Journal of Patient Safety最新文献

{"title":"A Qualitative Study Exploring the Acceptability and Usability of the e-Prescribing Risk and Safety Evaluation (ePRaSE) Assessment Within English Hospitals.","authors":"Jude Heed, Andrew Heed, Stephanie Klein, Ann Slee, Neil Watson, Andrew K Husband, Sarah P Slight","doi":"10.1097/PTS.0000000000001322","DOIUrl":"10.1097/PTS.0000000000001322","url":null,"abstract":"<p><strong>Objectives: </strong>The e-prescribing risk and safety evaluation (ePRaSE) tool was developed to support the evaluation of hospital e-prescribing (EP) systems. The tool uses fictitious patients alongside previously validated prescribing scenarios to detect whether these systems provide appropriate prescribing advice to users. We sought to evaluate the usability and acceptability of ePRaSE across different EP systems in England.</p><p><strong>Materials and methods: </strong>NHS hospitals in England with live EP systems were invited to participate. A combination of observations and semi-structured interviews were used to explore participants' perspectives on the acceptability and usability of ePRaSE throughout all stages of the tool development. The data were transcribed verbatim, coded, and analyzed using the Framework Approach.</p><p><strong>Results: </strong>The study was conducted over 2 periods: April-December 2019 and September 2022-January 2023. Thirty-two health care professionals across 22 different NHS hospitals participated in semi-structured interviews (n=25) and 13 observations (n=20) involving 11 different EP systems in total. The ePRaSE assessment was completed in 2 to 3 hours and participants described the tool as easy to use with clinically relevant prescribing tasks. However, some participants experienced difficulties inputting clinical data, such as laboratory results, due to restricted access to different parts of the electronic health record. Many participants suggested areas for further improvement such as capturing a broader range of implemented clinical decision support and requested more detailed feedback on the performance of their systems.</p><p><strong>Conclusions: </strong>EP system users found ePRaSE to be a useful and acceptable tool. Further refinement is desirable, particularly in recording EP system responses and providing detailed results to optimize EP systems for safety benefits.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"309-316"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383557","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":"Microbial Contamination of Eye Drops: A Systematic Review and Meta-analysis.","authors":"Samuel Kyei, Randy Asiamah, Sandra Owusu, Nyaradzo Ellen Masango","doi":"10.1097/PTS.0000000000001334","DOIUrl":"10.1097/PTS.0000000000001334","url":null,"abstract":"<p><strong>Objectives: </strong>To profile the array of microbial contaminants of eye drops, both native and non-native to the ocular surface, and associated factors for contamination.</p><p><strong>Methods: </strong>Potentially relevant studies were retrieved from major bibliographic databases (PubMed, Scopus, and Web of Science). Data were extracted, and study-specific estimates of the contamination rates of topical ophthalmic solutions were combined using meta-analysis to obtain pooled results.</p><p><strong>Results: </strong>A total of 33 studies that evaluated the microbial contamination rate in 4600 samples were included in this study. The microbial contamination rate of in-use ophthalmic medications is 10% (95% CI: 6%-17%; PI: 0%-78%, I2 =95.1%). The contamination rate among diagnostic eye drops is 13% (95% CI: 3%-42%; PI: 0%-98%, I2 =95.6%), and the contamination rate among therapeutic eye drops is 10% (95% CI: 6%-17%; PI: 1%-63%, I2 =94.9%). Staphylococcus spp. were the most prevalent gram-positive bacterial contaminants [3.55% (95% CI: 1.52%-8.04%; PI: 0.08%-63.46%), I2 =93.2%], Escherichia coli , the most prevalent gram-negative contaminants [1.02% (95% CI: 0.50%-2.05%; PI: 0.16 to 6.04%), I2 =24.8%], and Aspergillus spp., the most prevalent fungal contaminants [0.88% (95% CI: 0.31%-2.51%; PI: 0.03%-22.05%), I2 =89.9%].</p><p><strong>Conclusion: </strong>There is a high rate of microbial contamination in topical ophthalmic solutions, which has implications for patient safety and the effort to stem avoidable blindness. Similar to injectable medications, we recommend using single-use vials for topical ophthalmic solutions, as opposed to multi-use vials, which are stored for a protracted period of time and used on multiple patients.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"297-308"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606913","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":"Adverse Events Reported Across 15 Years of Multicenter Chiropractic Student Clinical Placements in Western Australia.","authors":"Lyndon G Amorin-Woods, Vincenzo Cascioli, Barrett E Losco, Gregory F Parkin-Smith","doi":"10.1097/PTS.0000000000001339","DOIUrl":"10.1097/PTS.0000000000001339","url":null,"abstract":"<p><strong>Aim: </strong>To report the rate and severity of adverse events (AEs) among patients receiving services at university-based chiropractic clinical placements over a 15-year period in Western Australia.</p><p><strong>Methods: </strong>Patients reporting AEs were identified from an incident register between 2008 and 2023. Details of all incidents were authenticated through extracted data from patient follow-up, clinical records, clinician reports, legal, and insurer advice and were graded (1-5) based on severity.</p><p><strong>Results and discussion: </strong>Chiropractic services were delivered by 921 chiropractic students and supervised by 44 registered chiropractors during the 15-year time span in metropolitan, rural, and remote locations. Among 410,957 clinical encounters (CE) comprising 349,075 treatment sessions for 61,882 unique patients, 20 mild (grade 1) clinical AEs were identified, yielding a crude incidence rate of 4.87 per 100,000 (95% CI: 2.79-7.52), or 1:20,548 clinical encounters. Signs and symptoms of AEs were acute or exacerbated low back pain, neck pain, and mid-back pain/shoulder pain. The most common presenting complaints among the patients reporting an AE were pain in 3 spinal regions.</p><p><strong>Conclusions: </strong>The incidence of AEs associated with chiropractic care in this population corroborates previous studies that report the rate and severity of AEs to be rare and mild.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"329-338"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711791","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":"Pre-endoscopy Anesthesiology Clinic Evaluation Does Not Reduce Adverse Event Rates for High-risk for Sedation Patients.","authors":"Tamar Thurm, Niv Zmora, Rafael Bruck, Nir Bar, Adam Philips, Oren Shibolet, Liat Deutsch","doi":"10.1097/PTS.0000000000001327","DOIUrl":"10.1097/PTS.0000000000001327","url":null,"abstract":"<p><strong>Objectives: </strong>Preoperative or preanesthesia evaluation is an established practice in patients undergoing surgery. The efficacy of a similar practice before endoscopic procedures has not yet been determined. At our medical center, patients with severe comorbidities, deemed at high risk for sedation, were assigned to an anesthesiologist-supervised endoscopic procedure (ASEP). Since late 2016 they are assessed at anesthesiology clinic pre-endoscopy. Our objective was to compare adverse events (AEs) between these 2 strategies.</p><p><strong>Methods: </strong>A retrospective review of all ambulatory upper and lower endoscopies between 2016 and 2017 was performed. Data on postprocedural (14 d) emergency department (ED) admissions, hospitalizations, operations, and mortality before and after policy change (BPC and APC) were compared.</p><p><strong>Results: </strong>During the study period 18,240 ambulatory upper and lower endoscopic procedures were performed in 14,906 patients, 7447 (49.96%) BPC, and 7459 (50.04%) APC; 580 were ASEP. The proportions of ASEP were comparable between the 2 time periods (BPC 295 versus APC 285; P =0.721); however, APC there was a 25-fold increase in pre-endoscopy anesthesiology clinic assessments [BPC-6 patients (2.03%) versus APC-146 patients (51.22%), P <0.001]. Postprocedural sedation-related AEs were comparable between the groups [0.07%-BPC (head injury, stroke, myocardial infarction, and aspiration) versus 0.03%-APC (aspiration and dyspnea), P =0.256]. None of these patients were sedated by an anesthesiologist.</p><p><strong>Conclusions: </strong>Policy change of pre-endoscopy evaluation for high-risk for sedation patients was not associated with a change in AE rates. Policy adherence was limited. The lack of AE rate reduction may indicate a marginal impact on an already low event rate with ASEP for high-risk patients.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"324-328"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460126","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":"Tirelessly Striving Towards the Challenging Goal of Patient Safety: A Content Analysis of Patient Advocacy Dialogs on Facebook.","authors":"Riley Wolynn, Beth L Hoffman, Scotland Huber, Paul E Phrampus, Jaime E Sidani","doi":"10.1097/PTS.0000000000001343","DOIUrl":"10.1097/PTS.0000000000001343","url":null,"abstract":"<p><strong>Objectives: </strong>Patient experiences are focal points in the discourse around medical errors and patient safety, with social media offering new avenues to explore them. This study aimed to understand patient and family perspectives through a mixed-method analysis of posts made to a public Facebook group focused on patient safety.</p><p><strong>Methods: </strong>A total of 200 posts posted between November 21, 2022 and June 23, 2023 were manually extracted and double-coded by 2 independent human coders using a systematically developed codebook. Frequencies were calculated and χ 2 tests were performed to analyze associations between codes. A grounded theory approach was used to qualitatively analyze key themes in the posts.</p><p><strong>Results: </strong>Of the 141 posts deemed relevant to patient safety, the majority (85%) included links to external news sources or information, rather than direct accounts of personal experiences. The most frequently discussed error types were surgical errors (28%) and infections (17%). The most frequent content codes were policy and regulatory issues (35%) and patient empowerment and advocacy (33%). Posts containing links had significantly more discussions about empowerment and advocacy, infections in vulnerable populations, and policy and advocacy compared with those without links. Overarching qualitative themes included the personal impact of medical errors, systemic challenges, the importance of empowerment through education, and the role of community support.</p><p><strong>Conclusions: </strong>This study underscores the importance of online communities in influencing patient safety discourse. Findings support the utility of using social media data for patient safety research and provide unique insights into patient concerns and advocacy efforts.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"364-370"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755421","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":"A Scoping Review on the Incidence of Nonoperating Room Anesthesia Safety Events.","authors":"Raina Khan, Kristie J Sun, Morgan O'Connor, Jacqueline M Leung","doi":"10.1097/PTS.0000000000001342","DOIUrl":"10.1097/PTS.0000000000001342","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the incidence of adverse and near-miss events in nonoperating room anesthesia (NORA); to identify study methodology, strength of findings, and knowledge gaps regarding these events.</p><p><strong>Methods: </strong>A scoping review was performed between 2022 and 2023, surveying literature from 2006 to 2023. The included studies examined adults undergoing a NORA procedure. Excluded studies were in the intensive care unit, peripartum areas, the operating room, or pediatric only.</p><p><strong>Results: </strong>A total of 586 records were identified using the keywords: \"NORA,\" \"non-operating room anesthesia,\" \"anesthesia,\" \"adverse event,\" and \"near miss event.\" After screening, 58 full texts were reviewed and 12 studies were included. Five were retrospective observational, 4 were retrospective claims analyses, and 3 were surveys. Incidence rates of adverse events ranged from 0.01% to 38.6%, partially reflecting heterogeneity in event definition. Only one publication studied near-miss events: a retrospective survey of anesthesia providers. It described that near-miss events occurred more often but were reported less frequently than adverse events. A near-miss incidence rate could not be determined. Included articles were assessed using the Grading of Recommendations, Assessment, Development, and Evaluations System criteria. The overall quality was low to moderate.</p><p><strong>Conclusions: </strong>There is limited investigation regarding NORA safety events and a lack of high-quality prospective studies. Specific areas for future investigation include: (1) standardized definition and incidence of safety events; (2) specific study of near-miss events; (3) evidence-based recommendations to optimize safety. Considering the anticipated growth of procedures and heterogenous locations, our findings strongly suggest a dedicated study of NORA-specific safety concerns.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"356-363"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732648","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":"Physician, Physician Assistant, Nurse Practitioner, and Pharmacist State Board Disciplinary Actions: Cross-sectional Analysis of the United States in 2023.","authors":"Jon Lewis, Paul M Miller, Sydnee Hill, Olivia Younger, Alison Lemme, Peyton Wahl","doi":"10.1097/PTS.0000000000001337","DOIUrl":"10.1097/PTS.0000000000001337","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this research is to audit, summarize, and analyze state board disciplinary actions reported to the public and the National Practitioner Data Bank (NPDB) in the United States in 2023 for MD, DO, PA, NP, and PharmD health care providers (HCPs).</p><p><strong>Methods: </strong>Researchers extracted disciplinary action data from state board public publications for select HCPs and compared this data to disciplinary actions reported through the NPDB Public Use Data File. Parametric (i.e., analysis of variance and t tests) and nonparametric (i.e., Kruskal-Wallis and Wilcoxon) statistical tests were utilized for data analysis. The primary outcome was an analysis of average disciplinary action rates per 1000 HCPs. Secondary outcomes analyzed included state board publicly reported disciplinary action outcomes and infractions.</p><p><strong>Results: </strong>Respectively, 3165 and 4037 disciplinary actions were identified from state board publications and the NPDB. PAs and NPs had a lower incurrence of disciplinary actions from state boards when compared with MDs, DOs, and PharmDs. There was significant underreporting of disciplinary actions to the public by MD and PharmD state boards. Of all the ad hoc outcomes and infractions researched, sexual misconduct was the only category with statistically significant differences between HCPs and with applicability for further analysis. Results indicated MDs had a higher incurrence of sexual misconduct disciplinary actions when compared with other HCPs. Significant underreporting of sexual misconduct to the NPDB was identified for MD, DO, PA, NP, and PharmD state boards.</p><p><strong>Conclusions: </strong>Results of this audit are indicative of a system functioning asynchronously, opaquely, and ineffectively. To better serve the public, all state boards must regularly and publicly report disciplinary actions.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"e56-e61"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021844","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":"Impact of Preoperative Povidone Nasal Swab on the Incidence of Surgical Site Infection: An Observational Study.","authors":"Michael A Edwards, Anyull D Bohorquez Caballero, Amy Glasgow, Renee Whaley, Dorin Colibaseanu, Wendelyn Bosch, Talal M Dahab, Aaron C Spaulding","doi":"10.1097/PTS.0000000000001348","DOIUrl":"10.1097/PTS.0000000000001348","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical site infections (SSIs) are the most common hospital-acquired infections in the United States, of which methicillin-resistant Staphylococcus aureu s (MRSA) accounts for 43%. Preoperative povidone-iodine nasal swab (PNS) is considered an effective and cost-saving treatment for Staphylococcus aureu s decolonization. We aim to assess the impact of preoperative PNS on SSI incidence.</p><p><strong>Materials and methods: </strong>This retrospective observational study utilized elective surgical cases between January 1, 2018 and May 31, 2023, at a single academic medical center. The cohort was divided into PNS and no PNS groups. The cohort was propensity-matched, and Pearson χ 2 /Kruskal-Wallis tests were performed to compare group differences. Multivariable logistic regression was utilized to compare events between cohorts before and after matching. An alpha of <0.05 was considered significant.</p><p><strong>Results: </strong>A total of 45,998 (22,999 per group) matched participants were evaluated. On multivariate regression, the non-PNS treatment group was associated with an increase in hospital overall SSI occurrence (OR: 1.48, P = 0.02) but not specifically in-hospital methicillin-sensitive Staphylococcus aureus SSI, MRSA-SSI, or any 30-day SSI ( P > 0.05). Compared with PNS treatment and prophylactic antibiotics, in-hospital SSI was higher in the absence of PNS treatment (OR: 1.83, P < 0.001), antibiotic (OR: 2.63, P < 0.001), or both (OR: 2.06, P < 0.01). Compared with PNS treatment plus prophylactic antibiotic, in-hospital MRSA-SSI was only higher in the absence of antibiotic (OR: 2.92, P < 0.01) treatment.</p><p><strong>Conclusions: </strong>Preoperative treatment with PNS may reduce overall in-hospital SSI but has no independent impact on MRSA SSI.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"348-355"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112494","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":"Unveiling the Impact of Operational Failures on Patients: A SEIPS-based Analysis From the Perspective of Hospital Nurses.","authors":"Sem Vanbelleghem, Melissa De Regge, Yves Van Nieuwenhove, Paul Gemmel","doi":"10.1097/PTS.0000000000001341","DOIUrl":"10.1097/PTS.0000000000001341","url":null,"abstract":"<p><strong>Objectives: </strong>Operational failures (OFs) in hospital environments pose significant challenges for nurses, affecting patient care, workflow efficiency, and clinical processes. Common OFs include supply chain disruptions, communication breakdowns, and equipment failures. Although OFs are pervasive and frequent, current research primarily focuses on process improvement and employee well-being, neglecting the patient-centric perspective in this discourse. The objective of this study is to explore the impact of OFs on patient well-being through semi-structured interviews conducted with hospital nursing staff.</p><p><strong>Methods: </strong>A qualitative and exploratory approach, in accordance with the SRQR guidelines, was employed to ensure methodological rigor and transparency by providing a comprehensive understanding of the phenomenon. This multicenter study was conducted in 23 wards across 5 general hospitals in Belgium. It included in-depth, semi-structured face-to-face interviews with 26 nurses, and 2 group discussions: one with nurse managers (n=6), and another with patients (n=14). Thematic analysis was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) framework to examine how OFs emerge within work systems and affect patients.</p><p><strong>Results: </strong>The results indicate that minor OFs, including short delays in care or small communication lapses, can disrupt the continuity of care, leading to heightened patient stress and dissatisfaction. Conversely, major OFs, such as critical equipment breakdowns or medication errors, pose substantial and widespread risks, negatively impacting both patient experience and safety. Patients' reactions to such failures depend on the preventability of the error and the severity of its consequences, ranging from understanding to outright anger.</p><p><strong>Conclusions: </strong>The numerous day-to-day problems that nurses encounter due to poorly performing work systems can significantly compromise patient well-being and safety, ultimately affecting patient satisfaction and trust in health care.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"339-347"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722112","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":"SCALPEL: A Structured Handoff Protocol for Scrub Nurses in the Operating Room for Patient Safety.","authors":"Saeid Amini Rarani","doi":"10.1097/PTS.0000000000001331","DOIUrl":"10.1097/PTS.0000000000001331","url":null,"abstract":"","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"e73"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524806","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}