Cardiovascular Engineering and Technology最新文献

{"title":"Motion Characterization of Pacemaker Lead Wire In Vivo for Piezoelectric Energy Harvesting Applications.","authors":"Christopher Hu, Kamran Behdinan","doi":"10.1007/s13239-023-00700-3","DOIUrl":"10.1007/s13239-023-00700-3","url":null,"abstract":"<p><strong>Purpose: </strong>Piezoelectric energy harvesters (PEH) for cardiac pacemakers typically use animal models to assess the performance of the PEH. However, if considering multiple designs, the use of animal models and prototyping increases costs and time. To reduce the use of animal models in research for pacemaker energy harvesting applications, this study investigates the motion of a pacemaker lead wire (PLW) in vivo using fluoroscopy imaging to quantify the position and displacements as a function of time, such that the data can be used in computer simulations.</p><p><strong>Methods: </strong>The proposed technique uses fluoroscopy imaging video data of a dual chamber pacemaker implanted in a patient, and image processing allows for the motion of the PLW captured. The motion is discretized into nodes for ease of implementation in finite element software. FEA simulation is presented using a piezoelectric energy harvester design integrated in the lead wire, and the energy output is predicted by finite element computer simulation.</p><p><strong>Results: </strong>A 2-dimensional analysis is conducted with the fluoroscopy imaging video data to characterize the PLW motion and results show close agreement with literature values. Simulations with an energy harvesting circuit using the nodal position and displacement data shows that a PEH integrated in the PLW can generate a direct current voltage of 1.12 V and power output of 0.125 μW, potentially extending the battery life of pacemakers by 0.75-1 years.</p><p><strong>Conclusions: </strong>The results suggest that fluoroscopy imaging data can be effective in evaluating PEH designs rather than using animal models, saving time and costs.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"111-122"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292419","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":"Shape-Setting of Self-Expanding Nickel–Titanium Laser-Cut and Wire-Braided Stents to Introduce a Helical Ridge","authors":"","doi":"10.1007/s13239-024-00717-2","DOIUrl":"https://doi.org/10.1007/s13239-024-00717-2","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Purpose</h3> <p>Altered hemodynamics caused by the presence of an endovascular device may undermine the success of peripheral stenting procedures. Flow-enhanced stent designs are under investigation to recover physiological blood flow patterns in the treated artery and reduce long-term complications. However, flow-enhanced designs require the development of customised manufacturing processes that consider the complex behaviour of Nickel-Titanium (Ni-Ti). While the manufacturing routes of traditional self-expanding Ni–Ti stents are well-established, the process to introduce alternative stent designs is rarely reported in the literature, with much of this information (especially related to shape-setting step) being commercially sensitive and not reaching the public domain, as yet.</p> </span> <span> <h3>Methods</h3> <p>A reliable manufacturing method was developed and improved to induce a helical ridge onto laser-cut and wire-braided Nickel–Titanium self-expanding stents. The process consisted of fastening the stent into a custom-built fixture that provided the helical shape, which was followed by a shape-setting in air furnace and rapid quenching in cold water. The parameters employed for the shape-setting in air furnace were thoroughly explored, and their effects assessed in terms of the mechanical performance of the device, material transformation temperatures and surface finishing.</p> </span> <span> <h3>Results</h3> <p>Both stents were successfully imparted with a helical ridge and the optimal heat treatment parameters combination was found. The settings of 500 °C/30 min provided mechanical properties comparable with the original design, and transformation temperatures suitable for stenting applications (<em>A</em>_f = 23.5 °C). Microscopy analysis confirmed that the manufacturing process did not alter the surface finishing. Deliverability testing showed the helical device could be loaded onto a catheter delivery system and deployed with full recovery of the expanded helical configuration.</p> </span> <span> <h3>Conclusion</h3> <p>This demonstrates the feasibility of an additional heat treatment regime to allow for helical shape-setting of laser-cut and wire-braided devices that may be applied to further designs.</p> </span>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"26 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139688807","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":"Overcoming Uncertainties in Electrogram-Based Atrial Fibrillation Mapping: A Review.","authors":"Simanto Saha, Dominik Linz, Dyuti Saha, Alistair McEwan, Mathias Baumert","doi":"10.1007/s13239-023-00696-w","DOIUrl":"10.1007/s13239-023-00696-w","url":null,"abstract":"<p><p>In clinical rhythmology, intracardiac bipolar electrograms (EGMs) play a critical role in investigating the triggers and substrates inducing and perpetuating atrial fibrillation (AF). However, the interpretation of bipolar EGMs is ambiguous due to several aspects of electrodes, mapping algorithms and wave propagation dynamics, so it requires several variables to describe the effects of these uncertainties on EGM analysis. In this narrative review, we critically evaluate the potential impact of such uncertainties on the design of cardiac mapping tools on AF-related substrate characterization. Literature suggest uncertainties are due to several variables, including the wave propagation vector, the wave's incidence angle, inter-electrode spacing, electrode size and shape, and tissue contact. The preprocessing of the EGM signals and mapping density will impact the electro-anatomical representation and the features extracted from the local electrical activities. The superposition of multiple waves further complicates EGM interpretation. The inclusion of these uncertainties is a nontrivial problem but their consideration will yield a better interpretation of the intra-atrial dynamics in local activation patterns. From a translational perspective, this review provides a concise but complete overview of the critical variables for developing more precise cardiac mapping tools.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"52-64"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157307","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":"ECG Signal Denoising Using an Improved Hybrid DWT-ADTF Approach.","authors":"Wissam Jenkal, Rachid Latif, Mostafa Laaboubi","doi":"10.1007/s13239-023-00698-8","DOIUrl":"10.1007/s13239-023-00698-8","url":null,"abstract":"<p><strong>Purpose: </strong>The electrocardiogram signal (ECG) presents a fundamental source of information to consider for the diagnosis of a heart condition. Given its low-frequency features, this signal is quite susceptible to various noise and interference sources. This paper presents an improved hybrid approach to ECG signal denoising based on the DWT and the ADTF methods.</p><p><strong>Methods: </strong>The proposed improvements consist of integrating an adaptive [Formula: see text] parameter into the ADTF approach, combining a soft thresholding ADTF-based process with the DWT details, along with employing the mean filter to handle the baseline wandering noise. Furthermore, the proposed approach incorporates several denoising measures based on various proposed noise features, which have also been introduced in this approach. Several real noises collected from the Noise Stress Test Database (NSTDB), as well as several synthetic noises at different SNR levels, are proposed to ensure a thorough assessment of the proposed method's performance.</p><p><strong>Results: </strong>The evaluation focuses on the SN Rimp, PRD, and MSE parameters, as well as the SINAD parameter as a diagnostic distortion measurement. Furthermore, a time complexity evaluation is proposed. The proposed approach demonstrated promising results compared to a recent hybridization of the DWT and ADTF methods, as well as recently published ECG signal denoising-based approaches in various real and synthetic noise cases using different statistical evaluation metrics.</p><p><strong>Conclusion: </strong>In the vast majority of the study cases, the proposed approach outperforms the compared methods in terms of statistical results for real and synthetic noises. Furthermore, compared to these methods, it provides a fairly low time complexity. This is consistent with the ambition of embedding this approach in low-cost hardware architectures.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"77-94"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177978","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":"Process Analysis and Parameter Selection of Cardiomyocyte Electroporation Based on the Finite Element Method.","authors":"Hao Zhang, Xingkai Ji, Lianru Zang, Shengjie Yan, Xiaomei Wu","doi":"10.1007/s13239-023-00694-y","DOIUrl":"10.1007/s13239-023-00694-y","url":null,"abstract":"<p><strong>Purpose: </strong>Pulsed-field ablation (PFA) has attracted attention for the treatment of atrial fibrillation. This study aimed to further explore the relationship between the transmembrane voltage, pore radius and the intensity and duration of pulsed electric fields, which are closely related to the formation of irreversible electroporation. The different mechanisms of microsecond and nanosecond pulses acting on cardiomyocyte cellular and nuclear membranes were studied.</p><p><strong>Methods: </strong>A 3-D cardiomyocyte model with a nucleus was constructed to simulate the process of electroporation in cells under an electric field. Cell membrane electroporation was used to simulate the effect of different pulse parameters on the process of electroporation.</p><p><strong>Results: </strong>Under a single pulse with a field strength of 1 kV/cm and width of 100 μs, the transmembrane potential (TMP) of the cell membrane reached 1.33 V, and the pore density and conductivity increased rapidly. The maximum pore radius of the cell membrane was 43.4 nm, and the electroporation area accounted for 4.6% of the total cell membrane area. The number of pores was positively correlated with the electric field intensity when the cell was exposed to electric fields of 0.5 to 6 kV/cm. Under a nanosecond pulse, the TMP of the nuclear and cell membranes exceeded 1 V after exposure to electric fields with strengths of 4 and 5 kV/cm, respectively.</p><p><strong>Conclusion: </strong>This study simulated the electroporation process of cardiomyocyte, and provides a basis for the selection of parameters for the application of PFA for application toward arrhythmias.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"22-38"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429213","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":"Dynamic Coronary Blood Flow Velocity and Wall Shear Stress Estimation Using Ultrasound in an Ex Vivo Porcine Heart.","authors":"Saeyoung Kim, Bowen Jing, Brooks A Lane, Jimena Martín Tempestti, Muralidhar Padala, Alessandro Veneziani, Brooks D Lindsey","doi":"10.1007/s13239-023-00697-9","DOIUrl":"10.1007/s13239-023-00697-9","url":null,"abstract":"<p><strong>Purpose: </strong>Wall shear stress (WSS) is a critically important physical factor contributing to atherosclerosis. Mapping the spatial distribution of local, oscillatory WSS can identify important mechanisms underlying the progression of coronary artery disease.</p><p><strong>Methods: </strong>In this study, blood flow velocity and time-varying WSS were estimated in the left anterior descending (LAD) coronary artery of an ex vivo beating porcine heart using ultrasound with an 18 MHz linear array transducer aligned with the LAD in a forward-viewing orientation. A pulsatile heart loop with physiologically-accurate flow was created using a pulsatile pump. The coronary artery wall motion was compensated using a local block matching technique. Next, 2D and 3D velocity magnitude and WSS maps in the LAD coronary artery were estimated at different time points in the cardiac cycle using an ultrafast Doppler approach. The blood flow velocity estimated using the presented approach was compared with a commercially-available, calibrated single element blood flow velocity measurement system.</p><p><strong>Results: </strong>The resulting root mean square error (RMSE) of 2D velocity magnitude acquired from a high frequency, linear array transducer was less than 8% of the maximum velocity estimated by the commercial system.</p><p><strong>Conclusion: </strong>When implemented in a forward-viewing intravascular ultrasound device, the presented approach will enable dynamic estimation of WSS, an indicator of plaque vulnerability in coronary arteries.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"65-76"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157306","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":"Feasibility of a Composite Measure of Pulmonary Vascular Impedance and Application to Patients with Chronic RV Failure Post LVAD Implant.","authors":"Timothy N Bachman, S M Nouraie, L E Williams, M L Boisen, K Kim, H S Borovetz, R Schaub, R L Kormos, M A Simon","doi":"10.1007/s13239-023-00671-5","DOIUrl":"10.1007/s13239-023-00671-5","url":null,"abstract":"<p><p>Pulmonary vascular impedance (PVZ) describes RV afterload in the frequency domain and has not been studied extensively in LVAD patients. We sought to determine (1) feasibility of calculating a composite (c)PVZ using standard of care (SoC), asynchronous, pulmonary artery pressure (PAP) and flow (PAQ) waveforms; and (2) if chronic right ventricular failure (RVF) post-LVAD implant was associated with changes in perioperative cPVZ.PAP and PAQ were obtained via SoC procedures at three landmarks: T(1), Retrospectively, pre-operative with patient conscious; and T(2) and T(3), prospectively with patient anesthetized, and either pre-sternotomy or chest open with LVAD, respectively. Additional PAP's were taken at T(4), following chest closure; and T(5), 4-24 h post chest closure. Harmonics (z) were calculated by Fast Fourier Transform (FFT) with cPVZ(z) = FFT(PAP)/FFT(PAQ). Total pulmonary resistance Z(0); characteristic impedance Zc, mean of cPVZ(2-4); and vascular stiffness PVS, sum of cPVZ(1,2), were compared at T(1,2,3) between +/-RVF groups.Out of 51 patients, nine experienced RVF. Standard hemodynamics and changes in cPVZ-derived parameters were not significant between groups at any T.In conclusion, cPVZ calculated from SoC measures is possible. Although data that could be obtained were limited it suggests no difference in RV afterload for RVF patients post-implant. If confirmed in larger studies, focus should be placed on cardiac function in these subjects.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833004","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":"On the Material Constitutive Behavior of the Aortic Root in Patients with Transcatheter Aortic Valve Implantation.","authors":"Chiara Catalano, Tahir Turgut, Omar Zahalka, Nils Götzen, Stefano Cannata, Giovanni Gentile, Valentina Agnese, Caterina Gandolfo, Salvatore Pasta","doi":"10.1007/s13239-023-00699-7","DOIUrl":"10.1007/s13239-023-00699-7","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat patients with severe aortic valve stenosis. However, there is limited knowledge on the material properties of the aortic root in TAVI patients, and this can impact the credibility of computer simulations. This study aimed to develop a non-invasive inverse approach for estimating reliable material constituents for the aortic root and calcified valve leaflets in patients undergoing TAVI.</p><p><strong>Methods: </strong>The identification of material parameters is based on the simultaneous minimization of two cost functions, which define the difference between model predictions and cardiac-gated CT measurements of the aortic wall and valve orifice area. Validation of the inverse analysis output was performed comparing the numerical predictions with actual CT shapes and post-TAVI measures of implanted device diameter.</p><p><strong>Results: </strong>A good agreement of the peak systolic shape of the aortic wall was found between simulations and imaging, with similarity index in the range in the range of 83.7% to 91.5% for n.20 patients. Not any statistical difference was observed between predictions and CT measures of orifice area for the stenotic aortic valve. After TAVI simulations, the measurements of SAPIEN 3 Ultra (S3) device diameter were in agreement with those from post-TAVI angio-CT imaging. A sensitivity analysis demonstrated a modest impact on the S3 diameters when altering the elastic material property of the aortic wall in the range of inverse analysis solution.</p><p><strong>Conclusions: </strong>Overall, this study demonstrates the feasibility and potential benefits of using non-invasive imaging techniques and computational modeling to estimate material properties in patients undergoing TAVI.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"95-109"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10884088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177911","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":"Evaluation of Wrist-Worn Photoplethysmography Trackers with an Electrocardiogram in Patients with Ischemic Heart Disease: A Validation Study.","authors":"Nur Syazwani Ibrahim, Sanjay Rampal, Wan Ling Lee, Eu Way Pek, Anwar Suhaimi","doi":"10.1007/s13239-023-00693-z","DOIUrl":"10.1007/s13239-023-00693-z","url":null,"abstract":"<p><strong>Purpose: </strong>Photoplethysmography measurement of heart rate with wrist-worn trackers has been introduced in healthy individuals. However, additional consideration is necessary for patients with ischemic heart disease, and the available evidence is limited. The study aims to evaluate the validity and reliability of heart rate measures by a wrist-worn photoplethysmography (PPG) tracker compared to an electrocardiogram (ECG) during incremental treadmill exercise among patients with ischemic heart disease.</p><p><strong>Methods: </strong>Fifty-one participants performed the standard incremental treadmill exercise in a controlled laboratory setting with 12-lead ECG attached to the patient's body and wearing wrist-worn PPG trackers.</p><p><strong>Results: </strong>At each stage, the absolute percentage error of the PPG was within 10% of the standard acceptable range. Further analysis using a linear mixed model, which accounts for individual variations, revealed that PPG yielded the best performance at the baseline low-intensity exercise. As the stages progressed, heart rate validity decreased but was regained during recovery. The reliability was moderate to excellent.</p><p><strong>Conclusions: </strong>Low-cost trackers AMAZFIT Cor and Bip validity and reliability were within acceptable ranges, especially during low-intensity exercise among patients with ischemic heart disease recovering from cardiac procedures. Though using the tracker as part of the diagnosis tool still requires more supporting studies, it can potentially be used as a self-monitoring tool with precautions.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"12-21"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400252","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":"Blood Pressure Estimation Based on PPG and ECG Signals Using Knowledge Distillation.","authors":"Hui Tang, Gang Ma, Lishen Qiu, Lesong Zheng, Rui Bao, Jing Liu, Lirong Wang","doi":"10.1007/s13239-023-00695-x","DOIUrl":"10.1007/s13239-023-00695-x","url":null,"abstract":"<p><strong>Objective: </strong>Easy access bio-signals are useful for alleviating the shortcomings and difficulties associated with cuff-based and invasive blood pressure (BP) measurement techniques. This study proposes a deep learning model, trained using knowledge distillation, based on photoplethysmographic (PPG) and electrocardiogram (ECG) signals to estimate systolic and diastolic blood pressures.</p><p><strong>Methods: </strong>The estimation model comprises convolutional layers followed by one bidirectional recurrent layer and attention layers. The training approach involves knowledge distillation, where a smaller model (student model) is trained by leveraging information from a larger model (teacher model).</p><p><strong>Results: </strong>The proposed multistage model was evaluated on 1205 subjects from Medical Information Mart for Intensive Care (MIMIC) III database using the Association for the Advancement of Medical Instrumentation (AAMI) and the standards of the British Hypertension Society (BHS). The results revealed that our model performance achieved grade A in estimating both systolic blood pressure (SBP) and diastolic blood pressure (DBP) and met the requirements of the AAMI standard. After training with knowledge distillation (KD), the model achieved a mean absolute error and standard deviation of 2.94 ± 5.61 mmHg for SBP and 2.02 ± 3.60 mmHg for DBP.</p><p><strong>Conclusion: </strong>Our results demonstrate the benefits of the knowledge distillation training method in reducing the number of parameters and improving the predictive accuracy of the blood pressure regression model.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"39-51"},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405217","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}