British journal of hospital medicine最新文献

{"title":"The Role of Neutrophil-to-Lymphocyte Ratio in Predicting All-Cause Mortality and Survival Rates in Patients With Cor Pulmonale.","authors":"Jingjing Liu, Xiaoli Liu","doi":"10.31083/BJHM56971","DOIUrl":"https://doi.org/10.31083/BJHM56971","url":null,"abstract":"<p><strong>Aims/background: </strong>Cor pulmonale is characterised by right ventricular hypertrophy and dysfunction due to chronic lung disease or pulmonary vascular disease. Mortality in patients with pulmonary heart disease is influenced by a variety of factors; therefore, elucidating prognostic factors is essential to improve patient management and therapeutic strategies. The neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has been implicated in cardiovascular and pulmonary diseases. This study aims to evaluate the prognostic value of NLR in assessing all-cause mortality and survival in patients with cor pulmonale.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of data from 6681 patients in the Medical Information Mart for Intensive Care IV database, classifying them into low and high NLR groups based on the median NLR value of 8.26. Clinical indicators, including albumin levels, kidney function, and haematological results, were compared between groups. Multivariate models were used to assess the relationship between NLR and mortality risk. Subgroup analyses were conducted to validate findings across different populations.</p><p><strong>Results: </strong>The high-NLR group exhibited significantly lower albumin levels, poorer kidney function, and unfavourable haematological parameters. Patients aged ≥65 years and those with high-risk medical histories were more prevalent in the high-NLR group. Model analysis demonstrated that elevated NLR was independently associated with increased risk of adverse outcomes, with hazard ratios of 1.58, 1.37, and 1.22 across three adjusted models. A strong correlation was observed between NLR and all-cause mortality, with a nonlinear relationship indicating a complex impact on mortality risk. Subgroup analyses confirmed the consistency of these findings across various patient subgroups.</p><p><strong>Conclusion: </strong>NLR is a significant prognostic marker for all-cause mortality in patients with cor pulmonale. Routine assessment of NLR may aid clinicians in risk assessments to enhance prognosis and management strategies. Further research is needed to explore the clinical utility of NLR in this population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"56971"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Factors Confounding Quantitative Measurements in Ultrasound Elastography of the Liver.","authors":"Maciej Cebula, Paweł Polewiak, Jakub Kufel","doi":"10.31083/BJHM53358","DOIUrl":"https://doi.org/10.31083/BJHM53358","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"53358"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Insulin Resistance and Serum 25-Hydroxyvitamin D, Insulin-Like Growth Factor-1, and Blood Lipid Profiles in Children With Obesity.","authors":"Zhufei Chu, Yue Liu, Kejun Ye","doi":"10.31083/BJHM56972","DOIUrl":"https://doi.org/10.31083/BJHM56972","url":null,"abstract":"<p><strong>Aims/background: </strong>Obesity in children was associated with insulin resistance (IR) and is often accompanied by dyslipidemia. 25-hydroxyvitamin D (25-(OH)D) and insulin-like growth factor-1 (IGF-1) have been implicated in IR. The purpose of this study was to explore the correlation between IR and serum 25-(OH)D, IGF-1, and blood lipid profiles in children with obesity.</p><p><strong>Methods: </strong>A total of 125 children with obesity who attended The Affiliated Yangming Hospital of Ningbo University between January 2023 and April 2025 were retrospectively analyzed. According to insulin sensitivity, participants were divided into two groups: the insulin-sensitive group (n = 56, Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] <3.16) and the insulin-resistant group (n = 69, HOMA-IR ≥3.16). Serum 25-(OH)D, IGF-1, and lipid profiles [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] were measured. Binary logistic regression analysis and receiver operating characteristic (ROC) analyses were performed to investigate the association between IR and these biomarkers.</p><p><strong>Results: </strong>Fasting insulin and HOMA-IR levels were significantly higher in the insulin-resistant group than in the insulin-sensitive group (<i>p</i> < 0.001). Compared with the insulin-sensitive group, levels of 25-(OH)D, IGF-1, and HDL-C were significantly lower in the insulin-resistant group (<i>p</i> < 0.001, <i>p</i> = 0.032, and <i>p</i> = 0.023, respectively), while TG and LDL-C levels were significantly higher (<i>p</i> < 0.001). No significant difference was observed in TC levels between the two groups (<i>p</i> = 0.334). Multivariate analysis identified 25-(OH)D (odds ratio [OR] = 0.934, 95% confidence interval [CI]: 0.877-0.995, <i>p</i> = 0.035), IGF-1 >238.68 (OR = 0.303, 95% CI: 0.103-0.894, <i>p</i> = 0.031), TG (OR = 3.979, 95% CI: 1.461-10.835, <i>p</i> = 0.007), and LDL-C (OR = 2.625, 95% CI: 1.398-4.928, <i>p</i> = 0.003) as independent factors associated with IR in children with obesity. ROC analysis showed that the areas under the curves (AUCs) for 25-(OH)D, IGF-1, TG, LDL-C, and the combined indicator were 0.692, 0.612, 0.775, 0.747, and 0.856, respectively (<i>p</i> < 0.001, <i>p</i> = 0.025, <i>p</i> < 0.001, <i>p</i> < 0.001, and <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In children with obesity, serum 25-(OH)D, IGF-1, TG, and LDL-C are significantly associated with IR.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"56972"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a Machine Learning Prediction Model for Postpartum Depression Based on Ensemble Learning Strategies.","authors":"Fengyuan Zhang, Zhengcheng Tu, Xiang Hong, Xiaoli Wu, Suli Wang, Hong Yu","doi":"10.31083/BJHM56968","DOIUrl":"https://doi.org/10.31083/BJHM56968","url":null,"abstract":"<p><strong>Aims/background: </strong>Postpartum depression (PPD) is a common perinatal mental health disorder that leads to adverse maternal and infant outcomes. Existing screening strategies rely on self-reported symptom presence, potentially delaying early identification. This study aims to integrate biological, psychological, and social predictive factors using an ensemble learning (EL) strategy to develop a superior early prediction machine learning (ML) model for PPD.</p><p><strong>Methods: </strong>By integrating sociodemographic characteristics, clinical baseline data, and psychological test results of 1323 postpartum women, PPD status was classified using the Edinburgh Postnatal Depression Scale (EPDS). Eight selection methods were used, and eleven base ML models were optimized through EL strategies (Voting and Stacking) to identify the model with the optimal predictive performance.</p><p><strong>Results: </strong>Twenty predictor features were selected for the model construction. The Voting top 5+XGBoost (eXtreme Gradient Boosting, Weight) model demonstrated the best overall performance (area under the curve [AUC] = 0.835) and the highest specificity (0.906), indicating that it is more suitable for differential diagnosis following an initial positive screening result. The Voting (Synthetic Minority Over-sampling Technique [SMOTE]) model performed exceptionally well in sensitivity (0.758) and clinical net benefit at low-risk thresholds, indicating its suitability for early screening for PPD.</p><p><strong>Conclusion: </strong>The results demonstrate that ensemble learning models outperform individual ML prediction models. Voting top 5+XGBoost (Weight) and Voting (SMOTE) show respective advantages in predictive specificity and sensitivity. This suite of models can provide distinct data-driven prediction strategies tailored to different clinical application contexts.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"56968"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Serum Lactate Dehydrogenase and Immune-Inflammatory Markers in Recurrent Spontaneous Abortion: A Retrospective Study.","authors":"Jianfeng Wen, Wenjun Cheng, Shanshan Hu, Shengnan Xia, Lingmei Shi","doi":"10.31083/BJHM56970","DOIUrl":"https://doi.org/10.31083/BJHM56970","url":null,"abstract":"<p><strong>Aims/background: </strong>Recurrent spontaneous abortion (RSA) may contribute to intrauterine adhesions and lead to female infertility. This study aims to analyze serum lactate dehydrogenase (LDH) levels and immune-inflammatory markers in patients with recurrent abortion and to evaluate their diagnostic value in RSA.</p><p><strong>Methods: </strong>A total of 120 patients with RSA admitted between January 2023 and December 2024 were included as the study group, and 80 pregnant women with normal prenatal examination findings during the same period were selected as controls. Serum and hematological assays were performed in both groups, and levels of LDH, immune-inflammatory markers, autoimmune antibodies, and lymphocyte subsets were compared. Factors associated with RSA were analyzed using logistic regression, and the diagnostic performance of each index was assessed using a receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Compared with the control group, serum LDH levels, immune-inflammatory markers [interleukin (IL)-6, IL-10, and interferon gamma (IFN-γ)], antiphospholipid antibodies, and T lymphocyte subsets were significantly different in the RSA group (<i>p</i> < 0.05). Serum LDH, IFN-γ, antiphospholipid antibodies (APA) positive rate and cluster of differentiation (CD)4⁺ T-cell levels were significantly higher in the RSA group than in controls (<i>p</i> < 0.05), whereas IL-6, IL-10, and CD8⁺ T-cell levels were significantly lower (<i>p</i> < 0.05). Binary logistic regression analysis showed that elevated serum LDH, reduced IL-6 level, increased proportion of CD4⁺ cells, and decreased proportion of CD8⁺ cells were independent risk factors for recurrent abortion in RSA patients (all <i>p</i> < 0.05). ROC curve analysis showed that the combined detection of serum LDH, IL-6, CD4⁺, and CD8⁺ yielded an area under the curve (AUC) of 0.908, with a sensitivity of 0.875 and specificity of 0.823. The combined model demonstrated superior diagnostic performance compared with individual markers.</p><p><strong>Conclusion: </strong>Combined assessment of serum LDH and selected immune-inflammatory markers (IL-6, CD4⁺, CD8⁺) shows good predictive and diagnostic value for RSA and may facilitate early identification of high-risk patients in clinical practice.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"56970"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian National Health Service: Crucial Issues and Potential Remedies.","authors":"Livio Garattini, Antonino Mazzone, Andrea Zovi","doi":"10.31083/BJHM53163","DOIUrl":"https://doi.org/10.31083/BJHM53163","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"53163"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Trends and Future Projections of Occupational Asthma and Lung Cancer in Southeast Asia: Insights From the Global Burden of Disease Study 1990-2021.","authors":"Rui Zhang, Pengyu Zhou, Jinnan Wu, Shuwen Zhang, Yanju Zhang, Jieru Huang","doi":"10.31083/BJHM56969","DOIUrl":"https://doi.org/10.31083/BJHM56969","url":null,"abstract":"<p><strong>Aims/background: </strong>Exposure to occupational hazards remains a significant driver of asthma- and lung cancer-related morbidity and mortality, particularly in rapidly industrializing regions such as Southeast Asia. However, comprehensive assessments of long-term regional trends and future projections of occupational respiratory diseases remain limited. This study aimed to evaluate the temporal dynamics of occupational asthma and occupational lung cancer burden in Southeast Asia from 1990 to 2021 and to project future trends through 2035.</p><p><strong>Methods: </strong>Data were obtained from the Global Burden of Disease (GBD) Study 2021 to assess mortality and disability-adjusted life years (DALYs) attributable to occupational asthma and lung cancer in Southeast Asia. To enhance model validation, additional metrics, including the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC), were applied, together with K-fold cross-validation to assess model generalizability. Sensitivity analyses were conducted to examine the robustness of findings under alternative assumptions.</p><p><strong>Results: </strong>From 1990 to 2021, the age-standardised DALY rate of occupational asthma declined by 33.45%, although the absolute number of DALYs increased due to population growth and ageing. In contrast, occupational lung cancer exhibited a persistent upward trend in both absolute burden and age-standardised rates, with older men disproportionately affected. Decomposition analyses identified that population ageing and population growth were the key contributors to the overall increase in disease burden. Projections through 2035 suggest that asthma-related burden will continue to decrease, whereas occupational lung cancer burden is expected to increase further.</p><p><strong>Conclusion: </strong>Although age-standardised rates of occupational asthma have improved, the overall burden remains substantial, largely due to population growth and ageing, which continue to place considerable pressure on occupational health systems.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"56969"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making and Professional Responsibility in High-Risk Endoscopic Retrograde Cholangiopancreatography for a Patient With Ankylosing Spondylitis: A Case-Based Reflection in Medical Ethics and Education.","authors":"Xiaoying Yang, Kun He, Liang Gong, Xinan Liu, Rutong Li, Liying Bian, Jiaxin Lang, Han Xiao, Jingyi Wang, Qingwei Jiang, Dong Wu","doi":"10.31083/BJHM52234","DOIUrl":"https://doi.org/10.31083/BJHM52234","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"52234"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Inflammatory and Placental-Related Markers for Adverse Neonatal Outcomes in Pregnant Women With Gestational Diabetes Mellitus and Preeclampsia.","authors":"Ting Chen, Lichun Wang, Li Chen, Weihui Yang, Xiaolei Long","doi":"10.31083/BJHM50744","DOIUrl":"10.31083/BJHM50744","url":null,"abstract":"<p><strong>Aims/background: </strong>The coexistence of gestational diabetes mellitus (GDM) and preeclampsia (PE) significantly increases the risk of adverse neonatal outcomes. However, effective predictive tools for this high-risk population remain limited. This study aimed to evaluate the predictive value of inflammatory and placental-related biomarkers for adverse neonatal outcomes in pregnant women with GDM and PE.</p><p><strong>Methods: </strong>This retrospective observational study enrolled 230 pregnant women with GDM and PE between February 2022 and February 2025. Participants were divided into an event group (n = 53) and a non-event group (n = 177) based on the occurrence of adverse neonatal outcomes. Baseline characteristics, inflammatory markers, and placental growth factor (PlGF) levels were collected. Independent predictive factors were identified using univariate and multivariate logistic regression analyses, with collinearity diagnostics performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the discriminative performance of individual markers and combined predictive models.</p><p><strong>Results: </strong>Univariate analysis indicated that fasting blood glucose, PlGF, glycated hemoglobin (HbA1c), neutrophil-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI) were significantly associated with adverse neonatal outcomes (all <i>p</i> < 0.05). Multivariate logistic regression, after adjustment for collinearity, identified elevated fasting blood glucose, reduced PlGF, increased HbA1c, and elevated SII as independent risk factors for adverse neonatal outcomes (all <i>p</i> < 0.001). ROC curve analysis demonstrated that the combined model incorporating these four variables achieved the highest predictive accuracy, with an area under the curve (AUC) of 0.944 (95% confidence interval [CI]: 0.902-0.986), sensitivity of 94.3%, and specificity of 84.7%, significantly outperforming individual markers.</p><p><strong>Conclusion: </strong>In pregnant women with GDM and PE, fasting blood glucose, PlGF, HbA1c, and SII represent independent predictors of adverse neonatal outcomes. A composite panel integrating metabolic, placental, and inflammatory biomarkers exhibits strong discriminative value and may provide objective evidence for neonatal risk stratification in this high-risk population, thereby informing targeted clinical management.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"50744"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Clinical Information on Whole-Body CT Requests for Major Trauma: A Quality Improvement Study.","authors":"Rima R Sansi, Leena Naidu, Ioan Marius Ile, Jatin Naidu","doi":"10.31083/BJHM53482","DOIUrl":"https://doi.org/10.31083/BJHM53482","url":null,"abstract":"<p><strong>Aims/background: </strong>Whole-body computed tomography (WBCT) is central to major trauma assessment, but appropriate justification and reporting depend on adequate clinical information at the time of request. The Royal College of Radiologists (RCR) 2024 major trauma guidance recommends six minimum data elements for trauma WBCT requests. This quality improvement project aimed to improve documentation compliance and reduce inappropriate WBCT requests at a district general hospital.</p><p><strong>Methods: </strong>A completed audit cycle was undertaken. Consecutive adult trauma patients undergoing WBCT were identified in a baseline audit (Cycle 1; n = 100, September-December 2024) and a post-intervention re-audit (Cycle 2; n = 100, September-December 2025). Three interventions were introduced: educational feedback to Department of Radiology and Department of Emergency Medicine staff, an RCR-derived electronic request proforma embedded within CareFlow Electronic Patient Record (EPR), and real-time radiologist feedback. Primary outcomes were compliance with the six RCR minimum dataset standards and the proportion of requests meeting RCR WBCT criteria.</p><p><strong>Results: </strong>Baseline compliance varied across documentation domains. In Cycle 1, documentation rates were 74% for mechanism of injury, 94% for primary survey findings, 7% for haemodynamic status, 5% for preceding investigations, 13% for past medical history, and 0% for trauma team leader contact details. Following intervention, mechanism documentation improved to 100% (<i>p</i> < 0.001), haemodynamic status to 93% (<i>p</i> < 0.001), and trauma team leader contact details to 92% (<i>p</i> < 0.001). Primary survey documentation remained high at 97% (<i>p</i> = 0.306). Past medical history increased to 18% (<i>p</i> = 0.329), while preceding investigations remained low at 4% (<i>p</i> = 1.000). Requests meeting RCR WBCT criteria increased from 57% to 96% (<i>p</i> < 0.001), while non-compliant requests fell from 43% to 4%. This represented 39 potentially avoidable scans and approximately 780 mSv of theoretically avoided radiation exposure per 100 requests.</p><p><strong>Conclusion: </strong>A theory-informed intervention combining education, a mandatory electronic proforma, and real-time radiologist feedback substantially improved trauma WBCT request documentation and reduced inappropriate requests. Embedding minimum datasets into electronic requesting systems is a low-cost, scalable strategy to support compliance with the Ionising Radiation (Medical Exposure) Regulations [IR(ME)R] 2017, as amended in 2020, and radiation stewardship.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 8","pages":"53482"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}