Heart and MindPub Date : 2024-07-17DOI: 10.4103/hm.hm-d-24-00031
Andrew Sherwood, James A. Blumenthal, A. Hinderliter
{"title":"Depression and Adverse Cardiovascular Disease Outcomes: Cause or Consequence?","authors":"Andrew Sherwood, James A. Blumenthal, A. Hinderliter","doi":"10.4103/hm.hm-d-24-00031","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00031","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829203","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00017
Michael R. Le Grande, Alison Beauchamp, Andrea Driscoll, Debra Kerr, Alun C Jackson
{"title":"Is Self-Reported Obstructive Sleep Apnea Associated with Cardiac Distress? A Network Analysis","authors":"Michael R. Le Grande, Alison Beauchamp, Andrea Driscoll, Debra Kerr, Alun C Jackson","doi":"10.4103/hm.hm-d-24-00017","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00017","url":null,"abstract":"\u0000 \u0000 \u0000 The relationship between obstructive sleep apnea (OSA), obesity, various metabolic variables, and psychosocial outcomes is complex. No studies have examined the association between these predictors and disease-specific distress related to heart disease (cardiac distress). We aimed to study the association between OSA and cardiac distress using a network analysis framework.\u0000 \u0000 \u0000 \u0000 This secondary analysis of an observational cross-sectional study conducted in 2021 consisted of 405 hospital- and community-sourced adults from Australia and the United States who reported an acute coronary event (such as a myocardial infarction, or procedures such as coronary artery bypass graft surgery, or percutaneous coronary intervention) in the previous 12 months. Participants were surveyed in relation to sociodemographic variables, clinical risk factors, comorbidities (including time since event, OSA, obesity, diabetes, hypertension, and hyperlipidemia), and cardiac distress (reported by the Cardiac Distress Inventory Short-Form). These data were subjected to bootstrapped exploratory graph analysis (EGA), which identifies the dimensions of variables that cluster together. Variables that contributed to the EGA dimensions were used to predict cardiac distress using multivariable logistic regression.\u0000 \u0000 \u0000 \u0000 Three distinct dimensions were identified by the EGA: Dimension 1 – clinical risk factors and conditions including OSA, Dimension 2 – variables related to the heart event, and Dimension 3 – variables closely related to cardiac distress. For Dimension 1, only OSA was a significant predictor of cardiac distress in the fully adjusted model (adjusted odds ratio = 2.08, 95% confidence interval = 1.02–4.25, P = 0.044). Further analysis indicated that OSA was associated with physical challenges and changes in roles and relationships.\u0000 \u0000 \u0000 \u0000 This study identified that self-reported OSA is associated with cardiac distress, particularly distress that was associated with physical challenges and changes to roles and relationships. These findings imply that OSA could potentially increase stress in a relationship; however, distress was only assessed from the perspective of the participant with OSA in this study. EGA is a useful method for describing complex associations between diverse predictor variables such as OSA and cardiac distress. Owing to the self-reported aspect of the data, further investigation to confirm study outcomes is warranted.\u0000","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845874","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00009
Ranjit Pawar, Rima Konsam, Anurag Garg, A. Dolas, Ankit Maheshwari, Jayant Bajaj
{"title":"Adherent Right Atrial Cardiac Lipoma with Obstructive Symptoms: An Unusual Case Report","authors":"Ranjit Pawar, Rima Konsam, Anurag Garg, A. Dolas, Ankit Maheshwari, Jayant Bajaj","doi":"10.4103/hm.hm-d-24-00009","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00009","url":null,"abstract":"\u0000 Benign cardiac tumors are rare, and cardiac lipomas constitute a small proportion. Since the majority of these lipomas vary in morphology, size, clinical presentation, and diagnosis, it is difficult to diagnose them until they become symptomatic. Management of large adherent cardiac lipomas presenting with obstructive symptoms can be challenging. It can be arduous to excise them completely, as they may involve vital structures and may sometimes need debulking only, leading to the possibility of recurring tumors. We report a case of a 60-year-old male with complaints of chest pain and dyspnea on exertion, diagnosed with a large right atrial mass, extensive involvement of the right atrial wall, and impingement on the tricuspid valve and was managed by surgical resection with a positive clinical result. This case highlights that obstructive or symptomatic cardiac lipomas can be effectively resected with favorable outcomes.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839223","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00052
MICHAEL V. Vitiello
{"title":"New Insights and Clinical Practice on Heart, Brain, and Mind","authors":"MICHAEL V. Vitiello","doi":"10.4103/hm.hm-d-24-00052","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00052","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838352","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00015
Abhishek Sharma, A. Chahal, Nidhi Sharma
{"title":"Enhancing Palliative Care for Deep Vein Thrombosis: A Scoping Review with Clinical Insights on the Integration of Physical Activity","authors":"Abhishek Sharma, A. Chahal, Nidhi Sharma","doi":"10.4103/hm.hm-d-24-00015","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00015","url":null,"abstract":"\u0000 \u0000 \u0000 This review aims to explore the role of physical activity as an integral palliative care strategy in managing deep vein thrombosis (DVT), providing a comprehensive analysis and practical insights for clinicians.\u0000 \u0000 \u0000 \u0000 A thorough review of relevant literature was conducted, encompassing studies, clinical trials, and expert opinions that examine the relationship between physical activity and palliative care from the perspective of DVT. The search included databases such as PubMed, PEDro, and Scopus, with an emphasis on articles published within the last decade.\u0000 \u0000 \u0000 \u0000 The review highlights the multifaceted benefits of incorporating physical activity into the palliative care approach for individuals with DVT. Physical activity has been effective in enhancing overall well-being, alleviating symptoms, and contributing to the holistic management of DVT-related complications. In addition, the literature underscores the importance of personalized exercise regimens tailored to the patient’s condition, ensuring safety and effectiveness.\u0000 \u0000 \u0000 \u0000 This comprehensive review underscores the significance of physical activity as a pivotal element in palliative care for individuals with DVT. Integrating personalized exercise regimens into the management strategy offers a holistic approach that addresses the physical and psychosocial aspects of DVT. As clinicians navigate the complexities of DVT palliative care, a thorough and timely incorporation of physical activity can significantly contribute to enhancing the overall quality of life for affected individuals.\u0000","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838929","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-23-00061
Helen Huang, Francesco Perone, K. Leung, Irfan Ullah, Quinncy Lee, Nicholas Chew, Tong Liu, G. Tse
{"title":"The Utility of Artificial Intelligence and Machine Learning in the Diagnosis of Takotsubo Cardiomyopathy: A Systematic Review","authors":"Helen Huang, Francesco Perone, K. Leung, Irfan Ullah, Quinncy Lee, Nicholas Chew, Tong Liu, G. Tse","doi":"10.4103/hm.hm-d-23-00061","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00061","url":null,"abstract":"\u0000 \u0000 \u0000 Takotsubo cardiomyopathy (TTC) is a cardiovascular disease caused by physical/psychological stressors with significant morbidity if left untreated. Because TTC often mimics acute myocardial infarction in the absence of obstructive coronary disease, the condition is often underdiagnosed in the population. Our aim was to discuss the role of artificial intelligence (AI) and machine learning (ML) in diagnosing TTC.\u0000 \u0000 \u0000 \u0000 We systematically searched electronic databases from inception until April 8, 2023, for studies on the utility of AI- or ML-based algorithms in diagnosing TTC compared with other cardiovascular diseases or healthy controls. We summarized major findings in a narrative fashion and tabulated relevant numerical parameters.\u0000 \u0000 \u0000 \u0000 Five studies with a total of 920 patients were included. Four hundred and forty-seven were diagnosed with TTC via International Classification of Diseases codes or the Mayo Clinic diagnostic criteria, while there were 473 patients in the comparator group (29 of healthy controls, 429 of myocardial infarction, and 14 of acute myocarditis). Hypertension and smoking were the most common comorbidities in both cohorts, but there were no statistical differences between TTC and comparators. Two studies utilized deep-learning algorithms on transthoracic echocardiographic images, while the rest incorporated supervised ML on cardiac magnetic resonance imaging, 12-lead electrocardiographs, and brain magnetic resonance imaging. All studies found that AI-based algorithms can increase the diagnostic rate of TTC when compared to healthy controls or myocardial infarction patients. In three of these studies, AI-based algorithms had higher sensitivity and specificity compared to human readers.\u0000 \u0000 \u0000 \u0000 AI and ML algorithms can improve the diagnostic capacity of TTC and additionally reduce erroneous human error in differentiating from MI and healthy individuals.\u0000","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851204","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00030
Nathan E. Howarth, Michelle A Miller
{"title":"Sleep, Sleep Disorders, and Mental Health: A Narrative Review","authors":"Nathan E. Howarth, Michelle A Miller","doi":"10.4103/hm.hm-d-24-00030","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00030","url":null,"abstract":"\u0000 Evidence suggests that sleep is a vital component of physical and health well-being. However, while sleep problems are present in individuals with mental health problems such as depression, it has not been clear whether these conditions are independent or whether they might be causally related. Indeed, if sleep or sleep disorders predispose or modify onset and outcomes of mental health issues, treatment of these factors could be explored as new mental health prevention or treatment options. The aim of this review was to examine in detail the bidirectional relationship between sleep, sleep disorders, and mental and physical health and well-being. It has considered the evidence that sleep architecture disruption, occurring through both quantity, quality, and timing of sleep as well as through the presence of sleep disorders may both influence mental health and well-being as well as be disrupted by both physical and mental health conditions. Also, the review has explored the effects of sleep disruption on mental health and performance through fatigue, mood, and vigilance. The review has considered the bidirectionality between sleep, sleep disorders, and mental health to examine how these may lead to or exacerbate mental health disorders such as affective, anxiety, autism, depressive and schizophrenia disorders but also considers how these conditions can affect sleep. The review highlights that poor sleep or the presence of a sleep disorder can increase the risks from mental health conditions such as suicidality. Furthermore, mental health conditions such as anxiety and worry can cause racing or repetitive thoughts that can keep an individual awake, leading to shortened sleep. It is important that sleep and sleep disorders are considered potential modifiable factors that could improve mental health outcomes. The important interconnect between both physical and mental health and sleep, in patient evaluations, also needs to be considered as these may affect treatment pathways and patient outcomes. Further, more robust and perspective research is required to establish the triad relationship of physical, mental health, and sleep.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853100","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00034
S. Kunutsor, J. Laukkanen
{"title":"Physical Activity, Sedentary Behaviors, and Venous Thromboembolism: A Narrative Review of the Current Evidence","authors":"S. Kunutsor, J. Laukkanen","doi":"10.4103/hm.hm-d-24-00034","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00034","url":null,"abstract":"\u0000 This narrative review aims to synthesize existing research on the impact of physical activity and sedentary behaviors on the risk of venous thromboembolism (VTE). It also delves into the biological mechanisms through which these lifestyle factors might influence VTE risk, assesses the clinical and public health implications of these findings, and highlights gaps in the current research landscape. Furthermore, it evaluates the causal relevance of physical activity and sedentary behaviors to VTE using Mendelian randomization studies. We conducted a literature search for interventional, observational cohort and genetic studies from MEDLINE and Embase up to April 2024. High physical activity levels are associated with a reduced risk of first-time VTE, independent of factors such as body mass index, age, sex, or geographical location. Nonetheless, the exact nature of the dose–response relationship between physical activity levels and VTE risk remains unclear, particularly regarding the optimal intensity, frequency, and duration needed for VTE prevention. Unlike its effects on initial VTE risk, physical activity does not appear to influence the risk of recurrent VTE. Conversely, sedentary behaviors such as prolonged television viewing and long-distance travel (e.g., long-haul flights) are linked to an increased risk of VTE, a risk that persists despite adherence to physical activity guidelines. The causality of these associations is supported by evidence suggesting biological pathways such as alterations in blood flow and coagulation, inflammation, endothelial and platelet function, and the modulation of cardiometabolic risk factors. Future research should aim to delineate the dose–response curves for the relationships, explore the use of objective measures to more accurately assess both physical activity and sedentary behaviors, and clarify their causal roles in VTE risk, potentially guiding targeted prevention strategies.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849605","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}
Heart and MindPub Date : 2024-07-01DOI: 10.4103/hm.hm-d-24-00027
Yang Yang, Lingqiong Xia, Yajun Li, Tingting Duan, Xia Lv, Yongshun Wang
{"title":"Effects of Meditation and Breathing Therapy on Anxiety Improvement before and after Percutaneous Coronary Intervention in Patients with Coronary Artery Disease: A Prospective Cohort Study","authors":"Yang Yang, Lingqiong Xia, Yajun Li, Tingting Duan, Xia Lv, Yongshun Wang","doi":"10.4103/hm.hm-d-24-00027","DOIUrl":"https://doi.org/10.4103/hm.hm-d-24-00027","url":null,"abstract":"\u0000 \u0000 \u0000 Coronary artery disease (CAD) is a leading cause of worldwide mortality, and percutaneous coronary intervention (PCI) has long been used to alleviate its symptoms. However, patient anxiety has been noted to exacerbate the negative symptoms of CAD, as well as reduce the effectiveness of PCI. Numerous techniques have been developed for alleviating patient stress, such as mindfulness and breathing exercises, though their efficacy with respect to improving PCI outcomes has still not been fully defined. In this study, we aimed to shed light by examining whether CAD patients who underwent such exercises demonstrated lowered anxiety and improved functional outcomes post-PCI compared to CAD patients who did not undergo these procedures.\u0000 \u0000 \u0000 \u0000 One hundred and sixty CAD patients were enrolled and randomly divided into two 80-member groups, one of which (intervention) was prescribed meditation therapies, in the form of 6-min mindfulness videos, breathing therapies carried out 12 times per cycle, for 3 times/day, as well as targeted psychological counseling. The other 80-patient group served as the untreated control (Con). Anxiety was monitored during that time period using the Zung’s Self-rating Anxiety Scale (SAS), while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI); furthermore, various cardiac functioning parameters, such as heart rate, were measured. In addition, the occurrence of serious adverse events (SAEs) was monitored during the 3-month follow-up period post-PCI.\u0000 \u0000 \u0000 \u0000 No significant differences were present between the intervention and Con groups for baseline patient characteristics, except for body mass index. However, the intervention group had lower stress levels, in the form of lower SAS, compared to baseline, while the opposite was true for the untreated Con group. Lower SAS also corresponded to lower PSQI pre-PCI in intervention, indicating that this group had improved sleep quality, while PSQI remained unchanged from baseline to PCI in Con. Along with lower stress levels, intervention had lower blood pressures, heart rate, and SAEs, compared to Con, both pre-PCI and during the 3-month follow-up period, illustrating that meditation and respiratory therapies are able to reduce stress pre-PCI, in turn improving PCI outcomes and reducing complications postprocedure.\u0000 \u0000 \u0000 \u0000 Meditation and respiratory therapies are able to effectively alleviate anxiety and improve sleep quality pre-PCI, in turn improving cardiac functional parameters and facilitating smooth PCI procedures. All of these improvements resulted in increased PCI success rates, lowered hospitalization time, and reduced postsurgical complications in the form of SAEs, enabling these strategies to be of great clinical utility for better preparing CAD patients for the procedure.\u0000 \u0000 \u0000 \u0000 ClinicalTrials.gov identifier is NCT05320848.\u0000","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850081","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}
Heart and MindPub Date : 2024-06-10DOI: 10.4103/hm.hm-d-23-00042
Abhilash Thatikala, A. R. Pakanati, S. Patro, Anil Bachu, S. Onteddu, Aadya Deshpande, Rashmi Tresa Philpose, Krishna Nalleballe
{"title":"Neuropsychiatric Manifestations of Monkeypox: A Retrospective Cross-Sectional Study","authors":"Abhilash Thatikala, A. R. Pakanati, S. Patro, Anil Bachu, S. Onteddu, Aadya Deshpande, Rashmi Tresa Philpose, Krishna Nalleballe","doi":"10.4103/hm.hm-d-23-00042","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00042","url":null,"abstract":"\u0000 \u0000 \u0000 The World Health Organization declared monkeypox (MPX), a global health crisis, in July 2022. Its symptoms include fever, rash, lymphadenopathy, myalgias, and fatigue; there have also been the reports of neurological manifestations and no data on psychiatric manifestations. In our study, we aimed to study neurologic and psychiatric manifestations in MPX patients.\u0000 \u0000 \u0000 \u0000 Our study used the TriNetX database to identify MPX patients along with their age, gender, race, ethnicity, and geographic location data. Using International Classification of Diseases, tenth revision codes for neurological, psychiatric symptoms, and diagnoses, we identified 331 individuals on November 22, 2022, who had neuropsychiatric signs within a month of diagnosis with MPX (n = 1,006).\u0000 \u0000 \u0000 \u0000 The most common neurological symptom was pain (17.3%) followed by headache (10.3%), while the most frequent psychiatric symptoms were mood disorders (11.9%), emotional issues (10.5%), and anxiety (9.4%).\u0000 \u0000 \u0000 \u0000 In this study, neuropsychiatric symptoms were present in about one-third of MPX patients. Physicians, neurologists, and psychiatrists should be aware of the potential for neuropsychiatric side effects associated with MPX infection in patients.\u0000","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364253","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}