Intensive and Critical Care Nursing最新文献

{"title":"The effects of structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions: A randomized controlled study","authors":"Yajun Ma ,&nbsp;Yuping Zhang ,&nbsp;Nianqi Cui ,&nbsp;Zhiting Guo ,&nbsp;Jingfen Jin","doi":"10.1016/j.iccn.2025.103944","DOIUrl":"10.1016/j.iccn.2025.103944","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the effect of a structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions.</div></div><div><h3>Design</h3><div>A three-arm parallel, single-blinded, randomized controlled trial was designed.</div></div><div><h3>Research methodology</h3><div>Patients were randomly assigned to one of three groups: structured family auditory stimulation (Group A), unstructured family auditory stimulation (Group B), and usual care (Group C). The primary outcome was delirium incidence, and secondary outcomes included delirium severity, delirium duration, delirium-free days, delirium subtypes, time to first delirium, the family anxiety and depression levels.</div></div><div><h3>Results</h3><div>A total of 213 patients were randomly assigned to three groups. There were no significant differences in demographic or clinical characteristics among the three groups. For the primary outcome, fewer patients developed delirium in Group A than in Group B and Group C (22.5 % vs. 26.8 % vs. 49.3 %, <em>P =</em> 0.001). For secondary outcomes, Group A had lower delirium severity scores than the other groups did (3.1 ± 0.4 vs. 4.0 ± 0.3 vs. 5.1 ± 0.3, <em>P</em> &lt; 0.001). Patients in Group A had shorter delirium durations (2.0 vs. 3.0 vs.4.0 days, <em>P</em> &lt; 0.001) and longer delirium-free days (3.0 vs. 2.0 vs. 1.0 days, <em>P</em> &lt; 0.001) than those in Group B and Group C. The time to first delirium was 3.0, 2.0, and 2.0 days, respectively (<em>P</em> &lt; 0.001). The SAS scores of the families in the three groups were 47.1 ± 5.7, 48.9 ± 5.5, and 56.5 ± 7.5 (<em>P</em> &lt; 0.001) and the SDS scores were 38.2 ± 5.8, 38.3 ± 5.7, and 42.7 ± 7.2 (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The results revealed that structured family auditory stimulation could reduce delirium incidence, decrease its severity, shorten the duration of delirium, increase delirium-free days, and prolong the time to first delirium among ICU patients with unplanned admission. Additionally, it could alleviate families’ anxiety and depression levels.</div></div><div><h3>Implications for clinical practice</h3><div>Structured family auditory stimulation prevents ICU delirium by maintaining the patients’ cognitive function and promoting early recovery, showing significant clinical potential in ICU delirium.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103944"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waiting to be discharged from intensive care units: Key factors shaping patient and family experiences","authors":"Yingyan Chen ,&nbsp;Jacqueline Peet ,&nbsp;Lauren Murray ,&nbsp;Mahesh Ramanan ,&nbsp;Kylie Jacobs ,&nbsp;Jane Brailsford ,&nbsp;Amelia Osmond ,&nbsp;Moreblessing Kajevu ,&nbsp;Peter Garrett ,&nbsp;Alexis Tabah ,&nbsp;Carol Mock ,&nbsp;Frances Fengzhi Lin","doi":"10.1016/j.iccn.2025.103961","DOIUrl":"10.1016/j.iccn.2025.103961","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the factors that facilitate and hinder intensive care unit (ICU) discharge processes related to patients and their family members.</div></div><div><h3>Methods</h3><div>This was a qualitative exploratory study conducted in three regional adult ICUs in Queensland, Australia. Data were collected through semi-structured interviews with patients and their family members (or patient representatives) in addition to daily reflections based on direct observation. A deductive content analysis was undertaken using the Structure, Process, and Outcomes framework, followed by an inductive approach to generate themes.</div></div><div><h3>Results</h3><div>A total of 16 participants participated in interviews, involving 14 patients, one family member, and one patient representative. Four themes included a desire to be involved, being kept informed, uncertainty in waiting, and the discharge rush. Participants spoke about the desire to be involved in their care and discharge transition. There was a prevailing tension among patients about being kept informed. Although participants remarked that staff communication was reassuring, supportive, and comforting, they noted that timelines for discharge were often unclear, causing hesitation in the discharge process and minimal information before a sudden transfer. Uncertainty in waiting was frequently mentioned by the participants and also reflected in the daily reflections. This uncertainty led to consequences, such as discharge against medical advice and after-hours discharge rush.</div></div><div><h3>Conclusion</h3><div>The findings of this study support existing literature that underlines the importance of patient and family involvement in care, effective communication, and coordination during the discharge processes. After-hours discharge rush should be avoided for the safety of the patients and others on the wards.</div></div><div><h3>Implications for clinical practice</h3><div>Gaining an understanding of patient and family perspectives on the ICU discharge processes can guide clinicians in developing strategies to improve the continuity and quality of care and therefore enhance patient safety during ICU discharge.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103961"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential impact of critical illness on sexuality","authors":"Louise Bourke,&nbsp;Valerie Smith,&nbsp;John Gilmore","doi":"10.1016/j.iccn.2025.103967","DOIUrl":"10.1016/j.iccn.2025.103967","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"88 ","pages":"Article 103967"},"PeriodicalIF":4.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with good death for end-of-life patients in the intensive care unit based on nurses’ perspectives: A systematic review","authors":"Ifa Hafifah ,&nbsp;Wasinee Wisesrith ,&nbsp;Noraluk Ua-Kit","doi":"10.1016/j.iccn.2024.103930","DOIUrl":"10.1016/j.iccn.2024.103930","url":null,"abstract":"<div><h3>Background</h3><div>Ensuring a good death in the intensive care unit (ICU) is crucial due to high global mortality rates. Despite the central role of nurses in end-of-life care, existing reviews often focus on patients or families and overlook nurses’ perspectives.</div></div><div><h3>Objectives</h3><div>This study aims to investigate the factors associated with a good death for end-of-life patients in the ICU based on nurses’ perspectives by systematically summarizing current evidence.</div></div><div><h3>Methods</h3><div>The researchers utilized a systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO. Databases searched included Scopus, ProQuest, PubMed, ScienceDirect, EBSCOhost, and Google Scholar. Inclusion criteria covered English-language quantitative studies published from the inception until February 20, 2024, that reported factors influencing a good death from the perspective of ICU nurses, and were available in full text. The exclusion criteria included studies with mixed participants if separate analyses for nurses were not provided. Risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for analytical cross-sectional studies, and a narrative synthesis was performed.</div></div><div><h3>Results</h3><div>Five high-quality studies were included, involving 1,654 ICU nurses with an average age between 28.64 and 41.40 years, predominantly female (54.8 % to 91 %). Identified factors included nurses’ personal factors, nurses’ job characteristics, nurses’ clinical competence in end-of-life care, and process of healthcare.</div></div><div><h3>Conclusions</h3><div>The review highlights the vital factor influencing a good death from ICU nurses’ perspectives. Awareness of personal and job-related factors, along with enhanced clinical competence in end-of-life care, are essential for supporting patients to achieve a good death.</div></div><div><h3>Implications for Clinical Practice</h3><div>ICU nurses can enhance their clinical competence in end-of-life care. Hospital managers should take into account nurses’ work experience when assigning staff and consider implementing fixed shifts. Future research should explore these factors globally and develop interventions to support a good death in the ICU.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103930"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk markers for postoperative reintubation of intensive care unit patients: A retrospective multicentre study of the National Intensive Care Registry","authors":"Hirotaka Masaki ,&nbsp;Shogo Suzuki ,&nbsp;Natsuki Nakayama ,&nbsp;Eri Kobayashi ,&nbsp;Akiko Fujii ,&nbsp;Kimitoshi Nishiwaki ,&nbsp;Masaaki Mizuno ,&nbsp;Masahiro Nakatochi","doi":"10.1016/j.iccn.2025.103956","DOIUrl":"10.1016/j.iccn.2025.103956","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate postoperative reintubation incidence and identify risk markers to expedite the identification of high-risk patients after ICU admission.</div></div><div><h3>Methods</h3><div>We performed this retrospective multicentre study that included postoperative adult patients admitted to Japanese ICUs between April 2015 and March 2022 using the Japanese Intensive care PAtient Database (JIPAD). Data regarding the patients treated in included ICUs were accumulated by the JIPAD, which we received for research use. Logistic regression analysis with generalised estimating equations was used to estimate odds ratios (ORs) of 1-standard deviation increments and 95 % confidence intervals (CIs) for the association of each variable available within 24 h after ICU admissions with reintubation.</div></div><div><h3>Results</h3><div>Among 13,219 admissions during the study period, 828 patients were postoperatively reintubated (incidence = 6.26 %, 95 % CI: 5.86–6.69). Maximum partial pressure of carbon dioxide (PaCO₂), bilirubin, and blood urea nitrogen (adjusted OR = 1.138, 95 % CI: 1.055–1.228; adjusted OR = 1.101, 95 % CI: 1.018–1.191; and adjusted OR = 1.105, 95 % CI: 1.016–1.203, respectively) and body mass index (BMI) and minimum white blood cells counts (adjusted OR = 0.867, 95 % CI: 0.797–0.944; and adjusted OR = 0.878, 95 % CI: 0.815–0.946, respectively) were significantly associated with postoperative reintubation.</div></div><div><h3>Conclusions</h3><div>Postoperative reintubation incidence in Japanese ICUs was estimated to be 6.26%. BMI, maximum PaCO₂, clinical laboratory data reflecting surgical invasiveness, and immunosuppression may be risk markers for postoperative reintubation.</div></div><div><h3>Implications for clinical practice</h3><div>Our study will help identify high-risk patients for postoperative reintubation early post-ICU admission, enabling early and focused nursing care to prevent reintubation, such as early mobilisation and ambulation.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103956"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and characteristics of device-related pressure injuries in intensive care: A four-year analysis","authors":"Paul Fulbrook ,&nbsp;Jacob Butterworth","doi":"10.1016/j.iccn.2025.103955","DOIUrl":"10.1016/j.iccn.2025.103955","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe and analyse the incidence and characteristics of intensive care-acquired device-related pressure injuries.</div></div><div><h3>Design</h3><div>Secondary data analysis of intensive care-acquired pressure injuries during 2019–2022.</div></div><div><h3>Setting</h3><div>Single general intensive care unit in Brisbane, Australia.</div></div><div><h3>Main outcome measures</h3><div>Intensive care-acquired pressure injury incidence, device-related pressure injury incidence, non-device-related pressure injury incidence, pressure injury category and location, device associated with pressure injury.</div></div><div><h3>Results</h3><div>During the 4-year period, there were 7343 intensive care admissions of whom 413 (5.6 %) patients developed an intensive care-acquired pressure injury. The incidence of device-related pressure injury was 4.0 % compared to 2.7 % non-device-related pressure injury. In total there were 461 device-related pressure injuries, which were mostly (55 %) associated with endotracheal tubes or the methods used to secure them. Consequently, the majority of injuries were found on the mucous membranes (lips, mouth and tongue). The other main devices associated with injuries were high-flow nasal prongs (9.3 %), indwelling urinary catheters (6.7 %), nasogastric tubes (6.5 %) and oxygen masks (5.0 %). Overall, device-related pressure injuries were less severe than non-device-related pressure injuries, however they occurred in a shorter time frame (median 4 days versus 6 days). A range of factors was associated with device-related pressure injuries but overall, their presence or duration was less than with non-device-related pressure injuries.</div></div><div><h3>Conclusion</h3><div>The study results provide rigorous evidence of the incidence and characteristics of device-related pressures injuries, that can be used to benchmark with other intensive care units nationally and internationally.</div></div><div><h3>Implications for Clinical Practice</h3><div>Endotracheal tube-associated pressure injuries were the most common type of device-related injury, providing a clear focus for preventative intervention. Given the high proportion of these device-related injuries, effective interventions would have a significant impact on overall reduction of intensive care-acquired pressure injuries. Since most injuries occur within three days of device insertion, early preventative intervention is time-critical.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103955"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Should we still use chlorhexidine oral care? Yes!”","authors":"Mónica Vázquez-Calatayud ,&nbsp;Rosa García-Díez","doi":"10.1016/j.iccn.2025.103953","DOIUrl":"10.1016/j.iccn.2025.103953","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103953"},"PeriodicalIF":4.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational interventions reduce the severity of post intensive care syndrome-family − Letter on Hayes et al.","authors":"Farshid Rahimi-Bashar,&nbsp;Athanasios Chalkias,&nbsp;Keivan Gohari-Moghadam,&nbsp;Malihe Salimi-bani,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103799","DOIUrl":"10.1016/j.iccn.2024.103799","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103799"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study","authors":"Bert Maertens ,&nbsp;Stijn Blot ,&nbsp;Diana Huis in ’t Veld ,&nbsp;Koen Blot ,&nbsp;Annelies Koch ,&nbsp;Katrien Mignolet ,&nbsp;Elise Pannier ,&nbsp;Tom Sarens ,&nbsp;Werner Temmerman ,&nbsp;Walter Swinnen","doi":"10.1016/j.iccn.2024.103769","DOIUrl":"10.1016/j.iccn.2024.103769","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</div></div><div><h3>Design</h3><div>Historical observational surveillance study conducted over 13 years.</div></div><div><h3>Setting</h3><div>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</div></div><div><h3>Participants</h3><div>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</div></div><div><h3>Interventions</h3><div><span>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, </span>chlorhexidine oral care, and daily sedation assessment.</div></div><div><h3>Measurements and main results</h3><div>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</div></div><div><h3>Conclusions</h3><div>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</div></div><div><h3>Implications for Practice</h3><div>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103769"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between microaspiration and ventilator-associated events: A post-hoc analysis of a randomized controlled trial","authors":"Guillaume Millot ,&nbsp;Hélène Behal ,&nbsp;Emmanuelle Jaillette ,&nbsp;Christophe Girault ,&nbsp;Guillaume Brunin ,&nbsp;Julien Labreuche ,&nbsp;Isabelle Alves ,&nbsp;Franck Minacori ,&nbsp;Hugues Georges ,&nbsp;Patrick Herbecq ,&nbsp;Cyril Fayolle ,&nbsp;Patrice Maboudou ,&nbsp;Farid Zerimech ,&nbsp;Malika Balduyck ,&nbsp;Saad Nseir","doi":"10.1016/j.iccn.2024.103778","DOIUrl":"10.1016/j.iccn.2024.103778","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between ventilator-associated events (VAE) and microaspiration in intubated patients has not be studied. The objective of this study was to evaluate the relationship between abundant microaspiration of oropharyngeal secretions or gastric contents and the incidence of VAE.</div></div><div><h3>Patients and methods</h3><div>This was a <em>post hoc</em> analysis of the BESTCUFF study, which was a multicenter, cluster randomized, cross-over, controlled, open-label trial in adult patients ventilated for over 48 h. All tracheal aspirates were sampled for 48 h following enrollment, with quantitative measurement of pepsin and alpha-amylase. VAE were identified using National Healthcare Safety Network criteria, based on PEEP or FiO₂ variations compared to stable parameters in previous days. The primary objective was to assess the relationship between abundant global microaspiration and the incidence of VAE, adjusted for pre-specified confounding factors (sex, SAPS II score and Glasgow coma scale).</div></div><div><h3>Results</h3><div>261 patients were included, of which 31 (11.9%) developed VAE, with an overall median age of 65 (interquartile range 52–74), a majority of male patients (164, 62.8%), a median SAPS II score of 50 [40–61], a median SOFA score of 8 [5–11], and acute respiratory failure as main reason for ICU admission (117, 44.8%).The incidence of VAE was not significantly associated with abundant global microaspiration (adjusted cause-specific hazard ratio (cHR): 1.55 [0.46–5.17), abundant gastric microaspiration (adjusted cHR: 1.24 [0.61–2.53), or with abundant oropharyngeal microaspiration (adjusted HR: 1.07 [0.47–2.42]).</div></div><div><h3>Conclusions</h3><div>Our results suggest no significant association between abundant global, gastric or oropharyngeal microaspiration and the incidence of VAE.</div></div><div><h3>Implications for clinical practice</h3><div>This study underscores that measuring microaspiration in intubated critically ill patients might not be useful to predict the diagnosis of VAE or to evaluate interventions aiming at preventing these complications.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103778"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}