{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:31:01Z","timestamp":1783103461735,"version":"3.54.6"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"funder":[{"name":"Clinical Research Support Fund of Chinese PLA General Hospital","award":["2018FC-304M-CXYY-01"],"award-info":[{"award-number":["2018FC-304M-CXYY-01"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Heart Vessels"],"published-print":{"date-parts":[[2021,4]]},"DOI":"10.1007\/s00380-020-01719-5","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T09:08:56Z","timestamp":1604912936000},"page":"518-527","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prognostic value of pulmonary oedema assessed by lung ultrasound in patient with acute heart failure"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7925-434X","authenticated-orcid":false,"given":"Feifei","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiushuang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjiang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"key":"1719_CR1","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1001\/jama.296.18.2217","volume":"296","author":"M Gheorghiade","year":"2006","unstructured":"Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O\u2019Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC, OPTIMIZE-HF Investigators and Coordinators (2006) Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA 296:2217\u20132226","journal-title":"JAMA"},{"key":"1719_CR2","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s001340050043","volume":"26","author":"SG Sakka","year":"2000","unstructured":"Sakka SG, R\u00fchl CC, Pfeiffer UJ, Beale R, McLuckie A, Reinhart K, Meier-Hellmann A (2000) Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med 26:180\u2013187","journal-title":"Intensive Care Med"},{"key":"1719_CR3","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1097\/01.CCM.0000130995.18334.8B","volume":"32","author":"R Katzenelson","year":"2004","unstructured":"Katzenelson R, Perel A, Berkenstadt H, Preisman S, Kogan S, Sternik L, Segal E (2004) Accuracy of transpulmonary thermodilution versus gravimetric measurement of extravascular lung water. Crit Care Med 32:1550\u20131554","journal-title":"Crit Care Med"},{"key":"1719_CR4","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1097\/00003246-199910000-00027","volume":"27","author":"S Kitashiro","year":"1999","unstructured":"Kitashiro S, Sugiura T, Tamura T, Izuoka T, Miyoshi H, Saito D, Takayama Y, Iwasaka T (1999) Factors associated with increased extravascular lung water in cardiac tamponade and myocardial ischemia. Crit Care Med 27:2229\u20132233","journal-title":"Crit Care Med"},{"key":"1719_CR5","doi-asserted-by":"publisher","first-page":"1462","DOI":"10.1111\/echo.13646","volume":"34","author":"F Yang","year":"2017","unstructured":"Yang F, Wang Q, Zhi G, Zhang L, Huang D, Shen D, Zhang M (2017) The application of lung ultrasound in acute decompensated heart failure in heart failure with preserved and reduced ejection fraction. Echocardiography 34:1462\u20131469","journal-title":"Echocardiography"},{"key":"1719_CR6","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1002\/ejhf.344","volume":"17","author":"S Coiro","year":"2015","unstructured":"Coiro S, Rossignol P, Ambrosio G, Carluccio E, Alunni G, Murrone A, Tritto I, Zannad F, Girerd N (2015) Prognostic value of residual pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure. Eur J Heart Fail 17:1172\u20131181","journal-title":"Eur J Heart Fail"},{"key":"1719_CR7","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1093\/eurjhf\/hfs033","volume":"14","author":"JJ McMurray","year":"2012","unstructured":"McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, B\u00f6hm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, K\u00f8ber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, R\u00f8nnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology, Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, ESC Committee for Practice Guidelines, Ponikowski P (2012) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 14:803\u2013869","journal-title":"Eur J Heart Fail"},{"issue":"1\u201339","key":"1719_CR8","first-page":"e14","volume":"28","author":"RM Lang","year":"2015","unstructured":"Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1\u201339):e14","journal-title":"J Am Soc Echocardiogr"},{"key":"1719_CR9","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s00134-012-2513-4","volume":"38","author":"G Volpicelli","year":"2012","unstructured":"Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, Melniker L, Gargani L, Noble VE, Via G, Dean A, Tsung JW, Soldati G, Copetti R, Bouhemad B, Reissig A, Agricola E, Rouby JJ, Arbelot C, Liteplo A, Sargsyan A, Silva F, Hoppmann R, Breitkreutz R, Seibel A, Neri L, Storti E, Petrovic T, International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS) (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577\u2013591","journal-title":"Intensive Care Med"},{"key":"1719_CR10","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.echo.2005.05.019","volume":"19","author":"E Picano","year":"2006","unstructured":"Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G (2006) Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiogr 19:356\u2013363","journal-title":"J Am Soc Echocardiogr"},{"key":"1719_CR11","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.ijcard.2019.01.055","volume":"281","author":"A Hubert","year":"2019","unstructured":"Hubert A, Girerd N, Le Breton H, Galli E, Latar I, Fournet M, Mabo P, Schnell F, Leclercq C, Donal E (2019) Diagnostic accuracy of lung ultrasound for identification of elevated left ventricular filling pressure. Int J Cardiol 281:62\u201368","journal-title":"Int J Cardiol"},{"key":"1719_CR12","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/s10741-019-09868-0","volume":"25","author":"A Palazzuoli","year":"2020","unstructured":"Palazzuoli A, Evangelista I, Nuti R (2020) Congestion occurrence and evaluation in acute heart failure scenario: time to reconsider different pathways of volume overload. Heart Fail Rev 25:119\u2013131","journal-title":"Heart Fail Rev"},{"key":"1719_CR13","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1093\/eurjhf\/hfq045","volume":"12","author":"M Gheorghiade","year":"2010","unstructured":"Gheorghiade M, Follath F, Ponikowski P, Barsuk JH, Blair JE, Cleland JG, Dickstein K, Drazner MH, Fonarow GC, Jaarsma T, Jondeau G, Sendon JL, Mebazaa A, Metra M, Nieminen M, Pang PS, Seferovic P, Stevenson LW, van Veldhuisen DJ, Zannad F, Anker SD, Rhodes A, McMurray JJ, Filippatos G, European Society of Cardiology; European Society of Intensive Care Medicine (2010) Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine. Eur J Heart Fail 12:423\u2013433","journal-title":"Eur J Heart Fail"},{"key":"1719_CR14","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/ejhf.1369","volume":"21","author":"W Mullens","year":"2019","unstructured":"Mullens W, Damman K, Harjola VP, Mebazaa A, Brunner-La Rocca HP, Martens P, Testani JM, Tang WHW, Orso F, Rossignol P, Metra M, Filippatos G, Seferovic PM, Ruschitzka F, Coats AJ (2019) The use of diuretics in heart failure with congestion-a position statement from the heart failure Association of the European Society of cardiology. Eur J Heart Fail 21:137\u2013155","journal-title":"Eur J Heart Fail"},{"key":"1719_CR15","first-page":"561","volume":"6","author":"D Lichtenstein","year":"1994","unstructured":"Lichtenstein D (1994) Ultrasound diagnosis of pulmonary edema. Rev Imag Med 6:561\u2013562","journal-title":"Rev Imag Med"},{"key":"1719_CR16","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1016\/j.amjcard.2004.02.012","volume":"93","author":"Z Jambrik","year":"2004","unstructured":"Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E (2004) Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 93:1265\u20131270","journal-title":"Am J Cardiol"},{"key":"1719_CR17","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12890-015-0091-2","volume":"15","author":"Z Zhao","year":"2015","unstructured":"Zhao Z, Jiang L, Xi X, Jiang Q, Zhu B, Wang M, Xing J, Zhang D (2015) Prognostic value of extravascular lung water assessed with lung ultrasound score by chest sonography in patients with acute respiratory distress syndrome. BMC Pulm Med 15:98","journal-title":"BMC Pulm Med"},{"key":"1719_CR18","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13054-015-0756-5","volume":"19","author":"P Enghard","year":"2015","unstructured":"Enghard P, Rademacher S, Nee J, Hasper D, Engert U, J\u00f6rres A, Kruse JM (2015) Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients. Crit Care 19:36","journal-title":"Crit Care"},{"key":"1719_CR19","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1002\/ejhf.1499","volume":"21","author":"E Platz","year":"2019","unstructured":"Platz E, Jhund PS, Girerd N, Pivetta E, McMurray JJV, Peacock WF, Masip J, Martin-Sanchez FJ, Mir\u00f3 \u00d2, Price S, Cullen L, Maisel AS, Vrints C, Cowie MR, DiSomma S, Bueno H, Mebazaa A, Gualandro DM, Tavares M, Metra M, Coats AJS, Ruschitzka F, Seferovic PM, Mueller C, Study Group on Acute Heart Failure of the Acute Cardiovascular Care Association and the Heart Failure Association of the European Society of Cardiology (2019) Expert consensus document: reporting checklist for quantification of pulmonary congestion bylung\u00a0ultrasound\u00a0in\u00a0heart failure. Eur J Heart Fail 21:844\u2013851","journal-title":"Eur J Heart Fail"},{"key":"1719_CR20","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1378\/chest.127.5.1690","volume":"127","author":"E Agricola","year":"2005","unstructured":"Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, Picano E (2005) \u201cUltrasound comet-tail images\u201d: a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest 127:1690\u20131695","journal-title":"Chest"},{"key":"1719_CR21","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1097\/ALN.0000000000000300","volume":"121","author":"G Volpicelli","year":"2014","unstructured":"Volpicelli G, Skurzak S, Boero E, Carpinteri G, Tengattini M, Stefanone V, Luberto L, Anile A, Cerutti E, Radeschi G, Frascisco MF (2014) Lung ultrasound predicts well extravascular lung water but is of limited usefulness in the prediction of wedge pressure. Anesthesiology 121:320\u2013327","journal-title":"Anesthesiology"},{"key":"1719_CR22","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/j.jcmg.2013.08.004","volume":"6","author":"MH Miglioranza","year":"2013","unstructured":"Miglioranza MH, Gargani L, Sant\u2019Anna RT, Rover MM, Martins VM, Mantovani A, Weber C, Moraes MA, Feldman CJ, Kalil RA, Sicari R, Picano E, Leiria TL (2013) Lung ultrasound for the evaluation of pulmonary congestion in outpatients: a comparison with clinical assessment, natriuretic peptides, and echocardiography. JACC Cardiovasc Imaging 6:1141\u20131151","journal-title":"JACC Cardiovasc Imaging"},{"key":"1719_CR23","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1007\/s00392-018-1221-7","volume":"107","author":"A Palazzuoli","year":"2018","unstructured":"Palazzuoli A, Ruocco G, Beltrami M, Nuti R, Cleland JG (2018) Combined use of lung ultrasound, B-type natriuretic peptide, and echocardiography for outcome prediction in patients with acute HFREF and HFPEF. Clin Res Cardiol 107:586\u2013596","journal-title":"Clin Res Cardiol"},{"key":"1719_CR24","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01724-8","author":"M Kobayashi","year":"2020","unstructured":"Kobayashi M, Gargani L, Palazzuoli A, Ambrosio G, Bay\u00e9s-Genis A, Lupon J, Pellicori P, Pugliese NR, Reddy YNV, Ruocco G, Duarte K, Huttin O, Rossignol P, Coiro S, Girerd N (2020) Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure: findings from a pooled analysis of four cohort studies. Clin Res Cardiol. https:\/\/doi.org\/10.1007\/s00392-020-01724-8","journal-title":"Clin Res Cardiol"},{"key":"1719_CR25","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.jchf.2017.09.023","volume":"6","author":"N Girerd","year":"2018","unstructured":"Girerd N, Seronde MF, Coiro S, Chouihed T, Bilbault P, Braun F, Kenizou D, Maillier B, Nazeyrollas P, Roul G, Fillieux L, Abraham WT, Januzzi J, Sebbag L, Zannad F, Mebazaa A, Rossignol P, INI-CRCT, Great Network, and the EF-HF Group (2018) Integrative assessment of congestion in\u00a0heart failure throughout the patient\u00a0journey. JACC Heart Fail 6:273\u2013285","journal-title":"JACC Heart Fail"},{"key":"1719_CR26","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1016\/j.cardfail.2007.07.003","volume":"13","author":"F Frassi","year":"2007","unstructured":"Frassi F, Gargani L, Tesorio P, Raciti M, Mottola G, Picano E (2007) Prognostic value of extravascular lung water assessed with ultrasound lung comets by chest sonography in patients with dyspnea and\/or chest pain. J Card Fail 13:830\u2013835","journal-title":"J Card Fail"},{"key":"1719_CR27","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12947-015-0033-4","volume":"13","author":"L Gargani","year":"2015","unstructured":"Gargani L, Pang PS, Frassi F, Miglioranza MH, Dini FL, Landi P, Picano E (2015) Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study. Cardiovasc Ultrasound 13:40","journal-title":"Cardiovasc Ultrasound"},{"key":"1719_CR28","doi-asserted-by":"publisher","first-page":"39426","DOI":"10.1038\/srep39426","volume":"6","author":"S Coiro","year":"2016","unstructured":"Coiro S, Porot G, Rossignol P, Ambrosio G, Carluccio E, Tritto I, Huttin O, Lemoine S, Sadoul N, Donal E, Zannad F, Girerd N (2016) Prognostic value of pulmonary congestion assessed by lung ultrasound imaging during heart failure hospitalisation: a two-centre cohort study. Sci Rep 6:39426","journal-title":"Sci Rep"},{"key":"1719_CR29","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1002\/ehf2.12208","volume":"5","author":"J \u00d6hman","year":"2018","unstructured":"\u00d6hman J, Harjola VP, Karjalainen P, Lassus J (2018) Focused echocardiography and lung ultrasound protocol for guiding treatment in acute heart failure. ESC Heart Fail 5:120\u2013128","journal-title":"ESC Heart Fail"},{"key":"1719_CR30","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.hrtlng.2018.10.027","volume":"48","author":"FM Russell","year":"2019","unstructured":"Russell FM, Ehrman RR, Ferre R, Gargani L, Noble V, Rupp J, Collins SP, Hunter B, Lane KA, Levy P, Li X, O\u2019Connor C, Pang PS (2019) Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial. Heart Lung 48:186\u2013192","journal-title":"Heart Lung"}],"updated-by":[{"DOI":"10.1007\/s00380-020-01749-z","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000}}],"container-title":["Heart and Vessels"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-020-01719-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00380-020-01719-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-020-01719-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T10:10:52Z","timestamp":1627639852000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00380-020-01719-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,9]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["1719"],"URL":"https:\/\/doi.org\/10.1007\/s00380-020-01719-5","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s00380-020-01749-z","asserted-by":"object"}]},"ISSN":["0910-8327","1615-2573"],"issn-type":[{"value":"0910-8327","type":"print"},{"value":"1615-2573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,9]]},"assertion":[{"value":"10 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2020","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00380-020-01749-z","URL":"https:\/\/doi.org\/10.1007\/s00380-020-01749-z","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the ethics committee of the Fourth Medical Center of Chinese PLA General Hospital, and written informed consent was provided by all the subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}}]}}