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Article ; Online: Heart Failure Due to High-Degree Atrioventricular Block: How Frequent Is It and What Is the Cause?

Viskin, Dana / Halkin, Amir / Sherez, Jack / Megidish, Ricki / Fourey, Dana / Keren, Gad / Topilsky, Yan

2021 Volume 37, Issue 10, Page(s) 1562–1568

Abstract: Background: The causes of heart failure (HF) during high-grade atrioventricular block (AVB) are poorly understood. This study assessed the mechanisms of HF in patients with AVB.: Methods: We studied patients presenting (between 2012 and 2016) with ... ...

Abstract	Background: The causes of heart failure (HF) during high-grade atrioventricular block (AVB) are poorly understood. This study assessed the mechanisms of HF in patients with AVB. Methods: We studied patients presenting (between 2012 and 2016) with high-grade AVB not related to acute myocardial infarction. Patients with preexisting significant valvular heart disease were excluded. All patients underwent comprehensive echocardiographic evaluation during AVB, before pacemaker implantation. The diagnosis of HF was based on the Framingham criteria. Results: A total of 122 patients were included in the study, 50% male, average age 76 ± 13 years. Twenty-eight patients (23%) with AVB presented with HF. Univariate correlates associated with HF were decrease in cardiac output (CO) (odds ratio [OR] 0.68 [95% confidence interval 0.49-0.9] per L/min; P = 0.007), measures of impaired left ventricular (LV) compliance, and increase in diastolic mitral regurgitation (MR) volume (OR 1.04 [1.01-1.07] per cc; P = 0.0016). Ventricular rate during AVB and LV ejection fraction were not significantly associated with the presence of HF. By multivariate nominal logistic analysis, the best model associated with HF included diastolic MR volume (OR 1.04 [1.001-1.09]; P = 0.02), A-wave deceleration time (OR 0.96 [0.94-0.9]; P = 0.001), and CO (OR 0.92 [0.4-1.00]; P = 0.005) (χ Conclusions: In the setting of high-degree AVB, clinical HF occurrence correlates with impaired LV compliance and diastolic MR volume, but not with heart rate or LV ejection fraction. The cardiac performance of patients with poor LV compliance and high-volume diastolic MR may show maladjustment to slow heart rates, manifesting as low CO and HF.
MeSH term(s)	Aged ; Atrioventricular Block/complications ; Atrioventricular Block/diagnosis ; Atrioventricular Block/epidemiology ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure/epidemiology ; Heart Failure/etiology ; Heart Failure/physiopathology ; Humans ; Incidence ; Israel/epidemiology ; Male ; Prognosis ; ROC Curve ; Retrospective Studies ; Survival Rate/trends ; Ventricular Function, Left/physiology
Language	English
Publishing date	2021-05-21
Publishing country	England
Document type	Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2021.05.007
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Article ; Online: Diastolic strain time as predictor for systolic dysfunction among patients with active breast cancer.

Hochstadt, Aviram / Arnold, Joshua / Rosen, Roni / Sherez, Chen / Sherez, Jack / Mor, Liat / Derakhshesh, Matthew / Moshkovits, Yonatan / Merdler, Ilan / Arbel, Yaron / Kapusta, Livia / Rozenbaum, Zach / Topilsky, Yan / Laufer-Perl, Michal

Echocardiography (Mount Kisco, N.Y.)

2020 Volume 37, Issue 11, Page(s) 1890–1896

Abstract: Background: Although diastolic dysfunction is common among patients treated with cancer therapy, no clear evidence has been shown that it predicts systolic dysfunction. This study evaluated the correlation of diastolic strain time (Dst) with the routine ...

Abstract	Background: Although diastolic dysfunction is common among patients treated with cancer therapy, no clear evidence has been shown that it predicts systolic dysfunction. This study evaluated the correlation of diastolic strain time (Dst) with the routine echocardiography diastolic parameters and estimated its role in the early detection of cardiotoxicity among patients with active breast cancer. Methods: Data were collected as part of the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling all adult patients referred to the cardio-oncology clinic. All patients with breast cancer, planned for Doxorubicin therapy, were included. Echocardiography, including global longitudinal systolic strain (GLS) and Dst, was assessed at baseline before chemotherapy (T1), during Doxorubicin therapy (T2) and after the completion of Doxorubicin therapy (T3). Cardiotoxicity was determined by GLS relative reduction of ≥15%. Dst was assessed as the time measured (ms) of the myocardium lengthening during diastole. Results: Among 69 patients, 67 (97.1%) were females with a mean age of 52 ± 13 years. Dst was significantly associated with the routine diastolic parameters. Significant GLS reduction was observed in 10 (20%) patients at T3. Both in a univariate and a multivariate analyses, the change in Ds basal time from T1 to T2 emerged to be significantly associated with GLS reduction at T3 (P < .04). Conclusions: Among breast cancer patients, Dst showed high correlation to the routine diastolic echocardiography parameters. Change in Ds basal time emerged associated with clinically significant systolic dysfunction as measured by GLS reduction.
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/complications ; Breast Neoplasms/drug therapy ; Diastole ; Early Detection of Cancer ; Female ; Humans ; Israel ; Male ; Middle Aged ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Function, Left
Language	English
Publishing date	2020-07-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	843645-9
ISSN	1540-8175 ; 0742-2822
ISSN (online)	1540-8175
ISSN	0742-2822
DOI	10.1111/echo.14791
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Zs.A 2170: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer.

Hochstadt, Aviram / Arnold, Joshua / Rosen, Roni / Sherez, Chen / Sherez, Jack / Mor, Liat / Moshkovits, Yonatan / Merdler, Ilan / Szekely, Yishay / Arbel, Yaron / Rozenbaum, Zach / Kapusta, Livia / Topilsky, Yan / Laufer-Perl, Michal

Clinical research in cardiology : official journal of the German Cardiac Society

2020 Volume 110, Issue 4, Page(s) 569–578

Abstract: Background: Diastolic dysfunction is a common finding in patients receiving cancer therapy. This study evaluated the correlation of diastolic strain slope (Dss) with routine echocardiography diastolic parameters and its role in early detection of ... ...

Abstract	Background: Diastolic dysfunction is a common finding in patients receiving cancer therapy. This study evaluated the correlation of diastolic strain slope (Dss) with routine echocardiography diastolic parameters and its role in early detection of systolic dysfunction and cardiovascular (CV) mortality within this population. Methods: Data were collected from the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling adult patient receiving cancer therapy. All patients performed at least three echocardiography exams (T1, T2, T3), including left ventricle Global Longitudinal Strain (LV GLS) and Dss. Systolic dysfunction was determined by either LV GLS relative reduction of ≥ 15% or LV ejection fraction reduction > 10% to < 53%. Dss was assessed as the early lengthening rate, measured by the diastolic slope (delta%/sec). Results: Among 144 patients, 114 (79.2%) were female with a mean age of 57.31 ± 14.3 years. Dss was significantly correlated with e' average. Mid segment Dss change between T1 and T2 showed significant association to systolic dysfunction development (Odds Ratio (OR) = 1.04 [1.01,1.06]. p = 0.036). In multivariate prediction, Dss increase was a significant predictor for the development of systolic dysfunction (OR = 1.06 [1.03,1.1], P < 0.001).An 8% increase in Dss between T1 and T2 was associated with a trend in increased CV mortality (HR = 3.4 [0.77,15.4], p = 0.085). Conclusions: This study is the first to use the novel measurement of Dss in patients treated with cancer therapies and to show significant correlation between routine diastolic dysfunction parameters and Dss. Changes in the mid segment were found to have significant independent early predictive value for systolic dysfunction development in univariate and multivariate analyses.
MeSH term(s)	Combined Modality Therapy/adverse effects ; Diastole ; Echocardiography ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Israel/epidemiology ; Male ; Middle Aged ; Myocardial Contraction/physiology ; Neoplasms/therapy ; Prospective Studies ; Registries ; Survival Rate/trends ; Systole ; Ventricular Dysfunction/etiology ; Ventricular Dysfunction/mortality ; Ventricular Dysfunction/physiopathology ; Ventricular Function/physiology
Language	English
Publishing date	2020-11-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-020-01776-w
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Article: Re-Appraisal of Echocardiographic Assessment in Patients with Pulmonary Embolism: Prospective Blinded Long-Term Follow-Up.

Shmueli, Hezzy / Steinvil, Arie / Aviram, Galit / Moaad, Sileman / Sharon, Adam / Bendet, Achiude / Biner, Simon / Shacham, Yacov / Sherez, Jack / Megidish, Ricki / Hasin, Yifat / Elazar, Ester / Letourneau-Shesaf, Sevan / Keren, Gad / Berliner, Shlomo / Topilsky, Yan

The Israel Medical Association journal : IMAJ

2020 Volume 11, Issue 22, Page(s) 688–695

Abstract: Background: Acute pulmonary embolism (PE) is considered to be one of the most common cardiovascular diseases with considerable mortality. Conflicting data imply possible role for echocardiography in assessing this disease.: Objectives: To determine ... ...

Abstract	Background: Acute pulmonary embolism (PE) is considered to be one of the most common cardiovascular diseases with considerable mortality. Conflicting data imply possible role for echocardiography in assessing this disease. Objectives: To determine which of the echo parameters best predicts short-term and long-term mortality in patients with PE. Methods: We prospectively enrolled 235 patients who underwent computed tomography of pulmonary arteries (CTPA) and transthoracic Echocardiography (TTE) within < 24 hours. TTE included a prospectively designed detailed evaluation of the right heart including right ventricular (RV) myocardial performance index (RIMP), RV end diastolic and end systolic area, RV fractional area change, acceleration time (AT) of pulmonary flow and visual estimation. Interpretation and performance of TTE were blinded to the CTPA results. Results: Although multiple TTE parameters were associated with PE, all had low discriminative capacity (AUC < 0.7). Parameters associated with 30-day mortality in univariate analysis were acceleration time (AT) < 81 msec (P = 0.04), stroke volume < 44 cc (P = 0.005), and RIMP > 0.42 (P = 0.05). The only RV independent echo parameter associated with poor long-term prognosis (adjusted for significant clinical, and routine echo associates of mortality) was RIMP (hazard ratio 3.0, P = 0.04). The only independent RV echo parameters associated with mortality in PE patients were RIMP (P = 0.05) and AT (P = 0.05). Addition of RIMP to nested models eliminated the significance of all other parameters assessing RV function. Conclusions: Doppler-based parameters like pulmonary flow AT, RIMP, and stroke volume, have additive value in addition to visual RV estimation to assess prognosis in patients with PE.
MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Echocardiography/methods ; Echocardiography, Doppler/methods ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Pulmonary Artery/diagnostic imaging ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/mortality ; Stroke Volume/physiology ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-11-29
Publishing country	Israel
Document type	Journal Article ; Observational Study
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Zs.A 5470: Show issues

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Article ; Online: Usefulness of Global Longitudinal Strain for Early Identification of Subclinical Left Ventricular Dysfunction in Patients With Active Cancer.

Laufer-Perl, Michal / Derakhshesh, Matthew / Milwidsky, Assi / Mor, Liat / Ravid, Dor / Amrami, Nadav / Sherez, Jack / Keren, Gad / Topilsky, Yan / Arbel, Yaron

The American journal of cardiology

2018 Volume 122, Issue 10, Page(s) 1784–1789

Abstract: Cardiotoxicity from cancer therapy has become a leading cause of morbidity and mortality in cancer survivors. The most commonly used definition is cancer therapeutic related cardiac dysfunction defined as a left ventricular ejection fraction (LVEF) ... ...

Abstract	Cardiotoxicity from cancer therapy has become a leading cause of morbidity and mortality in cancer survivors. The most commonly used definition is cancer therapeutic related cardiac dysfunction defined as a left ventricular ejection fraction (LVEF) reduction of >10%, to a value below 50%. However, according to the recent American and European Society of Echocardiography, global longitudinal strain (GLS) is the optimal parameter for early detection of subclinical left ventricular dysfunction. The objective of this study was to evaluate the frequency of GLS reduction in patients with active cancer and its correlation to other echocardiographic parameters. Data were collected as part of the International Cardio-Oncology Registry. All patients performed at least 2 echocardiograms including GLS. We evaluated the frequency of GLS reduction (≥10% relative reduction), its correlation to LVEF reduction and whether there are other predicting echocardiographic parameters. In 64 consecutive patients, 12 (19%) had ≥10% GLS relative reduction, of which 75% had no concomitant ejection fraction reduction. There were no significant differences in the baseline cardiac risk factors (hypertension, diabetes, hyperlipidemia, or smoking). Treatment with Doxorubicin, Pertuzumab, or Ifosfamide was significantly more frequent in patients GLS reduction. No other echocardiographic parameters, including diastolic function or systolic pulmonary artery pressure were significant predictors for GLS reduction. In conclusion, our study demonstrates that GLS reduction is frequent in active cancer patients, precedes LVEF reduction and cannot be anticipated by other echocardiographic parameters. Using GLS routinely during therapy may lead to an early diagnosis of cardiotoxicity.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Diastole ; Early Diagnosis ; Echocardiography/methods ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Myocardial Contraction/physiology ; Neoplasms/drug therapy ; Registries ; Retrospective Studies ; Ventricular Dysfunction, Left/chemically induced ; Ventricular Dysfunction, Left/diagnosis ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left/physiology
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2018-08-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2018.08.019
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Article: Isolated ventricular non-compaction: an underdiagnosed cause of congestive heart failure.

Schwartzenberg, Shmuel / Sherez, Jack / Wexler, Dov / Aviram, Galit / Keren, Gad

The Israel Medical Association journal : IMAJ

2009 Volume 11, Issue 7, Page(s) 426–429

Abstract: Isolated ventricular non-compaction is a frequently underdiagnosed rare congenital cardiomyopathy. The importance of diagnosing this cardiomyopathy lies especially in asymptomatic patients, screening relatives of index cases in order to focus on their ... ...

Abstract	Isolated ventricular non-compaction is a frequently underdiagnosed rare congenital cardiomyopathy. The importance of diagnosing this cardiomyopathy lies especially in asymptomatic patients, screening relatives of index cases in order to focus on their follow-up, and searching for criteria warranting prophylactic anticoagulation, implantable cardioverter defibrillator and anti-remodeling drugs such as angiotensin-converting inhibitors. We present the clinical and imaging characteristics of this entity and discuss some of the therapeutic dilemmas involving these patients.
MeSH term(s)	Cardiomyopathies/congenital ; Cardiomyopathies/diagnostic imaging ; Cardiomyopathies/pathology ; Coronary Angiography ; Heart Failure/etiology ; Heart Failure/pathology ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/pathology ; Humans ; Myocardium/pathology ; Prognosis ; Ultrasonography, Doppler, Color
Language	English
Publishing date	2009-07
Publishing country	Israel
Document type	Journal Article ; Review
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Article: Long-term effects of dual-chamber pacing with periodic echocardiographic evaluation of optimal atrioventricular delay in patients with hypertrophic cardiomyopathy >50 years of age.

Topilski, Ian / Sherez, Jack / Keren, Gad / Copperman, Itzchak

The American journal of cardiology

2006 Volume 97, Issue 12, Page(s) 1769–1775

Abstract: Various treatment modalities have been introduced to reduce the subaortic pressure gradient in patients with obstructive hypertrophic cardiomyopathy, including pacemaker insertion. Complete ventricular capture during pacing is essential and requires ... ...

Abstract	Various treatment modalities have been introduced to reduce the subaortic pressure gradient in patients with obstructive hypertrophic cardiomyopathy, including pacemaker insertion. Complete ventricular capture during pacing is essential and requires optimization of the atrioventricular interval (AVI). In this study, a protocol using echocardiographic examination assessing the changes in the left ventricular outflow tract (LVOT) gradient in different AVIs, pacing rates, and pacing modes was used for optimal pacemaker programming. Twenty-five patients with obstructive hypertrophic cardiomyopathy were implanted with DDD pacemakers and evaluated prospectively. The LVOT gradient was measured during periodic evaluations every 3 to 6 months. Gradient measurements were done with 5 different AVIs and 3 different rate combinations. After each evaluation, the optimal AVI, pacing rate, and mode were set on the basis of the minimal LVOT gradient not associated with systolic arterial cuff pressure reduction. Follow-up ranged from 18 to 126 months. Peak LVOT gradient immediately decreased in 92% of patients. During follow-up, the optimal AVI was prolonged in most patients. Sixty-four percent of patients showed a clear relation between pacemaker modifications and gradient reduction. In 75% of these patients, optimal gradient reduction required repeated AVI and pacing rate programming on the basis of echocardiographic evaluation. Symptoms decreased in 92% of patients, and New York Heart Association class improved significantly (3.1+/-0.7 vs 1.3+/-0.4, p<0.001) during follow-up. The symptomatic reduction was positively correlated with the LVOT gradient reduction. In conclusion, DDD pacing is effective in reducing the LVOT gradient and improving functional capacity in adult patients with hypertrophic cardiomyopathy. Pacemaker programming with the periodic echocardiographic evaluation of the optimal AVI, pacing rate, and mode is imperative for optimal results.
MeSH term(s)	Aged ; Aged, 80 and over ; Atrioventricular Node/diagnostic imaging ; Atrioventricular Node/physiopathology ; Cardiac Pacing, Artificial/methods ; Cardiomyopathy, Hypertrophic/diagnostic imaging ; Cardiomyopathy, Hypertrophic/physiopathology ; Cardiomyopathy, Hypertrophic/therapy ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; Prospective Studies
Language	English
Publishing date	2006-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2006.01.040
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Article ; Online: Discriminating Circulatory Problems From Deconditioning: Echocardiographic and Cardiopulmonary Exercise Test Analysis.

Rozenbaum, Zach / Khoury, Shafik / Aviram, Galit / Gura, Yaniv / Sherez, Jack / Man, Avi / Shimiaie, Jason / Le Tourneau, Thierry / Halkin, Amir / Biner, Simon / Keren, Gad / Topilsky, Yan

Chest

2017 Volume 151, Issue 2, Page(s) 431–440

Abstract: Background: Discriminating circulatory problems with reduced stroke volume (SV) from deconditioning, in which the muscles cannot consume oxygen normally, by gas exchange parameters is difficult.: Methods: We performed combined stress echocardiography ...

Abstract	Background: Discriminating circulatory problems with reduced stroke volume (SV) from deconditioning, in which the muscles cannot consume oxygen normally, by gas exchange parameters is difficult. Methods: We performed combined stress echocardiography (SE) and cardiopulmonary exercise tests (CPET) in 110 patients (20 with normal effort capacity, 54 with attenuated SV response, and 36 with deconditioning) to evaluate multiple hemodynamic parameters and oxygen content difference (A-V.o Results: Reduced anaerobic threshold (AT), low unchanging peak oxygen pulse, periodic breathing, shallow Δ peak oxygen consumption (V.o Conclusions: The best single gas exchange parameter to discriminate between circulatory problems and deconditioning is V.
MeSH term(s)	Aged ; Anaerobic Threshold ; Breath Tests ; Carbon Dioxide ; Cardiovascular Deconditioning/physiology ; Diagnosis, Differential ; Echocardiography ; Echocardiography, Stress ; Exercise Test ; Female ; Heart Failure/diagnosis ; Heart Failure/physiopathology ; Humans ; Male ; Middle Aged ; Oxygen Consumption/physiology ; Stroke Volume ; Ventricular Dysfunction, Left/diagnosis ; Ventricular Dysfunction, Left/physiopathology
Chemical Substances	Carbon Dioxide (142M471B3J)
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2016.09.027
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Zs.MO 349: Show issues

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Article ; Online: Mechanisms of Effort Intolerance in Patients With Heart Failure and Borderline Ejection Fraction.

Topilsky, Yan / Rozenbaum, Zach / Khoury, Shafik / Pressman, Gregg S / Gura, Yaniv / Sherez, Jack / Man, Avi / Shimiaie, Jason / Edwards, Sanford / Berookhim, Joshua / Le Tourneau, Thierry / Halkin, Amir / Biner, Simon / Keren, Gad / Aviram, Galit

The American journal of cardiology

2017 Volume 119, Issue 3, Page(s) 416–422

Abstract: Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A- ... ...

Abstract	Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A-VO
MeSH term(s)	Adult ; Aged ; Case-Control Studies ; Echocardiography ; Echocardiography, Stress ; Exercise Test ; Exercise Tolerance/physiology ; Female ; Heart Failure/diagnostic imaging ; Heart Failure/physiopathology ; Hemodynamics ; Humans ; Male ; Middle Aged ; Oxygen Consumption ; Retrospective Studies ; Stroke Volume ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/physiopathology
Language	English
Publishing date	2017-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2016.10.026
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Article: Images in Cardiovascular Interventions Complications of balloon mitral valvuloplasty.

Brosh, David / Sherez, Jack / Keren, Gad

International journal of cardiovascular interventions

2003 Volume 2, Issue 2, Page(s) 131

Language	English
Publishing date	2003-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1469145-0
ISSN	1462-8848
ISSN	1462-8848
DOI	10.1080/acc.2.2.131.131
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