Arquivos brasileiros de cardiologia最新文献

{"title":"Unveiling the Genetic Puzzle: Asymmetric Hypertrophy in a Heart Transplant Recipient Linked to Birt-Hogg-Dubé Syndrome.","authors":"Silas Ramos Furquim, Lucas Vieira Lacerda Pires, Nara Alves Buriti, Mariana Lombardi Peres de Carvalho, Emanuelle Leonilia Marques, Bianca Domit Werner Linnenkamp, Luciana Sacilotto, Fabiana G Marcondes-Braga, Iascara Wozniak de Campos, Luis Fernando Bernal da Costa Seguro, Sandrigo Mangini, Monica S Avila, Fernando Bacal, José Eduardo Krieger","doi":"10.36660/abc.20240444","DOIUrl":"https://doi.org/10.36660/abc.20240444","url":null,"abstract":"<p><p>A case of a 54-year-old man who underwent a heart transplant with early asymmetric hypertrophy unrelated to rejection. Donor's genetic analysis revealed a variant in folliculin gene, associated with Birt-Hogg-Dubé Syndrome. Screening of the donor's family uncovered a similar hypertrophy and same genetic variant in the donor's father. Although genetic evaluation of donors' tissues is not routine, it can be crucial for understanding changes unrelated to the transplant procedure and identifying carriers of pathogenic variants.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20240444"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060302","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":"Mean Platelet Volume to Platelet Distribution Width Ratio: The Most Effective Platelet Parameter in the Closer of Ductus Arteriosus.","authors":"Ufuk Cakir, Cuneyt Tayman","doi":"10.36660/abc.20240635","DOIUrl":"https://doi.org/10.36660/abc.20240635","url":null,"abstract":"<p><strong>Background: </strong>The role of platelets and platelet indices in the closure of the ductus arteriosus in premature infants is still controversial. We aimed to determine whether the platelet count and all platelet-related indices are effective on the closer of patent ductus arteriosus (PDA).</p><p><strong>Objectives: </strong>Demographic characteristics, prematurity morbidities, and platelet indices were compared between groups with and without hemodynamically significant PDA (hsPDA).</p><p><strong>Methods: </strong>Data of premature infants with a gestational age of <30 weeks were evaluated retrospectively. All platelet-related data were recorded from the complete blood count in the first 24 hours of all patients. The statistical analysis was performed on the obtained data. A p-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 1151 patients were included in the study, including 426 patients in the hsPDA group and 725 patients in the non-hsPDA group. Platelet parameters mean platelet volume (MPV), MPV/ plateletcrit (PCT), MPV/ platelet distribution width (PDW), platelet mass (PM), red cell distribution width (RDW) values were found to be significantly lower in the hsPDA group compared to the non-hsPDA group (p<0.001, p<0.001, p<0.001, p=0.015, and p<0.001, respectively). MPV/PDW ratio with the highest AUC value (0.748) was found to be the most valuable parameter in estimating the closer of PDA.</p><p><strong>Conclusions: </strong>The MPV/PDW ratio was found to be the most valuable parameter for the prediction of hsPDA among all platelet indices.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240635"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082718","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":"TIMI Risk Score for Secondary Prevention to Risk Stratify Chronic Coronary Syndrome Patients: External Validation Study.","authors":"Henrique Trombini Pinesi, Eduardo Martelli Moreira, Marcelo Henrique Moreira Barbosa, Fabio Grunspun Pitta, Fabiana Hanna Rached, Eduardo Gomes Lima, Eduardo Bello Martins, Carlos Vicente Serrano","doi":"10.36660/abc.20240821","DOIUrl":"https://doi.org/10.36660/abc.20240821","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification in chronic coronary syndrome (CCS) patients is challenging. TIMI Risk Score for Secondary Prevention (TRS2P) is a simple nine-point tool developed to predict cardiovascular death, myocardial infarction (MI), and ischemic stroke among post-MI patients. No studies have been conducted on it in the Brazilian population.</p><p><strong>Objective: </strong>Validate the TRS2P score among CCS patients at a tertiary center in Brazil.</p><p><strong>Methods: </strong>This is a registry-based study of patients with CCS, defined as having a previous revascularization procedure, previous MI, or ≥50% stenosis in at least one epicardial coronary artery. The primary outcome was the three-year incidence of MACE (death, MI or stroke). The predicted risk was as reported in the original derivation study. Calibration was assessed through a calibration plot and the Hosmer-Lemeshow test. Discrimination was evaluated through the concordance (C)-statistic. A significance level of 0.05 was adopted.</p><p><strong>Results: </strong>The study sample consisted of 515 patients. There were 173 (34%) women, 75 (15%) aged over 75 years, 298 (58%) had diabetes, and 156 (30%) had chronic kidney disease. During follow-up, 126 MACE were documented. The estimated three-year incidence was 24% (95% confidence interval [CI] 21%-28%), whereas the predicted incidence was 15%. Although higher TRS2P scores were associated with higher MACE incidence, the TRS2P risk score model underestimated MACE incidence at every strata (p < 0.01). The C-statistic was 0.64 (95% CI 0.58-0.69).</p><p><strong>Conclusion: </strong>The TRS2P score identifies patients with a higher risk of cardiovascular events but it underestimated MACE and presented poor discrimination in a Brazilian CCS cohort.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240821"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176368","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 Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?","authors":"Maxim Goncharov, Erlon Oliveira de Abreu Silva, Pedro Gabriel Melo de Barros E Silva, Fabiane Letícia de Freitas, Adriana Costa Moreira, Lucas Tramujas, Alexandre Biasi Cavalcanti, Ieda Maria Liguori, Fabio Biscegli Jatene, Ieda Biscegli Jatene, Claudia Maria Rodrigues Alves","doi":"10.36660/abc.20240664","DOIUrl":"https://doi.org/10.36660/abc.20240664","url":null,"abstract":"<p><strong>Background: </strong>Women undergoing coronary artery bypass grafting (CABG) tend to have worse in-hospital outcomes, but it is unclear whether these differences are due to gender or to clinical factors.</p><p><strong>Objective: </strong>To compare in-hospital outcomes between women and men undergoing CABG.</p><p><strong>Methods: </strong>This was a single-center, retrospective observational study analyzing data from 9,845 patients who underwent CABG between 1995 and 2022, of whom 1,947 (19.8%) were women. To evaluate female gender as a prognostic factor for in-hospital mortality, we used descriptive statistics, univariate and multivariate logistic regression, and propensity score matching. The significance level was set at 5%.</p><p><strong>Results: </strong>Women were older (66.7 vs 62.19 years, p<0.001), had lower body mass index (26.91 vs 27.64, p<0.001), and had a higher prevalence of diabetes mellitus (34.0% vs 31.6%, p=0.045). They also had longer hospital stays (14.84 vs 13.13 days, p<0.001) and higher operative mortality (4.8% vs 2.4%, p<0.001). In logistic regression, female gender was associated with higher mortality (OR=1.51; 95% CI: 1.15-1.99; p=0.003). After matching, there was no significant difference in mortality (OR=1.20; 95% CI: 0.88-1.64; p=0.241), but length of hospital stay remained longer in women.</p><p><strong>Conclusion: </strong>When clinical factors were matched between men and women, the mortality difference disappeared. This suggests that targeted interventions to reduce disparities may help improve mortality outcomes in women undergoing CABG.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240664"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176366","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":"Prognostic Value of Nonsustained Ventricular Tachycardia in Hypertrophic Cardiomyopathy in a Brazilian Cohort: Comparison with World Literature.","authors":"Diego Araújo Silva, Edmundo Arteaga-Fernandez, Viviane Tiemi Hotta, Charles Mady, Barbara Ianni, Felix Ramires, Luciano Nastari, Fábio Fernandes, Juliano Novaes Cardoso","doi":"10.36660/abc.20240399","DOIUrl":"https://doi.org/10.36660/abc.20240399","url":null,"abstract":"<p><strong>Background: </strong>In hypertrophic cardiomyopathy (HCM), there is a well-known association between nonsustained ventricular tachycardia (NSVT) and the risk of sudden death.</p><p><strong>Objectives: </strong>To assess the incidence of NSVT using 24-hour Holter monitoring in patients with HCM in a Brazilian cohort and correlate it with its characteristics and progression.</p><p><strong>Methods: </strong>This retrospective study of patients with HCM used 24-hour Holter monitoring to assess the presence of long-lasting, fast NSVT (≥ 10 beats and heart rate ≥ 130 bpm) or the presence of at least 3 episodes of NSVT with ≥ 3 beats and heart rate ≥ 120 bpm. Continuous variables were shown as arithmetic means and standard deviations, and categorical variables were shown as absolute and relative frequencies. P < 0.05 was considered significant.</p><p><strong>Results: </strong>We included 763 patients, 53.5% of whom were male. Their mean age was 52.6 years ± 16.7. NSVT was found in 10% (76 patients). Only 11 (1.4%) of them had NSVT with ≥ 10 beats and heart rate ≥ 130 bpm. There was no difference in the relationship between NSVT and sex, septum > 30 mm, age ≥ 40 years, betablocker dose, and presence of atrial fibrillation. In the group with NSVT, 15-year all-cause mortality was observed in 26.3%, compared to 15.9% in the group without NSVT (p = 0.021).</p><p><strong>Conclusions: </strong>The presence of NSVT on 24-hour Holter monitoring occurred in 10% of patients. Long-lasting, fast NSVT was rare. The presence of NSVT was associated with higher overall mortality during follow-up.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240399"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176367","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":"Clinical and Microbiology Predictors for Therapeutic Failure in Sternal Surgical Site Infections - A Retrospective Cohort Study.","authors":"Jaqueline Fabiano Palazzo, Diego Augusto Medeiros Santos, Bruno Adler Maccagnan Pinheiro Besen, Caio Sambo, Gabriel Fialkovitz da Costa Leite, Samuel Terra Gallafrio, Danielle Menosi Gualandro, Lani Paola Bonilla Cuello, Marcus Vinicius Barbosa Santos, Tania Mara Varejão Strabelli, Pablo Maria Alberto Pomerantzeff, Fabio Biscegli Jatene, Rinaldo Siciliano","doi":"10.36660/abc.20240464","DOIUrl":"10.36660/abc.20240464","url":null,"abstract":"<p><strong>Background: </strong>Although sternal surgical site infections (SSI) are an important complication after cardiac surgeries, predictors of treatment failure are poorly studied.</p><p><strong>Objectives: </strong>The aim of this study is to assess the clinical and microbiology predictors of a sternal SSI therapeutic failure.</p><p><strong>Methods: </strong>Patients who presented a sternal SSI were retrospectively analyzed. Data regarding demographic characteristics, clinical findings, initial laboratory and radiologic findings and treatment of index sternal SSI were evaluated. Primary outcome was treatment failure, comprising infection relapse (clinical sternal SSI after complete treatment) or infection persistence (outpatient antimicrobial treatment failure). The microbiology was assessed at the index infection and in the outcome. P-values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Among 489 included patients, mean age was 58 years, 265 (55%) were female, 185 (38%) had diabetes mellitus. The overall prevalence of therapeutic failure was 14% (67), occurring in a median of 174 days (±41) after index cardiac surgery. Most frequent etiologies were cocci Gram-positive and Klebsiella pneumoniae. None of laboratory or thoracic tomographic findings presented during the index sternal SSI was related to outcome. After multivariate analysis, Staphylococcus aureus, carbapenem-resistant Gram-negative bacilli (GNB), fungi, diabetes mellitus and presence of mediastinitis/osteomyelitis were positive predictors of therapeutic failure.</p><p><strong>Conclusions: </strong>Emerging carbapenem-resistant GNB, fungi and S. aureus were etiologies associated with higher risk of therapeutic failure in sternal SSI. DM and deep sternal wound infections were also contributing factors. Its clinical implications and the exact role of multi-resistant microorganism itself are subject for more studies.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240464"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113001","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":"Elements for Implementing Perioperative Optimization in Cardiac Surgery Based on Enhanced Recovery after Surgery.","authors":"Marcelo Jamus Rodrigues, Andréa de Fátima Cristino Bastos Crespo, Gabrielle Barbosa Borgomoni, Fábio Antônio Serra de Lima Júnior, Paola Keese Montanhesi, Luiz Fernando Falcão, Valter Furlan, Omar Asdrúbal Vilca Mejia","doi":"10.36660/abc.20240599","DOIUrl":"10.36660/abc.20240599","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240599"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082582","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":"Use of Artificial Intelligence Applied to Electrocardiogram for Diagnosis of Left Ventricular Systolic Dysfunction.","authors":"Wilton Batista de Santana Júnior, Marcelo M Pinto Filho, Sandhi Maria Barreto, Murilo Foppa, Luana Giatti, Rohan Khera, Antonio Luiz Pinho Ribeiro","doi":"10.36660/abc.20240740","DOIUrl":"10.36660/abc.20240740","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a disease associated with an important type of morbidity and mortality. The electrocardiogram (ECG), one of the tests used to evaluate HF, is low-cost and widely available.</p><p><strong>Objective: </strong>To evaluate the performance of an artificial intelligence (AI) algorithm applied to ECG to detect HF and compare it with the predictive power of major electrocardiographic alterations (MEA).</p><p><strong>Methods: </strong>This work is a diagnostic accuracy cross-sectional study. All participants were from the Longitudinal Study of Adult Health (Estudo Longitudinal da Saúde do Adulto - ELSA-Brasil) and presented a valid ECG and echocardiogram (ECHO). The algorithm estimated probability values for left ventricular systolic dysfunction (LVSD). The assessed endpoint was left ventricular ejection fraction (LVEF) <40% in the ECHO. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) were determined for both the algorithm and the MEA. The area under the ROC curve (AUC-ROC) for the algorithm was calculated.</p><p><strong>Results: </strong>In the analytical sample of 2,567 individuals, the prevalence of LVEF <40% was 1.13% (29 individuals). The values obtained for sensitivity, specificity, PPV, NPV, LR+, LR-, and DOR for the algorithm were 0.690, 0.976, 0.244, 0.996, 27.6, 0.32, and 88.74, respectively. For the MEA, the values were 0.172, 0.837, 0.012, 0.989, 1.09, 0.990, and 1.07, respectively. The AUC-ROC of the algorithm to predict the LVEF <40% was 0.947 (95% CI: 0.913 - 0.981).</p><p><strong>Conclusion: </strong>The AI algorithm performed well in detecting LVSD and can be used as a screening tool for LVSD.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240740"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112976","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":"Treating Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and Atrial Fibrillation: We Need to Talk About the Fifth Pillar.","authors":"Mauricio Pimentel, Lucas Simonetto Faganello, Ana Paula Arbo Magalhães, Eduardo Caberlon, Leandro Ioschpe Zimerman","doi":"10.36660/abc.20240585","DOIUrl":"10.36660/abc.20240585","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240585"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766071","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":"Parameter Predicting Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting Patients: Triglyceride-Cholesterol-Body Weight Index.","authors":"İlhan Koyuncu, Emin Koyun","doi":"10.36660/abc.20240607","DOIUrl":"10.36660/abc.20240607","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, particularly coronary artery bypass grafting (CABG). Despite advances in surgical techniques, POAF remains a significant cause of morbidity and mortality.</p><p><strong>Objectives: </strong>This study investigates the potential of the Triglyceride-Cholesterol-Body weight Index (TCBI) as a predictor of POAF, focusing on the impact of nutritional status on surgical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 321 patients who underwent CABG surgery between January 2010 and January 2024. TCBI was calculated using preoperative blood samples and compared between those who developed POAF and those who did not. Statistical analyses, including Cox regression and ROC analysis, were performed to assess the predictive value of TCBI for POAF. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Patients who developed POAF had significantly lower TCBI (1790.8 ± 689, 3413.3±1232, p<0.001, respectively) levels compared to those without POAF. Also, age (p<0.001), the frequency of hypertension (p=0.009), CRP (p=0.03), and WBC (p=0.02) values were also significantly higher in patients who developed POAF.TCBI was identified as an independent predictor of POAF (OR: 0.998, 95% CI: 0.997-0.999, p<0.001), with a cut-off value of 1932.4 predicting POAF with 75% sensitivity and 78% specificity.</p><p><strong>Conclusion: </strong>The TCBI is a reliable indicator for predicting POAF in CABG patients. Preoperative identification of patients with low TCBI could lead to targeted interventions, reducing postoperative complications and improving outcomes. Optimizing nutritional status before surgery may mitigate the risk of POAF.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240607"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766068","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}