Pulse最新文献

{"title":"Human Aortic Vasoreactivity in Response to Various Stimuli: A Review.","authors":"Cindy van Loo, Stan M R L Toonen, Leon J Schurgers, Tammo Delhaas, Bart Spronck","doi":"10.1159/000547617","DOIUrl":"https://doi.org/10.1159/000547617","url":null,"abstract":"<p><strong>Background: </strong>The aorta plays a crucial role in the blood circulation through its Windkessel function, buffering blood volume and regulating blood pressure. While traditionally viewed as primarily passive, this function may be actively regulated by vascular smooth muscle cells in the aortic wall through vasoconstriction or -dilation. Despite the widespread use of antihypertensive drugs that target vascular tone, our understanding of human aortic vasoreactivity remains limited. This review therefore aimed to evaluate the vasoreactivity of the human aorta in response to various pharmacological and non-pharmacological stimuli.</p><p><strong>Summary: </strong>A systematic search of the PubMed database was conducted for articles published before January 1, 2024. Of the 1,179 articles that were screened for inclusion, 30 articles met the inclusion criteria. Ten studies involved ex vivo examinations, while 20 studies involved in vivo measurements. Ex vivo pharmacological testing revealed vasoconstriction induced by adrenergic and endothelin-A receptor agonists and prostanoids. Pharmacological vasodilation was observed following in vivo or ex vivo administration of nitrates and calcium channel blockers, although acetylcholine did not induce vasodilation ex vivo. Additionally, tobacco smoking and intravenous cocaine use were associated with vasoconstriction, whereas anesthetic agents were involved in potential aortic vasodilation.</p><p><strong>Key messages: </strong>These findings challenge the traditional view of the aorta as a passive conduit, highlighting its vasoconstrictive and vasodilative properties in response to vasoactive stimuli. This revised understanding has significant implications for prescribing antihypertensive drugs, which commonly have vasodilatory effects. The potential impact of these vasoactive therapies on the aorta's Windkessel function warrants careful consideration, particularly in patients with aortic pathologies.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"121-139"},"PeriodicalIF":7.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252907","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":"Association of Office and 24-Hour Ambulatory Measurement of Aortic Pulse Wave Velocity with Target Organ Damage in Hypertension.","authors":"Huijuan Chao, Qian Wang, Biwen Tang, Yaya Bai, Shenshen Gao, Mark Butlin, Alberto P Avolio, Junli Zuo","doi":"10.1159/000547443","DOIUrl":"https://doi.org/10.1159/000547443","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the association of office arterial stiffness and 24 h arterial stiffness as measured by pulse wave velocity (PWV) with subclinical target organ damage (TOD) in a hypertensive cohort.</p><p><strong>Methods: </strong>We evaluated associations of TOD with office carotid-femoral PWV (cf-PWV) by radial tonometry (SphygmoCor) and 24-h ambulatory PWV measurements by brachial oscillometry (Mobil-O-Graph 24-h PWA Monitor) in 636 hospital inpatients (age 54 ± 13 years, 465 males) with primary hypertension. Subclinical TOD was assessed as left ventricular hypertrophy (LVH) obtained by echocardiography quantified by LV mass index (LVMI), carotid intima-media thickness (CIMT) >0.9 mm and chronic kidney disease including urine albumin-creatinine ratio (ACR) >3.5 mg/mmol in females and >2.5 mg/mmol in males or estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m².</p><p><strong>Results: </strong>After adjusting for confounding factors, both cf-PWV and 24-h PWV or night-PWV showed significant association with LVMI (<i>p</i> < 0.05). Only day-PWV was associated with eGFR (<i>p</i> = 0.037). When cf-PWV, 24-h PWV, day- and night-PWV including confounding factors were forced into the same logistic regression model, only cf-PWV (OR = 1.109 [1.001-1.228], <i>p</i> = 0.033) remained a significant determinant of increased LVH. Day-PWV (OR = 0.538 [0.415-0.696], <i>p</i> < 0.001) was significantly correlated with eGFR. For ACR, each 1 m/s increase in day-PWV was associated with risk of increased ACR (OR = 1.685 [1.178-2.410], <i>p</i> = 0.004). For CIMT >0.9 mm, neither ambulatory PWV nor cf-PWV was significant.</p><p><strong>Conclusion: </strong>Compared with 24-h ambulatory PWV, cf-PWV has a better correlation with LVH, while ambulatory PWV has a greater correlation with the decline in renal function.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"108-120"},"PeriodicalIF":7.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252952","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":"Ageing Arteries and Aerobic Exercise: Bridging Evidence and Innovation in Vascular Health.","authors":"Suriyaraj Shanmugasundaram Prema, Deepankumar Shanmugamprema","doi":"10.1159/000545852","DOIUrl":"https://doi.org/10.1159/000545852","url":null,"abstract":"","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"105-107"},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576450","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":"Tracking De-Stiffening Interventions of the Aorta: Can Wearables and Artificial Intelligence-Derived Vascular Age Biomarkers Help?","authors":"Gary L Pierce","doi":"10.1159/000545887","DOIUrl":"10.1159/000545887","url":null,"abstract":"","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"103-104"},"PeriodicalIF":3.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286643","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":"Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness with Cardiac Adiposity: A Narrative Review.","authors":"Minsuk Oh, Hyo-In Choi, Jong-Young Lee, Dong Hoon Lee, Justin Y Jeon","doi":"10.1159/000544804","DOIUrl":"10.1159/000544804","url":null,"abstract":"<p><strong>Background: </strong>Pericardial adipose tissue (PAT), an ectopic fat depot surrounding the coronary arteries, is a significant pathogenic risk factor for cardiometabolic diseases. Due to its anatomical proximity to the heart, PAT is considered a more potent risk factor for cardiovascular conditions compared to other visceral adipose tissues located in other parts of body. Modifiable lifestyle factors such as physical activity (PA), sedentary behavior (SB), exercise interventions, and cardiorespiratory fitness (CRF) have been associated with various health outcomes, but their relationship with PAT remains less understood.</p><p><strong>Summary: </strong>This review synthesizes current evidence on the associations of PA, SB, exercise interventions, and CRF with PAT. Increasing PA and CRF while reducing SB appears to be associated with lower PAT accumulation with age, independent of key health characteristics across diverse populations. Also, exercise interventions may be effective in reducing PAT. PAT is emerging as a critical cardiovascular disease and cardiometabolic risk factor. The review highlights the importance of PA, SB, exercise participations, and CRF as modifiable strategies to potentially mitigate this risk. Despite the documented benefits of PA, exercise interventions, and CRF and the negative impacts of SB on health, further research is warranted to explore these associations more comprehensively. Most existing studies are limited by small sample sizes, cross-sectional designs, and reliance on self-reported measures. Recent longitudinal studies suggest that PA, SB, and CRF may influence PAT volumes over time, though findings are often affected by baseline abdominal adiposity and the use of indirect measures.</p><p><strong>Key messages: </strong>(i) Increasing PA, exercise participation, and CRF while reducing SB may prevent PAT accumulation with age, independent of other health factors. (ii) PAT is a significant, emerging risk factor for cardiovascular and metabolic diseases, underscoring the need for effective lifestyle interventions. (iii) Future research should focus on larger, more diverse cohorts using objective measures to better understand the complex relationships between PA, SB, CRF, and PAT. (iv) Comprehensive exploration of these associations will aid in developing interventions to reduce cardiac adiposity and enhance cardiovascular health outcomes.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"92-102"},"PeriodicalIF":3.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043416","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":"Effect of Acute Resistance Exercise and Resistance Exercise Training on Central Pulsatile Hemodynamics and Large Artery Stiffness: Part II.","authors":"Denis J Wakeham, Gary L Pierce, Kevin S Heffernan","doi":"10.1159/000543314","DOIUrl":"10.1159/000543314","url":null,"abstract":"<p><strong>Background: </strong>In part one of this two-part series, we performed a detailed analysis of the hemodynamic signature produced during resistance exercise (RE) and discussed the subacute effects on short-term modulation of large artery stiffness and central pulsatile hemodynamics. In this second part of our two-part series, we consider the subacute recovery window as the driver of resistance exercise training (RET) adaptations. We then discuss the results of RET interventions and corroborate these findings against the information gleaned from cross-sectional studies in habitually strength-trained athletes. Finally, we explore associations between muscular strength and arterial stiffness.</p><p><strong>Summary: </strong>Our reanalysis of key studies assessing arterial stiffness in the hour post-RE suggests changes in both load-dependent and load-independent indices of arterial (aortic) stiffness. Regarding adaptations to habitual RET, a growing body of evidence contradicts earlier findings that suggested RET increases large artery stiffness. Recent meta-analyses conclude that longitudinal RET has no effect or may even reduce large artery stiffness. However, cross-sectional studies continue to support early RET intervention studies and note that habitual RET may increase large artery stiffness and central pulsatile hemodynamics. Complex interactions between vascular smooth muscle cells and the extracellular matrix may offer insight into inter-individual heterogeneity in subacute responses and chronic adaptations to acute RE and habitual RET.</p><p><strong>Key messages: </strong>Habitual RET is fundamentally important for skeletal muscle quality and quantity as well as cardiovascular function. Recent literature suggests that habitual RET has negligible effects on large artery stiffness and central hemodynamic pressure pulsatility, but cross-sectional observations still raise questions about the chronic large artery effects of habitual RET.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"45-61"},"PeriodicalIF":3.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483922","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":"Effect of Acute Resistance Exercise and Resistance Exercise Training on Central Pulsatile Hemodynamics and Large Artery Stiffness: Part I.","authors":"Denis J Wakeham, Gary L Pierce, Kevin S Heffernan","doi":"10.1159/000543313","DOIUrl":"10.1159/000543313","url":null,"abstract":"<p><strong>Background: </strong>Engaging in habitual resistance exercise training (RET; also known as strength training) causes systemic health effects beyond those caused by aerobic/endurance exercise training alone. Despite the resoundingly favorable effect of habitual RET on measures of cardiovascular disease risk, controversy still exists regarding the vascular health effects of this exercise modality largely because some studies find increases in large artery stiffness and central pulsatile hemodynamics with RET. In this two-part series, we examine the effect of acute resistance exercise (RE) and RET on large artery stiffness and pulsatile hemodynamics. We perform a historical overview of seminal/classic studies and report on key findings that have shaped the field. We provide personal commentary on the studies and potential implications of findings related to the acute effects of RE on large artery stiffness and central pulsatile hemodynamics. For part one of this two-part series, we perform a detailed analysis of the hemodynamic signature produced during RE and discuss the sub-acute effects on short-term modulation of large artery stiffness and central pulsatile hemodynamics.</p><p><strong>Summary: </strong>Acute RE elicits marked (\"extreme\") elevations in arterial pressure, mediated primarily by increases in vascular resistance and intrathoracic pressure (ITP). Vascular compression from muscular contraction contributes to increases in afterload via increased vascular resistance and pressure from wave reflections. However, as a result of the higher ITP associated with breath holds (Valsalva maneuver) during high relative efforts (>80%), the change in pressure across the aortic wall (transmural pressure) is less than the change in intra-arterial pressure.</p><p><strong>Key messages: </strong>The high arterial pressures during some heavy weight lifting exercises are associated with positive swings with ITP related to the Valsalva maneuver and elevations in vascular resistance. The pressure oscillations lead to marked stress within the vascular wall and likely contribute to elevations in large artery stiffness over the subsequent hour.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"31-44"},"PeriodicalIF":3.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483768","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":"Relationships between Cardio-Ankle Vascular Index and Peptides Related to Hypertensive Disorders of Pregnancy in Patients with Lower Extremity Arterial Disease.","authors":"Ichiro Wakabayashi, Yoko Sotoda","doi":"10.1159/000543726","DOIUrl":"10.1159/000543726","url":null,"abstract":"<p><strong>Introduction: </strong>Cardio-ankle vascular index (CAVI), a blood pressure-independent measure of heart-ankle pulse wave velocity, is a relatively new indicator of arterial stiffness. The absolute value of the difference in right CAVI and left CAVI (diff-CAVI) has been proposed as a new indicator of leg ischemia in patients with lower extremity arterial disease (LEAD). The aim of this study was to elucidate the relationships between diff-CAVI and peptides related to hypertensive disorders of pregnancy (HDP), which have been proposed as biomarkers for leg ischemia in patients with LEAD.</p><p><strong>Methods: </strong>The participants were 165 outpatients with LEAD who had already received medication therapy for LEAD. The relationships between diff-CAVI and serum levels of the seven HDP-related peptides, which were measured by mass spectrometry, were investigated.</p><p><strong>Results: </strong>HDP-related peptides with <i>m</i>/<i>z</i> 2091 (P-2091) and <i>m</i>/<i>z</i> 2378 (P-2378) showed significant positive correlations with diff-CAVI, and odds ratios (ORs) for large diff-CAVI (≥1.05) of the 3rd vs. 1st tertile groups of P-2091 (OR [99.3% confidence interval]: 3.71 [1.24-11.15]) and P-2378 (OR: 4.46 [1.39-14.30]) were significantly higher (<i>p</i> < 0.01) than the reference level. The associations of P-2091 and P-2378 with diff-CAVI were shown to be independent of age, gender, habit of smoking, history of diabetes, BMI, and blood pressure in multivariate analyses. The other peptides with <i>m</i>/<i>z</i> 2081, 2127, 2209, 2858, and 3156 did not show significant associations with diff-CAVI.</p><p><strong>Conclusion: </strong>P-2091 and P-2378 were associated with diff-CAVI and are thought to be useful indicators of leg ischemia in patients with LEAD.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"80-91"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031526","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":"Thoracic Aortic Three-Dimensional Geometry.","authors":"Cameron Beeche, Marie-Joe Dib, Bingxin Zhao, Joe David Azzo, Hamed Tavolinejad, Hannah Maynard, Jeffrey Thomas Duda, James Gee, Oday Salman, Walter R Witschey, Julio Chirinos","doi":"10.1159/000543613","DOIUrl":"10.1159/000543613","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic structure impacts cardiovascular health through multiple mechanisms. Aortic structural degeneration occurs with aging, increasing left ventricular afterload and promoting increased arterial pulsatility and target organ damage. Despite the impact of aortic structure on cardiovascular health, three-dimensional (3D) aortic geometry has not been comprehensively characterized in large populations.</p><p><strong>Methods: </strong>We segmented the complete thoracic aorta using a deep learning architecture and used morphological image operations to extract multiple aortic geometric phenotypes (AGPs, including diameter, length, curvature, and tortuosity) across various subsegments of the thoracic aorta. We deployed our segmentation approach on imaging scans from 54,241 participants in the UK Biobank and 8,456 participants in the Penn Medicine Biobank.</p><p><strong>Conclusion: </strong>Our method provides a fully automated approach toward quantifying the three-dimensional structural parameters of the aorta. This approach expands the available phenotypes in two large representative biobanks and will allow large-scale studies to elucidate the biology and clinical consequences of aortic degeneration related to aging and disease states.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"72-79"},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003561","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":"Assessing the Validity of Computerized Algorithms for Determining Pulse Wave Velocity: A Clinical Study.","authors":"Amira Tairi, Hasan Obeid, Saliha Addour, Mark Butlin, Alberto P Avolio, Catherine Fortier, Mohsen Agharazii","doi":"10.1159/000543354","DOIUrl":"10.1159/000543354","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic stiffness, assessed through carotid-femoral pulse wave velocity (PWV), has been associated with an increased risk of cardiovascular events and mortality. Measurements of PWV are based on the proper identification of the foot of the pulse waveform by either the maximum of the second-derivative method (as used in Complior) or the intersecting tangents algorithms (as used in SphygmoCor). These approaches can give different results, especially at higher PWV ranges. However, these devices also differ by signal acquisition technology, signal filtering, and quality control algorithms, making the true contribution of analytical algorithms uncertain. The aim of the present study was to identify the differences in pulse transit time (PTT) and PWV calculated by these two algorithms when provided with the same input signal.</p><p><strong>Methods: </strong>In 113 subjects, 346 recordings of 10 s were obtained using the Complior Analyse system (PWV_Comp-2nd). The pulse waves were imported into MATLAB and filtered (<i>n</i> = 4,102 pairs of pulse waves), where after inspection 3,770 pairs were available for determination of PTT using second-derivative and intersecting tangents algorithms (PTT_Mat-2nd and PTT_Mat-IT) and the respective PWV_Mat-2nd and PWV_Mat-IT for each pair. Additionally, the same pulse wave recordings were analyzed using the SphygmoCor system in simulation mode, employing the intersecting tangents algorithm (PWV_Sphyg-IT).</p><p><strong>Results: </strong>The mean beat-by-beat PTT_Mat-2nd and PTT_Mat-IT were 54.55 ± 18.55 ms (range 15.00-129.00) and 54.61 ± 18.61 ms (range 15.00-126.00) (<i>p</i> = 0.09), respectively. The mean per participant PWV_Mat-2nd and PWV_Mat-IT were 9.67 ± 3.46 m/s and 9.66 ± 3.4 m/s with a mean difference of 0.01 ± 0.32 m/s (<i>p</i> = 0.35). The PWV_Comp-2nd and PWV_Sphyg-IT were 9.48 ± 3.25 m/s and 9.59 ± 3.25 m/s with a mean difference of 0.11 ± 0.66 m/s (<i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>The present study shows that the difference between the two algorithms is negligible across a wide range of PTT and hence does not support the need for adjusting PWV according to the algorithm used for determining PTT.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"13 1","pages":"62-71"},"PeriodicalIF":3.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483765","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}