Cardiovascular Engineering and Technology最新文献

{"title":"Transcatheter Pulmonary Artery Banding in High-Risk Neonates: In-Vitro Study Provoked by Initial Clinical Experience.","authors":"Shannen B Kizilski,&nbsp;Dominic P Recco,&nbsp;Francesca Sperotto,&nbsp;Nora Lang,&nbsp;Peter E Hammer,&nbsp;Christopher W Baird,&nbsp;Nicola Maschietto,&nbsp;David M Hoganson","doi":"10.1007/s13239-023-00674-2","DOIUrl":"10.1007/s13239-023-00674-2","url":null,"abstract":"<p><strong>Purpose: </strong>Very high-risk, ductal-dependent or complex two-ventricle patients with associated comorbidities often require pulmonary blood flow restriction as bridge to a more definitive procedure, but current surgical options may not be well-tolerated. An evolving alternative utilizes a fenestrated Micro Vascular Plug (MVP) as a transcatheter, internal pulmonary artery band. In this study, we report a case series and an in-vitro evaluation of the MVP to elicit understanding of the challenges faced with device implantation.</p><p><strong>Methods: </strong>Following single-center, retrospective review of eight patients who underwent device placement, an in-vitro flow study was conducted on MVP devices to assess impact of device and fenestration sizing on pulmonary blood flow. A mathematical model was developed to relate migration risk to vessel size. Results of the engineering analysis were compared to the clinical series for validation.</p><p><strong>Results: </strong>At median follow-up of 8 months (range 1-15), survival was 63% (5/8), and 6 (75%) patients underwent subsequent target surgical intervention with relatively low mortality (1/6). Occluder-related challenges included migration (63%) and peri-device flow, which were evaluated in-vitro. The device demonstrated durability over normal and supraphysiologic conditions with minimal change in fenestration size. Smaller vessel size significantly increased pressure gradient due to reduced peri-device flow and smaller effective fenestration size.</p><p><strong>Conclusion: </strong>Device oversizing, with appropriate adjustment to fenestration size, may reduce migration risk and provide a clinically appropriate balance between resulting pressure gradient and Qp:Qs. Our results can guide the interventionalist in appropriately selecting the device and fenestrations based on patient-specific anatomy and desired post-implantation flow characteristics.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"640-654"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction and Validation of Arterial Geometries for Computational Fluid Dynamics Using Multiple Temporal Frames of 4D Flow-MRI Magnitude Images.","authors":"Scott MacDonald Black,&nbsp;Craig Maclean,&nbsp;Pauline Hall Barrientos,&nbsp;Konstantinos Ritos,&nbsp;Asimina Kazakidi","doi":"10.1007/s13239-023-00679-x","DOIUrl":"10.1007/s13239-023-00679-x","url":null,"abstract":"<p><strong>Purpose: </strong>Segmentation and reconstruction of arterial blood vessels is a fundamental step in the translation of computational fluid dynamics (CFD) to the clinical practice. Four-dimensional flow magnetic resonance imaging (4D Flow-MRI) can provide detailed information of blood flow but processing this information to elucidate the underlying anatomical structures is challenging. In this study, we present a novel approach to create high-contrast anatomical images from retrospective 4D Flow-MRI data.</p><p><strong>Methods: </strong>For healthy and clinical cases, the 3D instantaneous velocities at multiple cardiac time steps were superimposed directly onto the 4D Flow-MRI magnitude images and combined into a single composite frame. This new Composite Phase-Contrast Magnetic Resonance Angiogram (CPC-MRA) resulted in enhanced and uniform contrast within the lumen. These images were subsequently segmented and reconstructed to generate 3D arterial models for CFD. Using the time-dependent, 3D incompressible Reynolds-averaged Navier-Stokes equations, the transient aortic haemodynamics was computed within a rigid wall model of patient geometries.</p><p><strong>Results: </strong>Validation of these models against the gold standard CT-based approach showed no statistically significant inter-modality difference regarding vessel radius or curvature (p > 0.05), and a similar Dice Similarity Coefficient and Hausdorff Distance. CFD-derived near-wall hemodynamics indicated a significant inter-modality difference (p > 0.05), though these absolute errors were small. When compared to the in vivo data, CFD-derived velocities were qualitatively similar.</p><p><strong>Conclusion: </strong>This proof-of-concept study demonstrated that functional 4D Flow-MRI information can be utilized to retrospectively generate anatomical information for CFD models in the absence of standard imaging datasets and intravenous contrast.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"655-676"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Accurate Lumen Segmentation More Important than Outlet Boundary Condition in Image-Based Blood Flow Simulations for Intracranial Aneurysms?","authors":"Jana Korte,&nbsp;Samuel Voß,&nbsp;Gábor Janiga,&nbsp;Oliver Beuing,&nbsp;Daniel Behme,&nbsp;Sylvia Saalfeld,&nbsp;Philipp Berg","doi":"10.1007/s13239-023-00675-1","DOIUrl":"10.1007/s13239-023-00675-1","url":null,"abstract":"<p><strong>Purpose: </strong>Image-based blood flow simulations are increasingly used to investigate the hemodynamics in intracranial aneurysms (IAs). However, a strong variability in segmentation approaches as well as the absence of individualized boundary conditions (BCs) influence the quality of these simulation results leading to imprecision and decreased reliability. This study aims to analyze these influences on relevant hemodynamic parameters within IAs.</p><p><strong>Methods: </strong>As a follow-up study of an international multiple aneurysms challenge, the segmentation results of five IAs differing in size and location were investigated. Specifically, five possible outlet BCs were considered in each of the IAs. These are comprised of the zero-pressure condition (BC1), a flow distribution based on Murray's law with the exponents n = 2 (BC2) and n = 3 (BC3) as well as two advanced flow-splitting models considering the real vessels by including circular cross sections (BC4) or anatomical cross sections (BC5), respectively. In total, 120 time-dependent blood flow simulations were analyzed qualitatively and quantitatively, focusing on five representative intra-aneurysmal flow and five shear parameters such as vorticity and wall shear stress.</p><p><strong>Results: </strong>The outlet BC variation revealed substantial differences. Higher shear stresses (up to Δ9.69 Pa), intrasaccular velocities (up to Δ0.15 m/s) and vorticities (up to Δ629.22 1/s) were detected when advanced flow-splitting was applied compared to the widely used zero-pressure BC. The tendency of outlets BCs to over- or underestimate hemodynamic parameters is consistent across different segmentations of a single aneurysm model. Segmentation-induced variability reaches Δ19.58 Pa, Δ0.42 m/s and Δ957.27 1/s, respectively. Excluding low fidelity segmentations, however, (a) reduces the deviation drastically (>43%) and (b) leads to a lower impact of the outlet BC on hemodynamic predictions.</p><p><strong>Conclusion: </strong>With a more realistic lumen segmentation, the influence of the BC on the resulting hemodynamics is decreased. A realistic lumen segmentation can be ensured, e.g., by using high-resolved 2D images. Furthermore, the selection of an advanced outflow-splitting model is advised and the use of a zero-pressure BC and BC based on Murray's law with exponent n = 3 should be avoided.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"617-630"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10381092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational Assessment of Unsteady Flow Effects on Magnetic Nanoparticle Targeting Efficiency in a Magnetic Stented Carotid Bifurcation Artery.","authors":"Rodward L Hewlin,&nbsp;Michael Smith,&nbsp;John P Kizito","doi":"10.1007/s13239-023-00681-3","DOIUrl":"10.1007/s13239-023-00681-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Worldwide, cardiovascular disease is the leading cause of hospitalization and death. Recently, the use of magnetizable nanoparticles for medical drug delivery has received much attention for potential treatment of both cancer and cardiovascular disease. However, proper understanding of the interacting magnetic field forces and the hydrodynamics of blood flow is needed for effective implementation. This paper presents the computational results of simulated implant assisted medical drug targeting (IA-MDT) via induced magnetism intended for administering patient specific doses of therapeutic agents to specific sites in the cardiovascular system. The drug delivery scheme presented in this paper functions via placement of a faintly magnetizable stent at a diseased location in the carotid artery, followed by delivery of magnetically susceptible drug carriers guided by the local magnetic field. Using this method, the magnetic stent can apply high localized magnetic field gradients within the diseased artery, while only exposing the neighboring tissues, arteries, and organs to a modest magnetic field. The localized field gradients also produce the forces needed to attract and hold drug-containing magnetic nanoparticles at the implant site for delivering therapeutic agents to treat in-stent restenosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The multi-physics computational model used in this work is from our previous work and has been slightly modified for the case scenario presented in this paper. The computational model is used to analyze pulsatile blood flow, particle motion, and particle capture efficiency in a magnetic stented region using the magnetic properties of magnetite (Fe&lt;sub&gt;3&lt;/sub&gt;O&lt;sub&gt;4&lt;/sub&gt;) and equations describing the magnetic forces acting on particles produced by an external cylindrical electromagnetic coil. The electromagnetic coil produces a uniform magnetic field in the computational arterial flow model domain, while both the particles and the implanted stent are paramagnetic. A Eulerian-Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of particles under the influence of a range of magnetic field strengths (B&lt;sub&gt;r&lt;/sub&gt; = 2T, 4T, 6T, and 8T). Particle diameter sizes of 10 nm-4 µm in diameter were evaluated. Two dimensionless numbers were evaluated in this work to characterize relative effects of Brownian motion (BM), magnetic force induced particle motion, and convective blood flow on particle motion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The computational simulations demonstrate that the greatest particle capture efficiency results for particle diameters within the micron range of 0.7-4 µm, specifically in regions where flow separation and vortices are at a minimum. Similar to our previous work (which did not involve the use of a magnetic stent), it was also observed that the capture efficiency of particles decreases substantially with particle diameter, especially in the superparama","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"694-712"},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Fabrication of Low-Cost Patient-Specific Vascular Models for Particle Image Velocimetry.","authors":"Katrina L Falk,&nbsp;Rafael Medero,&nbsp;Alejandro Roldan-Alzate","doi":"10.1007/s13239-023-00655-5","DOIUrl":"https://doi.org/10.1007/s13239-023-00655-5","url":null,"abstract":"","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"615"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relation Between Viscous Energy Dissipation and Pulsation for Aortic Hemodynamics Driven by a Left Ventricular Assist Device.","authors":"Akshita Sahni,&nbsp;Erin E McIntyre,&nbsp;Kelly Cao,&nbsp;Jay D Pal,&nbsp;Debanjan Mukherjee","doi":"10.1007/s13239-023-00670-6","DOIUrl":"https://doi.org/10.1007/s13239-023-00670-6","url":null,"abstract":"<p><p>Left ventricular assist device (LVAD) provides mechanical circulatory support for patients with advanced heart failure. Treatment using LVAD is commonly associated with complications such as stroke and gastro-intestinal bleeding. These complications are intimately related to the state of hemodynamics in the aorta, driven by a jet flow from the LVAD outflow graft that impinges into the aorta wall. Here we conduct a systematic analyses of hemodynamics driven by an LVAD with a specific focus on viscous energy transport and dissipation. We conduct a complementary set of analysis using idealized cylindrical tubes with diameter equivalent to common carotid artery and aorta, and a patient-specific model of 27 different LVAD configurations. Results from our analysis demonstrate how energy dissipation is governed by key parameters such as frequency and pulsation, wall elasticity, and LVAD outflow graft surgical anastomosis. We find that frequency, pulsation, and surgical angles have a dominant effect, while wall elasticity has a weaker effect, in determining the state of energy dissipation. For the patient-specific scenario, we also find that energy dissipation is higher in the aortic arch and lower in the abdominal aorta, when compared to the baseline flow without an LVAD. This further illustrates the key hemodynamic role played by the LVAD outflow jet impingement, and subsequent aortic hemodynamics during LVAD operation.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"560-576"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Vector Fitting Approach for the Automated Estimation of Lumped Boundary Conditions of 1D Circulation Models.","authors":"Elisa Fevola,&nbsp;Tommaso Bradde,&nbsp;Piero Triverio,&nbsp;Stefano Grivet-Talocia","doi":"10.1007/s13239-023-00669-z","DOIUrl":"https://doi.org/10.1007/s13239-023-00669-z","url":null,"abstract":"<p><strong>Purpose: </strong>The choice of appropriate boundary conditions is a crucial step in the development of cardiovascular models for blood flow simulations. The three-element Windkessel model is usually employed as a lumped boundary condition, providing a reduced order representation of the peripheral circulation. However, the systematic estimation of the Windkessel parameters remains an open problem. Moreover, the Windkessel model is not always adequate to model blood flow dynamics, which often require more elaborate boundary conditions. In this study, we propose a method for the estimation of the parameters of high order boundary conditions, including the Windkessel model, from pressure and flow rate waveforms at the truncation point. Moreover, we investigate the effect of adopting higher order boundary conditions, corresponding to equivalent circuits with more than one storage element, on the accuracy of the model.</p><p><strong>Method: </strong>The proposed technique is based on Time-Domain Vector Fitting, a modeling algorithm that, given samples of the input and output of a system, such as pressure and flow waveforms, can derive a differential equation approximating their relation.</p><p><strong>Results: </strong>The capabilities of the proposed method are tested on a 1D circulation model consisting of the 55 largest human systemic arteries, to demonstrate its accuracy and its usefulness to estimate boundary conditions with order higher than the traditional Windkessel models. The proposed method is compared to other common estimation techniques, and its robustness in parameter estimation is verified in presence of noisy data and of physiological changes of aortic flow rate induced by mental stress.</p><p><strong>Conclusion: </strong>Results suggest that the proposed method is able to accurately estimate boundary conditions of arbitrary order. Higher order boundary conditions can improve the accuracy of cardiovascular simulations, and Time-Domain Vector Fitting can automatically estimate them.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"505-525"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Numerical Study of a Thrombus Migration Risk in Aneurysm After Coil Embolization in Patient Cases: FSI Modelling.","authors":"C Paz,&nbsp;E Suárez,&nbsp;A Cabarcos,&nbsp;S I S Pinto","doi":"10.1007/s13239-023-00672-4","DOIUrl":"https://doi.org/10.1007/s13239-023-00672-4","url":null,"abstract":"<p><strong>Purpose: </strong>There are still many challenges for modelling a thrombus migration process in aneurysms. The main novelty of the present research lies in the modelling of aneurysm clot migration process in a realistic cerebral aneurysm, and the analysis of forces suffered by clots inside an aneurysm, through transient FSI simulations.</p><p><strong>Methods: </strong>The blood flow has been modelled using a Womersley velocity profile, and following the Carreau viscosity model. Hyperelastic Ogden model has been used for clot and isotropic linear elastic model for the artery walls. The FSI coupled model was implemented in ANSYS® software. The hemodynamic forces suffered by the clot have been quantified using eight different clot sizes and positions inside a real aneurysm.</p><p><strong>Results: </strong>The obtained results have shown that it is almost impossible for clots adjacent to aneurysm walls, to leave the aneurysm. Nevertheless, in clots positioned in the centre of the aneurysm, there is a real risk of clot migration. The risk of migration of a typical post-coiling intervention clot in an aneurysm, in contact with the wall and occupying a significant percentage of its volume is very low in the case studied, even in the presence of abnormally intense events, associated with sneezes or impacts.</p><p><strong>Conclusions: </strong>The proposed methodology allows evaluating the clot migration risk, vital for evaluating the progress after endovascular interventions, it is a step forward in the personalized medicine, patient follow-up, and helping the medical team deciding the optimal treatment.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"544-559"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Viscosity Biosensor Based on Electromagnetic Resonator.","authors":"Amin Eidi","doi":"10.1007/s13239-023-00678-y","DOIUrl":"https://doi.org/10.1007/s13239-023-00678-y","url":null,"abstract":"<p><strong>Introduction: </strong>The resonant properties of mechanical resonators provide valuable parameters for liquids density and viscosity measurement. The viscosity of liquids in industry and medicine has always been of interest to researchers.</p><p><strong>Methods: </strong>In this paper, a viscosity sensor is designed and fabricated for liquids based on mechanical resonator and electromagnetic actuators. In this proposed sensor, a coil is used to monitor the output of this sensor.</p><p><strong>Results: </strong>This sensor is proposed to measure the blood viscosity, while its results for some people blood viscosity is reported and verified.</p><p><strong>Conclusion: </strong>The exact design of the proposed sensor and its experimental results are presented using a prototype for some liquids that indicate the sensor precision.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"526-533"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking of Blood Vessels Motion from 4D-flow MRI Data.","authors":"Mocia Agbalessi,&nbsp;Alain Lalande,&nbsp;Olivier Bouchot,&nbsp;Toshiyuki Hayase,&nbsp;Jean-Joseph Christophe,&nbsp;Miguel Angel Fernández,&nbsp;Damiano Lombardi","doi":"10.1007/s13239-023-00677-z","DOIUrl":"https://doi.org/10.1007/s13239-023-00677-z","url":null,"abstract":"<p><p>This paper presents a novel approach to track objects from 4D-flow MRI data. A salient feature of the proposed method is that it fully exploits the geometrical and dynamical nature of the information provided by this imaging modality. The underlying idea consists in formulating the tracking problem as a data assimilation problem, in which both position and velocity observations are extracted from the 4D-flow MRI data series. Optimal state estimation is then performed in a sequential fashion via Kalman filtering. The capabilities of the method are extensively assessed in a numerical study involving synthetic and clinical data.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"14 4","pages":"577-604"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}