Cardiology in Review最新文献

{"title":"Enhancing Outcomes in Subdural Hematoma: The Role of Middle Meningeal Artery Embolization.","authors":"Mohamed Elfil, Hazem Ghaith, Eris Spirollari, Ariel Sacknovitz, Ankita Jain, Jon Rosenberg, Andrew Bauerschmidt, Stephan A Mayer, Chirag Gandhi, Fawaz Al-Mufti","doi":"10.1097/CRD.0000000000000922","DOIUrl":"10.1097/CRD.0000000000000922","url":null,"abstract":"<p><p>Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition with increasing incidence, especially among the elderly. The pathophysiology of cSDH is multifactorial, involving inflammation, fibrinolysis, and angiogenesis, with fragile neovascularization contributing to recurrent microbleeding and hematoma persistence. While burr-hole evacuation remains a standard surgical approach, recurrence rates remain high, necessitating adjunctive strategies such as subdural drain placement, subdural-peritoneal shunting, and pharmacologic interventions. Middle meningeal artery embolization (MMAE) has emerged as a promising adjunctive therapy for cSDH by targeting the abnormal neovascularization of the dura and within the hematoma's outer membrane. In this meta-analysis, we pooled data from 4 recent clinical trials (EMBOLISE, STEM, MAGIC-MT, and MEMBRANE) to evaluate MMAE's efficacy and safety. Our results demonstrate that MMAE plus usual care significantly reduces recurrence or residual cSDH compared with standard care alone (RR = 0.56, P = 0.001), and is associated with lower mortality (RR = 0.54, P = 0.03). No significant differences were observed in functional outcomes, serious adverse events, or major disabling stroke. These findings highlight MMAE as an effective adjunct in cSDH management. Future studies should aim to further assess long-term outcomes and cost-effectiveness, as well as refine the optimal patient selection criteria for MMAE.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"470-471"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973222","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":"Unmet Needs in Acute Ischemic Stroke: Overcoming Recalcitrant Clots.","authors":"Mahmood Mirza, Christian Ulfert, Ray McCarthy, Patrick Brouwer","doi":"10.1097/CRD.0000000000000977","DOIUrl":"10.1097/CRD.0000000000000977","url":null,"abstract":"<p><p>Endovascular thrombectomy has revolutionized acute ischemic stroke treatment, significantly improving recanalization rates. However, up to 20% of cases involve recalcitrant clots that fail to recanalize or require multiple passes, negatively impacting clinical outcomes. This review explores the multifaceted nature of these challenging clots, including insights from preclinical, imaging, and clinical studies, with strategies to overcome them. Ex-vivo clot characterization reveals red blood cell-poorness in clots as a common feature in fibrin-rich, platelet-rich, neutrophil extracellular traps-rich, collagenous or bacteria-rich clots. Preclinical models have evolved alongside ex-vivo clot analysis, demonstrating properties such as increased stiffness, toughness, hardness, and stickiness that hinders retrieval. Imaging markers such as absence of the hyperdense artery sign or susceptibility vessel sign correlate with recalcitrant clots, although reliable predictors of recalcitrant clots remain elusive. Recent innovations, including specifically designed tough clot stent-retrievers such as Nimbus and technologies to improve complete clot ingestion such as super-bore aspiration catheters and cyclic aspiration have shown promise. Yet, a substantial proportion of cases still have difficulty or fail to achieve recanalization. Techniques such as rescue stenting and dual-stent-retriever approaches offer additional strategies but carry risks of vascular injury and complications. Major research limitations include clot deformation during retrieval and the inability to remove some clots. Furthermore, some interactions are poorly understood, such as the biological interaction between the clot and vessel wall or with circulating thrombo-influencing proteins. Overcoming these challenges can pave the pathway for creative solutions to elegantly improve the recanalization of tough clots.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"472-482"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Challenges Beyond Earth: Investigating the Impact of Space Travel on Astronauts' Cardiovascular Health.","authors":"Ramsha Mahmood, Tanveer Shaik, Inder P Kaur, Vasu Gupta, Ayesha Shaik, Fnu Anamika, Nikita Garg, Rohit Jain","doi":"10.1097/CRD.0000000000000642","DOIUrl":"10.1097/CRD.0000000000000642","url":null,"abstract":"<p><p>In the coming decades, as humanity aims to establish a presence on Mars, there is a growing significance in comprehending, monitoring, and controlling the diverse health challenges arising from space exploration. The extended exposure to microgravity during space missions leads to various physical alterations in astronauts, such as shifts in bodily fluids, reduced plasma volume, loss of bone density, muscle wasting, and cardiovascular deconditioning. These changes can ultimately lead to orthostatic intolerance, underscoring the increasing importance of addressing these health risks. Astronauts are exposed to cosmic radiation consisting of high-energy particles from various sources, including solar cosmic rays and galactic cosmic rays. These radiations can impact the electrical signals in the heart, potentially causing irregular heart rhythms. Understanding the risks to the heart and blood circulation brought on by exposure to space radiation and the overall stress of spaceflight is essential and this article reviews the cardiovascular effects of space travel on astronauts.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"567-572"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478092","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 Education in United States Schools: Shortcomings and Future Directions.","authors":"Harris Z Whiteson, Matthew B Weiss, William H Frishman","doi":"10.1097/CRD.0000000000000661","DOIUrl":"10.1097/CRD.0000000000000661","url":null,"abstract":"<p><p>Cardiopulmonary resuscitation (CPR) is a lifesaving procedure that is performed during a cardiac arrest. CPR consists of chest compressions, rescue breaths, and the usage of an automated external defibrillator (AED) based on availability. Performance of CPR can greatly increase the chances of survival by enabling the manual perfusion of vital organs in lieu of the heart's normal function. Despite extensive studies demonstrating the efficacy and necessity of CPR in an emergency, most of the public across the United States is ill-equipped and/or educated on how to perform it. While there may be other contributing factors, the lack of CPR education across schools in the United States almost certainly furthers the CPR illiteracy of the general population. Although states require some degree of CPR training, the level of education that students receive varies widely across communities and school districts, largely dictated by the available funding for training courses. Despite the lack of CPR education in the United States, studies conducted abroad have shown the efficacy of a CPR course in preparing students to respond in emergencies-lending hope to mending the current situation in the United States. In this article, we analyze legislation dictating CPR instruction and hypothesize ways in which states' Department of Education might be able to promote education and hands-on experience for students across all ages of schooling. Ultimately, we hope to highlight the importance and feasibility of preparing the next generation of citizens across the United States to respond when their name is called upon in an emergency.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"552-555"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697020","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":"Evaluating the Efficacy of Interatrial Shunt Devices in Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.","authors":"Mohamed Riad Abouzid, Karim Ali","doi":"10.1097/CRD.0000000000000641","DOIUrl":"10.1097/CRD.0000000000000641","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a prevalent and challenging condition with limited therapeutic options. This meta-analysis aims to assess the feasibility and effectiveness of interatrial shunt devices (IASD) in the treatment of HFpEF, focusing on key hemodynamic parameters and clinical outcomes. Six clinical trials, encompassing 324 patients, were included in this analysis. The results showed a significant reduction in pulmonary capillary wedge pressure (PCWP) at rest after IASD implantation, with a mean difference of 1.55 mm Hg. PCWP during exercise also exhibited a decrease, indicating improved exercise tolerance. However, there was an increase in mean right atrial pressure following IASD implantation. These findings suggest that IASD implementation can effectively lower left atrial pressure, a critical target in HFpEF management. This results in substantial clinical improvements, including enhanced New York Heart Association class, quality of life, and 6-minute walk distance. Echocardiographic assessments revealed a reduction in left ventricular end-diastolic volume index and stable right ventricular changes. The meta-analysis underscores the potential benefits of IASD in ameliorating the symptoms and clinical outcomes of HFpEF patients. The increase in mean right atrial pressure warrants further investigation into its effects on right heart function. Additionally, this analysis emphasizes the need for larger, randomized clinical trials to validate these findings and determine optimal patient selection criteria. IASD implantation holds promise as a therapeutic option for HFpEF, offering the potential to improve the quality of life and functional status of affected patients. However, further research is imperative to confirm its efficacy relative to existing treatments and to address concerns regarding its impact on right heart function. This meta-analysis contributes to a deeper understanding of IASD's role in HFpEF management.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"531-538"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697021","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":"Age-Related Orthostatic Hypotension: A Comprehensive Analysis of Prevalence, Mechanisms, and Management in the Geriatric Population.","authors":"Varsha Srinivas, Udit Choubey, Sreerag Kapparath, Tanveer Shaik, Bhupinder Singh, Ramsha Mahmood, Nikita Garg, Priyanka Aggarwal, Rohit Jain","doi":"10.1097/CRD.0000000000000636","DOIUrl":"10.1097/CRD.0000000000000636","url":null,"abstract":"<p><p>Geriatric patients frequently encounter orthostatic hypotension (OH), a multifaceted condition characterized by a significant drop in blood pressure upon assuming an upright position. As the elderly population is particularly susceptible to OH, our review endeavors to comprehensively explore the complex nature of this condition and various factors contributing to its development. We investigate the impact of comorbidities, polypharmacy, age-related physiological changes, and autonomic dysfunction in the pathogenesis of OH. Geriatric patients with OH are faced with an elevated risk of falls, syncope, a decline in their overall quality of life, and hence increased mortality. These implications require careful consideration, necessitating a thorough examination of therapeutic strategies. We evaluate various pharmaceutical and nonpharmacological therapies, delving into the effectiveness and safety of each approach in managing OH within geriatric populations. We explore the role of pharmacotherapy in alleviating symptoms and mitigating OH-related complications, as well as the potential benefits of volume expansion techniques to augment blood volume and stabilize blood pressure. We place particular emphasis on the significance of lifestyle changes and nonpharmacological interventions in enhancing OH management among the elderly. These interventions encompass dietary modifications, regular physical activity, and postural training, all tailored to the unique needs of the individual patient. To optimize outcomes and ensure patient safety, we underscore the importance of individualized treatment plans that take into account the geriatric patient's overall health status, existing comorbidities, and potential interactions with other medications. This review aims to improve clinical practice and patient outcomes by advocating for early detection, properly tailored management, and targeted interventions to address OH in the elderly population. By raising awareness of OH's prevalence and complexities among healthcare professionals, we hope to foster a comprehensive understanding of OH and contribute to the overall wellness and quality of life of this vulnerable demographic.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"556-566"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377225","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":"Beta-Blocker Use in Post-Myocardial Infarction Patients With Preserved Ejection Fraction: A Review.","authors":"Darshilkumar Maheta, Vedanshi Sandip Shah, Siddharth Pravin Agrawal, Saptak Mankad, Dhruvi Joshi, Srushti Sahukar, Hritvik Jain, Anjaneyulu Dunde, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001066","DOIUrl":"10.1097/CRD.0000000000001066","url":null,"abstract":"<p><p>Beta-adrenergic blockers [beta-blockers (BBs)] have long been a cornerstone of therapy after myocardial infarction (MI) based on early trials showing reduced mortality. However, their role in patients who recover from MI with preserved left ventricular ejection fraction (LVEF) is increasingly debated in the modern era of reperfusion and contemporary medical therapy. We reviewed randomized controlled trials, observational studies, meta-analyses, and clinical guidelines regarding BB use in post-MI patients without left ventricular systolic dysfunction (normal LVEF) and preserved ejection fraction (EF), acknowledging a lack of evidence in this subgroup. In patients with MI without reduced LVEF, long-term BB therapy has not demonstrated clear outcome benefits in the contemporary era. BBs remain indicated for those with reduced LVEF (≤40%), heart failure, arrhythmias, or ongoing ischemia, but routine continuation in all post-MI patients with normal EF may be unnecessary. Ongoing trials should further clarify which patients benefit from BBs after MI. Clinicians should individualize decisions, considering potential side effects and patient comorbidities, and current guidelines suggest re-evaluating the need for BBs in stable post-MI patients with preserved EF.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191173","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":"CRISPR/Cas9-Based Gene Editing for Correcting Inherited Channelopathies.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Krutagni Adwait Mehta, Marina Basta, Maggie James, Daniel Elias, Yghor Myrtho Figaro, Damien Islek, Abraham Lo, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001076","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001076","url":null,"abstract":"<p><p>Inherited cardiac channelopathies, including long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia, are major causes of arrhythmic morbidity and sudden cardiac death in young individuals. Current therapies, such as pharmacologic agents, implantable cardioverter-defibrillators, and lifestyle modifications, reduce risk but fail to correct the underlying genetic substrate, creating an urgent need for curative strategies. CRISPR/Cas9 genome editing has emerged as a transformative platform with the potential to directly repair pathogenic variants. Recent advances in base and prime editing, together with novel viral and nonviral delivery platforms, have enabled precise correction of disease-causing mutations in preclinical models. Proof-of-concept studies using animal models and patient-derived iPSC-cardiomyocytes demonstrate restoration of electrophysiologic stability, suppression of arrhythmias, and durable functional benefit. Nevertheless, translational challenges remain, including off-target effects, delivery barriers, immune responses, scalability, and ethical considerations. Ongoing innovations-such as engineered nucleases, improved delivery vectors, immunogenicity mitigation strategies, and integration of artificial intelligence for personalized guide design-are expected to accelerate clinical translation. This review synthesizes current knowledge on CRISPR-based strategies for inherited channelopathies, highlighting both the promise and limitations of gene editing as a path toward durable, disease-modifying therapies capable of preventing sudden cardiac death.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343703","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":"Determinants of Progression and Regression of Subclinical Atherosclerosis: A Temporal Perspective.","authors":"Rimsha Ahmad, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001053","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001053","url":null,"abstract":"<p><p>Subclinical atherosclerosis is a preclinical stage of atherosclerotic cardiovascular disease marked by structural arterial changes in the absence of symptoms or ischemic events. Its early identification and characterization are central to targeted prevention. This review synthesizes evidence from large cohorts, randomized trials, and meta-analyses on clinical, biochemical, lifestyle, and imaging determinants influencing its progression or regression. Traditional risk factors, including age, male sex, hypertension, dyslipidemia, diabetes, and smoking, remain the strongest predictors of plaque progression. Emerging contributors such as elevated lipoprotein(a), chronic inflammation, metabolic syndrome, genetic susceptibility, and psychosocial stress are increasingly recognized as independent modulators of risk. Imaging tools such as coronary artery calcium scoring, carotid intima-media thickness, and coronary computed tomography angiography allow quantification of plaque burden and composition. Novel markers, including perivascular fat attenuation and radiomic features, provide additional prognostic insights. Although regression is less frequent than progression, it is achievable through intensive lipid-lowering, strict blood pressure control, lifestyle modification, and anti-inflammatory therapies. Despite these advances, uncertainties persist regarding optimal monitoring intervals, individualized treatment thresholds, and the prognostic utility of emerging imaging biomarkers. Future priorities include longitudinal, multiethnic studies with standardized imaging protocols and incorporation of artificial intelligence-driven analytics to enhance predictive models and guide personalized therapy. Understanding the multifactorial drivers of subclinical atherosclerosis remains critical for advancing primary prevention and reducing the global burden of atherosclerotic cardiovascular disease.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336517","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":"Balloon Pulmonary Angioplasty Versus Riociguat in Inoperable Chronic Thromboembolic Pulmonary Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Iftikhar Khan, Ghazal Ishaque, Ahmed Ali Khan, Fakhra Shafiq, Savaliya Prashntkumar, Mahnoor Ishaque, Aditya Gaur, Rumaisa Riaz, Nimra Ehsan, Vaneeza Qureshi, Soban Ali Qasim, Saad Khan, Raheel Ahmad","doi":"10.1097/CRD.0000000000001049","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001049","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) results from unresolved pulmonary emboli that lead to persistent obstruction of the pulmonary vasculature, elevated pulmonary arterial pressure, and subsequent right-heart strain. About half of CTEPH patients cannot have surgery to remove blockages and need other treatments-either balloon pulmonary angioplasty (BPA), a procedure that widens vessels, or riociguat, a medication that relaxes them. We followed PRISMA guidelines and searched PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov for randomized trials from January 2018 to April 2025 that directly compared BPA and riociguat in adults with inoperable CTEPH. We pooled data from 3 trials (262 patients total: 134 BPA, 128 riociguat) using random-effects models and checked consistency with I² and leave-one-out tests. Compared to riociguat, BPA reduced mean pulmonary arterial pressure by 12.23 mm Hg (95% CI, 15.32-9.15; I² = 82%), pulmonary vascular resistance by 208.58 dyn·s/cm⁵ (95% CI, 299.85-117.32; I² = 87%), right atrial pressure by 2.18 mm Hg (95% CI, 3.13-1.23; I² = 66%), and NT-proBNP by 989.61 pg/mL (95% CI, 1456.66-522.55; I² = 0%) (all P < 0.0001). Riociguat led to a larger increase in cardiac output (0.47 L/min; 95% CI, 0.37-0.58; I² = 0%; P < 0.00001). Removing the Kawakami trial eliminated heterogeneity (I² = 0%). Both treatments were similarly safe. In summary, BPA delivers stronger pressure and biomarker improvements, while riociguat better boosts heart output. Combining or sequencing these treatments deserves further study in larger trials.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211920","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}