CJC Open最新文献

{"title":"Rationale and Trial Design of Feedbacks Using Behavioural Economic Theories on STEP Counts (FOOTSTEPS) Trial in Patients With Cardiovascular Disease","authors":"Takahiro Suzuki MD, MPH ,&nbsp;Jiro Aoki MD, PhD ,&nbsp;Kohei Abe MD ,&nbsp;Taku Asano MD, PhD ,&nbsp;Daisuke Yoneoka PhD ,&nbsp;Shuntaro Sato PhD ,&nbsp;Jeffrey Rewley PhD ,&nbsp;Kotaro Miyata MD ,&nbsp;Masafumi Ono MD, PhD ,&nbsp;Akira Saito MD, MPH ,&nbsp;Takayoshi Kanie MD ,&nbsp;Kenta Okui MD ,&nbsp;Akinari Takahashi MD ,&nbsp;Koichiro Isa MD ,&nbsp;Satoshi Takasago MD ,&nbsp;Yumi Shiina MD, PhD ,&nbsp;Yosuke Nishihata MD, PhD ,&nbsp;Hiroyuki Niinuma MD, PhD ,&nbsp;Keita Masuda MD, PhD ,&nbsp;Yasufumi Kijima MD, PhD ,&nbsp;Atsushi Mizuno MD, PhD","doi":"10.1016/j.cjco.2024.12.009","DOIUrl":"10.1016/j.cjco.2024.12.009","url":null,"abstract":"<div><div>Physical activity is crucial for reducing cardiovascular disease (CVD) risk. Interventions for nonsupervised exercise therapy have not been broadly implemented, and few patients with CVD achieve the recommended activity levels (eg, 8000 daily steps). Behavioural economics-based programs increased physical activity in the general population; however, their effectiveness—including the impact of gain vs loss framing—in patients with CVD remains unclear. This study investigates the effectiveness of gamification with social incentives and support in promoting physical activity among patients with CVD using smartphone applications.</div><div>This 5-arm, randomized controlled trial will recruit adult patients with CVD from a single acute tertiary emergency hospital in Tokyo, Japan. Participants will be randomly assigned to 1 of 5 groups: control, gamification (loss framing), gamification (gain framing), gamification (loss framing) + social support, or gamification (gain framing) + social support. The smartphone application incorporates gamification elements: points, rankings, and framing effects. Participants in social support arms will nominate a family member or friend to receive weekly progress reports and provide encouragement. The intervention period is 6 weeks, followed by a 6-week follow-up. The primary outcome is the change in mean daily step count from baseline to the intervention period. The target sample size is 325 participants (65 per arm), and mixed-effects regression models will be used to assess changes in physical activity.</div><div>This trial will evaluate the effectiveness of gamification with social incentives and support to increase physical activity in patients with CVD. These findings may provide valuable evidence regarding the effectiveness of gamification systems in improving outcomes for this population.</div></div><div><h3>Trial Registration Number</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID NCT06446076</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 535-544"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792031","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":"Readmission Mortality After TAVR: The Combined Effect of Teaching Hospital Status and Cause of Readmission","authors":"Carlos E. Diaz-Castrillon MD ,&nbsp;Dustin Kliner MD ,&nbsp;Derek Serna-Gallegos MD ,&nbsp;Catalin Toma MD ,&nbsp;AJ Conrad Smith MD ,&nbsp;Hemal Gada MD ,&nbsp;Amber Makani MD ,&nbsp;Irsa Hasan MD ,&nbsp;Takuya Ogami MD ,&nbsp;Yisi Wang MPH ,&nbsp;Ibrahim Sultan MD","doi":"10.1016/j.cjco.2024.12.014","DOIUrl":"10.1016/j.cjco.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Variability in transcatheter aortic valve replacement (TAVR) readmission rates highlights the importance of assessing post-discharge outcomes. Understanding how teaching hospital status and causes of readmission influence mortality could optimise post-TAVR care.</div></div><div><h3>Methods</h3><div>Using the National Readmissions Database, we identified 155,298 TAVR admissions from 2012 to 2020. We evaluated the interaction effect between teaching status and cause of readmission on readmission-related mortality through adjusted mixed-effects models.</div></div><div><h3>Results</h3><div>Overall, 18.9% of patients (n = 29,479) had a nonelective readmission within 90 days, with no significant difference between teaching and nonteaching hospitals (19.3% vs 18.9%; <em>P</em> &gt; 0.05). Cardiac-related readmissions accounted for 42.7% of cases, while noncardiac readmissions made up 57.3%, with no differences observed in their distribution between teaching and nonteaching hospitals. The unadjusted 90-day readmission mortality rate was 3.8%, without significant differences between teaching and nonteaching hospitals (3.8% vs 4.1%; <em>P</em> = 0.38). A downward trend in nonelective readmission and readmission-related mortality rates was observed, regardless of teaching status. An interaction effect between teaching status and the cause of readmission was identified: Noncardiac readmissions to teaching hospitals were associated with increased odds of death (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.59-2.07; <em>P</em> &lt; 0.001) compared with nonteaching hospitals, whereas cardiac readmissions to teaching hospitals were associated with decreased odds of in-hospital mortality (OR 0.55, 95% CI 0.48-0.62; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our findings indicate a differential association between teaching hospital status and 90-day readmission mortality, contingent on the cause of readmission. Further research, including the use of metrics such as failure to rescue, is needed to better understand the relationship between patient-level variables and teaching hospital status.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 481-488"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791430","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":"Guideline Directed Anticoagulant Treatment and Dosing in a Contemporary Atrial Fibrillation Cohort: Analysis of the TRANSECT-AF Program","authors":"Cole Clifford MD ,&nbsp;Shaun G. Goodman MD, MSc ,&nbsp;Mary K. Tan MSc ,&nbsp;Jean Gregoire MD ,&nbsp;Jeffrey Habert MD ,&nbsp;Anil Gupta MD ,&nbsp;Walter Chow MD ,&nbsp;Shahin Jaffer MD, MHSc ,&nbsp;Sandeep G. Aggarwal MD ,&nbsp;Michael Heffernan MD ,&nbsp;Robert Maranda MD ,&nbsp;Kevin Saunders MD ,&nbsp;Andrew T. Yan MD","doi":"10.1016/j.cjco.2024.12.010","DOIUrl":"10.1016/j.cjco.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Optimal thromboprophylaxis in atrial fibrillation (AF) requires the accurate application of modern clinical guidelines. We evaluated the point prevalence and factors associated with nonguideline-directed anticoagulation and direct oral anticoagulant (DOAC) dosing in Canadian patients with AF.</div></div><div><h3>Methods</h3><div>TRANSECT-AF is a retrospective registry of consecutive Canadian patients with AF collected between March 2021 and August 2023. Patients were categorized as guideline directed therapy (GDT) or nonguideline-directed therapy (NGDT) based on concordance of their reported thromboprophylaxis with the CHADS-65 algorithm. Patients on GDT with a DOAC were subcategorized as concordant or discordant dosing based on concordance of their reported DOAC doses with the 2020 Canadian Cardiovascular Society AF dosing recommendations.</div></div><div><h3>Results</h3><div>In total, 3043 patients were included (median age 77, 37% women, median CHADS-VASc score 4, median HAS-BLED score 2) and 11% received NGDT, which was independently associated with younger age, lower thromboembolic risk, better renal function, and antiplatelet therapy. Within the GDT cohort, 32% of patients were on guideline discordant DOAC doses. Older age, lower body mass index, female sex, lower renal function, higher thromboembolic risk and non-apixaban DOAC use were independently associated with discordant dosing.</div></div><div><h3>Conclusions</h3><div>Within this Canadian AF registry, 11% of patients were on NGDT and 32% of patients on GDT with a DOAC were treated with a guideline-discordant dose. Our analysis describes predictors of guideline discordant anticoagulation and DOAC dosing that may be used to identify target populations for future quality improvement initiatives in AF thromboprophylaxis.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 412-419"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792026","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":"An Updated Global Perspective of Atrial Fibrillation: Trends, Risk Factors, and Socioeconomic Disparities","authors":"Sukrit Treewaree MD ,&nbsp;Gregory Y.H. Lip MD, FRCP, DFM, FACC, FESC, FEHRA","doi":"10.1016/j.cjco.2024.12.003","DOIUrl":"10.1016/j.cjco.2024.12.003","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 259-261"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609454","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":"A Rare Case of Adventitial Cystic Disease of the Popliteal Artery With Intermittent Claudication With Recurrent Exacerbations and Remissions","authors":"Hiroki Mori MD ,&nbsp;Tairo Kurita MD ,&nbsp;Kenta Uno MD ,&nbsp;Toshiki Sawai MD ,&nbsp;Takafumi Koji MD ,&nbsp;Hitoshi Kakimoto MD ,&nbsp;Kaoru Dohi MD","doi":"10.1016/j.cjco.2024.12.002","DOIUrl":"10.1016/j.cjco.2024.12.002","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 334-337"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609708","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":"Evaluation of Information About Cardiovascular Implications of Gender-Affirming Care From Online Chat-based Artificial Intelligence Systems","authors":"Brototo Deb MD, MIDS ,&nbsp;Michael Fradley MD ,&nbsp;Stephen Cook MD ,&nbsp;Geoffrey D. Barnes MD, MSc","doi":"10.1016/j.cjco.2024.11.020","DOIUrl":"10.1016/j.cjco.2024.11.020","url":null,"abstract":"<div><div>Because of restrictive laws in multiple states for gender-affirming care, patients might be prompted to get recommendations from contemporary online chatbots. This study explored the appropriateness of such recommendations using validated tools to assess patient education materials by a team of LGBTQ-affirming cardiologists. The study showed that although all systems emphasize the need for multidisciplinary care, there were notable differences in the comprehensiveness, cultural appropriateness, and presentation of their responses. GPT-4 (<span><span>https://chatbotapp.ai</span><svg><path></path></svg></span>) and Gemini (<span><span>https://gemini.google.com/app</span><svg><path></path></svg></span>) outperformed Bing (<span><span>https://copilot.microsoft.com</span><svg><path></path></svg></span>), particularly in the balanced and culturally sensitive delivery of information.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 338-343"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609691","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":"An International Perspective on Priority Areas for Women’s Cardiovascular Health Research: Qualitative Findings From a Cross-Sectional Survey","authors":"Stacey Matthews MPH ,&nbsp;Christine Faubert PhD ,&nbsp;Stephanie Couperthwaite BSc ,&nbsp;Brian H. Rowe MD, MSc ,&nbsp;Global Cardiovascular Research Funders Forum","doi":"10.1016/j.cjco.2024.12.001","DOIUrl":"10.1016/j.cjco.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>The Global Cardiovascular Research Funders Forum (GCRFF) unites international research funders interested in supporting cardiovascular disease (CVD) research. One focus area is women’s cardiovascular health; the present study aimed to identify priority themes for future joint research funding opportunities.</div></div><div><h3>Methods</h3><div>After ethics approval, a survey was developed based on literature review, GCRFF feedback, and input from methodologists/content experts. The survey comprised 3 open-ended and 5 multiple-choice questions. With the use of widespread dissemination strategies, an electronic survey portal was opened for 8 weeks, from November 15, 2023, to January 15, 2024, with various language options. Results were downloaded into a secure REDCap database for analysis. Independent theming of responses was completed by 3 reviewers until coding consensus was achieved, following which 1 coder completed the remaining theming. Descriptive statistics are reported.</div></div><div><h3>Results</h3><div>Among the 191 responses, all 9 GCRFF countries were represented. Most respondents identified as women (74%) and clinicians/academics (77%); fewer people with lived or living experience participated (23%). Common themes included women-specific risk factors and prevention strategies (56%), life-course issues (43%), and sex- and gender-specific treatments and outcomes (36%). Common topics were CVD (66%), coronary artery disease (CAD) (18%), and heart disease (13%). Designated research pillars included clinical (52%), population health (36%), and basic science (30%). Solutions proposed included knowledge generation (71%), increased funding (55%), networking researchers (52%), and knowledge mobilisation (41%). Congruence of priority ordering was demonstrated between sex and respondent residence subgroups.</div></div><div><h3>Conclusion</h3><div>Diverse international input prioritised research in risk factors and prevention strategies specific to women and in sex- and gender-specific treatment and outcomes of heart disease, with considerations of life-course issues across all research pillars.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 344-350"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609692","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":"Intracardiac Thrombus Resulting in Multiple Cardiovascular Complications as a Manifestation of Behçet Disease: A Case Report","authors":"Alba García Suárez MD ,&nbsp;Nuria Vicente Ibarra PhD ,&nbsp;Cintia Romera-López PhD ,&nbsp;Andrea Romero Valero MD ,&nbsp;Marina Martínez Moreno PhD ,&nbsp;Jose Albors Martin PhD ,&nbsp;Daniel Nuñez Pernas PhD ,&nbsp;Alejandra Tamayo Obregon MD ,&nbsp;Pedro Morillas Blasco PhD","doi":"10.1016/j.cjco.2024.12.012","DOIUrl":"10.1016/j.cjco.2024.12.012","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 362-365"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609707","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":"Evaluating the Readability and Understandability of Online Patient Educational Material for Percutaneous Coronary Intervention in Canada","authors":"Raumil V. Patel MD, MSc ,&nbsp;Denis Qeska HBSc ,&nbsp;Jennifer M. Amadio MD, MEHP ,&nbsp;Nicolas Bowers MD, MSc ,&nbsp;Andrew C.T. Ha MD, MSc ,&nbsp;Harindra C. Wijeysundera MD, PhD","doi":"10.1016/j.cjco.2024.11.012","DOIUrl":"10.1016/j.cjco.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous coronary intervention (PCI) is the most common treatment for coronary artery disease revascularization. Many patients undergoing PCI may seek educational information online, but the reliability of such resources remains uncertain. This study seeks to assess the readability and understandability of online patient resources for PCI from Canadian hospital sources.</div></div><div><h3>Methods</h3><div>We performed a descriptive study evaluating online educational materials pertaining to PCI hosted by all Canadian hospitals that perform the procedure. The primary outcomes were readability, assessed using the Flesch-Kincaid Grade Level (FKGL) and Scolarius score, and understandability plus actionability, as assessed using the Patient Education Materials Assessment Tool (PEMAT). Educational clinical material is recommended to be written at an FKGL between 6 and 8. A score between 50 and 89 on the Scolarius tool suggests the text is readable by most adults, and a PEMAT score &gt;70% corresponds to an understandable and actionable educational material.</div></div><div><h3>Results</h3><div>A total of 29 Canadian hospitals performing PCI and hosting unique educational content were identified. Only 71% of PCI-capable hospitals provide relevant online educational resources to patients. The average FKGL of the analyzed content was 10 (range 5-18) and the average Scolarius score was 127.8 (range 79-173). The average total PEMAT print score was 46.1%, whereas the average total PEMAT audiovisual score was 71.8%.</div></div><div><h3>Conclusions</h3><div>Most of the educational material pertaining to PCI created by Canadian hospitals is in English and print format, and of poor readability, understandability, and actionability. Audiovisual materials perform better but are sparsely used.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 297-303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609685","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":"Screening of Diabetic and Heart Failure Patients for Silent Atrial Fibrillation","authors":"Elvira Silajdzija MD ,&nbsp;Ida Marie Lund MD ,&nbsp;Julie Bech Jensen MD ,&nbsp;Annam Pervez Sheikh MD ,&nbsp;Johanne Lynge Hansen BScMed ,&nbsp;Maya Tourkaman MD ,&nbsp;Valborg Heinesen MD ,&nbsp;Thomas Kallemose MSc ,&nbsp;Jenny Lillqvist MD ,&nbsp;Clemens Steinwender MD ,&nbsp;Martin Clodi MD ,&nbsp;Tijn Hendrikx MD, PhD ,&nbsp;Johan Engdahl MD, PhD ,&nbsp;Helmut Pürerfellner MD ,&nbsp;Ulrik Dixen MD, PhD","doi":"10.1016/j.cjco.2024.11.023","DOIUrl":"10.1016/j.cjco.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a common heart rhythm disorder with various clinical presentations, including asymptomatic AF, known as silent AF. High-risk patients not treated with anticoagulants are at increased risk of stroke. Therefore, systematic screening has been evaluated to reduce death and cardiovascular complications. Concentrating screening efforts on high-risk populations may optimize the effectiveness of future screening strategies. The aim of our study was to determine the prevalence of silent AF in a high-risk population 65 years or older with diabetes mellitus type 2 (DM2) or congestive heart failure (CHF).</div></div><div><h3>Methods</h3><div>A multicentre, observational, prospective cohort study of 645 patients with DM2 or CHF screened for AF in primary care and outpatient clinics in Denmark, Sweden, and Austria from 2016 to 2020. Patients were examined by intermittent electrocardiogram (ECG) recordings using a handheld ECG device 4 times daily for 2 weeks. AF was diagnosed with at least 1 recording (30 seconds) of AF. Patients with fewer than 40 recordings were excluded from the analyses.</div></div><div><h3>Results</h3><div>Overall 3.3 %, 3.0%, and 3.9%, respectively, of the patients with DM2 and CHF, and 5.5% of patients older than 74 years were diagnosed with previously undetected AF.</div></div><div><h3>Conclusions</h3><div>Intermittent handheld ECG screening revealed AF in 1 in every 30 patients in a high-risk population, with an increased observed risk in elderly patients.</div></div><div><h3>Clinical Registration Number</h3><div>H-16015331.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 3","pages":"Pages 262-269"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609453","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}