Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission
In patients with heart failure, some organizational and modifiable factors could be prognostic factors. We aimed to assess the association between the in-hospital care pathways during hospitalization for acute heart failure and the risk of readmission. This retrospective study included all elderly p...
Gespeichert in:
| Veröffentlicht in: | Scientific reports 2020-06, Vol.10 (1), p.10644, Article 10644 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 1 |
| container_start_page | 10644 |
| container_title | Scientific reports |
| container_volume | 10 |
| creator | Duflos, Claire Troude, Pénélope Strainchamps, David Ségouin, Christophe Logeart, Damien Mercier, Grégoire |
| description | In patients with heart failure, some organizational and modifiable factors could be prognostic factors. We aimed to assess the association between the in-hospital care pathways during hospitalization for acute heart failure and the risk of readmission. This retrospective study included all elderly patients who were hospitalized for acute heart failure at the Universitary Hospital Lariboisière (Paris) during 2013. We collected the wards attended, length of stay, admission and discharge types, diagnostic procedures, and heart failure discharge treatment. The clinical factors were the specific medical conditions, left ventricular ejection fraction, type of heart failure syndrome, sex, smoking status, and age. Consistent groups of in-hospital care pathways were built using an ascending hierarchical clustering method based on a primary components analysis. The association between the groups and the risk of readmission at 1 month and 1 year (for heart failure or for any cause) were measured via a count data model that was adjusted for clinical factors. This study included 223 patients. Associations between the in-hospital care pathway and the 1 year-readmission status were studied in 207 patients. Five consistent groups were defined: 3 described expected in-hospital care pathways in intensive care units, cardiology and gerontology wards, 1 described deceased patients, and 1 described chaotic pathways. The chaotic pathway strongly increased the risk (p = 0.0054) of 1 year readmission for acute heart failure. The chaotic in-hospital care pathway, occurring in specialized wards, was associated with the risk of readmission. This could promote specific quality improvement actions in these wards. Follow-up research projects should aim to describe the processes causing the generation of chaotic pathways and their consequences. |
| doi_str_mv | 10.1038/s41598-020-66788-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7327074</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2419413563</sourcerecordid><originalsourceid>FETCH-LOGICAL-c559t-48691c4b4a17b6f14fb8569140be71167f1c4c97bf7865cb9eeb47f949aebe9e3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhiNERavSP8ABWeLCAYPtOP7ggFRVwCKt1Et7thzvpHGVjYPtFIVfj0uWUnrAB9vyPO87M56qekXJe0pq9SFx2miFCSNYCKkUXp5VJ4zwBrOaseeP7sfVWUq3pKyGaU71i-q4ZoKIsp1UbhPS5LMd_E-bfRhRFyKybs6AerAxo876YY7wEeUekB9xf-CRsxHQZHP_wy5oirDzLicURsBLEaIIdrf3KRXPl9VRZ4cEZ4fztLr-8vnqYoO3l1-_XZxvsWsanTFXQlPHW26pbEVHedeqpjxx0oKkVMiuRJ2WbSeVaFyrAVouO821hRY01KfVp9V3mts97ByMOdrBTNHvbVxMsN78Gxl9b27CnZE1k0TyYvBuNeifyDbnW-PHBHFvCFOacEbuaMHfHvLF8H2GlE1p2MEw2BHCnAwrn81p3Yi6oG-eoLdhjmP5jXtKKSVUwwrFVsrFkFKE7qEISsz91M069VIEMb-nbpYiev246wfJnxkXoF6BVELjDcS_uf9j-wti9roO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2418886852</pqid></control><display><type>article</type><title>Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Nature Free</source><source>PubMed Central</source><source>Springer Nature OA/Free Journals</source><source>Free Full-Text Journals in Chemistry</source><creator>Duflos, Claire ; Troude, Pénélope ; Strainchamps, David ; Ségouin, Christophe ; Logeart, Damien ; Mercier, Grégoire</creator><creatorcontrib>Duflos, Claire ; Troude, Pénélope ; Strainchamps, David ; Ségouin, Christophe ; Logeart, Damien ; Mercier, Grégoire</creatorcontrib><description>In patients with heart failure, some organizational and modifiable factors could be prognostic factors. We aimed to assess the association between the in-hospital care pathways during hospitalization for acute heart failure and the risk of readmission. This retrospective study included all elderly patients who were hospitalized for acute heart failure at the Universitary Hospital Lariboisière (Paris) during 2013. We collected the wards attended, length of stay, admission and discharge types, diagnostic procedures, and heart failure discharge treatment. The clinical factors were the specific medical conditions, left ventricular ejection fraction, type of heart failure syndrome, sex, smoking status, and age. Consistent groups of in-hospital care pathways were built using an ascending hierarchical clustering method based on a primary components analysis. The association between the groups and the risk of readmission at 1 month and 1 year (for heart failure or for any cause) were measured via a count data model that was adjusted for clinical factors. This study included 223 patients. Associations between the in-hospital care pathway and the 1 year-readmission status were studied in 207 patients. Five consistent groups were defined: 3 described expected in-hospital care pathways in intensive care units, cardiology and gerontology wards, 1 described deceased patients, and 1 described chaotic pathways. The chaotic pathway strongly increased the risk (p = 0.0054) of 1 year readmission for acute heart failure. The chaotic in-hospital care pathway, occurring in specialized wards, was associated with the risk of readmission. This could promote specific quality improvement actions in these wards. Follow-up research projects should aim to describe the processes causing the generation of chaotic pathways and their consequences.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-66788-y</identifier><identifier>PMID: 32606326</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/4019 ; 692/700/228 ; Aged ; Aged, 80 and over ; Cardiology and cardiovascular system ; Congestive heart failure ; Critical Pathways - statistics & numerical data ; Female ; Geriatric Assessment - statistics & numerical data ; Geriatrics ; Heart failure ; Heart Failure - epidemiology ; Heart Failure - pathology ; Heart Failure - therapy ; Hospitals ; Human health and pathology ; Humanities and Social Sciences ; Humans ; Inpatients - statistics & numerical data ; Intensive care units ; Life Sciences ; Male ; multidisciplinary ; Patient Readmission - statistics & numerical data ; Patients ; Quality control ; Research projects ; Science ; Science (multidisciplinary) ; Ventricle</subject><ispartof>Scientific reports, 2020-06, Vol.10 (1), p.10644, Article 10644</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Attribution</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c559t-48691c4b4a17b6f14fb8569140be71167f1c4c97bf7865cb9eeb47f949aebe9e3</citedby><cites>FETCH-LOGICAL-c559t-48691c4b4a17b6f14fb8569140be71167f1c4c97bf7865cb9eeb47f949aebe9e3</cites><orcidid>0000-0002-7239-530X ; 0000-0001-5531-4515</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/PMC7327074/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327074/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,41120,42189,51576,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32606326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-02890420$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Duflos, Claire</creatorcontrib><creatorcontrib>Troude, Pénélope</creatorcontrib><creatorcontrib>Strainchamps, David</creatorcontrib><creatorcontrib>Ségouin, Christophe</creatorcontrib><creatorcontrib>Logeart, Damien</creatorcontrib><creatorcontrib>Mercier, Grégoire</creatorcontrib><title>Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>In patients with heart failure, some organizational and modifiable factors could be prognostic factors. We aimed to assess the association between the in-hospital care pathways during hospitalization for acute heart failure and the risk of readmission. This retrospective study included all elderly patients who were hospitalized for acute heart failure at the Universitary Hospital Lariboisière (Paris) during 2013. We collected the wards attended, length of stay, admission and discharge types, diagnostic procedures, and heart failure discharge treatment. The clinical factors were the specific medical conditions, left ventricular ejection fraction, type of heart failure syndrome, sex, smoking status, and age. Consistent groups of in-hospital care pathways were built using an ascending hierarchical clustering method based on a primary components analysis. The association between the groups and the risk of readmission at 1 month and 1 year (for heart failure or for any cause) were measured via a count data model that was adjusted for clinical factors. This study included 223 patients. Associations between the in-hospital care pathway and the 1 year-readmission status were studied in 207 patients. Five consistent groups were defined: 3 described expected in-hospital care pathways in intensive care units, cardiology and gerontology wards, 1 described deceased patients, and 1 described chaotic pathways. The chaotic pathway strongly increased the risk (p = 0.0054) of 1 year readmission for acute heart failure. The chaotic in-hospital care pathway, occurring in specialized wards, was associated with the risk of readmission. This could promote specific quality improvement actions in these wards. Follow-up research projects should aim to describe the processes causing the generation of chaotic pathways and their consequences.</description><subject>692/4019</subject><subject>692/700/228</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiology and cardiovascular system</subject><subject>Congestive heart failure</subject><subject>Critical Pathways - statistics & numerical data</subject><subject>Female</subject><subject>Geriatric Assessment - statistics & numerical data</subject><subject>Geriatrics</subject><subject>Heart failure</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - pathology</subject><subject>Heart Failure - therapy</subject><subject>Hospitals</subject><subject>Human health and pathology</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Inpatients - statistics & numerical data</subject><subject>Intensive care units</subject><subject>Life Sciences</subject><subject>Male</subject><subject>multidisciplinary</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Patients</subject><subject>Quality control</subject><subject>Research projects</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Ventricle</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1v1DAQhiNERavSP8ABWeLCAYPtOP7ggFRVwCKt1Et7thzvpHGVjYPtFIVfj0uWUnrAB9vyPO87M56qekXJe0pq9SFx2miFCSNYCKkUXp5VJ4zwBrOaseeP7sfVWUq3pKyGaU71i-q4ZoKIsp1UbhPS5LMd_E-bfRhRFyKybs6AerAxo876YY7wEeUekB9xf-CRsxHQZHP_wy5oirDzLicURsBLEaIIdrf3KRXPl9VRZ4cEZ4fztLr-8vnqYoO3l1-_XZxvsWsanTFXQlPHW26pbEVHedeqpjxx0oKkVMiuRJ2WbSeVaFyrAVouO821hRY01KfVp9V3mts97ByMOdrBTNHvbVxMsN78Gxl9b27CnZE1k0TyYvBuNeifyDbnW-PHBHFvCFOacEbuaMHfHvLF8H2GlE1p2MEw2BHCnAwrn81p3Yi6oG-eoLdhjmP5jXtKKSVUwwrFVsrFkFKE7qEISsz91M069VIEMb-nbpYiev246wfJnxkXoF6BVELjDcS_uf9j-wti9roO</recordid><startdate>20200630</startdate><enddate>20200630</enddate><creator>Duflos, Claire</creator><creator>Troude, Pénélope</creator><creator>Strainchamps, David</creator><creator>Ségouin, Christophe</creator><creator>Logeart, Damien</creator><creator>Mercier, Grégoire</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</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>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7239-530X</orcidid><orcidid>https://orcid.org/0000-0001-5531-4515</orcidid></search><sort><creationdate>20200630</creationdate><title>Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission</title><author>Duflos, Claire ; Troude, Pénélope ; Strainchamps, David ; Ségouin, Christophe ; Logeart, Damien ; Mercier, Grégoire</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c559t-48691c4b4a17b6f14fb8569140be71167f1c4c97bf7865cb9eeb47f949aebe9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/4019</topic><topic>692/700/228</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiology and cardiovascular system</topic><topic>Congestive heart failure</topic><topic>Critical Pathways - statistics & numerical data</topic><topic>Female</topic><topic>Geriatric Assessment - statistics & numerical data</topic><topic>Geriatrics</topic><topic>Heart failure</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - pathology</topic><topic>Heart Failure - therapy</topic><topic>Hospitals</topic><topic>Human health and pathology</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Inpatients - statistics & numerical data</topic><topic>Intensive care units</topic><topic>Life Sciences</topic><topic>Male</topic><topic>multidisciplinary</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Patients</topic><topic>Quality control</topic><topic>Research projects</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duflos, Claire</creatorcontrib><creatorcontrib>Troude, Pénélope</creatorcontrib><creatorcontrib>Strainchamps, David</creatorcontrib><creatorcontrib>Ségouin, Christophe</creatorcontrib><creatorcontrib>Logeart, Damien</creatorcontrib><creatorcontrib>Mercier, Grégoire</creatorcontrib><collection>Springer Nature OA/Free Journals</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 & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</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 Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</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 Basic</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duflos, Claire</au><au>Troude, Pénélope</au><au>Strainchamps, David</au><au>Ségouin, Christophe</au><au>Logeart, Damien</au><au>Mercier, Grégoire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2020-06-30</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>10644</spage><pages>10644-</pages><artnum>10644</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>In patients with heart failure, some organizational and modifiable factors could be prognostic factors. We aimed to assess the association between the in-hospital care pathways during hospitalization for acute heart failure and the risk of readmission. This retrospective study included all elderly patients who were hospitalized for acute heart failure at the Universitary Hospital Lariboisière (Paris) during 2013. We collected the wards attended, length of stay, admission and discharge types, diagnostic procedures, and heart failure discharge treatment. The clinical factors were the specific medical conditions, left ventricular ejection fraction, type of heart failure syndrome, sex, smoking status, and age. Consistent groups of in-hospital care pathways were built using an ascending hierarchical clustering method based on a primary components analysis. The association between the groups and the risk of readmission at 1 month and 1 year (for heart failure or for any cause) were measured via a count data model that was adjusted for clinical factors. This study included 223 patients. Associations between the in-hospital care pathway and the 1 year-readmission status were studied in 207 patients. Five consistent groups were defined: 3 described expected in-hospital care pathways in intensive care units, cardiology and gerontology wards, 1 described deceased patients, and 1 described chaotic pathways. The chaotic pathway strongly increased the risk (p = 0.0054) of 1 year readmission for acute heart failure. The chaotic in-hospital care pathway, occurring in specialized wards, was associated with the risk of readmission. This could promote specific quality improvement actions in these wards. Follow-up research projects should aim to describe the processes causing the generation of chaotic pathways and their consequences.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32606326</pmid><doi>10.1038/s41598-020-66788-y</doi><orcidid>https://orcid.org/0000-0002-7239-530X</orcidid><orcidid>https://orcid.org/0000-0001-5531-4515</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2045-2322 |
| ispartof | Scientific reports, 2020-06, Vol.10 (1), p.10644, Article 10644 |
| issn | 2045-2322 2045-2322 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7327074 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Nature Free; PubMed Central; Springer Nature OA/Free Journals; Free Full-Text Journals in Chemistry |
| subjects | 692/4019 692/700/228 Aged Aged, 80 and over Cardiology and cardiovascular system Congestive heart failure Critical Pathways - statistics & numerical data Female Geriatric Assessment - statistics & numerical data Geriatrics Heart failure Heart Failure - epidemiology Heart Failure - pathology Heart Failure - therapy Hospitals Human health and pathology Humanities and Social Sciences Humans Inpatients - statistics & numerical data Intensive care units Life Sciences Male multidisciplinary Patient Readmission - statistics & numerical data Patients Quality control Research projects Science Science (multidisciplinary) Ventricle |
| title | Hospitalization for acute heart failure: the in-hospital care pathway predicts one-year readmission |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T22%3A04%3A58IST&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=Hospitalization%20for%20acute%20heart%20failure:%20the%20in-hospital%20care%20pathway%20predicts%20one-year%20readmission&rft.jtitle=Scientific%20reports&rft.au=Duflos,%20Claire&rft.date=2020-06-30&rft.volume=10&rft.issue=1&rft.spage=10644&rft.pages=10644-&rft.artnum=10644&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-020-66788-y&rft_dat=%3Cproquest_pubme%3E2419413563%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=2418886852&rft_id=info:pmid/32606326&rfr_iscdi=true |