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Analysis of microRNA expression profiles involved oxidative stress in a deep tissue pressure injury 深层组织压力损伤中涉及氧化应激的microRNA表达谱分析
Pub Date : 2023-11-06 DOI: 10.1097/nr9.0000000000000043
Xiaoying Wang, Hui Shan, Ju Zhang
Abstract Objective: To investigate the association between oxidative stress and the development of deep tissue pressure injury (DTPI) at the genetic level by analyzing microRNA (miRNA) expression profiles in DTPI tissues. Methods: A model of DTPI was established in three adult mice and three elderly mice, while another set of three adult mice and three elderly mice was used as controls. Wound tissues were stained with hematoxylin and eosin to observe the histological changes, and total RNA was extracted for high-throughput sequencing. Differentially expressed oxidative stress-related miRNAs were screened, and target genes were predicted using TargetScan (v5.0) and Miranda (v3.3a). Enrichment analysis of these genes was executed using the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. Selected differentially expressed miRNAs were further validated by qRT-PCR. Results: The results showed that 128 miRNAs were associated with oxidative stress, among which 86 were down-regulated, and 42 were upregulated in the DTPI-elderly group; 21 were differentially expressed in the DTPI-adult group ( P <0.05). Moreover, the miRNA associated with oxidation stress between the two groups was miR-181a-1-3p. Its target genes mainly regulated MAPK and AGE pathways. qRT-PCR results showed that miR-181a-1-3p and miR-21a-5p were significantly downregulated in DTPI tissues. Conclusion: By analyzing miRNA expression profiles related to oxidative stress via a high-throughput sequencing system, this study sheds light on the potential pathological mechanisms underpinning DTPI.
摘要目的:通过分析深层组织压力损伤(DTPI)组织中microRNA (miRNA)的表达谱,从遗传水平探讨氧化应激与DTPI发生的关系。方法:建立3只成年小鼠和3只老年小鼠DTPI模型,另设3只成年小鼠和3只老年小鼠作为对照。采用苏木精和伊红染色观察创面组织组织学变化,提取总RNA进行高通量测序。筛选氧化应激相关差异表达的mirna,并使用TargetScan (v5.0)和Miranda (v3.3a)预测靶基因。利用基因本体(GO)和京都基因与基因组百科全书(KEGG)数据库对这些基因进行富集分析。选择的差异表达mirna通过qRT-PCR进一步验证。结果:结果显示,与氧化应激相关的mirna有128个,其中dtpi -老年组下调86个,上调42个;dtpi -成年组差异表达21个(P <0.05)。此外,两组之间与氧化应激相关的miRNA为miR-181a-1-3p。其靶基因主要调控MAPK和AGE通路。qRT-PCR结果显示,miR-181a-1-3p和miR-21a-5p在DTPI组织中显著下调。结论:通过高通量测序系统分析与氧化应激相关的miRNA表达谱,本研究揭示了DTPI的潜在病理机制。
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引用次数: 0
Advancing home-like environments for memory care residents within nursing homes 为疗养院内的记忆性护理住院患者营造类似家庭的环境
Pub Date : 2023-11-01 DOI: 10.1097/NR9.0000000000000044
M. Strickfaden, Orsolya Welch
Abstract Objective: This article reports on 5 specialized memory care environments within nursing homes in Canada through the theory of affordances with the aim of understanding the layered implications of affordances on memory care residents by curating objects within and configuring or designing spatial environments. Methods: A spatial/object-centric approach was taken by using a detailed analysis framework based on a robust interpretation of the theory of affordances and well-known elements, principles, and physical/construction properties of interior and spatial design. A web content analysis method, using hundreds of photographs, drawings, and textual information belonging to 5 nursing homes posted on websites and on social media, was used. Results: The results include a detailed analysis framework informed by affordance theory and 3 themes that reveal details about the designed environments. The 3 themes are: (1) how contextual factors of affordances of place and care played out, (2) how physical, cultural, and semantic affordances aided or detracted from memory care, and (3) how home-like environments with public, semiprivate, and private spaces involved multiple affordances and constraints that provided multisensory clues towards supporting and/or limiting memory care residents’ possible actions. Conclusions: We conclude that although affordances can open a range of possible actions, they are not ideal for configuring or designing home-like environments, and it is necessary for memory care residents to be presented with constraints that limit alternatives and misaffordances. This article provides evidence about how affordances and constraints are (and could be) intentionally embedded in home-like memory care environments in nursing homes.
摘要 目的:本文通过负担能力理论,对加拿大疗养院内的 5 个专门记忆护理环境进行了报道,旨在通过在空间环境中策划物品、配置或设计空间环境,了解负担能力对记忆护理住院者的多层次影响。方法:我们采用了以空间/物体为中心的方法,使用了一个详细的分析框架,该框架基于对可承受性理论以及室内和空间设计中众所周知的元素、原则和物理/建筑特性的有力解释。使用网络内容分析法,对 5 家养老院在网站和社交媒体上发布的数百张照片、图纸和文字信息进行分析。研究结果结果包括一个详细的分析框架,该框架参考了承受力理论和 3 个揭示设计环境细节的主题。这 3 个主题是(1)场所和护理的可承受性的环境因素是如何发挥作用的;(2)物理、文化和语义上的可承受性是如何帮助或减弱记忆护理的;(3)具有公共、半私人和私人空间的家庭式环境是如何涉及多种可承受性和限制的,这些可承受性和限制为支持和/或限制记忆护理住院者可能采取的行动提供了多感官线索。结论:我们得出的结论是,虽然负担能力可以开启一系列可能的行动,但它们并不是配置或设计家庭式环境的理想选择,有必要为记忆性护理住院者提供限制备选方案和错误负担能力的约束条件。这篇文章提供了证据,说明在养老院的家庭式记忆护理环境中,如何有意识地嵌入负担能力和约束条件。
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引用次数: 0
Design and preliminary evaluation of a low-cost three-dimensional biomechanical force plate 低成本三维生物力学受力板的设计与初步评估
Pub Date : 2023-11-01 DOI: 10.1097/NR9.0000000000000045
Disha Zhu, Xuefeng Wang, Shaomei Shang
Abstract Objective: The three-dimensional (3D) force plate is a widely used device in biomechanical research, capable of measuring the ground reaction force (GRF) exerted on the sole of the foot. The forces of human joints are calculated by combining GRF with motion capture data. In the field of nursing and rehabilitation, evaluation of joint pressure can inform further therapy. However, its high cost often limits its application to a small population. Therefore, we aimed to design and manufacture a low-cost 3D force plate to address this issue, which will advance the evaluation of joint pressure in nursing practices. Methods: Through mechanical derivation and finite element method simulation, the feasibility of this 3D force plate was tested. We proposed a method based on simulation results to assist in calibration. Furthermore, we collected the GRF data of the author using the 3D force plate designed in this study. Then we imported this GRF data and the data obtained from motion capture into OpenSim. Results: The 3D force plate consisted of two 3D force sensors and a 600 × 300 mm board. The 3D force plate could measure the 3D reaction force between the sole of a subject’s foot and the ground. The 3D force plate was validated the usability in this study through theoretical calculation and a complete musculoskeletal analysis process. Conclusion: We have completed the design and practicality verification of this low-cost 3D force plate and provided a calibration method based on finite element method simulation assistance. Low-cost 3D force plates can accelerate the popularization and application of musculoskeletal analysis in the field of nursing and rehabilitation, which is helpful for precision health.
摘要 目的:三维(3D)测力板是生物力学研究中广泛使用的一种设备,能够测量施加在脚底的地面反作用力(GRF)。通过将地面反作用力与运动捕捉数据相结合,可以计算出人体关节的受力情况。在护理和康复领域,对关节压力的评估可为进一步的治疗提供依据。然而,其高昂的成本往往限制了其在少数人群中的应用。因此,我们旨在设计和制造一种低成本的三维测力板来解决这一问题,从而推动护理实践中的关节压力评估。方法:通过力学推导和有限元法模拟,测试了该三维受力板的可行性。我们根据模拟结果提出了一种辅助校准的方法。此外,我们还使用本研究中设计的三维受力板收集了作者的 GRF 数据。然后,我们将这些 GRF 数据和运动捕捉获得的数据导入 OpenSim。结果三维测力板由两个三维力传感器和一块 600 × 300 毫米的木板组成。三维测力板可以测量受试者脚底与地面之间的三维反作用力。本研究通过理论计算和完整的肌肉骨骼分析过程验证了三维测力板的可用性。结论:我们已经完成了这种低成本三维测力板的设计和实用性验证,并提供了基于有限元法模拟辅助的校准方法。低成本的三维受力板可以加速肌肉骨骼分析在护理和康复领域的推广和应用,有利于精准健康。
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引用次数: 0
RDT-FSDet: Few-shot object detection for rapid antigen test RDT-FSDet:快速抗原检测的少针靶检测
Pub Date : 2023-11-01 DOI: 10.1097/nr9.0000000000000042
Yaofei Duan, Tao Tan, Chan-Tong Lam, Rongsheng Wang, Xiaoyan Jin, Sio-Kei Im
Abstract Objective: Manual verification of RDT (rapid diagnostic test) results is a time-consuming task; therefore, it is essential to introduce an object detection model into RDT result recognition to reduce the time involved. To address these problems, a detector that can rapidly adapt to different RDT results in various regions is important. Methods: We employed the few-shot object detection strategy and trained the Faster R-CNN detector with the mainland dataset as the base class, followed by fine-tuning with the few-shot approach on the Macau RDT result dataset. Moreover, we introduced two novel data augmentation methods, namely the Light Simulation Mask method and Synthetic Positive Samples for an unbalanced dataset, to increase the sample size and balance the dataset of the RDT detection task. Result: Compared to LightR-YOLOv5, RDT-FSDet achieved mAP of 91.18 and recall of 93.59 on the Macau RDT dataset, demonstrating that this model can rapidly adapt to RDT results in different regions. The inference time of RDT-FSDet for each RDT result was 0.14 seconds, which can save approximately 90% of the detection time compared to manual screening. Conclusion: In addition to its application in the context of the COVID-19 pandemic, this model can also be used as a general small-sample detection model. RDT-FSDet can be applied to the detection tasks of other small datasets such as managing and analyzing detection results in other or future epidemics.
摘要目的:快速诊断试验(RDT)结果的人工验证是一项耗时的任务;因此,在RDT结果识别中引入目标检测模型以减少耗时是十分必要的。为了解决这些问题,一种能够快速适应不同区域不同RDT结果的检测器非常重要。方法:采用少镜头目标检测策略,以大陆数据集为基类训练Faster R-CNN检测器,然后在澳门RDT结果数据集上采用少镜头方法进行微调。此外,我们引入了两种新的数据增强方法,即光模拟掩模法和非平衡数据集的合成阳性样本,以增加样本大小并平衡RDT检测任务的数据集。结果:与LightR-YOLOv5相比,RDT- fsdet在澳门RDT数据集上的mAP值为91.18,召回率为93.59,表明该模型能够快速适应不同地区的RDT结果。RDT- fsdet对每个RDT结果的推断时间为0.14秒,与人工筛选相比,可节省约90%的检测时间。结论:该模型除了适用于新冠肺炎大流行背景外,还可以作为一般的小样本检测模型。RDT-FSDet可应用于其他小型数据集的检测任务,例如管理和分析其他或未来流行病的检测结果。
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引用次数: 0
A review on intelligent aid diagnosis for dysphagia using swallowing sounds 利用吞咽声进行吞咽困难智能辅助诊断综述
Pub Date : 2023-11-01 DOI: 10.1097/NR9.0000000000000040
Dan Li, Junhui Wu, Xiaoyan Jin, Yanyun Li, Beibei Tong, Wen Zeng, Peiyuan Liu, Weixuan Wang, Shaomei Shang
Abstract Dysphagia, a widespread clinical condition in the elderly, can lead to malnutrition, aspiration pneumonia, and even death. Swallowing sounds emanate from vibrations that occur during the contraction of muscles in the mouth, pharynx, and laryngeal; the opening or closure of the glottis and esophageal sphincter; or the movement of food particles through the throat during swallowing. The development of wearable sensors, data science, and machine learning has spurred growing attention to the clinical method of monitoring swallowing sounds for accurate dysphagia diagnosis. This review delves into the acoustic theory foundation and the application of swallowing sound signal analysis methods, elucidating their potential clinical value for dysphagia diagnosis and treatment.
摘要 吞咽困难是老年人的一种常见临床症状,可导致营养不良、吸入性肺炎甚至死亡。吞咽声音来自口腔、咽部和喉部肌肉收缩时产生的振动;声门和食管括约肌的打开或关闭;或吞咽过程中食物颗粒在喉咙中的移动。随着可穿戴传感器、数据科学和机器学习的发展,人们越来越关注通过监测吞咽声来准确诊断吞咽困难的临床方法。本综述将深入探讨吞咽声信号分析方法的声学理论基础和应用,阐明其在吞咽困难诊断和治疗中的潜在临床价值。
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引用次数: 0
Mechanisms and intervention strategies of emotional dysregulation in individuals with non-suicidal self-injury 非自杀性自伤个体情绪失调的机制与干预策略
Pub Date : 2023-10-27 DOI: 10.1097/nr9.0000000000000041
Mengyuan Li, Qiuhong Li, Chao Wu
Abstract Non-suicidal self-injury (NSSI) is a deliberate, direct, socially unacceptable, and nonsuicidal form of self-hurt, with a high incidence rate among adolescents. NSSI harms people’s bodies and minds, dampening their social function and increasing the risk of suicide. The Benefit and Barrier Model of NSSI proposes that the core benefit of NSSI is emotional gain, in other words, the emotion regulation effect of the NSSI behaviors. The purpose of this study was to elucidate the relationship between NSSI and emotional dysregulation, analyze the possible behavioral and neural mechanisms underlying emotional dysregulation in NSSI, and summarize the application of emotion regulation strategies in the intervention for NSSI. This review provides evidence and implications for further research on the mechanisms and interventions related to emotional dysregulation in people with NSSI.
非自杀性自伤(NSSI)是一种故意的、直接的、社会不能接受的、非自杀性的自伤形式,在青少年中发病率很高。自伤伤害人的身心,抑制人的社会功能,增加自杀的风险。自伤的收益与障碍模型认为,自伤行为的核心收益是情绪收益,即自伤行为的情绪调节效应。本研究旨在阐明自伤与情绪失调的关系,分析自伤中情绪失调可能的行为和神经机制,总结情绪调节策略在自伤干预中的应用。这一综述为进一步研究自伤患者情绪失调的机制和干预措施提供了证据和启示。
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引用次数: 0
Autonomy-supportive environments for people with dementia: an evidence-based review 痴呆患者自主支持环境:一项基于证据的综述
Pub Date : 2023-10-20 DOI: 10.1097/nr9.0000000000000036
Jiajing Li
Abstract Objective: As one of the core principles of person-centered care, supporting the autonomy of residents with dementia has received increasing attention worldwide. Supportive physical environments play an important role in promoting autonomy in the everyday life of residents in care facilities. However, there is no universal definition for autonomy in everyday life nor focused research on autonomy-supportive environments. Thus, this study aims to systematically review the existing evidence of autonomy-supportive design features based on a synthesized concept analysis of autonomy in everyday life. Methods: A synthesized concept analysis on autonomy was conducted based on related definitions of autonomy in design guidelines and environmental assessment tools of elderly care facilities. Using keywords from the concept analysis, multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, and Dementia Design Info were used to carry out a systematic review of autonomy-supportive environmental design features for people with dementia. Additional guidelines and standards were manually searched. The design features supported by empirical studies and studies based on experts’ experience were extracted from the literature. The evidence intensity of each feature was assessed according to the quality and quantity of related studies. Results: Four domains of autonomy, freedom, independence, control, and choice emerged based on the concept analysis. Seventy-eight autonomy-supportive design features were extracted from the literature. Features are summarized into 8 categories: building layout, circulation space, living room, dining space, bathroom, bedroom, outdoor space, and details. Of design features, 60% in the category of building layout have been cross-validated by empirical studies, whereas only 25% of the overall design features have. Conclusions: The results of this review show that numerous design features of the physical environment can support the autonomy of people with dementia in the 4 domains. Features of building layout are well researched and the evidence intensity for the rest of design features still needs to be improved through future empirical studies.
摘要目的:作为以人为本的护理的核心原则之一,支持痴呆患者的自主性越来越受到世界各国的关注。支持性物理环境在促进护理机构居民日常生活中的自主性方面发挥着重要作用。然而,对于日常生活中的自主性,目前还没有一个通用的定义,也没有针对自主支持环境的重点研究。因此,本研究旨在基于日常生活中自主性的综合概念分析,系统地回顾自主支持设计特征的现有证据。方法:结合养老设施设计指南和环境评价工具中自主性的相关定义,对自主性进行综合概念分析。使用概念分析中的关键词,使用PubMed、Web of Science、CINAHL、PsycINFO和Dementia Design Info等多个数据库,对痴呆患者的自主支持环境设计特征进行系统回顾。手动搜索其他指导方针和标准。从文献中提取实证研究支持的设计特征和基于专家经验的研究。根据相关研究的质量和数量对各特征的证据强度进行评价。结果:在概念分析的基础上,出现了自主、自由、独立、控制和选择四个领域。从文献中提取了78个自主支持设计特征。特征归纳为8类:建筑布局、交通空间、客厅、餐厅空间、浴室、卧室、室外空间和细节。在设计特征中,60%的建筑布局类别经过了实证研究的交叉验证,而总体设计特征只有25%经过了实证研究的交叉验证。结论:本综述的结果表明,物理环境的许多设计特征可以支持痴呆患者在这四个领域的自主性。对建筑布局特征的研究比较充分,其余设计特征的证据强度有待于进一步的实证研究来提高。
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引用次数: 0
5G technology: a perspective on transforming nursing education 5G技术:护理教育转型的视角
Pub Date : 2023-10-17 DOI: 10.1097/nr9.0000000000000039
Lin Han, Mengyao Jiang, Lingling Zhang, Ning An
aEvidence-Based Nursing Center, School of Nursing, Lanzhou University, 28 Yanxi Road, Lanzhou730000, Gansu, China bDepartment of Nursing, Gansu Provincial Hospital, Lanzhou730000, Gansu, China cDepartment of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan430030, Hubei, China dDepartment of Nursing, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA 02125, USA eKey Laboratory of Knowledge Engineering with Big Data of the Ministry of Education, School of Computer Science and Information Engineering, Hefei University of Technology, Hefei 230009, Anhui, China E-mail: [email protected] Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author: Mengyao Jiang, MSN This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
a兰州大学护理学院循证护理中心,甘肃兰州市延西路28号;b甘肃省立医院护理部,甘肃兰州市730000;c华中科技大学同济医学院同济医院护理部,湖北武汉430030解放大道1095号;合肥工业大学计算机科学与信息工程学院美国大数据知识工程教育部重点实验室,安徽合肥230009 E-mail: [email protected]本文最后披露了可能与内容相关的赞助或利益竞争。■■*通讯作者:蒋梦瑶,MSN这是一篇在知识共享署名-非商业-禁止衍生产品许可4.0 (CCBY-NC-ND)条款下发布的开放获取文章,在适当引用的情况下,允许下载和分享。未经本刊许可,不得以任何方式更改或用于商业用途。http://creativecommons.org/licenses/by-nc-nd/4.0/
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引用次数: 0
Effect of socio-community environment on the impacts of COVID-19 pandemic and well-being among older people in Hong Kong 社会-社区环境对新冠肺炎大流行及香港长者福祉的影响
Pub Date : 2023-10-13 DOI: 10.1097/nr9.0000000000000033
Xiaoting Ou, Daniel W.L. Lai, Zideng Huang, Hazy H.Y. Lee
Abstract Background: This study examined the effects of socio-community environment on the impacts of the COVID-19 pandemic among the older people in Hong Kong. Methods: A random sample of 1,200 60+ participants completed a telephone survey in 2020. Socio-community environment variables covering trust toward politicians, government officials, and medical professionals, and community safety factors covering confirmed cases in the building of the participant, perceived neighborhood safety, and perceived safety in Hong Kong were the independent variables. The dependent variables were impacts of COVID-19 related to social activities, finance and routines, interpersonal relationships, and workplace. Hierarchical regression analysis was conducted with variables on trust and community safety entered as separate block while adjusting the effects of the participants’ demographics. Results: Older people in community environment that was perceived as less safe reported more negative impacts of COVID. A higher level of trust toward the various types of authorities also demonstrated to have different effects on the perceived negative impacts of the COVID in different aspects of the older people’s daily lives. Conclusion: Trustworthy government policies and measures as well as building a safe community environment are important directions for addressing concerns and the negative impacts of pandemic in future.
摘要背景:本研究探讨社会社区环境对新冠肺炎大流行对香港老年人的影响。方法:2020年,随机抽取120060余人进行电话调查。自变量为社会-社区环境变量(包括对政治家、政府官员和医疗专业人员的信任)和社区安全因素(包括参与者在建设中确诊病例、感知邻里安全和感知香港安全)。因变量为COVID-19对社会活动、财务和日常生活、人际关系和工作场所的影响。在调整参与者人口统计学影响的同时,将信任和社区安全变量作为单独块进行分层回归分析。结果:在被认为不太安全的社区环境中,老年人报告了更多的负面影响。对各类权威机构的更高信任度也对老年人日常生活不同方面的负面影响产生了不同的影响。结论:可信的政府政策措施和安全的社区环境是未来应对疫情负面影响的重要方向。
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引用次数: 0
Consolidating a program theory on how social media supports healthcare providers’ knowledge use in clinical practice: a realist-informed qualitative study 巩固关于社会媒体如何支持医疗保健提供者在临床实践中的知识使用的程序理论:一项现实主义者知情的定性研究
Pub Date : 2023-10-13 DOI: 10.1097/nr9.0000000000000038
Junqiang Zhao, Gillian Harvey, Amanda Vandyk, Mandy Huang, Wendy Gifford
Abstract Objective: This study aimed to consolidate a program theory, developed from a previous realist review, to further understand how and under what circumstances social media supports healthcare providers’ knowledge use. Methods: A realist-informed qualitative study was conducted. We carried out in-depth interviews with 11 participants, including content developers and healthcare providers from China, Australia, and Canada. The data analysis was informed by categorizing and connecting strategies. Results: Ten context-mechanism-outcome configurations (CMOs) were developed to consolidate the program theory. Among these, four CMOs confirmed the original CMOs from the realist review, four refined the original ones, and two were new propositions. These 10 CMOs were situated within four interconnected levels of outcomes: social media product, access, engagement, and knowledge use. They considered 1) content developers’ capabilities and capacities, 2) healthcare providers’ increased attention, 3) fulfillment of information needs, 4) access to social influence and support, 5) perception of message value and implementability, 6) behaviour capabilities, self-efficacy, intention, and awareness; and 7) ability to exercise professional autonomy as the key mechanisms. We developed the consolidated program theory based on the 10 CMOs. Conclusions: Social media can promote knowledge use by healthcare providers. Future empirical studies drawing on the program theory need to be conducted to further optimize the theoretical understanding.
摘要目的:本研究旨在巩固一个程序理论,从之前的现实主义回顾发展,以进一步了解社交媒体如何以及在什么情况下支持医疗保健提供者的知识使用。方法:采用现实知情的定性研究。我们对11名参与者进行了深入访谈,其中包括来自中国、澳大利亚和加拿大的内容开发商和医疗保健提供商。数据分析是通过分类和连接策略进行的。结果:建立了十个情境-机制-结果配置(cmo)来巩固程序理论。其中,4个cmo从现实主义的审视中确认了原来的cmo, 4个对原来的cmo进行了提炼,2个是新的命题。这10个cmo位于四个相互关联的结果层次:社交媒体产品、访问、参与和知识使用。他们考虑了1)内容开发者的能力和能力,2)医疗保健提供者的更多关注,3)满足信息需求,4)获得社会影响和支持,5)对信息价值和可实现性的感知,6)行为能力、自我效能、意图和意识;7)专业自主能力作为关键机制。我们发展了基于10个cmo的综合程序理论。结论:社交媒体可以促进医护人员的知识使用。未来的实证研究需要借鉴程序理论,进一步优化理论认识。
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引用次数: 0
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Interdisciplinary nursing research
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