Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Long-Term Association Between Comprehensive Cardiac Rehabilitation and Atrial Fibrillation Recurrence After Rhythm-Control Interventions.","authors":"Guillermo De la Osa Hernández, Joaquín Vila-García, Cristina Contreras Lorenzo, Rafael Peinado, Raúl Moreno, Almudena Castro Conde","doi":"10.1097/HCR.0000000000001077","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001077","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiologic Stress During Walking and Cycling Early After Cardiac Surgery.","authors":"Dillon J Dzikowicz, Sudhir K Mummidi, Yichen Yu, Xiaojuan Xia, Jean-Philippe Couderc, Daniel J Lachant","doi":"10.1097/HCR.0000000000001074","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001074","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize cardiac effort and heart rate (HR) responses during the 6-minute walk test (6MWT) early after cardiac surgery, compare HR patterns between walking and cycle ergometry, and evaluate differences by sex, frailty, and atrial fibrillation status.</p><p><strong>Methods: </strong>We analyzed a publicly available PhysioNet dataset of adults ≥65 years with pre-frailty/frailty undergoing cardiac surgery who completed a 6MWT and symptom-limited cycle ergometry with continuous single-lead electrocardiogram (ECG) monitoring (Polar H10). Cardiac effort was defined as total 6MWT heartbeats divided by distance walked (beats/m). Associations with cycle-ergometry performance were assessed using Spearman correlations with bootstrap CI; paired t tests compared HR responses between modalities; subgroup differences were evaluated using Welch t tests and multivariable linear regression.</p><p><strong>Results: </strong>Of 80 enrolled participants, 66 (83%) had analyzable 6MWT ECG recordings (mean age 73 ± 5 years; 67% male; 18 ± 8 days post-surgery). Mean 6-minute walking distance (6MWD) was 300 ± 79 m, and mean cardiac effort was 1.62 ± 0.52 beats/m. In 38 participants with paired cycle-ergometry data, HR responses were similar between walking and cycling. Greater 6MWD was associated with better cycle-ergometry performance, while higher cardiac effort was associated with lower cycle-ergometry performance. In multivariable analysis, female sex was independently associated with higher cardiac effort (β = .34 beats/m; P = .042), atrial fibrillation with lower average and end-of-test HR (P ≤ .035), and greater frailty with shorter 6MWD (P = .036).</p><p><strong>Conclusions: </strong>Cardiac effort is a feasible ECG-derived metric that complements 6MWD by integrating heart rate response with functional performance early after cardiac surgery. In this frail, predominantly beta-blocked cohort, HR responses during walking closely mirrored cycle ergometry.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Common Methods of Prescribing Cardiac Rehabilitation Exercise Intensity in the United States.","authors":"Robert Berry, Ash Walker, Steven J Keteyian, Carl Foster","doi":"10.1097/HCR.0000000000001072","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001072","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Efficacy of Cardiac Rehabilitation in Takotsubo Syndrome.","authors":"Kevin G Tayon, Ashley E Carlisle, Artur Schneider, Brian P Shapiro, Elizabeth H Dineen, Leslie T Cooper, Bryan J Taylor","doi":"10.1097/HCR.0000000000001073","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001073","url":null,"abstract":"<p><strong>Purpose: </strong>Despite normalization of left ventricular ejection fraction (LVEF), symptoms and impaired exercise capacity can persist ~1 year after Takotsubo syndrome (TTS). We evaluated the impact of cardiac rehabilitation (CR) on cardiac structure and function, functional exercise capacity, and health-related quality of life (HRQoL) in patients with TTS.</p><p><strong>Methods: </strong>Patients with TTS who completed (TTS-CR, n = 33) and did not complete (TTS-CTL, n = 24) CR were retrospectively analyzed. Cardiac structure and function (via echocardiogram) were assessed at index hospitalization and follow-up (post-CR in TTS-CR; >1 month later in TTS). The 6-minute walk test distance and Dartmouth Cooperative Functional Assessment Charts quality-of-life score were assessed pre- and post-CR (TTS-CR). Major adverse cardiovascular events within 1-year post index hospitalization were recorded (all groups).</p><p><strong>Results: </strong>The LVEF improved similarly in TTS-CR (39 ± 9% vs 60 ± 6%) and TTS (39 ± 10% vs 60 ± 7%, P = .58). The left ventricular end-diastolic volume decreased similarly in TTS-CR (125 ± 40 vs 105 ± 37 mL) and TTS-CTL (126 ± 26 vs 109 ± 27 mL, P = .81). In TTS-CR, 6-minute walk test distance (330 ± 126 vs 364 ± 97 m, P = .007) and Dartmouth Cooperative Functional Assessment Charts quality-of-life score (22 ± 6 vs 19 ± 7 m, P = .04) improved significantly from pre- to post-CR. Rates of major adverse cardiovascular events were similar between groups (P > .05).</p><p><strong>Conclusions: </strong>Cardiac rehabilitation did not enhance cardiac structural or functional recovery but did improve functional exercise capacity and HRQoL in patients with TTS.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Home-Based Telerehabilitation Versus Center-Based Cardiac Rehabilitation on Cardiopulmonary Function and Exercise Capacity in Patients After Coronary Artery Bypass Grafting: A RANDOMIZED CONTROLLED TRIAL.","authors":"Huili Liu, Xugang Wang, Cuihua Wang, Manman Kong, Jingjing Ma, Yan Liu","doi":"10.1097/HCR.0000000000001057","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001057","url":null,"abstract":"<p><strong>Purpose: </strong>The objective is to compare the effects of a home-based telerehabilitation (HBTCR) program, traditional center-based cardiac rehabilitation (CBCR), and usual care on cardiopulmonary function and exercise capacity in patients after coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>In this randomized controlled trial, 111 patients, 4 to 8 weeks after CABG surgery, were assigned to 12 weeks of HBTCR (n = 37), CBCR (n = 37), or to a control group (n = 37). The HBTCR group utilized wearable sensors and a mobile app for remote monitoring and coaching. The CBCR group underwent supervised on-site sessions. Primary outcomes were changes in peak oxygen uptake () and 6-minute walk distance. Secondary outcomes included left ventricular ejection fraction, psychological status, and quality of life.</p><p><strong>Results: </strong>Among 101 completers, both HBTCR and CBCR groups showed significant improvements in (HBTCR: +5.1; CBCR: +4.8 mL/kg/min) and 6-minute walk distance (HBTCR: +85.2 m; CBCR: +81.5 m) versus control (P < .001), with no difference between interventions. Significant improvements in left ventricular ejection fraction, psychological scores, and quality of life were also observed in both intervention groups compared with control (P < .05). Adherence was high (HBTCR: 92.1%; CBCR: 85.3%) with no major adverse events.</p><p><strong>Conclusions: </strong>The findings suggest that an HBTCR program has similar efficacy as CBCR in improving cardiopulmonary function, exercise capacity, and patient-centered outcomes after CABG. An HBTCR program represents a viable, accessible alternative model for delivering comprehensive cardiac rehabilitation and secondary prevention.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Smoking Status on Patient Outcomes in Pulmonary Rehabilitation.","authors":"Sulamunn R M Coleman, Diann E Gaalema, Raisha Ismail, Yu Zhang, Katherine E Menson","doi":"10.1097/HCR.0000000000001060","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001060","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the effects of smoking status upon pulmonary rehabilitation (PR) entry (current vs never/former) on clinical outcomes of PR using the American Association of Cardiovascular and Pulmonary Rehabilitation PR Registry.</p><p><strong>Methods: </strong>Participants with chronic obstructive pulmonary disease (N = 41,087) were from 319 PR programs in the US contributing data between 2013 and 2021. Baseline characteristics included demographics (age, sex, race, education, insurance), body mass index, and smoking status (current vs former/never). Outcomes included the number of PR sessions attended, functional capacity (6-minute walk distance [6MWD]), depression and anxiety symptoms, and dyspnea.</p><p><strong>Results: </strong>Current smoking was reported by 14% of participants. Compared to those who never or formerly smoked, those currently smoking were younger (64.1 ± 8.8 vs 70.8 ± 8.9 years), more likely to have Medicaid (17% vs 7%), had lower body mass index (28.3 ± 8.2 vs 30.0 ± 7.9 kg/m2), greater 6MWD (906.9 ± 343.0 vs 841.3 ± 350.6 ft), and higher depression (8.5 ± 6.1 vs 6.3 ± 5.3) and anxiety (6.9 ± 4.6 vs 5.5 ± 4.3) symptoms. At PR completion, those who smoke attended fewer sessions (14.9 ± 10.8 vs 18.7 ± 10.8 sessions), yet had similar improvements in 6MWD, anxiety symptoms, and dyspnea, but less improvement in depression symptoms (+0.52 [95% CI, 0.35-0.69]) compared to those who never or formerly smoked.</p><p><strong>Conclusion: </strong>Despite attending fewer PR sessions, patients with chronic obstructive pulmonary disease who currently smoke have clinically significant improvements in functional capacity, anxiety symptoms, and dyspnea comparable to patients who never or formerly smoked, yet their depression symptoms remain higher at program completion. Thus, PR programs should not restrict entry based on smoking status.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Rehabilitation and Exercise Capacity, Rehospitalization, and Survival After Lung Transplant.","authors":"Jinghui Yang, Joey M Saavedra, Tathagat Narula, Francisco Alvarez, Ashley E Carlisle, Leah G Gutzwiller, Bryan J Taylor","doi":"10.1097/HCR.0000000000001063","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001063","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relationships between the dose of post-lung transplantation (LTx) pulmonary rehabilitation (PR) and exercise capacity, rehospitalization, and survival in LTx recipients.</p><p><strong>Methods: </strong>Demographic and clinical data of LTx recipients from January 2020 to April 2023 were extracted and reviewed. The association between PR and the pre- to post-PR change in 6-minute walk test distance (6MWTd) was determined using lasso regression for variable selection followed by multiple linear regression. The association between the number of PR sessions completed and rehospitalization and survival after LTx was determined using negative binomial regression and Cox proportional hazards models.</p><p><strong>Results: </strong>Aerobic training volume was a significant independent predictor of 6MWTd improvement from pre- to post-PR (β = .318, P < .001). Each additional PR session was associated with a 4.7-m greater 6MWTd (P = .010), a 3.8% lower rate of rehospitalization within 1 year of transplantation (IRR = 0.962, P = .078), and a 9.0% lower mortality risk (HR = 0.910, P = .052). Completing 16 to 27 PR sessions was associated with a 48% lower rehospitalization rate (IRR = 0.518, P =.037) and a 73% lower mortality risk (HR = 0.266, P = .071) compared with completing 1 to 11 sessions.</p><p><strong>Conclusions: </strong>Greater aerobic training volume was an independent predictor of improved exercise capacity, while a greater number of PR sessions was associated with fewer total rehospitalizations within 1 year of LTx and a trend toward improved survival.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facility-Level Variation in Cardiac Rehabilitation Completion.","authors":"Aryan V Patel, Hechuan Hou, Steven J Keteyian, Lisa M Pollack, Jessica R Golbus, Quinn R Pack, Michael P Thompson","doi":"10.1097/HCR.0000000000001071","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001071","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify facility-level variation in cardiac rehabilitation (CR) completion among Medicare beneficiaries after major cardiovascular procedures.</p><p><strong>Methods: </strong>We analyzed Medicare fee-for-service claims for beneficiaries discharged alive after common cardiovascular procedures between July 2016 and December 2018. Beneficiaries were attributed to CR facilities via the national provider identifier on CR claims. Facilities with <20 patients were excluded. CR completion was defined as finishing 36 sessions within 1 year of hospital discharge. Hierarchical logistic regression estimated risk-adjusted facility completion rates, adjusting for demographics, procedure, clinical complexity, and clustering between facilities. The model cluster-level variance informed the median OR to quantify the between-facility variation in CR completion. Bivariate analyses compared risk-adjusted completion across urbanicity, facility-volume quartiles, US census region, and local community distress.</p><p><strong>Results: </strong>Among 183 888 beneficiaries who attended ≥1 CR session across 2194 facilities, the mean ± SD number of sessions attended was 25.6 ± 12.4, with 53 558 (29%) completing CR. Risk-adjusted facility-level completion rates ranged from 0% to 90.9% (median: 32.9%; IQR: 18.7%, 44.9%). After adjusting for patient factors, the median OR for CR adherence between facilities was 2.34 (95% CI, 2.26-2.43), indicating a facility-level difference in completion independent of patient mix. Completion did not differ significantly by urbanicity or facility volume but varied by region and level of community distress (P < .001).</p><p><strong>Conclusions: </strong>Completion of CR varies widely across facilities and is highly facility-dependent, indicating opportunities for quality improvement.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond One-Size-Fits-All: A MODIFIED, TWO-ROUND DELPHI CONSENSUS STUDY TO IDENTIFY KEY PRIORITIES FOR ADAPTING THE MEDITERRANEAN DIET IN MULTICULTURAL CARDIAC REHABILITATION SETTINGS.","authors":"Camila Kümmel Duarte, Fatim Ajwani, Veronica Rouse, Gabriela Lima de Melo Ghisi","doi":"10.1097/HCR.0000000000001067","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001067","url":null,"abstract":"<p><strong>Purpose: </strong>To identify and prioritize key considerations for culturally adapting the Mediterranean diet for diverse populations participating in cardiac rehabilitation (CR) programs outside the Mediterranean region.</p><p><strong>Methods: </strong>This modified, 2-round Delphi consensus study (September to December 2025) included 3 phases. Phase 1 involved online focus groups with dietitians from Canada and Brazil. Phase 2 comprised in-person and virtual focus groups with adults enrolled in a Canadian CR program. Data from Phases 1 and 2 were analyzed using thematic analysis to generate candidate recommendations. Phase 3 consisted of a 2-round Delphi process with CR health care professionals and patients from 31 countries across all 6 World Health Organization regions, who rated recommendation importance using a 5-point Likert scale. Consensus was assessed using descriptive statistics.</p><p><strong>Results: </strong>Focus groups with dietitians (n = 27) and CR participants (n = 15) generated 26 recommendations across 7 thematic categories. In the 2-round Delphi process (N = 102), 15 recommendations reached consensus in round 1 and were refined, while 11 were excluded or merged. Twelve recommendations progressed to round 2, yielding a final set of 11 consensus-based recommendations. Key priorities included flexibility, cultural and religious relevance, affordability, local food availability, individualized counseling, and emphasis on heart-healthy behaviors over weight loss. Alcohol was considered nonessential, with support for excluding it from educational materials.</p><p><strong>Conclusions: </strong>This international, stakeholder-informed study established 11 consensus recommendations to guide culturally responsive adaptation of the Mediterranean diet in CR. Findings support flexible, patient-centered dietary approaches that maintain cardioprotective principles while enhancing feasibility and relevance across diverse global settings.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Individualized Physical Activity Counseling Added to Pulmonary Rehabilitation on Physical Activity, Sedentary Behavior, and Exercise Motivation in Individuals With COPD: A Randomized Controlled Trial.","authors":"Tiago Pastilha, Rui Macedo, Susana Vale, Rita Santos, Vitória Martins, Joana Borges, Viviana Sebastião, Ana S Alexandrino","doi":"10.1097/HCR.0000000000001027","DOIUrl":"10.1097/HCR.0000000000001027","url":null,"abstract":"<p><strong>Purpose: </strong>Individual counseling during pulmonary rehabilitation (PR) has the potential to modify physical activity levels and motivation for exercise in patients with chronic obstructive pulmonary disease (COPD). This study analyzes the effect of an individual counseling session, added to a PR program, on physical activity, sedentary behavior, and motivation for exercise in patients with COPD.</p><p><strong>Methods: </strong>A double-blind randomized controlled trial was conducted at the Hospital Distrital da Figueira da Foz PR center. Twenty patients with COPD were randomly allocated to an intervention group (IG) or a control group (CG). The IG received an individual physical activity counseling session during PR for 3 months. The CG received the PR. The number of steps and light, moderate, vigorous, and moderate-to-vigorous physical activity was studied as well as sedentary behavior, using the Actigraph wGT3X-BT accelerometer. Motivation for exercise was assessed with the Behavioral Regulations in Exercise Questionnaire. Data were collected at baseline and after 3 months. Data collectors and analysts were blinded.</p><p><strong>Results: </strong>No significant differences were found between groups at baseline. After 3 months, the IG increased the number of steps ( P = .001), light ( P = .033) and moderate ( P =.001) physical activity, and moderate-to-vigorous physical activity ( P = .001) compared with CG. Sedentary behavior decreased in IG ( P = .009) compared with CG. Motivation for exercise was significantly higher in IG ( P = .012).</p><p><strong>Conclusions: </strong>The individual counseling session, when added to PR, may improve physical activity, reduce sedentary behavior, and increase motivation to exercise in COPD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"330-340"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}