Following a superior transseptal approach, extensive postoperative septal conduction impairment facilitated a right atrium–dominant single-loop biatrial tachycardia mimicking reverse typical atrial flutter. Detailed biatrial mapping and entrainment revealed limited left atrial participation, highlighting the importance of recognizing biatrial circuits in patients with prior septal surgery.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136648","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":"Appropriate ICD Therapies in Primary Prevention: A Propensity-Matched Comparison of Contemporary and Historic Heart Failure Cohorts","authors":"Inês Ferreira Neves,&nbsp;Guilherme Portugal,&nbsp;Julien Lopes,&nbsp;Ana Rita Teixeira,&nbsp;Pedro Silva Cunha,&nbsp;Bruno Valente,&nbsp;Ana Lousinha,&nbsp;Rita Moreira,&nbsp;Hélder Santos,&nbsp;António Gonçalves,&nbsp;Rui Cruz Ferreira,&nbsp;Mário Martins Oliveira","doi":"10.1002/joa3.70497","DOIUrl":"https://doi.org/10.1002/joa3.70497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In heart failure with reduced ejection fraction (HFrEF), a substantial proportion of deaths are arrhythmic. Implantable cardioverter-defibrillators (ICDs) are recommended for primary prevention in patients with left ventricular ejection fraction (LVEF) ≤ 35% despite guideline-directed medical therapy (GDMT), but landmark trials predate widespread use of angiotensin receptor–neprilysin inhibitors (ARNI) and sodium–glucose cotransporter 2 inhibitors (SGLT2i), raising uncertainty about arrhythmic risk in the contemporary treatment era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied consecutive HFrEF patients undergoing primary-prevention ICD implantation at a single center (2015–2022), categorized into historical-era and contemporary-era cohorts by ARNI/SGLT2i adoption. Propensity-score matching balanced baseline characteristics. The primary endpoint was time to first appropriate ICD therapy (antitachycardia pacing or shock).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 289 patients (mean age 62 ± 11 years, 82% male), 234 (117 per group) remained after matching. Mean follow-up was 51 months. Appropriate ICD therapy incidence did not differ significantly between contemporary-era and historical-era cohorts (hazard ratio [HR] 1.52, 95% CI 0.84–2.72; <i>p</i> = 0.165). Competing-risk-adjusted cumulative incidence was numerically higher in the contemporary-era cohort at a pre-specified 36-months horizon, consistent with a sensitivity analysis using an expanded propensity-score model (HR 1.55, 95% CI 0.82–2.94).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ICD therapy rates were not significantly different between the contemporary-era and historical-era cohorts, a finding robust to sensitivity and competing-risk analyses. These results should be interpreted cautiously, as the study may be underpowered to detect modest differences, and clinically relevant effects cannot be excluded.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146410","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 Advantages and Pitfalls of Pulsed Field Ablation: How to Prevent ALH Syndrome","authors":"Hiroshi Nakagawa,&nbsp;Quim Castellvi,&nbsp;Masafumi Sugawara,&nbsp;Atsushi Ikeda,&nbsp;Salman Farshchi-Heydari,&nbsp;Jennifer Maffre,&nbsp;Ayman A. Hussein,&nbsp;Pasquale Santangeli,&nbsp;Walid I. Saliba,&nbsp;Yukihito Higashi,&nbsp;Warren M. Jackman","doi":"10.1002/joa3.70482","DOIUrl":"10.1002/joa3.70482","url":null,"abstract":"<p>Catheter ablation for tachyarrhythmias was first introduced in the early 1980s using direct-current (DC) energy. Following the clinical introduction of radiofrequency (RF) ablation in the late 1980s, thermal ablation technologies became the foundation of catheter ablation because of their superior controllability, efficacy, and safety. In 2014, Wittkampf developed a DC-energy-delivery catheter system preventing electrical arcing, thereby initiating a modern “revival of DC-ablation” based on catheter ablation using electroporation. Subsequent development of high-voltage, short-duration pulse-train delivery led to the emergence of pulsed field ablation (PFA). Exposure of myocytes to high-voltage electric fields induces reversible electroporation through nanoscale pore formation within the lipid bilayer, whereas higher electric-field delivery produces irreversible electroporation, resulting in permanent membrane disruption, apoptosis, and durable lesion formation.</p><p>PFA is regarded as a predominantly nonthermal and potentially tissue-selective ablation modality. Nevertheless, clinical trials of pulmonary vein isolation for atrial fibrillation have demonstrated that PFA is noninferior to conventional thermal ablation strategies, although clear superiority—other than shorter procedural times—has not yet been established. Importantly, recent studies suggest that electrode–tissue contact remains a critical determinant of durable lesion formation. Accumulating evidence indicates that PFA is associated with new complications not commonly observed with thermal ablation, including acute kidney injury, stroke, coronary vasospasm, myocardial ischemia, ventricular fibrillation, and sudden cardiac death. Although the mechanisms remain incompletely understood, hemolysis-related injury induced by high-voltage pulse delivery may represent an important contributing mechanism. Development of PFA systems capable of real-time prediction of irreversible lesion size may be essential for optimizing both procedural efficacy and safety.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136589","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":"Substrate-Based Ablation Guided by Combined Fractionation and Frequency Analysis for Multiple and Unmappable Ventricular Tachycardias","authors":"Maiko Kuroda,&nbsp;Kenichi Hiroshima,&nbsp;Kenji Ando","doi":"10.1002/joa3.70487","DOIUrl":"10.1002/joa3.70487","url":null,"abstract":"<p>Stepwise evaluation of fractionation and peak frequency maps on substrate mapping identified VT-related substrate regions in a patient with multiple ventricular tachycardias. This complementary substrate-based approach may help guide ablation when complete circuit characterization is challenging.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110063","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}