Circulation reports最新文献

{"title":"Repeated Aortic Regurgitation Treated by Sequential Self-Expandable Valve Implantation in TAV-in-TAV-in-SAV.","authors":"Nao Tamura, Hideki Kitahara, Shogo Okita, Ko Miyakoda, Hiroaki Yaginuma, Ryo Toishi, Hiroaki Yamamoto, Tomoyoshi Kanda, Kaoru Matsuura, Goro Matsumiya, Yoshio Kobayashi","doi":"10.1253/circrep.CR-26-0198","DOIUrl":"https://doi.org/10.1253/circrep.CR-26-0198","url":null,"abstract":"","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 10","pages":"1765-1766"},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170161","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":"Development and Internal Validation of D-DASH: A Prediction Model for Eating Difficulty at Discharge in Acute Heart Failure.","authors":"Koji Matsuo, Daiki Onoda, Kazuhiro Mibu, Kikka Kobayashi, Hiroaki Tatsuki, Seiji Tamiya","doi":"10.1253/circrep.CR-26-0146","DOIUrl":"https://doi.org/10.1253/circrep.CR-26-0146","url":null,"abstract":"<p><strong>Background: </strong>Eating difficulty is an important complication in patients with acute heart failure (AHF), but no AHF-specific tool has been established for the early prediction of eating difficulty. We aimed to develop and internally validate the Development of eating Difficulty Assessment Score in acute Heart failure (D-DASH) using variables available during early hospitalization.</p><p><strong>Methods and results: </strong>This single-center retrospective observational study included 644 patients hospitalized for AHF who had no eating difficulty before admission. The outcome was eating difficulty at discharge, defined as a Food Intake LEVEL Scale ≤8. A multivariable logistic regression model was constructed using age, dementia, New York Heart Association class IV, albumin, and maximal tongue pressure. Eating difficulty at discharge occurred in 110 (17.1%) patients. Older age (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.07), dementia (OR 2.66; 95% CI 1.44-4.85), lower albumin (OR 0.59; 95% CI 0.39-0.89), and lower maximal tongue pressure (OR 0.94; 95% CI 0.90-0.98) were independently associated with eating difficulty at discharge. The model showed moderate discrimination (area under the curve 0.749; 95% CI 0.700-0.797) with acceptable calibration. Bootstrap internal validation demonstrated an optimism-corrected C-index of 0.739 and a calibration slope of 0.940.</p><p><strong>Conclusions: </strong>This study developed a predictive scoring system to identify patients with AHF at risk of eating difficulty, enabling timely intervention to mitigate this risk.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 10","pages":"1601-1609"},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171971","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":"Gaps in Onco-Cardiology Practice and Educational Needs for the Next Generation of Pharmacists in Japan.","authors":"Kazunori Morita, Yuma Shibutani, Shinichi Masuda, Dan Kanehira, Yudai Ishikawa, Junpei Nakamura, Makiko Takabayashi, Takuro Imaoka, Moe Kondo, Tomomi Ueda, Akito Shindo, Kanna Nakamura, Yuri Okazoe-Hirakawa, Shohei Ueno, Koki Uehara, Yoko Taminishi, Taro Shiga, Hiroshi Akazawa, Yasuko K Bando, Hironobu Minami","doi":"10.1253/circrep.CR-26-0092","DOIUrl":"https://doi.org/10.1253/circrep.CR-26-0092","url":null,"abstract":"<p><strong>Background: </strong>Cancer therapy-related cardiovascular toxicity is increasingly recognized as a major issue in cancer care, underscoring the need for multidisciplinary onco-cardiology. Although pharmacists are expected to play important roles in this field, their real-world involvement and challenges in onco-cardiology practice in Japan remain unclear.</p><p><strong>Methods and results: </strong>We conducted a cross-sectional web-based survey of early career pharmacists (aged ≤45 years) in Japan between July and August, 2025. The questionnaire assessed pharmacists' background, awareness of onco-cardiology and related clinical guidelines, areas of interest, clinical experience, perceived challenges, interprofessional collaboration, and educational needs. A total of 105 pharmacists responded. Approximately 80% of respondents reported moderate to high interest in onco-cardiology. However, clinical experience in onco-cardiology was limited; 56.2% of respondents managed only 1-5 cases per month, and 20.0% reported no prior experience. Collaboration scores differed significantly across domains, with hospital pharmacy-community pharmacy collaboration being significantly lower than collaboration between pharmacists and oncologists or cardiologists (P<0.001). Major challenges included insufficient knowledge, limited educational opportunities, and difficulties in multidisciplinary collaboration.</p><p><strong>Conclusions: </strong>Although early career pharmacists participating in this study demonstrate strong interest in onco-cardiology, their clinical involvement remains limited, and interprofessional collaboration is suboptimal. Structured educational programs and strengthened collaboration frameworks, particularly between hospital and community pharmacy settings, are needed to facilitate pharmacists' integration into multidisciplinary onco-cardiology care.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 10","pages":"1711-1719"},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169295","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":"Safety and Efficacy of the Extravascular Implantable Cardioverter-Defibrillator (EV-ICD) in Japanese Patients: Final Results From the EV ICD Japan Study.","authors":"Mitsuru Wada, Nobuhiro Nishii, Kohei Ishibashi, Christopher Wiggenhorn, Takuto Yamamoto, Kengo Kusano","doi":"10.1253/circrep.CR-26-0131","DOIUrl":"10.1253/circrep.CR-26-0131","url":null,"abstract":"<p><strong>Background: </strong>The extravascular implantable cardioverter-defibrillator (EV-ICD) has proven efficacy and a low complication rate in global populations, but data from Japanese patients is limited. We report the safety and efficacy of the EV-ICD system in a Japanese cohort through 12 months of follow-up.</p><p><strong>Methods and results: </strong>Patients from Japan with a Class I or IIa indication for a single-chamber ICD were enrolled and implanted with the EV-ICD system. Defibrillation success was determined following implant. System programming changes, device electrical performance, freedom from major system- or procedure-related complications through 12 months post-implant, and follow-up status at all visits were assessed. From February to September 2023, 14 patients (12 males, 2 females) were enrolled and successfully implanted across 2 sites (age: 53.6±14.7 years; left ventricular ejection fraction: 52.6±15.6%; secondary prevention: 42.9%). Defibrillation testing was successful in all patients (14/14, 100%). At 2 weeks and 12 months, freedom from major system- and/or procedure-related complications was 92.9% and 85.7%, respectively. One patient received 7 appropriate shocks that were successful in terminating the arrhythmia. There were no inappropriate shocks delivered, and a single inappropriate antitachycardia pacing therapy was delivered through follow-up.</p><p><strong>Conclusions: </strong>The EV-ICD system was safely implanted and effective at terminating both induced and spontaneous ventricular arrhythmias in a small cohort of Japanese patients.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 9","pages":"1396-1403"},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932232","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":"Circulating Amino Acids Independently Predict Longitudinal Progression of Cardio-Ankle Vascular Index in Japanese Older Adults: The Kyotango Longevity Cohort Study.","authors":"Masatsugu Oishi, Tomoya Kitani, Shiho Tamagaki, Norihiro Ouchi, Atsuo Adachi, Yayoi Matoba, Koji Ikeda, Yuji Naito, Tadaaki Kamitani, Satoaki Matoba","doi":"10.1253/circrep.CR-26-0182","DOIUrl":"https://doi.org/10.1253/circrep.CR-26-0182","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness is an established predictor of cardiovascular morbidity and mortality. Circulating amino acids have emerged as metabolic markers linked to cardiovascular risk, but longitudinal evidence in community-dwelling Japanese older adults remains limited. Therefore, we investigated whether baseline amino acid profiles predict progression of arterial stiffness, as assessed by the cardio-ankle vascular index (CAVI), in this population.</p><p><strong>Methods and results: </strong>This prospective analysis of the Kyotango Longevity Cohort Study included 592 participants aged ≥65 years with repeated CAVI measurements (mean follow-up 3.2±0.5 years). Fasting blood samples were analyzed for 23 amino acids with sufficient data availability at baseline. Primary screening analyses adjusted for age, sex, and baseline CAVI identified glutamic acid, isoleucine, and leucine as significantly associated with greater CAVI increase (q<0.10). After multivariable adjustment for cardiovascular risk factors, these associations remained significant. No significant interactions were observed between the identified amino acids and markers of inflammation (interleukin 6 and high-sensitivity C-reactive protein), oxidative stress (8-hydroxy-2'-deoxyguanosine), or physical function (grip strength). Branched-chain amino acids and Fischer ratio were also independently associated with CAVI progression.</p><p><strong>Conclusions: </strong>Circulating amino acid profiles, particularly glutamic acid, leucine, and isoleucine, together with branched-chain amino acid-derived indices, independently predict longitudinal progression of arterial stiffness as assessed by CAVI in Japanese older adults.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 10","pages":"1631-1638"},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171309","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":"Human Epididymis Protein 4 in Cardiovascular Disease: A Fibrosis-Driven Mediator of Tissue Remodeling and Inter-Organ Communication.","authors":"Shinsuke Hanatani, Masahiro Yamamoto, Fumihiko Ogata, Yuki Okuno, Satoshi Araki, Yuichiro Arima, Eiichiro Yamamoto, Yasuhiro Izumiya, Kenichi Tsujita","doi":"10.1253/circrep.CR-26-0186","DOIUrl":"https://doi.org/10.1253/circrep.CR-26-0186","url":null,"abstract":"<p><p>Human epididymis protein 4 (HE4), originally identified as a tumor biomarker, has emerged as a regulator of tissue remodeling, with roles that extend beyond oncology. Recent findings suggest that HE4 is involved in extracellular matrix turnover, immune system modulation, and maintenance of epithelial balance, indicating its complex role in fibrosis and tissue remodeling. In cardiovascular diseases, the circulating HE4 level is consistently associated with disease severity, myocardial fibrosis, and adverse clinical outcomes in conditions such as heart failure, aortic stenosis, and ischemic heart disease, suggesting its role as a marker of fibrosis-driven remodeling in diverse cardiovascular conditions. Mechanistically, HE4 influences fibrosis via protease inhibition, fibroblast activation, and immune signaling pathways, and may function as a mediator of inter-organ communication. In particular, its strong association with renal dysfunction and expression in injured kidney tissues supports its role in cardiorenal interactions. Recent findings suggest that HE4 plays a role in systemic remodeling processes that extend beyond heart function, including those associated with pulmonary vascular disease. Collectively, these insights propose a conceptual framework in which HE4 acts as a context-dependent regulator of tissue remodeling, integrating structural, immune, and inter-organ communication pathways. This perspective positions HE4 as a biomarker and a mechanistically relevant mediator of disease progression, with potential implications for risk stratification and therapeutic targeting in cardiovascular disease.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 10","pages":"1583-1589"},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170996","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":"Longitudinal Wire Bias Pattern on Intravascular Ultrasound as an Independent Predictor of Coronary Artery Injury During Orbital Atherectomy for Calcified Nodules: A Single-Center Retrospective Study.","authors":"Nobuhiro Watanabe, Yoshiro Tsukiyama, Tomohiro Inoue, Taishi Miyata, Hiroto Kinutani, Nobuyuki Takahashi, Hiroyuki Yamamoto, Shinsuke Nakano, Koki Matsuo, Keisuke Miwa, Mitsuaki Itoh, Hiroya Kawai, Tomofumi Takaya","doi":"10.1253/circrep.CR-26-0105","DOIUrl":"10.1253/circrep.CR-26-0105","url":null,"abstract":"<p><strong>Background: </strong>Calcified nodules (CN) are a challenging coronary lesion subset often treated with orbital atherectomy (OA), which, although effective, carries a risk of coronary artery injury (CAI), including hematoma and perforation. In this study we assessed the relationship between intravascular ultrasound (IVUS) findings, particularly the wire bias pattern, and CAI during OA for CN.</p><p><strong>Methods and results: </strong>We retrospectively analyzed 67 patients with CN who underwent IVUS-guided percutaneous coronary intervention with OA between August 2020 and August 2023. The primary endpoint was CAI, defined as hematoma or perforation. IVUS findings, including tenting sign, undesirable wire position, and a newly classified wire bias pattern (Types A-D), were evaluated. 9 patients (13.4%) developed CAI: 8 hematomas (11.9%) and 1 perforation (1.5%). Type D wire bias showed the highest incidence of CAI (47.1%, P<0.001). Multivariate logistic regression identified Type D as the sole independent predictor of CAI (odds ratio 22.43; 95% confidence interval 2.61-192.9; P=0.005). Neither tenting sign nor undesirable wire position was significantly associated.</p><p><strong>Conclusions: </strong>A Type D wire bias pattern on IVUS (defined as the guidewire tracking along the healthy vessel wall proximal and distal to the CN) was an independent predictor of CAI during OA. Preprocedural identification of this pattern may improve risk stratification and procedural strategies to minimize complications.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 9","pages":"1523-1530"},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932204","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":"Coronary Microvascular Dysfunction in Hemodialysis-Dependent End-Stage Renal Disease: Prevalence, Characteristics, and Prognostic Implications.","authors":"Hiroshi Yoshikawa, Tadashi Murai, Taishi Yonetsu, Masao Yamaguchi, Aki Ito, Yoshinori Kanno, Ippei Saito, Atsushi Takahashi, Yuko Onishi, Hiroyuki Fujii, Hiroyuki Hikita, Tsunekazu Kakuta, Tetsuo Sasano","doi":"10.1253/circrep.CR-26-0153","DOIUrl":"10.1253/circrep.CR-26-0153","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) is an established mechanism in cardiovascular diseases and is associated with adverse outcomes. However, CMD in hemodialysis (HD) patients remains poorly characterized. This study evaluated the prevalence, physiological profiles, and prognostic implications of CMD in this high-risk population.</p><p><strong>Methods and results: </strong>Among 894 patients who underwent intracoronary physiological assessment of the left anterior descending artery, 87 were on HD. A control group of 87 non-HD patients was selected using propensity score matching for established CMD risk factors. Microvascular resistance reserve (MRR) and the baseline index of microvascular resistance (b-IMR) and hyperemic IMR were compared. MRR was significantly lower in HD than non-HD patients (median [interquartile range (IQR)] 2.4 [1.9-3.4] vs. 3.8 [2.6-5.0], P<0.001). This was driven primarily by lower b-IMR in the HD than non-HD group (median [IQR] 42.3 [23.6-61.0] vs. 68.7 [42.7-90.9], P<0.001); IMR was comparable between the 2 groups (18.6 [12.0-24.7] vs. 18.3 [12.7-26.0], respectively; P=0.65). In HD patients, an MRR of 2.1 was optimal for predicting the composite endpoint (all-cause mortality, heart failure, and acute myocardial infarction). Kaplan-Meier analysis showed event-free survival was significantly worse in HD patients with MRR <2.1 (log-rank P=0.001).</p><p><strong>Conclusions: </strong>CMD is highly prevalent in HD patients and is characterized by markedly reduced b-IMR. In this population, MRR serves as a potent prognostic indicator.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 9","pages":"1500-1511"},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932439","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":"Monitoring the Electrical Phenotype of Transthyretin Amyloid Cardiomyopathy in the Era of Disease-Modifying Therapy.","authors":"Keisuke Yonezu, Hidekazu Kondo, Naohiko Takahashi","doi":"10.1253/circrep.CR-26-0220","DOIUrl":"10.1253/circrep.CR-26-0220","url":null,"abstract":"","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 9","pages":"1540-1542"},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932249","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":"Clinical Impact of Hospital-Associated Disability in Patients With Acute Decompensated Heart Failure.","authors":"Yuta Nagatomi, Takeo Fujino, Tomomi Ide, Takeshi Tohyama, Tae Higuchi, Tomoyuki Nezu, Shoei Yamamoto, Nobuyuki Enzan, Hidetaka Kaku, Kayo Misumi, Keisuke Shinohara, Toru Hashimoto, Shouji Matsushima, Hiroyuki Tsutsui, Kohtaro Abe","doi":"10.1253/circrep.CR-26-0145","DOIUrl":"10.1253/circrep.CR-26-0145","url":null,"abstract":"<p><strong>Background: </strong>Hospital-associated disability (HAD) may affect long-term outcomes in heart failure (HF), but evidence remains limited, so in this study we aimed to evaluate the impact of HAD on long-term outcomes in acute decompensated HF (ADHF).</p><p><strong>Methods and results: </strong>We analyzed data from the Japanese Registry of Acute Decompensated Heart Failure (JROADHF), including patients enrolled from January 2013 to December 2017. HAD was defined as a decline of ≥5 points in the Barthel Index from admission to discharge. The primary outcome was all-cause death, and the secondary outcomes were cardiovascular (CV) death, non-CV death, and HF readmission. Of the 8,965 patients enrolled (mean age 76.9±12.7 years; 54.8% male), 537 (6.0%) had HAD. In the multivariate analysis, HAD was independently associated with all-cause death (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.31-1.91; P<0.001) and non-CV death (HR: 1.44; 95% CI: 1.08-1.92; P=0.013), but not with CV death or HF readmission. Subgroup analyses revealed a stronger association between HAD and all-cause death in patients under 80 years (<80 years: HR: 2.48; 95% CI: 1.80-3.41; ≥80 years: HR: 1.36; 95% CI: 1.09-1.71; P for interaction <0.001).</p><p><strong>Conclusions: </strong>HAD significantly affects the long-term mortality rate in ADHF patients, particularly in those under 80 years of age. These findings highlight the importance of considering age-specific management approaches in this population.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 9","pages":"1450-1458"},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932452","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}