Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care

Orthopaedic trauma care frequently necessitates prompt and precise assessment of musculoskeletal injuries and wound depth. The potential for improved diagnostic accuracy and patient outcomes exists with the integration of sophisticated imaging modalities such as computed tomography (CT) and magnetic...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:International wound journal 2024-01, Vol.21 (1), p.e14647-n/a
Hauptverfasser: Xue, Zujun, Wen, Bi
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page n/a
container_issue 1
container_start_page e14647
container_title International wound journal
container_volume 21
creator Xue, Zujun
Wen, Bi
description Orthopaedic trauma care frequently necessitates prompt and precise assessment of musculoskeletal injuries and wound depth. The potential for improved diagnostic accuracy and patient outcomes exists with the integration of sophisticated imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) with focused assessment with sonography for trauma (FAST). The purpose of this research was to examine the benefits and drawbacks of this integrative method in the clinical environment. From June 2022 to September 2023, 250 patients who were admitted to Ningbo University Affiliated People's Hospital, participated in this cross‐sectional observational study. Following the administration of FAST, CT and MRI were utilized to evaluate orthopaedic injuries and skin wounds in patients. Analyses of data centred on the precision of diagnoses, the influence of treatment decisions and patient outcomes. Aged and gendered differently, the study participants sustained the variety of injuries and superficial wounds that were predominantly the result of traffic accidents. The FAST assay exhibited sensitivity of 65%, specificity of 80% and 72% overall accuracy. MRI demonstrated the finest diagnostic performance (85% sensitivity, 95% specificity and 89% accuracy), whereas CT scans offered improved diagnostic efficacy (80% sensitivity, 90% specificity and 84% accuracy). Treatment decisions were substantially impacted by integration of these imaging modalities, resulting in modifications in 20%–35% of cases, depending on the specific modality employed. Specifically, MRI played a pivotal role in informing treatment approaches, influencing non‐surgical as well as surgical procedures. This study substantiates the significant advantages of integrating FAST with CT and MRI in orthopaedic trauma care, particularly in the accurate assessment of wound depth. The synergistic use of these imaging techniques not only enhances diagnostic precision but also positively impacts treatment strategies and patient outcomes, emphasizing the need for a comprehensive diagnostic approach in trauma care settings.
doi_str_mv 10.1111/iwj.14647
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10805531</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3090610200</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4587-f1e07c4b88bcbff5df23ec3ccb41f5519adb610b98be9a04ba697d8eafa1e6d53</originalsourceid><addsrcrecordid>eNp1ksuO1DAQRSMEYoaBBT-ALLGBRU_bSZwHGwQjHoNGYgEIdlbFqXS7Sexgx9MKH8k3UUOaFiDhjUuuU9fX8k2Sh4KfC1prs9-di7zIy1vJqSjzdJVX4svtY83FSXIvhB3naS1leTc5yaq0TMtaniY_XhoHFvp5Mhp6htfQR5iMs8x1bO-ibVmL47RlQNUQg469C1-xx4loY3fRGwzP2IfZot-Y78ZuWOd0DNgyCAFDGNBObG9IITjrNh7G7UyIZ5OHOMDS0m4Y40QzkxsOzHqAjUVyxTzSJFiNzNDZzQ2G3Plp60bAloCDkgaP95M7HfQBHxz2s-TT61cfL96urt6_ubx4cbXSuazKVSeQlzpvqqrRTdfJtksz1JnWTS46KUUNbVMI3tRVgzXwvIGiLtsKoQOBRSuzs-T5ojvGZsBW0yM99Gr0ZNHPyoFRf3es2aqNu1aCV1zKTJDCk4OCd98ihkkNJmjse7DoYlBpLeoyLzKZEvr4H3TnoqdPCyrjNSejKedEPV0o7V0IHrujG8HVTUwUxUT9igmxj_60fyR_54KA9QLsTY_z_5XU5ed3i-RP0PvQ5w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3090610200</pqid></control><display><type>article</type><title>Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Wiley-Blackwell Open Access Titles</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library All Journals</source><source>PubMed Central</source><creator>Xue, Zujun ; Wen, Bi</creator><creatorcontrib>Xue, Zujun ; Wen, Bi</creatorcontrib><description>Orthopaedic trauma care frequently necessitates prompt and precise assessment of musculoskeletal injuries and wound depth. The potential for improved diagnostic accuracy and patient outcomes exists with the integration of sophisticated imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) with focused assessment with sonography for trauma (FAST). The purpose of this research was to examine the benefits and drawbacks of this integrative method in the clinical environment. From June 2022 to September 2023, 250 patients who were admitted to Ningbo University Affiliated People's Hospital, participated in this cross‐sectional observational study. Following the administration of FAST, CT and MRI were utilized to evaluate orthopaedic injuries and skin wounds in patients. Analyses of data centred on the precision of diagnoses, the influence of treatment decisions and patient outcomes. Aged and gendered differently, the study participants sustained the variety of injuries and superficial wounds that were predominantly the result of traffic accidents. The FAST assay exhibited sensitivity of 65%, specificity of 80% and 72% overall accuracy. MRI demonstrated the finest diagnostic performance (85% sensitivity, 95% specificity and 89% accuracy), whereas CT scans offered improved diagnostic efficacy (80% sensitivity, 90% specificity and 84% accuracy). Treatment decisions were substantially impacted by integration of these imaging modalities, resulting in modifications in 20%–35% of cases, depending on the specific modality employed. Specifically, MRI played a pivotal role in informing treatment approaches, influencing non‐surgical as well as surgical procedures. This study substantiates the significant advantages of integrating FAST with CT and MRI in orthopaedic trauma care, particularly in the accurate assessment of wound depth. The synergistic use of these imaging techniques not only enhances diagnostic precision but also positively impacts treatment strategies and patient outcomes, emphasizing the need for a comprehensive diagnostic approach in trauma care settings.</description><identifier>ISSN: 1742-4801</identifier><identifier>ISSN: 1742-481X</identifier><identifier>EISSN: 1742-481X</identifier><identifier>DOI: 10.1111/iwj.14647</identifier><identifier>PMID: 38272795</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Abdominal Injuries ; Accuracy ; Age ; Aged ; Clinical outcomes ; Cross-Sectional Studies ; Emergency Medical Services ; Focused Assessment with Sonography for Trauma ; Fractures ; Hemorrhage ; Humans ; Injuries ; Magnetic Resonance Imaging ; Medical imaging ; musculoskeletal injuries ; Original ; Orthopedics ; Patients ; Performance evaluation ; Sensitivity and Specificity ; skin lesions and lacerations ; Tomography ; Tomography, X-Ray Computed ; traffic accidents ; Trauma ; Trauma care ; Ultrasonic imaging ; Ultrasonography ; wound depth ; Wounds, Nonpenetrating</subject><ispartof>International wound journal, 2024-01, Vol.21 (1), p.e14647-n/a</ispartof><rights>2024 The Authors. published by Medicalhelplines.com Inc and John Wiley &amp; Sons Ltd.</rights><rights>2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley &amp; Sons Ltd.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4587-f1e07c4b88bcbff5df23ec3ccb41f5519adb610b98be9a04ba697d8eafa1e6d53</cites><orcidid>0009-0006-0578-4715</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805531/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805531/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1416,11561,27923,27924,45573,45574,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38272795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xue, Zujun</creatorcontrib><creatorcontrib>Wen, Bi</creatorcontrib><title>Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care</title><title>International wound journal</title><addtitle>Int Wound J</addtitle><description>Orthopaedic trauma care frequently necessitates prompt and precise assessment of musculoskeletal injuries and wound depth. The potential for improved diagnostic accuracy and patient outcomes exists with the integration of sophisticated imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) with focused assessment with sonography for trauma (FAST). The purpose of this research was to examine the benefits and drawbacks of this integrative method in the clinical environment. From June 2022 to September 2023, 250 patients who were admitted to Ningbo University Affiliated People's Hospital, participated in this cross‐sectional observational study. Following the administration of FAST, CT and MRI were utilized to evaluate orthopaedic injuries and skin wounds in patients. Analyses of data centred on the precision of diagnoses, the influence of treatment decisions and patient outcomes. Aged and gendered differently, the study participants sustained the variety of injuries and superficial wounds that were predominantly the result of traffic accidents. The FAST assay exhibited sensitivity of 65%, specificity of 80% and 72% overall accuracy. MRI demonstrated the finest diagnostic performance (85% sensitivity, 95% specificity and 89% accuracy), whereas CT scans offered improved diagnostic efficacy (80% sensitivity, 90% specificity and 84% accuracy). Treatment decisions were substantially impacted by integration of these imaging modalities, resulting in modifications in 20%–35% of cases, depending on the specific modality employed. Specifically, MRI played a pivotal role in informing treatment approaches, influencing non‐surgical as well as surgical procedures. This study substantiates the significant advantages of integrating FAST with CT and MRI in orthopaedic trauma care, particularly in the accurate assessment of wound depth. The synergistic use of these imaging techniques not only enhances diagnostic precision but also positively impacts treatment strategies and patient outcomes, emphasizing the need for a comprehensive diagnostic approach in trauma care settings.</description><subject>Abdominal Injuries</subject><subject>Accuracy</subject><subject>Age</subject><subject>Aged</subject><subject>Clinical outcomes</subject><subject>Cross-Sectional Studies</subject><subject>Emergency Medical Services</subject><subject>Focused Assessment with Sonography for Trauma</subject><subject>Fractures</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Injuries</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical imaging</subject><subject>musculoskeletal injuries</subject><subject>Original</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Performance evaluation</subject><subject>Sensitivity and Specificity</subject><subject>skin lesions and lacerations</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>traffic accidents</subject><subject>Trauma</subject><subject>Trauma care</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>wound depth</subject><subject>Wounds, Nonpenetrating</subject><issn>1742-4801</issn><issn>1742-481X</issn><issn>1742-481X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1ksuO1DAQRSMEYoaBBT-ALLGBRU_bSZwHGwQjHoNGYgEIdlbFqXS7Sexgx9MKH8k3UUOaFiDhjUuuU9fX8k2Sh4KfC1prs9-di7zIy1vJqSjzdJVX4svtY83FSXIvhB3naS1leTc5yaq0TMtaniY_XhoHFvp5Mhp6htfQR5iMs8x1bO-ibVmL47RlQNUQg469C1-xx4loY3fRGwzP2IfZot-Y78ZuWOd0DNgyCAFDGNBObG9IITjrNh7G7UyIZ5OHOMDS0m4Y40QzkxsOzHqAjUVyxTzSJFiNzNDZzQ2G3Plp60bAloCDkgaP95M7HfQBHxz2s-TT61cfL96urt6_ubx4cbXSuazKVSeQlzpvqqrRTdfJtksz1JnWTS46KUUNbVMI3tRVgzXwvIGiLtsKoQOBRSuzs-T5ojvGZsBW0yM99Gr0ZNHPyoFRf3es2aqNu1aCV1zKTJDCk4OCd98ihkkNJmjse7DoYlBpLeoyLzKZEvr4H3TnoqdPCyrjNSejKedEPV0o7V0IHrujG8HVTUwUxUT9igmxj_60fyR_54KA9QLsTY_z_5XU5ed3i-RP0PvQ5w</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Xue, Zujun</creator><creator>Wen, Bi</creator><general>Blackwell Publishing Ltd</general><general>John Wiley &amp; Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0009-0006-0578-4715</orcidid></search><sort><creationdate>202401</creationdate><title>Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care</title><author>Xue, Zujun ; Wen, Bi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4587-f1e07c4b88bcbff5df23ec3ccb41f5519adb610b98be9a04ba697d8eafa1e6d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Injuries</topic><topic>Accuracy</topic><topic>Age</topic><topic>Aged</topic><topic>Clinical outcomes</topic><topic>Cross-Sectional Studies</topic><topic>Emergency Medical Services</topic><topic>Focused Assessment with Sonography for Trauma</topic><topic>Fractures</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Injuries</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical imaging</topic><topic>musculoskeletal injuries</topic><topic>Original</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Performance evaluation</topic><topic>Sensitivity and Specificity</topic><topic>skin lesions and lacerations</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed</topic><topic>traffic accidents</topic><topic>Trauma</topic><topic>Trauma care</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>wound depth</topic><topic>Wounds, Nonpenetrating</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xue, Zujun</creatorcontrib><creatorcontrib>Wen, Bi</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International wound journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xue, Zujun</au><au>Wen, Bi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care</atitle><jtitle>International wound journal</jtitle><addtitle>Int Wound J</addtitle><date>2024-01</date><risdate>2024</risdate><volume>21</volume><issue>1</issue><spage>e14647</spage><epage>n/a</epage><pages>e14647-n/a</pages><issn>1742-4801</issn><issn>1742-481X</issn><eissn>1742-481X</eissn><abstract>Orthopaedic trauma care frequently necessitates prompt and precise assessment of musculoskeletal injuries and wound depth. The potential for improved diagnostic accuracy and patient outcomes exists with the integration of sophisticated imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) with focused assessment with sonography for trauma (FAST). The purpose of this research was to examine the benefits and drawbacks of this integrative method in the clinical environment. From June 2022 to September 2023, 250 patients who were admitted to Ningbo University Affiliated People's Hospital, participated in this cross‐sectional observational study. Following the administration of FAST, CT and MRI were utilized to evaluate orthopaedic injuries and skin wounds in patients. Analyses of data centred on the precision of diagnoses, the influence of treatment decisions and patient outcomes. Aged and gendered differently, the study participants sustained the variety of injuries and superficial wounds that were predominantly the result of traffic accidents. The FAST assay exhibited sensitivity of 65%, specificity of 80% and 72% overall accuracy. MRI demonstrated the finest diagnostic performance (85% sensitivity, 95% specificity and 89% accuracy), whereas CT scans offered improved diagnostic efficacy (80% sensitivity, 90% specificity and 84% accuracy). Treatment decisions were substantially impacted by integration of these imaging modalities, resulting in modifications in 20%–35% of cases, depending on the specific modality employed. Specifically, MRI played a pivotal role in informing treatment approaches, influencing non‐surgical as well as surgical procedures. This study substantiates the significant advantages of integrating FAST with CT and MRI in orthopaedic trauma care, particularly in the accurate assessment of wound depth. The synergistic use of these imaging techniques not only enhances diagnostic precision but also positively impacts treatment strategies and patient outcomes, emphasizing the need for a comprehensive diagnostic approach in trauma care settings.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>38272795</pmid><doi>10.1111/iwj.14647</doi><tpages>7</tpages><orcidid>https://orcid.org/0009-0006-0578-4715</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1742-4801
ispartof International wound journal, 2024-01, Vol.21 (1), p.e14647-n/a
issn 1742-4801
1742-481X
1742-481X
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10805531
source MEDLINE; DOAJ Directory of Open Access Journals; Wiley-Blackwell Open Access Titles; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals; PubMed Central
subjects Abdominal Injuries
Accuracy
Age
Aged
Clinical outcomes
Cross-Sectional Studies
Emergency Medical Services
Focused Assessment with Sonography for Trauma
Fractures
Hemorrhage
Humans
Injuries
Magnetic Resonance Imaging
Medical imaging
musculoskeletal injuries
Original
Orthopedics
Patients
Performance evaluation
Sensitivity and Specificity
skin lesions and lacerations
Tomography
Tomography, X-Ray Computed
traffic accidents
Trauma
Trauma care
Ultrasonic imaging
Ultrasonography
wound depth
Wounds, Nonpenetrating
title Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T06%3A36%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Bioanalytical%20evaluation%20of%20wound%20depth%20and%20musculoskeletal%20injuries:%20Synergizing%20focused%20assessment%20with%20sonography%20for%20trauma%20with%20computed%20tomography/magnetic%20resonance%20imaging%20in%20orthopaedic%20trauma%20care&rft.jtitle=International%20wound%20journal&rft.au=Xue,%20Zujun&rft.date=2024-01&rft.volume=21&rft.issue=1&rft.spage=e14647&rft.epage=n/a&rft.pages=e14647-n/a&rft.issn=1742-4801&rft.eissn=1742-481X&rft_id=info:doi/10.1111/iwj.14647&rft_dat=%3Cproquest_pubme%3E3090610200%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3090610200&rft_id=info:pmid/38272795&rfr_iscdi=true