Pub Date : 2024-09-19DOI: 10.1016/j.bja.2024.07.003
{"title":"Evaluation of the physical and psychosocial sequelae of ICU admission at 3, 6, and 12 months post-ICU discharge using a validated scoring system and a post-ICU discharge telephone clinic","authors":"","doi":"10.1016/j.bja.2024.07.003","DOIUrl":"10.1016/j.bja.2024.07.003","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.bja.2024.07.004
{"title":"Troponin clearance via continuous renal replacement therapies in the ICU","authors":"","doi":"10.1016/j.bja.2024.07.004","DOIUrl":"10.1016/j.bja.2024.07.004","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.bja.2024.07.002
{"title":"Readability of patient information in paediatric anaesthesia","authors":"","doi":"10.1016/j.bja.2024.07.002","DOIUrl":"10.1016/j.bja.2024.07.002","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1016/j.bja.2024.08.005
Nicholas J Douville,Mark E Smolkin,Bhiken I Naik,Michael R Mathis,Douglas A Colquhoun,Sachin Kheterpal,Stephen R Collins,Linda W Martin,Wanda M Popescu,Nathan L Pace,Randal S Blank,
BACKGROUNDLimited data exist to guide oxygen administration during one-lung ventilation for thoracic surgery. We hypothesised that high intraoperative inspired oxygen fraction during lung resection surgery requiring one-lung ventilation is independently associated with postoperative pulmonary complications (PPCs).METHODSWe performed this retrospective multicentre study using two integrated perioperative databases (Multicenter Perioperative Outcomes Group and Society of Thoracic Surgeons General Thoracic Surgery Database) to study adult thoracic surgical procedures using one-lung ventilation. The primary outcome was a composite of PPCs (atelectasis, acute respiratory distress syndrome, pneumonia, respiratory failure, reintubation, and prolonged ventilation >48 h). The exposure of interest was high inspired oxygen fraction (FiO2), defined by area under the curve of a FiO2 threshold > 80%. Univariate analysis and logistic regression modelling assessed the association between intraoperative FiO2 and PPCs.RESULTSAcross four US medical centres, 141/2733 (5.2%) procedures conducted in 2716 patients (55% female; mean age 66 yr) resulted in PPCs. FiO2 was univariately associated with PPCs (adjusted OR [aOR]: 1.17, 95% confidence interval [CI]: 1.04-1.33, P=0.012). Logistic regression modelling showed that duration of one-lung ventilation (aOR: 1.20, 95% CI: 1.03-1.41, P=0.022), but not the time-weighted average FiO2 (aOR: 1.01, 95% CI: 1.00-1.02, P=0.165), was associated with PPCs.CONCLUSIONSOur results do not support limiting the inspired oxygen fraction for the purpose of reducing postoperative pulmonary complications in thoracic surgery involving one-lung ventilation.
{"title":"Association between inspired oxygen fraction and development of postoperative pulmonary complications in thoracic surgery: a multicentre retrospective cohort study.","authors":"Nicholas J Douville,Mark E Smolkin,Bhiken I Naik,Michael R Mathis,Douglas A Colquhoun,Sachin Kheterpal,Stephen R Collins,Linda W Martin,Wanda M Popescu,Nathan L Pace,Randal S Blank,","doi":"10.1016/j.bja.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.bja.2024.08.005","url":null,"abstract":"BACKGROUNDLimited data exist to guide oxygen administration during one-lung ventilation for thoracic surgery. We hypothesised that high intraoperative inspired oxygen fraction during lung resection surgery requiring one-lung ventilation is independently associated with postoperative pulmonary complications (PPCs).METHODSWe performed this retrospective multicentre study using two integrated perioperative databases (Multicenter Perioperative Outcomes Group and Society of Thoracic Surgeons General Thoracic Surgery Database) to study adult thoracic surgical procedures using one-lung ventilation. The primary outcome was a composite of PPCs (atelectasis, acute respiratory distress syndrome, pneumonia, respiratory failure, reintubation, and prolonged ventilation >48 h). The exposure of interest was high inspired oxygen fraction (FiO2), defined by area under the curve of a FiO2 threshold > 80%. Univariate analysis and logistic regression modelling assessed the association between intraoperative FiO2 and PPCs.RESULTSAcross four US medical centres, 141/2733 (5.2%) procedures conducted in 2716 patients (55% female; mean age 66 yr) resulted in PPCs. FiO2 was univariately associated with PPCs (adjusted OR [aOR]: 1.17, 95% confidence interval [CI]: 1.04-1.33, P=0.012). Logistic regression modelling showed that duration of one-lung ventilation (aOR: 1.20, 95% CI: 1.03-1.41, P=0.022), but not the time-weighted average FiO2 (aOR: 1.01, 95% CI: 1.00-1.02, P=0.165), was associated with PPCs.CONCLUSIONSOur results do not support limiting the inspired oxygen fraction for the purpose of reducing postoperative pulmonary complications in thoracic surgery involving one-lung ventilation.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1016/j.bja.2024.07.021
Tom Salih,Laura Elgie,Yaa Acheampong,S Ramani Moonesinghe
{"title":"Entonox® use for labour analgesia in the context of environmental impact and occupational exposure: a national survey of UK midwives.","authors":"Tom Salih,Laura Elgie,Yaa Acheampong,S Ramani Moonesinghe","doi":"10.1016/j.bja.2024.07.021","DOIUrl":"https://doi.org/10.1016/j.bja.2024.07.021","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1016/j.bja.2024.08.004
Bradley A. Fritz, Christopher R. King, Mohamed Abdelhack, Yixin Chen, Alex Kronzer, Joanna Abraham, Sandhya Tripathi, Arbi Ben Abdallah, Thomas Kannampallil, Thaddeus P. Budelier, Daniel Helsten, Arianna Montes de Oca, Divya Mehta, Pratyush Sontha, Omokhaye Higo, Paul Kerby, Stephen H. Gregory, Troy S. Wildes, Michael S. Avidan
Anaesthesiologists might be able to mitigate risk if they know which patients are at greatest risk for postoperative complications. This trial examined the impact of machine learning models on clinician risk assessment. This single-centre, prospective, randomised clinical trial enrolled surgical patients aged ≥18 yr. Anaesthesiologists and nurse anaesthetists providing remote telemedicine support reviewed electronic health records with (assisted group) or without (unassisted group) reviewing machine learning predictions. Clinicians predicted the likelihood of postoperative 30-day all-cause mortality and postoperative acute kidney injury (AKI) within 7 days. The primary outcome was area under the receiver operating characteristic curve (AUROC) for clinician predictions of mortality and AKI, comparing AUROCs between assisted and unassisted assessments. We analysed 5071 patients (mean [range] age: 58 [18-100] yr; 52% female) assessed by 89 clinicians. Of these, 98 (2.2%) patients died within 30 days of surgery and 450 (11.1%) patients sustained AKI. Clinician predictions agreed with the models more strongly in the assisted unassisted group (weighted kappa 0.75 0.62 for death, mean difference: 0.13 [95% CI 0.10–0.17]; and 0.79 0.54 for AKI, mean difference: 0.25 [95% CI 0.21–0.29]). Clinical prediction of death was similar between the assisted (AUROC 0.793) and unassisted (AUROC 0.780) groups (mean difference: 0.013 [95% CI –0.070 to 0.097]; =0.76). Prediction of AKI had an AUROC of 0.734 in the assisted group 0.688 in the unassisted group (difference 0.046 [95% CI –0.003 to 0.091]; =0.06). Clinician performance was not improved by machine learning assistance. Further work is needed to clarify the role of machine learning in real-time perioperative risk stratification. NCT05042804.
如果麻醉医师知道哪些患者术后并发症的风险最大，他们就有可能降低风险。这项试验研究了机器学习模型对临床医生风险评估的影响。这项单中心、前瞻性、随机临床试验招募了年龄≥18 岁的外科手术患者。提供远程远程医疗支持的麻醉医师和麻醉护士在审查机器学习预测结果的情况下（辅助组）或不在审查机器学习预测结果的情况下（无辅助组）审查电子健康记录。临床医生预测了术后 30 天全因死亡率和术后 7 天内急性肾损伤 (AKI) 的可能性。主要结果是临床医生预测死亡率和 AKI 的接收者操作特征曲线下面积 (AUROC)，比较辅助评估和非辅助评估的 AUROC。我们分析了由 89 名临床医生评估的 5071 名患者（平均 [范围] 年龄：58 [18-100] 岁；52% 为女性）。其中，98 例（2.2%）患者在术后 30 天内死亡，450 例（11.1%）患者出现 AKI。在无辅助辅助组中，临床医生的预测与模型的一致性更高（死亡的加权卡帕为 0.75 0.62，平均差异为 0.13 [95% CI]）：0.13 [95% CI 0.10-0.17]；AKI 为 0.79 0.54，平均差异为 0.25 [95% CI 0.10-0.17]：0.25 [95% CI 0.21-0.29]）。辅助组（AUROC 0.793）和非辅助组（AUROC 0.780）对死亡的临床预测结果相似（平均差异：0.013 [95% CI -0.070 to 0.097]; =0.76）。辅助组预测 AKI 的 AUROC 为 0.734，非辅助组为 0.688（差异为 0.046 [95% CI -0.003 至 0.091]；=0.06）。临床医生的表现并未因机器学习辅助而提高。要明确机器学习在围手术期实时风险分层中的作用，还需要进一步的工作。NCT05042804。
{"title":"Effect of machine learning models on clinician prediction of postoperative complications: the Perioperative ORACLE randomised clinical trial","authors":"Bradley A. Fritz, Christopher R. King, Mohamed Abdelhack, Yixin Chen, Alex Kronzer, Joanna Abraham, Sandhya Tripathi, Arbi Ben Abdallah, Thomas Kannampallil, Thaddeus P. Budelier, Daniel Helsten, Arianna Montes de Oca, Divya Mehta, Pratyush Sontha, Omokhaye Higo, Paul Kerby, Stephen H. Gregory, Troy S. Wildes, Michael S. Avidan","doi":"10.1016/j.bja.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.bja.2024.08.004","url":null,"abstract":"Anaesthesiologists might be able to mitigate risk if they know which patients are at greatest risk for postoperative complications. This trial examined the impact of machine learning models on clinician risk assessment. This single-centre, prospective, randomised clinical trial enrolled surgical patients aged ≥18 yr. Anaesthesiologists and nurse anaesthetists providing remote telemedicine support reviewed electronic health records with (assisted group) or without (unassisted group) reviewing machine learning predictions. Clinicians predicted the likelihood of postoperative 30-day all-cause mortality and postoperative acute kidney injury (AKI) within 7 days. The primary outcome was area under the receiver operating characteristic curve (AUROC) for clinician predictions of mortality and AKI, comparing AUROCs between assisted and unassisted assessments. We analysed 5071 patients (mean [range] age: 58 [18-100] yr; 52% female) assessed by 89 clinicians. Of these, 98 (2.2%) patients died within 30 days of surgery and 450 (11.1%) patients sustained AKI. Clinician predictions agreed with the models more strongly in the assisted unassisted group (weighted kappa 0.75 0.62 for death, mean difference: 0.13 [95% CI 0.10–0.17]; and 0.79 0.54 for AKI, mean difference: 0.25 [95% CI 0.21–0.29]). Clinical prediction of death was similar between the assisted (AUROC 0.793) and unassisted (AUROC 0.780) groups (mean difference: 0.013 [95% CI –0.070 to 0.097]; =0.76). Prediction of AKI had an AUROC of 0.734 in the assisted group 0.688 in the unassisted group (difference 0.046 [95% CI –0.003 to 0.091]; =0.06). Clinician performance was not improved by machine learning assistance. Further work is needed to clarify the role of machine learning in real-time perioperative risk stratification. NCT05042804.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1016/j.bja.2024.07.028
Barry N Singleton,Aisling Ní Eochagain
{"title":"Regional anaesthesia and mixed reality: threading the implementation needle.","authors":"Barry N Singleton,Aisling Ní Eochagain","doi":"10.1016/j.bja.2024.07.028","DOIUrl":"https://doi.org/10.1016/j.bja.2024.07.028","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1016/j.bja.2024.08.002
Marko Zdravkovic,Barbara Kabon,Olivia Dow,Martina Klincová,Federico Bilotta,Joana Berger-Estilita,
BACKGROUNDPregnancy adds challenges for healthcare professionals, regardless of gender. We investigated experiences during pregnancy, attitudes towards pregnant colleagues, family planning decisions, and awareness of regulations among European anaesthesiologists and intensivists.METHODSA cross-sectional online survey was conducted among 3590 anaesthesiologists and intensivists from 47 European countries. The survey, available for 12 weeks, collected data on demographics, working conditions, safety perceptions, and the impact of clinical practice and training demands on family planning. Quantitative data were analysed using descriptive statistics, whereas qualitative data underwent thematic content analysis.RESULTSOnly 41.4% (n=678) of women were satisfied with their working conditions during pregnancy, and only 38.5% (n=602) considered their working environment safe. The proportion of women who changed their clinical practice during pregnancy and who took sick leave to avoid potentially harmful working conditions increased over time (P<0.001 for both). Men had children more often during residency than women (P<0.001). Pregnant colleagues' safety concerns influenced clinical practice, with women and men who had experience with their own and partner's pregnancy being more likely to modify their practices. Work and training demands discouraged plans to have children, particularly among women, leading to consideration of leaving training. Awareness of national regulations was limited, and respondents highlighted a need for better support and flexible working conditions.CONCLUSIONSImproved support and working environments for pregnant colleagues and ability to express preferred clinical areas for work are needed. Department heads should commit to safety and family friendliness, and men transitioning to parenthood should not be neglected.
{"title":"Working conditions during pregnancy: a survey of 3590 European anaesthesiologists and intensivists.","authors":"Marko Zdravkovic,Barbara Kabon,Olivia Dow,Martina Klincová,Federico Bilotta,Joana Berger-Estilita,","doi":"10.1016/j.bja.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.bja.2024.08.002","url":null,"abstract":"BACKGROUNDPregnancy adds challenges for healthcare professionals, regardless of gender. We investigated experiences during pregnancy, attitudes towards pregnant colleagues, family planning decisions, and awareness of regulations among European anaesthesiologists and intensivists.METHODSA cross-sectional online survey was conducted among 3590 anaesthesiologists and intensivists from 47 European countries. The survey, available for 12 weeks, collected data on demographics, working conditions, safety perceptions, and the impact of clinical practice and training demands on family planning. Quantitative data were analysed using descriptive statistics, whereas qualitative data underwent thematic content analysis.RESULTSOnly 41.4% (n=678) of women were satisfied with their working conditions during pregnancy, and only 38.5% (n=602) considered their working environment safe. The proportion of women who changed their clinical practice during pregnancy and who took sick leave to avoid potentially harmful working conditions increased over time (P<0.001 for both). Men had children more often during residency than women (P<0.001). Pregnant colleagues' safety concerns influenced clinical practice, with women and men who had experience with their own and partner's pregnancy being more likely to modify their practices. Work and training demands discouraged plans to have children, particularly among women, leading to consideration of leaving training. Awareness of national regulations was limited, and respondents highlighted a need for better support and flexible working conditions.CONCLUSIONSImproved support and working environments for pregnant colleagues and ability to express preferred clinical areas for work are needed. Department heads should commit to safety and family friendliness, and men transitioning to parenthood should not be neglected.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.1016/j.bja.2024.06.029
Background
The way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU.
Methods
In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction.
Results
Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0–5) vs 0 (0–6); P=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction.
Conclusions
Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary.
{"title":"Effect of a comfort scale compared with a pain numerical rate scale on opioids consumption in postanaesthesia care unit: the COMFORT study","authors":"","doi":"10.1016/j.bja.2024.06.029","DOIUrl":"10.1016/j.bja.2024.06.029","url":null,"abstract":"<div><h3>Background</h3><p>The way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU.</p></div><div><h3>Methods</h3><p>In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction.</p></div><div><h3>Results</h3><p>Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0–5) <em>vs</em> 0 (0–6); <em>P</em>=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, <em>P</em>=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction.</p></div><div><h3>Conclusions</h3><p>Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary.</p></div><div><h3>Clinical trial registration</h3><p><span><span>NCT05234216</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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