Cardiology in the Young最新文献

{"title":"Achieving caloric goal in postoperative management of CHD surgery.","authors":"Murat Tanyildiz, Selin Ece Erden, Asli Ece Yakici, Omer Ozden, Ipek Otrav, Mehmet Bicer, Atif Akcevin, Ender Odemis","doi":"10.1017/S1047951125000484","DOIUrl":"10.1017/S1047951125000484","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the prevalence of malnutrition, time to achieve caloric goals, and nutritional risk factors after surgery for CHD in a cardiac ICU.</p><p><strong>Method: </strong>This retrospective study included patients with CHD (1 month-18 years old) undergoing open-heart surgery (2021-2022). We recorded nutritional status, body mass index-for-age z-score, weight-for-length/height z-score, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3 score, Paediatric Logistic Organ Dysfunction-2 score, vasoactive inotropic score, total duration of mechanical ventilation, length of stay in the cardiac ICU, mortality, and time to achieve caloric goals.</p><p><strong>Results: </strong>Of the 75 included patients, malnutrition was detected in 17% (<i>n</i>= 8) based on the body mass index-for-age z-score and in 35% (<i>n</i>= 10) based on the weight-for-length/height z-score. Sex, mortality, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and vasoactive inotropic score, duration of mechanical ventilation, and length of cardiac ICU stay were similar between patients with and without malnutrition. Patients who achieved caloric goals on the fourth day and those who achieved them beyond the fourth day showed statistical differences in mortality, maximum vasoactive inotropic score, duration of mechanical ventilation, cardiopulmonary bypass and aortic cross-clamp time, Paediatric Risk of Mortality-3, Paediatric Logistic Organ Dysfunction-2, and length of cardiac ICU and hospital stay (<i>p</i>< 0.05). Logit regression analysis indicated that the duration of mechanical ventilation, Paediatric Logistic Organ Dysfunction-2 and Paediatric Risk of Mortality-3 score was a risk factor for achieving caloric goals (<i>p</i>< 0.05).</p><p><strong>Conclusions: </strong>Malnutrition is prevalent in patients with CHD, and concomitant organ failure and duration of mechanical ventilation play important roles in achieving postoperative caloric goals.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"668-678"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac treatment for Duchenne muscular dystrophy: consensus recommendations from the ACTION muscular dystrophy committee.","authors":"Paul Esteso, Scott R Auerbach, Neha Bansal, Rachel Harris, Jonathan H Soslow, Brian F Birnbaum, Jennifer Conway, Linda H Cripe, Deipanjan Nandi, Emily Hayes, Katheryn E Gambetta, E Kevin Hall, Daphne T Hsu, Beth D Kaufman, David Rosenthal, Sonya Kirmani, Michelle S Ploutz, Ashwin K Lal, David M Peng, Chet R Villa, Svetlana Shugh, Carol A Wittlieb-Weber, Renata Shih","doi":"10.1017/S1047951125000587","DOIUrl":"10.1017/S1047951125000587","url":null,"abstract":"<p><strong>Introduction: </strong>Duchenne muscular dystrophy is a devastating neuromuscular disorder characterized by the loss of dystrophin, inevitably leading to cardiomyopathy. Despite publications on prophylaxis and treatment with cardiac medications to mitigate cardiomyopathy progression, gaps remain in the specifics of medication initiation and optimization.</p><p><strong>Method: </strong>This document is an expert opinion statement, addressing a critical gap in cardiac care for Duchenne muscular dystrophy. It provides thorough recommendations for the initiation and titration of cardiac medications based on disease progression and patient response. Recommendations are derived from the expertise of the Advance Cardiac Therapies Improving Outcomes Network and are informed by established guidelines from the American Heart Association, American College of Cardiology, and Duchenne Muscular Dystrophy Care Considerations. These expert-derived recommendations aim to navigate the complexities of Duchenne muscular dystrophy-related cardiac care.</p><p><strong>Results: </strong>Comprehensive recommendations for initiation, titration, and optimization of critical cardiac medications are provided to address Duchenne muscular dystrophy-associated cardiomyopathy.</p><p><strong>Discussion: </strong>The management of Duchenne muscular dystrophy requires a multidisciplinary approach. However, the diversity of healthcare providers involved in Duchenne muscular dystrophy can result in variations in cardiac care, complicating treatment standardization and patient outcomes. The aim of this report is to provide a roadmap for managing Duchenne muscular dystrophy-associated cardiomyopathy, by elucidating timing and dosage nuances crucial for optimal therapeutic efficacy, ultimately improving cardiac outcomes, and improving the quality of life for individuals with Duchenne muscular dystrophy.</p><p><strong>Conclusion: </strong>This document seeks to establish a standardized framework for cardiac care in Duchenne muscular dystrophy, aiming to improve cardiac prognosis.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"770-775"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary resuscitation training decreases anxiety levels in parents of infants with congenital heart disease.","authors":"Desiree S Machado, Zasha Vazquez-Colon, Victoria Botelho, Cynthia Garvan, Dalia Lopez-Colon, Daniel Rodriguez, Leah Breault, Joseph Philip, Laurel Barwick, Jennifer Munoz Pareja, Camila Melchior, Estela Azeka, Erica Cascio","doi":"10.1017/S1047951124026441","DOIUrl":"10.1017/S1047951124026441","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of cardiac arrest among parents of infants with heart disease can cause stress and anxiety. Literature is scarce on the effects of cardiopulmonary resuscitation training (CPRt) on anxiety and stress of parents. We analysed the impact of CPRt on anxiety, stress, and comfort levels on parents of infants with heart disease.</p><p><strong>Methods: </strong>Cardiopulmonary resuscitation (CPR) and choking relief manoeuvre (CRM) comfort level, Parental State-Trait Anxiety Inventory (STAI), and Parenting Stress Index (PSI) scores were prospectively collected pre-, immediately post-, and 3 months post-CPRt.</p><p><strong>Results: </strong>There were 97 participants: 80% (<i>n</i> = 78) mothers/grandmothers and 20% (<i>n</i> = 19) fathers. The mean (SD) age of participants was 28.7 (5.6) years old. There was a significant decrease in STAI across the three time points collected; STAI decreased by 12% from baseline to immediately post-CPRt and 19% from baseline to 3 months post-CPRt (<i>p</i> < .0001). There were no significant changes in PSI across the time points. Baseline to immediately post-teaching, we found that CPRt significantly increased comfort performing CPR, CRM, and comfort in knowing what to do (<i>p</i>=< .001, <i>p</i>=< .001, <i>p</i>=< .001, respectively). Comfort levels persisted elevated when comparing pre- to 3 months post-CPRt (<i>p</i>=< .001, <i>p</i>= .002, <i>p</i>= .001, respectively), maintaining at least a 177% average increase up to 3 months post-CPRt for all aspects.</p><p><strong>Conclusion: </strong>CPRt can aid in improving anxiety and comfort levels of parents of infants with heart disease around hospital discharge. Parental preparedness and reassurance to know what to do in emergency situations can be enhanced by a simple intervention such as CPRt.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"732-737"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and cardiac function in patients with Duchenne muscular dystrophy.","authors":"Mary Killian, Jaclyn Tamaroff, Karry Su, Kimberly Crum, Kristen George-Durrett, Larry W Markham, Maciej Buchowski, Thomas Donnelly, W Bryan Burnette, Jonathan H Soslow","doi":"10.1017/S1047951125000162","DOIUrl":"10.1017/S1047951125000162","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy is the leading cause of death in patients with Duchenne muscular dystrophy. The relationship between cardiac and skeletal muscle progression is unclear. The objective of this study was to evaluate the correlation between muscle activity and cardiomyopathy. We hypothesised that cardiomyopathy and skeletal muscle activity are directly related.</p><p><strong>Methods: </strong>Physical activity was assessed with accelerometers worn for 7 days. Average activity (vector magnitude/min) and percentage of time in different activities were reported. Cardiac MRI was used to assess left ventricular ejection fraction, global circumferential strain (Ecc), late gadolinium enhancement, and cardiac index. Associations were assessed between physical activity and cardiac variables using a Spearman correlation.</p><p><strong>Results: </strong>Duchenne muscular dystrophy subjects (<i>n</i> = 46) with an average age of 13 ± 4 years had a mean left ventricular ejection fraction of 57 ± 8%. All physical activity measures showed significant correlations with left ventricular ejection fraction (rho = 0.38, <i>p</i> = 0.01) and left ventricular cardiac index (rho = 0.51, <i>p</i> < 0.001). Less active subjects had lower left ventricular ejection fraction (<i>p</i> = 0.10) and left ventricular cardiac index (<i>p</i> < 0.01). Non-ambulatory patients (<i>n</i> = 29) demonstrated a stronger association between physical activity and left ventricular ejection fraction (rho = 0.40, <i>p</i> = 0.03) while ambulatory patients demonstrated a stronger association between physical activity and left ventricular cardiac index (rho = 0.53, <i>p</i> = 0.03). Ecc did not associate with physical activity in either cohort.</p><p><strong>Conclusion: </strong>Physical activity correlates with left ventricular ejection fraction and left ventricular cardiac index and is modified by ambulation. Future analysis should assess the temporal relationship between physical activity and cardiomyopathy.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"688-694"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter closure of a huge complex pulmonary arteriovenous malformation with four devices: a case report.","authors":"Utku Pamuk, Harun Terin, Hazim Alper Gursu","doi":"10.1017/S1047951125000575","DOIUrl":"10.1017/S1047951125000575","url":null,"abstract":"<p><p>Pulmonary arteriovenous malformations are abnormal vascular connections between pulmonary arteries and veins, often causing right-to-left shunting. In this report, a 4-year-old boy with low oxygen saturation was diagnosed with a large, complex pulmonary arteriovenous malformation involving four feeding arteries. Percutaneous transcatheter closure was performed using four devices to occlude the major feeding arteries, resulting in increased arterial oxygen saturation from 72 to 98%. This report depicts the successful use of multiple devices for percutaneous closure of a complex pulmonary arteriovenous malformation in a child and highlights the minimally invasive and effective nature of this approach.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"860-862"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance against standardization recommendations for outpatient care of common forms of congenital heart disease.","authors":"Sara F Morehous, Jeffrey B Anderson, Eunice Hahn, Nicholas J Ollberding, Christopher J Statile","doi":"10.1017/S1047951125001246","DOIUrl":"10.1017/S1047951125001246","url":null,"abstract":"<p><strong>Background: </strong>The American College of Cardiology has published clinical practice algorithms for common congenital heart lesions, including atrial septal defect, patent ductus arteriosus, valvar pulmonary stenosis, aortic coarctation, and ventricular septal defect. The purpose of this study was to define the current practice patterns in the management of these lesions and describe the impact of departure from these recommendations.</p><p><strong>Methods: </strong>This was a retrospective analysis of the most recent 100 outpatient appointments for each lesion at our centre. Electronic medical records were queried to determine whether the scheduling, testing, and follow-up plan for each appointment were consistent with the published algorithms.</p><p><strong>Results: </strong>A total of 500 visits were evaluated (150 new visits; 350 follow-up visits); 32% (<i>n</i> = 162) of encounters did not receive appropriate testing, 37% (<i>n</i> = 186) departed from recommended follow-up plans, and of the 350 follow-up visits, 45% (<i>n</i> = 156) departed from scheduling guidelines. Impact of these departures was quantified in reference to over- or under-expenditure of clinical resources. Of the aberrant testing encounters, 60% (<i>n</i> = 97) saw too few tests. Of the deviant follow-up plans created, 74% (<i>n</i> = 138) brought patients back to clinic too soon.</p><p><strong>Conclusion: </strong>This study explores the deviation between current practice patterns and published clinical care guidelines. There is considerable variation across domain of analysis, diagnosis, and encounter type, resulting in uneven resource utilisation. Standardisation of care in these areas will improve utilisation and can be a starting point for improvement work.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"812-817"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe conduction block and cardiomyopathy associated with desminopathy.","authors":"Ningning Sun, Chunli Wang, Shiwei Yang","doi":"10.1017/S1047951125000125","DOIUrl":"10.1017/S1047951125000125","url":null,"abstract":"<p><p>Desminopathy is a rare heritable cardiac and skeletal muscle disease caused by variants in the <i>DES</i> gene, which encodes the primary muscle-specific intermediate filament protein, known as desmin. Childhood-onset is commonly associated with severe early-onset myopathy and early death. Here, we reported an 11-year-old Chinese girl presenting with complete atrioventricular block and cardiomyopathy, without skeletal muscle involvement. Genetic analysis identified a <i>de novo</i> variant (c.152C > T/p.Ser51Phe) in the <i>DES</i> gene.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"850-852"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chylothorax: a rare postoperative complication in paediatric cardiac surgery patients - a 15-year retrospective study from a tertiary care centre in a developing country.","authors":"Bshara Sleem, Jad Abdul Khalek, Adham Makarem, Salah Yamout, Christophe El Rassi, Rana Zareef, Mounir Obeid, Issam El Rassi, Fadi Bitar, Mariam Arabi","doi":"10.1017/S104795112500126X","DOIUrl":"10.1017/S104795112500126X","url":null,"abstract":"<p><p>Chylothorax, a postoperative complication of CHD surgery, involves chyle accumulation in the pleural cavity, posing challenges in diagnosis and management. This retrospective study investigates the prevalence, aetiology, management, and outcomes of postoperative chylothorax in paediatric patients undergoing cardiac corrective surgery at a tertiary care centre over 15 years. Medical records of paediatric patients who underwent cardiothoracic surgery at the Children's Heart Center at the American University of Beirut Medical Center between 2007 and 2022 were retrospectively reviewed. Data collection included demographic characteristics, blood parameters, chylous fluid characteristics, diagnostic criteria, treatment modalities, and hospitalisation details. Ethical approval was obtained, and descriptive statistics were employed using SAS 9.4. Among 2,997 children who underwent cardiothoracic surgery, nineteen cases of postoperative chylothorax were identified. The majority were females (63.2%) with a median age of 9 months. Glenn, Fontan, and Blalock-Taussig shunt-related surgeries were the most common operations associated with chylothorax. Single ventricle physiology was the predominant CHD observed (58%). Diagnosis relied primarily on clinical presentation, imaging studies, and triglyceride levels in pleural fluid. Treatment options included conservative dietary modifications, medical therapy such as octreotide, and surgical intervention if necessary. No mortalities were reported, and patients were adequately followed up. This study sheds light on postoperative chylothorax in paediatric cardiac patients, offering insights into its epidemiology, aetiology, clinical features, and treatment outcomes. While conservative and medical approaches effectively managed chylothorax in this group, larger studies are needed to develop standardised diagnostic and treatment protocols, improving outcomes in paediatric patients with postoperative chylothorax.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"798-804"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-invasive surgical approach for hybrid pulmonary valve implantation: an option for very high-risk patients.","authors":"Biagio Castaldi, Vincenzo Tarzia, Giuseppe Tarantini, Domenico Sirico, Daniela Mancuso, Nicola Pradegan, Giovanni Di Salvo, Gino Gerosa","doi":"10.1017/S1047951125000411","DOIUrl":"10.1017/S1047951125000411","url":null,"abstract":"<p><p>Transcatheter pulmonary valve replacement is the first choice to treat residual or recurrent right ventricular outflow tract dysfunction. Surgery is an effective option when anatomy is not permissive for transcatheter procedures. When surgical risk is too high, hybrid procedures might be considered.In this paper, we describe the first use of Harmony valve in Europe in a 59 years old patient with a huge right ventricular outflow tract. The procedure was performed by a hybrid approach: before valve deployment, through an anterior mini-thoracotomy, the pulmonary artery was plicated to create a landing zone. The valve was deployed by trans-femoral venous approach. It was secured by putting a suture on the distal stent raw under fluoroscopic guidance. The procedure was uneventful and patient's New York Heart Association class rapidly improved from III-IV to II.In conclusion, hybrid strategies might represent an acceptable option for huge right ventricular outflow tract, to be less invasive and to minimise device embolisation risks. When a good match between patient's anatomy and device can be achieved, a mini-invasive or micro-invasive surgical approach might be considered to minimise bleeding risks and shorten the hospital's length of stay.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"845-849"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closure of perimembranous ventricular septal defects using the Amplatzer vascular plug II: experience of a Mexican centre.","authors":"Roberto Mijangos-Vázquez, Rogelio Hernández-Reyes","doi":"10.1017/S1047951125000381","DOIUrl":"10.1017/S1047951125000381","url":null,"abstract":"<p><strong>Objectives: </strong>To demonstrate safety and efficacy of using the Amplatzer^TM vascular plug II device for perimembranous ventricular septal defect closure with retrograde approach and show the follow-up in all patients.</p><p><strong>Background: </strong>At present, there is no FDA-approved device for transcatheter closure of perimembranous ventricular septal defects. Small studies and case reports have shown the use of various catheter-based devices in an off-label management; however, there are no large studies to show their efficacy. The second generation of Amplatzer^TM vascular plug seems to offer a safe and attractive alternative for this procedure. Besides, a retrograde approach might decrease procedure time and radiation exposure time.</p><p><strong>Methods and results: </strong>Patients with congenital perimembranous ventricular septal defects who underwent transcatheter closure using Amplatzer vascular plug II devices were included. Primary end point was to determine efficacy and safety of this generation of devices and the incidence of complications at follow-up (complete heart block and aortic/tricuspid/mitral regurgitation). Forty-five patients underwent perimembranous ventricular septal defect closure at a median age of 6 years (9 months-17 years). During the catheterization, there were only minor complications and at follow-up of 48 ± 25.7 months (up to 96 months). Closure rate was high of 93.3% and freedom from atrioventricular block was 100%.</p><p><strong>Conclusions: </strong>The second generation of the Amplatzer^TM vascular plug II seems to offer a safe and attractive alternative for percutaneous closure of the perimembranous ventricular septal defects.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"683-687"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}