Intensive and Critical Care Nursing最新文献

{"title":"The Impact of Non-Pharmacological Sleep Interventions on Delirium Prevention and Sleep Improvement in Postoperative ICU Patients: A Systematic Review and Network Meta-Analysis","authors":"Jiaqi Li ,&nbsp;Yingying Fan ,&nbsp;Ruoyu Luo ,&nbsp;Na Yin ,&nbsp;Yangyang Wang ,&nbsp;Jiyong Jing ,&nbsp;Ju Zhang","doi":"10.1016/j.iccn.2024.103925","DOIUrl":"10.1016/j.iccn.2024.103925","url":null,"abstract":"<div><h3>Objectives</h3><div>Analyze the effectiveness of different non-pharmacological sleep interventions in preventing delirium among postoperative ICU patients.</div></div><div><h3>Research methodology</h3><div>We conducted a comprehensive search on PubMed, Cochrane Library, Web of Science, Embase, CINAHL, OpenGrey and reference lists up to May 2024.</div></div><div><h3>Setting</h3><div>We systematically searched all randomized controlled trials related to non-pharmacological sleep interventions for the prevention of delirium.</div></div><div><h3>Results</h3><div>The results of the network <em>meta</em>-analysis showed that, compared to Usual Care, multicomponent interventions are the most effective measures for preventing delirium in postoperative ICU patients (RR = 0.32, 95 % CI = 0.20 to 0.51). This is followed by non-pharmacological sleep interventions aimed at stress relief (RR = 0.60, 95 % CI = 0.41 to 0.89) and circadian rhythm (RR = 0.61, 95 % CI = 0.39 to 0.96). Additionally, non-pharmacological sleep interventions focusing on circadian rhythm demonstrated an improvement in sleep quality among postoperative ICU patients (SMD = −0.99, 95 % CI = −1.88 to −0.11).</div></div><div><h3>Conclusions</h3><div>Our study found that multicomponent non-pharmacological sleep interventions are effective in reducing the incidence of delirium in postoperative ICU patients. Furthermore, non-pharmacological interventions focused on circadian rhythm regulation significantly enhance sleep quality among these patients.</div></div><div><h3>Implications for clinical practice</h3><div>Based on this study, intensive care units and nursing staff have an opportunity to implement the most effective non-pharmacological sleep interventions to prevent delirium and improve sleep quality in postoperative ICU patients. This could contribute to a reduction in the incidence of delirium in postoperative ICU patients.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103925"},"PeriodicalIF":4.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879121","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":"A quality improvement program to reduce surgical site infections after cardiac surgery: A 10-year cohort study","authors":"Elena Conoscenti ,&nbsp;Giuseppe Enea ,&nbsp;Mieke Deschepper ,&nbsp;Diana Huis in ’t Veld ,&nbsp;Maria Campanella ,&nbsp;Giuseppe Raffa ,&nbsp;Barbara Ragonesi ,&nbsp;Alessandra Mularoni ,&nbsp;Alessandro Mattina ,&nbsp;Stijn Blot","doi":"10.1016/j.iccn.2024.103926","DOIUrl":"10.1016/j.iccn.2024.103926","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess trends in surgical site infection (SSI) incidence in cardiosurgery following a quality improvement initiative in infection prevention and control (IP&amp;C).</div></div><div><h3>Methods</h3><div>This is a historical cohort study encompassing a 10-year surveillance period (2014–2023) in a cardiosurgical department in a multi-organ transplant center. The study encompassed three periods: a baseline period (Phase_1: January 2014-December 2018); an implementation phase covering quality improvement initiatives targeting various aspects of IP&amp;C including organizational factors, pre-operative, intra-operative, post-operative measures, and post-hospitalization care (Phase_2: January 2019-June 2021); a post-implementation phase (Phase_3: July 2021-September 2023). A general linear mixed model was used to assess differences in SSI rates between distinct phases, adjusted for length of hospitalization, American Society of Anaesthesiologists (ASA) physical status classification, and Diagnostic-Related Groups (DRG) weight. The latter two were used as random effects. Results are reported as odds ratios [OR] with 95% confidence interval [CI].</div></div><div><h3>Results</h3><div>All cardiac surgery patients were included (n = 5851). A total of 208 patients developed SSI (3.5 %). SSI incidence for phase_1, phase_2 and phase_3 were 4.5 %, 4.1 %, and 1.2 %, respectively. The mixed model regression analysis indicated that, compared with the reference period (Phase1), SSI risk did not drop during the implementation phase (OR 0.81, 95 % CI 0.59–1.13, P &lt; 0.001 <em>vs.</em> reference period). A decrease in SSI risk was observed during the post-implementation phase (OR 0.19, 95 % CI 0.11–0.32)</div></div><div><h3>Conclusions</h3><div>A quality improvement initiative encompassing measurements at all levels potentially impacting SSI risk was implemented over a 2.5 years period. While no risk reduction was observed during the implementation phase, a significant reduction in SSI risk took place in the post-implementation phase.</div></div><div><h3>Implications for Clinical Practice</h3><div>This study suggests that considerable time may be required to achieve a substantial SSI risk reduction. We assume this may be attributed to the time required to achieve appropriate adherence with IP&amp;C protocols.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103926"},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873699","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":"Clinical debriefing: Who’s invited – Response to Dewdney & Wait","authors":"Anne-Françoise Rousseau,&nbsp;Alexandre Ghuysen,&nbsp;Bernard Lambermont,&nbsp;Méryl Paquay","doi":"10.1016/j.iccn.2024.103913","DOIUrl":"10.1016/j.iccn.2024.103913","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103913"},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873700","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":"Current insights on awake prone positioning in the ICU","authors":"W. Stilma,&nbsp;F. Paulus","doi":"10.1016/j.iccn.2024.103916","DOIUrl":"10.1016/j.iccn.2024.103916","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103916"},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866827","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":"Relationship between perceived stress and health literacy on family satisfaction among family members of critically ill patients: A multicenter exploratory study","authors":"Cristobal Padilla-Fortunatti ,&nbsp;Yasna Palmeiro-Silva ,&nbsp;Victor Ovalle-Meneses ,&nbsp;Maria Abaitua-Pizarro ,&nbsp;Jessica Espinoza-Acuña ,&nbsp;Claudia Bustamante-Troncoso ,&nbsp;Noelia Rojas-Silva","doi":"10.1016/j.iccn.2024.103895","DOIUrl":"10.1016/j.iccn.2024.103895","url":null,"abstract":"<div><h3>Background</h3><div>Intensive care unit (ICU) admission is often a stressful experience that can negatively influence family satisfaction (FS) with patient care, communication, and decision-making. Health literacy (HL) is associated with the patient’s ability to obtain, process, and understand health-related information. Few studies have explored the influence of perceived stress and HL on FS simultaneously.</div></div><div><h3>Objective</h3><div>To examine the association of perceived stress and HL with FS among family members of ICU patients.</div></div><div><h3>Design</h3><div>A multicenter exploratory cross-sectional study.</div></div><div><h3>Methods</h3><div>An exploratory, cross-sectional, multicenter study was conducted in three ICUs from different hospitals in Chile. Family members of ICU patients with ≥48 h of stay and respiratory support were eligible. The Family Satisfaction in the Intensive Care Unit-24 questionnaire and the Perceived Stress Scale were used. HL was evaluated using three screening questions. Multiple beta regressions were fit to explore the association between perceived stress, HL, and FS.</div></div><div><h3>Results</h3><div>A total of 101 family members with 63.4% identified as at risk of low HL were included. Multiple beta regression revealed that low HL was not associated with FS. Conversely, FS was negatively associated with perceived stress, being admitted to the ICU of the central or southern region, and having a close personal relationship with a healthcare provider but positively associated with the number of communications with ICU staff.</div></div><div><h3>Conclusions</h3><div>While perceived stress can be detrimental to FS, HL seems not to impact FS levels among family members of ICU patients. Further studies are required to explore the influence of HL on FS.</div></div><div><h3>Implications of the clinical practice</h3><div>This study advances the knowledge regarding variables affecting FS in the ICU. Evaluating the family members’ emotional status may help ICU healthcare providers in the allocation of resources to support family members and to properly assess their satisfaction.</div></div><div><h3>Patient or public contribution</h3><div>Family members of ICU patients participated in this study.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103895"},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866830","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":"The relationship between spiritual climate and secondary traumatic stress in ICU nurses: The mediating role of moral resilience","authors":"Mengyi Hu ,&nbsp;Yan Wang ,&nbsp;Hongli Zhang ,&nbsp;Chao Wu ,&nbsp;Xinhui Liang ,&nbsp;Yu Zhang ,&nbsp;Hongjuan Lang","doi":"10.1016/j.iccn.2024.103815","DOIUrl":"10.1016/j.iccn.2024.103815","url":null,"abstract":"<div><h3>Background</h3><div>Secondary traumatic stress is acknowledged as a substantial psychological risk factor in nursing practice with the potential to negatively impact nurses’ mental health. However, little is known about the mechanisms underlying the spiritual climate and secondary traumatic stress among ICU nurses.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the spiritual climate, moral resilience, and secondary traumatic stress in Chinese ICU nurses and to investigate whether moral resilience mediates the relationship between spiritual climate and secondary traumatic stress.</div></div><div><h3>Methods</h3><div>A cross-sectional study design was used to recruit 229 intensive care unit nurses. The nurses completed online questionnaires comprising demographic characteristics, spiritual climate, moral resilience, and secondary traumatic stress. Data analysis and structural equation modeling were conducted using SPSS 26.0 and AMOS 24.0.</div></div><div><h3>Results</h3><div>STS scores were (38.42 ± 13.27). Secondary traumatic stress was correlated with spiritual climate and moral resilience (r₁ = −0.370, r₂ = −0.575; p &lt; 0.01), and spiritual climate was positively correlated with moral resilience (r = 0.427; p &lt; 0.01). A mediating effect of moral resilience between spiritual climate and secondary traumatic stress held (mediating effect of 0.235, 95 % CI: −2.108 to −0.823, accounting for 57.32 % of the total effect).</div></div><div><h3>Conclusions</h3><div>The spiritual climate has a significant direct influence on secondary traumatic stress in ICU nurses and serves to reduce their secondary traumatic stress through moral resilience. Creating a positive spiritual climate and enhancing the moral resilience of ICU nurses are effective methods to reduce their secondary traumatic stress.</div></div><div><h3>Implications for clinical practice</h3><div>This study highlights that the spiritual climate for ICU nurses can reduce their secondary traumatic stress, and that moral resilience diminishes the secondary traumatic stress related to the spiritual climate. Establishing support systems and improving the environment are primary tasks for nursing administrators. These include, but are not limited to, improving the spiritual climate of the department, providing moral resilience training, and taking other measures to prevent and regulate secondary traumatic stress in ICU nurses in order to maintain their mental health.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103815"},"PeriodicalIF":4.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789738","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":"Family perspectives on physical restraint practices and minimization in an adult intensive care unit: A qualitative descriptive study","authors":"Ziad Alostaz ,&nbsp;Louise Rose ,&nbsp;Sangeeta Mehta ,&nbsp;Linda Johnston ,&nbsp;Craig Dale","doi":"10.1016/j.iccn.2024.103901","DOIUrl":"10.1016/j.iccn.2024.103901","url":null,"abstract":"<div><h3>Objective</h3><div>To explore family perspectives on physical restraint practices and their minimization in an adult intensive care unit.</div></div><div><h3>Design &amp; Methods</h3><div>A qualitative descriptive study with one-on-one semi-structured interviews. A deductive content analysis approach was undertaken using the Theoretical Domains Framework.</div></div><div><h3>Setting</h3><div>A 20-bed medical, surgical, trauma ICU in Toronto, Canada.</div></div><div><h3>Findings</h3><div>Fifteen family members were interviewed. Three themes emerged: (i) barriers and facilitators to restraint minimization. Barriers noted by families included patient agitation posing risks of losing endotracheal tubes, nurse reluctance to remove restraints, lack of family involvement, limited knowledge of alternatives, and a noisy environment. Facilitators included family involvement in decision-making, timely extubation, use of less restrictive alternatives such as mittens, mandating shorter periods of restraints application, and environmental modifications; (ii) unilateral decision-making regarding physical restraint use, where clinicians made decisions with inadequate communication with families nor obtaining consent; and (iii) the emotional impact of physical restraint use, with families experiencing sadness and shock and believing the patient would feel similarly.</div></div><div><h3>Conclusion</h3><div>This qualitative study highlights significant issues surrounding the use of physical restraints, particularly the lack of family involvement in decision-making, the emotional toll on families, and various barriers and facilitators to minimizing restraint use. Effective communication and collaboration between clinicians and families are crucial to addressing these issues.</div></div><div><h3>Implications for Clinical Practice</h3><div>Our findings underscore the critical need to enhance communication between clinicians and families, alongside consent processes. Identifying barriers and facilitators at various levels can inform individualized strategies to reduce restraint use, including integrating alternatives like mittens and involving families in care. Timely introduction of alternatives and family involvement are vital to prevent further emotional distress for families. Prioritizing the reduction of restraint duration is crucial, particularly in settings emphasizing harm minimization.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103901"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756647","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":"Effectiveness of non-pharmacological interventions for pain reduction following chest tube removal: A systematic review and network meta-analysis","authors":"Chun-Sheng Tsai ,&nbsp;Heng-Hsin Tung ,&nbsp;Ching-Ju Fang ,&nbsp;Chia-Te Chen","doi":"10.1016/j.iccn.2024.103909","DOIUrl":"10.1016/j.iccn.2024.103909","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the most effective non-pharmacological intervention for pain relief following chest tube removal in adult patients.</div></div><div><h3>Methods</h3><div>We performed a systematic review with network <em>meta</em>-analysis, searching electronic databases for randomized controlled trials up to January 20, 2024. Compared to control or placebo groups, the trials included adult patients receiving non-pharmacological interventions, such as cold therapy, relaxation exercises, music therapy, transcutaneous electrical nerve stimulation, or aromatherapy. Data analysis utilized a random-effects model, reporting standardized mean differences (SMD) with 95% confidence intervals (CI), and treatment ranking was determined through surface under the cumulative ranking analysis and forest plots.</div></div><div><h3>Results</h3><div>Sixteen studies enrolling 1,342 patients were included, with moderate to high heterogeneity. Cold therapy and relaxation exercises effectively reduced pain after chest tube removal, with SMD of −1.84 (95 % CI: −2.81 to −0.87) and −2.04 (95 % CI: −3.43 to −0.65), respectively, from baseline to immediately post-removal. From baseline to ten to twenty minutes after removal, both therapies continued to show significant pain reduction, with SMD of −1.96 (95 % CI: −3.14 to −0.77) for cold therapy and −2.01 (95 % CI: −3.75 to −0.28) for relaxation exercises. Sensitivity analysis supported these findings, and cold therapy’s efficacy appeared unaffected by obesity. However, publication bias, possibly due to small study samples, was noted.</div></div><div><h3>Conclusions</h3><div>Cold therapy and relaxation exercises proved most effective for reducing pain immediately and up to ten to twenty minutes after chest tube removal. Given their cost-effectiveness, lack of side effects, and ease of use, we recommend relaxation exercises as a practical alternative to cold therapy. Nonetheless, further studies are needed to comprehensively assess non-pharmacological options for managing chest tube removal pain.</div></div><div><h3>Implications for clinical practice</h3><div>Incorporate cold therapy and relaxation exercises into post-chest tube removal pain management to improve patient comfort and minimize reliance on pharmacological interventions.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103909"},"PeriodicalIF":4.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745901","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":"Multidisciplinary healthcare Professionals’ attitudes towards family engagement in the adult intensive care unit","authors":"Brigitte Cypress ,&nbsp;Rida Gharzeddine ,&nbsp;Mei Rosemary Fu ,&nbsp;Thomas Dahan ,&nbsp;Samantha Abate","doi":"10.1016/j.iccn.2024.103896","DOIUrl":"10.1016/j.iccn.2024.103896","url":null,"abstract":"<div><h3>Objectives</h3><div>Family engagement in the intensive care unit (ICU) is a crucial aspect of healthcare delivery, yet it remains an inconsistent practice and an understudied area of healthcare for adult patients in the ICU. This study aimed to explore the attitudes of healthcare professionals (e.g., registered nurses (RNs), physicians, pharmacists, respiratory therapists, social workers, and dietitians) on family engagement in the adult ICU and to elucidate factors that impact these attitudes.</div></div><div><h3>Methods</h3><div>We used descriptive cross-sectional analysis to explore the attitudes of a sample of 90 healthcare professionals toward family engagement in the ICU for adult patients. Data were collected using the Families’ Importance in Nursing Care-Nurses’ Attitudes (FINC-NA) questionnaire. The data were analyzed using descriptive statistics and multiple linear regression.</div></div><div><h3>Main Outcome Measures</h3><div>Healthcare professionals’ attitudes towards family engagement in the ICU varied across different professional roles and were associated with years of experience. Results demonstrated that physicians had the highest positive attitude score towards family engagement on the total attitude scale and the family as a resource.</div></div><div><h3>Implications to Nursing Practice</h3><div>Understanding the attitudes of healthcare professionals is a crucial step toward developing evidence-based interventions that can facilitate family engagement in care for adult patients in the ICU. Cultivating a partnership culture with patients’ families in the ICU is crucial, but interventions are needed to enhance nurses’ and other healthcare professionals’ attitudes toward family engagement. Specialized training, resources, and institutional policies supporting nurses and other providers in family care are essential to promote positive attitudes toward family engagement. A collective effort is required to change the culture and practice of family engagement by implementing evidence-based policies and guidelines. The study’s findings provided significant insights that may shape and improve healthcare practice, particularly in the ICU.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103896"},"PeriodicalIF":4.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745899","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":"Sustainability in ICU: Less plastic, greener future – Response to Lucchini et al.","authors":"Mohamed H. Eid,&nbsp;Kevin Hambridge,&nbsp;Patricia Schofield,&nbsp;Jos M. Latour","doi":"10.1016/j.iccn.2024.103914","DOIUrl":"10.1016/j.iccn.2024.103914","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103914"},"PeriodicalIF":4.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723438","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}