Enfermeria intensiva最新文献

{"title":"Patient perception of frailty assessment in intensive care units: A phenomenological study","authors":"María Teresa González-Gil RN, MsC, PhD ,&nbsp;Susana Arias-Rivera RN, MsC, PhDc","doi":"10.1016/j.enfie.2025.500548","DOIUrl":"10.1016/j.enfie.2025.500548","url":null,"abstract":"<div><div>Frail patients admitted to the Intensive Care Unit (ICU) have a poorer outcome that may be related to Post ICU Syndrome, readmissions or death within a year of discharge. Assessing frailty can help guide decision-making and care planning.</div></div><div><h3>Objective</h3><div>To explore the perception of patients in relation to the assessment of frailty in the ICU.</div></div><div><h3>Methodology</h3><div>Qualitative phenomenological study through semi-structured interviews in the ICU of a public hospital of intermediate complexity. Thirteen patients with experience of admission to the ICU participated. A thematic analysis of the discourse was carried out following Braun and Clarke's proposal.</div></div><div><h3>Results</h3><div>Three themes and seven subthemes were identified as pivotal in describing the patients' experience: perception of own frailty, coping styles and resources for dealing with frailty, and the value of monitoring the evolution of frailty. Participants understand frailty as opposed to strength, from a multidimensional perspective and linked to the idea of loss of capabilities. They try to deal with fragility by coping and struggling with it, drawing on intrapersonal and interpersonal resources. They place value on monitoring the evolution of frailty insofar as they feel considered and supported.</div></div><div><h3>Conclusions</h3><div>The patients' narratives evidence the important repercussion that an ICU admission has on the physical and psycho-socio-emotional dimensions of patients and caregivers. The assessment of frailty and the monitoring of its evolution at discharge is valued as important to be able to adapt care and significant as a facilitator of emotional support. There is a clear need for support at discharge in the different spheres and for accompanying the patient throughout their recovery to enable an early return to their life prior to admission.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500548"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10 key issues for prevention, monitoring and non-pharmacological treatment of delirium in critically ill patients","authors":"Olga Vallés-Fructuoso RN, MSc ,&nbsp;Juan José Rodríguez-Mondéjar RN, MSc, PhD ,&nbsp;David Alonso-Crespo RN, MSc ,&nbsp;Gemma Robleda-Font RN, MSc, PhD ,&nbsp;Candelas López-López RN, MSc, PhD ,&nbsp;Diana Gil-Castillejos RN, MSc, PhD ,&nbsp;María Acevedo-Nuevo RN, MSc, PhD","doi":"10.1016/j.enfie.2025.100499","DOIUrl":"10.1016/j.enfie.2025.100499","url":null,"abstract":"<div><div>In intensive care units, due to critical illness nature and environment special characteristics, it is relatively common for admitted patients to develop acute confusional syndrome (ACS) or delirium. The nurse’s duties are to carry out interventions that reduce the presentation of this process, which is still an important complication as it is related to longer periods of mechanical ventilation, longer ICU and hospital stays, higher mortality; both in-hospital and after discharge and grater long term cognitive dysfunction. Therefore, nurses participation is essential to prevent and treat delirium, and more specifically in the autonomous part with non-pharmacological measures such as pain control, avoid under or oversedation, promoting restful sleep and facilitating family support among other measures. The objective is to carry out an update that describes 10 key points focused on the tools for detecting/monitoring delirium and non-pharmacological measures for its prevention and treatment. Based on the review of the literature, the 10 most common interventions are described to serve as an action plan to be included in the care plans of patients affected with delirium, providing quality care to prevent and/or treat delirium in critical patients.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 100499"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanization strategies in pediatric intensive care: A scoping review","authors":"María Esther Salgado-Reguero PhD, MsC, RN ,&nbsp;Sara Furtado-Eraso PhD, RN ,&nbsp;Arantxa Bujanda-Sainz de Murieta PhD, MsC, RN ,&nbsp;Cristina García-Vivar PhD, RN ,&nbsp;Nelia Soto-Ruiz PhD, RN ,&nbsp;Paula Escalada-Hernández PhD, RN","doi":"10.1016/j.enfie.2025.500531","DOIUrl":"10.1016/j.enfie.2025.500531","url":null,"abstract":"<div><h3>Background</h3><div>The international HU-CI project advocates eight strategic strands for the humanization of intensive care units. Despite of adult ICUs have received attention to promote humanization of care, in the paediatric context, the humanization of care continues to receive limited attention, with limited data on paediatric structures and humanization patterns lacking integration into practice.</div></div><div><h3>Objectives</h3><div>Identify available evidence related to humanization concepts according to the theoretical framework of the HU-CI Project and understand the implementations in the field of paediatric intensive care units.</div></div><div><h3>Method</h3><div>A scoping review was conducted through a literature search in PubMed and CINAHL. Studies addressing concepts or elements related to the strategic lines of the HU-CI framework within the context of paediatric intensive care units were included. The perspective of patients, families, and frontline healthcare professionals was considered, using quantitative, qualitative, and mixed methods approaches. Data analysis followed a narrative approach, categorically synthesised according to the strategic lines of the HU-CI framework in paediatric intensive care units.</div></div><div><h3>Results</h3><div>A total of 41 articles were included. Within the eight action lines of action of the HU-CI framework, end-of-life care and communication predominated over flexible schedules, family presence and participation in care, patient well-being, professional care, post-ICU syndrome and humanised infrastructure.</div></div><div><h3>Conclusions</h3><div>The analysed action lines suggest the need for development and improvement through further research to facilitate their full integration into the practice of paediatric intensive care units.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500531"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between family caregiver competence and dependency in patients discharged from the Intensive Care Unit","authors":"Natalia Esquivel Garzón,&nbsp;Dora Inés Parra","doi":"10.1016/j.enfie.2025.500540","DOIUrl":"10.1016/j.enfie.2025.500540","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between the competence (knowledge, skill and preparation) of the family caregiver and the degree of dependency of patients discharged from Intensive Care Unit.</div></div><div><h3>Method</h3><div>A descriptive, cross-sectional study was carried out to characterize family caregivers and patients discharged from the ICU with moderate, severe or total dependence according to Barthel score. Competence was measured with the application of the CUIDAR instrument and caregiver performance (execution of activities in a specific situation) with an instrument that evaluated the performance of actions aimed at supplying basic needs of feeding, elimination, body hygiene, skin care, oxygen therapy and medication administration in a sample of 140 caregivers.</div></div><div><h3>Results</h3><div>A positive association was found between patient functionality and caregiver performance (Spearman rho: 0.38; <em>p</em> &lt; .001). In contrast, no significant correlation was observed between the self-perception of caregiver competence assessed with the CUIDAR instrument and the patient’s functionality, measured by the Barthel scale (Spearman rho: 0.12; <em>p</em> = .16). The 69.3% of the participants had a medium or low competence, only (30.7%) were classified at a high level. The lowest scores were obtained in knowledge (62.9%), followed by uniqueness (32.9%).</div></div><div><h3>Conclusion</h3><div>There is a significant association between patient functionality and objectively assessed caregiver performance; thus, caregivers of more dependent patients have significant challenges to achieve adequate performance in their role.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500540"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical and legal considerations and recommendations for action in the physical restraint use in critically ill patients","authors":"Maria Acevedo-Nuevo RN, MsC, PhD ,&nbsp;Tayra Velasco-Sanz RN, MsC, PhD ,&nbsp;Belen Del Olmo-Somolinos RN, MsC ,&nbsp;Gemma Vía-Clavero RN, MsC, PhD","doi":"10.1016/j.enfie.2025.100497","DOIUrl":"10.1016/j.enfie.2025.100497","url":null,"abstract":"<div><div>Physical restraint use is a common practice in Intensive Care Units. However, despite this high prevalence, it is a practice full of adverse effects, with uncertain effectiveness in preventing self-removal devices and that raises numerous ethical conflicts. Current recommendations suggest restraints should be a last resort measure, they should not be prolonged beyond what is strictly necessary and that they should only be used if, in the interprofessional assessment of benefits-risks for the patient, benefits greatly outweigh harms. This manuscript aims to serve as a guide for decision-making from an ethical perspective on the use or non-use of physical restraints in critically ill patients. Likewise, a review of the legal and deontological framework that governs restraint use in our country is proposed. Finally, recommendations for practice are offered, both for healthcare professionals and healthcare managers, upon the construction of restraints-free Intensive Care Units and good practices in the exceptional cases they are necessary.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 100497"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TeamSTEPPS®-based teamwork training through an escape room experience: A mixed research study","authors":"Oscar Arrogante RN, Psy, MSc, PhD ,&nbsp;Marta Raurell-Torredà RN, MSN, PhD ,&nbsp;Elena Maestre-González RN, MsC ,&nbsp;Francisco Javier Sánchez-Chillón RN, MSN ,&nbsp;Martín Torralba-Melero RN, MSN ,&nbsp;Anna Maria Aliberch-Raurell RN, MSN ,&nbsp;Andrés Rojo-Rojo RN, PhD ,&nbsp;Ignacio Zaragoza-García RN, PhD","doi":"10.1016/j.enfie.2025.500536","DOIUrl":"10.1016/j.enfie.2025.500536","url":null,"abstract":"<div><h3>Introduction</h3><div>The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve teamwork among critical care professionals. The <em>escape</em> room as an educational strategy is effective for the learning process of professionals according to recent evidence.</div></div><div><h3>Objectives</h3><div>To analyse the degree of satisfaction and explore the perceptions of intensive care nurses after an <em>escape</em> room experience based on the TeamSTEPPS® programme.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive and phenomenological study using a mixed methodology. A specific and adapted satisfaction survey was applied to the participants of the <em>escape</em> room, including at the end an open-ended question for them to make comments and thus analyse their perceptions of the experience. A thematic content analysis of the comments was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 29.0 and ATLAS.ti 24™ respectively.</div></div><div><h3>Results</h3><div>Fifty-five nursing professionals from different intensive care units in Spain participated, with a median age of 34 years (RIC = 12) and 9 years of experience in intensive care (RIC = 11), most of them being women (89.1%). The participants expressed high overall satisfaction with the activity, with a median of 47 points out of 50 (RIC = 4). Three main categories with their respective subcategories emerged from their comments: learning through the <em>escape</em> room (learning new tools; fun way to learn); usefulness of TeamSTEPPS® strategies (communication skills, patient safety and teamwork); implementation in clinical practice (applicable strategies and ease of implementation).</div></div><div><h3>Conclusions</h3><div>The <em>escape</em> room can be a dynamic, interactive, engaging, and fun way to promote teamwork training and education in intensive care nurses through the TeamSTEPPS® training programme.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500536"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catamenial pneumothorax: A case report","authors":"Jorge Álvarez-López RN, MSN ,&nbsp;Cristina Pérez-Talavera RN, MSc","doi":"10.1016/j.enfie.2025.500530","DOIUrl":"10.1016/j.enfie.2025.500530","url":null,"abstract":"<div><h3>Introduction</h3><div>Catamenial pneumothorax (CN) is a rare type of pneumothorax that affects women of childbearing age. Its etiopathogenesis is controversial and several theories have been proposed, although there is a frequent relationship with intrathoracic endometriosis. The diagnosis can be a challenge, so recurrences can appear until it is found and it can be treated correctly. This document describes a case of catamenial pneumothorax and develops a care plan tailored at a patient suffering from this type of pathology.</div></div><div><h3>Case description</h3><div>A 41-year-old woman, with no personal or family history who attended the emergency department reporting pain in the right hemithorax and dyspnea. The chest X-ray revealed a complete pneumothorax that required placement of a chest drain. During the surgical intervention, cicatricial lesions with gray and black diaphragmatic pores are observed, which suggests a pneumothorax of catamenial origin.</div></div><div><h3>Assessment</h3><div>The nursing assessment was designed using the conceptual model of Marjory Gordon, where the patterns of activity-exercise, rest, perception and sexuality-related patterns were identified as altered.</div></div><div><h3>Diagnosis</h3><div>Using the taxonomy created by NANDA, nursing diagnoses related to impaired gas exchange, pain, rest, skin integrity, and problems related to gynecologic-obstetric aspects were established.</div></div><div><h3>Planning</h3><div>The objectives and interventions were established based on the previously marked diagnoses, using the NOC and NIC taxonomy. Those related to gas exchange, skin care at the level of the chest tube area, pain, rest and those with gynaecological links stand out.</div></div><div><h3>Discussion</h3><div>CN is a rare entity and it is necessary to know its etiopathogenesis for early detection of the problem and apply care aimed at meeting the needs of the patient and avoiding complications derived from it.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500530"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the nurse workload and impact of patient volume and flow in a Surgical ICU","authors":"Amaia Gutiérrez-Abarca MSN,&nbsp;Alberto Casado-Álvarez MSN,&nbsp;Sare Espinosa-Carcabilla MSN","doi":"10.1016/j.enfie.2025.500535","DOIUrl":"10.1016/j.enfie.2025.500535","url":null,"abstract":"<div><h3>Introduction</h3><div>A poor Nurse-to-Patient (N:P) ratio has a negative impact on the health of both patients and professionals. There are several tools to quantify the Nurse Workload (NW) and adjust nurse staffing. The use of such tools in the Intensive Care Units (ICU) can facilitate the adaptation of Nursing resources to patients’ real needs and improve working conditions.</div></div><div><h3>Objective</h3><div>To determine the NW in a Surgical ICU.</div></div><div><h3>Methodology</h3><div>Descriptive, transversal and unicentric study during March and April 2023. Determination of the operative N:P ratio adequated to the NW using the “Nursing Activities Score” (NAS). Measurement of the NW using NAS and “Valoración de Cargas de Trabajo y Tiempos de Enfermería” (VACTE) scales, together with the proposed NW indicators. Management and efficiency analysis of the Nursing Resources using the “Work Utilization Ratio” Index (WUR). Identification of work days and shifts with greater workload. Bivariate analysis relating NAS and VACTE to reason for admission. Calculation of the NW of each reason for admission relating the stay average and its NAS and VACTE average. Correlation analysis between scales.</div></div><div><h3>Results</h3><div>1705 records per scale were collected. NAS per patient median: 55.70 (IR: 51.30−60.38), (95%CI: 54.74−56.66). NAS per patient mean: 56,67 (SD: ±8,28), (95%CI: 55.72–57.63). NW per bed NAS: 63.39, VACTE: 652.93. NAS per nurse: 135.23%. B:P Ratio: 1:1.09. Operative N:P Ratio: 1:1.76. WUR &gt; 1. Correlation coefficient between scales: 0.45.</div></div><div><h3>Conclusions</h3><div>There is a shortage of nurses in relation to the work generated. An update in the scales is required. The NAS per nurse is more effective than the NAS per patient for the adequacy of the Nursing workforce. The new proposed indicators might be suitable to determine the NW and to optimize the calculation of Nursing resources.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500535"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional intervention in the prevention of PICS and PICS-F","authors":"Beatriz Lobo-Valbuena MD, PhD, MBE ,&nbsp;María Dolores Sánchez-Roca RN ,&nbsp;María Pilar Regalón-Martín RN ,&nbsp;Julia Torres-Morales RN ,&nbsp;Victoria Enciso-Calderón MD","doi":"10.1016/j.enfie.2025.500528","DOIUrl":"10.1016/j.enfie.2025.500528","url":null,"abstract":"<div><div>The follow-up of the critically ill patient at discharge is an essential process to ensure continuity of care and prevent complications after the stay in an intensive care unit (ICU). The nurse's role as coordinator of this follow-up is crucial because of her experience in managing complex care and her ability to act as a liaison between the patient, her family and the interprofessional health care team. The article highlights that the transition of the critically ill patient from the ICU to other inpatient units or home represents a vulnerable period, where the risk of readmission and complications is high. The nurse plays a central role in planning and executing a comprehensive discharge plan, which includes educating the patient and family about continuing care, communicating with other healthcare professionals, and recognising warning signs that require immediate medical attention. In addition, she addresses the emotional and psychological needs of the patient and family, providing support and resources to adjust to life post-ICU. The nurse acts as an advocate for the patient, ensuring that person-centred care is maintained, respecting the patient's preferences and values.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500528"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing specialization in intensive care: A scoping review","authors":"Cristina Pérez-Talavera RN, MSc","doi":"10.1016/j.enfie.2025.500529","DOIUrl":"10.1016/j.enfie.2025.500529","url":null,"abstract":"<div><h3>Introduction</h3><div>Nursing in Intensive Care Units (ICU) presents an additional difficulty due to the highly complex nature of the patients. This implies a demand for training, skills, and management from the nurses attending to this type of patient, which is not currently guaranteed due to the lack of mandatory prior training. Despite the importance of such education and training, there is currently no existing regulation or national or international consensus regarding its mandatory requirement for performing professional activities in ICUs.</div></div><div><h3>Objectives</h3><div>The main research question posed is to identify the existing recommendations on specialised nursing care in adult intensive care.</div></div><div><h3>Methodology</h3><div>A scoping review was conducted using the databases PubMed, CINAHL, MEDLINE, COCHRANE, CUIDEN, and SciELO. The review included studies in both Spanish and English with varied designs on the topic of study. The quality of the articles was analyzed, achieving moderate to high levels of compliance with quality guidelines.</div></div><div><h3>Results</h3><div>A sample of N = 25 was selected, divided according to the primary theme of the articles: 40% (n = 10) on the implementation of training programmes in ICUs, 24% (n = 6) on nursing competencies, 16% (n = 4) on the needs identified by ICU staff themselves, and 20% (n = 5) on the clinical specialty of ICU nursing.</div></div><div><h3>Conclusions</h3><div>The findings indicate an improvement in both patient outcomes and the functioning of ICUs following appropriate training of nursing staff. A model for an Intensive Care Nursing Specialty in Spain is proposed as a viable option to develop the necessary specific training.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500529"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}