Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Preoperative ketamine administration for prevention of postoperative neurocognitive disorders after major orthopedic surgery in elderly patients: A multicenter randomized blinded placebo-controlled trial","authors":"Franck Verdonk ,&nbsp;Pierre Lambert ,&nbsp;Clément Gakuba ,&nbsp;Anais Charles Nelson ,&nbsp;Thomas Lescot ,&nbsp;Fanny Garnier ,&nbsp;Jean-Michel Constantin ,&nbsp;Danielle Saurel ,&nbsp;Sigismond Lasocki ,&nbsp;Emmanuel Rineau ,&nbsp;Pierre Diemunsch ,&nbsp;Lucas Dreyfuss ,&nbsp;Benoît Tavernier ,&nbsp;Lucillia Bezu ,&nbsp;Julien Josserand ,&nbsp;Alexandre Mebazaa ,&nbsp;Marine Coroir ,&nbsp;Karine Nouette-Gaulain ,&nbsp;Gerard Macouillard ,&nbsp;Pauline Glasman ,&nbsp;Jean Mantz","doi":"10.1016/j.accpm.2024.101387","DOIUrl":"10.1016/j.accpm.2024.101387","url":null,"abstract":"<div><h3>Background</h3><p>Preventive anesthetic impact on the high rates of postoperative neurocognitive disorders in elderly patients is debated. The Prevention of postOperative Cognitive dysfunction by Ketamine (POCK) study aimed to assess the effect of ketamine on this condition.</p></div><div><h3>Methods</h3><p>This is a multicenter, randomized, double-blind, interventional study. Patients ≥60 years undergoing major orthopedic surgery were randomly assigned in a 1:1 ratio to receive preoperative ketamine 0.5 mg/kg as an intravenous bolus (n = 152) or placebo (n = 149) in random blocks stratified according to the study site, preoperative cognitive status and age. The primary outcome was the proportion of objective delayed neurocognitive recovery (dNR) defined as a decline of one or more neuropsychological assessment standard deviations on postoperative day 7. Secondary outcomes included a three-month incidence of objective postoperative neurocognitive disorder (POND), as well as delirium, anxiety, and symptoms of depression seven days and three months after surgery.</p></div><div><h3>Results</h3><p>Among 301 patients included, 292 (97%) completed the trial. Objective dNR occurred in 50 (38.8%) patients in the ketamine group and 54 (40.9%) patients in the placebo group (OR [95% CI] 0.92 [0.56; 1.51], <em>p</em> = 0.73) on postoperative day 7. Incidence of objective POND three months after surgery did not differ significantly between the two groups nor did incidence of delirium, anxiety, apathy, and fatigue. Symptoms of depression were less frequent in the ketamine group three months after surgery (OR [95% CI] 0.34 [0.13–0.86]).</p></div><div><h3>Conclusions</h3><p>A single preoperative bolus of intravenous ketamine does not prevent the occurrence of dNR or POND in elderly patients scheduled for major orthopedic surgery. (Clinicaltrials.gov NCT02892916).</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101387"},"PeriodicalIF":3.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352556824000456/pdfft?md5=61502f894f2403990e4a0e1559fcf9b2&pid=1-s2.0-S2352556824000456-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative dexamethasone is associated with a lower risk of respiratory failure in thoracic surgery: Observational cohort study (SURTHODEX)","authors":"Rayan Braik ,&nbsp;Yohan Germain ,&nbsp;Thomas Flet ,&nbsp;Anis Chaba ,&nbsp;Piere-Grégoire Guinot ,&nbsp;Leo Garreau ,&nbsp;Stephane Bar ,&nbsp;Momar Diouf ,&nbsp;Osama Abou-Arab ,&nbsp;Yazine Mahjoub ,&nbsp;Pascal Berna ,&nbsp;Hervé Dupont","doi":"10.1016/j.accpm.2024.101386","DOIUrl":"10.1016/j.accpm.2024.101386","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative complications, particularly respiratory complications, are of significant clinical concern in patients undergoing elective thoracic surgery. Dexamethasone (DXM), commonly administered to prevent postoperative nausea and vomiting (PONV), has potential anti-inflammatory effects that might be beneficial in reducing these complications. We aimed to investigate whether intraoperative DXM administration could mitigate the occurrence of respiratory complications following elective thoracic surgery.</p></div><div><h3>Methods</h3><p>We conducted a single-center observational study, including patients who underwent elective thoracic surgery from 2012 to 2020. The primary outcome was the onset of acute respiratory failure within 7 days post-surgery. Secondary outcomes encompassed other postoperative complications, duration of hospital stay, and mortality within 30 days post-surgery. An overlap propensity score analysis was employed to estimate the treatment effect.</p></div><div><h3>Results</h3><p>We included 1,247 adult patients, 897 who received dexamethasone (DXM) and 350 who served as controls. Intraoperative dexamethasone administration was associated with a significant reduction in respiratory complications with an adjusted relative risk (RR) of 0.65 (95% CI: 0.43−0.97). There was also a significant decline in composite infectious criteria with an adjusted RR of 0.76 (95% CI: 0.63−0.93). Cardiac complications were also assessed as a composite criterion, and a significant reduction was observed (adjusted RR, 0.68; 95% CI, 0.51−0.9). However, there were no association with mechanical complications, mortality within 30 days (adjusted RR of 0.43, 95% CI: 0.17–1.09) or in the length of hospital stay (adjusted RR of 0.85, 95% CI: 0.71–1.02).</p></div><div><h3>Conclusions</h3><p>Dexamethasone administration was associated with a reduction in postoperative respiratory complications. Further prospective studies are needed to confirm these findings.</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101386"},"PeriodicalIF":3.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a natural language processing algorithm using national reporting data to improve identification of anesthesia-related ADVerse evENTs: The “ADVENTURE” study","authors":"Paul M Mertes ,&nbsp;Claire Morgand ,&nbsp;Paul Barach ,&nbsp;Geoffrey Jurkolow ,&nbsp;Karen E. Assmann ,&nbsp;Edouard Dufetelle ,&nbsp;Vincent Susplugas ,&nbsp;Bilal Alauddin ,&nbsp;Patrick Georges Yavordios ,&nbsp;Jean Tourres ,&nbsp;Jean-Marc Dumeix ,&nbsp;Xavier Capdevila","doi":"10.1016/j.accpm.2024.101390","DOIUrl":"10.1016/j.accpm.2024.101390","url":null,"abstract":"<div><h3>Background</h3><p>Reporting and analysis of adverse events (AE) is associated with improved health system learning, quality outcomes, and patient safety. Manual text analysis is time-consuming, costly, and prone to human errors. We aimed to demonstrate the feasibility of novel machine learning and natural language processing (NLP) approaches for early predictions of adverse events and provide input to direct quality improvement and patient safety initiatives.</p></div><div><h3>Methods</h3><p>We used machine learning to analyze 9559 continuously reported AE by clinicians and healthcare systems to the French National Health accreditor (HAS) between January 1, 2009, and December 31, 2020 . We validated the labeling of 135,000 unique de-identified AE reports and determined the associations between different system's root causes and patient consequences. The model was validated by independent expert anesthesiologists.</p></div><div><h3>Results</h3><p>The machine learning (ML) and Artificial Intelligence (AI) model trained on 9559 AE datasets accurately categorized 8800 (88%) of reported AE. The three most frequent AE types were “difficult orotracheal intubation” (16.9% of AE reports), “medication error” (10.5%), and “post-induction hypotension” (6.9%). The accuracy of the AI model reached 70.9% sensitivity, 96.6% specificity for “difficult intubation”, 43.2% sensitivity, and 98.9% specificity for “medication error.”</p></div><div><h3>Conclusions</h3><p>This unsupervised ML method provides an accurate, automated, AI-supported search algorithm that ranks and helps to understand complex risk patterns and has greater speed, precision, and clarity when compared to manual human data extraction. Machine learning and Natural language processing (NLP) models can effectively be used to process natural language AE reports and augment expert clinician input. This model can support clinical applications and methodological standards and used to better inform and enhance decision-making for improved risk management and patient safety.</p></div><div><h3>Trial Registration</h3><p>The study was approved by the ethics committee of the French Society of Anesthesiology (IRB 00010254-2020-20) and the CNIL (CNIL: 118 58 95) and the study was registered with ClinicalTrials.gov (NCT: NCT05185479).</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101390"},"PeriodicalIF":5.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352556824000481/pdfft?md5=209048f02e8f384ce8121fb06025882a&pid=1-s2.0-S2352556824000481-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing patient needs with environmental impacts for best practices in general anesthesia: Narrative review and clinical perspective","authors":"Matthieu Jabaudon ,&nbsp;Bhadrish Vallabh ,&nbsp;H. Peter Bacher ,&nbsp;Rafael Badenes ,&nbsp;Franz Kehl","doi":"10.1016/j.accpm.2024.101389","DOIUrl":"10.1016/j.accpm.2024.101389","url":null,"abstract":"<div><p>Discussions of the environmental impacts of general anesthetics have focused on greenhouse gas (GHG) emissions from inhaled agents, with those of total intravenous anesthesia (TIVA) recently coming to the forefront. Clinical experts are calling for the expansion of research toward life cycle assessment (LCA) to comprehensively study the impact of general anesthetics. We provide an overview of proposed environmental risks, including direct GHG emissions from inhaled anesthetics and non-GHG impacts and indirect GHG emissions from propofol. A practical description of LCA methodology is also provided, as well as how it applies to the study of general anesthesia. We describe available LCA studies comparing the environmental impacts of a lower carbon footprint inhaled anesthetic, sevoflurane, to TIVA/propofol and discuss their life cycle steps: manufacturing, transport, clinical use, and disposal. Significant hotspots of GHG emission were identified as the manufacturing and disposal of sevoflurane and use (attributed to the manufacture of the required syringes and syringe pumps) for propofol. However, the focus of these studies was solely on GHG emissions, excluding other environmental impacts of wasted propofol, such as water/soil toxicity. Other LCA gaps included a lack of comprehensive GHG emission estimates related to the manufacturing of TIVA plastic components, high-temperature incineration of propofol, and gas capture technologies for inhaled anesthetics. Considering that scarce LCA evidence does not allow for a definite conclusion to be drawn regarding the overall environmental impacts of sevoflurane and TIVA, we conclude that current anesthetic practice involving these agents should focus on patient needs and established best practices as more LCA research is accumulated.</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101389"},"PeriodicalIF":3.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric obstructive sleep apnea: a prospective observational study of respiratory events in the immediate recovery period after adenotonsillectomy","authors":"Proshad N. Efune ,&nbsp;Pedro Pinales ,&nbsp;Jenny Park ,&nbsp;Kiley F. Poppino ,&nbsp;Ron B. Mitchell ,&nbsp;Peter Szmuk","doi":"10.1016/j.accpm.2024.101385","DOIUrl":"10.1016/j.accpm.2024.101385","url":null,"abstract":"<div><h3>Background</h3><p>Adenotonsillectomy is often curative for pediatric obstructive sleep apnea, yet children remain at high risk of respiratory complications in the postoperative period. We sought to determine the incidence and risk factors for respiratory depression and airway obstruction, as well as clinically apparent respiratory events in the post-anesthesia care unit (PACU) in high-risk children after adenotonsillectomy.</p></div><div><h3>Methods</h3><p>In this prospective cohort study, we enrolled 60 high-risk children having adenotonsillectomy. Our primary outcome was respiratory depression and airway obstruction in the PACU measured using a noninvasive respiratory volume monitor (RVM) and defined by episodes of predicted minute ventilation less than 40% for at least 2 min. We measured clinically apparent respiratory events using continuous observation by trained study staff.</p></div><div><h3>Results</h3><p>The median (range) age of our sample was 4 years (1, 16) and 27 (45%) were female. Black and Hispanic race children comprised 80% (n = 48) of our cohort. Thirty-nine (65%) had at least one episode of PACU respiratory depression or airway obstruction measured using the RVM, while only 21 (35%) had clinically apparent respiratory events. Poisson regression demonstrated the following associations with an increase in episodes of respiratory depression and airway obstruction: BMI Z-score less than −1 (estimate 3.91; [95%CI 1.49–10.23]), BMI Z-score 1–2 (estimate 2.04; [1.20–3.48]), and two or more comorbidities (estimate 1.96; [1.11–3.46]).</p></div><div><h3>Conclusions</h3><p>Respiratory volume monitoring in the immediate postoperative period after pediatric high-risk adenotonsillectomy identifies impaired ventilation more frequently than is clinically apparent.</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101385"},"PeriodicalIF":3.7,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New approach of classifying venous congestion in critically ill patients based on unsupervised machine-learning technique","authors":"Adrian Wong ,&nbsp;Jihad Mallat ,&nbsp;Marc-Olivier Fischer","doi":"10.1016/j.accpm.2024.101383","DOIUrl":"10.1016/j.accpm.2024.101383","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 3","pages":"Article 101383"},"PeriodicalIF":5.5,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of cerebral oxygenation based on regional cerebral oxygen saturation monitoring during carotid endarterectomy: a Phase III multicenter, double-blind randomized controlled trial","authors":"Yann Le Teurnier ,&nbsp;Bertrand Rozec ,&nbsp;Cecile Degryse ,&nbsp;François Levy ,&nbsp;Youcef Miliani ,&nbsp;Gilles Godet ,&nbsp;Georges Daccache ,&nbsp;Cyrille Truc ,&nbsp;Eric Steinmetz ,&nbsp;Alexandre Ouattara ,&nbsp;Bernard Cholley ,&nbsp;Jean-Marc Malinovsky ,&nbsp;Denis Portier ,&nbsp;Gregory Dupont ,&nbsp;Darius Liutkus ,&nbsp;Pierre Viard ,&nbsp;Morgane Pere ,&nbsp;Benjamin Daumas-Duport ,&nbsp;Pierre-Aubin Magras ,&nbsp;Mickael Vourc’h","doi":"10.1016/j.accpm.2024.101388","DOIUrl":"10.1016/j.accpm.2024.101388","url":null,"abstract":"<div><h3>Background</h3><p>Whether the optimization of cerebral oxygenation based on regional cerebral oxygen saturation (rSO₂) monitoring reduces the occurrence of cerebral ischemic lesions is unknown.</p></div><div><h3>Methods</h3><p>This multicenter, randomized, controlled trial recruited adults admitted for scheduled carotid endarterectomy. Patients were randomized between the standard of care or optimization of cerebral oxygenation based on rSO₂ monitoring using near-infrared spectroscopy. In the intervention group, in case of a decrease in rSO₂ in the intervention, the following treatments were sequentially recommended: (1) increasing oxygenotherapy, (2) reducing the tidal volume, (3) legs up-raising, (4) performing a fluid challenge and (5) initiating vasopressor support. The primary endpoint was the number of new cerebral ischemic lesions detected using magnetic resonance imaging pre- and postoperatively. Secondary endpoints included new neurological deficits and mortality on day 120 after surgery.</p></div><div><h3>Results</h3><p>Among the 879 patients who were randomized, 665 (75.7%) were men. There was no statistically significant difference between groups for the mean number of new cerebral ischemic lesions per patient up to 3 days after surgery: 0.35 (<strong>±</strong>1.05) in the standard group <em>vs.</em> 0.58 (<strong>±</strong>2.83), in the NIRS group; mean difference, 0.23 [95% CI, −0.06 to 0.52]; estimate, 0.22 [95% CI, −0.06 to 0.50]. New neurological deficits up to day 120 after hospital discharge were not different between the groups: 15 (3,39%) in the standard group <em>vs.</em> 42 (5,49%) in the NIRS group; absolute difference, 2,10 [95% CI, −0,62 to 4,82]. There was no significant difference between groups for the median [IQR] hospital length of stay: 4.0 [4.0–6.0] in the standard group <em>vs.</em> 5.0 [4.0–6.0] in the NIRS group; mean difference, −0.11 [95% CI, −0.65 to 0.44]. The mortality rate on day 120 was not different between the standard group (0.68%) <em>vs.</em> the NIRS group (0.92%); absolute difference = 0.24% [95% CI, −0.94 to 1.41].</p></div><div><h3>Conclusions</h3><p>Among patients undergoing carotid endarterectomy, optimization of cerebral oxygenation based on rSO₂ did not reduce the occurrence of cerebral ischemic lesions postoperatively compared with controlled hypertensive therapy.</p></div><div><h3>Trial registration</h3><p>ClinicalTrials.gov identifier: NCT01415648.</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101388"},"PeriodicalIF":3.7,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352556824000468/pdfft?md5=cd274378313fad99e946a95c75ec61d0&pid=1-s2.0-S2352556824000468-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial of the LMA® Gastro™ compared to nasal cannula for endoscopic retrograde cholangiopancreatography","authors":"Katherine B. Hagan ,&nbsp;Emmanuel Coronel ,&nbsp;Phillip Ge ,&nbsp;Carin Hagberg","doi":"10.1016/j.accpm.2024.101379","DOIUrl":"10.1016/j.accpm.2024.101379","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101379"},"PeriodicalIF":3.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating critical airways: videolaryngoscopy's role in transesophageal echocardiography probe insertion","authors":"Ahed Zeidan ,&nbsp;Morgan le Guen ,&nbsp;Munir Bamadhaj","doi":"10.1016/j.accpm.2024.101381","DOIUrl":"10.1016/j.accpm.2024.101381","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 3","pages":"Article 101381"},"PeriodicalIF":5.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of preoxygenation devices using a lung simulator mimicking normal adult spontaneous breathing","authors":"Antoine Charles ,&nbsp;Sandrine Jaffre ,&nbsp;Karim Lakhal ,&nbsp;Raphael Cinotti ,&nbsp;Corinne Lejus-Bourdeau","doi":"10.1016/j.accpm.2024.101378","DOIUrl":"10.1016/j.accpm.2024.101378","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 4","pages":"Article 101378"},"PeriodicalIF":3.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}