CJC Open最新文献

{"title":"Factors Associated with Same-Day Discharge After Catheter Ablation Procedures for Supraventricular Tachycardia in Ontario, Canada","authors":"Sheldon M. Singh MD ,&nbsp;Jiming Fang PhD ,&nbsp;Olivia Haldenby MSc ,&nbsp;Dennis T. Ko MD, MSc","doi":"10.1016/j.cjco.2025.03.001","DOIUrl":"10.1016/j.cjco.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Variation exists in the practice of same-day discharge (SDD) after supraventricular tachycardia (SVT) catheter-ablation procedures. The aim of this study was to evaluate factors associated with SDD after SVT catheter-ablation procedures.</div></div><div><h3>Methods</h3><div>All Ontario residents aged &gt; 18 years undergoing a first-ever SVT ablation procedure between April 1, 2011 and May 31, 2020 were included. The rate of SDD at each hospital and the annual rate within Ontario were determined. A series of logistic regression models were created to determine the influence of clinical and procedural characteristics, and of the hospital performing the procedure, on the probability of SDD occurring. The median odds ratio was calculated to estimate the variation in the odds of similar patients receiving SDD at different hospitals.</div></div><div><h3>Results</h3><div>The cohort included 16,044 individuals (aged 55.9 ± 16.5 years; female: 45.9%). Transseptal catheterization was performed in 7.8% of the cohort. The rate of SDD increased from 61% in 2011 to 91% in 2020. Hospital rates of SDD ranged from 41% to 95%. The discrimination ability (measured by C-statistics) in predicting SDD was high, at 0.84, in the model that included the hospital, as opposed to 0.58 in the model that did not include the hospital. After adjusting for age, sex, patient comorbidities, the arrhythmia diagnosis, and procedural details, the median odds ratio attributed to the hospital performing the procedure was 3.82.</div></div><div><h3>Conclusions</h3><div>Variation in SDD after SVT ablation procedures is primarily related to hospital factors. Policymakers are encouraged to explore hospital-level barriers to adopting this approach.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 564-570"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhythm vs Rate Control Strategies for Perioperative Atrial Fibrillation After Noncardiac Surgery: A Systematic Review and Meta-analysis","authors":"Michael Ke Wang MD ,&nbsp;Ghazal Razeghi BSc ,&nbsp;Geethan Baskaran BHSc ,&nbsp;Louis Park BHSc ,&nbsp;Steffen Blum MD, PhD ,&nbsp;Rachel Heo MD ,&nbsp;Tina Stegmann MD ,&nbsp;P.J. Devereaux MD, PhD ,&nbsp;William F. McIntyre MD, PhD ,&nbsp;Jeff S. Healey MD, MSc ,&nbsp;Michael Prystajecky MD, MSc ,&nbsp;Rémi LeBlanc MD ,&nbsp;Shannon M. Ruzycki MD ,&nbsp;Mohamed Panju MD ,&nbsp;Kiven Vuong BSc, MPH ,&nbsp;David Conen MD, MPH","doi":"10.1016/j.cjco.2025.01.018","DOIUrl":"10.1016/j.cjco.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>For patients with perioperative atrial fibrillation (POAF) after noncardiac surgery, earlier conversion to sinus rhythm might improve outcomes. The efficacy of a rhythm vs rate control strategy for the acute management of POAF remains uncertain.</div></div><div><h3>Methods</h3><div>We searched databases for randomized controlled trials (RCTs) and observational studies that included patients with POAF after noncardiac surgery and reported outcomes for patients acutely treated with a rhythm control strategy vs either a rate control or no treatment strategy. Studies were pooled using random effects models.</div></div><div><h3>Results</h3><div>Of the observational studies, a rhythm control strategy was associated with higher conversion rates to sinus rhythm compared with a rate control or no treatment strategy (risk ratio [RR], 1.93; 95% confidence interval [CI], 1.25-2.97; 9 studies; N = 591). Compared with a rate control or no treatment strategy, a rhythm control strategy was not associated with differences in length of hospital stay (mean difference, -1.67 days; 95% CI, -7.10 to 3.76; 2 studies), length of intensive care stay (mean difference, -1.90 days; 95% CI, -7.62 to 3.82; 1 study), or all-cause mortality (RR, 1.12; 95% CI, 0.62-2.00; 5 studies). In an RCT that compared amiodarone vs magnesium, the RR was 0.56 for conversion to sinus rhythm (95% CI, 0.31-1.03; N = 34).</div></div><div><h3>Conclusions</h3><div>A rhythm control strategy was associated with greater success rates for conversion to sinus rhythm compared with a rate control or no treatment strategy. However, the observational studies were of low quality and only 1 small RCT was identified, and few data were available for other outcomes.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 579-587"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity Gaps in the Diagnosis and Treatment of Occlusion Myocardial Infarction","authors":"Varunaavee Sivashanmugathas BSc ,&nbsp;Mazen El-Baba MD, MSc ,&nbsp;Marcella K. Jones MD ,&nbsp;Alex Kiss PhD ,&nbsp;H. Pendell Meyers MD ,&nbsp;Stephen W. Smith MD ,&nbsp;Lucas B. Chartier MD, CM, MPH, MBA ,&nbsp;Jesse T.T. McLaren MD","doi":"10.1016/j.cjco.2025.01.016","DOIUrl":"10.1016/j.cjco.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Patients with occlusion myocardial infarction (OMI) who meet the ST-elevation myocardial infarction (STEMI) criteria experience inequitable delays in care, because of sociodemographic factors, such as age and sex. OMI patients who do not meet STEMI criteria and are admitted to the hospital as non-STEMI patients, experience further delays. However, whether equity gaps exist in OMI care remains unknown.</div></div><div><h3>Methods</h3><div>A retrospective chart review included patients with acute coronary syndrome admitted to the hospital through 2 academic emergency departments, in the period from January 1, 2021 to December 31, 2022. Patients were categorized as having one of the following: OMI (acute culprit with Thrombolysis In Myocardial Infarction [TIMI] 0-2 flow, or acute culprit with TIMI 3 flow, and a troponin I level &gt; 10,000 ng/L; or if they had no angiogram, a troponin I level &gt; 10,000 ng/L plus new regional wall-motion abnormality on echocardiogram); non-OMI (MI that did not meet the OMI threshold); or MI ruled out.</div></div><div><h3>Results</h3><div>Among 662 charts, 260 were OMI patients, 296 were non-OMI patients, and 106 were patients with MI ruled out. Of the 260 OMI patients, 116 were admitted to the hospital as STEMI patients (true-positive), and 144 (55.4%) were admitted as non-STEMI patients (false-negative). In bivariate analyses, true-positive STEMI patients with atypical symptoms had a longer door-to-electrocardiogram (ECG) time (<em>P</em> &lt; 0.0001) and a longer ECG-to-catheterization time (<em>P</em> &lt; 0.001). False-negative STEMI patients had a longer door-to-ECG time for atypical symptoms (<em>P</em> &lt; 0.0001), a longer ECG-to-catheterization time for atypical symptoms (<em>P</em> = 0.003), and were aged ≥75 years (<em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>True-positive STEMI patients had delayed ECGs and catheterization for those presenting with atypical symptoms. More than half of those with OMI were admitted as non-STEMI patients, with further reperfusion delays for older patients and those presenting with atypical symptoms. Shifting to the OMI paradigm highlights reperfusion delays and equity gaps in the management of ACS.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 632-640"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Over 10 years and 1000 Exercise Hours of Cardiac Rehabilitation in a Patient with a Left Ventricular Assist Device","authors":"Javier Loureiro Diaz MSc ,&nbsp;Prasobh Jacob MSc ,&nbsp;Praveen Jayaprabha Surendran MPT ,&nbsp;Omar Ibrahim MD","doi":"10.1016/j.cjco.2025.03.006","DOIUrl":"10.1016/j.cjco.2025.03.006","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 667-670"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Models to Predict Major Adverse Cardiovascular Events in Chronic Kidney Disease","authors":"Navdeep Tangri MD, PhD ,&nbsp;Thomas W. Ferguson MSc ,&nbsp;Ryan J. Bamforth MSc ,&nbsp;Manish M. Sood MD, MSc ,&nbsp;Pietro Ravani MD, PhD ,&nbsp;Alix Clarke Stat MSc ,&nbsp;Alessandro Bosi MSc ,&nbsp;Juan J. Carrero Pharm PhD","doi":"10.1016/j.cjco.2025.02.016","DOIUrl":"10.1016/j.cjco.2025.02.016","url":null,"abstract":"<div><h3>Background</h3><div>Accurate cardiovascular (CV) risk prediction tools may heighten awareness and monitoring, improve the use of evidence-based therapies and help inform shared decision making for patients with chronic kidney disease (CKD). The purpose of this study was to develop and externally validate a risk prediction model for incident and recurrent CV events across all stages of CKD using commonly available demographics and laboratory data.</div></div><div><h3>Methods</h3><div>A series of models were developed using administrative and laboratory data (n=36,317) from Manitoba, Canada, between April 1, 2006, and December 31, 2018, with external validation in health system’s data from Alberta, Canada (n=95,191), and Stockholm, Sweden (n=83,000). Adults with incident CKD stages G1-G4 were followed for the occurrence of major adverse cardiovascular events (MACE) (myocardial infraction, stroke, and CV death), and MACE including hospitalization for heart failure (MACE+). Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUC), Brier scores, and plots of observed vs predicted risk, and the models were compared to an existing model from the Chronic Renal Insufficiency Cohort (CRIC).</div></div><div><h3>Results</h3><div>In the Alberta cohort, the AUCs for predicting MACE and MACE+ were 0.77 (0.77-0.77) and 0.80 (0.79-0.80), respectively. In the Stockholm cohort, the model achieved an AUC of 0.87 (0.86-0.87) for predicting MACE and 0.88 (0.88-0.88) for MACE+. Overall performance was improved relative to CRIC.</div></div><div><h3>Conclusions</h3><div>A model including commonly available administrative data and laboratory results can predict the risk of MACE and MACE+ outcomes among individuals with CKD.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 686-694"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mobile Setup for Atrial Fibrillation Catheter Ablation","authors":"William K. Chan MD, FRCPC, DRCPSC,&nbsp;Umjeet S. Jolly MD, FRCPC, DRCPSC","doi":"10.1016/j.cjco.2025.02.015","DOIUrl":"10.1016/j.cjco.2025.02.015","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 593-594"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Failure to Positive Result: Turning Aortic Insufficiency in Neocuspidization Procedure Into Excellent Results","authors":"Marien Lenoir MD, PhD ,&nbsp;Loïc Mace MD, PhD ,&nbsp;Beatrice Desnous MD, PhD ,&nbsp;Grégoire Stolpe MD ,&nbsp;Jean-Marc El Arid MD","doi":"10.1016/j.cjco.2025.02.013","DOIUrl":"10.1016/j.cjco.2025.02.013","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 675-677"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Dielectric Sensing Technology in Heart Failure: Correlating Lung-Fluid Volume Shifts with Postural Changes and Dyspnea Severity","authors":"Li-Kai Wang MD, MSc ,&nbsp;Yi-Ju Tsai PhD ,&nbsp;Ying-Chou Wang PhD ,&nbsp;June-Horng Lue PhD ,&nbsp;Chun-Ta Huang MD","doi":"10.1016/j.cjco.2025.03.003","DOIUrl":"10.1016/j.cjco.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Orthopnea, a common symptom in heart failure (HF), arises from elevated pulmonary pressures and interstitial edema due to positional shifts. Remote dielectric sensing (ReDS) offers a noninvasive method to quantify lung-fluid volume. This study evaluated ReDS system measurements in response to posture changes in HF patients, and the correlation of these measurements with dyspnea severity.</div></div><div><h3>Methods</h3><div>This prospective observational study included both healthy volunteers and HF patients. Lung-fluid volume was measured using the ReDS system, with the patients in 3 positions—sitting, supine, and supine with elevated legs. HF patients additionally reported dyspnea levels on a visual analog scale immediately before and after ReDS measurements were made.</div></div><div><h3>Results</h3><div>A total of 86 healthy volunteers and 20 HF patients were included in the study. In healthy volunteers, ReDS values modestly increased when patients changed from a sitting to a supine position (21% vs 22%; <em>P</em> &lt;0.001), and from being supine to supine with raised legs (22% vs 24%; <em>P</em> &lt;0.001). In contrast, HF patients showed significantly higher ReDS values across all positions (29%, 31%, and 34%, respectively), with more pronounced increases between positions compared to those of healthy subjects (<em>P</em> for interaction &lt; 0.001). A strong correlation was observed between ReDS system measurements and dyspnea visual analog scale scores in HF patients following posture changes (Pearson’s <em>r</em> = 0.718, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The ReDS system effectively quantifies lung-fluid volume changes due to body-position shifts in HF patients. Its measurements correlate well with alterations in dyspnea severity, potentially offering an objective means to monitor HF symptoms. Further studies are needed to validate these findings in a larger cohort and over an extended period.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 606-613"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Mixed Phenotype Hereditary Transthyretin Amyloidosis: A Case-Based, Canadian Perspective","authors":"Nowell Fine MD ,&nbsp;Anique Ducharme MD ,&nbsp;Genevieve Matte MD ,&nbsp;Michelle Mezei MD ,&nbsp;Vera Bril MD ,&nbsp;Diego Delgado MD, MSc","doi":"10.1016/j.cjco.2025.03.002","DOIUrl":"10.1016/j.cjco.2025.03.002","url":null,"abstract":"<div><div>Hereditary amyloid transthyretin variant (ATTRv) amyloidosis is a rare, life-threatening disease, characterized by the deposition of aggregated transthyretin (TTR) protein in multiple organs and tissues. Diagnosis is often delayed due to its heterogeneity in presentation, which includes a wide range of cardiac and/or neurologic symptoms. Thus, awareness of ATTRv amyloidosis across multiple specialties is needed for its early diagnosis and management. This paper provides a review surrounding the diagnosis and management of mixed phenotype ATTRv amyloidosis, addressed through 3 clinical questions. This paper discusses: (i) the need for patients with ATTRv amyloidosis to be screened for mixed cardiac and neurologic phenotypes through early multidisciplinary referral; (ii) the therapeutic landscape for ATTRv amyloidosis in Canada, with emphasis on the need for prompt therapy selection and initiation, based on multidisciplinary collaboration; and (iii) how disease can be monitored pre- and post-treatment. Case studies are provided to illustrate how the available evidence impacts practice.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 614-627"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CArdiovasculaR Outcomes Based Upon EjectIon Systolic TimE in Patients With ST Elevation Myocardial Infarction (ARISE-STEMI) Study","authors":"Tyler Szun BSc ,&nbsp;Alexander Zaremba BSc ,&nbsp;Aleksander Dokollari MD, PhD ,&nbsp;Azin Khafipour MSc ,&nbsp;Hilary Bews MD, FRCPC ,&nbsp;Seth Cheung ,&nbsp;James W. Tam MD, FRCPC ,&nbsp;Shuangbo Liu MD, FRCPC ,&nbsp;Derek So MD, FRCPC ,&nbsp;Sean Van Diepen MD, FMSc ,&nbsp;Ashish H. Shah MD, MD-Research, FRCP","doi":"10.1016/j.cjco.2024.11.014","DOIUrl":"10.1016/j.cjco.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Despite improvements in revascularization, systems of care, and secondary prevention therapies, 30-day mortality rates in patients presenting with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains 4% to 6%. This study aims to investigate the utility of the ejection systolic time (EST) and ejection systolic period (ESP) in identifying high-risk STEMI patients.</div></div><div><h3>Methods</h3><div>In this retrospective study, consecutive patients with STEMI undergoing PPCI at a tertiary cardiac center between January 2020 and October 2021 were included. EST and ESP were calculated on the MacLab. Univariable and multivariable Cox regression analysis were used to identify risk predictors. The primary outcome was mortality at 30 days.</div></div><div><h3>Results</h3><div>Six hundred forty-one STEMI patients (mean age: 64.4 ± 13.2 years; 182/641 [28.4%] female patients) were recruited. Within 30 days of presentation, 32 patients (5.0%) died, and they were more frequently older, female, and had higher rates of previous stroke, chronic kidney disease, and dialysis use. Patients dying within 30 days had lower EST (0.20 ± 0.04 vs 0.24 ± 0.04 seconds/beat; <em>P</em> &lt; 0.0001) and ESP (17.64 ± 2.66 vs 19.29 ± 2.74 seconds/min; <em>P</em> = 0.004). After multivariable modeling, only EST was a significant predictor of early (&lt;30 days) mortality (hazard ratio 4.5, 95% confidence interval 1.7-12.1; <em>P</em> = 0.003), prolonged in-hospital stay (&gt;4 days), diuretic use, new diagnosis of heart failure, need for intubation or ventilation, and inotrope and/or vasopressor use during the index hospital admission. ESP and EST were not associated with the mortality between 30 days and 1 year.</div></div><div><h3>Conclusions</h3><div>A lower EST was associated with mortality at 30 days and in-hospital adverse outcomes. EST may serve as a useful hemodynamic marker to risk-stratify STEMI patients.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 516-524"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791434","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}