Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101684
Milan Jaiswal BA , Lucas Ribe MD , Rana O. Afifi MD , Yuki Ikeno MD , Alana C. Cecchi MS , Bihong Zhao MD, PhD , Akiko Tanaka MD, PhD , Gustavo S. Oderich MD , L. Maximilian Buja MD , Dianna M. Milewicz MD, PhD , Siddharth K. Prakash MD, PhD , Anthony L. Estrera MD
Heritable thoracic aortic disease is caused by dominantly inherited mutations in more than a dozen genes, including TGFB2 mutations that cause Loeys-Dietz syndrome. McGovern Medical School at UTHealth Houston convenes a regular conference that includes cardiothoracic and vascular surgeons, cardiologists, geneticists, radiologists, and pathologists to formulate multidisciplinary approaches for the management of complex heritable thoracic aortic disease cases. In this report, we highlight the unique management of individuals with distinct presentations of Loeys-Dietz syndrome owing to TGFB2 mutations.
{"title":"Case studies in heritable vascular disease: Proceedings of the UTHealth Houston Multidisciplinary Aortic Conference","authors":"Milan Jaiswal BA , Lucas Ribe MD , Rana O. Afifi MD , Yuki Ikeno MD , Alana C. Cecchi MS , Bihong Zhao MD, PhD , Akiko Tanaka MD, PhD , Gustavo S. Oderich MD , L. Maximilian Buja MD , Dianna M. Milewicz MD, PhD , Siddharth K. Prakash MD, PhD , Anthony L. Estrera MD","doi":"10.1016/j.jvscit.2024.101684","DOIUrl":"10.1016/j.jvscit.2024.101684","url":null,"abstract":"<div><div>Heritable thoracic aortic disease is caused by dominantly inherited mutations in more than a dozen genes, including <em>TGFB2</em> mutations that cause Loeys-Dietz syndrome. McGovern Medical School at UTHealth Houston convenes a regular conference that includes cardiothoracic and vascular surgeons, cardiologists, geneticists, radiologists, and pathologists to formulate multidisciplinary approaches for the management of complex heritable thoracic aortic disease cases. In this report, we highlight the unique management of individuals with distinct presentations of Loeys-Dietz syndrome owing to <em>TGFB2</em> mutations.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101684"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932739","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101676
Bohyun Ro MSc , John P. Spence BBA , Paul A. Spence MD , Christian Buckley BS , Raghu L. Motaganahalli MD , Bruno T. Roseguini PhD
People with symptomatic lower extremity peripheral artery disease (PAD) suffer from severe leg pain, walking impairment, and reduced quality of life, but few effective treatments are available. Emerging evidence suggests that regular heat therapy (HT) may improve cardiovascular and physical function in patients with PAD. However, the lack of accessible, practical modalities for unsupervised HT, especially for elderly individuals, has hindered clinical implementation. The goals of this study were to design and assess the feasibility of a portable leg HT system for elderly patients with PAD. Building on a cryotherapy water-circulating device used in sports recovery, we developed a new prototype system consisting of a single-touch controller unit integrating a heater, water pump, and air pump, and leg sleeves with inner-layer water-circulating pads and an outer layer of inflatable bladders. The system was designed to ensure efficient heat transfer through gentle pneumatic inflation, adapting to varying limb dimensions. Safety features included temperature sensors with auto shut-off and a built-in timer. The prototype's feasibility and safety were evaluated in a single-arm pilot trial with six symptomatic patients with PAD, who were asked to apply the therapy daily for 90 minutes for 12 weeks. Primary outcomes included completion rates, safety, and device usability. Secondary outcomes were changes in blood pressure, 6-minute walk distance, calf strength, sit-to-stand performance, and quality of life. Participants underwent a 90-minute supervised treatment session with the prototype HT units to assess the acute physiological responses before starting the 12-week intervention. Leg HT gradually increased leg skin temperature from 33.8 ± 0.8°C to 38.7 ± 0.7°C at 90 minutes and reduced arterial blood pressure, with mean reductions of 13 mm Hg in systolic and 12 mm Hg in diastolic blood pressure after treatment. All participants completed the 12-week program without serious adverse events, indicating that leg HT is safe and well-tolerated. The 6-minute walk distance improved by an average of 32 m, coupled with increased calf muscle strength and reduced time for the sit-to-stand test. Improvements were also observed in self-reported walking speed and quality of life. This study represents the first step in developing a portable leg heating system for elderly patients with PAD, demonstrating that home-based leg HT is feasible and safe. However, further engineering refinements are needed to enhance portability, simplify application, and encourage long-term adherence. Developing methods to track compliance with the treatment regimen will be crucial for the success of this unsupervised, home-based therapy.
有症状的下肢外周动脉疾病（PAD）患者患有严重的腿部疼痛、行走障碍和生活质量下降，但很少有有效的治疗方法。新出现的证据表明，定期热疗法（HT）可以改善PAD患者的心血管和身体功能。然而，缺乏可获得的、实用的无监督HT治疗方式，特别是对老年人，阻碍了临床实施。本研究的目的是设计和评估便携式腿部HT系统用于老年PAD患者的可行性。在运动恢复中使用的冷冻水循环装置的基础上，我们开发了一个新的原型系统，包括一个单触控单元，集成了加热器、水泵和气泵，以及带有内层水循环垫和外层充气膀胱的腿套。该系统旨在通过温和的气动膨胀确保有效的传热，适应不同的肢体尺寸。安全功能包括具有自动关闭功能的温度传感器和内置计时器。该原型的可行性和安全性在一项单臂试验中进行了评估，6名有症状的PAD患者被要求在12周内每天应用90分钟的治疗。主要结局包括完成率、安全性和设备可用性。次要结果是血压、6分钟步行距离、小腿力量、坐立表现和生活质量的变化。在开始为期12周的干预之前，参与者接受了90分钟的监督治疗，使用原型高温疗法单元评估急性生理反应。腿部HT在90分钟内逐渐使腿部皮肤温度从33.8±0.8℃升高到38.7±0.7℃，动脉血压降低，治疗后收缩压平均降低13 mm Hg，舒张压平均降低12 mm Hg。所有参与者完成了12周的计划，没有严重的不良事件，表明腿部HT是安全且耐受性良好的。6分钟的步行距离平均提高了32米，同时增加了小腿肌肉力量，减少了坐立测试的时间。自我报告的步行速度和生活质量也有所改善。本研究是为老年PAD患者开发便携式腿部加热系统的第一步，证明了基于家庭的腿部热疗是可行和安全的。然而，需要进一步的工程改进来增强可移植性，简化应用程序，并鼓励长期遵守。开发跟踪治疗方案依从性的方法对于这种无监督的家庭治疗的成功至关重要。
{"title":"Development and feasibility testing of a new device for home-based leg heat therapy in patients with lower extremity peripheral artery disease","authors":"Bohyun Ro MSc , John P. Spence BBA , Paul A. Spence MD , Christian Buckley BS , Raghu L. Motaganahalli MD , Bruno T. Roseguini PhD","doi":"10.1016/j.jvscit.2024.101676","DOIUrl":"10.1016/j.jvscit.2024.101676","url":null,"abstract":"<div><div>People with symptomatic lower extremity peripheral artery disease (PAD) suffer from severe leg pain, walking impairment, and reduced quality of life, but few effective treatments are available. Emerging evidence suggests that regular heat therapy (HT) may improve cardiovascular and physical function in patients with PAD. However, the lack of accessible, practical modalities for unsupervised HT, especially for elderly individuals, has hindered clinical implementation. The goals of this study were to design and assess the feasibility of a portable leg HT system for elderly patients with PAD. Building on a cryotherapy water-circulating device used in sports recovery, we developed a new prototype system consisting of a single-touch controller unit integrating a heater, water pump, and air pump, and leg sleeves with inner-layer water-circulating pads and an outer layer of inflatable bladders. The system was designed to ensure efficient heat transfer through gentle pneumatic inflation, adapting to varying limb dimensions. Safety features included temperature sensors with auto shut-off and a built-in timer. The prototype's feasibility and safety were evaluated in a single-arm pilot trial with six symptomatic patients with PAD, who were asked to apply the therapy daily for 90 minutes for 12 weeks. Primary outcomes included completion rates, safety, and device usability. Secondary outcomes were changes in blood pressure, 6-minute walk distance, calf strength, sit-to-stand performance, and quality of life. Participants underwent a 90-minute supervised treatment session with the prototype HT units to assess the acute physiological responses before starting the 12-week intervention. Leg HT gradually increased leg skin temperature from 33.8 ± 0.8°C to 38.7 ± 0.7°C at 90 minutes and reduced arterial blood pressure, with mean reductions of 13 mm Hg in systolic and 12 mm Hg in diastolic blood pressure after treatment. All participants completed the 12-week program without serious adverse events, indicating that leg HT is safe and well-tolerated. The 6-minute walk distance improved by an average of 32 m, coupled with increased calf muscle strength and reduced time for the sit-to-stand test. Improvements were also observed in self-reported walking speed and quality of life. This study represents the first step in developing a portable leg heating system for elderly patients with PAD, demonstrating that home-based leg HT is feasible and safe. However, further engineering refinements are needed to enhance portability, simplify application, and encourage long-term adherence. Developing methods to track compliance with the treatment regimen will be crucial for the success of this unsupervised, home-based therapy.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101676"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932832","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101673
Morgan Colling BS , Yousef Souri MD , Thomas Reifsnyder MD
Thromboangiitis obliterans (TAO) is an inflammatory vasculopathy that often presents in young men with substantial tobacco use. Cannabis arteritis is the cannabis-associated counterpart, but there remains controversy over its classification due to overwhelming concurrent tobacco use. A 31-year-old man developed lifestyle-limiting claudication that coincided with vaping high-potency tetrahydrocannabinol. Notably, his tobacco exposure was limited to a remote history of <1 pack-year. His claudication considerably improved after 4 weeks of cannabis cessation. This case demonstrates a rare instance of cannabis arteritis without concurrent tobacco use, suggesting cannabis may act as an independent causative agent of a distinct thromboangiitis obliterans-like arteritis.
{"title":"Tetrahydrocannabinol vape-associated cannabis arteritis in a patient with minimal tobacco exposure","authors":"Morgan Colling BS , Yousef Souri MD , Thomas Reifsnyder MD","doi":"10.1016/j.jvscit.2024.101673","DOIUrl":"10.1016/j.jvscit.2024.101673","url":null,"abstract":"<div><div>Thromboangiitis obliterans (TAO) is an inflammatory vasculopathy that often presents in young men with substantial tobacco use. Cannabis arteritis is the cannabis-associated counterpart, but there remains controversy over its classification due to overwhelming concurrent tobacco use. A 31-year-old man developed lifestyle-limiting claudication that coincided with vaping high-potency tetrahydrocannabinol. Notably, his tobacco exposure was limited to a remote history of <1 pack-year. His claudication considerably improved after 4 weeks of cannabis cessation. This case demonstrates a rare instance of cannabis arteritis without concurrent tobacco use, suggesting cannabis may act as an independent causative agent of a distinct thromboangiitis obliterans-like arteritis.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101673"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847908","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}
Pub Date : 2025-02-01DOI: 10.1016/S2468-4287(25)00005-X
{"title":"Events of Interest","authors":"","doi":"10.1016/S2468-4287(25)00005-X","DOIUrl":"10.1016/S2468-4287(25)00005-X","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101723"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143177179","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101682
Patrick D. Conroy MD , Jennifer Li MD , Allen Hamdan MD
Iliac artery aneurysms commonly present in patients with associated aortic disease. Isolated aneurysms of the iliac arteries are uncommon, mostly involving the common iliac artery. Isolated external iliac artery aneurysms are the rarest iliac aneurysmal pathology. We present the case of an asymptomatic isolated external iliac artery aneurysm with no other concomitant vascular disease in a middle-aged man, treated with a stent graft.
{"title":"Isolated external iliac artery aneurysm in a patient without any concomitant vascular disease","authors":"Patrick D. Conroy MD , Jennifer Li MD , Allen Hamdan MD","doi":"10.1016/j.jvscit.2024.101682","DOIUrl":"10.1016/j.jvscit.2024.101682","url":null,"abstract":"<div><div>Iliac artery aneurysms commonly present in patients with associated aortic disease. Isolated aneurysms of the iliac arteries are uncommon, mostly involving the common iliac artery. Isolated external iliac artery aneurysms are the rarest iliac aneurysmal pathology. We present the case of an asymptomatic isolated external iliac artery aneurysm with no other concomitant vascular disease in a middle-aged man, treated with a stent graft.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101682"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933009","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}
Type II endoleaks after en`dovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypogastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve.
{"title":"Perioperative and mid-term results of trans-graft embolization of the hypogastric artery for treatment of type II endoleaks after endovascular aortic repair with off-label use of re-entry catheters","authors":"Filippo Griselli MD , Alessia D’Andrea MD , Sandro Lepidi MD , Beatrice Grando MD , Giovanni Badalamenti MD , Mario D’Oria MD","doi":"10.1016/j.jvscit.2024.101674","DOIUrl":"10.1016/j.jvscit.2024.101674","url":null,"abstract":"<div><div>Type II endoleaks after en`dovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypogastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101674"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847901","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101677
Michelle Mendiola Pla MD, MHSc , Bryan Bennett DO , Yonjae Kim MD , Jack R. Chamberlin MD , Atif Baqai MD
We present two cases where a transradial-based approach was used to implant thoracic branch aortic endografts to repair aortic aneurysms totally percutaneously. Both procedures were performed electively at a 330-bed suburban community hospital. No complications were associated with either procedure with both patients only requiring overnight observation and being discharged home the next day. With careful patient selection, the transradial through-and-through approach for thoracic endovascular aortic repair using the Gore Thoracic Branch Endoprosthesis provides a totally percutaneous option that can be performed feasibly and safely within a community hospital setting.
{"title":"Transradial-based thoracic branch endograft repair for thoracic aortic aneurysms experience at a suburban community hospital","authors":"Michelle Mendiola Pla MD, MHSc , Bryan Bennett DO , Yonjae Kim MD , Jack R. Chamberlin MD , Atif Baqai MD","doi":"10.1016/j.jvscit.2024.101677","DOIUrl":"10.1016/j.jvscit.2024.101677","url":null,"abstract":"<div><div>We present two cases where a transradial-based approach was used to implant thoracic branch aortic endografts to repair aortic aneurysms totally percutaneously. Both procedures were performed electively at a 330-bed suburban community hospital. No complications were associated with either procedure with both patients only requiring overnight observation and being discharged home the next day. With careful patient selection, the transradial through-and-through approach for thoracic endovascular aortic repair using the Gore Thoracic Branch Endoprosthesis provides a totally percutaneous option that can be performed feasibly and safely within a community hospital setting.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101677"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847925","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jvscit.2024.101661
Cyrus J. Darvish BS , Nicholas P. Lagerman MS , Oldrich Virag BS , Hannah Parks BS , Yash K. Pandya MD , Mohammad H. Eslami MD , David A. Vorp PhD , Timothy K. Chung PhD
Abdominal aortic aneurysm (AAA) is the focal dilation of the terminal aorta, which can lead to rupture if left untreated. Traditional endovascular aneurysm repair techniques are minimally invasive and pose low mortality rates compared with open surgical repair; however, endovascular aneurysm repair procedures face challenges in accommodating variations in the patient's anatomy. Complex aneurysms are defined when the sac extends past the renal arteries or has an insufficient neck landing zone to deploy a traditional endograft. Fenestrated endografts were introduced to enable the repair of complex aneurysms by the creation of fenestrations to enable blood flow into the visceral arteries. This study investigates proof of concept for creating antegrade in situ fenestrations of off-the-shelf endografts using a novel endovascular orifice detection device. Our technique enables the precise location of the visceral artery orifices using fiber optic cables and an infrared light source. The endovascular orifice detection device was tested rigorously in precisely locating an artery opening in blood and a custom AAA phantom model. The study also explored the safest means of creating a fenestration using mechanical puncture and a laser. This innovative approach offers a viable alternative for patients with complex AAAs.
{"title":"Development of a method to achieve antegrade in situ fenestration of endovascular stent grafts in abdominal aortic aneurysms","authors":"Cyrus J. Darvish BS , Nicholas P. Lagerman MS , Oldrich Virag BS , Hannah Parks BS , Yash K. Pandya MD , Mohammad H. Eslami MD , David A. Vorp PhD , Timothy K. Chung PhD","doi":"10.1016/j.jvscit.2024.101661","DOIUrl":"10.1016/j.jvscit.2024.101661","url":null,"abstract":"<div><div>Abdominal aortic aneurysm (AAA) is the focal dilation of the terminal aorta, which can lead to rupture if left untreated. Traditional endovascular aneurysm repair techniques are minimally invasive and pose low mortality rates compared with open surgical repair; however, endovascular aneurysm repair procedures face challenges in accommodating variations in the patient's anatomy. Complex aneurysms are defined when the sac extends past the renal arteries or has an insufficient neck landing zone to deploy a traditional endograft. Fenestrated endografts were introduced to enable the repair of complex aneurysms by the creation of fenestrations to enable blood flow into the visceral arteries. This study investigates proof of concept for creating antegrade in situ fenestrations of off-the-shelf endografts using a novel endovascular orifice detection device. Our technique enables the precise location of the visceral artery orifices using fiber optic cables and an infrared light source. The endovascular orifice detection device was tested rigorously in precisely locating an artery opening in blood and a custom AAA phantom model. The study also explored the safest means of creating a fenestration using mechanical puncture and a laser. This innovative approach offers a viable alternative for patients with complex AAAs.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 1","pages":"Article 101661"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856034","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}
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