Journal of cardiovascular ultrasound最新文献

{"title":"The Use of Cardiac Magnetic Resonance in Patients with Suspected Coronary Artery Disease: A Clinical Practice Perspective.","authors":"Sung-A Chang,&nbsp;Raymond J Kim","doi":"10.4250/jcu.2016.24.2.96","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.96","url":null,"abstract":"<p><p>Cardiac magnetic resonance imaging (CMR) is a useful diagnostic imaging modality in patients with known or suspected coronary artery disease (CAD). It provides unique information not available from other modalities, however, it is complex. CMR is not a single technique. Instead, it consists of multiple distinct techniques and a lack of understanding of which techniques to perform and how to interpret the findings in combination limits its efficacy and widespread use. Conversely, its multiparametric nature can provide a comprehensive assessment with the potential for higher accuracy than is achievable by other modalities. Moreover, its ability to directly assess myopathic processes often contributes insights that change patient management. In this article we provide a brief technical overview and focus on specific clinical scenarios in patients with known or suspected CAD. We highlight the multiparametric nature of CMR and discuss cases which illustrate the unique information that CMR can contribute. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"96-103"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.96","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34525894","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":"Neutrophil-to-Lymphocyte Ratio for Risk Assessment in Coronary Artery Disease and Carotid Artery Atherosclerosis.","authors":"Jun-Bean Park","doi":"10.4250/jcu.2016.24.2.104","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.104","url":null,"abstract":"REFER TO THE PAGE 115-122 \u0000 \u0000Two decades ago, there was an optimistic prediction that the treatment of dyslipidemia and hypertension would eliminate coronary artery disease (CAD) by the 20th century. However, cardiovascular diseases (CVD) is now the greatest single contributor (nearly one-third) to global mortality and, unfortunately, CAD still accounts for the largest proportion of CVD.1) Furthermore, CVD is expected to dominate mortality trend over the next few decades.2) These facts force us to consider novel effective methods of risk stratification and treatment strategies. Hence, it is not surprising that intense attention has been focusing on the search of novel biomarkers providing prognostic information in CAD patients. In this endeavor, inflammation has been a prominent target because of its importance in the development and behavior of atherosclerotic plaques. Specifically, intimal infiltration of inflammatory cells is considered one of the initial steps in the development of atherosclerosis.3) Inflammatory cells also contribute to the development of necrotic core and the disruption of the overlying fibrous cap driven by several molecular mechanisms including the apoptosis of foam cells and the release of proinflammatory mediators and matrix metalloproteinases.4) \u0000 \u0000Besides the detection of local inflammation in plaques, the assessment of systemic inflammation is also a relevant approach, when considering that atherosclerosis is a diffuse disease affecting various arteries of the body. Indeed, many studies have suggested that the risk of CAD is significantly associated with the levels of systemic inflammatory markers, including C-reactive protein (CRP), erythrocyte sedimentation rate, fibrinogen, and circulating adhesion molecules.5),6) In this issue of the Journal of Cardiovascular Ultrasound, Kim et al.7) reported an association of coronary and carotid artery atherosclerosis with the values of neutrophil-to-lymphocyte ratio (NLR), another inflammatory marker. Furthermore, these authors determined that the addition of NLR significantly improved the discrimination of the risk of significant CAD and carotid artery atherosclerosis beyond classical cardiovascular risk factors. This biomarker is attractive because it has the advantages of being readily available, inexpensive, and thus capable of being used in the daily clinical practice, compared with other indicators of systemic inflammation. \u0000 \u0000However, more data are clearly required in larger populations to determine whether NLR can be applied clinically in the management of CAD patients. What kinds of data are needed to justify the clinical use of NLR as a valuable biomarker of systemic inflammation? One of the easiest ways is to follow a well-established precedent, such as CRP. Indeed, there is extensive evidence supporting the view that CRP plays an important role in risk assessment of patients with CVD. Specifically, multiple prospective epidemiological studies have shown the clinica","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"104-5"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34525896","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 Combined Impact of Neutrophil-to-Lymphocyte Ratio and Type 2 Diabetic Mellitus on Significant Coronary Artery Disease and Carotid Artery Atherosclerosis.","authors":"Bong-Joon Kim,&nbsp;Sang-Hoon Cho,&nbsp;Kyoung-Im Cho,&nbsp;Hyun-Su Kim,&nbsp;Jung-Ho Heo,&nbsp;Tae-Joon Cha","doi":"10.4250/jcu.2016.24.2.115","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.115","url":null,"abstract":"<p><strong>Background: </strong>Neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a new important inflammatory marker for predicting cardiovascular events. This study aimed to evaluate the combined impact of NLR and type 2 diabetes mellitus (T2DM) on significant coronary artery disease (CAD) and carotid artery atherosclerosis.</p><p><strong>Methods: </strong>This study includes a total of 828 patients evaluated by coronary angiography and carotid ultrasonography. Significant CAD was defined as at least one vessel with stenosis greater than 50%. We employed logistic regression models to investigate the association of NLR and T2DM with significant CAD. The goodness-of-fit and discriminability of the models were assessed by the loglikelihood ratio test and C-index, respectively. Also, we investigated the clinical relevance of the categorized NLR that classifies patients into three risk groups (low, intermediate, high).</p><p><strong>Results: </strong>According to logistic regression analysis, both NLR {adjusted odds ratio (OR) 1.31, p < 0.001} and T2DM (adjusted OR 2.46, p = 0.006) were independent risk factors of significant CAD. The addition of NLR and T2DM into a logistic regression model including conventional cardiovascular risk factors significantly improved the goodness-of-fit (p < 0.001) and the discriminability of the model (p = 0.004). Also, T2DM patients assigned into the high risk group (NLR > 2) showed the greater prevalence of significant CAD and carotid artery atherosclerosis compared with patients without T2DM or type 2 diabetic patients assigned into the low risk group (NLR ≤ 1).</p><p><strong>Conclusion: </strong>Our results suggest that type 2 diabetic patients with high inflammatory state would be more vulnerable to significant CAD and carotid artery atherosclerosis.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"115-22"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688825","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":"Myocardial Tissue Doppler Velocity in Child Growth.","authors":"Sun-Ha Choi,&nbsp;Lucy Youngmin Eun,&nbsp;Nam Kyun Kim,&nbsp;Jo Won Jung,&nbsp;Jae Young Choi","doi":"10.4250/jcu.2016.24.1.40","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.40","url":null,"abstract":"<p><strong>Background: </strong>In adults, tissue Doppler imaging (TDI) is a recommended component of routine echocardiography. However, TDI velocities are less accepted in pediatrics, due to their strong variability and age dependence in children. This study examines the distribution of myocardial tissue Doppler velocities in healthy children to assess the effect of age with cardiac growth on the various echocardiographic measurements.</p><p><strong>Methods: </strong>Total 144 healthy children were enrolled in this study. They were recruited from the pediatric outpatient clinic for routine well-child visits. The statistical relationships between age and TDI values were analyzed. Also, the statistical relationships between body surface area (BSA) and TDI values, left ventricle end-diastolic dimension (LVEDD) and TDI values were analyzed. Also, we conducted multivariate analysis of cardiac growth parameters such as, age, BSA, LVEDD and TDI velocity data.</p><p><strong>Results: </strong>All of the age, BSA, and LVEDD had positive correlations with deceleration time (DT), pressure half-time (PHT), peak early diastolic myocardial velocity, peak systolic myocardial velocity, and had negative correlations with peak late diastolic velocity (A) and the ratio of trans-mitral inflow velocity to early diastolic velocity of mitral annulus (E/E'). In the multivariate analysis, all of the age, BSA, and LVEDD had positive correlations with DT, PHT, and negative correlations with A and E/E'.</p><p><strong>Conclusion: </strong>The cardiac growth parameters related alterations of E/E' may suggest that diastolic myocardial velocities are cardiac growth dependent, and diastolic function has positive correlation with cardiac growth in pediatric group. This cardiac growth related myocardial functional variation would be important for assessment of cardiac involvement either in healthy and sick child.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"40-7"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34405195","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 Case of Microangiopathic Hemolytic Anemia after Myxoma Excision and Mitral Valve Repair Presenting as Hemolytic Uremic Syndrome.","authors":"Young Joo Park,&nbsp;Sang Pil Kim,&nbsp;Ho-Jin Shin,&nbsp;Jung Hyun Choi","doi":"10.4250/jcu.2016.24.1.75","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.75","url":null,"abstract":"<p><p>Microangiopathic hemolytic anemia occurs in a diverse group of disorders, including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and prosthetic cardiac valves. Hemolytic anemia also occurs as a rare complication after mitral valve repair. In this report, we describe a case of microangiopathic hemolytic anemia following myxoma excision and mitral valve repair, which was presented as hemolytic uremic syndrome. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"75-8"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.75","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34406289","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":"Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke.","authors":"Darae Kim,&nbsp;Chi Young Shim,&nbsp;In Jeong Cho,&nbsp;Young Dae Kim,&nbsp;Hyo Suk Nam,&nbsp;Hyuk-Jae Chang,&nbsp;Geu-Ru Hong,&nbsp;Jong-Won Ha,&nbsp;Ji Hoe Heo,&nbsp;Namsik Chung","doi":"10.4250/jcu.2016.24.1.20","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.20","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a well-established risk factor for stroke. Interestingly, ischemic stroke increases risk of incident AF in patients without prior diagnosed AF. For better risk stratification for post-stroke AF, we studied left atrial (LA) size and mechanical function using two-dimensional (2D) speckle tracking imaging in patients with acute ischemic stroke.</p><p><strong>Methods: </strong>A total of 227 patients (132 males, age 67 ± 12) with acute ischemic stroke without a history of AF underwent 2D transthoracic echocardiography and speckle tracking imaging for the assessment of LA volume index and global LA longitudinal strain (LALS). From clinical variables, the CHA2DS2-VASc score and National Institute of Health Stroke Scale (NIHSS) were calculated in each patient. Post-stroke AF was defined as newly diagnosed AF during the course after ischemic stroke.</p><p><strong>Results: </strong>Post-stroke AF occurred in 25 patients (11%). Patients with post-stroke AF were older and showed a higher tendency of CHA2DS2-VASc score, significantly higher log NIHSS, larger LA volume index and lower global LALS than those without. In multivariate analysis, global LALS was an independent predictor for post-stroke AF (hazard ratio 0.90, 95% confidence interval 0.83.0.97, p < 0.01) after controlling for confounding factors. Furthermore, global LALS provided incremental predictive value for post-stroke AF over the CHA2DS2-VASc score, NIHSS, and LA volume index. The global LALS < 14.5% better distinguished post-stroke AF (area under the curve 0.837, sensitivity 60%, specificity 95%, p < 0.01) than CHA2DS2-VASc score.</p><p><strong>Conclusion: </strong>Global LALS as a marker of LA mechanical function has incremental predictive value for post-stroke AF in patients with acute ischemic stroke.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"20-7"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.20","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34405192","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":"Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State.","authors":"Rajendra Kumar Gokhroo,&nbsp;Avinash Anantharaj,&nbsp;Kamal Kishor,&nbsp;Bhanwar Ranwa","doi":"10.4250/jcu.2016.24.1.68","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.68","url":null,"abstract":"<p><p>Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"68-70"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.68","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34406287","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":"Pocket-Sized Echocardiography Devices: One Stop Shop Service?","authors":"Andreas Seraphim,&nbsp;Stavroula A Paschou,&nbsp;Julia Grapsa,&nbsp;Petros Nihoyannopoulos","doi":"10.4250/jcu.2016.24.1.1","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.1","url":null,"abstract":"<p><p>The introduction of portable, pocket-sized echocardiography devices in various healthcare systems has raised new questions with regards to their realistic use in clinical practice. Several studies have already attempted to provide information regarding their safety and diagnostic potential, the training required to operate them, as well as their direct comparison with standard echocardiography machines. This manuscript is a review of the literature of the documents or position papers which employ the use of pocket or handheld devices. Following review of the literature, we suggest that these miniaturized devices can provide a valuable diagnostic tool that can complement and improve the diagnostic yield of clinical examination. When operated by appropriately trained professionals, they can provide a limited but very reliable echocardiographic assessment. Pocket-sized echocardiography is a part of physical examination and should not be considered a complete echocardiographic scan. Optimal training is required for the smooth operation of handheld echocardiography. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34463565","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":"2-Dimensional Strain Analysis of Regional Change in Right Ventricular Function after Treadmill Exercise.","authors":"Se-Jung Yoon,&nbsp;Hye-Sun Seo,&nbsp;Sujung Park,&nbsp;Wook-Jin Chung","doi":"10.4250/jcu.2016.24.1.35","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.35","url":null,"abstract":"<p><strong>Background: </strong>Function of right ventricle (RV) influences on symptoms and prognosis in various diseases. However the regional RV function analyzed with 2-dimensional (2D) strain echocardiography before and just after treadmill test has not been evaluated. The aim of this study was to show the change of regional RV function just after treadmill exercise with strain analysis.</p><p><strong>Methods: </strong>A total of thirty eight patients who visited hospital for hypertension, chest pain or dyspnea between January 2007 and December 2010 were retrospectively analyzed (men, 47.4%; mean age, 54.9 ± 7.2 years). Treadmill exercise test and pre and post echocardiography were performed. 2D strain echocardiography was analyzed off line in RV free wall and septum.</p><p><strong>Results: </strong>Mean exercise duration was 737 ± 132 sec. Tissue velocity in lateral tricuspid annulus is significantly increased in post exercise (initial, 10.5 ± 2.4 cm/sec vs. post exercise, 12.2 ± 1.8 cm/sec, p = 0.006). Systolic strain of RV free wall apex and mid portion were significantly changed in post exercise stage (free wall apex, -18.2 ± 7.6% vs. -22.3 ± 5.8%, p = 0.010; free wall mid, -14.1 ± 6.7% vs. -22.6 ± 6.8%, p = 0.022).</p><p><strong>Conclusion: </strong>2D strain imaging provides a precise tool to quantify regional RV function and reveals a characteristic regional pattern of RV after treadmill exercise.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"35-9"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.35","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34405194","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":"Letter Regarding Article, \"Biventricular Takotsubo Cardiomyopathy Associated with Epilepsy\".","authors":"John E Madias","doi":"10.4250/jcu.2016.24.1.87","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.1.87","url":null,"abstract":"I read the report by Koo et al.1) published in the December 2015 issue of the Journal, about the 83-year-old woman with history of post-hemorrhagic stroke epilepsy, and status epilepticus-triggered Takotsubo syndrome (TTS), involving both the right and left ventricles. I have some comments and questions for the kind consideration of the authors: 1) The electrocardiogram (ECG) of their patient showed ST-segment elevations, Qwaves in leads V1–3, and low amplitude QRS complexes (LAQRS) in the limb leads, in accordance with a new insight recently published.2) Since such LAQRS are transient, I wonder whether prior or subsequent ECGs showed larger QRS complexes in the limb leads. Also, were the Q-waves transient? And, did the patient develop T-wave inversions and QTc prolongation during her 10 days of hospitalization? 2) I fully concur with the authors' views about the link between epilepsy and TTS, and its connotations about possible mechanistic association with the syndrome of the sudden unexpected death in epilepsy.1) 3) One wonders how we should act to protect our patients with recurrent seizures from TTS. Do such patients suffer atypical episodes of TTS,3) which do not reach a severity level requiring hospitalization? Do ECGs in patients with T-wave inversions, in the aftermath of such recurrent seizures, signify that such patients after all suffer mild forms of TTS? Indeed this author has proposed use by the patients or care-givers of \"smart phone technology\"-based frequent transmission of their ECGs4) to their physicians for evaluation? Such a strategy may be feasible for evaluation of patients following seizures, in their ambulatory environment, since serial echocardiograms cannot be realistically be recorded.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 1","pages":"87"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.1.87","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34406292","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}