American heart journal plus : cardiology research and practice最新文献

{"title":"The clinical impact of prophylactic concomitant left atrial appendage occlusion during cardiac surgery: A systematic review and meta-analysis","authors":"Chengji Zhao ,&nbsp;Evaldas Girdauskas ,&nbsp;Jan W. Schoones ,&nbsp;Robert J.M. Klautz ,&nbsp;Meindert Palmen ,&nbsp;Anton Tomšič","doi":"10.1016/j.ahjo.2025.100534","DOIUrl":"10.1016/j.ahjo.2025.100534","url":null,"abstract":"<div><h3>Background</h3><div>Recently, concomitant left atrial appendage occlusion (LAAO) has emerged as prophylactic treatment option for preventing thromboembolic events in patients undergoing cardiac surgery with no known history of atrial fibrillation. The efficacy of prophylactic LAAO remains unknown.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science, Emcare, and the Cochrane Library were searched for studies on prophylactic LAAO in patients undergoing cardiac surgery. The primary endpoints were postoperative thromboembolic complications and postoperative atrial fibrillation (POAF).</div></div><div><h3>Results</h3><div>Three randomized trials and seven retrospective observational studies were included: in total, 7369 patients received either prophylactic LAAO (<em>n</em> = 3823) or no prophylactic LAAO (<em>n</em> = 3546) during their index cardiac surgery. Prophylactic LAAO reduced the risk of early thromboembolic events by 58 % (risk ratio: 0.42; 95 % confidence interval: 0.25 to 0.73; <em>p</em> = 0.002; I² = 0 %) with an estimated absolute risk reduction of 0.8 %. On the other hand, a higher risk, albeit statistically not significant, of POAF was seen with LAAO (risk ratio: 1.15; 95 % confidence interval: 1.00 to 1.32; <em>p</em> = 0.051; I² = 64 %). Prophylactic LAAO also reduced the risk of all-time thromboembolic complications by 52 % (hazards ratio: 0.48; 95 % CI: 0.29 to 0.80; <em>p</em> = 0.005; I² = 41 %).</div></div><div><h3>Conclusion</h3><div>Prophylactic LAAO was associated with a reduction in early and all-time thromboembolic events but demonstrated a potential relation to a higher risk of POAF.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100534"},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705286","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":"Predictors of improvement in cardiovascular biomarkers with singing","authors":"Nitin Somasundaram ,&nbsp;Nicholas Mohrdieck ,&nbsp;Alexis Visotcky ,&nbsp;Jacquelyn Kulinski","doi":"10.1016/j.ahjo.2025.100533","DOIUrl":"10.1016/j.ahjo.2025.100533","url":null,"abstract":"<div><div>Although regular physical exercise lowers the risk of coronary heart disease in both primary and secondary prevention populations, physical exercise may be difficult for some individuals, prompting the need for alternative therapies. This study is a sub-analysis of a previously completed clinical trial that aimed to assess the effect of singing on cardiac biomarkers. The previous trial included 60 patients recruited from a cardiology clinic (mean age 61 ± 13 years; 68 % women) with measurements of vascular endothelial function and heart rate variability (HRV), and the results showed that 14 min of singing improves endothelial function acutely, similar to a short bout of physical exercise. The present sub-analysis examined whether predictive variables (prior singing experience, gender, age, enjoyment level, effort, smoking history) impacted changes in outcome measures. No significant change was seen in endothelial function or HRV based on exposure variables except for smoking status. Past smoking (compared to never smoking) predicted improvement in vascular endothelial function after singing. Abnormal baseline endothelial function was a predictor of acute improvement in endothelial function. These findings suggest that singing may have beneficial effects on vascular endothelial function, especially in patients with abnormal baseline endothelial function, regardless of singing experience.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100533"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725236","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":"Shedding light on radiation exposure: Emergency vs. elective catheterization procedures in a prospective cohort study","authors":"Haitham Abu Khadija ,&nbsp;Mohammad Alnees ,&nbsp;Jacob George ,&nbsp;Manar Bakry ,&nbsp;Dalia Abasi ,&nbsp;Nizar Abu Hamdeh ,&nbsp;Mahdi Awwad ,&nbsp;Alena Kirzhner ,&nbsp;Tal Schiller ,&nbsp;Alex Blatt ,&nbsp;Gabby Elbaz-Greener","doi":"10.1016/j.ahjo.2025.100530","DOIUrl":"10.1016/j.ahjo.2025.100530","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Cardiac catheterization employs ionizing radiation, although imaging technologies have improved safety, the influence of procedural urgency on radiation exposure has rarely been investigated. This study compares radiation parameters in elective versus emergency cardiac catheterizations.</div></div><div><h3>Methods</h3><div>This prospective cohort study examined 108 patients (elective: 27; emergency: 81) undergoing cardiac catheterization at University Hospital between October 2014 and March 2015. All procedures were performed by a single operator utilizing the Allura Clarity X-ray system, reducing variability. Radiation metrics such as fluoroscopy time, cine time, Dose Area Product (DAP), and Air Kerma Product (KAP) were registered. Dosimeters were placed at the level of patients' heads and the level of operators' chests.</div></div><div><h3>Results</h3><div>In the crude analysis, cine time was significantly higher in emergency procedures than in elective procedures, with a difference of 22.69 ms (<em>P</em> = 0.009). In contrast, KAP demonstrated an inverse relationship, indicating a reduction of 770.48 mGy in emergency procedures (<em>P</em> = 0.021). Moving to the adjusted analysis, cine time remained significant. Additionally, DAP became significant, with a coefficient of 38,394.88 mGy·cm² (<em>P</em> = 0.028). Meanwhile, KAP shifted to a direct relationship, showing an increase of 680.96 mGy in emergency procedures (<em>P</em> = 0.027). Confidence intervals improved following adjustment and became even narrower.</div></div><div><h3>Conclusions</h3><div>Procedure urgency is a significant factor in radiation exposure in cardiac catheterization. Technologies for dose reduction and protocol standardization are essential for minimizing risks to patients and providers.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100530"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714974","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":"Fatty acid desaturase genetic variations in heart failure and cardiovascular disease","authors":"David Gittess ,&nbsp;Iain Thompson ,&nbsp;Dmitry O. Traktuev ,&nbsp;Julio D. Duarte ,&nbsp;Ellen C. Keeley","doi":"10.1016/j.ahjo.2025.100529","DOIUrl":"10.1016/j.ahjo.2025.100529","url":null,"abstract":"<div><div>Omega (ω)-3 polyunsaturated fatty acids (PUFAs) have gained prominence for their putative cardioprotective functions. However, the data supporting their beneficial effects has been inconsistent. One possible explanation is that there is genetic variability in the fatty acid desaturase (<em>FADS</em>) 1 and 2 genes (encoding the delta-5 and delta-6 desaturase enzymes, respectively) which may influence PUFA levels. These enzymes are responsible for adding a double bond to the tails of ω−3 fatty acids and constitute the rate limiting step in ω−3 PUFA processing. As a result, they appear to have downstream effects on circulating blood levels of ω−3 PUFAs. In this review, we discuss commonly reported genetic variants within the <em>FADS</em> genes that have been associated with cardiovascular disease and/or cardiovascular risk factors. In addition, we summarize the data assessing the association between these genetic variants and the incidence of cardiovascular disease and cardiovascular risk factors, desaturase expression, circulating blood levels of ω−3 PUFAs, and the effect of diet and ω−3 dietary supplements on circulating levels.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100529"},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697732","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":"Indole metabolism and its role in diabetic macrovascular and microvascular complications","authors":"W. Hu ,&nbsp;C. Garrison ,&nbsp;R. Prasad ,&nbsp;M.E. Boulton ,&nbsp;M.B. Grant","doi":"10.1016/j.ahjo.2025.100532","DOIUrl":"10.1016/j.ahjo.2025.100532","url":null,"abstract":"<div><div>Tryptophan (Trp), an essential amino acid obtained through dietary sources, plays a crucial role in various physiological processes. The metabolism of Trp branches into three principal pathways: the serotonin pathway, the kynurenine pathway, and the indole pathway. The kynurenine and serotonin pathways are host pathways while the indole pathway is solely the result of bacterial metabolism. Trp metabolites extend their influence beyond protein biosynthesis to affect a spectrum of pathophysiological mechanisms including, but not limited to, neuronal function, immune modulation, inflammatory responses, oxidative stress regulation, and maintenance of intestinal health. This review focuses on indole derivatives and their impact on vascular health. Trp-containing dipeptides are highlighted as a targeted nutraceutical approach to modulate Trp metabolism, enhance beneficial metabolite production, and mitigate risk factors for vascular diseases. The importance of optimizing Trp intake and dietary strategies to harness the benefits of Trp-derived metabolites for vascular health is underscored, bringing to light the need for further research to refine these therapeutic approaches.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100532"},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734762","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 multicenter pragmatic implementation study of AI-ECG-based clinical decision support software to identify low LVEF: Clinical trial design and methods","authors":"Francisco Lopez-Jimenez ,&nbsp;Heather M. Alger ,&nbsp;Zachi I. Attia ,&nbsp;Barbara Barry ,&nbsp;Ranee Chatterjee ,&nbsp;Rowena Dolor ,&nbsp;Paul A. Friedman ,&nbsp;Stephen J. Greene ,&nbsp;Jason Greenwood ,&nbsp;Vinay Gundurao ,&nbsp;Sarah Hackett ,&nbsp;Prerak Jain ,&nbsp;Anja Kinaszczuk ,&nbsp;Ketan Mehta ,&nbsp;Jason O'Grady ,&nbsp;Ambarish Pandey ,&nbsp;Christopher Pullins ,&nbsp;Arjun R. Puranik ,&nbsp;Mohan Krishna Ranganathan ,&nbsp;David Rushlow ,&nbsp;Samir Awasthi","doi":"10.1016/j.ahjo.2025.100528","DOIUrl":"10.1016/j.ahjo.2025.100528","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) enabled algorithms can detect or predict cardiovascular conditions using electrocardiogram (ECG) data. Clinical studies have evaluated ECG-AI algorithms, including a recent single-center study which evaluated outcomes when clinicians were provided with ECG-AI results. A Multicenter Pragmatic IMplementation Study of ECG-AI-Based Clinical Decision Support Software to Identify Low LVEF (AIM ECG-AI) will evaluate clinical impacts of clinical decision support software (CDSS) integrated within the electronic health record (EHR) to provide point-of-care ECG-AI results to clinicians during routine outpatient care.</div></div><div><h3>Methods</h3><div>AIM ECG-AI is a multicenter, cluster-randomized trial recruiting and randomizing clinicians to receive access to the CDSS (intervention) or provide usual care. Clinicians are recruited from 5 geographically distinct health systems and clustered at the care team level. AIM ECG-AI will evaluate clinical care provided during &gt;32,000 eligible clinical encounters with adult patients with no history of low LVEF and who have a digital ECG documented within the health system's EHR, with 90 day follow up.</div></div><div><h3>Results</h3><div>Study data includes clinician surveys, study software metrics, and EHR data as a read-out for clinician decision-making. AIM ECG-AI will evaluate detection of left ventricular ejection fraction ≤40 % by echocardiography, with exploratory endpoints. Subgroup analyses will evaluate the health system, clinician, and patient-level characteristics associated with outcomes (<span><span>NCT05867407</span><svg><path></path></svg></span>).</div></div><div><h3>Conclusion</h3><div>AIM ECG-AI is the first multisite clinical evaluation of an EHR-integrated, point-of-care CDSS to provide ECG-AI results in the clinical workflow. The findings will provide valuable insights for clinically focused software design to bring AI into routine clinical practice.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100528"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815658","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":"Letter by Mauriello and Russo regarding article, “Implantable loop recorder migration: Case-based review and implications for clinical practice”","authors":"Alfredo Mauriello ,&nbsp;Vincenzo Russo","doi":"10.1016/j.ahjo.2025.100531","DOIUrl":"10.1016/j.ahjo.2025.100531","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100531"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679861","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":"Intracoronary acetylcholine for vasospasm provocation in women with ischemia and no obstructive coronary artery disease","authors":"Benita Tjoe ,&nbsp;Christine Pacheco ,&nbsp;Nissi Suppogu ,&nbsp;Bruce Samuels ,&nbsp;Panteha Rezaeian ,&nbsp;Balaji Tamarappoo ,&nbsp;Daniel S. Berman ,&nbsp;Behzad Sharif ,&nbsp;Michael Nelson ,&nbsp;R. David Anderson ,&nbsp;John Petersen ,&nbsp;Carl J. Pepine ,&nbsp;Louise E.J. Thomson ,&nbsp;C. Noel Bairey Merz ,&nbsp;Janet Wei","doi":"10.1016/j.ahjo.2025.100527","DOIUrl":"10.1016/j.ahjo.2025.100527","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the utility of higher dose intracoronary acetylcholine (ACh) during invasive coronary function testing (CFT) in women with suspected ischemia and no obstructive coronary artery disease (INOCA) for detection of epicardial vasospasm, relation to quality of life (QoL) and the presence of scar by late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI).</div></div><div><h3>Background</h3><div>CFT is an established method for diagnosis of coronary microvascular dysfunction (CMD). The utility of epicardial vasospasm provocation testing with higher dose ACh infusion is not fully understood.</div></div><div><h3>Methods</h3><div>Women with suspected INOCA undergoing invasive CFT were enrolled in the Women's Ischemia Syndrome Evaluation-Pre-Heart Failure with Preserved Ejection Fraction (WISE Pre-HFpEF) study (<span><span>NCT03876223</span><svg><path></path></svg></span>). Incremental infusions of 0.364, 36.4 μg and 108 μg ACh were used for vasospasm provocation. Vasospasm was defined as ≥75 % artery diameter reduction compared to post-nitroglycerin diameter and related to QoL and LGE on CMRI.</div></div><div><h3>Results</h3><div>Among 73 women (56 ± 11 years), epicardial vasospasm was detected in 17 (23 %). Among women with vasospasm, the vast majority (94 %) had coronary endothelial dysfunction and few (12 %) had other abnormal CFT measures. Those with vasospasm had more nocturnal angina symptoms, calcium channel blocker use, poorer QoL (all <em>p</em> = 0.001) and disease perception (<em>p</em> = 0.02) than those without. LGE scar by CMRI was not associated with vasospasm (<em>p</em> = 0.22).</div></div><div><h3>Conclusions</h3><div>Among women with suspected INOCA, intracoronary Ach spasm testing provoked epicardial vasospasm in one fourth. Women with epicardial vasospasm overwhelmingly had concomitant endothelial dysfunction, worse QoL but not more frequent myocardial scar on CMRI.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100527"},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643454","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":"The current use of vasoactive agents in cardiogenic shock related to myocardial infarction and acute decompensated heart failure","authors":"Ana Florencia Becerra ,&nbsp;Udochukwu Amanamba ,&nbsp;Jonathan E. Lopez ,&nbsp;Noah J. Blaker ,&nbsp;David E. Winchester","doi":"10.1016/j.ahjo.2025.100524","DOIUrl":"10.1016/j.ahjo.2025.100524","url":null,"abstract":"<div><div>Cardiogenic shock (CS) is a heterogeneous condition associated with exceptionally high mortality rates, despite significant advances in the field of cardiology. The primary causes of CS are myocardial infarction-related CS (AMI-CS) and acute decompensated heart failure-related CS (ADHF-CS). Management of CS is inherently complex, with the initial focus—irrespective of the underlying etiology—centered on preserving end-organ perfusion. Parenteral vasopressors and inotropes are the cornerstone of therapy to achieve this objective. However, data on the comparative efficacy of different vasoactive agents in CS remain limited, and no single agent has demonstrated clear superiority. Recent progress in the staging and phenotyping of CS has provided a framework for more tailored therapeutic approaches. This review offers a comprehensive and updated summary of current evidence on the use of vasopressors and inotropes in AMI-CS and ADHF-CS, including a discussion of specific scenarios, such as right ventricular CS (RV-CS).</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"52 ","pages":"Article 100524"},"PeriodicalIF":1.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609653","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":"Colchicine therapy in cardiovascular medicine: A literature review","authors":"Jennifer Trube,&nbsp;Michael Sabina,&nbsp;Aqeel Khanani,&nbsp;Kayla Hernandez,&nbsp;Zoya Khan,&nbsp;Anas Bizanti","doi":"10.1016/j.ahjo.2025.100525","DOIUrl":"10.1016/j.ahjo.2025.100525","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammation is a key risk factor in cardiovascular diseases, such as atherosclerosis, and has been linked to increased mortality following myocardial infarction. While inflammation promotes tissue repair, sustained inflammation can drive adverse cardiac remodeling, fibrosis, and impaired contractility, resulting in poorer outcomes. This maladaptive remodeling, compounded by oxidative stress, also predisposes patients to cardiovascular diseases. Colchicine has shown anti-inflammatory benefits in cardiovascular disease, but its role in individual diseases remains unclear. This literature review seeks to understand and evaluate the clinical trials evaluating colchicine in cardiovascular treatment.</div></div><div><h3>Methods</h3><div>A literature search identified randomized controlled trials (RCTs) evaluating colchicine in cardiovascular disease including coronary artery disease, post-myocardial infarction treatment, atrial fibrillation, heart failure, and stroke.</div></div><div><h3>Conclusions</h3><div>Colchicine has been studied across many cardiovascular conditions including atrial fibrillation (AF), coronary artery disease (CAD), post-myocardial infarction treatment, heart failure (HF) and stroke; however, evidence of its clinical effectiveness remains mixed. While colchicine has shown prfomise in reducing recurrent cardiovascular events in stable CAD, its impact in postoperative AF prevention, acute coronary syndrome (ACS), HF, and stroke prevention is limited.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"52 ","pages":"Article 100525"},"PeriodicalIF":1.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579529","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}