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Article ; Online: Targeting

Zouein, Joseph / Noujaim, Charbel / Kourie, Hampig Raphael

2021 Volume 15, Issue 9, Page(s) 609–613

MeSH term(s)	Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Class I Phosphatidylinositol 3-Kinases/antagonists & inhibitors ; Female ; Humans ; Protein Kinase Inhibitors/therapeutic use ; Receptor, ErbB-2/metabolism
Chemical Substances	Protein Kinase Inhibitors ; Class I Phosphatidylinositol 3-Kinases (EC 2.7.1.137) ; PIK3CA protein, human (EC 2.7.1.137) ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2021-06-01
Publishing country	England
Document type	Editorial
ZDB-ID	2481014-9
ISSN	1752-0371 ; 1752-0363
ISSN (online)	1752-0371
ISSN	1752-0363
DOI	10.2217/bmm-2021-0236
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Zs.A 6985: Show issues

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Article ; Online: Differences in postablation cardiac MRI scar between radiofrequency and cryoballoon ablation: A DECAAF II subanalysis.

Nelson, Daniel Wetherbee / Dhorepatil, Aneesh / Kreidieh, Omar / Mekhael, Mario / Noujaim, Charbel / Assaf, Ala / Feng, Han / Marrouche, Nassir

Journal of cardiovascular electrophysiology

2023 Volume 34, Issue 4, Page(s) 810–822

Abstract: Introduction: Pulmonary vein isolation (PVI) using radiofrequency (RF) and cryoballoon (Cryo) ablation are standard approaches for rhythm control in patients with symptomatic atrial fibrillation. Both strategies create scars in the left atrium (LA). ... ...

Abstract	Introduction: Pulmonary vein isolation (PVI) using radiofrequency (RF) and cryoballoon (Cryo) ablation are standard approaches for rhythm control in patients with symptomatic atrial fibrillation. Both strategies create scars in the left atrium (LA). There have been few studies investigating the difference in scar formation between patients undergoing RF and Cryo using cardiac magnetic resonance (CMR) imaging. Methods: The current study is a subanalysis of the control arm of the Delayed-Enhancement MRI Determinant of Successful Catheter Ablation of Atrial Fibrillation study (DECAAF II). The study was a multicenter, randomized, controlled, single-blinded trial that evaluated atrial arrhythmia recurrence (AAR) between PVI alone and PVI plus CMR atrial fibrosis-guided ablation. Preablation CMR and 3- to 6-month postablation CMR were obtained to assess baseline LA fibrosis and scar formation, respectively. Results: Of the 843 patients randomized in the DECAAF II trial, we analyzed the 408 patients in the primary analysis control arm that received standard PVI. Five patients received combined RF and Cryo ablations, so they were excluded from this subanalysis. Of the 403 patients analyzed, 345 underwent RF and 58 Cryo. The average procedure duration was 146 min for RF and 103 min for Cryo (p = .001). The rate of AAR at ~15 months occurred in 151 (43.8%) patients in the RF group and 28 (48.3%) patients in the Cryo group (p = .62). On 3-month post-CMR, the RF arm had significantly more scar (8.8% vs. 6.4%, p = .001) compared to Cryo. Patients with ≥6.5% LA scar (p < .001) and ≥2.3% LA scar around the PV antra (p = .01) on 3-month post-CMR had less AAR independent of the ablation technique. Cryo caused a greater percentage of right and left pulmonary vein (PV) antral scar (p = .04, p = .02) and less non-PV antral scar (p = .009) compared to RF. On Cox regression, Cryo patients free of AAR had a greater percentage of left PV antral scar (p = .01) and less non-PV antral scar (p = .004) compared to RF free of AAR. Conclusion: In this subanalysis of the control arm of the DECAAF II trial, we observed that Cryo formed a more significant percentage of PV antral scar and less non-PV antral scar compared to RF. Post ablation LA scar ≥6.5% predicted freedom from AAR, independent of ablation technique. These findings may have prognostic implications in ablation technique selection and freedom from AAR.
MeSH term(s)	Humans ; Atrial Fibrillation/surgery ; Cicatrix/etiology ; Magnetic Resonance Imaging ; Heart Atria ; Cryosurgery/adverse effects ; Fibrosis
Language	English
Publishing date	2023-03-16
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	1025989-2
ISSN	1540-8167 ; 1045-3873
ISSN (online)	1540-8167
ISSN	1045-3873
DOI	10.1111/jce.15879
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Article ; Online: Atrial fibrillation ablation as first-line therapy for patients with heart failure with reduced ejection fraction (HFrEF): evaluating the impact on patient survival.

Younes, Hadi / Noujaim, Charbel / Mekhael, Mario / Chouman, Nour / Assaf, Ala / Kreidieh, Omar / Lim, Chanho / Marrouche, Nassir / Donnellan, Eoin

Expert review of cardiovascular therapy

2023 Volume 21, Issue 2, Page(s) 111–121

Abstract: Introduction: Atrial fibrillation and congestive heart failure share several pathophysiological mechanisms. As a result of their association, patients have worse outcomes than if either condition were present alone.: Areas covered: While multiple ... ...

Abstract	Introduction: Atrial fibrillation and congestive heart failure share several pathophysiological mechanisms. As a result of their association, patients have worse outcomes than if either condition were present alone. Areas covered: While multiple trials report no significant difference between the use of pharmacological rhythm control and the use of rate control in terms of mortality and morbidity in patients with HFrEF, there is evidence to suggest that catheter ablation is beneficial in this patient population. The present review aims to provide a comprehensive overview of catheter ablation as a treatment modality for atrial fibrillation in patients with HFrEF as well as evaluate its outcome on survival. Expert opinion: An appropriate patient selection strategy for patients with HFrEF could be the next step in determining which patients might benefit most from catheter ablation. Future atrial fibrillation management may incorporate digital health and pulsed-field ablation.
MeSH term(s)	Humans ; Atrial Fibrillation ; Heart Failure/surgery ; Stroke Volume/physiology ; Treatment Outcome ; Ventricular Dysfunction, Left ; Catheter Ablation
Language	English
Publishing date	2023-02-10
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2192343-7
ISSN	1744-8344 ; 1477-9072
ISSN (online)	1744-8344
ISSN	1477-9072
DOI	10.1080/14779072.2023.2172402
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Article ; Online: Conduction system disease in cardiac amyloidosis.

Assaf, Ala' / Mekhael, Mario / Noujaim, Charbel / Chouman, Nour / Younes, Hadi / Kreidieh, Omar / Marrouche, Nassir / Donnellan, Eoin

Trends in cardiovascular medicine

2023 Volume 34, Issue 4, Page(s) 250–253

Abstract: Cardiac amyloidosis (CA) has diverse and deleterious effects on the conductive system. Atrial fibrillation is by far the most common electrophysiological manifestation of CA and is associated with more mortality, morbidity, and hospitalizations. While AF ...

Abstract	Cardiac amyloidosis (CA) has diverse and deleterious effects on the conductive system. Atrial fibrillation is by far the most common electrophysiological manifestation of CA and is associated with more mortality, morbidity, and hospitalizations. While AF increases the risk of thrombosis regardless of the CHA
MeSH term(s)	Humans ; Amyloidosis/therapy ; Amyloidosis/physiopathology ; Amyloidosis/diagnosis ; Cardiomyopathies/physiopathology ; Cardiomyopathies/therapy ; Cardiomyopathies/diagnosis ; Risk Factors ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Atrial Fibrillation/epidemiology ; Heart Conduction System/physiopathology ; Prognosis ; Cardiac Conduction System Disease/physiopathology ; Cardiac Conduction System Disease/therapy ; Cardiac Conduction System Disease/diagnosis ; Defibrillators, Implantable ; Action Potentials ; Electric Countershock/instrumentation ; Electric Countershock/adverse effects ; Treatment Outcome ; Heart Rate/drug effects ; Risk Assessment
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1097434-9
ISSN	1873-2615 ; 1050-1738
ISSN (online)	1873-2615
ISSN	1050-1738
DOI	10.1016/j.tcm.2023.02.004
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Zs.A 3419: Show issues

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Article ; Online: Comprehensive atrial fibrillation burden and symptom reduction post-ablation: insights from DECAAF II.

Noujaim, Charbel / Assaf, Ala / Lim, Chanho / Feng, Han / Younes, Hadi / Mekhael, Mario / Chouman, Nour / Shamaileh, Ghaith / El Hajjar, Abdel Hadi / Ayoub, Tarek / Isakadze, Nino / Chelu, Mihail G / Marrouche, Nassir / Donnellan, Eoin

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2024 Volume 26, Issue 5

Abstract: Aims: Traditional atrial fibrillation (AF) recurrence after catheter ablation is reported as a binary outcome. However, a paradigm shift towards a more granular definition, considering arrhythmic or symptomatic burden, is emerging. We hypothesize that ... ...

Abstract	Aims: Traditional atrial fibrillation (AF) recurrence after catheter ablation is reported as a binary outcome. However, a paradigm shift towards a more granular definition, considering arrhythmic or symptomatic burden, is emerging. We hypothesize that ablation reduces AF burden independently of conventional recurrence status in patients with persistent AF, correlating with symptom burden reduction. Methods and results: Ninety-eight patients with persistent AF from the DECAAF II trial with pre-ablation follow-up were included. Patients recorded daily single-lead electrocardiogram (ECG) strips, defining AF burden as the proportion of AF days among total submitted ECG days. The primary outcome was atrial arrhythmia recurrence. The AF severity scale was administered pre-ablation and at 12 months post-ablation. At follow-up, 69 patients had atrial arrhythmia recurrence and 29 remained in sinus rhythm. These patients were categorized into a recurrence (n = 69) and a no-recurrence group (n = 29). Both groups had similar baseline characteristics, but recurrence patients were older (P = 0.005), had a higher prevalence of hyperlipidaemia (P = 0.007), and had a larger left atrial (LA) volume (P = 0.01). There was a reduction in AF burden in the recurrence group when compared with their pre-ablation burden (65 vs. 15%, P < 0.0001). Utah Stage 4 fibrosis and diabetes predicted less improvement in AF burden. The symptom severity score at 12 months post-ablation was significantly reduced compared with the pre-ablation score in the recurrence group, and there was a significant correlation between the reduction in symptom severity score and the reduction in AF burden (R = 0.39, P = 0.001). Conclusion: Catheter ablation reduces AF burden, irrespective of arrhythmia recurrence post-procedure. There is a strong correlation between AF burden reduction and symptom improvement post-ablation. Notably, elevated LA fibrosis impedes AF burden decrease following catheter ablation.
MeSH term(s)	Humans ; Atrial Fibrillation/surgery ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/diagnosis ; Catheter Ablation/methods ; Male ; Female ; Middle Aged ; Recurrence ; Aged ; Treatment Outcome ; Electrocardiography ; Severity of Illness Index ; Time Factors ; Risk Factors
Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Multicenter Study
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euae104
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Article: Predictors of Lesions Contiguity and Transmurality in Canine Ventricular Models After Catheter Ablation.

El Hajjar, Abdel Hadi / Mekhael, Mario / Huang, Chao / Noujaim, Charbel / Zhang, Yichi / Kholmovski, Eugene / Ayoub, Tarek / Lim, Chan Ho / Marrouche, Nassir

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 920539

Abstract: Background: Interlesion gaps and transmurality of lesions after catheter ablation can precipitate suboptimal efficacy in preventing arrhythmias.: Aims: We aim to assess predictors of acute transmural lesion formation and the interlesion distance ... ...

Abstract	Background: Interlesion gaps and transmurality of lesions after catheter ablation can precipitate suboptimal efficacy in preventing arrhythmias. Aims: We aim to assess predictors of acute transmural lesion formation and the interlesion distance threshold for creating a continuous, chronic scar after ventricular ablation. Materials and methods: Ablation procedures were performed on 7 canines followed by late gadolinium enhancement MRI (LGE-MRI). Transmurality of lesions was assessed by 2 independent operators. Ablation parameters such as duration (s), power (W), temperature (C), contact force (CF) (g), were collected for each ablation point. After 7-12 weeks, LGE-MRI was performed, followed by euthanasia, and heart excision. Some lesions were created in pair. Lesion pairs were spaced 7-21 mm apart as measured by Electroanatomic mapping (EAM), with different operating parameters (power 35 or 50W, duration of energy delivery 10, 20 or 30s and contact force of 10g or above). We performed a logistic regression analysis to determine predictors of transmural lesion formation. Results: Eighty-one radiofrequency ablation were performed in total [33 in the Left ventricle (LV) and 48 in the Right ventricle (RV)]. Higher CF was a significant predictor of transmural lesion formation (β = 0.15, OR = 1.16, 95% CI [1.03 - 1.3], Conclusion: To create contiguous scars on the ventricular endocardial surface, paired lesions should be spaced less than ten millimeters apart. Higher contact force should be used in ventricular ablation to create transmural lesions.
Language	English
Publishing date	2022-06-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.920539
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Article ; Online: Identifying the prognostic significance of early arrhythmia recurrence during the blanking period and the optimal blanking period duration: insights from the DECAAF II study.

Noujaim, Charbel / Lim, Chanho / Mekhael, Mario / Feng, Han / Chouman, Nour / Younes, Hadi / Assaf, Ala / Shan, Botao / Shamaileh, Ghaith / Dhore-Patil, Aneesh / Nelson, Daniel / Lanier, Brennan / Makan, Noor / Marrouche, Nassir / Donnellan, Eoin

2023 Volume 25, Issue 6

Abstract: Objective: Early atrial arrhythmia recurrence following atrial fibrillation (AF) ablation is common. Current guidelines promulgate a 3-month blanking period. We hypothesize that early atrial arrhythmia recurrence during the blanking period may predict ... ...

Abstract	Objective: Early atrial arrhythmia recurrence following atrial fibrillation (AF) ablation is common. Current guidelines promulgate a 3-month blanking period. We hypothesize that early atrial arrhythmia recurrence during the blanking period may predict longer-term ablation outcomes. Methods and results: A total of 688 patients with persistent AF undergoing catheter ablation were included in the DECAAF II trial database. The primary endpoint of the study was the first confirmed recurrence of atrial arrhythmia. Recurrence was also monitored during the 90-day blanking period. A total of 287 patients experienced recurrent atrial arrhythmia during the blanking period, while 401 remained in sinus rhythm. Rates of longer-term arrhythmia recurrence were substantially higher among those who developed recurrence during the blanking period compared to those who remained in sinus rhythm throughout the blanking period (68% vs. 32%, P < 0.001). The study cohort was divided into three groups according to the timing of arrhythmia recurrence during the blanking period. Of those who had recurrent arrhythmia during the first month of the blanking period (Group 1), 43.9% experienced longer-term recurrence, compared to 61.6% who recurred during the second month of the blanking period (Group 2), and 93.3% of those who had arrhythmia recurrence during the third month (Group 3, P < 0.001). The risk of recurrent arrhythmia was highest in Group 3 (HR = 10.15), followed by Group 2 (HR = 2.35) and Group 1 (HR = 1.5). Receiver operating characteristic analysis was performed to assess the relationship between the timing of arrhythmia recurrence and the primary outcome (AUC = 0.746, P < 0.001). The optimal blanking period duration was identified as 34 days. Atrial fibrillation burden determined by smartphone electrocardiogram technology over the 18 months follow-up period was significantly higher in Group 3 (29%) compared to Groups 1 (6%) and 2 (7%) and in patients who stayed in sinus rhythm during the blanking period (5%) (P < 0.0001). Conclusion: Early atrial arrhythmia recurrence during the blanking period, particularly during the third month, is significantly associated with later recurrence. Although a blanking period is warranted, it should be abbreviated.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Atrial Fibrillation/etiology ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Electrocardiography ; Prognosis ; Pulmonary Veins/surgery ; Recurrence ; Treatment Outcome
Language	English
Publishing date	2023-06-20
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euad173
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Zs.A 5434: Show issues

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Article ; Online: Effect of fibrosis regionality on atrial fibrillation recurrence: insights from DECAAF II.

Assaf, Ala / Mekhael, Mario / Noujaim, Charbel / Chouman, Nour / Younes, Hadi / Feng, Han / ElHajjar, Abdelhadi / Shan, Botao / Kistler, Peter / Kreidieh, Omar / Marrouche, Nassir / Donnellan, Eoin

2023 Volume 25, Issue 9

Abstract: Aims: The amount of fibrosis in the left atrium (LA) predicts atrial fibrillation (AF) recurrence after catheter ablation (CA). We aim to identify whether regional variations in LA fibrosis affect AF recurrence.: Methods and results: This post hoc ... ...

Abstract	Aims: The amount of fibrosis in the left atrium (LA) predicts atrial fibrillation (AF) recurrence after catheter ablation (CA). We aim to identify whether regional variations in LA fibrosis affect AF recurrence. Methods and results: This post hoc analysis of the DECAAF II trial includes 734 patients with persistent AF undergoing first-time CA who underwent late gadolinium enhancement magnetic resonance imaging (LGE-MRI) within 1 month prior to ablation and were randomized to MRI-guided fibrosis ablation in addition to standard pulmonary vein isolation (PVI) or standard PVI only. The LA wall was divided into seven regions: anterior, posterior, septal, lateral, right pulmonary vein (PV) antrum, left PV antrum, and left atrial appendage (LAA) ostium. Regional fibrosis percentage was defined as a region's fibrosis prior to ablation divided by total LA fibrosis. Regional surface area percentage was defined as an area's surface area divided by the total LA wall surface area before ablation. Patients were followed up for a year with single-lead electrocardiogram (ECG) devices. The left PV had the highest regional fibrosis percentage (29.30 ± 14.04%), followed by the lateral wall (23.23 ± 13.56%), and the posterior wall (19.80 ± 10.85%). The regional fibrosis percentage of the LAA was a significant predictor of AF recurrence post-ablation (odds ratio = 1.017, P = 0.021), and this finding was only preserved in patients receiving MRI-guided fibrosis ablation. Regional surface area percentages did not significantly affect the primary outcome. Conclusion: We have confirmed that atrial cardiomyopathy and remodelling are not a homogenous process, with variations in different regions of the LA. Atrial fibrosis does not uniformly affect the LA, and the left PV antral region has more fibrosis than the rest of the wall. Furthermore, we identified regional fibrosis of the LAA as a significant predictor of AF recurrence post-ablation in patients receiving MRI-guided fibrosis ablation in addition to standard PVI.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Contrast Media ; Gadolinium ; Heart Atria/diagnostic imaging ; Heart Atria/surgery ; Heart Atria/pathology ; Fibrosis ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Recurrence ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/surgery ; Pulmonary Veins/pathology ; Treatment Outcome
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2023-07-10
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euad199
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Article ; Online: Comparison of Ablation Strategies for Persistent Atrial Fibrillation: A Post Hoc Analysis of the DECAAF II Study.

Noujaim, Charbel / Shan, Botao / Kim, Jitae A / Mekhael, Mario / Feng, Han / Assaf, Ala / Younes, Hadi / Chouman, Nour / Lim, Chanho / Ayyoub, Tarek / Huang, Chao / Marrouche, Nassir F / Chelu, Mihail G

Circulation. Arrhythmia and electrophysiology

2023 Volume 16, Issue 10, Page(s) e011975

MeSH term(s)	Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Heart Atria ; Treatment Outcome ; Catheter Ablation ; Pulmonary Veins/surgery ; Recurrence
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.123.011975
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Article ; Online: Left atrial volume affects the correlation of voltage map with magnetic resonance imaging.

Li, Dan L / Hajjar, Abdel Hadi El / Ayoub, Tarek / Zhang, Yichi / Huang, Chao / Kholmovski, Eugene G / Mekhael, Mario / Noujaim, Charbel / Feng, Han / Lim, Chanho / Marrouche, Nassir F

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

2023 Volume 67, Issue 2, Page(s) 263–271

Abstract: Background: The low-voltage area detected by electroanatomic mapping (EAM) is a surrogate marker of left atrial fibrosis. However, the correlation between the EAM and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been inconsistent ...

Abstract	Background: The low-voltage area detected by electroanatomic mapping (EAM) is a surrogate marker of left atrial fibrosis. However, the correlation between the EAM and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been inconsistent among studies. This study aimed to investigate how LA size affects the correlation between EAM and LGE-MRI. Methods: High-density EAMs of the LA during sinus rhythm were collected in 22 patients undergoing AF ablation. The EAMs were co-registered with pre-ablation LGE-MRI models. Voltages in the areas with and without LGE were recorded. Left atrial volume index (LAVI) was calculated from MRI, and LAVI > 62 ml/m Results: Atrial bipolar voltage negatively correlates with the left atrial volume index. The median voltages in areas without LGE were 1.1 mV vs 2.0 mV in patients with vs without significant LAE (p = 0.002). In areas of LGE, median voltages were 0.4 mV vs 0.8 mV in patients with vs without significant LAE (p = 0.02). A voltage threshold of 1.7 mV predicted atrial LGE in patients with normal or mildly enlarged LA (sensitivity and specificity of 74% and 59%, respectively). In contrast, areas of voltage less than 0.75 mV correlated with LGE in patients with significant LA enlargement (sensitivity 68% and specificity 66%). Conclusions: LAVI affects left atrial bipolar voltage, and the correlation between low-voltage areas and LGE-MRI. Distinct voltage thresholds according to the LAVI value might be considered to identify atrial scar by EAM.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Contrast Media ; Gadolinium ; Heart Atria/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Fibrosis ; Catheter Ablation/methods
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2023-03-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1329179-8
ISSN	1572-8595 ; 1383-875X
ISSN (online)	1572-8595
ISSN	1383-875X
DOI	10.1007/s10840-023-01522-y
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