JACC. Asia最新文献

{"title":"Elevated Exercise Capacity Mitigates Atrial Fibrillation Incidence and Major Cardiovascular Outcomes","authors":"Chi-Ting Lu MD ,&nbsp;Ching-Wei Lee MD ,&nbsp;Wei-Ming Huang MD, PhD ,&nbsp;Wen-Chung Yu MD ,&nbsp;Hao-Min Cheng MD, PhD ,&nbsp;Chern-En Chiang MD, PhD ,&nbsp;Chen-Huan Chen MD ,&nbsp;Shih-Hsien Sung MD, PhD","doi":"10.1016/j.jacasi.2025.06.009","DOIUrl":"10.1016/j.jacasi.2025.06.009","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) increases cardiovascular risks and reduces quality of life. Although impaired physical activity has correlated with incident AF, the impacts of exercise capacity and blood pressure changes during exercise on AF development remain unclear.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the association between exercise capacity and AF incidence and its effects on major adverse cardiovascular events (MACE).</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using a prospectively maintained administrative database of patients undergoing exercise treadmill testing between 2003 and 2012. Blood pressure measurements at baseline, peak exercise, and recovery were recorded. Participants were followed for new-onset AF and MACE.</div></div><div><h3>Results</h3><div>Among 15,450 subjects (median follow-up: 9.1 years; IQR: 7.0-11.5 years), 515 (3.3%) developed AF. Peak METS (pMETs) independently predicted a lower risk of incident AF (HR: 0.92; 95% CI: 0.88-0.97), after adjusting for confounders. Cubic spline analysis revealed a continuous inverse association between pMETs and incident AF. This association was stronger in older adults and those without chronotropic incompetence. Although incident AF increased the risks of ischemic stroke and MACE, higher pMETs independently reduced the risks of ischemic stroke (HR: 0.88; 95% CI: 0.83-0.94) and MACE (HR: 0.86; 95% CI: 0.84-0.88), even after adjusting for incident AF as a time-dependent variable. Additionally, diastolic blood pressure during recovery independently also correlated with incident AF and ischemic stroke.</div></div><div><h3>Conclusions</h3><div>Higher exercise capacity was associated with a lower AF incidence and reduced risks of ischemic stroke and MACE, reinforcing the prognostic value of cardiorespiratory fitness in AF prevention and cardiovascular risk reduction.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1346-1356"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805414","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":"South Asian Representation in Cardiovascular Disease Randomized Controlled Trials","authors":"Nishant Uppal MD, MBA ,&nbsp;Aniruddh P. Patel MD ,&nbsp;Deepak L. Bhatt MD, MPH, MBA ,&nbsp;Pradeep Natarajan MD, MMSc","doi":"10.1016/j.jacasi.2025.06.017","DOIUrl":"10.1016/j.jacasi.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>One in 4 individuals worldwide is of South Asian ancestry and is therefore at increased risk for cardiovascular disease (CVD). However, South Asian representation in CVD randomized controlled trials (RCTs) is not well known.</div></div><div><h3>Objectives</h3><div>The aim of this systematic review was to measure South Asian representation in CVD RCTs and extract post-randomization primary outcome estimates for this population.</div></div><div><h3>Methods</h3><div>We conducted a systematic review to identify major CVD RCTs published between 2018 and 2022. Each study was manually screened and reviewed to identify South Asian participants and representation rates. The protocol for this systematic review was prospectively registered in PROSPERO (South Asian Representation in Cardiovascular Clinical Trials; <span><span>CRD42023396522</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>We included 310 RCTs, representing 1,036,737 total and 32,764 (3.2%) South Asian participants. Most South Asian participants (75.4%) were enrolled in trials in South Asia, and 65.2% were enrolled in a single trial in India. After excluding this trial, South Asian individuals represented 1.1% of total trial participants. South Asian representation was highest in trials studying coronary artery disease (9.0%), whereas no South Asian individuals were identified in trials studying heart failure, cardiac arrest, or valvular heart disease. Post-randomization data were available for 28,197 South Asian individuals, representing 7.3% of all participants with post-randomization data.</div></div><div><h3>Conclusions</h3><div>South Asian individuals are underrepresented in major CVD RCTs, and efforts to extend enrollment initiatives in RCTs to South Asian individuals are urgently needed. The extent to which this underrepresentation is a driver of elevated cardiovascular disease risk merits further study.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1244-1256"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859970","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":"The Asia Pacific Cardiovascular Research (ASPIRE) Network","authors":"Clement Lau MBChB, PhD ,&nbsp;Philip D. Adamson MBChB, PhD ,&nbsp;Nicholas Chew MBChB ,&nbsp;Gemma Figtree MD, PhD ,&nbsp;Alan Fong MBChB ,&nbsp;Diana HP Foo MD, MBA ,&nbsp;Gary C.H. Gan MBBS, PhD ,&nbsp;Wael Al Mahmeed MD, FRCPC ,&nbsp;Chien-Yi Hsu MD, PhD ,&nbsp;Chun-Yao Huang MD, PhD ,&nbsp;Young-Hoon Jeong MD, PhD ,&nbsp;Takashi Kajiya MD ,&nbsp;Dharmaraj Karthikesan MD, MSc ,&nbsp;Yongcheol Kim MD, PhD ,&nbsp;Rungroj Krittayaphong MD ,&nbsp;Chi-Hang Lee MBBS, MD ,&nbsp;Jiunn-Lee Lin MD, PhD ,&nbsp;Siti Elkana Nauli MD ,&nbsp;Seitaro Nomura MD, PhD ,&nbsp;Duk-Woo Park MD, PhD ,&nbsp;Derek J. Hausenloy MBChB, PhD","doi":"10.1016/j.jacasi.2025.05.019","DOIUrl":"10.1016/j.jacasi.2025.05.019","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1239-1243"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981293","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":"Is Septal Pacing Effective for Antitachycardia Pacing of Implantable Cardioverter-Defibrillator?","authors":"Kohei Ishibashi MD, PhD,&nbsp;Nobuhiko Ueda MD, PhD,&nbsp;Kengo Kusano MD, PhD","doi":"10.1016/j.jacasi.2025.08.008","DOIUrl":"10.1016/j.jacasi.2025.08.008","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1344-1345"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236174","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":"Growing Burden of CVD in South Asia Highlights Need for Prevention and Control","authors":"Rajeev Gupta MD, PhD","doi":"10.1016/j.jacasi.2025.08.012","DOIUrl":"10.1016/j.jacasi.2025.08.012","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1369-1372"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236238","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":"Predicting the Surge in Valve-in-Valve Volume","authors":"Yohei Ohno MD ,&nbsp;Philippe Généreux MD ,&nbsp;Roy D. Dar PhD ,&nbsp;Ulrich Gerckens MD ,&nbsp;Danny Dvir MD ,&nbsp;Didier Tchétché MD ,&nbsp;Norihiko Kamioka MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Norio Tada MD ,&nbsp;Masanori Yamamoto MD ,&nbsp;Kentaro Hayashida MD ,&nbsp;Yusuke Watanabe MD","doi":"10.1016/j.jacasi.2025.07.014","DOIUrl":"10.1016/j.jacasi.2025.07.014","url":null,"abstract":"<div><h3>Background</h3><div>Understanding trends in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) utilization is essential for predicting valve-in-valve (ViV) TAVR usage, a viable option for failed bioprosthetic valves that presents a promising avenue for lifetime management of aortic stenosis.</div></div><div><h3>Objectives</h3><div>This study aimed to predict and compare the future annual ViV volume in the United States and Japan based on past and current TAVR/SAVR utilization under some underlying assumptions.</div></div><div><h3>Methods</h3><div>We developed a MATLAB-based Monte Carlo model engine to simulate the lifespan of bioprosthetic TAVR and SAVR valves. The valves are simulated for each individual TAVR/SAVR procedure from 1998 to 2035, accounting for over 4.4 million AVRs in the United States and 800,000 AVRs in Japan. The model allocates ages of the index procedure, valve durability, patient survival postprocedure, and accounts for redo open-heart procedures (in the U.S. model).</div></div><div><h3>Results</h3><div>The model outputs for total annual ViV volume for the United States and Japan show strong alignment with the 2023 TVT (Transcatheter Valve Therapy) and 2024 J-TVT (Japanese Transcatheter Valve Therapy) registry data, respectively. Both the U.S. and Japan ViV trends are made up of 2 parts—TAVR-in-SAVR dominates initially, after which TAVR-in-TAVR rises and dominates, with TAVR-in-SAVR flattening out after 2028. Total ViV is projected to reach approximately 42,000 (95% CI: 41,888-42,112) U.S. procedures (∼15% of U.S. TAVR) and 4,972 (95% CI: 4,935-5,009) Japanese procedures (∼8% of Japanese TAVR) in 2035.</div></div><div><h3>Conclusions</h3><div>Future ViV procedures are predicted to surge in the United States and Japan, with TAVR-in-TAVR dominating both markets in 2035.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 10","pages":"Pages 1288-1297"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981316","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":"Lipoprotein(a) in Japanese Patients With Cardiovascular Disease: A Systematic Review.","authors":"Hiroshi Yoshida, Michel Kroes, Yoko Sakai, Yuri Takahashi, Yosuke Yamanaka, Bruce Crawford, Junya Ako","doi":"10.1016/j.jacasi.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.08.017","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease (CVD), but its characterization within the Japanese population remains unexplored. This systematic literature review synthesizes evidence on the association between Lp(a) levels and CVD in Japanese patients. To ensure comparability, the review focused on studies using the widely used LATEX-based immunoassay method. Most studies categorized patients into \"high\" and \"low\" Lp(a) groups; this review concentrates on findings from the \"high\" groups to evaluate the impact of elevated Lp(a). Although definitions of \"high\" Lp(a) varied, a consistent association between elevated Lp(a) and increased cardiovascular risk has been observed, aligning with international findings. Variability across studies was noted, likely due to differences in study design, endpoints, and follow-up durations. Although no approved therapies specifically target elevated Lp(a), several randomized controlled trials are currently ongoing. Continued research is essential to better understand the clinical implications of elevated Lp(a) among Japanese individuals.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240471","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":"Risk Prediction Models of Cardiotoxicity in Patients With Breast Cancer: Multicenter Prospective CHECK HEART-BC Study.","authors":"Yosuke Terui, Kotaro Nochioka, Hideki Ota, Hiroshi Tada, Haruka Sato, Satoshi Miyata, Shigeru Toyoda, Shu Inami, Akihiro Nomura, Masaya Shimojima, Yasuhiro Izumiya, Yusuke Kodama, Takeshi Kitai, Kaoru Iwabuchi, Shu Suzuki, Daisuke Kitano, Keisuke Kida, Kiyotaka Shibuya, Takuya Oikawa, Takeru Nabeta, Toshiyuki Yano, Hiroyuki Iwano, Masayoshi Oikawa, Tatsuhiro Shibata, Yutaka Miura, Yoshito Ogihara, Nobuyuki Komiyama, Hiroshi Kato, Koji Higuchi, Sakiko Miyazaki, Yugo Yamashita, Satoshi Yasuda, Koichiro Sugimura","doi":"10.1016/j.jacasi.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.08.018","url":null,"abstract":"<p><strong>Background: </strong>Early detection and treatment of cardiotoxicity are essential for reducing cardiac events. However, a reliable predictive model for cardiotoxicity in patients with breast cancer receiving chemotherapy is lacking.</p><p><strong>Objectives: </strong>In this study, we aimed to develop a risk prediction model and establish effective surveillance for cardiotoxicity in patients with breast cancer undergoing chemotherapy.</p><p><strong>Methods: </strong>Patients with breast cancer scheduled for neoadjuvant and/or adjuvant chemotherapy were prospectively screened at 25 participating institutions between August 2017 and March 2020. Cardiotoxicity was defined as a reduction in left ventricular ejection fraction of >10% from baseline to a value <53%.</p><p><strong>Results: </strong>The study included 559 chemotherapy-naïve female patients. Cardiotoxicity was observed in 46 of 559 patients (8.2%) during a median follow-up period of 366 days (Q1-Q3: 365-367 days). The CHECK HEART (Comprehensive Heart Imaging to Evaluate Cardiac Damage Linked With Chemotherapy in Breast Cancer Patients) score consisted of 6 variables: heart rate, left ventricular global longitudinal strain, left ventricular end-systolic and end-diastolic diameters, right ventricular fractional area change, and treatment with anthracycline and trastuzumab. The time-dependent area under the receiver operating characteristic curve (AUC) at 12 months based on pretreatment data showed acceptable accuracy (AUC: 0.82; 95% CI: 0.76-0.89).</p><p><strong>Conclusions: </strong>The developed multivariable risk prediction models can accurately predict cardiotoxicity and support effective surveillance in patients with breast cancer receiving chemotherapy.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202210","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":"Integrated Use of Late Gadolinium Enhancement and Left Ventricular Global Longitudinal Strain in Hypertrophic Cardiomyopathy.","authors":"Soongu Kwak, Jihoon Kim, Min-Ha Jeong, Chan Soon Park, Hyun-Jung Lee, Jun-Bean Park, Seung-Pyo Lee, Yoon Seong Lee, Eun-Ah Park, Whal Lee, Yong-Jin Kim, Hyung-Kwan Kim, Sang-Chol Lee","doi":"10.1016/j.jacasi.2025.07.026","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.026","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) and left ventricular global longitudinal strain (LV-GLS) are structural and functional left ventricular remodeling markers in hypertrophic cardiomyopathy (HCM).</p><p><strong>Objectives: </strong>This study investigated the prognostic value of integrating both markers for risk stratification in HCM.</p><p><strong>Methods: </strong>Consecutive patients with HCM who underwent CMR between 2008 and 2020 at 2 tertiary hospitals were retrospectively analyzed. LGE% and LV-GLS were measured, with LV-GLS reported as an absolute value. The primary outcome was cardiovascular (CV) events: CV death, sudden cardiac death-related events, and heart failure hospitalization.</p><p><strong>Results: </strong>Among 652 patients with HCM (median age 56 years; 74% [481 of 652] male), median LGE% and LV-GLS were 4.2% and 14.3%, respectively. During the median 7.4-year follow-up (Q1-Q3: 3.4-10.3 years), 59 patients (9.0%) experienced CV events. Higher LGE% and lower LV-GLS were associated with increased CV events (per 1% LGE% increase, adjusted HR [aHR]: 1.04 [95% CI: 1.01-1.06; P = 0.005]; per 1% LV-GLS decrease, aHR: 1.08 [95% CI 1.00-1.15; P = 0.038]). When analyzing the 4 groups stratified according to LGE% and LV-GLS, patients with both high LGE% (>4.2%) and low LV-GLS (<14.3%) had the highest incidence of CV events (aHR: 2.88; 95% CI: 1.21-6.85; P = 0.017). Mediation analysis showed a significant indirect effect of LGE% on CV events through LV-GLS. Sudden cardiac death-related events were most frequent in patients with both high LGE and low LV-GLS.</p><p><strong>Conclusions: </strong>LGE and LV-GLS provide complementary prognostic information in HCM. Patients with both increased LGE and decreased LV-GLS are at particularly high risk, highlighting the value of integrating both biomarkers for risk stratification.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201980","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":"Constipation and Incident Cardiovascular Disease: A Nationwide, Real-World Cohort Study.","authors":"Keiichiro Iwasaki, Kentaro Ejiri, Hidehiro Kaneko, Yuta Suzuki, Toru Miyoshi, Satoshi Taya, Takuro Masuda, Yoichi Takaya, Satoshi Akagi, Akira Okada, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Hideo Yasunaga, Norihiko Takeda, Shinsuke Yuasa","doi":"10.1016/j.jacasi.2025.07.027","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.027","url":null,"abstract":"<p><strong>Background: </strong>The association of constipation with incident cardiovascular disease (CVD) has been suggested; however, there are few studies including general population and assessing whether constipation can improve the predictive performance for future CVD.</p><p><strong>Objectives: </strong>This study aims to quantify the association of constipation with the risk and attribution of developing CVD using a nationwide epidemiological database in Japan.</p><p><strong>Methods: </strong>In 1,516,763 individuals without prior CVD from the DeSC database between April 2014 and November 2022, constipation was defined by International Classification of Diseases-10th revision code before the initial health checkup. We assessed the association of constipation with incident CVDs including myocardial infarction (MI), angina pectoris, stroke, heart failure (HF), atrial fibrillation (AF), and a composite of them using multivariable Cox models.</p><p><strong>Results: </strong>Constipation was observed in 186,448 individuals (12.3%), showing a significant association with composite and each CVD, particularly with HF (HR: 1.30; 95% CI: 1.29-1.32 and HR: 1.32; 95% CI: 1.29-1.34, respectively). Followed by hypertension, constipation was the second highest population attributable fractions for the composite CVD, stroke, HF, and AF. Adding constipation to the established risk factors showed a modest but significant improvement in the prediction for the CVDs (net reclassification improvement for composite CVD: 0.122; 95% CI: 0.116-0.127; P < 0.001).</p><p><strong>Conclusions: </strong>In individuals without prior CVD, constipation was associated with incident CVDs including myocardial infarction, angina pectoris, stroke, HF, and AF. Constipation may be promising for the prediction of future CVD other than established risk factors, suggesting the importance of constipation not just as a quality-of-life issue but as a potential cardiovascular risk in the general population.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152062","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}