International journal of cardiology. Congenital heart disease最新文献

{"title":"Worldwide prevalence of heart failure due to congenital heart disease: An analysis from the Global Burden of Disease Study 2021","authors":"Ahmed Kheiwa ,&nbsp;Inhae Baek ,&nbsp;Ian S. Harris ,&nbsp;Abdul Mannan Khan Minhas ,&nbsp;Dmitry Abramov","doi":"10.1016/j.ijcchd.2024.100552","DOIUrl":"10.1016/j.ijcchd.2024.100552","url":null,"abstract":"<div><h3>Background</h3><div>There are limited data on the prevalence of heart failure (HF) due to congenital heart diseases (CHD).</div></div><div><h3>Methods</h3><div>The Global Burden of Disease (GBD) dataset was used to analyze the disease burden of HF due to CHD between 1990 and 2021. Age-standardized rates (ASR) (crude prevalence rates for age groups) and total percent change for the overall worldwide burden as well as among subgroups based on age and geographic regions were determined.</div></div><div><h3>Results</h3><div>The global prevalence of HF due to CHD in 1990 and 2021 was 2,494,547 (95 % IU 2,054,729 to 3,030,909) and 3,155,991 (95 % IU 2,578,552 to 3,843,062) individuals respectively, with an increase in ASR from 41.02 (33.79–49.79) to 45.33 (37.15–55.17) per 100,000 individuals during that period. HF due to CHD in 2021 was most common in children aged 2–4, crude rate of 248.44 (195.99–302.57), followed by children &lt;1 years of age, crude rate of 142.75 (116.87–174.26), and children aged 5–14, crude rate of 89.55 (62.35–129.61). During the study period, there was an increase in the prevalence of HF due to CHD among most age groups, other than children &lt;1 year of age who had stable rates and individuals &gt;70 who had no reported prevalence. There were geographic differences in the prevalence and trends of HF due to CHD.</div></div><div><h3>Conclusions</h3><div>There are differences in prevalence and trends of HF due to CHD among age groups and worldwide regions. These results demonstrate the worldwide burden and trends of HF due to CHD.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100552"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163928","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":"Using machine learning analysis to describe patterns in tissue Doppler and speckle tracking echocardiography in patients with transposition of the great arteries after arterial switch operation","authors":"Covadonga Terol Espinosa de los Monteros ,&nbsp;Roel L.F. van der Palen ,&nbsp;Jef Van den Eynde ,&nbsp;Lukas Rammeloo ,&nbsp;Mark G. Hazekamp ,&nbsp;Nico A. Blom ,&nbsp;Irene M. Kuipers ,&nbsp;Arend D.J. ten Harkel","doi":"10.1016/j.ijcchd.2024.100560","DOIUrl":"10.1016/j.ijcchd.2024.100560","url":null,"abstract":"<div><h3>Background</h3><div>Advanced echocardiographic techniques such as Tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) can detect more subtle changes in ventricular performance. We aimed to study the ventricular performance in patients with transposition of the great arteries (TGA) at mid-term follow-up after the arterial switch operation (ASO) with advanced echocardiographic techniques. In addition, we sought to discover new clinical phenotypes using unsupervised machine learning.</div></div><div><h3>Methods</h3><div>Conventional, TDI and STE echocardiographic parameters were prospectively obtained from 124 TGA patients (66.1 % male, age 10.8 ± 5.1 years, 24.2 % with ventricular septal defect) in this observational study. The data was analyzed with conventional statistics and new machine learning techniques.</div></div><div><h3>Results</h3><div>TGA patients had reduced biventricular systolic (septal s’ Z-score −2.28 ± 1.26; RV s’ Z-score −2.16 ± 0.71; mean left ventricular longitudinal strain Z-score of the LV -2.49 ± 1.68) and RV diastolic performance (RV E/e’ Z-score 2.35 ± 1.70) mid-term after ASO. Unsupervised clustering within the TGA population revealed 3 clusters. Interestingly, cluster 3 defined a group of patients with older age at ASO, the most reduced ventricular performance as well as the highest rates of reoperations and interventions.</div></div><div><h3>Conclusions</h3><div>Assessment of ventricular performance with TDI and STE 10 years after ASO showed that TGA patients have decreased biventricular systolic and diastolic function, especially at the septal regions. Novel analytical methods such as unsupervised clustering may help identify new clinical phenotypes from multiple variables and may contribute to improved risk stratification.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100560"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163933","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":"Right heart reverse remodeling: “facta non verba”","authors":"Tommaso Recchioni ,&nbsp;Giovanna Manzi ,&nbsp;Alexandra Mihai ,&nbsp;Francesca Ileana Adamo ,&nbsp;Annalisa Caputo ,&nbsp;Domenico Filomena ,&nbsp;Giorgia Serino ,&nbsp;Silvia Papa ,&nbsp;Nadia Cedrone ,&nbsp;Carmine Dario Vizza ,&nbsp;Roberto Badagliacca","doi":"10.1016/j.ijcchd.2025.100568","DOIUrl":"10.1016/j.ijcchd.2025.100568","url":null,"abstract":"<div><div>Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and arterial narrowing, leading to a progressive rise in right ventricular (RV) afterload and poor survival outcomes. PAH prognosis largely depends on RV remodeling and function: when the increased afterload exceeds the RV's adaptive capacity, ventricular-arterial uncoupling occurs, ultimately causing right heart failure and death. In this clinical setting the primary treatment goal is to achieve low mortality risk and right heart reverse remodeling (RHRR). Unfortunately, the definition of RHRR vary across studies and imaging modalities (echocardiography or Cardiac Magnetic Resonance). The likelihood of RHRR increases with a significant reduction in pulmonary vascular resistance (PVR) from baseline, ideally by at least 50 %. Evidence supports initial triple therapy, including parenteral prostanoids, as the most effective approach to reduce PVR enough to facilitate RHRR and thus achieve the low-risk status.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100568"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163936","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":"Family caregiver frailty in adult congenital heart disease is overlooked: A call to action","authors":"Arianna Magon ,&nbsp;Serena Francesca Flocco ,&nbsp;Laura Schianchi ,&nbsp;Massimo Chessa ,&nbsp;Daniele Ciofi ,&nbsp;Salvatore Angileri ,&nbsp;Maddalena De Maria ,&nbsp;Gianluca Conte ,&nbsp;Silvia Favilli ,&nbsp;Cristina Arrigoni ,&nbsp;Rosario Caruso","doi":"10.1016/j.ijcchd.2025.100567","DOIUrl":"10.1016/j.ijcchd.2025.100567","url":null,"abstract":"<div><div>The frailty of family caregivers (FCs) of adults with congenital heart disease (CHD) is an underrecognized yet critical issue in healthcare. As individuals with CHD live longer, their FCs, often aging alongside them, face escalating physical, emotional, and psychological challenges. This brief report examines frailty in FCs as a multidimensional issue stemming from prolonged caregiving demands and cumulative stress. The evidence gathered in this regard identifies three key domains affecting FCs: psychological stress and childcare, physical health decline, and the challenges of caregiving during transitions to adulthood. These findings underscore the urgent need for family-centered care models that incorporate tailored frailty assessments and targeted interventions to support FCs throughout their caregiving journey. Addressing caregiver frailty could improve outcomes for both patients and caregivers, strengthen resilience, and optimize resource allocation. This perspective calls for immediate action in research and policy to prioritize caregiver well-being in transition care programs, enhancing the quality of life for both caregivers and patients.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100567"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124126","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":"Atrial tachycardia in patients with repaired tetralogy of Fallot; its characteristics and catheter ablation outcome","authors":"Qasim J. Naeemah ,&nbsp;Miyako Igarashi ,&nbsp;Noor K. Albakaa ,&nbsp;Yuichi Hanaki ,&nbsp;Noboru Ichihara ,&nbsp;Chihiro Ota ,&nbsp;Akira Kimata ,&nbsp;Kojiro Ogawa ,&nbsp;Naoto Kawamatsu ,&nbsp;Tomoko Machino ,&nbsp;Yuki Komatsu ,&nbsp;Hiro Yamasaki ,&nbsp;Akihiko Nogami ,&nbsp;Masaki Ieda ,&nbsp;Tomoko Ishizu","doi":"10.1016/j.ijcchd.2024.100558","DOIUrl":"10.1016/j.ijcchd.2024.100558","url":null,"abstract":"<div><h3>Background</h3><div>Patients with repaired tetralogy of Fallot (TOF) now live longer. However, dysrhythmia becomes prevalent in adults with repaired TOF, especially atrial tachyarrhythmia.</div></div><div><h3>Objective</h3><div>To identify the characteristics of patients who develop atrial tachycardia (AT) and the mechanism of the clinical AT and the induced one.</div></div><div><h3>Method</h3><div>Seventy-seven patients with repaired TOF were enrolled. The patients were divided into two groups (AT and non-AT). Clinical and electrophysiologic data were studied.</div></div><div><h3>Results</h3><div>The mean age was 34 years. Twenty-three patients had AT (30 %). In AT group, the left ventricular ejection fraction was lower (58 ± 6 vs 62 ± 5; <em>P</em> = 0.011), the right and left atrial area (cm²) was larger (29 ± 13 vs 15 ± 5; <em>P</em> &lt; 0.001, and 19 ± 3 vs 16 ± 4; <em>P</em> &lt; 0.001, respectively), and the right ventricular S′ wave (cm/s) was smaller (8 ± 2 vs 10 ± 3; <em>P</em> = 0.029).</div><div>Patients with AT underwent catheter ablation, and 32 AT were ablated. The mechanism of AT was intra-atrial reentrant tachycardia in 14 AT (44 %), cavotricuspid isthmus-dependent in 12 AT (37 %), and focal activity in the remaining 6 AT (19 %). An important finding was that after the first AT was ablated, another AT was induced in 7 patients. The mechanism was focal in about half of them, in contrast to the first ablated AT, where the focal mechanism was the least common. After a median follow-up of 37 months, four patients had AT recurrence.</div></div><div><h3>Conclusion</h3><div>The patients with AT had biventricular dysfunction and bi-atrial dilatation. Aggressive induction and ablation of the induced AT may reduce the future AT recurrence.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100558"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562048","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":"Does stroke volume limit exercise capacity in TGA patients after the arterial switch operation?","authors":"Renée S. Joosen ,&nbsp;Michiel Voskuil ,&nbsp;Wieke G. de Pater ,&nbsp;Sebastiaan W.H. van Wijk ,&nbsp;Dominika Suchá ,&nbsp;Abraham van Wijk ,&nbsp;Heleen B.van der Zwaan ,&nbsp;Gregor J. Krings ,&nbsp;Tim Takken ,&nbsp;Johannes M.P.J. Breur","doi":"10.1016/j.ijcchd.2025.100576","DOIUrl":"10.1016/j.ijcchd.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Patients with transposition of the great arteries (TGA) experience reduced exercise capacity after the arterial switch operation (ASO), possibly due to limited stroke volume. This study evaluates the role of stroke volume in reduced exercise capacity in these patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on TGA patients who underwent a transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) within one year between September 2009 and February 2024 at the University Medical Center Utrecht. Excluding those with submaximal CPET results, the remaining patients were divided into &lt;18 and ≥ 18 years old groups. Reduced exercise capacity was defined as a peak oxygen uptake (VO²peak) with a Z-score &lt; -2. Left and right ventricular (LV and RV) data including volumes, function, strain and RV outflow tract obstructions were collected from TTE and CMR.</div></div><div><h3>Results</h3><div>A total of 126 patients (72 % male, mean age 19 ± 8 years) were included. Left ventricular function, RV volumes, function and strain were relatively preserved on CMR. Reduced VO²peak was seen in 55 % of patients ≥18 years, significantly more than those &lt;18 years (23 %, p &lt; 0.001). Reduced VO²peak was independently associated with time since ASO, body mass index, peak heat rate (HRpeak), and O²pulse. VO²peak showed weak to moderate correlations with time after ASO (R = −0.295,p &lt; 0.001), body mass index (R = −0.468,p &lt; 0.001) and HRpeak (R = 0.270,p = 0.002) and a strong correlation with O²pulse (R = 0.621,p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Exercise capacity in TGA patients after ASO might be limited by an impaired ability to increase stroke volume.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100576"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436565","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":"Effect of pregnancy on bioprosthetic structural valve degeneration","authors":"Joshua J. Price ,&nbsp;Kalani Ruiz ,&nbsp;Jaewon Lim ,&nbsp;Yuli Kim ,&nbsp;Jonathan Buber","doi":"10.1016/j.ijcchd.2024.100559","DOIUrl":"10.1016/j.ijcchd.2024.100559","url":null,"abstract":"<div><h3>Background</h3><div>Despite increasing frequency of pregnancies among patients with cardiac conditions, including the presence of prosthetic heart valves, data on the effects of physiological changes during pregnancy on the function of bioprosthetic valves remains scarce and shows conflicting results.</div></div><div><h3>Objectives</h3><div>This study was aimed to determine the effect of pregnancy on the rate of bioprosthetic structural valve degeneration.</div></div><div><h3>Methods</h3><div>We designed a retrospective matched cohort study of patients seen between June 2018 and February 2023. All pregnant patients with bioprosthetic valves were matched to non-pregnant controls with prior valve replacement based on bioprosthetic valve location, time since valve implantation, age of the patient at valve implantation and time between baseline and follow up echocardiograms. Echocardiograms of pregnant patients were evaluated for bioprosthetic structural valve degeneration grade based on a dedicated scale before and after pregnancy. Non-pregnant controls had echocardiogram scoring of structural valve degeneration over a similar time period.</div></div><div><h3>Results</h3><div>Thirty four pregnant patients with bioprosthetic valves in the pulmonary, aortic and mitral positions were matched with 71 non-pregnant controls with identical bioprosthetic valves locations. Over a median follow up period of 13.5 months that included the gestational period, 18 (53 %) pregnant patients had an increase in structural valve degeneration score as compared to 17 (26 %) of the non-pregnant patients in median follow up of 13.7 months (OR 3.87, p = 0.004). On multivariable analysis, pregnancy was the only variable associated with increased structural valve degeneration score.</div></div><div><h3>Conclusions</h3><div>Our results suggest that pregnancy is associated with increased bioprosthetic structural valve degeneration.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100559"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163934","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 root of the matter: Linking oral health to chronic diseases prevention","authors":"Francesca D'Aiuto ,&nbsp;Jeanie Suvan ,&nbsp;Nisachon Siripaiboonpong ,&nbsp;Michael A. Gatzoulis ,&nbsp;Francesco D'Aiuto","doi":"10.1016/j.ijcchd.2025.100574","DOIUrl":"10.1016/j.ijcchd.2025.100574","url":null,"abstract":"<div><div>Oral health is increasingly recognized as a vital component of general health, influencing various systemic systems. Periodontal diseases, particularly periodontitis, a chronic inflammatory condition affecting the gums and supporting tissues of teeth, have far-reaching implications beyond the oral cavity. Treating periodontitis not only benefits oral health but also plays a crucial role in reducing the burden of these chronic conditions, improving patient outcomes and lowering healthcare costs. Regular screenings for oral health issues, especially in patients with conditions such as cardiovascular disease or diabetes, should become standard practice in medical settings. Additionally, oral health professionals must be empowered to identify early signs of systemic diseases, creating a bidirectional flow of referrals between dentists and physicians. Ultimately, prioritizing oral health not only enhances individual well-being but also serves the greater public health good.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100574"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452994","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":"Cardiac rehabilitation in ACHD: Further investment is now due","authors":"Ioannis Kasouridis ,&nbsp;Heather Probert ,&nbsp;Michael A. Gatzoulis","doi":"10.1016/j.ijcchd.2024.100564","DOIUrl":"10.1016/j.ijcchd.2024.100564","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100564"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070034","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":"Hypoplastic left heart syndrome (HLHS) becomes of age: Assessing the young adult with HLHS including the neoaorta/aortic arch","authors":"Polona Kačar ,&nbsp;Pietro Paolo Tamborrino ,&nbsp;Giulia Iannaccone ,&nbsp;Gianfranco Butera ,&nbsp;Margarita Brida ,&nbsp;Katja Prokšelj ,&nbsp;Michael A. Gatzoulis ,&nbsp;Claudia Montanaro","doi":"10.1016/j.ijcchd.2024.100555","DOIUrl":"10.1016/j.ijcchd.2024.100555","url":null,"abstract":"<div><div>Hypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects (CHD), characterized by a hypoplastic left ventricle (LV), dominant right ventricle (RV) and small left-sided heart structures. The introduction of the Norwood operation has significantly improved outcomes, with 5-year survival reported up to 65 %. Despite these advances, post-operative morbidity and mortality remain high, and the long-term complications in adult survivors represent a challenge. The number of HLHS patients with Fontan circulation is expected to double in the next 20 years, leading to a growing population requiring specialized care from adult congenital heart disease (ACHD) teams.</div><div>This article reviews current management strategies for HLHS, outlines potential long-term complications, and highlights existing knowledge gaps. Specific considerations in this population include the assessment of the neo-aorta and aortic arch, and systemic RV dysfunction in the setting of a Fontan circulation. The proposed surveillance strategy emphasizes the need for vigilant monitoring and timely intervention to treat the complications unique to this population, ensuring better outcomes for HLHS patients reaching adulthood.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"19 ","pages":"Article 100555"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163419","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}