<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.1 20151215//EN" "https://jats.nlm.nih.gov/publishing/1.1/JATS-journalpublishing1.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="other" dtd-version="1.1" specific-use="sps-1.9" xml:lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">ijcs</journal-id>
      <journal-title-group>
        <journal-title>International Journal of Cardiovascular Sciences</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Int J Cardiovasc Sci </abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2359-4802</issn>
      <issn pub-type="epub">2359-5647</issn>
      <publisher>
        <publisher-name>Sociedade Brasileira de Cardiologia</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id specific-use="scielo-v3" pub-id-type="publisher-id">FghRWrJXsnnXbNwWZCQ48Hq</article-id>
      <article-id specific-use="scielo-v2" pub-id-type="publisher-id">S2359-56472021000400336</article-id>
      <article-id pub-id-type="publisher-id">ijcs.20210185</article-id>
      <article-id pub-id-type="doi">10.36660/ijcs.20210185</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>PREFACE</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Heart Disease is the Leading Cause of Death for Women &#8211; We must Change the Status Quo</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-0737-6188</contrib-id>
          <name>
            <surname>Oliveira</surname>
            <given-names>Gl&#225;ucia Maria Moraes de</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-1466-9413</contrib-id>
          <name>
            <surname>Mesquita</surname>
            <given-names>Claudio Tinoco</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>2</sup>
          </xref>
          <xref ref-type="aff" rid="aff3">
            <sup>3</sup>
          </xref>
          <xref ref-type="aff" rid="aff4">
            <sup>4</sup>
          </xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution content-type="orgname">Universidade Federal do Rio de Janeiro</institution>
        <addr-line>
          <named-content content-type="city">Rio de Janeiro</named-content>
          <named-content content-type="state">RJ</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">P&#243;s-gradua&#231;&#227;o em Cardiologia da UFRJ, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brazil</institution>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution content-type="orgdiv1">Ebserh/HUAP</institution>
        <institution content-type="orgname">Universidade Federal Fluminense</institution>
        <addr-line>
          <named-content content-type="city">Niter&#243;i</named-content>
          <named-content content-type="state">RJ</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">P&#243;s-Gradua&#231;&#227;o em Ci&#234;ncias Cardiovasculares, Ebserh/HUAP, Universidade Federal Fluminense,Niter&#243;i, RJ - Brazil</institution>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution content-type="orgname">Hospital Pr&#243;-Card&#237;aco</institution>
        <addr-line>
          <named-content content-type="city">Rio de Janeiro</named-content>
          <named-content content-type="state">RJ</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Hospital Pr&#243;-Card&#237;aco, Rio de Janeiro, RJ - Brazil</institution>
      </aff>
      <aff id="aff4">
        <label>4</label>
        <institution content-type="orgdiv1">International Journal of Cardiovascular Sciences</institution>
        <institution content-type="orgname">Sociedade Brasileira de Cardiologia</institution>
        <addr-line>
          <named-content content-type="city">Rio de Janeiro</named-content>
          <named-content content-type="state">RJ</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Editor-in-Chief International Journal of Cardiovascular Sciences, Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil</institution>
      </aff>
      <author-notes>
        <corresp id="c01"><bold>Mailing Address: Gl&#225;ucia Maria Moraes de Oliveira</bold> Universidade Federal do Rio de Janeiro &#8211; R. Prof. Rodolpho P. Rocco, 255 &#8211; 8&#176;. Andar &#8211; Sala 6, UFRJ. Postal Code 21941-913, Cidade Universit&#225;ria, RJ &#8211; Brazil E-mail: <email>glauciam@cardiol.br</email> </corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic">
        <day>09</day>
        <month>08</month>
        <year>2021</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <season>Jul-Aug</season>
        <year>2021</year>
      </pub-date>
      <volume>34</volume>
      <issue>4</issue>
      <fpage>336</fpage>
      <lpage>337</lpage>
      <permissions>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
          <license-p> This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. </license-p>
        </license>
      </permissions>
      <counts>
        <fig-count count="2"/>
        <table-count count="0"/>
        <equation-count count="0"/>
        <ref-count count="11"/>
        <page-count count="2"/>
      </counts>
    </article-meta>
  </front>
  <body>
    <p>
      <fig id="f01">
        <graphic xlink:href="2359-5647-ijcs-34-04-0336-10185-gf01.tif"/></fig>
    </p>
    <p>According to the Continuous National Household Sample Survey, in 2019, the Brazilian population was composed of 48.2% men and 51.8% women. In the age group up to 24 years old, men and women accounted for 17.8% and 17.2% of the population, respectively, in 2019. From 25 years of age onwards, the proportion of women was higher than that of men in all age groups, 30.4% and 34.6%, respectively, for men and women. On the other hand, life expectancy for men in that same year was 73.1 years, and, for women, it was 80.1 years. Therefore, it is important to build data about Brazilian women in all stages of their course of life.<sup><xref ref-type="bibr" rid="B1">1</xref></sup></p>
    <p>The greatest burden of death and disability among women worldwide is attributable to non-communicable diseases, especially cardiovascular diseases (CVD). Moreover, nearly 80% of non-communicable diseases occur in low-income and middle-income countries, such as Brazil.<sup><xref ref-type="bibr" rid="B2">2</xref></sup> Marques-Santos and Oliveira highlighted the differences in CVD between female and male sex and emphasized the higher proportional mortality in Brazilian women.<sup><xref ref-type="bibr" rid="B3">3</xref></sup> According to Global Burden of Disease 2019, in Brazil, CVD accounted for 22.42% of deaths in women, compared to 20.83% in men, considering all ages.<sup><xref ref-type="bibr" rid="B4">4</xref></sup></p>
    <p>In the same line, Parapid &amp; Bond highlight several aspects of the inequity unveiled by COVID-19 in women's lives, and they proposed actions to improve the careers of women in the frontline of the health-care sector. Finally, they conclude that &#8220;most importantly, as doctors, we know that, as long as there is a will, we tend to find a way, and, finally, if not us, then who?&#8221; That is our mission, to meet women where they are to provide better cardiovascular care.<sup><xref ref-type="bibr" rid="B5">5</xref></sup></p>
    <p>Several aspects of risk stratification in women have been shown in the original articles, especially those specific to the female sex, in a country like Brazil with different socioeconomic determinants. It is worth noting that cardiovascular risk in Brazilian women, mostly at young ages, has been changing in recent years, with increased obesity, diabetes, and arterial hypertension, in accordance with data from Global Burden of Disease 2019.<sup><xref ref-type="bibr" rid="B4">4</xref></sup> However, most of them are preventable by means of healthy lifestyles at the population and individual levels.</p>
    <p>Women are underdiagnosed and undertreated compared to men with the worst prognosis in various diseases, such as ischemic heart disease, myocardial infarction, mitral valve diseases, and infective endocarditis, as we can see in the articles in this issue.<sup><xref ref-type="bibr" rid="B6">6</xref> - <xref ref-type="bibr" rid="B10">10</xref></sup></p>
    <p>Dr. Fausto Pinto, President of the World Heart Federation, highlighted the necessity of getting gender equity and listed several suggestions proposed by the ACC&#8217;s Cardiovascular Disease in Women Committee to reduce existing gaps. And he emphasizes that "a lot has been done, but a lot more still needs to be done. It is up to all of us to ensure that will happen".<sup><xref ref-type="bibr" rid="B11">11</xref></sup></p>
    <p>Brazil is a continent-sized country with great heterogeneity and local diversity due to socioeconomic and cultural aspects of women's lives. Therefore, it is fundamental to promote initiatives to increase knowledge about the importance of cardiovascular health in all women's life courses. Furthermore, it is crucial to better understand local disparities in women's cardiovascular health in order to define public policy and health care, reduce gaps, and promote gender equity in Brazilian health care.<sup><xref ref-type="bibr" rid="B3">3</xref></sup></p>
    <p>We would like to thank Dr. Roxana Mehran, Professor of Medicine and Director of Interventional Cardiovascular Research and Clinical Trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai, for accepting the invitation to co-edit this issue. Dr. Mehran is an international leader in cardiology, and she is involved in multiple activities that contribute to the empowerment of women in cardiology and to coping with cardiovascular disease in women. In addition to our special thanks to Dr. Mehran, we extend our thanks to all editors, authors, reviewers, contributors, translators, statisticians, and members of the editorial board of the <italic>International Journal of Cardiovascular Sciences</italic> who have undertaken the enormous effort to bring us this special issue.</p>
    <p>We invite you to read this special issue that intends to understand better all aspects of cardiovascular health care in women in order to give them healthy lives wherever they are. We greatly appreciate all the women who helped us build this special edition, especially Ms. Tailane Rodrigues, who put forth all her best efforts to bring us this outstanding issue of the <italic>International Journal of Cardiovascular Sciences</italic> completely devoted to Brazilian women.</p>
    <p>
      <fig id="f02">
        <caption>
          <title>Tailane Rodrigues Editorial Assistant of the IJCS Journal Postgraduate in Library Science Fluminense Federal University (UFF), Niter&#243;i, RJ - Brazil</title>
        </caption>
        <graphic xlink:href="2359-5647-ijcs-34-04-0336-10185-gf02.tif"/></fig>
    </p>
  </body>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="B1">
        <label>1</label>
        <mixed-citation>1. Instituto Brasileiro de Geografia e Estat&#237;stica. Pesquisa Nacional por Amostra de Domic&#237;lios Cont&#237;nua - PNAD. Bras&#237;lia: IBGE; 2019.</mixed-citation>
        <element-citation publication-type="book">
          <person-group person-group-type="author">
            <collab>Instituto Brasileiro de Geografia e Estat&#237;stica</collab>
          </person-group>
          <source>Pesquisa Nacional por Amostra de Domic&#237;lios Cont&#237;nua - PNAD</source>
          <publisher-loc>Bras&#237;lia</publisher-loc>
          <publisher-name>IBGE</publisher-name>
          <year>2019</year>
        </element-citation>
      </ref>
      <ref id="B2">
        <label>2</label>
        <mixed-citation>2. Oliveira GMM, Brant LCC, Polanczyk CA, Biolo A, Nascimento BR, Malta DC, et al. Cardiovascular Statistics - Brazil 2020. Arq Bras Cardiol. 2020;115(3):308-439. doi: 10.36660/abc.20200812.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Oliveira</surname>
              <given-names>GMM</given-names>
            </name>
            <name>
              <surname>Brant</surname>
              <given-names>LCC</given-names>
            </name>
            <name>
              <surname>Polanczyk</surname>
              <given-names>CA</given-names>
            </name>
            <name>
              <surname>Biolo</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Nascimento</surname>
              <given-names>BR</given-names>
            </name>
            <name>
              <surname>Malta</surname>
              <given-names>DC</given-names>
            </name>
            <etal>et al</etal>
          </person-group>
          <article-title>Cardiovascular Statistics - Brazil 2020</article-title>
          <source>Arq Bras Cardiol</source>
          <year>2020</year>
          <volume>115</volume>
          <issue>3</issue>
          <fpage>308</fpage>
          <lpage>439</lpage>
          <pub-id pub-id-type="doi">10.36660/abc.20200812</pub-id>
        </element-citation>
      </ref>
      <ref id="B3">
        <label>3</label>
        <mixed-citation>3. Marques-Santos C, Oliveira GMM. Are Women the Fragile Sex? Or are They the Singular Sex? Int J Cardiovasc Sci. 2021; 34(4):344-346. doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210171">https://doi.org/10.36660/ijcs.20210171</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Marques-Santos</surname>
              <given-names>C</given-names>
            </name>
            <name>
              <surname>Oliveira</surname>
              <given-names>GMM</given-names>
            </name>
          </person-group>
          <article-title>Are Women the Fragile Sex? Or are They the Singular Sex?</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>344</fpage>
          <lpage>346</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210171">https://doi.org/10.36660/ijcs.20210171</ext-link>
        </element-citation>
      </ref>
      <ref id="B4">
        <label>4</label>
        <mixed-citation>4. Global Burden of Disease Study 2019 (GBD 2019) Results. Global Health Data Exchange Website. Seattle, WA: Institute for Health Metrics and Evaluation (IHME), University of Washington; 2019.</mixed-citation>
        <element-citation publication-type="book">
          <person-group person-group-type="author">
            <collab>Global Burden of Disease Study 2019 (GBD 2019) Results</collab>
          </person-group>
          <source>Global Health Data Exchange Website</source>
          <publisher-loc>Seattle, WA</publisher-loc>
          <publisher-name>Institute for Health Metrics and Evaluation (IHME), University of Washington</publisher-name>
          <year>2019</year>
        </element-citation>
      </ref>
      <ref id="B5">
        <label>5</label>
        <mixed-citation>5. Parapid B, Bond RM. COVID-19: An Insult to Injury on Equity. Int J Cardiovasc Sci. 2021; 34(4):342-343. doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210165">https://doi.org/10.36660/ijcs.20210165</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Parapid</surname>
              <given-names>B</given-names>
            </name>
            <name>
              <surname>Bond</surname>
              <given-names>RM</given-names>
            </name>
          </person-group>
          <article-title>COVID-19: An Insult to Injury on Equity</article-title>
          <source>Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>342</fpage>
          <lpage>343</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210165">https://doi.org/10.36660/ijcs.20210165</ext-link>
        </element-citation>
      </ref>
      <ref id="B6">
        <label>6</label>
        <mixed-citation>6. Vogel B, Acevedo M, Appelman Y, Merz CNB, Chieffo A, Figtree GA, et al. The Lancet Women and Cardiovascular Disease Commission: Reducing the Global Burden by 2030. Lancet. 2021;397(10292):2385-438. doi: 10.1016/S0140-6736(21)00684-X.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Vogel</surname>
              <given-names>B</given-names>
            </name>
            <name>
              <surname>Acevedo</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Appelman</surname>
              <given-names>Y</given-names>
            </name>
            <name>
              <surname>Merz</surname>
              <given-names>CNB</given-names>
            </name>
            <name>
              <surname>Chieffo</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Figtree</surname>
              <given-names>GA</given-names>
            </name>
            <etal>et al</etal>
          </person-group>
          <article-title>The Lancet Women and Cardiovascular Disease Commission: Reducing the Global Burden by 2030</article-title>
          <source>Lancet</source>
          <year>2021</year>
          <volume>397</volume>
          <issue>10292</issue>
          <fpage>2385</fpage>
          <lpage>2438</lpage>
          <pub-id pub-id-type="doi">10.1016/S0140-6736(21)00684-X</pub-id>
        </element-citation>
      </ref>
      <ref id="B7">
        <label>7</label>
        <mixed-citation>7. Ferreira MCM, Oliveira MV, Paiva MSM, Lemke V, Mangione F, Oliveira GMM. Closing the Gender Gap in Ischemic Heart Diseases and Myocardial Infarction. Int J Cardiovasc Sci. 2021; 34(4):471-483 doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210001">https://doi.org/10.36660/ijcs.20210001</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Ferreira</surname>
              <given-names>MCM</given-names>
            </name>
            <name>
              <surname>Oliveira</surname>
              <given-names>MV</given-names>
            </name>
            <name>
              <surname>Paiva</surname>
              <given-names>MSM</given-names>
            </name>
            <name>
              <surname>Lemke</surname>
              <given-names>V</given-names>
            </name>
            <name>
              <surname>Mangione</surname>
              <given-names>F</given-names>
            </name>
            <name>
              <surname>Oliveira</surname>
              <given-names>GMM</given-names>
            </name>
          </person-group>
          <article-title>Closing the Gender Gap in Ischemic Heart Diseases and Myocardial Infarction</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>471</fpage>
          <lpage>483</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210001">https://doi.org/10.36660/ijcs.20210001</ext-link>
        </element-citation>
      </ref>
      <ref id="B8">
        <label>8</label>
        <mixed-citation>8. Moreira JL, Barletta PHAAS, Baucia JA. Women Undergoing Mitral Valve Replacement: A Retrospective Analysis. Int J Cardiovasc Sci. 2021; 34(4):431-442. doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20200412">https://doi.org/10.36660/ijcs.20200412</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Moreira</surname>
              <given-names>JL</given-names>
            </name>
            <name>
              <surname>Barletta</surname>
              <given-names>PHAAS</given-names>
            </name>
            <name>
              <surname>Baucia</surname>
              <given-names>JA</given-names>
            </name>
          </person-group>
          <article-title>Women Undergoing Mitral Valve Replacement: A Retrospective Analysis</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>431</fpage>
          <lpage>442</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20200412">https://doi.org/10.36660/ijcs.20200412</ext-link>
        </element-citation>
      </ref>
      <ref id="B9">
        <label>9</label>
        <mixed-citation>9. Sousa C, Nogueira PJ, Pinto FJ. Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal &#8211; How do Women and Men Compare? Int J Cardiovasc Sci. 2021; 34(4):347-355. doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210032">https://doi.org/10.36660/ijcs.20210032</ext-link> </mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Sousa</surname>
              <given-names>C</given-names>
            </name>
            <name>
              <surname>Nogueira</surname>
              <given-names>PJ</given-names>
            </name>
            <name>
              <surname>Pinto</surname>
              <given-names>FJ</given-names>
            </name>
          </person-group>
          <article-title>Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal &#8211; How do Women and Men Compare?</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>347</fpage>
          <lpage>355</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210032">https://doi.org/10.36660/ijcs.20210032</ext-link>
        </element-citation>
      </ref>
      <ref id="B10">
        <label>10</label>
        <mixed-citation>10. Mehran R, Vogel B. Women and Cardiac Disease: A Special Issue. Int J Cardiovasc Sci. 2021; 34(4):338-339. doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210173">https://doi.org/10.36660/ijcs.20210173</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Mehran</surname>
              <given-names>R</given-names>
            </name>
            <name>
              <surname>Vogel</surname>
              <given-names>B</given-names>
            </name>
          </person-group>
          <article-title>Women and Cardiac Disease: A Special Issue</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>338</fpage>
          <lpage>339</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210173">https://doi.org/10.36660/ijcs.20210173</ext-link>
        </element-citation>
      </ref>
      <ref id="B11">
        <label>11</label>
        <mixed-citation>11. Pinto FJ. Gender Equity: Time to Act. Int J Cardiovasc Sci. 2021; 34(4):340-341.doi: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210183">https://doi.org/10.36660/ijcs.20210183</ext-link>.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Pinto</surname>
              <given-names>FJ</given-names>
            </name>
          </person-group>
          <article-title>Gender Equity: Time to Act</article-title>
          <source>Int J Cardiovasc Sci</source>
          <year>2021</year>
          <volume>34</volume>
          <issue>4</issue>
          <fpage>340</fpage>
          <lpage>341</lpage>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.36660/ijcs.20210183">https://doi.org/10.36660/ijcs.20210183</ext-link>
        </element-citation>
      </ref>
    </ref-list>
  </back>
</article>
