Critical care science最新文献

{"title":"Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies.","authors":"Juliana Carvalho Ferreira, Arthur Oswaldo de Abreu Vianna, Bruno Valle Pinheiro, Israel Silva Maia, Sérgio Vasconcellos Baldisserotto, Alexandre Marini Isola, Alexandre Biasi Cavalcanti, Ana Maria Casati Nogueira da Gama, Angelo Roncalli Miranda Rocha, Antonio Gonçalves de Oliveira, Ary Serpa Neto, Augusto Manoel de Carvalho Farias, Bianca Rodrigues Orlando, Bruno da Costa Esteves, Bruno Franco Mazza, Camila de Freitas Martins Soares Silveira, Carlos Roberto Ribeiro de Carvalho, Carlos Toufen Junior, Carmen Silvia Valente Barbas, Cassiano Teixeira, Débora Dutra da Silveira, Denise Machado Medeiros, Edino Parolo, Eduardo Leite Vieira Costa, Eliana Bernadete Caser, Ellen Pierre de Oliveira, Eric Grieger Banholzer, Erich Vidal Carvalho, Fabio Ferreira Amorim, Felipe Saddy, Fernanda Alves Ferreira Gonçalves, Filomena Regina Barbosa Gomes Galas, Giovanna Carolina Gardini Zanatta, Gisele Sampaio Silva, Glauco Adrieno Westphal, Gustavo Faissol Janot de Matos, João Claudio Emmerich de Souza, João Manoel Silva Junior, Jorge Luis Dos Santos Valiatti, José Ribamar do Nascimento Junior, Jose Rodolfo Rocco, Ludhmila Abrahão Hajjar, Luiz Alberto Forgiarini Junior, Luiz Marcelo Sá Malbuisson, Marcelo Alcantara Holanda, Marcelo Britto Passos Amato, Marcelo Park, Marco Antonio da Rosa E Oliveira, Marco Antonio Soares Reis, Marcos Soares Tavares, Mario Henrique Dutra de Souza, Marta Cristina Pauleti Damasceno, Marta Maria da Silva Lira-Batista, Max Morais Pattacini, Murillo Santucci Cesar de Assunção, Neymar Elias de Oliveira, Oellen Stuani Franzosi, Patricia Rieken Macedo Rocco, Pedro Caruso, Pedro Leme Silva, Pedro Vitale Mendes, Pericles Almeida Delfino Duarte, Renato Fabio Alberto Della Santa Neto, Ricardo Goulart Rodrigues, Ricardo Luiz Cordioli, Roberta Fittipaldi Palazzo, Rosane Goldwasser, Sabrina Dos Santos Pinheiro, Sandra Regina Justino, Sergio Nogueira Nemer, Vanessa Martins de Oliveira, Vinicius Zacarias Maldaner da Silva, Wagner Luis Nedel, Wanessa Teixeira Bellissimo-Rodrigues, Wilson de Oliveira Filho","doi":"10.62675/2965-2774.20250242-en","DOIUrl":"10.62675/2965-2774.20250242-en","url":null,"abstract":"<p><p>Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250242en"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific output and intensive care units organizational characteristics: a tale of unintended consequences.","authors":"Roberta Muriel Longo Roepke, Juliana Carvalho Ferreira, Alejandro Bruhn","doi":"10.62675/2965-2774.20250305","DOIUrl":"10.62675/2965-2774.20250305","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250305"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency, financial impact, and factors associated with cost outliers in intensive care units: a cohort study in Belgium.","authors":"Arnaud Bruyneel, Julie Van den Bulcke, Pol Leclercq, Magali Pirson","doi":"10.62675/2965-2774.20250207","DOIUrl":"10.62675/2965-2774.20250207","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the association between high outliers and intensive care unit admissions and to identify the factors contributing to high intensive care unit costs.</p><p><strong>Methods: </strong>This retrospective cohort study used data from 17 Belgian hospitals from 2018 and 2019. The study focused on the 10 most frequently admitted diagnosis-related groups in the intensive care unit. The dataset included medical discharge summaries and cost per stay from the hospital perspective.</p><p><strong>Results: </strong>A total of 39,279 hospital stays were analyzed, 11,124 of which were intensive care unit admissions; additionally, 2,500 of these stays were high outliers. The proportion of high outliers was significantly greater in the intensive care unit group, and admission to the intensive care unit was significantly associated with high outliers in the multivariate analyses. Factors associated with high intensive care unit outliers included the medical diagnosis-related group category, patients from nursing homes, intensive care unit stay duration exceeding 4 days, and specific technical procedures (measurement of intracranial pressure, continuous hemofiltration, and mechanical ventilation).</p><p><strong>Conclusion: </strong>Admission to the intensive care unit increases the likelihood of being classified as an outlier, thus significantly impacting hospital costs. This study identified factors that can be used to predict intensive care unit outliers, which can enable adjustments to diagnosis-related group-based funding for intensive care units.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250207"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral arterial oxygen saturation to fraction of inspired oxygen ratio: a versatile parameter for critically ill patients.","authors":"Eduardo Butturini de Carvalho, Bruno Valle Pinheiro, Pedro Leme Silva","doi":"10.62675/2965-2774.20250156","DOIUrl":"10.62675/2965-2774.20250156","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250156"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lycopene supplementation reduces inflammatory, histopathological and DNA damage in an acute lung injury rabbit model.","authors":"José Roberto Fioretto, Susiane Oliveira Klefens, Mário Ferreira Carpi, Marcos Aurélio Moraes, Rossano César Bonatto, Ana Lúcia Anjos Ferreira, Camila Renata Corrêa, Cilmery Suemi Kurokawa, Carlos Fernando Ronchi","doi":"10.62675/2965-2774.20250250","DOIUrl":"10.62675/2965-2774.20250250","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of lycopene supplementation on inflammation, lung histopathology and systemic DNA damage in an experimentally induced lung injury model, ventilated by conventional mechanical ventilation and high-frequency oscillatory ventilation, compared with a control group.</p><p><strong>Methods: </strong>Fifty-five rabbits sampled by convenience were supplemented with 10mg/kg lycopene for 21 days prior to the experiment. Lung injury was induced by tracheal infusion of warm saline. The rabbits were randomly assigned to the control group and subjected to protective conventional mechanical ventilation (n = 5) without supplementation or the experimental group that was subjected to acute lung injury and provided conventional mechanical ventilation and high-frequency oscillatory ventilation with and without lycopene supplementation (n = 10 rabbits in each group). Lung oxidative stress and the inflammatory response were assessed based on the number of polymorphonuclear leukocytes in bronchoalveolar lavage fluid, DNA damage and pulmonary histological damage.</p><p><strong>Results: </strong>A significant worsening of oxygenation and a decrease in static lung compliance was noted in all groups after pulmonary injury induction (partial pressure of oxygen before 451.86 ± 68.54 and after 71 ± 19.27, p < 0.05). After 4 hours, the high-frequency oscillatory ventilation groups with and without lycopene supplementation as well as the group receiving protective conventional mechanical ventilation with lycopene supplementation showed significant oxygenation improvement compared with the protective conventional mechanical ventilation group without supplementation (partial pressure of oxygen of the group with mechanical ventilation without lycopene of 102 ± 42, of the group that received conventional protective mechanical ventilation with lycopene supplementation of 362 ± 38, of the high-frequency group without lycopene supplementation of 420 ± 28 and of the high-frequency group with lycopene supplementation of 422 ± 25; p < 0.05). Compared with rabbits not receiving supplementation, those in the groups that received protective conventional mechanical ventilation with lycopene supplementation and high-frequency oscillatory ventilation with lycopene supplementation had significantly less inflammation as well as less histological injury (p < 0.05). Compared with rabbits subjected to protective conventional mechanical ventilation, significantly lower DNA damage was observed in rabbits supplemented with lycopene (p < 0.05).</p><p><strong>Conclusion: </strong>Lycopene supplementation reduces inflammatory and histopathological lung injuries, regardless of the associated ventilatory mode. In addition, lycopene improved oxygenation and reduced DNA damage when protective conventional mechanical ventilation was used.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250250"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early weaning from invasive mechanical ventilation via high-flow nasal oxygen versus conventional weaning in patients with hypoxemic respiratory failure: a prospective randomized controlled study.","authors":"Hareesh Ayyawar, Pradeep Bhatia, Sadik Mohammed, Nikhil Kothari, Bharat Paliwal, Ankur Sharma","doi":"10.62675/2965-2774.20250157","DOIUrl":"10.62675/2965-2774.20250157","url":null,"abstract":"<p><strong>Objective: </strong>Although the efficacy of high-flow nasal oxygen therapy in delaying or avoiding intubation in patients with hypoxemic respiratory failure has been studied, its potential for facilitating early weaning from invasive mechanical ventilation remains unexplored.</p><p><strong>Methods: </strong>In this randomized controlled trial, 80 adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation for > 48 hours were enrolled and divided into two groups: conventional weaning and early weaning via high-flow nasal oxygen. In the conventional weaning group, the spontaneous breathing trial was performed after the PaO2/FiO2 ratio was ≥ 200, whereas in the high-flow nasal oxygen group, the spontaneous breathing trial was conducted earlier when the PaO2/FiO2 ratio was 150 - 200. Following each successful spontaneous breathing trial, patients were extubated and put on oxygen supplementation via a venturi mask or high-flow nasal oxygen on the basis of their group allocation. The primary objective was to compare extubation failure (reintubation within 48 hours). The secondary objectives were to compare total invasive mechanical ventilation, oxygen requirement and sedation requirement days, ventilator-associated pneumonia incidence, invasive mechanical ventilation-free days, intensive care unit length of stay, and intensive care unit all-cause mortality.</p><p><strong>Results: </strong>Extubation failure was not significantly different between the high-flow nasal oxygen group and the conventional weaning group [12.5% versus 25%, respectively; odds ratio (95%CI) 0.5 (0.19 - 1.33)] (p = 0.25). Early weaning from invasive mechanical ventilation via high-flow nasal oxygen was associated with significantly increased invasive mechanical ventilation-free days and total oxygen requirement days (p = 0.02 and p = 0.01, respectively). No significant between-group differences were observed in total invasive mechanical ventilation days, ventilator-associated pneumonia incidence, intensive care unit length of stay, sedation duration, or all-cause mortality.</p><p><strong>Conclusion: </strong>Among patients with acute hypoxemic respiratory failure, early extubation with high-flow nasal oxygen is a feasible and superior alternative to the conventional method of weaning, as it increases the number of invasive mechanical ventilation-free days.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250157"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculitis incidence and outcomes in patients with aneurysmal subarachnoid hemorrhage: a prospective observational study.","authors":"Ricardo Turon, Pedro Kurtz, Carla Rynkowski, Letícia Petterson, Bruno Gonçalves, Vanessa de Caro, Marco Prazeres, Fernando Augusto Bozza, Cassia Righy","doi":"10.62675/2965-2774.20250076","DOIUrl":"10.62675/2965-2774.20250076","url":null,"abstract":"<p><strong>Objective: </strong>To define the incidence of ventriculostomy-associated infections and their impact on the mortality and functional outcomes of patients with aneurysmal subarachnoid hemorrhage.</p><p><strong>Methods: </strong>We prospectively included all consecutive adult aneurysmal subarachnoid hemorrhage patients admitted to the neurological intensive care units of the Instituto Estadual do Cérebro Paulo Niemeyer (Rio de Janeiro, Brazil) and Hospital Cristo Redentor (Rio Grande do Sul, Brazil) who required external ventricular drains from July 2015 to December 2020. Daily clinical and laboratory variables were collected at admission and during the hospital stay. The presence of ventriculostomy-associated infections was evaluated daily, according to the Centers for Disease Control and Prevention and Infectious Diseases Society of America criteria. Hospital and 12-month outcomes were compared between patients with and without ventriculostomy-associated infections via both univariate and multivariate analyses.</p><p><strong>Results: </strong>Out of the 676 patients screened, 271 received external ventricular drains (40%) and were included in the study. The mean age was 54 years (IQR 46-63), 198 were female (72%), 47% had poor grade status (World Federation of Neurological Surgeons scale 4 and 5), and 75% had modified Fisher 3 or 4. The mean time from admission to external ventricular drain placement was 8.8 days. Ventriculostomy-associated infections developed in 127 patients (47%), and the mean time from external ventricular drain to ventriculostomy-associated infection diagnosis was 4.4 days. Hospital and 12-month mortality rates did not differ between the ventriculostomy-associated infection group and the nonventriculostomy-associated infection group (36% versus 40% and 43% versus 49%, respectively). Poor functional outcomes, defined as modified Rankin scores of 4 to 6, showed no difference between groups at hospital discharge (ventriculostomy-associated infections 75% versus nonventriculostomy-associated infections 73%; p = NS) or at 12 months (ventriculostomy-associated infections 49% versus nonventriculostomy-associated infections 53%; p = NS).</p><p><strong>Conclusion: </strong>Ventriculostomy-associated infections are common complications after aneurysmal subarachnoid hemorrhage. Although it was not associated with hospital mortality or functional outcomes in our cohort, improving diagnostic accuracy and preventive measures is essential for better understanding the long-term impact of one of the most severe infectious complications after aneurysmal subarachnoid hemorrhage.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250076"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical analysis plan for hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: the ANDROMEDA-SHOCK-2 randomized clinical trial.","authors":"Nicolas Orozco, Gustavo García-Gallardo, Alexandre Biasi Cavalcanti, Tiago Mendonça Dos Santos, Gustavo Ospina-Tascón, Jan Bakker, Sebastián Morales, Karla Ramos, Leyla Alegria, Jean Louis Teboul, Daniel De Backer, Antoine Vieillard-Baron, Liliana Vallecilla Fernandez, Lucas Martins de Lima, Lucas Petri Damiani, Erica Ribeiro Sady, Eliana Vieira Santucci, Glenn Hernandez, Eduardo Kattan","doi":"10.62675/2965-2774.20250140","DOIUrl":"10.62675/2965-2774.20250140","url":null,"abstract":"<p><strong>Background: </strong>ANDROMEDA-SHOCK 2 is an international, multicenter, randomized controlled trial comparing hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock to standard care resuscitation to test the hypothesis that the former is associated with lower morbidity and mortality in terms of hierarchal analysis of outcomes.</p><p><strong>Objective: </strong>To report the statistical plan for the ANDROMEDA--SHOCK 2 randomized clinical trial.</p><p><strong>Methods: </strong>We briefly describe the trial design, patients, methods of randomization, interventions, outcomes, and sample size. We portray our planned statistical analysis for the hierarchical primary outcome using the stratified win ratio method, as well as the planned analysis for the secondary and tertiary outcomes. We also describe the subgroup and sensitivity analyses. Finally, we provide details for presenting our results, including mock tables, baseline characteristics, and the effects of treatments on outcomes.</p><p><strong>Conclusion: </strong>According to best trial practices, we report our statistical analysis plan and data management plan prior to locking the database and initiating the analyses. We anticipate that this practice will prevent analysis bias and improve the utility of the study's reported results.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250140"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculostomy-associated infections: a healthcare issue in the neurointensive care unit.","authors":"Viviane Cordeiro Veiga, André Kalil, Pedro Henrique Rigotti Soares, Pedro Póvoa","doi":"10.62675/2965-2774.20250250ed","DOIUrl":"10.62675/2965-2774.20250250ed","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250250ed"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical guide to assess the immune response to sepsis: from bench to bedside.","authors":"José Pedro Cidade, Gonçalo Guerreiro, Pedro Póvoa","doi":"10.62675/2965-2774.20240179-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240179-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240179en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}