Pub Date : 2026-03-01Epub Date: 2025-12-03DOI: 10.1016/j.hrtlng.2025.11.022
Eline te Braake , Christiane Grünloh , Monique Tabak
Introduction
Chronic Obstructive Pulmonary Disease (COPD) is an incurable chronic disease, and self-management is often used to support patients. Current research often targets clinical aspects, while actual self-management is performed by the patient at home. However, little is known about the patient experience.
Objectives
This research identifies which self-management strategies people with COPD apply and what the facilitators and barriers are to adopting these. Specific attention is given to the recruitment approach, aiming to increase response rates and the generalizability of the self-management model.
Methods
A self-management survey developed for people with rheumatic and musculoskeletal diseases (RMDs) was adapted for COPD, pilot-tested, and disseminated via traditional (e.g., via email) and enhanced (e.g., offline support) recruitment routes. Anonymized responses were deductively coded, using the self-management model for RMDs and the model of positive health.
Results
From 33 respondents, 152 self-management strategies were identified. All strategies could be categorised using the self-management model. ‘Physical activity’ was the most common category. Motivations to start a strategy are mostly derived from the ‘bodily functioning dimension’. Participants reported 122 facilitators and 41 barriers, such as ‘time’ and ‘support’. Passive approaches, in which participants themselves have to sign up, to improve response rates, were not substantial.
Conclusion
People with COPD perform diverse self-management strategies. These efforts may not always be visible in the clinical setting, as these are often initiated by one’s search journey and thus are additional to standard Healthcare Professionals´ (HCP) advice. Future research should investigate alternative approaches to reach the wider COPD population.
{"title":"Identifying the self-management strategies of people with chronic obstructive pulmonary disease in their daily lives: A qualitative survey","authors":"Eline te Braake , Christiane Grünloh , Monique Tabak","doi":"10.1016/j.hrtlng.2025.11.022","DOIUrl":"10.1016/j.hrtlng.2025.11.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic Obstructive Pulmonary Disease (COPD) is an incurable chronic disease, and self-management is often used to support patients. Current research often targets clinical aspects, while actual self-management is performed by the patient at home. However, little is known about the patient experience.</div></div><div><h3>Objectives</h3><div>This research identifies which self-management strategies people with COPD apply and what the facilitators and barriers are to adopting these. Specific attention is given to the recruitment approach, aiming to increase response rates and the generalizability of the self-management model.</div></div><div><h3>Methods</h3><div>A self-management survey developed for people with rheumatic and musculoskeletal diseases (RMDs) was adapted for COPD, pilot-tested, and disseminated via traditional (e.g., via email) and enhanced (e.g., offline support) recruitment routes. Anonymized responses were deductively coded, using the self-management model for RMDs and the model of positive health.</div></div><div><h3>Results</h3><div>From 33 respondents, 152 self-management strategies were identified. All strategies could be categorised using the self-management model. ‘Physical activity’ was the most common category. Motivations to start a strategy are mostly derived from the ‘bodily functioning dimension’. Participants reported 122 facilitators and 41 barriers, such as ‘time’ and ‘support’. Passive approaches, in which participants themselves have to sign up, to improve response rates, were not substantial.</div></div><div><h3>Conclusion</h3><div>People with COPD perform diverse self-management strategies. These efforts may not always be visible in the clinical setting, as these are often initiated by one’s search journey and thus are additional to standard Healthcare Professionals´ (HCP) advice. Future research should investigate alternative approaches to reach the wider COPD population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 124-131"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679675","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}
Pub Date : 2026-03-01Epub Date: 2025-12-05DOI: 10.1016/j.hrtlng.2025.11.023
Bilge Gore PT, MSc, Aynur Demirel PhD
Background
Inspiratory muscle training (IMT) is a component of the pulmonary rehabilitation(PR) program for patients with chronic lung disease.
Objectives
This systematic review aimed to determine the effects of IMT on respiratory muscle strength, functional exercise capacity, dyspnea, quality of life (QoL), lung functions, and diffusion capacity (DLCO) in patients with Interstitial Lung Disease (ILD).
Methods
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Publications from inception to 2025 were searched using MeSH terms across six databases. The titles and abstracts of the studies were screened via Rayyan-AI software by two independent authors. After full-text screening, randomized controlled trials that met the inclusion criteria were included.
Results
According to mesh terms, 9020 articles were identified at baseline. After the screening, duplicate articles removed, and three randomized controlled trials were included. Finally, A total of 109 patients with ILD were included.Although only 3 studies were included in this systematic review, the evidence level for IMT on functional exercise capacity, dyspnea and inspiratory muscle strength was strong and no effect on lung functions and DLCO in patients with ILD. Additionally, there is conflicting evidence regarding the improvement in QoL, with limited evidence of the progress in expiratory muscle strength.
Conclusion
Considering the small number of articles included in this systematic review, IMT programs lasting ≥6 weeks appear beneficial and safe for improving respiratory muscle strength, dyspnea, and functional exercise capacity. However, more rigorous studies are needed to confirm these benefits.
{"title":"Effects of respiratory muscle training in patients with interstitial lung diseases: Systematic review","authors":"Bilge Gore PT, MSc, Aynur Demirel PhD","doi":"10.1016/j.hrtlng.2025.11.023","DOIUrl":"10.1016/j.hrtlng.2025.11.023","url":null,"abstract":"<div><h3>Background</h3><div>Inspiratory muscle training <strong>(</strong>IMT) is a component of the pulmonary rehabilitation(PR) program for patients with chronic lung disease.</div></div><div><h3>Objectives</h3><div>This systematic review aimed to determine the effects of IMT on respiratory muscle strength, functional exercise capacity, dyspnea, quality of life (QoL), lung functions, and diffusion capacity (DLCO) in patients with Interstitial Lung Disease (ILD).</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Publications from inception to 2025 were searched using MeSH terms across six databases. The titles and abstracts of the studies were screened via Rayyan-AI software by two independent authors. After full-text screening, randomized controlled trials that met the inclusion criteria were included.</div></div><div><h3>Results</h3><div>According to mesh terms, 9020 articles were identified at baseline. After the screening, duplicate articles removed, and three randomized controlled trials were included. Finally, A total of 109 patients with ILD were included.Although only 3 studies were included in this systematic review, the evidence level for IMT on functional exercise capacity, dyspnea and inspiratory muscle strength was strong and no effect on lung functions and DLCO in patients with ILD. Additionally, there is conflicting evidence regarding the improvement in QoL, with limited evidence of the progress in expiratory muscle strength.</div></div><div><h3>Conclusion</h3><div>Considering the small number of articles included in this systematic review, IMT programs lasting ≥6 weeks appear beneficial and safe for improving respiratory muscle strength, dyspnea, and functional exercise capacity. However, more rigorous studies are needed to confirm these benefits.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 132-138"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693551","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}
Pub Date : 2026-03-01Epub Date: 2025-11-17DOI: 10.1016/j.hrtlng.2025.11.011
Yaping Deng MSN, RN , Junyan Zheng BSN, RN , Lengmeng Wang MSN, RN , Xi Cao PhD, RN (Associate Professor)
Background
Sedentary behavior is associated with poor health outcomes in elderly populations. However, the profile of sedentary behavior and its associated factors among older adults with hypertension—a subgroup particularly vulnerable to adverse health outcomes is less understood. It is crucial to identify these factors to develop effective interventions that improve health outcomes in this high-risk subgroup.
Objective
To investigate the sedentary behavior profile and its determinants in the elderly with hypertension.
Methods
This cross-sectional study included a total of 330 older adults (aged ≥ 60 years) with hypertension who were recruited from a tertiary hospital in Guangzhou from October 2022 to May 2023. Data on sedentary behavior, exercise self-efficacy, exercise social support, and community walking environment were collected in addition to sociodemographic and clinical data. Multiple linear regression analyses were performed to identify factors associated with sedentary behavior.
Results
The participants spent an average of 7.4 ± 1.86 hours/day engaged in sedentary behavior. Screen time was the most frequently reported sedentary activity, with an average of 4.3 ± 2.09 hours spent on screens per day. Multiple linear regression analysis revealed that exercise self-efficacy (B = -0.03, P < 0.001), exercise social support (B = -0.03, P = 0.001), community walking environment (B = -0.03, P = 0.045) were negatively associated with total sedentary time. Those who were male, had higher education levels, had uncontrolled blood pressure, and had more comorbidities reported more total sedentary time.
Conclusion
Sedentary behavior is highly prevalent among older adults with hypertension. Exercise self-efficacy, exercise social support, and the lack of a community walking environment were associated with sedentary time, which provides clues for developing targeted interventions to reduce sedentary time for this high-risk population.
背景：久坐行为与老年人健康状况不佳有关。然而，老年人高血压患者的久坐行为及其相关因素的概况-一个特别容易产生不良健康结果的亚组-尚不清楚。确定这些因素对于制定有效的干预措施以改善这一高危亚群的健康结果至关重要。目的：探讨老年高血压患者的久坐行为特征及其影响因素。方法：本横断面研究纳入了2022年10月至2023年5月在广州某三级医院招募的330名高血压老年人（年龄≥60岁）。除了社会人口学和临床数据外，还收集了久坐行为、运动自我效能、运动社会支持和社区步行环境的数据。进行多元线性回归分析以确定与久坐行为相关的因素。结果：参与者平均每天花7.4±1.86小时从事久坐行为。屏幕时间是最常见的久坐活动，平均每天花在屏幕上的时间为4.3±2.09小时。多元线性回归分析显示，运动自我效能感（B = -0.03, P < 0.001）、运动社会支持（B = -0.03, P = 0.001）、社区步行环境（B = -0.03, P = 0.045）与总久坐时间呈负相关。那些受教育程度较高、血压不受控制、有更多合并症的男性报告了更多的久坐时间。结论：久坐行为在老年高血压患者中非常普遍。运动自我效能感、运动社会支持和缺乏社区步行环境与久坐时间有关，这为开发有针对性的干预措施以减少这一高危人群的久坐时间提供了线索。
{"title":"Sedentary behavior and its determinants among Chinese older adults with hypertension: A cross-sectional study","authors":"Yaping Deng MSN, RN , Junyan Zheng BSN, RN , Lengmeng Wang MSN, RN , Xi Cao PhD, RN (Associate Professor)","doi":"10.1016/j.hrtlng.2025.11.011","DOIUrl":"10.1016/j.hrtlng.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Sedentary behavior is associated with poor health outcomes in elderly populations. However, the profile of sedentary behavior and its associated factors among older adults with hypertension—a subgroup particularly vulnerable to adverse health outcomes is less understood. It is crucial to identify these factors to develop effective interventions that improve health outcomes in this high-risk subgroup.</div></div><div><h3>Objective</h3><div>To investigate the sedentary behavior profile and its determinants in the elderly with hypertension.</div></div><div><h3>Methods</h3><div>This cross-sectional study included a total of 330 older adults (aged ≥ 60 years) with hypertension who were recruited from a tertiary hospital in Guangzhou from October 2022 to May 2023. Data on sedentary behavior, exercise self-efficacy, exercise social support, and community walking environment were collected in addition to sociodemographic and clinical data. Multiple linear regression analyses were performed to identify factors associated with sedentary behavior.</div></div><div><h3>Results</h3><div>The participants spent an average of 7.4 ± 1.86 hours/day engaged in sedentary behavior. Screen time was the most frequently reported sedentary activity, with an average of 4.3 ± 2.09 hours spent on screens per day. Multiple linear regression analysis revealed that exercise self-efficacy (<em>B</em> = -0.03, <em>P</em> < 0.001), exercise social support (<em>B</em> = -0.03, <em>P</em> = 0.001), community walking environment (<em>B</em> = -0.03, <em>P</em> = 0.045) were negatively associated with total sedentary time. Those who were male, had higher education levels, had uncontrolled blood pressure, and had more comorbidities reported more total sedentary time.</div></div><div><h3>Conclusion</h3><div>Sedentary behavior is highly prevalent among older adults with hypertension. Exercise self-efficacy, exercise social support, and the lack of a community walking environment were associated with sedentary time, which provides clues for developing targeted interventions to reduce sedentary time for this high-risk population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 40-46"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551912","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}
Pub Date : 2026-03-01Epub Date: 2025-11-30DOI: 10.1016/j.hrtlng.2025.11.006
Wenwen Yan , Li Peng , Jian Zhang , Zheng Liu , Heling Zhao
Background
Acute respiratory distress syndrome (ARDS) remains a life-threatening condition in critically ill patients. Chest wall loading has been proposed as a potential intervention to improve respiratory mechanics in specific ARDS phenotypes, but evidence from large cohorts is lacking.
Objectives
This study aimed to investigate the effects of acute chest wall loading on respiratory mechanics in patients with low-compliance ARDS.
Methods
A prospective study included 76 patients with severe pneumonia-induced ARDS (PaO2/FiO2 ≤150, Crs ≤35 mL/cmH2O). A 5 kg sandbag was applied to the anterior chest wall in the supine position. Respiratory mechanics (respiratory system compliance-Crs, plateau pressure-Pplat, driving pressure-DP, intrinsic and total PEEP), hemodynamic parameters (heart rate-HR, mean arterial pressure-MAP), and oxygenation index (PaO2/FiO2) were measured before and 30 min after loading. Ventilator settings remained unchanged.
Results
Chest wall loading significantly improved respiratory system compliance (median increase 4.8 mL/cmH2O, P < 0.001) and reduced both plateau pressure (median decrease 2.1 cmH2O, P < 0.001) and driving pressure (median decrease 2.3 cmH2O, P < 0.001). No significant changes occurred in HR, MAP, or PaO2/FiO2. Improvements were more pronounced in patients with lower baseline compliance (Spearman's ρ = -0.420, P < 0.001).
Conclusion
Acute chest wall loading with a 5 kg sandbag significantly improves respiratory mechanics in low-compliance ARDS patients by enhancing compliance and reducing plateau and driving pressures, without compromising hemodynamics or oxygenation. This simple intervention may serve as a useful adjunct to lung-protective ventilation in this subset of patients.
背景急性呼吸窘迫综合征（ARDS）在危重患者中仍然是危及生命的疾病。胸壁负荷被认为是一种潜在的干预措施，可以改善特定ARDS表型的呼吸力学，但缺乏大型队列的证据。目的探讨急性胸壁负荷对低顺应性ARDS患者呼吸力学的影响。方法对76例急性肺炎性ARDS （PaO2/FiO2≤150,Crs≤35 mL/cmH2O）患者进行前瞻性研究。取仰卧位，前胸壁敷5 kg沙袋。测量呼吸力学（呼吸系统顺应性- crs、平台压- pplat、驱动压- dp、内在PEEP和总PEEP）、血流动力学参数（心率- hr、平均动脉压- map）和氧合指数（PaO2/FiO2）。通风机设置保持不变。结果测试壁负荷显著改善呼吸系统顺应性（中位数增加4.8 mL/cmH2O, P < 0.001），降低平台压（中位数减少2.1 cmH2O, P < 0.001）和驱动压（中位数减少2.3 cmH2O, P < 0.001）。HR、MAP、PaO2/FiO2均无明显变化。基线依从性较低的患者改善更为明显（Spearman ρ = -0.420, P < 0.001）。结论5kg沙袋急性胸壁负荷可显著改善低顺应性ARDS患者的呼吸力学，增强顺应性，降低平台压和驱动压，而不影响血流动力学和氧合。这种简单的干预可以作为这类患者肺保护性通气的有用辅助。
{"title":"Effects of chest wall loading in supine position on respiratory mechanics in low-compliance ARDS patients","authors":"Wenwen Yan , Li Peng , Jian Zhang , Zheng Liu , Heling Zhao","doi":"10.1016/j.hrtlng.2025.11.006","DOIUrl":"10.1016/j.hrtlng.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Acute respiratory distress syndrome (ARDS) remains a life-threatening condition in critically ill patients. Chest wall loading has been proposed as a potential intervention to improve respiratory mechanics in specific ARDS phenotypes, but evidence from large cohorts is lacking.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the effects of acute chest wall loading on respiratory mechanics in patients with low-compliance ARDS.</div></div><div><h3>Methods</h3><div>A prospective study included 76 patients with severe pneumonia-induced ARDS (PaO2/FiO2 ≤150, Crs ≤35 mL/cmH2O). A 5 kg sandbag was applied to the anterior chest wall in the supine position. Respiratory mechanics (respiratory system compliance-Crs, plateau pressure-Pplat, driving pressure-DP, intrinsic and total PEEP), hemodynamic parameters (heart rate-HR, mean arterial pressure-MAP), and oxygenation index (PaO2/FiO2) were measured before and 30 min after loading. Ventilator settings remained unchanged.</div></div><div><h3>Results</h3><div>Chest wall loading significantly improved respiratory system compliance (median increase 4.8 mL/cmH2O, <em>P</em> < 0.001) and reduced both plateau pressure (median decrease 2.1 cmH2O, <em>P</em> < 0.001) and driving pressure (median decrease 2.3 cmH2O, <em>P</em> < 0.001). No significant changes occurred in HR, MAP, or PaO2/FiO2. Improvements were more pronounced in patients with lower baseline compliance (Spearman's ρ = -0.420, <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Acute chest wall loading with a 5 kg sandbag significantly improves respiratory mechanics in low-compliance ARDS patients by enhancing compliance and reducing plateau and driving pressures, without compromising hemodynamics or oxygenation. This simple intervention may serve as a useful adjunct to lung-protective ventilation in this subset of patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"98"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624710","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}
Pub Date : 2026-03-01Epub Date: 2025-11-21DOI: 10.1016/j.hrtlng.2025.11.009
Kelley M Anderson, Sarah E Schroeder, Robert J DiDomenico, Salvatore Carbone, Carol Barsness, Quin E Denfeld, Alexandra L McPherson, Amanda Bergeron, Windy W Alonso, Christine M Hallman, Carolyn Lekavich, Linda Rohyans
Cardiac cachexia is a complex and multifactorial syndrome in patients with heart failure (HF). Cardiac cachexia is associated with poor functional status, symptoms, increased hospitalizations, and psychosocial effects. Despite its significant association with morbidity and mortality, cardiac cachexia remains under-recognized and undertreated. This scientific statement provides a comprehensive overview of the contemporary understanding of cardiac cachexia by detailing the definition, prevalence, prognostic implications, mechanisms, clinical manifestations, diagnostic strategies, treatment modalities, and recommendations for future clinical and research considerations. The development of cardiac cachexia is an indication of advanced serious illness. Diagnostic challenges persist due to the heterogeneous condition of HF, fluid imbalances that may mask or mimic weight changes, and the lack of definitive diagnostic evaluation. While no standard treatment exists, a multidisciplinary approach combining nutritional support, physical activity, and pharmacologic management is recommended. Greater clinical awareness and early identification of cardiac cachexia are essential for improving outcomes in patients with HF. Future research recommendations include prioritizing clinical trials that specifically evaluate cardiac cachexia within the context of HF to develop comprehensive treatment strategies targeting catabolic and anabolic pathways, and the associated psychosocial manifestations of the conditions.
{"title":"Cardiac cachexia: A scientific statement from the American Association of Heart Failure Nurses (AAHFN).","authors":"Kelley M Anderson, Sarah E Schroeder, Robert J DiDomenico, Salvatore Carbone, Carol Barsness, Quin E Denfeld, Alexandra L McPherson, Amanda Bergeron, Windy W Alonso, Christine M Hallman, Carolyn Lekavich, Linda Rohyans","doi":"10.1016/j.hrtlng.2025.11.009","DOIUrl":"10.1016/j.hrtlng.2025.11.009","url":null,"abstract":"<p><p>Cardiac cachexia is a complex and multifactorial syndrome in patients with heart failure (HF). Cardiac cachexia is associated with poor functional status, symptoms, increased hospitalizations, and psychosocial effects. Despite its significant association with morbidity and mortality, cardiac cachexia remains under-recognized and undertreated. This scientific statement provides a comprehensive overview of the contemporary understanding of cardiac cachexia by detailing the definition, prevalence, prognostic implications, mechanisms, clinical manifestations, diagnostic strategies, treatment modalities, and recommendations for future clinical and research considerations. The development of cardiac cachexia is an indication of advanced serious illness. Diagnostic challenges persist due to the heterogeneous condition of HF, fluid imbalances that may mask or mimic weight changes, and the lack of definitive diagnostic evaluation. While no standard treatment exists, a multidisciplinary approach combining nutritional support, physical activity, and pharmacologic management is recommended. Greater clinical awareness and early identification of cardiac cachexia are essential for improving outcomes in patients with HF. Future research recommendations include prioritizing clinical trials that specifically evaluate cardiac cachexia within the context of HF to develop comprehensive treatment strategies targeting catabolic and anabolic pathways, and the associated psychosocial manifestations of the conditions.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":" ","pages":"174-189"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582581","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}
Pub Date : 2026-03-01Epub Date: 2025-11-22DOI: 10.1016/j.hrtlng.2025.11.010
Sang Hyuk Kim , Chin Kook Rhee , Won-Yeon Lee , Sang-Hoon Kim , Seong Yong Lim , Hye Yun Park , Hyoung Kyu Yoon , Kwang Ha Yoo , Kyung Hoon Min , Youlim Kim
Background
High blood eosinophil counts correlate with the risk of future exacerbations. It is uncertain whether this correlation is still valid even in stable chronic obstructive pulmonary disease (COPD) patients receiving optimal management.
Objectives
To evaluate whether increased blood eosinophil counts are associated with future exacerbation risk in stable COPD patients receiving dual bronchodilator use.
Methods
This study used data from the Korean COPD Subgroup Study (KOCOSS) cohort. Stable COPD was defined as experiencing fewer than two moderate or no severe exacerbations in the previous year. The exposure variable was blood eosinophil level, with a high level defined as ≥ 300 cells/μL. The primary and secondary outcomes were the moderate-to-severe and severe acute exacerbation of COPD (AECOPD). The risk of AECOPD was assessed using a multivariable Cox regression model.
Results
Over a median follow-up of 12 months (interquartile ranges, 6–24 months), the incidence of moderate-to-severe AECOPD was 16.5 %. In multivariable analysis, the risk of moderate-to-severe and severe AECOPD increased by 14 % and 27 % for every 100-cell/μL increase in blood eosinophil count (95 % CI: 1.00–1.30). Patients with a high eosinophil count also exhibited an increased risk of moderate-to-severe AECOPD compared to those without (adjusted hazard ratio [aHR] = 1.79, 95 % confidence interval [CI] = 1.05–3.03). Exploratory analyses showed that higher blood eosinophil counts were also associated with an increased the risk of severe AECOPD (aHR: 1.27, 95 % CI: 1.04–1.54).
Conclusions
Higher blood eosinophil counts were associated with an increased risk of AECOPD in stable COPD patients, even among those receiving dual bronchodilators.
{"title":"Blood eosinophil counts and exacerbation risk in stable COPD with ≤1 moderate exacerbation on dual bronchodilator therapy","authors":"Sang Hyuk Kim , Chin Kook Rhee , Won-Yeon Lee , Sang-Hoon Kim , Seong Yong Lim , Hye Yun Park , Hyoung Kyu Yoon , Kwang Ha Yoo , Kyung Hoon Min , Youlim Kim","doi":"10.1016/j.hrtlng.2025.11.010","DOIUrl":"10.1016/j.hrtlng.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div>High blood eosinophil counts correlate with the risk of future exacerbations. It is uncertain whether this correlation is still valid even in stable chronic obstructive pulmonary disease (COPD) patients receiving optimal management.</div></div><div><h3>Objectives</h3><div>To evaluate whether increased blood eosinophil counts are associated with future exacerbation risk in stable COPD patients receiving dual bronchodilator use.</div></div><div><h3>Methods</h3><div>This study used data from the Korean COPD Subgroup Study (KOCOSS) cohort. Stable COPD was defined as experiencing fewer than two moderate or no severe exacerbations in the previous year. The exposure variable was blood eosinophil level, with a high level defined as ≥ 300 cells/μL. The primary and secondary outcomes were the moderate-to-severe and severe acute exacerbation of COPD (AECOPD). The risk of AECOPD was assessed using a multivariable Cox regression model.</div></div><div><h3>Results</h3><div>Over a median follow-up of 12 months (interquartile ranges, 6–24 months), the incidence of moderate-to-severe AECOPD was 16.5 %. In multivariable analysis, the risk of moderate-to-severe and severe AECOPD increased by 14 % and 27 % for every 100-cell/μL increase in blood eosinophil count (95 % CI: 1.00–1.30). Patients with a high eosinophil count also exhibited an increased risk of moderate-to-severe AECOPD compared to those without (adjusted hazard ratio [aHR] = 1.79, 95 % confidence interval [CI] = 1.05–3.03). Exploratory analyses showed that higher blood eosinophil counts were also associated with an increased the risk of severe AECOPD (aHR: 1.27, 95 % CI: 1.04–1.54).</div></div><div><h3>Conclusions</h3><div>Higher blood eosinophil counts were associated with an increased risk of AECOPD in stable COPD patients, even among those receiving dual bronchodilators.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 60-65"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589747","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}
Pub Date : 2026-03-01Epub Date: 2025-11-29DOI: 10.1016/j.hrtlng.2025.11.016
Yifan Deng , Yahui Li , Jiapei Gao , Shenghu He , Li Zhu , Jing Zhang
Background
The incidence of coronary heart disease (CHD) continues to rise among younger populations, necessitating the development of rapid and effective risk prediction models to provide new approaches for secondary prevention of CHD. Objective: To construct a clinical prediction model for premature coronary heart disease (PCHD) in the Chinese population based on machine learning algorithms.
Methods
A retrospective cohort study was conducted young and middle-aged patients undergoing coronary angiography at Northern Jiangsu People's Hospital (November 2018-May 2023).Feature selection was performed using Lasso regressionwith 10-fold cross-validation, followed by multivariate logistic regression. Seven supervised learning algorithms were evaluated: Logistic Regression (LR), LightGBM (LGBM), Random Forest (RF), Decision Trees (DT), Support Vector Machines (SVM), eXtreme Gradient Boosting (XGBoost), k-Nearest Neighbors (KNN), and Naïve Bayes (NB).
Results
This study enrolled a total of 1276 participants, comprising 881 in the PCHD group and 395 in the non-PCHD group. LASSO regression analysis identified nine potential predictors. All sevne machine learning models demonstrated good predictive performance. After excluding overfitted models, the LR model (AUC: 0.82; Sensitivity: 0.654; Specificity: 0.805; Recall: 0.654; F1: 0.749) and SVM model had higher AUC values than XGBoost (AUC: 0.794; Sensitivity: 0.858; Specificity: 0.504; Recall: 0.858; F1: 0.82) in the validation set. Therefore, we used Nomogram and SHAP summary plot to visualize and interpret the LR model and SVM model, respectively.
Conclusion
The LR-based nomogram and SVM-SHAP model provide clinically actionable tools for PCHD risk stratification. These models facilitate early identification of high-risk individuals for targeted preventive interventions.
{"title":"Development and validation of a machine learning-based predictive model for coronary heart disease risk in middle-aged and young adults","authors":"Yifan Deng , Yahui Li , Jiapei Gao , Shenghu He , Li Zhu , Jing Zhang","doi":"10.1016/j.hrtlng.2025.11.016","DOIUrl":"10.1016/j.hrtlng.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of coronary heart disease (CHD) continues to rise among younger populations, necessitating the development of rapid and effective risk prediction models to provide new approaches for secondary prevention of CHD. Objective: To construct a clinical prediction model for premature coronary heart disease (PCHD) in the Chinese population based on machine learning algorithms.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted young and middle-aged patients undergoing coronary angiography at Northern Jiangsu People's Hospital (November 2018-May 2023).Feature selection was performed using Lasso regressionwith 10-fold cross-validation, followed by multivariate logistic regression. Seven supervised learning algorithms were evaluated: Logistic Regression (LR), LightGBM (LGBM), Random Forest (RF), Decision Trees (DT), Support Vector Machines (SVM), eXtreme Gradient Boosting (XGBoost), k-Nearest Neighbors (KNN), and Naïve Bayes (NB).</div></div><div><h3>Results</h3><div>This study enrolled a total of 1276 participants, comprising 881 in the PCHD group and 395 in the non-PCHD group. LASSO regression analysis identified nine potential predictors. All sevne machine learning models demonstrated good predictive performance. After excluding overfitted models, the LR model (AUC: 0.82; Sensitivity: 0.654; Specificity: 0.805; Recall: 0.654; F1: 0.749) and SVM model had higher AUC values than XGBoost (AUC: 0.794; Sensitivity: 0.858; Specificity: 0.504; Recall: 0.858; F1: 0.82) in the validation set. Therefore, we used Nomogram and SHAP summary plot to visualize and interpret the LR model and SVM model, respectively.</div></div><div><h3>Conclusion</h3><div>The LR-based nomogram and SVM-SHAP model provide clinically actionable tools for PCHD risk stratification. These models facilitate early identification of high-risk individuals for targeted preventive interventions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 113-123"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624679","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}
Pub Date : 2026-03-01Epub Date: 2025-11-28DOI: 10.1016/j.hrtlng.2025.11.017
Paweł Łajczak , Ayesha Ayesha , Ogechukwu Obi , Leo Noanh Consoli , Oguz Kagan Sahin , Sherif Eltawansy , Faizan Ahmed , Ilias Georgios Koziakas , Luis Rene Puglla-Sanchez , Anna Łajczak , Stanisław Buczkowski , Kamil Jóźwik , Przemysław Nowakowski , Michele Schincariol
Background
Conventional percutaneous coronary intervention (CV-PCI) remains a standard treatment approach for coronary artery disease (CAD); however, robotic PCI (RB-PCI) is gaining attention due to possible radiation reduction.
Objectives
This meta-analysis aims to compare periprocedural outcomes of RB-PCI with those of CV-PCI using a Bayesian framework.
Methods
A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, to identify studies comparing RB-PCI and CV-PCI. A Bayesian non-informative random-effects model was applied to synthesize the data, providing posterior estimates with credible intervals (Crl).
Results
A total of ten studies and one report encompassing 3587 cases (RB-PCI and CV-PCI) were included. No significant differences were observed between RB-PCI and CV-PCI in terms of procedure time (MD 5.99; 95 % Crl -3.44 to 15.40), fluoroscopy time (MD -0.03; 95 % Crl -2.22 to 2.05), contrast volume (MD -5.87; 95 % CrI -17.85 to 6.55), or dose area product (MD -786.96; 95 % Crl -2374.70 to 773.10). Additionally, there was no significant difference in complications.
Conclusion
This Bayesian meta-analysis indicates that RB-PCI offers procedural efficiency and clinical outcomes comparable to those of CV-PCI, with no significant differences in key procedural parameters. The outcomes of this synthesis may question the cost-effectiveness of this technology in the management of CAD, as the benefits of RB-PCI are limited to radiation reduction. Lack of high-quality randomized trials leads to lower certainty of current evidence.
{"title":"New technology or tradition? A Bayesian meta-analysis of robotic vs. manual percutaneous coronary intervention","authors":"Paweł Łajczak , Ayesha Ayesha , Ogechukwu Obi , Leo Noanh Consoli , Oguz Kagan Sahin , Sherif Eltawansy , Faizan Ahmed , Ilias Georgios Koziakas , Luis Rene Puglla-Sanchez , Anna Łajczak , Stanisław Buczkowski , Kamil Jóźwik , Przemysław Nowakowski , Michele Schincariol","doi":"10.1016/j.hrtlng.2025.11.017","DOIUrl":"10.1016/j.hrtlng.2025.11.017","url":null,"abstract":"<div><h3>Background</h3><div>Conventional percutaneous coronary intervention (CV-PCI) remains a standard treatment approach for coronary artery disease (CAD); however, robotic PCI (RB-PCI) is gaining attention due to possible radiation reduction.</div></div><div><h3>Objectives</h3><div>This meta-analysis aims to compare periprocedural outcomes of RB-PCI with those of CV-PCI using a Bayesian framework.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, to identify studies comparing RB-PCI and CV-PCI. A Bayesian non-informative random-effects model was applied to synthesize the data, providing posterior estimates with credible intervals (Crl).</div></div><div><h3>Results</h3><div>A total of ten studies and one report encompassing 3587 cases (RB-PCI and CV-PCI) were included. No significant differences were observed between RB-PCI and CV-PCI in terms of procedure time (MD 5.99; 95 % Crl -3.44 to 15.40), fluoroscopy time (MD -0.03; 95 % Crl -2.22 to 2.05), contrast volume (MD -5.87; 95 % CrI -17.85 to 6.55), or dose area product (MD -786.96; 95 % Crl -2374.70 to 773.10). Additionally, there was no significant difference in complications.</div></div><div><h3>Conclusion</h3><div>This Bayesian meta-analysis indicates that RB-PCI offers procedural efficiency and clinical outcomes comparable to those of CV-PCI, with no significant differences in key procedural parameters. The outcomes of this synthesis may question the cost-effectiveness of this technology in the management of CAD, as the benefits of RB-PCI are limited to radiation reduction. Lack of high-quality randomized trials leads to lower certainty of current evidence.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 91-97"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624788","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}
Pub Date : 2026-03-01Epub Date: 2025-11-21DOI: 10.1016/j.hrtlng.2025.11.008
Masood Azhar , Dorsa L. Majdpour , Sergio Enrique Mesa , Muni B. Rubens , Sandra Chaparro , Anshul Saxena , Venkataraghavan Ramamoorthy , Mukesh Roy , Javier Jimenez
Background
Coexisting interstitial lung disease (ILD) and pulmonary hypertension (PH) often results in poor outcomes.
Objectives
This study examines differences in US national hospitalization trends and outcomes between ILD with PH and PH alone using the National Inpatient Sample (NIS) database.
Methods
We conducted a retrospective analysis (2016–2021) of the NIS database identifying admissions of patients ≥18 years with PH-ILD and PH using ICD-10 codes. Main outcomes included in-hospital mortality rate, non-home discharge, prolonged hospital length of stay (LOS), mechanical ventilation, and vasopressor use. Logistic regression models evaluated predictors of adverse outcomes.
Results
A total of 6789 PH-ILD, and 11,863 PH admissions were analyzed. PH-ILD hospitalizations remained stable (3.2/100,000), while PH hospitalizations increased slightly (5.2 to 5.4/100,000). The adverse outcomes such as mortality rate (3.2 % versus 2.9 %, P < 0.001), disposition other than home (51.6 % versus 50.9 %, P < 0.001), prolonged hospital LOS (19.5 % versus 17.1 %, P < 0.001), mechanical ventilation (73 % versus 57.1 %, P < 0.001), and vasopressor use (57.4 % versus 41.8 %, P < 0.001) were significantly higher among those with PH-ILD, compared to PH. Logistics regression showed that PH-ILD admissions had significantly higher odds for mortality rate (aOR, 1.92, 95 % CI: 1.72–2.15, P < 0.001), disposition other than home (aOR, 1.71, 95 % CI: 1.41–1.98, P < 0.001), prolonged hospital LOS (aOR, 1.51, 95 % CI: 1.29–1.62, P < 0.001), mechanical ventilation (aOR, 2.01, 95 % CI: 1.79–2.38, P < 0.001), and vasopressor use (aOR, 1.87, 95 % CI: 1.66–2.09, P < 0.001).
Conclusion
In-hospital adverse outcomes were higher in hospitalizations with concomitant PH-ILD. This highlights the need to risk stratify patients with concomitant ILD and PH during any hospitalization.
{"title":"Hospital outcomes of interstitial lung disease with pulmonary hypertension patients versus pulmonary hypertension alone: results from the national inpatient sample (2016–2021)","authors":"Masood Azhar , Dorsa L. Majdpour , Sergio Enrique Mesa , Muni B. Rubens , Sandra Chaparro , Anshul Saxena , Venkataraghavan Ramamoorthy , Mukesh Roy , Javier Jimenez","doi":"10.1016/j.hrtlng.2025.11.008","DOIUrl":"10.1016/j.hrtlng.2025.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Coexisting interstitial lung disease (ILD) and pulmonary hypertension (PH) often results in poor outcomes.</div></div><div><h3>Objectives</h3><div>This study examines differences in US national hospitalization trends and outcomes between ILD with PH and PH alone using the National Inpatient Sample (NIS) database.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis (2016–2021) of the NIS database identifying admissions of patients ≥18 years with PH-ILD and PH using ICD-10 codes. Main outcomes included in-hospital mortality rate, non-home discharge, prolonged hospital length of stay (LOS), mechanical ventilation, and vasopressor use. Logistic regression models evaluated predictors of adverse outcomes.</div></div><div><h3>Results</h3><div>A total of 6789 PH-ILD, and 11,863 PH admissions were analyzed. PH-ILD hospitalizations remained stable (3.2/100,000), while PH hospitalizations increased slightly (5.2 to 5.4/100,000). The adverse outcomes such as mortality rate (3.2 % versus 2.9 %, <em>P</em> < 0.001), disposition other than home (51.6 % versus 50.9 %, <em>P</em> < 0.001), prolonged hospital LOS (19.5 % versus 17.1 %, <em>P</em> < 0.001), mechanical ventilation (73 % versus 57.1 %, <em>P</em> < 0.001), and vasopressor use (57.4 % versus 41.8 %, <em>P</em> < 0.001) were significantly higher among those with PH-ILD, compared to PH. Logistics regression showed that PH-ILD admissions had significantly higher odds for mortality rate (aOR, 1.92, 95 % CI: 1.72–2.15, <em>P</em> < 0.001), disposition other than home (aOR, 1.71, 95 % CI: 1.41–1.98, <em>P</em> < 0.001), prolonged hospital LOS (aOR, 1.51, 95 % CI: 1.29–1.62, <em>P</em> < 0.001), mechanical ventilation (aOR, 2.01, 95 % CI: 1.79–2.38, <em>P</em> < 0.001), and vasopressor use (aOR, 1.87, 95 % CI: 1.66–2.09, <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>In-hospital adverse outcomes were higher in hospitalizations with concomitant PH-ILD. This highlights the need to risk stratify patients with concomitant ILD and PH during any hospitalization.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 55-59"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579884","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}
Pub Date : 2026-03-01Epub Date: 2025-12-08DOI: 10.1016/j.hrtlng.2025.11.018
Zhiyue Li , Xinxin Li , Xincan Zhou , Xinying Song , Jianke Lei , Weihong Zhang
Background
Community-dwelling older adults with coronary heart disease (CHD) exhibit low adherence to exercise regimens. Exercise aids in secondary prevention, yet adherence remains low.
Objectives
Guided by self-determination theory (SDT), this study aimed to investigate the current status of exercise adherence and its associated factors among older adult patients with coronary heart disease who reside in the community and to explore the interconnections among exercise motivation, basic psychological needs for exercise, and exercise adherence.
Methods
A cross-sectional study of 207 community-dwelling older adults with CHD was conducted from communities in Zhengzhou City between February and May 2023. Data were collected using validated instruments, including the General Information Questionnaire, Exercise Adherence Questionnaire, Psychological Needs Satisfaction in Exercise Scale (PNSE), Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2), and Control Attitudes Scale-Revised (CAS-R).
Results
Exercise adherence was moderate (M = 24.02, SD = 5.74). Key predictors included monthly income (≥3000 CNY), exercise frequency, basic psychological needs, autonomous motivation, and perceived control (p < 0.05). Basic psychological needs directly predicted exercise adherence (β = 0.257, p < 0.001) and indirectly via exercise motivation (indirect effect = 0.323, 95% CI [0.240, 0.416]), accounting for 55.7% of the total effect.
Conclusion
Basic psychological needs for exercise had a predictive direct impact on the exercise adherence of community-dwelling older adults with coronary heart disease. It is possible to improve exercise adherence by intervening in patients’ exercise motivation and basic psychological needs for exercise.
{"title":"Exercise motivation mediates the relationship between basic psychological needs and exercise adherence in older adults with coronary heart disease","authors":"Zhiyue Li , Xinxin Li , Xincan Zhou , Xinying Song , Jianke Lei , Weihong Zhang","doi":"10.1016/j.hrtlng.2025.11.018","DOIUrl":"10.1016/j.hrtlng.2025.11.018","url":null,"abstract":"<div><h3>Background</h3><div>Community-dwelling older adults with coronary heart disease (CHD) exhibit low adherence to exercise regimens. Exercise aids in secondary prevention, yet adherence remains low.</div></div><div><h3>Objectives</h3><div>Guided by self-determination theory (SDT), this study aimed to investigate the current status of exercise adherence and its associated factors among older adult patients with coronary heart disease who reside in the community and to explore the interconnections among exercise motivation, basic psychological needs for exercise, and exercise adherence.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 207 community-dwelling older adults with CHD was conducted from communities in Zhengzhou City between February and May 2023. Data were collected using validated instruments, including the General Information Questionnaire, Exercise Adherence Questionnaire, Psychological Needs Satisfaction in Exercise Scale (PNSE), Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2), and Control Attitudes Scale-Revised (CAS-R).</div></div><div><h3>Results</h3><div>Exercise adherence was moderate (<em>M</em> = 24.02, <em>SD</em> = 5.74). Key predictors included monthly income (≥3000 CNY), exercise frequency, basic psychological needs, autonomous motivation, and perceived control (<em>p</em> < 0.05). Basic psychological needs directly predicted exercise adherence (<em>β</em> = 0.257, <em>p</em> < 0.001) and indirectly via exercise motivation (indirect effect = 0.323, 95% CI [0.240, 0.416]), accounting for 55.7% of the total effect.</div></div><div><h3>Conclusion</h3><div>Basic psychological needs for exercise had a predictive direct impact on the exercise adherence of community-dwelling older adults with coronary heart disease. It is possible to improve exercise adherence by intervening in patients’ exercise motivation and basic psychological needs for exercise.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"76 ","pages":"Pages 147-153"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716740","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号