Journal of Cardiology Cases最新文献

{"title":"Early recurrence of mitral annular calcification-related calcified amorphous tumor despite complete surgical resection","authors":"Yuto Hagiwara MD,&nbsp;Makoto Miyake MD, PhD,&nbsp;Shinji Sumiyoshi MD, PhD,&nbsp;Yu Noguchi MD,&nbsp;Shoko Nakagawa MD, PhD,&nbsp;Jiro Sakamoto MD, PhD,&nbsp;Hirokazu Kondo MD, PhD,&nbsp;Kyokun Uehara MD, PhD,&nbsp;Toshihiro Tamura MD, PhD","doi":"10.1016/j.jccase.2026.05.015","DOIUrl":"10.1016/j.jccase.2026.05.015","url":null,"abstract":"<div><div>Calcified amorphous tumor (CAT) is a non-neoplastic cardiac mass that rarely recurs after resection. We report a case of early recurrence of CAT despite complete surgical resection. A 59-year-old woman with end-stage renal disease and a recent cerebral infarction was found to have mobile masses attached to mitral annular calcification. The masses were surgically resected to prevent further embolic events, and histopathological examination confirmed the diagnosis of CAT. Follow-up echocardiography 7 months after surgery revealed recurrence, leading to a second resection. CAT can recur even in the early postoperative period; therefore, careful follow-up with echocardiography is essential for prompt detection of recurrence.</div></div><div><h3>Learning objective</h3><div>Although rare, calcified amorphous tumor can recur in the early postoperative period despite macroscopically complete resection. In particular, mitral annular calcification-related calcified amorphous tumor may grow rapidly, making careful postoperative follow-up essential. Echocardiography is an effective modality for monitoring and detecting recurrence.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 106-109"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859547","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":"Management of pericardial effusion with andexanet alfa during epicardial ventricular tachycardia ablation","authors":"Mayu Nakajima MD,&nbsp;Yasuyuki Takada MD, PhD,&nbsp;Muryo Terasawa MD, PhD,&nbsp;Kazuhiro Satomi MD, PhD,&nbsp;Yoshinao Yazaki MD, PhD","doi":"10.1016/j.jccase.2026.05.009","DOIUrl":"10.1016/j.jccase.2026.05.009","url":null,"abstract":"<div><div>Andexanet alfa, a reversal agent for factor Xa inhibitors, is rarely used during catheter ablation procedures. We describe a case in which andexanet alfa was effective to manage hemorrhagic pericardial effusion during epicardial ablation for ventricular tachycardia. After the administration of andexanet alfa, the therapeutic range of activated clotting times was difficult to achieve despite heparin administration. The procedure was completed safely by focusing on epicardial targets with minimal endocardial manipulation. Specific consideration of anticoagulation strategies is required in patients with hemorrhagic complications during ablation procedure.</div></div><div><h3>Learning objective</h3><div>This case presents the first reported use of andexanet alfa during catheter ablation for ventricular arrhythmias and emphasizes the importance of tailoring procedural strategies to each case, including consideration of the arrhythmogenic substrate location, to avoid thromboembolic complications.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 102-105"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859381","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":"Successful control of intractable Impella 5.5 graft site bleeding using a Viabahn stent graft: A case report","authors":"Seimei Kure MD, PhD,&nbsp;Taiichi Takasaki MD, PhD,&nbsp;Khoirur Rijal Ashsholih MD,&nbsp;Toshifumi Hiraoka MD, PhD,&nbsp;Shinya Takahashi MD, PhD","doi":"10.1016/j.jccase.2026.05.016","DOIUrl":"10.1016/j.jccase.2026.05.016","url":null,"abstract":"<div><div>Impella 5.5 (Abiomed Inc., Danvers, MA, USA) provides effective mechanical circulatory support in severe heart failure but requires surgical implantation via a prosthetic graft, which may be complicated by bleeding. We report a case of uncontrollable oozing hemorrhage at the axillary graft anastomosis site during Impella 5.5 support in a 35-year-old man with acute decompensated heart failure due to idiopathic cardiomyopathy. The patient had previously been supported with Impella CP, resulting in severe coagulopathy. To control the bleeding while preserving limb perfusion, a Viabahn covered stent (Vascutek Ltd, Inchinnan, United Kingdom) was deployed in the right subclavian artery to cover the graft anastomosis site, achieving immediate and complete hemostasis. After subsequent recovery of cardiac function, the Impella 5.5 was safely explanted. Viabahn stent graft placement may be an effective rescue strategy for intractable graft site bleeding during Impella 5.5 support when standard surgical hemostasis fails, allowing continuation of mechanical support and safe device removal.</div></div><div><h3>Learning objective</h3><div>Impella 5.5–related graft-site bleeding associated with coagulopathy after Impella CP or extracorporeal membrane oxygenation can be effectively controlled by Viabahn stent graft placement when conventional surgical hemostasis fails.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 122-124"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859552","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":"Acute coronary syndrome associated with probable immunoglobulin G4–related coronary periarteritis successfully treated with a drug-coated balloon","authors":"Takeshi Niizeki MD, PhD, FJCC,&nbsp;Tadateru Iwayama MD, PhD,&nbsp;Toshiki Sasaki MD, PhD","doi":"10.1016/j.jccase.2026.06.001","DOIUrl":"10.1016/j.jccase.2026.06.001","url":null,"abstract":"<div><div>Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disorder that can rarely affect the coronary arteries, leading to acute coronary syndrome (ACS). A 68-year-old man with IgG4-RD presented with exertional chest pain. An electrocardiogram showing ST-segment elevation in II, III, aVF leads, and rising troponin levels confirmed ACS. Emergent coronary angiography (CAG) revealed right coronary artery occlusion, and intravascular ultrasound (IVUS) showed vasculitis-related coronary pathology. Based on these findings and the patient's clinical background, ACS secondary to IgG4-related coronary periarteritis (IgG4-related CP) was diagnosed. Because stent implantation for inflammation-associated lesions carries a high risk of restenosis, percutaneous coronary intervention (PCI) without stenting was performed. Plaque ablation was achieved using excimer laser coronary atherectomy, followed by angioplasty with a drug-coated balloon. Post-PCI coronary computed tomography angiography demonstrated perivascular soft tissue around the culprit lesion, suggestive of ongoing inflammation. Follow-up CAG and IVUS confirmed good patency without restenosis after intensification of steroid therapy. This case highlights the complexity of ACS secondary to IgG4-related CP. Coronary involvement in IgG4-RD remains under-recognized, necessitating a high index of suspicion and multimodal imaging for diagnosis.</div></div><div><h3>Learning objective</h3><div>Although rare, immunoglobulin G4–related coronary involvement should be considered a potential cause of acute coronary syndrome. Awareness of this entity and a multidisciplinary, multimodality imaging–based approach, including serial coronary computed tomography and intravascular ultrasound to assess treatment response, are essential for optimal management. In cases with insufficient response to corticosteroids, additional immunosuppressive therapy may be required.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 125-128"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859379","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":"Mechanical thrombectomy and venous-dedicated stent implantation for acute iliofemoral deep vein thrombosis with iliac vein compression","authors":"Ayano Kobayashi,&nbsp;Yasuhiro Tanabe MD, PhD,&nbsp;Kazuki Muramatsu MD,&nbsp;Masahiro Sekiguchi MD,&nbsp;Nozomi Kotoku MD, PhD,&nbsp;Masaki Izumo MD, PhD,&nbsp;Misa Kougo MD,&nbsp;Yoshihiro J. Akashi MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.014","DOIUrl":"10.1016/j.jccase.2026.05.014","url":null,"abstract":"<div><div>Venous catheter intervention has been reported to promptly improve symptoms in patients with deep vein thrombosis (DVT) and may potentially prevent progression to post-thrombotic syndrome. However, the dissemination of this treatment in Japan has been limited due to the lack of dedicated devices. In December 2024, venous-specific mechanical thrombectomy and stent systems became available in Japan. We report the case of a 71-year-old man with extensive left iliofemoral DVT complicated by iliac vein compression, which was refractory to direct oral anticoagulants, catheter-directed heparin infusion and balloon angioplasty. He underwent mechanical thrombectomy using the ClotTriever® system (Inari Medical, Irvine, CA, USA), followed by deployment of a Venovo™ venous stent (BD, Franklin Lakes, NJ, USA). Following the intervention, swelling and tightness in the left lower extremity improved immediately. On postoperative day 1, the thigh and calf circumferences had decreased from 50.5 cm and 41.0 cm preoperatively to 46.0 cm and 33.0 cm, respectively. This case suggests that a novel mechanical thrombectomy system, combined with a dedicated venous stent, offers a safe and effective treatment option for refractory iliofemoral DVT without the use of thrombolytic agents.</div></div><div><h3>Learning objective</h3><div>Transcatheter venous intervention using a novel mechanical thrombectomy system combined with dedicated venous stent implantation for extensive deep vein thrombosis with iliac vein compression is effective in restoring venous flow and alleviating symptoms without the use of thrombolytic agents, and may reduce the progression to post-thrombotic syndrome.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 117-121"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859551","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":"Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy in patients with situs inversus totalis: A two-case series","authors":"Hiroki Ueno MD,&nbsp;Yoshihisa Kanaji MD, PhD,&nbsp;Eisuke Usui MD, PhD,&nbsp;Kaisei Hosokawa MD,&nbsp;Shunta Hiroi MD,&nbsp;Riko Murakami MD,&nbsp;Takahiro Watanabe MD,&nbsp;Kodai Sayama MD,&nbsp;Takumi Watanabe MD,&nbsp;Taishi Yonetsu MD, PhD,&nbsp;Tsunekazu Kakuta MD, PhD","doi":"10.1016/j.jccase.2026.05.013","DOIUrl":"10.1016/j.jccase.2026.05.013","url":null,"abstract":"<div><div>Percutaneous transluminal septal myocardial ablation (PTSMA) is an established treatment for hypertrophic obstructive cardiomyopathy (HOCM), but its application in patients with situs inversus totalis (SIT) is complicated by mirror-image anatomy. We describe two successful PTSMA procedures in women, aged 82 and 69 years, with HOCM and coexisting SIT. The second patient had additional complexities, including Kartagener syndrome and chronic steroid therapy for rheumatoid arthritis. Both patients presented with severe, drug-refractory symptoms and significant left ventricular outflow tract (LVOT) pressure gradients. Guided by meticulous pre-procedural planning and multi-modality imaging, PTSMA was successfully performed, leading to a substantial reduction in LVOT gradients and marked symptomatic relief in both patients. The procedures were well-tolerated without major complications, demonstrating the feasibility of PTSMA despite advanced age, complex comorbidities, and profound anatomical variations. Our experience suggests that PTSMA is a viable, safe, and effective therapeutic option for HOCM in the rare and complex setting of SIT.</div></div><div><h3>Learning objective</h3><div><ul><li><span>1.</span><span><div>To recognize that percutaneous transluminal septal myocardial ablation (PTSMA) can be a feasible, safe, and effective septal reduction therapy for patients with hypertrophic obstructive cardiomyopathy and coexisting situs inversus totalis, leading to significant hemodynamic and clinical improvement.</div></span></li><li><span>2.</span><span><div>To understand that advanced age and comorbidities, such as chronic low-dose steroid use, are not absolute contraindications to PTSMA.</div></span></li><li><span>3.</span><span><div>To appreciate the critical importance of meticulous pre-procedural planning and multi-modality intraprocedural imaging to navigate mirror-image anatomy and ensure procedural success.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 110-113"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859548","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":"Reply to the comments on A rare case of left ventricular cardiac rupture in the acute phase of takotsubo syndrome","authors":"Shu Iwata MD, PhD,&nbsp;Shoichiro Yatsu MD, PhD,&nbsp;Hirohisa Endo MD, PhD,&nbsp;Manabu Ogita MD, PhD","doi":"10.1016/j.jccase.2026.06.005","DOIUrl":"10.1016/j.jccase.2026.06.005","url":null,"abstract":"","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 137-138"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859546","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":"Difficulty in identifying the culprit lesion in ST-elevation myocardial infarction with marked coronary tortuosity","authors":"Tetsuo Yamanaka MD,&nbsp;Yuki Tomimitsu MD,&nbsp;Kei Mabuchi MD,&nbsp;Hiroshi Fukunaga MD,&nbsp;Yoshimaro Ichinohe MD,&nbsp;Michiaki Higashitani MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.05.011","DOIUrl":"10.1016/j.jccase.2026.05.011","url":null,"abstract":"<div><div>We report a 90-year-old woman with ST-segment elevation myocardial infarction. Twelve-lead electrocardiography and transthoracic echocardiography suggested a lesion from the anteroseptum to the apex, implicating the left anterior descending artery (LAD). Coronary angiography showed marked tortuosity of the left coronary artery, complicating identification of the occluded LAD. Careful multi-angle evaluation enabled successful reperfusion. This case demonstrates that coronary artery tortuosity (CAT) can hinder culprit lesion identification. Although CAT is associated with myocardial ischemia, its impact on identifying the culprit lesion is rarely reported. Awareness of this scenario is important as tortuosity increases with aging.</div></div><div><h3>Learning objective</h3><div>Coronary artery tortuosity (CAT) can complicate the identification of the culprit lesion in acute myocardial infarction. Careful and systematic interpretation of coronary angiography, in conjunction with electrocardiography and echocardiographic findings, is essential for successful percutaneous coronary intervention in tortuous coronary arteries. With the aging population, the prevalence of CAT is increasing, highlighting the need for heightened clinical awareness and preparedness for complex coronary interventions.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 129-132"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859550","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":"Progression of chronic thromboembolic pulmonary disease without pulmonary hypertension in a case with JAK2 V617F mutation","authors":"Mizuki Momoi MD, PhD,&nbsp;Atsushi Anzai MD, PhD,&nbsp;Takashi Maeda MD,&nbsp;Shogo Ikegami MD,&nbsp;Yoshiki Shinya MD,&nbsp;Takahiro Hiraide MD, PhD,&nbsp;Yasuyuki Shiraishi MD, PhD,&nbsp;Masaki Ieda MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.06.004","DOIUrl":"10.1016/j.jccase.2026.06.004","url":null,"abstract":"<div><div>Chronic thromboembolic pulmonary disease (CTEPD) is characterized by persistent obstruction of pulmonary arteries with organized thrombotic materials. Patients with CTEPD without pulmonary hypertension (PH) are generally considered unlikely to progress to chronic thromboembolic pulmonary hypertension (CTEPH). Here, we report a case of a 75-year-old woman with essential thrombocythemia harboring <em>JAK2</em> V617F mutation, who had a history of acute pulmonary embolism. Initial evaluation of contrast-enhanced computed tomography and pulmonary angiography revealed organized thrombi predominantly in the right main and lobar pulmonary arteries, accompanied by perfusion defects on lung perfusion scintigraphy. Right heart catheterization (RHC) showed a mean pulmonary arterial pressure (mPAP) of 18 mmHg, leading to a diagnosis of CTEPD without PH. As the patient declined invasive treatment, she was followed with anticoagulation therapy alone. Three years later, her symptoms worsened, and RHC revealed an elevated mPAP of 33 mmHg, along with slight progression of thrombotic lesions and newly identified calcified deposits. She again refused invasive treatment and died one year later despite medical therapy. This case suggests that the <em>JAK2</em> V617F mutation could be a risk factor for progression from CTEPD without PH to CTEPH, underscoring the importance of close follow-up and early consideration of invasive treatment in such patients.</div></div><div><h3>Learning objective</h3><div>This case highlights that chronic thromboembolic pulmonary disease without pulmonary hypertension can progress to chronic thromboembolic pulmonary hypertension, particularly in patients with high-risk features such as the <em>JAK2</em> V617F mutation. It underscores the importance of careful long-term follow-up and early consideration of invasive treatment despite initially normal hemodynamics.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 133-136"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859380","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":"Silent post-infarction ventricular septal rupture obscured by apical thrombus formation: A case report","authors":"Eijiro Yagi MD, PhD,&nbsp;Koichiro Matsumura MD, PhD,&nbsp;Satoshi Suzuki MD,&nbsp;Manabu Shirotani MD, PhD,&nbsp;Gaku Nakazawa MD, PhD","doi":"10.1016/j.jccase.2026.05.006","DOIUrl":"10.1016/j.jccase.2026.05.006","url":null,"abstract":"<div><div>Ventricular septal rupture (VSR) is a catastrophic mechanical complication of acute myocardial infarction, usually associated with hemodynamic collapse and high mortality. We report an extremely rare case of delayed post-infarction VSR that remained hemodynamically stable without surgical intervention. A 53-year-old male smoker presented with persistent chest pressure for three days and was diagnosed with anterior myocardial infarction. Coronary angiography revealed multivessel coronary artery disease. Although the patient remained clinically stable, transthoracic echocardiography on day 11 demonstrated a large apical thrombus without evidence of VSR. After anticoagulation therapy, the thrombus resolved, and an apical VSR became apparent on day 36. Despite moderate left-to-right shunting, right ventricular pressure and cardiac output were preserved, and neither heart failure nor cardiogenic shock developed. Cardiopulmonary exercise testing before discharge confirmed preserved exercise tolerance. Long-term follow-up demonstrated improvement in left ventricular function and a reduction in shunt volume. Temporary sealing of the septal defect by an apical thrombus may have prevented acute hemodynamic deterioration. This case suggests that conservative management with comprehensive hemodynamic and functional assessment may lead to favorable outcomes in carefully selected patients with preserved hemodynamics.</div></div><div><h3>Learning objective</h3><div>Ventricular septal rupture (VSR) and apical thrombus are relatively rare complications of acute myocardial infarction. Although short-term mortality following VSR remains high, conservative management may be feasible in selected cases. In the present case, VSR was identified after treatment of an apical thrombus. The presence of the apical thrombus might have contributed to maintaining hemodynamic stability during the acute phase of VSR.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"34 3","pages":"Pages 98-101"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859382","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}